Québec Euthanasia data from the Commission on end-of-life care

This article was written by Amy Hasbrouck and published by the Euthanasia Prevention Coalition on October 31, 2017.

The number of euthanasia deaths continue to increase, compliance with the law remains questionable.

Link to the euthanasia report that was submitted to the Québec’s National Assembly on Thursday, October 26, 2017. 

• 1982 reported assisted deaths in the first full year in Canada.

Summary of information:

• 37% of forms/reports from doctors, and an unnamed percentage of reports from institutions, needed more information. Some doctors openly refused to provide the additional information requested by the Commission.
• The most frequent compliance problem is a lack of independence of the second doctor. Québec solved this problem by eliminating the requirement that the second doctor be independent. Footnote a. of table on page 22 (translated) reads: “Since February 2017, the Commission has adapted its assessment of this criterion in the light of ongoing work in partnership with the MSSS [Ministère de santé et services sociaux] and the CMQ [Collège des Médecins du Québec]. These cases would now be considered compliant, as long as the other criteria are met.”  
• The Commission on End-of-life care has a backlog of 138 cases that have not been examined or ruled on.  
• Forms/reports are not submitted in a timely manner by doctors.  
• Confusion and inconsistency exists between euthanasia figures offered by the various sources; the “number of forms received and examined“ by the commission, the reports of the institutions, and the reports from the Collège des médecins du Québec.
• A 5% or 7% error rate (with 3% undetermined) would not be acceptable where lives depended on the effective application of safeguards (e.g. the airline industry).  
• The three cases in which the safeguards were clearly violated (two where the person did not have a “serious and incurable illness” and one where the person was not at the “end of life”) were not addressed as the crimes that they are. 
• If people are not given information necessary to make a “free and informed” decision, this is another serious breach of the safeguards.

Data for the period of June 10, 2016 to June 9, 2017   
Statistics from institutions and the College des médecins

• Continuous Palliative Sedation - (817)
• Euthanasia requests - (992)
• Euthanasia administered - Institutions (618)
• Euthanasia administered - College des médecins (638)
  [June 10, 2016 - June 27, 2017]
• Euthanasia not provided - (377)

Reasons why euthanasia was not done

• Person not eligible/no longer eligible - (159)
• Person died before euthanasia administered - (107)
• Person withdrew request - (79)
• Person was still in the process of being evaluated - (15)
• Person returned home or transferred to another institution - (10)
• Person was in distress and had a rapid decline - (5)
• The request was suspended pending the person's choosing date - (2)

Number of forms/reports Examined - (634). 

• More information was needed on 37% of the forms - (237) 
• Decisions were rendered on (579) forms  
• Unexamined and undecided cases – (55)  
• 92% of cases respected the law.

19 cases (3%) where Commission couldn’t reach a decision on compliance with the law,

• 12 cases – supplemental information was still insufficient 
• 4 cases – the commission did not receive the supplementary information requested  
• 3 cases – the doctor refused to provide the supplementary information requested.

Non-respect of the law = 5% of the cases (31)

• 20 cases – second physician wasn’t independent 
• 7 cases – doctor who administered euthanasia did not have a conversation with the person to verify:
  • That the request was free and informed 
  • That suffering was persistent  
  • The consistency of the wish to die

• 2 cases – the request was signed by a witness who wasn’t a recognized professional 
• 1 case – person did not have a serious and incurable illness.  
• 1 case – Person’s health insurance had expired.

Cumulative total data - December 10, 2015 - June 27, 2017
Forms/reports Examined = 786 but total of Institutions + College des médecins = 805

• Cases ruled on = 648 
• Unexamined and undecided – 138
• 19 forms/reports appear to be missing.

90% of cases respected the law 

• 3% insufficient information to make a determination 
• 7% of cases did not comply with the law. (43)

Reasons why the case did not comply with the law:

• Second doctor was not independent (29)* 
• Doctor who administered euthanasia did not speak to the person to verify that: The request was free and informed, that suffering was persistent, the consistency of the wish to die. (7) 
• The request was signed by a witness who wasn't a medical professional (2) 
• The person did not have a "serious or incurable illness" (2) 
• The person was not at the end-of-life (2) 
• The person did not have health insurance (1)

* As of February 2017 these cases do not violate the law.

Data from institutions and the College des médecins Dec 10, 2015 - June 9, 2017

• Continuous Palliative Sedation - (1080) 
• Euthanasia requests - (1245) 
• Euthanasia administered Institutions - (784)
• Euthanasia administered - College des médecins - (805)
  [December 10, 2016 - June 27, 2017]
• Euthanasia not done - (462)

Reasons why euthanasia was not done

• Person not eligible/no longer eligible - (195) 
• Person died before euthanasia administered - (128) 
• Person withdrew request - (103) 
• Person was still in the process of being evaluated - (18) 
• Person returned home or transferred to another institution - (10) 
• Person was in distress and had a rapid decline - (5) 
• The request was suspended pending the person's choosing date - (3)

Amy Hasbrouck is the founder of the disability rights group: Toujour Vivant - Not Dead Yet and the President of the Euthanasia Prevention Coalition

Margaret Dore: Analysis Opposing Victoria Australia Euthanasia Bill

Margaret Dore

I. Introduction

I am an attorney in Washington State USA where assisted suicide is legal.[1] I am also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. Last year, I met with a parliamentary delegation from the Legal and Social Issues Committee, Parliament of Victoria, to discuss Oregon’s law and related issues.

Washington’s law is based on Oregon’s law. Both laws are similar to the proposed bill, titled the “Voluntary Assisted Dying Bill.” The bill, however, is not limited to voluntary deaths or to people near death. I urge you to reject this measure.

II. Definitions

Assisted suicide occurs when a person provides the means or information for another person to commit suicide, for example, by providing a gun or lethal drug. If the assisting person is a physician, a more precise term is “physician-assisted suicide.”[2]

“Euthanasia” is the direct administration of a lethal agent to cause another person’s death.[3] Euthanasia is also known as “mercy killing.”[4]

III. Assisting Persons Can Have An Agenda

Persons assisting a suicide can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[5]

In other US states, reported motives for assisting suicide include: the “thrill” of getting other people to kill themselves; a desire for sympathy and attention; and “want[ing] to see someone die.”[6]

Medical professionals too can have an agenda, for example, to hide malpractice. There is also the occasional doctor who just likes to kill people, for example, Michael Swango, now incarcerated.[7]

IV. Push-back Against Assisted Suicide

Several US states have strengthened their laws against assisted suicide. These states include Alabama, Arizona, Georgia, Idaho and Louisiana.[8]

Last year, the Supreme Court of the State of New Mexico overturned a decision recognizing physician aid in dying, meaning physician assisted suicide.[9] Physician-assisted suicide is no longer legal in the State of New Mexico.

V. Few States Allow Assisted Suicide

Oregon and Washington State legalized assisted suicide through ballot measures in 1997 and 2008, respectively. Since then, just three US states and the District of Columbia have passed similar laws.[10] In the fine print, these laws also allow euthanasia.

VI. How The Victoria Bill Works

The Victoria bill has an application process to obtain the lethal dose, which may be administered by the patient.[11]

In the case of administration by a patient, there is no required oversight.[12] No witness, not even a doctor, is required to be present at the death.[13]

VII. The Bill Applies To People With Years To Live

The bill applies to people with a “disease, illness or medical condition,” which is expected to cause death in less than twelve months.[14] Such persons may, in fact, have years to live. This is true for three reasons:

A. Treatment Can Lead to Recovery. 

In 2000, Jeanette Hall was diagnosed with cancer in Oregon and made a settled decision to use Oregon’s law.[15] Her doctor convinced her to be treated instead, which eliminated the cancer.[16] Her declaration states:

It has now been 17 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.[17]

B. Predictions of Life Expectancy Can Be Wrong 

Eligible persons may also have years to live because predictions of life expectancy can be wrong. This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[18]

Consider John Norton, diagnosed with ALS at age 18.[19] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[20] Instead, the disease progression stopped on its own.[21] In a 2012 affidavit, at age 74, he states:

If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[22] 

C. If Victoria Follows Oregon, the Bill Will Apply to People With Insulin Dependent Diabetes

The bill applies to people expected to die in less than twelve months due to a “disease, illness or medical condition.”[23] Oregon’s law applies to people expected to die in less than six months due to a terminal disease.[24]

In practice, Oregon’s law is interpreted to include chronic conditions such as “diabetes mellitus,” better known as diabetes.[25] These conditions qualify for assisted suicide when there is dependence on medication, such as insulin, to live. Oregon doctor, William Toffler, explains:

[P]eople with chronic conditions are “terminal” [such that they qualify for assisted suicide] if without their medications, they have less than six months to live. This is significant when you consider that a typical insulin-dependent 20 year-old will live less than a month without insulin.[26]

Dr. Toffler adds:

Such persons, with insulin, are likely to have decades to live.[27]If Victoria enacts the proposed bill and follows Oregon practice, the bill will apply to people with insulin dependent diabetes. Such persons, with insulin, can have decades to live.

VIII. The Bill Applies To Older People

According to government statistics from Oregon and Washington State, most people who die under their laws are elders, aged 65 or older.[28] This demographic is already an especially at risk group for abuse and financial exploitation. This is true in both the US and Australia.

A. Elder Abuse and Financial Exploitation

Elder abuse and exploitation perpetrators are often family members.[29] They typically start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or to coercing victims to sign over deeds to their homes, to change their wills or to liquidate their assets.[30] Amy Mix, an elder law attorney in the US, explains why older people are especially vulnerable:

The elderly are at an at-risk group for a lot of reasons, including, but not limited to diminished capacity, isolation from family and other caregivers, lack of sophistication when it comes to purchasing property, financing, or using computers . . . .  

[D]efendants are family members, lots are friends, often people who befriend a senior through church . . . . We had a senior victim who had given her life savings away to some scammer who told her that she’d won the lottery and would have to pay the taxes ahead of time. . . . The scammer found the victim using information in her husband’s obituary.[31]

B. Elder Abuse and Financial Exploitation Are Sometimes Fatal

In some cases, elder abuse and financial exploitation are fatal. More notorious cases include California’s “black widow” murders, in which two women took out life insurance policies on homeless men.[32] Their first victim was 73 year old Paul Vados, whose death was staged to look like a hit and run accident.[33] The women collected $589,124.93.[34]

Consider also, People v. Stuart in which an adult child killed her mother with a pillow, allowing the child to inherit. The Court observed:

Financial considerations [are] an all too common motivation for killing someone.[35]

C. Victims Do Not Report

In both Australia and the US, victims do not report abuse. For example, in Victoria, it is estimated that there are more than 20,000 unreported cases of abuse, neglect and exploitation each year and approximately 100,000 in Australia nationwide.[36] Meanwhile, in the US, it’s estimated that only 1 in 14 cases ever comes to the attention of the authorities.”[37] In another study, it was 1 out of 25 cases.[38] Reasons for the lack of reporting include:

Many who suffer from abuse . . . don’t want to report their own child as an abuser.[39]

IX. The Bill Creates The Perfect Crime

A. “Even If a Patient Struggled, Who Would Know?

”The bill allows a patient to administer the lethal dose in private, without a witness or doctor present.[40] In addition, the drugs typically used are water and alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[41] 

Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:

With assisted suicide laws in Washington and Oregon [and with proposed bill], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).[42]

B. The Cause of Death Will Be Registered as a “Disease, Illness or Medical Condition,” Which Will Prevent Prosecution for Murder

The bill amends the Births, Deaths and Marriages Registration Act 1996, by requiring a death under the bill to be registered as a “disease, illness or medical condition.” The amendment states:

The Registrar, on being notified by a doctor of a death under section 37 and in accordance with section 67 of the Voluntary Assisted Dying Act 2017, must register the death in the Register by making an entry about the death that records the cause of death as the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying. (Emphasis changed).[43]

The significance of requiring a disease, illness or medical condition to be listed as the cause of death is that it creates a legal inability to prosecute. The official legal cause of death is a disease, illness or medical condition (not murder) as a matter of law.

X. Patients Otherwise Lack Protection

A. Participants in a Patient’s Death Are Merely Required to Act in “Accordance” With the Bill, Which Renders Patient Protections Unenforceable

The bill has page after page of patient protections, including that the co-ordinating medical practitioner “must” refer the person to another registered medical practitioner for a consulting assessment and that the person’s final request “must” be according to a specified time frame.[44]

The bill also holds medical practitioners and other participants in a patient’s death to an “accordance” standard.[45] Indeed, the bill uses the term nearly 50 times.[46]

The bill does not define accordance.[47] Dictionary definitions include “in the spirit of,” meaning “in thought or intention.”[48] With these definitions, a participant’s mere thought or intention to comply with the bill is good enough. Patient protections are not enforceable.

B. In an Orwellian Twist, the Term, “Self-Administer,” May Allow Someone Else to Administer the Lethal Dose to the Patient

The bill repeatedly describes the lethal dose as being “self-administered” by the patient, a term which is not defined.[49] The term or a variation thereof is used in the bill at least 50 times.[50]

The bill does not define “self-administer.”[51] In Washington State, the term is specially defined to allow someone else to administer the lethal dose to the patient. Washington’s law states:

“Self-administer” means a qualified patient’s act of ingesting medication to end his or her life . . . (Emphasis added).[52]

Washington’s law does not define “ingest.” Dictionary definitions include:

[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing. (Emphasis added).[53]

With these definitions, someone else putting the lethal dose in the patient’s mouth qualifies as self-administration because the patient will be “swallowing” the lethal dose, i.e., “ingesting” it. Someone else placing a medication patch on the patient’s arm will qualify because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration, similarly, will qualify because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it.

With the bill’s failure to define “self-administer,” and given Washington’s definition, the bill may be determined to allow someone else, such as a family member, to administer the lethal dose. Family members are common abusers.[54] Patients will not necessarily be in control of their fate.

XI. Other Considerations

A. The Swiss Study: Physician-Assisted Suicide Can Be Traumatic for Family Members

A European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[55] The study found that one out of five family members or friends present at an assisted suicide was traumatized. These people,

experienced full or sub-threshold PTSD (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.[56]

B. My Clients Suffered Trauma in Oregon and Washington State

I have had two cases where my clients suffered trauma due to legal assisted suicide. In the first case, one side of my client’s family wanted her father to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client was severely traumatized. The father did not take the lethal dose and died a natural death.

In the other case, my client’s father died via the lethal dose at a suicide party. It’s not clear, however, that administration of the lethal dose was voluntary. A man who was present told my client that his father had refused to take the lethal dose when it was delivered, stating: "You're not killing me. I'm going to bed." The man also said that my client’s father took the lethal dose the next night when he (the father) was already intoxicated on alcohol. The man who told this to my client subsequently changed his story.

My client, although he was not present, was traumatized over the incident, and also by the sudden loss of his father.

C. In Oregon, Other Suicides Have Increased with Legalization of Physician-Assisted Suicide

Government reports from Oregon show a positive correlation between the legalization of physician-assisted suicide and an increase in other (conventional) suicides. This correlation is consistent with a suicide contagion in which legalizing physician-assisted suicide encouraged other suicides. Consider the following:

Oregon's assisted suicide act went into effect “in late 1997.”[57]

• By 2000, Oregon's conventional suicide rate was "increasing significantly."[58] 
• By 2007, Oregon's conventional suicide rate was 35% above the national average.[59]
• By 2010, Oregon's conventional suicide rate was 41% above the national average.[60]
• By 2012, Oregon's conventional suicide rate was 42% above the national average.[61]

For a more detailed discussion of suicide contagion in Oregon, see Margaret Dore, “In Oregon, Other Suicides Have Increased with Legalization of Assisted Suicide.”[62]

D. The Oregon Statistics Provide Little, If Any, Support for the Idea That the Passage Is Needed Due to Physical Pain

I am not aware of any case in which Oregon’s law has been used for physical pain. According to Oregon’s most recent annual report, there were 47 people who died under the law in 2016 who expressed the following concern:

Inadequate pain control or concern about it. (Emphasis added).[]

With use of the word, “or,” the total number of persons who had inadequate pain control could be zero. In the alternative, the total number could be as high as 47.

If, for the purpose of argument, all 47 had inadequate pain control, this would be 47 people out of approximately 35,000 deaths in Oregon, which is far less than one percent (.127%) and/or not statistically significant.

The Oregon statistics provide little, if any, support for the idea that passage of the bill is needed due to physical pain. The argument is not supported by the evidence.

XII. Conclusion
The bill allows administration of the lethal dose to occur in private without a doctor or witness present. Even if a patient struggled, who would know? The death record will list a “disease, illness or medical condition” as the legal cause of death, which will prevent prosecution for murder. The bill, if enacted, will create the perfect crime.

Elder abuse and financial exploitation are already a problem in Victoria. Passage of the bill will make a bad situation worse. People with years or decades to live will have their lives ended due to the desires, wants and greed of other people.

I urge you to reject the proposed bill seeking to legalize assisted suicide and euthanasia.

Respectfully Submitted,

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
www.margaretdore.org
1001 4th Avenue, Suite 4400
Seattle, WA USA 98154
001 206 697 1217

Endnotes

[1] For more information, see my CV at this link: https://choiceisanillusion.files.wordpress.com/2016/04/dore-cv-04-22-16.pdf
[2] See e.g., The American Medical Association Code of Medical Ethics, Opinion 5.7 (defining physician-assisted suicide).
[3] Id., Opinion 5.8, “Euthanasia,” (lower half of the page).
[4] “Mercy killing” - The Free Legal Dictionary
[5] KTVZ.com, “Sawyer Arraigned on State Fraud Charges,” 07/14/11, at https://choiceisanillusion.files.wordpress.com/2016/10/sawyer-arraigned-a-63.pdf
[6] See: Associated Press for Minnesota, “Former nurse helped instruct man on how to commit suicide, court rules,” The Guardian, 12/28/15 (“he told police he did it ‘for the thrill of the chase’”) a; “Woman in texting suicide wanted sympathy, attention, prosecutor says,” CBS News, June 6, 2017; and Ben Winslow, “Teen accused of helping friend commit suicide could face trial for murder,” (Deputy Utah County Attorney argued that the defendant “wanted to see someone die”). Available at https://www.aol.com/article/news/2017/10/12/teen-accused-of-helping-friend-commit-suicide-could-face-trial-for-murder/23241619/
[7] See: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor, July 12, 2000, at https://www.cbsnews.com/news/life-in-jail-for-poison-doctor; James B. Stewart, “Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder,” Simon and Schuster, copyright 1999; and https://en.wikipedia.org/wiki/Michael_Swango
[8] See Margaret Dore, Alabama: Assisted Suicide Ban Act to Go Into Effect,” http://www.choiceillusion.org/2017/07/alabama-assisted-suicide-ban-act-to-go.html; Kansascity.com, “Brewer signs bill targeting assisted suicide,” available http://www.choiceillusion.org/2014/05/arizona-strengthens-its-law-against.html; Georgia General Assembly printout 06/08/15; Margaret Dore,“Idaho Strengthens Law Against Assisted-Suicide,” July 4, 2011, at http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html; and Associated Press, “La. assisted-suicide ban strengthened,” April 24, 2012.
[9] Morris v. Brandenburg, 376 P.3d 836 (2016). See also “New Mexico Upholds Assisted Suicide Prohibition,” July 1, 2016 at http://newmexicoagainstassistedsuicide.org/2016/07/new-mexico-upholds-assisted-suicide.html
[10] Vermont, California and Colorado.
[11] Bill Clause 45 (allowing a patient to “use and self-administer” a lethal substance). The bill also allows a medical practitioner to administer the lethal dose. See Clause 46 (allowing a “co-ordinating medical practitioner” to administer a lethal substance to cause the person’s death).
[12] See the bill in its entirety, available at http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/D162E1F2FCC3F7C3CA2581A1007A8903/$FILE/581392bi1.pdf
[13] Id.
[14] The bill, Clause 9(1)(d), states:
[T]he person must be diagnosed with a disease, illness or medical condition that -
(i) is incurable; and
(ii) is advanced, progressive and will cause death; and
(iii)is expected to cause death within weeks or months, not exceeding 12 months ...
[15] Affidavit of Kenneth Stevens, MD, Hall declaration, in the appendix at A-33
[16] Id.
[17] Affidavit of Jeanette Hall, ¶ 4.
[18] Cf. Jessica Firger, “12 million Americans misdiagnosed each year,” CBS NEWS, 4/17/14, and Nina Shapiro, “Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live. But what if they're wrong?,” The Seattle Weekly, 01/14/09.
[19] Affidavit of John Norton, 08/18/12
[20] Id., ¶ 1
[21] Id., ¶ 4
[22] Id., ¶ 5
[23] Bill Clause 9(1)(d).
[24] Oregon’s law states: “Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. Or. Rev. Stat. 127.800 s.1.01(12)
[25] “Diabetes mellitus” is listed as a qualifying terminal disease in Oregon government reports. See Declaration of William Toffler, MD, pp. A-14 to A-15, ¶¶ 2-4, and report excerpts at A-17 & A-18.
[26] Toffler Declaration at A-15, ¶ 5.
[27] Id., ¶ 6
[28] Appendix, at A-34 and A-35
[29] See Met Life Mature Market Institute, Broken Trust: Elders, Family and Finances,” March 2009, https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf and Facts on Elder Abuse - Australia, at http://www.ohchr.org/Documents/Issues/OlderPersons/Submissions/ElderAbusePreventionAssociation.pdf
[30] Metlife supra, at p.14.
[31] Kathryn Alfisi, “Breaking the Silence on Elder Abuse,” Washington Lawyer, February 2015. https://www.dcbar.org/bar-resources/publications/washington-lawyer/articles/february-2015-elder-abuse.cfm
[32] See People v. Rutterschmidt, 55 Cal.4th 650 (2012) and https://en.wikipedia.org/wiki/Black_Widow_Murders
[33] Rutterschmidt, at 652-3.
[34] Id. at 652.
[35] 67 Cal.Rptr.3d 129, 143 (2007).
[36] Facts on Elder Abuse-Australia, available at http://www.ohchr.org/Documents/Issues/OlderPersons/Submissions/ElderAbusePreventionAssociation.pdf
[37] Nat’l Center on Elder Abuse, http://www.ncea.aoa.gov/Library/Data/
[38] Id.
[39] “Adult Abuse,” District of Columbia, Department of Human Services, as of April 5, 2016. See also http://dhs.dc.gov/service/adult-abuse
[40] See the bill in its entirety, at http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/D162E1F2FCC3F7C3CA2581A1007A8903/$FILE/581392bi1.pdf
[41] The drugs typically used in Oregon and Washington State include Secobarbital, Pentobarbital and Phenobarbital, which are water and/or alcohol soluble. See excerpt from Oregon’s and Washington’s most recent annual reports, in the appendix at A-44 & A-45 (listing these drugs). See also http://www.drugs.com/pr/seconal-sodium.html, http://www.drugs.com/pro/nembutal.html and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013
[42] Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010, page 14, available at http://www.margaretdore.com/info/October_Letters.pdf
[43] The Bill, Clause 117.
[44] Id., Clauses 22 and 38.
[45] See, for example, the Bill, Division 2, “Protection from liability for those who assist, facilitate, do not act or act in accordance with this Act.” (Emphasis added). See also Bill Clause 79, which states:
A person who in good faith does something or fails to do something
(a) that assists or facilitates any other person who the person believes on reasonable grounds is requesting access to or is accessing voluntary assisted dying in accordance with this Act; and
(b) that apart from this section, would constitute an offence at common law or under any other enactment-does not commit the offense.
[46] See the bill in its entirety
[47] Id.
[48] See definitions in the appendix at A-57 and A-58.
[49] See the bill in its entirety
[50] Id.
[51] Id.
[52] RCW 70.245.010(12), in the appendix at A-67.
[53] www.yourdictionary.com, in the appendix at A-59.
[54] Facts on Elder Abuse-Australia, p. 2, in the appendix at A-49, "Victimisation Facts” (“Among known perpetrators of abuse and neglect, the perpetrator is a family member in 90 percent of the cases. Two-thirds of the perpetrators are adult children or spouses. The offender is most commonly a close relative ....”)
[55] “Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf (Cover page in the appendix at A-60)
[56] Id.
[57] Oregon’s assisted suicide report for 2014, first line, at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf
[58] See Oregon Health Authority News Release, 09/09/10. ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). (Attached in the appendix at A-61).
[59] Report excerpts in the appendix at A-62 & A-63.
[60] Oregon Health Authority Report excerpts, attached in the appendix at A-64 & A-65.
[61] Oregon State Report attached in the appendix at A-66
[62] And http://www.choiceillusionsouthdakota.org/2017/06/in-oregon-other-suicides-have-increased_18.html (a different version)
[63] Oregon report excerpt for 2016 in the appendix at A-68. To view the entire 2016 report, click here
[64] See Oregon’s report for 2016 attached in the appendix at A-69 (listing 35,709 Oregon resident deaths in 2015).

World Medical Association speaks out against euthanasia bill in Australia.

This statement was released by the World Medical Association on October 27, 2017

The WMA and its national member medical associations, which include the Australian Medical Association, have strongly reiterated their long-standing opposition to physician assisted suicide and euthanasia on the basis that they constitute the unethical practice of medicine.

The WMA calls on Australia’s Victorian Upper House to reject the Victorian Voluntary Assisted Dying Bill.

The Association cites its Declaration on Euthanasia which states: 

‘Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical’.

It also refers to its Statement on Physician Assisted Suicide which declares: 

‘Physician assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically’.

And further it quotes its Resolution on Euthanasia, which notes that the practice of euthanasia with physician assistance has been adopted into law in some countries and that ‘The World Medical Association reaffirms its strong belief that euthanasia is in conflict with basic ethical principles of medical practice, and strongly encourages all national medical associations and physicians to refrain from participating in euthanasia, even if national law allows it or decriminalizes it under certain conditions’.

Finally, the WMA has expressed its concern that should the Victorian Bill be passed into law, it will create a situation of direct conflict with physicians’ ethical obligations to patients and will harm the “ethical tone” of the profession. It also warns that vulnerable people will be placed at risk of abuse and that a precedent will be set that physician assisted suicide and euthanasia are ethically acceptable.

Never enough euthanasia in Québec.

This article was written and published by Wesley Smith on October 28, 2017

Wesley Smith

By Wesley Smith

The ink is barely dry on Canada’s expansive right to euthanasia and there is already much talk of expanding the killing to new categories–such as children. 

Now, after more than 600 sick people were put down in Quebec 2016-2017–if we are going to reduce medical ethics to veterinary standards, let’s use the proper lexicon–provincial leaders are talking about expanding the lethality to those who cannot decide to be killed. From the Toronto City TV News story: 

Veronique Hivon of the Parti Quebecois said “a lot of people” approach her about modifying the law to allow family members with degenerative illnesses such as Alzheimer’s access to the procedure…  

“There is a very clear desire within the population to debate expanding the legislation. We need this debate to happen.”  

Quebec Health Minister Gaetan Barrette said in a statement the government is putting together a committee of experts to look into the “complex question” of expanding the law to have it apply to people who are deemed “legally and clinically unfit” to give consent to the procedure. 

The law was always going to be expanded. Indeed, that was the plan. Because there can never be enough euthanasia

Canadian Paediatricians consider extending euthanasia to newborns, minors and teens.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

For countries, such as Australia, that are debating the legalization of euthanasia, they need to realize that once Canada legalized "assisted death" that tremendous pressure now exists to expand the scope of the law.

Link to the Canadian Paediatric Society report.

Kathryn Blaze Baum wrote an article for the Globe and Mail  concerning a recent report from the Canadian Paediatric Society that appears to feed the demand to expand euthanasia, in Canada, to teens, minors and even newborns. 

According to the Globe and Mail report the CPSP report found that:

Of the 1,050 pediatricians who participated in the survey, 118 said that over the course of a year, they had MAID-related discussions with a total of 419 parents; most of the minors in question were children under the age of 13. When it came to explicit MAID requests, 45 doctors said they dealt with a total of 91 parents. Nearly half of the requests related to infants less than one month old. 

The survey also found that 35 doctors had exploratory conversations with a total of 60 minors, and nine pediatricians reported getting explicit MAID requests from a total of 17 minors. The vast majority of the minors in both scenarios were aged 14 or older.

• Parents of Five year old plead to the Prime Minister not to legalize euthanasia.

Dr. Dawn Davies, the survey's principal investigator and a pediatrician specializing in palliative care described possible cases including euthanasia of newborns with disabilities. 

brain-damaged babies who cannot breathe on their own or swallow their saliva; children with neuro-degenerative diseases that attack their body and brain; and teenagers with advanced cancer who say they would rather end it all than go on this way.

Blaze Baum also interviewed (Alex Schadenberg) for the article:

The executive director of the Euthanasia Prevention Coalition, which opposes MAID altogether, said minors – as with some elderly people and those with a severe mental illness – are highly dependent on others and particularly vulnerable to outside influences. 

"The question remains, are they fully autonomous?" said Alex Schadenberg. "This is a very difficult question, and I would say it's one that should be left closed."

Health Canada recently released its report indicating that there were 1982 "MAiD" deaths in the first full year of legal lethal injections in Canada.

Amy Hasbrouck, the founder of the disability rights group, Toujours Vivant - Not Dead Yet wrote that the more important information (in the report) is what’s missing.

The lesson from Canada is don't legalize euthanasia and/or assisted suicide.

Australian Oncologist speaks out against assisted suicide.

This article was published by HOPE Australia on October 26, 2017

In a moving article, a cancer doctor recently voiced her concerns about the dangers of offering assisted suicide to patients. Director of the Familial Cancer Centre at Monash Health, Dr Marion Harris describes the difficulties her patients have experienced, and how many of them wanted to give up at some point in their diagnosis, but persevered.

Dr Harris said that the initial shock of the diagnosis is usually the most difficult for her patients:

When a patient seeks assisted dying, it is often when they are first told they have a limited life expectancy and before they are truly unwell. They are so distressed by such difficult news that they anticipate what is to come and can be consumed with fear and an urge to regain control.

Dr Marian Harris

However, she said once they make it past that initial shock:

A request to die is uncommon, and is often driven by poorly controlled pain or nausea, as well as fear, loss of function and hopelessness. Usually when pain and other symptoms are under control, good nursing care is on hand, and psychological support has been provided, patients no longer want their death to be hastened.

She expressed her many concerns with the lack of adequate provisions in the law. From a doctor’s perspective, it can be difficult to accurately gauge life expectancy. There is no psychiatric assessment or specialist palliative care assessment required under the Victorian model. Patients are even able to access assisted suicide without consulting their treating doctor or informing their family member. The entire process can be completed in as quickly as ten days.

Additionally, she points out the contradiction of legalising suicide for some individuals, while trying to prevent it in others.

Her greatest fear is that, if assisted suicide is normalised, patients will feel pushed towards it.

Dr Harris believes that the best solution to care for patients facing a terminal illness is to ensure that they receive strong emotional support and proper palliative care. She says we really should be focused on providing better care, because thousands of Victorians die each year without proper palliative care. In her experience, patients given proper care want to fight until the end, and the process does not have to be difficult for the patient and their family.

In summary, Harris says it best:

It is not the solution to the complex problems people face at the end of life, and it creates more problems and injustices than it solves.

• Australian Medical Association opposes bill to legalize euthanasia.