Thursday, August 1, 2019

Report into Wettlaufer deaths will not protect people from suspicious euthanasia deaths.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Elizabeth Wettlaufer
In June 2017, Elizabeth Wettlaufer, a former nurse who confessed to killing 8 people nursing homes in Woodstock and London Ontario, was sentenced to 25 years without eligibility for parole. Justice Thomas stated, during the sentencing:

"It is a complete betrayal of trust when a caregiver does not prolong life, but terminates it," 
"She was the shadow of death that passed over them on the night shift where she supervised."
I agree with Justice Thomas, but I wondered how to interpret this statement now that"MAiD" euthanasia is legal in Canada?

Justice Eileen Gillese
On July 31, Justice Eileen Gillese made 91 recommendations in her 4 volume 1441 page report concluding the Public Inquiry into the Safety and Security of Residents in the Long-term Care Homes System. The report made some good statements. 

Under the heading that these deaths were not "mercy killings" the report stated:
No one has the right to define the value and meaning of someone else’s life and decide when it is time for that life to be over. This statement is particularly true for healthcare providers, who have been given the privilege and power of caring for us. The vulnerable members of our communities who rely on the long-term care system have lives with value and meaning for them and their loved ones. It is their right – and our collective obligation – to ensure that they live out their lives in safety and security, and with dignity.
The report recognizes that a threat to patients exists. Under the heading, the threat has not passed, the report comments on healthcare serial killers:
The murders Elizabeth Wettlaufer committed while working as a nurse are shocking and tragic. However, they are not unprecedented. A growing body of research and literature shows that healthcare serial killing is a phenomenon which, while rare, is long-standing and universal in its reach, with documented cases dating back to the 1800s. Expert evidence presented in this Inquiry shows that since 1970, 90 healthcare serial killers have been convicted throughout the world, including in Canada, the United States, and Western Europe. Even during this Inquiry, the media reported the arrests of two more alleged healthcare serial killers. In July 2018, a British healthcare worker was arrested on the suspicion that she had murdered eight babies and tried to kill six others while she worked at the Countess of Chester Hospital in northwestern England. Days later, there were reports that a Japanese nurse had been arrested on the suspicion that she injected disinfectant into intravenous bags, killing approximately 20 elderly patients in her care at a Yokohama hospital.
The report stated that healthcare serial killers are rare but the number of deaths attributed to these killers is significant. The report states:
Professor Crofts Yorker acknowledges that the number of healthcare serial killers is quite small, as is the number of serial killers generally. However, while the known number of healthcare serial killers is small, the number of victims is not. The 90 healthcare serial killers convicted since 1970 have been found guilty of murdering at least 450 patients. They have also been convicted of assault or grave bodily injury involving at least 150 other patients. But, according to Professor Crofts Yorker, those figures significantly understate the actual number of victims: the total number of suspicious deaths attributed to the 90 convicted healthcare serial killers exceeds 2,600. 
Furthermore, after the prosecution of a healthcare serial killer is complete, it is not unusual for the number of deaths linked to a particular HCSK to be revised upward. For example, German nurse Niels Högel was sentenced in 2008 for attempted murder... In November 2017, the total number of victims attributed to Högel was revised to 106, with further suspicious deaths still under investigation. In January 2018, German prosecutors charged Högel with the murder of 97 additional patients. Högel subsequently admitted to killing these patients. Investigators and prosecutors ultimately indicated he may have killed more than 200 people. Dr. Harold Shipman, a British physician, is another such example. Shipman was convicted of murdering 15 patients in 2000. A public inquiry concluded that he had in fact killed 215 of his patients over the course of his career, and it identified a further 45 deaths associated with Dr. Shipman as suspicious.
There are more healthcare serial killers:

In December 2016, an Italian emergency room anaesthetist Leonardo Cazzaniga, 60, and nurse Laura Taroni, 40, were arrested for the deaths of at least five patients but prosecutors were examining the medical files of more than 50.

Charles Cullen
Charles Cullen, a nurse who was also a medical serial killer in the United States. known as the 'Angel of Death' murdered at least 40 patients to become one of America's worst serial killers. He spoke from prison to chillingly claim: 'I thought I was helping.'

Dr Michael Swango is believed to have killed 35 - 60 patients, and similar to Cullen, he was simply asked to resign, or moved to another medical center. Aino Nykopp-Koski is a nurse who was convicted of killing 5 patients in Finland. In March, 2013 Dr Virginia Soares de Souza was arrested in Brazil and was suspected of killing 300 patients. Then there is the case of William Melchert-Dinkel, the Minnesota nurse who was convicted of 2 counts of assisted suicide for counselling depressed people to commit suicide.

The three principal findings in the report were:
  • if Wettlaufer had not confessed, the Offences would not have been discovered; 
  • the Offences were the result of systemic vulnerabilities, and, therefore, no findings of individual misconduct are warranted; and 
  • the long-term care system is strained but not broken.
Will the recommendations prevent further abuse?

Wettlaufer was not caught until she confessed to a counselor that she had killed and attempted to kill patients. She killed 8 people without being caught.

Several of the recommendations concern the need for accurate information on the death certificate to uncover signs of abuse within a care home, etc.

It is interesting that Canada's euthanasia law requires the doctor/nurse practitioner who carries out the euthanasia death to lie on the death certificate. The law requires the death certificate to state that the cause of death was the "medical condition" that the person was living with rather than death by MAiD (euthanasia).

Based on the recommendations in the Public Inquiry into the Safety and Security of Residents in the Long-term Care Homes System report, a person will be required to have accurate and complete information on the death certificate, unless they die from euthanasia (lethal injection).

Canada's euthanasia law requires that the doctor or nurse practitioner who cause death by euthanasia (MAiD) to also report the death. There is no independent authority reporting that the euthanasia death fulfilled the criteria of the law. This self-reporting system enables doctors or nurse practitioners to hide the facts when the euthanasia death was outside of the law/questionable or it enables them to not report every MAiD death.

For instance, the third report from Québec's euthanasia commission indicates that doctors did not report 142 of the euthanasia deaths.

A NEJM study on the practice of euthanasia in the Flanders region of Belgium found that in 2013 1.7% of all deaths (more than 1000 deaths) were assisted deaths without explicit request and more than 40% of the assisted deaths were not reported.

A NEJM study analyzing the Netherlands euthanasia experience found that there were 431 assisted deaths without explicit request in 2015 in the Netherlands and 23% of the assisted deaths were not reported.

I agree with the report that Wettlaufer's killings were not motivated by "mercy" but I also recognize that many Canadian doctors are now legally lethally injecting their patients, which will lead to more abuse based on the nature of the act and the health conditions of the patients.

It is not safe to give physicians/nurse practitioners, or others, the right in law to cause death.

Canada's euthanasia law gives medical professionals, who are willing to kill their patients the legal right to proceed.

Canadians must go past their fear of dying a bad death and realize that Canada's euthanasia law is fatally flawed. 

The law provides no effective oversight of the law while giving physicians and nurse practitioners the right in law to kill you.

1 comment:

Morten Andreas Horn said...

Alex, you might add to the list the case of Arnfinn Nesset, a Norwegian nurse and nursing home administrator, who was convicted of killing at least 22 of his elderly patients in the nursing home in Orkdal, Norway, in 1977.
He injected them by night with Curacit, a muscle paralyzing agent.

Actually, ny aunt Kari Noer was the local doctor who raised suspicions against Nesset, leading to his arrest. But I do believe she hesitated a bit, such a thing was unthinkable at the time, I think she maybe repproached herself afterwards for not shouting out sooner.

But that's the thing: These things do happen, these people do exist. Allowing doctor-assisted and poorly supervised killing of patients allows for such persons to give in to their darker sides, with small opportunities for the authorities to stop them.

In Europe, we have doctors like Erika Preisig (Switzerland) and Marc van Hoey (Belgium) - and several more! - who admit performing large numbers of assisted deaths. This may be for humanitarian, altruistic motivations, sure. But if these doctors really were "Angels of Death" who somehow enjoyed being involved in other peoples' death - how would we know? How could we check them?

One might say that assisted death is wrong - I do, but some disagree. But we may surely say, strongly, that it's unsafe for vulnerable patients. We cannot escape the fact that this legalization may be abused by people like Mr Nesset, and the others mentioned here.

Mr Nesset's case is here on Wikipedia (Norwegian):

Kind regards,
Morten Horn, MD, PHD
Consultant in neurology
Member of the Medical ethics Council of the Norwegian Medical Association
Oslo, Norway