Wednesday, September 30, 2020

Doctors are Saying No to Assisted Suicide in New Zealand.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Sinead Donnelly
New Zealand is having a referendum on euthanasia as part of its October 17 federal election.

Doctors say no is an Open Letter to New Zealanders by doctors supporting the World Medical Association and New Zealand Medical Association position statements that euthanasia and assisted suicide are unethical, even if they become legal.

Doctors say no have more than 1750 signatures from New Zealand doctors for a letter to New Zealand citizens opposing euthanasia and assisted suicide. The letter states:
We are committed to the concept of death with dignity and comfort, including the provision of effective pain relief and excellence in palliative care.

We endorse the views of the World Medical Association and the New Zealand Medical Association that physician assisted suicide and euthanasia are unethical, even if they were made legal.

We uphold the right of patients to decline treatment, as set out in the NZ Code of Health and Disability Services Consumers’ Rights.

We know that the proper provision of pain relief, even if it may unintentionally hasten the death of the patient, is ethical and legal. Equally the withdrawal or withholding of futile treatment in favour of palliative care is ethical and legal.

We believe that crossing the line to intentionally assist a person to die would fundamentally weaken the doctor-patient relationship which is based on trust and respect.

We are especially concerned with protecting vulnerable people who can feel they have become a burden to others, and we are committed to supporting those who find their own life situations a heavy burden.

Doctors are not necessary in the regulation or practice of assisted suicide. They are included only to provide a cloak of medical legitimacy. Leave doctors to focus on saving lives and providing real care to the dying.
Doctors say no’ is an Open Letter to all New Zealanders by doctors supporting the World Medical Association and New Zealand Medical Association position statements that euthanasia and assisted suicide are unethical, even if they were to become legal.

More articles on the New Zealand euthanasia referendum.

Canadian Push for Medical Schools to Teach Euthanasia

This article was published by National Review online on September 29, 2020

Wesley Smith
By Wesley J Smith

You knew it would come to this. The push is on in Canada to persuade medical schools to teach students how to euthanize patients — that is, to commit homicide — known euphemistically as medical assistance in dying (MAID). Now, the Canadian Medical Educational Journal lists several suggestions on how to persuade medical schools to include lethal injection training in the curricula. From the study:

We identified numerous change driving and change restraining influences that impacted the inclusion of MAID topics in health sciences curricula. MAID inclusion into health sciences curricula may be aided by the use of faculty development modules to support knowledge attainment and reconciliation of personal beliefs. MAID entry-level competencies and inclusion of MAID in accreditation standards would support informed curricular placement, including the years and courses for content inclusion and leveling of student competencies.

Furthermore, MAID specific course objectives in courses would assist the consistency of MAID inclusion. It is essential to identify the forces impacting MAID content inclusion in curricula, so the drivers of change can be capitalized, and the “inertial constraints” are recognized and mitigated to move health sciences curriculum into an era of MAID as a legally available care option.
When the Canadian Supreme Court imposed a nationwide right to euthanasia on Canada, I thought that the medical community would fight back and that only a few bottom feeders would participate. But to my great shock, the medical and nursing associations have been the law’s greatest boosters and most enthusiastic proponents for expanding eligibility. This “study,” really an advocacy document, is just the latest case in point.

Think about this, too. Time that would otherwise be spent on teaching new doctors how to treat, heal, palliate, counsel, and diagnose serious medical maladies will instead be refocused on teaching them how to kill patients. Moreover, professors will be expected to convince students that killing the sick and disabled is proper and ethical practice. It is a subversion of everything that medical school should be about.

Finally, brilliant and talented would-be doctors may well decide to pursue a different career because being a doctor could now require them to lethally inject patients. I know that would stop me.

It’s all so disheartening. Euthanasia corrupts everything it touches.


Tuesday, September 29, 2020

Irish assisted dying bill is not limited to terminally ill people.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I recently assessed the Tasmania bill which allows wide-open euthanasia. The Tasmania bill is a massive 122 page spider web of text that appears to have comprehensive safeguards but is actually designed to protect medical practitioners who choose to kill rather than protecting vulnerable people.

The Irish "Dying with dignity" euthanasia bill is short but it also crafted to protect medical practitioners who are willing to kill. It is important to note that the Irish bill legalizes both euthanasia (lethal injection) and assisted suicide. 

The bill first outlines the penalties that medical practitioners could face if they abuse the law, but when reading the law, it appears impossible to charge someone for abusing the law.


Qualifying persons

7. For the purposes of this Act, a person is a qualifying person if he or she—

(a) is terminally ill,

(b) has a clear and settled intention to end his or her own life and has made adeclaration to that effect in accordance with section 9, and

(c) on the day the declaration is made—

    (i) the individual is aged 18 or over, and

    (ii) is a resident on the island of Ireland and has been for not less than one year.
Terminally ill

8. For the purposes of this Act, a person is terminally ill if that person—
(a) has been diagnosed by a registered medical practitioner as having an incurable and progressive illness which cannot be reversed by treatment, and the person is likely to die as a result of that illness or complications relating there to (“a terminal illness”), and

(b) treatment which only relieves the symptoms of an inevitably progressive condition temporarily is not to be regarded for the purposes of paragraph (a) as treatment which can reverse that condition.
The bill claims to be limited to terminally ill people, but the definition of terminal illness: "having an incurable and progressive illness which cannot be reversed by treatment, and the person is likely to die as a result of that illness or complications" does not include a time-frame for death and uses the term likely to cause death.

Therefore the bill is not limited to terminally ill people but rather people with chronic or terminal conditions. There are many people who are not terminally ill but are defined as terminally ill by this bill.

The bill permits death by lethal injection (euthanasia) and death by (self-administering) assisted suicide. Canada legalized euthanasia and assisted suicide but nearly all of the deaths are done by euthanasia. Within four years already two percent of all Canadian deaths are assisted. The promoters of the bill may compare Ireland to Oregon, where assisted suicide but not euthanasia is legal. When euthanasia is also legal the number of deaths will be much higher.

The bill requires the attending physician to be present at the time of administering the lethal drugs. The bill does not require an independent person to be present at the time of administering lethal drugs to ensure that the law is followed.

Similar to other jurisdictions, the Irish bill requires the attending physician to report the death to the "Review Committee." The law uses a "self-reporting" system which is designed to protect medical professionals who are willing to kill. Medical professionals will not self-report possible abuse of the law.

Conscience protection.

The bill does not require medical practitioners object to killing to participate but it does require a "transfer of care."

The Irish "Dying with dignity" euthanasia bill claims to limit euthanasia and assisted suicide to terminally ill people, but in fact it redefines terminal illness to include people with chronic conditions. Many people with chronic conditions are not dying but are defined as terminally ill within the bill.

The bill is designed to provide legal protection for medical practitioners who are willing to kill. The bill starts with legal penalties for abusing the law, but there is no effective mechanism to determine that the law has been abused. The only way to uncover abuse of the law is through the reporting system, but the law employs a self-reporting system which completely protects the doctors who participate in the law.

Ireland must reject the "Dying with Dignity" euthanasia bill and commit to caring and not killing.

Friday, September 25, 2020

Two Massachusetts Veterans home administrators charged for their handling of COVID-19 virus.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Holyoke Former Soldiers' Home
The Associatied Press reported that two Massachusetts veterans home administrators have been charged based on their handling of the COVID-19 virus. 76 residents at the Holyoke Former Soldiers' Home died.

Massachusetts Attorney General Maura Healey said that the Holyoke Former Soldiers’ Home Superintendent Bennett Walsh and former Medical Director Dr. David Clinton could each face prison time if convicted of charges of causing or permitting serious bodily injury or neglect of an elder.

The Alanna Durkin Richer stated in her Associated Press report that:
The charges come three months after a scathing independent report said “utterly baffling” decisions made by Walsh and other administrators allowed the virus to spread there unchecked. The “worst decision” was to combine the two locked dementia units, both of which already housed some residents with the virus, said investigators led by former federal prosecutor Mark Pearlstein.

Healey said Walsh and Clinton were the ones ultimately responsible for the decision to combine the two units, which she said led to “tragic and deadly results.” More than 40 veterans were packed into a single unit that usually had 25 beds, and space was so limited that nine veterans — some with symptoms and some without — were sleeping in the dining room, Healey said.

“This never should have happened. It never should have happened form an infection controls standpoint,” Healey said.

Since March 1, 76 veterans who contracted COVID-19 at the home have died, officials said. The first veteran tested positive March 17. Even though he had shown symptoms for weeks, staff “did nothing to isolate” him until his test came back positive, allowing him to remain with three roommates, wander the unit and spend time in a common room, investigators found.

Decisions that led to deaths of nursing home residents must be investigated. On July 8 I published an article urging an independent investigation into New York Governor Andrew Cuomo's policy that forced nursing homes to accept COVID-19 contagious residents. On July 20 I published an article about California Governor Gavin Newsom forcing nursing homes to accept COVID-19 contagious residents.

Policies that led to the deaths of nursing home residents were particularly horrific in some places but it happened in many US states. On June 28 I published an article explaining that 43% of all US COVID-19 deaths were nursing home residents.

Deaths of nursing home residents was even a greater problem in Canada. On June 25 I published an article explaining that 81% of COVID-19 deaths in Canada were nursing home residents. On June 26 I published an article asking how many Canadian nursing home residents with COVID-19 were killed?

Charges at the Former Soldiers’ Home in Holyoke Massachusetts are the first but they should not be the only charges. Nursing home residents were subject to degrading conditions that led to their deaths. This can only be described as elder abuse. Whether they are veterans or not, they deserve equality before the law. They deserve Justice.

Why is New Zealand considering assisted dying during a pandemic?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New Zealand is having a referendum on euthanasia as part of its October 17 federal election.

New Zealand's parliament passed a euthanasia bill in November 2019 by a vote of 69 to 51. To obtain the votes to pass the Act the government agreed to a referendum.

Robyn Hunt, a joint coordinator of the disability rights group Not Dead Yet Aotearoa, wrote an article that was published yesterday in The Spinoff in New Zealand asking: Why are we considering assisted dying during a pandemic?

Robyn Hunt
Hunt writes:
Considering assisted dying in the middle of a deadly world pandemic seems counterintuitive. We are fortunate to live in a country that has worked hard to preserve life, has recognised that certain groups are greatly at risk and tried, largely successfully, to protect them. But we are to vote in a referendum for the End of Life Choice Act in just a few weeks, so it is important to carefully consider its implications in this context.
Hunt explains her concerns:
There is no way to get around the fact that this is bad law, badly written. The worst of it, from the point of view of the disability community, is that of the eligibility criteria. They are very loose. Supporters of the act believe that discounting age, mental illness and disability provides protection for the groups who expressed concern during the inquiry and the progress of the legislation.

But there is no bright line in real life between disability and terminal illness. The supposed exclusion of disability is meaningless, as the disability community understands only too well. Baroness Jane Campbell put it very clearly when she said, “The distinction between disability and terminal illness is a false one: for many disabled people a chest infection is a terminal illness unless treated. The disabled person dependent on a ventilator is terminally ill if the ventilator is switched off. I am many years over my prognosis end date, along with countless others who have a progressive condition.”
Hunt continues with the lived experience of people with disabilities.
Disability and illness easily become conflated. MS and motor neuron disease are impairments that result in illness. Severe illness brings impairment. The two are conflated in the bill and not understood by its supporters or the general public. “Incurable disease” has been described as code for “disability”.

There’s a sort of existential dread surrounding disability, a fear of perceived pain and suffering that causes perfect strangers to approach people I know, particularly those who use wheelchairs, and say, “If I were like you I would kill myself,” with absolutely no thought of the effect those remarks would have on the disabled person.

There’s the “someone else having to wipe your bum” test that makes many non-disabled people think death is preferable. Yet I know people who live such lives already with grace and dignity, and manage full lives on their own terms, when access to quality support allows them. But the negative societal attitudes subtly devalue lives and can grind people down.
She then comments on the subtle pressures.
Societal and personal pressure can be extremely subtle. Can we be absolutely sure that nobody would ever choose assisted dying because of pressure from another person or group of people? Or from constant negative social pressure and the feeling that they are a worthless burden? They are constantly reminded of their precariousness as people who may need considerable support of various kinds, and often have to struggle simply to get what they need.

Disabled people can be made to feel worthless by a deeply ableist society. New Zealand has a very high youth suicide rate yet we have no record of how many of them are disabled.
Hunt comments on native people with disabilities.
The act is highly individualistic. It holds the right of the individual above the rights of the group, a concept that I know makes many Māori and disabled people feel uneasy. As one disabled Māori leader says, “Why should Māori trust the state on the topic of euthanasia, when we can’t even trust the state to provide adequate and equitable health care, education and housing?” Māori and Pacific disabled people have less access to disability services and supports than other disabled people so that level of cynicism is hardly surprising.
She explains how trust has been eroded for people with disabilities.
Disabled people do not trust a system that already allows violence, abuse and deaths to go unreported and often unacknowledged. Families who kill disabled members are treated more leniently by the courts than others who kill family members. There is talk of “mercy” killings. Of course situations like this are complicated, and can’t be “fixed” by a simple solution. But disabled people don’t trust a system that so often fails them.
She explains that mental health and palliative care services are lacking.
Our mental health services are failing people who need them, and months of lockdown and Covid uncertainty have not helped. The health system is also struggling to meet the needs of the poorest New Zealanders, and in particular children and Māori and Pacific peoples.

In some parts of New Zealand, those approaching the end of their lives have access to world-class palliative care. Unfortunately that isn’t the case everywhere. The option of quality palliative care ought to be readily available before we consider euthanasia or assisted suicide.
She then comments on the fear of wrongful death.
I’ve always found it comforting and appropriate that one of the reasons for abolishing capital punishment was the possibility, and proven occurrence, of wrongful death. Ironically, there is no protection against it in this act. The worst criminals have better protection than some of our most at-risk citizens.
Hunt concludes by stating the concerns of the disability community.
Despite what supporters still claim, opposition to assisted suicide in New Zealand is not always based on religious grounds. While some disabled opposition will be based on sincerely held faith-based views, the majority of disabled people here and internationally are opposed on the grounds of hard-fought and hard-won human rights protections that they are desperate to protect from the erosion this act allows.

Disabled people live on the front lines of the health system in a society that increasingly devalues old, ill and disabled people. Most of the reasons people give for wanting assisted suicide are really disability issues like dependence and independence, without understanding that we are all interdependent. Supporters of the act call for choice. Disabled people want social justice.
More articles on the New Zealand euthanasia referendum.

Vatican document on euthanasia - Solidarity vs solitude.

This article was published by Mercatornet on September 24, 2020.

In a new document, the Vatican denounces it as a crime, but insists on understanding and compassion.

Michael Cook
By Michael Cook
Editor of Mercatornet

If anyone was unsure of where the Catholic Church stood on assisted suicide and euthanasia, they can have no doubts now. In a lengthy document titled Samaritanus Bonus (“the good Samaritan”), the Vatican has released a lengthy response to the spread of “assisted dying”.

Assisted suicide or euthanasia or both are permitted in the Netherlands, Belgium, Luxembourg, Canada, Colombia, Switzerland, eight states in the United States plus the District of Columbia, and two states in Australia. A number of other countries are considering legalisation.

The document is clear and emphatic: euthanasia is “an intrinsically evil act, in every situation or circumstance”.

As well, anyone who cooperates is guilty as well, even those who defend legalisation.

“Euthanasia is an act of homicide that no end can justify and that does not tolerate any form of complicity or active or passive collaboration. Those who approve laws of euthanasia and assisted suicide, therefore, become accomplices of a grave sin that others will execute. They are also guilty of scandal because by such laws they contribute to the distortion of conscience, even among the faithful.”
The Church’s opposition is hardly news. More than 50 years ago the Second Vatican Council condemned euthanasia. Long before the Netherlands legalised it in 2002, Pope John Paul II forbade it in an encyclical, Evangelium Vitae (“the Gospel of Life”). However, the disagreeable reality of legalisation presents problems for Catholics – and other Christians who oppose it in theory. Should people who request assisted suicide or euthanasia receive the Church’s last rites? Should they be given a Christian funeral?

Some bishops appeared to lean toward a policy of demonstrating compassion by “accompanying” a person who chooses to die in this way.

Samaritanus Bonus puts the kibosh on this. People who request assisted suicide or euthanasia may not receive the Church’s sacraments. Even membership in an association organising “assisted dying” is forbidden. They “must manifest the intention of cancelling such a registration before receiving the sacraments”.

Whilst this sounds harsh, the document acknowledges that in extremis people may be so distressed that they are not fully responsible for choosing this kind of death. It urges priests to look for “adequate signs of conversion”. But in principle, there should be no cooperation whatsoever:

Those who spiritually assist these persons should avoid any gesture, such as remaining until the euthanasia is performed, that could be interpreted as approval of this action. Such a presence could imply complicity in this act. This principle applies in a particular way, but is not limited to, chaplains in the healthcare systems where euthanasia is practiced, for they must not give scandal by behaving in a manner that makes them complicit in the termination of human life.

Familiar stuff, perhaps, for friends and foes of Catholicism.

What’s different about this document is that it also offers a perceptive bioethical analysis of euthanasia, along with theological prescriptions.

The principal justification for euthanasia is autonomy. It’s my life; I can do what I want with it. Nobody can tell me what to do. We have to respect a patient’s autonomous decision. Choosing the time and place of death is the ultimate affirmation of autonomy, etc. The arguments are nearly always drawn straight from the playbook of the 19th century British philosopher John Stuart Mill.

The philosophy underlying the secular arguments deployed in Samaritanus Bonus is completely different. Instead of departing from the autonomy of the patient, it emphasises the universal experience of vulnerability.

For the fully autonomous man, think of lron Man in the Marvel Universe. Zipping around in his suit of armour, he is invulnerable. But what makes him interesting is the fact that Tony Stark is vulnerable. He suffers from PTSD, narcissism and loneliness. It’s not the strength of Iron Man’s armour that makes him human, but the fragility of Tony Stark’s character.

Which is more or less what the Vatican says:
“The need for medical care is born in the vulnerability of the human condition in its finitude and limitations. Each person’s vulnerability is encoded in our nature as a unity of body and soul: we are materially and temporally finite, and yet we have a longing for the infinite and a destiny that is eternal. As creatures who are by nature finite, yet nonetheless destined for eternity, we depend on material goods and on the mutual support of other persons, and also on our original, deep connection with God.“
Given this vision of what a human being is, the appropriate response to illness is not to kill a patient, but to care for him.
“Our vulnerability forms the basis for an ethics of care, especially in the medical field, which is expressed in concern, dedication, shared participation and responsibility towards the women and men entrusted to us for material and spiritual assistance in their hour of need.“
Furthermore, the document points out that measuring a patient’s dignity by his autonomy leads to the contradiction which has always bedevilled Mill’s theory. How can the highest expression of autonomy be to extinguish it? If that were true, couldn’t we choose to sell ourselves into slavery to settle our debts? No. “Just as we cannot make another person our slave, even if they ask to be, so we cannot directly choose to take the life of another, even if they request it,” it points out.
“Therefore, to end the life of a sick person who requests euthanasia is by no means to acknowledge and respect their autonomy, but on the contrary to disavow the value of both their freedom, now under the sway of suffering and illness, and of their life by excluding any further possibility of human relationship, of sensing the meaning of their existence, or of growth in the theologal life. Moreover, it is to take the place of God in deciding the moment of death.“
The document also makes some very shrewd observations about the implications of pretending that we are Iron Man instead of acknowledging ruefully that underneath we are really Tony Stark.

In fact, if autonomy is the highest value, people whose autonomy is impaired are in trouble.
“Those who find themselves in a state of dependence and unable to realize a perfect autonomy and reciprocity, come to be cared for as a favor to them. The concept of the good is thus reduced to a social accord: each one receives the treatment and assistance that autonomy or social and economic utility make possible or expedient. As a result, interpersonal relationships are impoverished, becoming fragile in the absence of supernatural charity, and of that human solidarity and social support necessary to face the most difficult moments and decisions of life.”
In short, the proper response to Tony Stark’s end-of-life existential crisis is not to end his life, but to lavish care upon him, to treat him as unique and precious (which is what happens in Avengers: Endgame).

An even better parable is the Biblical story of the Good Samaritan. Instead of allowing the Jew on the way to Jericho to die autonomously, the Good Samaritan tenderly cares for him and pays for him to be nursed back to health. The choice of solidarity over solitude is ultimately the message of this splendid meditation on human weakness in the face of death.

Thursday, September 24, 2020

Nova Scotia case continues. Katherine is trying to prevent the wrongful euthanasia death of her husband.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Nova Scotia court case concerning a woman who is trying to prevent her husband of 48-years from dying by euthanasia returned to court today.

Katherine's husband was approved for (MAiD) euthanasia even though he received conflicting assessments for MAiD (euthanasia). Katherine says he is not dying and is delusional about his medical condition.

The Canadian Press report on the trial stated:
The woman is appealing last month’s decision by Nova Scotia Supreme Court Justice Peter Rosinski who rejected her request for a temporary injunction against her husband.

Her lawyers told the three-member panel of judges today that the woman has been given power of attorney by her 83-year-old husband and has an obligation under the law to step in.

They say there were conflicting medical reports about his health condition and about his capacity to seek an assisted death.
Katherine's lawyer, Hugh Scher stated that there is no other way to cross examine the medical experts who assessed Katherine's husband.

According to the Canadian Press, the lawyer for Katherine's husband, Philip Romney, argued that:
a proper medical assessment was made under the law and it’s not the duty of the appeal court, or any court, to act as a substitute for the opinion of medical experts.

Romney says the medical assistance in dying process would “fall apart” if the decisions of doctors and nurse practitioners were subject to court review. He said medical professionals would decline to participate in the procedure if their decisions were systematically questioned by the courts.
The Chief Justice stated that the decision would be made quickly.

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More information on this story.

Is death by lethal injection (euthanasia) similar to drowning?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Earlier this month I published the article: Do euthanasia drugs cause a painful death? The article was based on research on autopsies of people who died by lethal injection in capital punishment.

The research indicated that lethal injection usually results in death by pulmonary edema (similar to drowning). This research is important because the same and similar drugs are used for euthanasia.

On September 21 I read a report by Noah Caldwell, Ailsa Chang and Jolie Myers that was published by NPR which further outlined the research from the autopsies of people who died by capital punishment. The report explains:

It was 2016, and the autopsy reports had been given to him (Dr Joel Zivot) by lawyers representing inmates on death row. He had received simple instructions: Interpret the levels of an anesthetic in the blood to determine whether the inmates were conscious during their execution. As an anesthesiologist at Emory University Hospital in Atlanta, Zivot specialized in reading these levels. But as he looked beyond the toxicology reports, something else caught his eye. The lungs were way too heavy.

Pulmonary Edema
He checked another autopsy. Again, heavy lungs. The average human lung weighs about 450 grams. Many of these lungs weighed twice that, sometimes more. His best guess was that they were filled with fluid — but he needed a second opinion. 
His colleague Mark Edgar, an anatomical pathologist at Emory, agreed to help. Zivot didn't mention the lungs at all, to see if Edgar would catch the same aberrations. He did. And he confirmed that Zivot's hunch had been correct — the lungs were filled with a mixture of blood and plasma and other fluids. 
It was a severe form of a condition called pulmonary edema, which can induce the feeling of suffocation or drowning. 
Maybe it was a fluke? Zivot and Edgar needed more autopsies to be sure. Lawyers in other states shared autopsies of former clients who had been executed. The evidence explained why multiple inmates in recent years had gasped for air after their executions began.

Eventually, Zivot and Edgar found pulmonary edema occurring in about three-quarters of more than three dozen autopsy reports they gathered.

When selling euthanasia to legislators and voters (New Zealand referendum) the euthanasia lobby claim that death by lethal injection is a quick and painless death. This research is important because people often support euthanasia based on fear of a painful death.

The NPR article continued:

"The autopsy findings were quite striking and unambiguous," says Zivot. He had imagined that lethal injection induced a quick death and would leave an inmate's body pristine, or at least close to it. But the autopsies told another story. 
"I began to see a picture that was more consistent with a slower death," he says. "A death of organ failure, of a dramatic nature that I recognized would be associated with suffering." 
In some cases, there was even froth and foam in the airways: "Frothy fluid present in the lower airways," read one report. 
The froth was a clue: It meant that the inmates were still alive and trying to breathe as their lungs filled with fluid, because froth could form only if air was still passing through the lungs. It also meant that the pulmonary edema was being caused by the first drug given during a lethal injection, since the second drug, a paralytic, stops the inmate's breathing altogether.

Euthanasia and capital punishment both use a three drug system. The first drug is to anesthetize; the second paralyzes; the third stops the heart. Dr Zivot's asked the question:

"How do we ask an inmate whether or not they experience their own death as cruel?"

This question also applies to euthanasia.

After publishing the article a physician, who opposes MAiD, said that these drugs rarely cause death by pulmonary edema.

In response to the question that these drugs rarely cause death by pulmonary edema, Zivot's has extended his research to 200 autopsy reports with 84% of those reports indicating signs of pulmonary edema. 

The autopsies were on deaths by capital punishment and not euthanasia, nonetheless, the drugs and protocols to cause death are the same or similar to euthanasia.

The article continued:

Philippe Camus, a pulmonologist in Dijon, France ... has spent decades studying and compiling the various ways that drugs can negatively affect the lungs. He says that when a high dose of drugs is rapidly injected into the body, it pushes a concentrated "front" through the bloodstream. Doses vary slightly by states, but many inmates receive 500 milligrams of midazolam; for comparison, in a hospital setting patients may receive 1 or 2 milligrams.

"The quicker the injection, the denser the front, and the higher the risk of causing damage," Camus says.

Specifically, that concentrated front of drugs damages the thin barrier between blood vessels and air sacs in the lungs. Jeffrey Sippel, a pulmonologist who reviewed autopsies obtained by NPR, likens this phenomenon to a river flooding its banks.

"Water is supposed to be in the river, and the banks are supposed to be dry," he says. In this case, the dry banks are the lungs' air sacs, and the river is a network of capillaries; in healthy lungs, they are separated by a thin membrane. "When there is pulmonary edema, that normal relationship is awry. There's water on the banks where it doesn't belong."

When that membrane breaks, fluid from the capillaries enters the air sacs, impeding one's ability to breathe.

"It would be a feeling of drowning, a feeling of suffocation — a feeling of panic, imminent doom," says Sippel.
Based on the autopsy research from capital punishment deaths, death by lethal injection is usually caused by pulmonary edema, which is similar to drowning.

Covering the inhumane symptoms associated with dying by euthanasia with drugs to anesthetize; and drugs to paralyze does not change the nature of the death.

Furthermore, people have the right to know before consenting to euthanasia.

More articles on this topic:

Wednesday, September 23, 2020

Assisted suicide deaths may not be quick or peaceful.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

When debating assisted suicide, legislators and voters assume that an assisted death is quick and peaceful. This is important because people often support assisted suicide based on fear of a painful death.

The theory is not the same as the reality.

What is not known is that assisted suicide activists have been experimenting for several years with lethal drug cocktails on people approved for assisted suicide.

According to an article by Lisa Krieger published by the Medical Xpress:

When Californians passed the medical aid-in-dying law - inspired by Oakland's Brittany Maynard, San Mateo's Jennifer Glass and others who sought to end their suffering from cancer - voters assumed it promised them a neat Shakespearean-styled ending, like Romeo's quick poisoning in Verona. That was the goal, but it didn't always happen.

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change.

"The public thinks that you take a pill and you're done," said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. "But it's more complicated than that."

But what is not said in the article is that assisted suicide promoters and practitioners are developing new lethal drug cocktails through human trials rather than animal trials. The human experimentation is ethically questionable and should be investigated by the Food and Drug Administration.

Furthermore, the doctors, who are doing the experiments, may have consent to assist a person's death but have they obtained consent to use experimental drug cocktails in the process? 

Krieger explains that these experiments are not new:

When aid-in-dying was first passed in Oregon in 1997, patients were given secobarbital, sold under the brand name Seconal. It induces deep sleep, then a coma that is so deep that the brain no longer drives respiration.

But that drug wasn't consistently quick. Then it became prohibitively expensive, finally unavailable.

To replace Seconal, the doctors invented a three-drug cocktail - a painkiller, sedative and a heart-slowing agent - based on their experiences with overdose deaths. They later added another cardiac drug. But problems remained.
The assisted suicide lobby is not honest about the fact that many assisted suicide deaths are slow and painful. The design of the law enables doctors to cover-up the reality.

A Daily Mail article by Vanessa Chalmers titled - Assisted Dying can cause inhumane deaths examined an article, by Professor Jaideep Pandit, as reported in the British Medical Journal. The article explains how death by assisted suicide is often inhumane. 

Chalmers reported:
Patients are usually given barbiturates – strong sedatives – which knock them out and eventually cause the lungs and heart to stop. 
But the report found complications including difficulty in swallowing the prescribed dose (up to nine per cent) and vomiting in 10 per cent, both of which can prevent proper dosing. 
Re-emergence from a coma occurred in two per cent of cases, with a small number of patients even sitting up during the dying process, the authors said.  
'This raises a concern that some deaths may be inhumane,' the researchers reported in the journal Anaesthesia
After oral sedative ingestion, patients usually lose consciousness within five minutes. However, death takes considerably longer. 
Death occurs within 90 min in two thirds of cases. 
But in a third of cases, death can take up to 30 hours, and some deaths took as many as seven days to occur (four per cent).

Before legalizing assisted suicide, legislators and voters need to know how it is done, the negative consequences associated with these drugs and the ethics related to the development and use of these drugs.

Assisted suicide deaths can be slow and painful.

More articles on this topic:

Monday, September 21, 2020

Who really wants to die? Part V: The absence of suicidal desire amongst the survivors of catastrophic injury.

Gordon Friesen

A fundamental truth

Cutting directly to the chase: survivors of catastrophic injury (such as those suffering from paralysis due to spinal cord injury), have no greater desire to die than anybody else. There is, therefore, no rationale for facilitating access to assisted death on their account.

In crude figures: only somewhat less than one percent of the victims of spinal chord injuries will despair, renounce, and end their lives during the first crucial five years of recovery (and after that time, their specific suicide rates become statistically identical to those of the general population). That is, of course, a huge number of individual suicides (and roughly twenty times the normal expectation). But it remains, none-the-less, only one percent of the whole.

These facts may come as a surprise to many. But such is the incontrovertible truth.

Once again, as with celebrity suicide, and with the general euthanasia rates observed around the world: we see that the “service” of euthanasia has been grossly oversold in proportion to the scale of voluntary organic demand on the part of its’ intended clientele. And even more importantly, this demand has been energetically misrepresented over the years, by suggesting that certain specific categories of ill and disabled individuals, including (especially) major injury survivors, people with AIDS or persons experiencing progressive neurological decline, and those diagnosed with terminal cancer, do indeed wish to die, when, by the dispassionate measure of statistical evidence: such is clearly not the case.

To what, then, do we owe this false, dangerous, and all too popular misconception?

At the heart of pro-euthanasia messaging: the ideal notion of “suffering”

Fully -- and confidently -- imbued with the early twentieth century spirit of progressive scientific utilitarianism, the Voluntary Euthanasia Society (UK) was formed in 1935 (four years before the onset of war), dedicated to the following principle: 

“incurable sufferers should have the right to choose a Merciful Death”
Ten years later, however, when the Second World War had ended the fascist dream of a “new social order” (and faced at Nuremberg with the appalling evidence of what can really happen when the medical profession is instrumentalized in the pursuit of utilitarian public policy), support for euthanasia virtually disappeared.

As a result, those few creative and powerful personalities who, for whatever reason, remained deeply attached to this ideology, found themselves in a similar situation to that of anti-euthanasia activists today, which is to say, firmly on the back foot and comprehensively obliged to reinvent their goals and methods.

In this extremity (and at the price of a deep fracturing within the Society itself), the immediate goal of access to euthanasia was abandoned; and what was left of the movement transitioned (in the post-fascist period) to a more modest set of objectives, beginning with the first and most basic patient prerogative on the road to full access euthanasia: the right to refuse treatment.

Refusal of treatment, and the original slippery slope

Today, of course this principle is universally accepted. We should, however, frankly realize that refusal of treatment has crucial suicidal implications: that by accepting refusal of treatment we are also deemed to have credited the idea that suicide need not be, by definition, a wrongful act; that we do not have an unconditional duty to prevent suicide; that suicide is not necessarily “bad”; that suicide can, in fact, be “good”; and ultimately, that we might be morally required to provide assistance in suicide. In other words, from the first formal acceptance of “refusal of treatment” (and with far greater effect from the later refusal of “care”), the road became clearly laid out -- through the logical falling of successive legal dominoes -- to that situation in which we find ourselves today.

For clearly: categorical interdictions can not be (formally) breached without inviting far-reaching consequences.

A required moral consensus on the desirability of (at least) some suicides

Perhaps the most brilliant and effective aspect of the strategy outlined above lies in this fact: that the entire collective and utilitarian justification for euthanasia -- previously quite obvious but now unavowable -- had been displaced by this one remaining principle of unfettered individual choice.

And yet there still remained a crucial obstacle to this plan. We must understand, I believe, how difficult it was for people, at that time, to openly promote the idea of suicidal choice. It was not enough, three quarters of a century ago, to simply fall back (as one might today) on the sovereign personal right of capricious subjective desire. Those who wished to enable suicide, assisted suicide, and ultimately euthanasia itself, faced the very real challenge of convincing a democratic majority that suicide can be (and is in fact), objectively “good” (in specific instances).

In practical terms, of course, this would mean convincing the common man that there were situations in which, he -- or anyone else -- would naturally wish to die. And to achieve this goal, euthansia promoters began with a truly ingenious linguistic tool, for soliciting agreement with their underlying thesis. This involved a minute, almost invisible change, introducing the notion, no longer of merely “incurable” suffering, but that of a suffering which was incurable and “unbearable”! For in this case, IF we accept at the outset that there is (in fact) such a thing as “unbearable suffering”, THEN by definition, anybody so afflicted would automatically wish to die, and the argument is carried without further demonstration.

The only task remaining, therefore, was to sow this treacherous conceptual seed in collective consciousness (appealing, also, to pre-existing popular prejudice), by presenting ideal images of people “suffering” in seemingly “unbearable” circumstances. Unfortunately, as we shall see, this challenge was actually undertaken with great success over a period of fifty years (in spite of clear statistical proof to the contrary), by mere literary representations of fictional suffering, involving notably (among others) the paralysed survivors of spinal cord injury.

An outstandingly successful instance of fictional misrepresentation: spinal cord injury

As early as 1972, a television drama championing the right to die, intitled “Whose Life is it Anyway”, by author Brian Clark (1932 - ), appeared in UK (once again), which was subsequently brought out on the stage (London 1978, Broadway 1979) and was ultimately produced as a Hollywood film starring Richard Dreyfuss (MGM 1981).

The subject of this film concerned the suicidal desires of a young man (Dreyfuss) who was rendered quadriplegic in a car accident. The point of the film however -- it’s purpose -- was to convince the average sympathetic spectator, that a life of paralysis is objectively unworthy of living; or at least, that if he or she were to find themselves in such a case, that they would not wish to live. The fundamental goal, therefore, lies in soliciting the spectator’s agreement with that essential euthanistic premise identified above: that there do indeed exist extraordinary instances of “suffering” which are objectively “unbearable” (and for which the act of suicide -- and indeed of homicide also -- must be postulated as a positive “good”).

Unfortunately however – incidentally and unforgivably -- it was also grossly (and falsely) intimated through this fictional imagery, that the typical paralysed survivors of spinal cord injury are indeed “suffering” in that mythically “unbearable” fashion so artfully evoked, and naturally desire death in consequence!

Never mind that this is a bald-faced lie. Never mind that ninety-nine percent of catastrophic injury survivors will show no more suicidal tendency than anybody else! People of the author’s ilk have no interest in such distractions: In fact, it would surprise me greatly to learn that Brian Clark actually cared if real spinal cord injuries wished to die. He might easily have discovered that they do not (And perhaps knew this perfectly well)!

Even the spinal cord issue, itself, (as choice of subject) was probably a mere happenstance. Apparently, Clark simply picked the worst infirmity he could think of (while still getting aesthetically photogenic shots). His one simple goal, for whatever reason, was to convince “normal” people that their “suffering” neighbors should be allowed to die. And if that demonstration depended on a completely fallacious description of reality, advanced unselfconsciously through a work of political fiction, then so be it.

A personal, indignant resentment, evoked at the view of this film

The reader may have detected a particularly warm tone in my treatment of this particular subject. And the reason for that “warmth”, is because, coincidentally, “Whose Life is it Anyway” appeared as a film only two years after I myself became paralysed in circumstances very similar to those depicted in the movie.

The terrible nature of such literary assault

Without the will to live, even the strongest man, in the most favorable circumstances, will soon disappear. For that is the inflexible rule of all life, which has governed evolution from the very start: Life must be desired; life must be nurtured; life must be defended; life must be striven after. Among humans, indeed, the capacity for adaptation is virtually limitless, and the will to live, therefore, is not a secondary, but the first and determining predictor of outcome: for almost any situation is livable to the person who desires life; but no situation will suffice for the one who does not.

Generally speaking, then: How could anyone fail to understand the mortal danger posed by such a work, to people at grips with these intimate and personal adjustments? In those first crucial four, or five years? In that first devastating year? How could anyone ignore the terrible implications of telling such people (at that most delicate of times), that their lives were (objectively) not worthy of life?

As concerns myself personally: forty years ago, my survival teetered on the knife’s edge. My life depended, quite simply, on the confidence required to make positive choices; and the suggestive force of Clark’s propaganda, with its nihilistic view of disabled life (whether wittingly or no) posed a direct threat to my existence.

I do not hesitate to affirm, therefore: that the production and distribution of this film (and the still very popular stage-play from which it sprang) were (and remain) acts of criminal assault upon real people; some of whom, sadly, will not succeed in repulsing this poisonous ideation.

And yet most happily: the human powers of recuperation (from psychic no less than from physical assault), are much greater than we might intuitively expect (and certainly much greater than the shameless pornographers of “unbearable” suffering would have us believe).

A more faithful portrait of real life

People who have lived through these sorts of difficult adaptations, and those also, who have been the intimate witnesses to such feats, naturally see them as unique, heroic, victories over misfortune. And they definitely are. But the superb level and intensity of the efforts made – and of the satisfaction achieved -- does not change their equally ordinary nature. It is simply a lie (albeit a nearly universally credited lie) that only a very few superior individuals can possibly overcome the challenges of catastrophic injury. In reality – and this is a truth which cannot possibly be over-stated: this kind of amazing adaptive power reveals itself as a standard characteristic of humanity. Especially where it is expected and embraced.

A conclusion of infantile simplicity

Once again, let us remember the main thesis of this present series of articles: that observed demand for euthanasia is wildly below what we would expect as a justification for the scale of the service offered (and for the sacrifices demanded of both typical patients and typical doctors) in the satisfaction of what little demand there is.

What is the reason for that? Why is this dishonest (and clearly false) nihilistic messaging (epitomized by the film “Whose Life is it Anyway”), still allowed to stand? Where are the ninety-nine other films logically required to faithfully portray observed proportional reality? Where are the popular commentators, eager to “set the record straight”?

Whatever answers might be found for these intriguing questions, something has clearly gone wrong with the scenario imagined seventy-five years ago by post-fascist euthanasia apologists suddenly recycled as apostles of personal choice: Doors to the “service” have been thrown wide open. Doctors are now instructed to be on the lookout and to recruit as many clients as possible. Yet to their enduring frustration (and, I believe, entirely predictably): As long as euthanasia depends on choice it can never prevail over the normal human instinct of survival. Or to recall the familiar Children’s Tale:

Then said the Little Red Hen:
“I have convinced the general population that “suffering” is worse than death;

I have changed the law to allow doctors to kill their patients;

I have transformed the public healthcare system along utilitarian lines in order to maximize access to euthanasia;

And now, who wishes to die?”

“Not I”, said the Pig.

“Not I”, said the Cow.

“Not I”, said the survivors of catastrophic injury...
How long will it take (and how much damage will be done to our medical establishment) before judges, administrators and opinion-makers realize that they are attempting to force a “product” upon us, for which there is no corresponding market organically expressed?

And how long will we – patients and taxpayers – allow this abuse of our trust?

This article is the fifth in a series of articles.

Friday, September 18, 2020

Netherlands euthanasia clinic: two year waiting list for euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On March 1, 2012; the Netherlands euthanasia lobby launched the euthanasia clinic with six mobile euthanasia teams. The euthanasia lobby anticipated that these mobile euthanasia teams would perform 1000 euthanasia deaths per year.

The mobile euthanasia teams planned to fill "unmet" demand by focusing on euthanasia for people with chronic depression (mental pain), people with disabilities, people with dementia/ Alzheimer, loneliness, and those whose request for euthanasia is declined by their physician.

Janene Pieters reported for the NL Times that there is now a two year wait time for euthanasia for mental illness at the euthanasia clinic. According to Pieters last year the euthanasia clinic received 3122 requests for euthanasia representing a 22% increase over the previous year.

Pieters reports that Paulan Starcke of the Expertise Center said:
While the coronavirus pandemic is an easy thing to blame for the increasing waiting times, the crisis was really only part of the problem... According to her, the pandemic caused a maximum delay of two months. 
"Our waiting list is primarily a signal that regular mental health care still does not often seriously respond to a request for euthanasia. We are referred to too often," 
Patients are referred to the Euthanasia Expertise Center if their regular doctor considers their request too complex to handle themselves. The Expertise Center provided euthanasia to over 60 people with mental health problems last year. Doctors who are not affiliated with the center only did so six times.
The Netherlands euthanasia clinic temporarily shut-down during the Coronavirus crisis. The euthanasia clinic which specializes in euthanasia for mental illness and euthanasia for people with dementia or questionable competency, reported that euthanasia deaths, increased to 898 in 2019 up from 727 in 2018.

The 2018 euthanasia report indicates that there were 6126 reported euthanasia deaths in the Netherlands in 2018. According to the news:
Of the cases reported to the committee last year, 146 concerned people with dementia and 67 people had severe psychiatric problems. In 205 cases, patients had multiple problems derived from the ageing process.

I am concerned that in 2018, 205 people were placed into a new category off euthanasia for people who have multiple problems derived from the aging process. This sounds very similar to "the completed life.

I contend that very few psychiatrists, in the Netherlands, are willing to do euthanasia because it is counter to the role of a psychiatrist who is trained to prevent suicide not provide it.