Monday, January 24, 2022

UK Millionaire claims he killed is first wife "compassionately" and beat his second wife.

Alex Schadenberg
Executive Director, Euthansia Prevention Coalition

On Saturday I published excerpts from an article by Simon Caldwell accusing the Sunday Times of championing the euthanasia story of an abusive husband because it fit their pro-euthanasia stance.

An article by Gregory Kirby published by the Daily Mail on Sunday January 23 further uncovers the story of the millionaire ex-army medic, Douglas Laing. Laing confessed to killing his first wife in 1998, in what he referred to as an "assisted death" as part of a campaign to legalize euthanasia in the UK.

With a little digging researchers uncovered that in October 2017, Laing was accused by his second wife, Susan, of hitting her three times with a wooden mallet. Laing was convicted with a three year jail sentence for beating his wife.

Kirby explains that a murder investigation into the death of Laing's first wife has been launched. The story is significant since Laing released his "confession" as part of a campaign to challenge the laws prohibiting euthanasia and assisted suicide.

Douglas Laing
According to Kirby's article:
Laing said doctors familiar with his military nursing experience provided him with the lethal drugs to prevent his wife dying in a hospice.

He kept it secret until last year, when he began to follow the Sunday Times campaign Dying with Dignity, which backs efforts to legalise assisted dying.

Laing was being supported by Dignity in Dying, a separate campaign to change the law on assisted suicides, but the charity distanced itself from him after the latest revelations emerged.

Chief executive Sarah Wootton said: 'Dignity in Dying will not be commenting further while police investigations are ongoing.'
It is important to note that Dignity in Dying were supporting Laing and likely wrote his confession letter where he admitted to killing his first wife. Notice how they are now silent about their campaign with Laing.

In his contrived confession letter that was published by the Sunday Times in October 2021 Laing stated:

...'I'm in tears as I recall that conversation. 

'I have struggled with what I did and only recently spoken to close family about it. 

'I wanted to make my actions public knowledge in support of the move to legalise assisted dying.

'Taking the brave decision she did allowed my wife to say goodbye to our two sons while she was able to, and allowed us to have a final cuddle. Then she was gone. 

'I know the consequences and it doesn't bother me one jot.' 

This story reminds me of the research done several years ago by Research by Donna Cohen, a professor of psychiatry and behavioral sciences and a suicide researcher, and others proving that murder-suicide is rarely related to assisted suicide.

Cohen stated the following in a March 2009 Minnesota Tribune article:
When people read reports of a murder-suicide they will often ask the question, was this an Act of love, or desperation? Cohen who has researched this question tries to find answers. 
She stated in the article:
That notion is common in murder-suicides, said Cohen, who has testified before Congress, written extensively and helped train families and physicians. She is a professor of aging and mental health at the University of South Florida and heads its Violence and Injury Prevention Program. 
"If they were consulted, families usually would try to stop it,'' she said. "In fact, murder-suicide almost always is not an act of love. It's an act of desperation."
Cohen explains that murder-suicide does not equate with assisted suicide. She said:
Some people equate murder-suicide with assisted suicide and the right to control when you will die, Cohen said. "It usually is not the same. This is suicide and murder.''
According to Cohen, the typical murder-suicide case involves a depressed controlling husband who shoots his ill wife. 
"The wife does not want to die and is often shot in her sleep. If she was awake at the time, there are usually signs that she tried to defend herself."
Laing appears to fit the profile of a controlling man who killed his wife.

Hippocratic Medicine is Hallowed Ground.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ronald Pies
For those who read the articles that I publish, you will notice that Dr Ronald Pies has written a series of articles in response to Joshua Pagano, DO's. 

This latest article is in response to Dr Pagano's article - “Finding Common Ground in This Life.” where Pagano asks the hypethetical question if assisted suicide is acceptable when a: "terminally ill patient who has had access to marvelously comprehensive care, including “pain management,” assessment of underlying mental illnesses, personal and family counseling, and information regarding “all possible options.” Dr Pagano then opines that—notwithstanding such stellar care—there will still be “the patient who will legitimately choose medical aid in dying.”

Dr Pies responds by stating that the "hypethetical patient" is rare considering access to good end-of-life care and the availability of psychological / mental health care, nonetheless, Pies argues that physicians, are not ethically or legitimately empowered to honor the choice of assisted suicide.

Pies urges Pagano to consider the importance of Hippocratic medicine:
I would encourage Dr Pagano to reflect on our Hippocratic roots, as physicians. I am not speaking solely of the famous “Hippocratic Oath,” with its solemn vow, “I will give no deadly medicine to anyone if asked, nor suggest any such counsel…” I am referring to the entire tradition of Hippocratic medicine, over the past 2500 years. The refusal to administer a lethal drug to dying patients was a distinguishing feature of Hippocratic physicians—setting them apart from their contemporary colleagues. It is only since the rise of the consumer rights movement in the 1960s—whereby patients became “service users” and physicians, mere “providers”—that assisted suicide has been seriously advanced as a medical “service.”
Pies then quotes medical ethicist and physician Leon Kass, MD, PhD, who stated:
“In forswearing the giving of poison, the physician recognizes and restrains a godlike power he wields over patients, mindful that his drugs can both cure and kill. But in forswearing the giving of poison when asked for it, the Hippocratic physician [also] rejects the view that the patient’s choice for death can make killing him—or assisting his suicide—right.”
Pies concludes his article by stating that finding common ground is important but it is more laudable still is knowing when one is treading on hallowed ground.

Previous articles by Dr Ronald Pies:
  • Physician-Assisted Suicide: An egregious boundary violation (Link).
  • Assisted suicide and the autonomy myth (Link).
  • 12 myths to assisted suicide and medical aid in dying (Link).
Dr Ronald Pies is professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University; clinical professor of psychiatry, Tufts University School of Medicine; and editor in chief emeritus of Psychiatric TimesTM (2007-2010).

Friday, January 21, 2022

Sunday Times champions the euthanasia story of an abusive husband because it fit their pro-euthanasia stance.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Simon Caldwell, writing on January 21 in the TCW calls the Sunday Times Newspaper a cheerleader for euthanasia. There is nothing new about a newspaper taking an editorial position on a topic but Caldwell argues that:
Since last summer that great watchdog of our liberties, the Sunday Times, has fervently campaigned for the legalisation of assisted suicide.

Barely a week goes by without its running a story planted by Dignity in Dying (formerly known as the Voluntary Euthanasia Society) or its acolytes, invariably without any balancing comments from any of the dozen or so groups run by disabled people who ardently oppose such a law, or the many politicians, doctors, lobby groups and so on who equally insist, with sound reasons, why it would be extremely unwise to license doctors to assist in the suicides of their patients.
Caldwell challenges the Sunday Times in their treatment of the Douglas Laing case:
Cancelling the voices of the weak and vulnerable while giving carte blanche to euthanasia activists is misguided, and the Sunday Times has now compounded its misjudgement by championing the case of Douglas Laing, a former Army nurse who admitted to the newspaper that he administered a lethal injection to his cancer-stricken first wife in 1998 at her behest.

When, on the back of its tear-jerking coverage, Devon and Cornwall Police investigated Laing for murder, the paper was outraged, refusing to co-operate with the force on principle and using its leader column to describe the inquiries as ‘idiotic’ and a ‘wrong-headed and pointless’ waste of police time.

However Private Eye magazine has also taken an interest in Laing, revealing in its latest issue (January 19) that he has form when it comes violence against women, having bludgeoned his second wife Susan with a mallet in 2017, seriously injuring her. Laing admitted wounding her with intent to cause grievous bodily harm and was given a three-year jail sentence. Who knew? If the Sunday Times did, which you would expect it to since it was reported by other papers, it kept it to itself.
Caldwell accuses the Sunday Times of turning a blind eye to Laing's violence against women because his story fit their pro-euthanasia position.

Later in the article Caldwell refers to developments in New Zealand and Canada to explain why euthanasia and assisted suicide should not be legalized. He writes"
In New Zealand, where legal euthanasia came into force only in November, the Ministry of Health admitted in a response to the equivalent to a Freedom of Information request that some Covid patients are eligible for lethal injections. This was not envisaged by legislators but it is permitted by the letter of the law they passed – an unforeseen consequence.

In Canada the removal of a ‘reasonably foreseeable death’ as a criterion of eligibility from the five-year-old euthanasia law there (initial safeguards are frequently later removed) has raised the question of what protections now exist for elderly, given that frailty can be perceived as an intolerable burden warranting a lethal injection.
He concludes by urging the Sunday Times to do their job:
They also merit truthful examination and open debate in the media. They are far too deadly to be ignored or covered up by newspapers who label the police as ‘idiotic’ for doing their jobs properly while they smugly participate in the shameful work of a death cult.
In Canada, during the 2016 debate to legalize euthanasia, nearly every media outlet took a pro-euthanasia stance and then intentionally ignored the positions from groups opposing euthanasia. It was very frustrating when false comments and ideas were provided ink on paper while reasoned opposition was ignored.

Thursday, January 20, 2022

People with disabilities speak out against Delaware assisted suicide bill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by DJ McAneny that was published by on Tuesday January 18 reports on a press conference organized by disability leaders concerning Delaware's assisted suicide bill HB 140

Terri Hancharick
McAneny quotes Terri Hancharick, the chairperson for the State Council for Persons with Disabilities who says that people with disabilities need options for living not dying:
"...Give them the option of support. Help them to live their best lives," ... "I'm just very surprised at the timing of this. Instead of institutionalizing death for the disability community, Delaware legislators should focus on ensuring that everyone has the care and resources that they need. We have to continue to advocate for reliable, competent care in the community. We have to include to advocate for full inclusion of people with disabilities."
McAneny quotes Daniese McMullin Powell from the ADAPT disability group who argues assisted suicide makes suicide too easy.:
"It just doesn't make any sense to have that law in place, because it's too easy. It leads to suicide contagion when such laws take the stigma off of having assistance, or even doing it yourself," ... "It makes it more common. And it makes other people that aren't even terminal have the idea that it's okay to go ahead with that, and that it's just a societal thing, and there's 'nothing wrong with it.'"
Stephanie Packer
McAneny reports that Stephanie Packer, from California, spoke about how her insurance company recommended lethal assisted suicide drugs for her terminal condition.
Stephanie Packer, a mother of four from California, said her terminal diagnosis led to her insurance recommending to her lethal drugs to perform assisted suicide would be much cheaper than life0saving treatments. While they eventually agreed to cover her treatment, she echoed McMullin Powell's concerns that governments shouldn't be setting such black-and-white legislation when that's not how businesses like health insurance work, and are instead focused on financial savings.
McAneny stated that Matt Valliere, Executive Director for the Patients Rights Action Fund stated that assisted suicide is a public policy that makes suicide a medical treatment for a subset of people, always, it's a subset of people with disabilities.

Delaware is being pressured by the assisted suicide lobby to legalize assisted suicide. The Delaware Assisted suicide bill will give doctors and nurses the right in law to prescribe a lethal suicide drug cocktail.

Wednesday, January 19, 2022

Euphemisms mask the true nature of assisted suicide and euthanasia

This article was written by Noreen O'Carroll and published by Mercatornet on January 19, 2022. This article was originally published in the Summer issue of the Irish journal Studies.

By Noreen O'Carroll

Disguising the true meaning of words is a powerful weapon in the "right to die" armoury

The lower house of the Irish Parliament, the Dáil Éireann is currently considering the “Dying with Dignity Bill 2020”. The most striking feature of this bill is that it does not mention the words “assisted suicide” or “euthanasia” in any of its qualifying criteria or provisions but instead uses expressions and phrases such “assistance in dying”; “the prescription of substances which can be orally ingested”; “prescribing and providing the means of self-administration”; and “the substance or substances may be administered”.

Language matters. It can persuade us to buy products when they are labelled and packaged attractively. It can also shape people’s attitudes and approaches to controversial issues and questions. Assisted suicide and euthanasia are labelled and packaged attractively in the Dying with Dignity Bill through the use of euphemistic terms that obscure important ethical and empirical distinctions. But they are very influential in swaying public opinion in favour of assisted suicide and euthanasia.

Euphemisms designate something unpleasant by a milder term. In the bill euphemisms operate by dissociating language from the experience of reality and putting something illusory in its place instead.

What’s in a name?

This can be seen in the title and provisions of the bill. The title is quite misleading. By using the euphemism “dying with dignity” it dissociates the choice to take one’s life intentionally, or have one’s life ended deliberately by a healthcare professional, from the experience of “suicide” or “euthanasia”, which is what the bill’s provisions are about.

This is a cause of considerable distress to all who have lost a loved one who died naturally with dignity, because it implies that a death with dignity is only achieved by assisted suicide or euthanasia.

It has been suggested that the rationale for using euphemistic language in the bill is to better reflect the wishes of patients with terminal illness whose desire is for a death with dignity. However, legislation doesn’t apply to patients only; it also affects others – doctors, nurses, families, communities and society as a whole.

A more linguistically appropriate title for the bill is, arguably, the “Assisted Suicide and Euthanasia Bill”.

The provision for assisted suicide in Section 11 of the bill is expressed in language stating that a medical practitioner may prescribe or provide a substance or substances which can be orally ingested or self-administered by a person; or prepare a device which will enable that person to self-administer the medicine, “with the purpose of enabling that person to end his or her own life”.

The euphemisms “orally ingesting” and “self-administration” dissociate the idea from the reality of the experience of committing suicide by ingesting or self-administering lethal medication prescribed or provided by a doctor or nurse; the definition of terms in Part 1 of the bill states that an “assisting healthcare professional means a registered medical practitioner or a registered nurse who has been authorised by the attending medical practitioner to deliver any substance or substances prescribed”. In this situation, the patient is the direct causal agent ending his or her own life.

Absent words

The absence of the words “suicide” and “assisted suicide” is striking. The provision for euthanasia in Section 11 of the bill is also expressed euphemistically, stating that in the case that it is not possible for a person to self-administer, “then the substance or substances may be administered” – and this too is qualified by the phrase “with the intention of enabling the person to end his or her own life”.

This is less than honest. Obviously, if the patient is unable to self-administer and the substances may be administered, then clearly someone else is involved. Who? The identity of the healthcare professional who euthanises the patient is disclosed in Section 11 (6) as either “the attending medical practitioner or the assisting healthcare professional”, who can be either a doctor or a nurse. The doctor or nurse is legally obliged to remain with the person “until the person has self-administered the substance or substances or have it or them administered”. This situation is one where the doctor or nurse is the direct causal agent who ends the patient’s life.

Couched in euphemistic language, this is euthanasia and specifically voluntary euthanasia when it is done at the request of the patient. The idea conveyed in the words “the attending medical practitioner or assisting healthcare professional must remain with the person until the person has self-administered the substance or substances or have it or them administered” (my emphasis) is dissociated from the experience it is intended to convey – of one’s life being ended deliberately through the administration of a lethal substance by a doctor or a nurse. The absence of the words “euthanasia” and “voluntary euthanasia” is striking.

Conscientious objection

The provision for conscientious objection in Section 13 of the bill obliges medical practitioners who do not want to participate in ending the life of a patient to make arrangements “for the transfer of care” of the patient to another medical practitioner.

“The transfer of care” is a euphemism for compelling a doctor who does not want to co-operate in ending a patient’s life intentionally to send the patient to another doctor who will do so. This is a travesty of genuine conscientious objection, because it compels doctors to be complicit in acts they believe to be morally wrong and unjustifiable.

When is suicide not suicide?

When he introduced the bill in the Dáil, Mr Kenny argued that “assisted dying” should not be conflated with suicide and that a terminally ill, mentally competent patient who wants to end their life is not suicidal. He said: “I take exception to conflating this with suicide. People with a terminal illness are not suicidal”.

At the second stage, when the government proposed referring the Dying with Dignity Bill 2020 to a special Oireachtas committee to consider the legislation and report back within a year, he referred to “assisted suicide” but that it was irresponsible to conflate assisted dying with suicide, which had very different connotations.

However, it is a distortion of language to suggest that someone who takes their own life with assistance from a doctor is not suicidal.

The word “suicide” means to kill oneself, derived from Latin, sui (of oneself), and caedo (to kill). The words infanticide, homicide, parricide and gendercide derive from the same root. To suggest that someone is not committing suicide when they take their own life with assistance from a doctor flies in the face of the word’s meaning.

Ireland has a national suicide prevention strategy, Connecting for Life, published jointly by the Department of Health, the HSE, the National Suicide Prevention Office and Health Ireland. This defines the word “suicide” and its cognates in fidelity to its root meaning of “to kill oneself”: “Suicide is death resulting from an intentional, self-inflicted act”. The foreword to the strategy states: “Suicide prevention is everybody’s concern. This national strategy sets out what we must do as a government and society to protect and save lives. Since suicide is a ‘whole-of-society’ issue, we’re taking a ‘whole-of-government’ approach….”

One wonders whether the 81 TDs who voted to progress the Dying with Dignity Bill 2020 have ever heard of, or read, Ireland’s national suicide prevention strategy.

Remarkably, in his Dáil speech Mr Kenny did not make any reference to the bill’s provision for voluntary euthanasia. Yet there is a world of difference between a person committing suicide with assistance from a doctor or nurse, and that person having his or her life ended by a doctor or nurse following a request to do so. The World Medical Association defines the former as “assisted suicide” and the latter as “voluntary euthanasia”.

The use of euphemistic language in the Dying with Dignity Bill 2020 is in line with what is happening in other jurisdictions.

In the United States, where assisted suicide has been legalised in some individual states, the legislation is given titles such as Death with Dignity Act (Oregon, Washington State, Washington DC, and Maine); Patient Choice and Control at the End of Life (Vermont); End of Life Option Act (California), Our Care Our Choice Act (Hawaii); Aid in Dying for the Terminally Ill Act (New Jersey). In Canada the criminal code was amended to include “Medical Assistance in Dying (MAID)”, legalising assisted suicide and euthanasia. In Australia the states of Victoria, Western Australia and Tasmania have all passed Voluntary Assisted Dying laws making assisted suicide and euthanasia available.

Dr Noreen O’Carroll is a lecturer in medical ethics at RCSI University of Medicine and Health Sciences.

Tuesday, January 18, 2022

Andrew Coyne: Canada's slippery assisted suicide slope.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Andrew Coyne
Andrew Coyne is a well known Canadian columnist with the Globe and Mail and is a past editor of the National Post. Coyne has commented on assisted suicide on several occasions but today, in the Hub, Coyne clearly states his concern with Canada's MAiD euthanasia law. Coyne states:
I think in particular, though, with assisted suicide, it was how easily the slope became slippery. You know, undergraduates are all taught, “Slippery slopes, it’s just a fallacy.” Well, no, it’s not always a fallacy; some slopes are indeed slippery. And when you see the progression of how that came to pass, where it was initially pitched as people who were in the last agonizing stages of a terminal disease; who were physically unable to end their own lives. I mean, nobody wants to ban suicide, but in this case, they were physically unable to do it, and therefore the argument was, “Well, they have, you know, somebody has to help them to put them out of their misery.” But that’s a very, very narrow case; it was the Sue Rodriguez type of case, and it was almost instantly, instantly elasticized.

First, it was to people who aren’t in that stage now but might be in the future, and therefore, they need to be able to avail themselves of assistance now, because, you know, when they’re in the last age, they wouldn’t be able to do so. Or it started to include not just physical pain, but psychological pain, which is a much more elusive thing to define. And when you started to sort of burrow into the underlying rationale for it, it really didn’t allow for any constraint, as we’re starting to see. Once you accept this idea that this is actually just a basic human right to have somebody else kill you, then are you going to prevent the mentally handicapped from availing themselves of that? Are you going to prevent children from doing so? And of course, when that was first raised, people said, “Slippery slope; this is alarmism,” and they were perhaps unaware that people even then we’re arguing precisely that, and were going to continue to argue precisely that.

So, I think the nature of that I found very disturbing, and it was, at the same time, kind of interesting to unpack it as an intellectual puzzle. How did people go down this road? How do they allow themselves to lose their bearings so much that we could start advocating a society for basically killing disabled children?
Coyne is correct, that Canada has quickly slid down the slide from discussing assisted suicide for difficult cases to accepting euthanasia for psychological suffering and mental illness and now considering child euthanasia.

Previous articles by Andrew Coyne

What is the Good of Euthanasia? Part V: How different policies, from Quebec and Canada, have created a philosophical fork-in-the-road, for Canadian provinces.

Gordon Friesen
By Gordon Friesen
EPC board member

The legal justification for Medical Aid in Dying has two distinct parts. First, there is a purported "right" to "choose" death. Second, there is a claim that euthanasia be considered a legitimate medical "treatment".

Thus far, the acceptance of euthanasia, in Canada (and other places where the "medical aid in dying" vocabulary has been adopted) has depended on a slip-shod conflation of these two justifications, blithely ignoring the fundamental contradictions involved. It is my belief, however, that recent developments in the Province of Quebec are ultimately destined to bring this unstable MAID construct under increasing (and perhaps unsustainable) strain.

In fact, the first significant cracks have already appeared.

How medical provisions in Quebec are expected to differ from criminal immunity under federal law

Following the acceptance of federal law C-7 --extending euthanasia access to those not in imminent peril of death (and after March 2023, even to those suffering uniquely from psychological disorders)-- the provincial legislators of Quebec immediately undertook a review of their own law (QC Bill 52, "Act Respecting End-Of-Life Care").

The two most important recommendations of this review are 1) the acceptance of MAID by advance directive (on reception of a diagnosis of neurodegenerative disease), and 2) the refusal of MAID to those suffering from mental illness only. Both of these proposals are contrary to the federal dispositions of C-7: for Quebec wishes to enable advance directives (which the federal government has refused); and Quebec wishes to refuse MAID for mental illness (which the federal power has approved)!

The table is therefore (apparently) set for a major test of wills. However, this test is not to be based upon substantive disagreement only, but rather, on a true conflict of federal and provincial powers. Quebec, to be clear (as all other provinces) has exclusive jurisdiction in the domain of public health care. This means that Quebec will likely decree that euthanasia for mental illness is not medically justifiable, but that euthanasia by advance directive is. As a result, we will soon see (in all probability), people accessing Maid by advance directive (in the Province of Quebec) even though no criminal immunity has been created to that end in federal law. And similarly (assuming that the March 2023 deadline of C-7 is respected) we will also see people legally dying in Quebec, by euthanasia for reasons of mental illness, even though that province may have declined to define such deaths as legitimate instances of medical assistance in dying.

In other words, there will now be an open, and very significant, disagreement between that which is legally permitted (throughout Canada in virtue of the Criminal Code) and that which is offered as medical treatment (in Quebec, in virtue of provincial health powers). Nor is their any reason that such disagreement be definitely settled any time soon (one way or the other), because both province and federation would seem to be in the right from a constitutional point of view. And the ultimate meaning of these facts will be the realization (should honest clarity prevail), that we are not actually talking about one single thing (MAID), but of two very different things indeed: on the one hand, euthanasia decriminalized to support a purported "right to die"; and on the other, euthanasia justified as medical treatment.

A positive road forward

Throughout this present series of articles, I have attempted to show that the ethical path (and the logical implementation) of euthanasia-as-right-to-die and euthanasia-as-medical-treatment are entirely different and that great harm has already come of confounding the two. Happily then (in Canada at least), it would now appear that our political and legal landscape is actually divided (between the provinces and the federation) in such a way as to naturally force us towards precisely this desirable conclusion. And whether by the genius of our founders (or by the blind luck of historical compromise) we would now seem to be ideally placed to pursue these questions in a dynamic environment of honestly competing principles and policies.

For Quebec is not alone in possessing the real powers (and the potential motivations) required to adopt a distinct vision of medical euthanasia. There are, in fact, ten provinces, each representing populations of varying philosophical persuasions, and each of which benefits from the same constitutional powers described. Quebec has indeed furnished us with valuable precedents in this regard, but other provinces can soon be expected to respond in kind.

For instance, the original medical interpretation of euthanasia was strictly limited to patients who were actually dying. In the critically important Quebec Bill 52, the practice was explicitly defined as "end-of-life care". (And that, by the way, is the only instance in the world of euthanasia actually defined as medical care.) I personally had the honor of addressing the Quebec Special Commission (on the evolution of end-of-life care, 2021 -- french only, audition , memoire ) where I encouraged the deputies present to simply ignore C-7. "Why", I asked, "should Quebec accept a medical interpretation of euthanasia practiced upon people who were not dying?" For quite simply: a rapid study of the reasons proposed for adopting the original law 52 ("An Act Regarding End-of-life Care") reveals that these reasons could not possibly apply to the viable patient (a view with which several of the original architects of that law now concur). Moreover, the rejection of euthanasia, for the mentally ill, would imply that such arguments have not been entirely unfruitful.

Criminal law, and medical practice, therefore, are now on diverging paths. Euthanasia-by-choice and euthanasia-as-medical-treatment, are no longer interchangeable terms. There is no reason why other provinces should not define medical euthanasia in a narrower sense: to maintain the end-of-life provision, or indeed: to reject the notion of medical euthanasia entirely.

No such action would prevent deaths resulting from the legal immunity provided by federal bills C-14 and C-7, which now enable a de facto "right-to-die" (by decriminalizing assisted suicide and euthanasia under prescribed circumstances). However, provincial definitions of medical euthanasia will have a critical impact upon the medical professions, and upon the therapeutic experience of the typical non-suicidal patient.

It is time, I believe, that provincial representatives, everywhere, become aware of the power and the responsibility that they possess in this domain.

January 18, 2022

Gordon Friesen, Montreal (français) (english site in development) (personal philosophical musings)

Sunday, January 16, 2022

Assisted suicide for anorexia nervosa.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The American Clinicians Academy on Medical Aid in Dying (ACAMAID) "Ethics Consultation Service" decided that it is ethical to assist the suicide of a person with anorexia nervosa. The ACAMAID is an organization of medical practitioners who provide assisted suicide. According to the case report:
Female patient with anorexia nervosa requested aid in dying from her palliative care physician. She had participated in multiple inpatient and outpatient treatment programs for eating disorders over the past years without any sustained recovery. Her eating disorder physician, who participated in the consultation call, felt that, although the patient had not accepted or agreed to the “gold standard” treatment of full weight restoration to evaluate brain function, she was terminally ill. This physician as well as the consulting psychiatrist felt that the patient had decisional capacity. The patient was enrolled in hospice and lived with her family who supported her request to access aid in dying.
Sounds like abandonment. Her palliative care physician and psychiatrist had given up on her and her family supported her dying by lethal drugs.

Even though the ACAMAID consultation service acknowledged that:
There is no consensus in the eating disorder literature regarding whether a patient who has severe enduring anorexia nervosa is “terminally” and “irreversibly” ill according to the definition in the State statute.
The ACAMAID consultation service decided that:
If the patient’s eating disorder treating physician and evaluating psychiatrist agreed that she had a “terminal disease” and retained decision-making capacity, she would meet those requirements of the aid in dying statute in her jurisdiction.
Traditionally people asked how do we cure or care for a person? How is it possible to acknowledge that there is no consensus as to whether the patient is terminal or irreversible but then decide if the patients treating physician and psychiatrist believe that she is terminal then she can die? This means that you live if you have a doctor or psychiatrist who oppose killing and you die if you don't.

The approval of assisted suicide for this woman who has struggled with anorexia nervosa is not based on providing a "freedom to die" but rather it is an abandonment of a woman with incredible needs.

The concept of Do No Harm is clearly lost on the ACAMAID as they focus on killing.

A duty to warn Americans after years of medicalized assisted death in Canada

Gordon Friesen
By Gordon Friesen, EPC board member

A proposition for legislative opposition to the medical justification of assisted suicide and euthanasia, based upon years of experience with hyper-medicalized assisted death in Canada

A unique Canadian experience, and a duty to forewarn

It is an unfortunate fact that Canada, since 2015, has had a much greater and more painful experience of assisted death than any other country in the English speaking world. It is therefore to be hoped that our experience may be of some use to those, of similar cultural affinity, who are currently faced with the legalization and expansion of such practices, and particularly, of some help to our immediate American neighbours.

From the Canadian experience, one may rapidly deduce that -- beyond the mere legalization of assisted death as such -- the most pernicious associated phenomenon has been the tendency to justify, to normalize, and to expand this practice as essential medical care.

The conceptual danger of accepting assisted dying as medical care.

Medical care is almost universally perceived as a desirable good. There is, in fact, an enormous volume of political opinion currently supporting the idea of medical care as a basic human right, on the same footing as food or shelter.

Therefore, from the moment that assisted dying (whether assisted suicide or euthanasia) is perceived as medical care, it becomes possible, for its promoters, to claim far-reaching rights of practice, and even, to claim assumed obligations -- of the State, of medical professionals, and of institutions -- to provide assisted dying services, and to actively disseminate information to that end; or at the very least (for individual professionals) to collaborate with, and to provide direct access to, other professionals who will.

Real consequences, as currently experienced North of the Canadian border

In Canada, we now have conclusive and dramatic experience to demonstrate exactly where such thinking logically leads: for of all nations, Canada stands alone in explicitly defining assisted suicide, and euthanasia, as medical care (via legislation in the Province of Quebec that has subsequently been accepted as a de facto national standard) Practical results include the following:

  1. Euthanasia is currently practiced in Canada, to the virtual exclusion of assisted suicide, and that, even though previous legal discussion always centered on assisted suicide, while euthanasia was presented only as an exceptional procedure (to overcome accessibility issues affecting a small number of patients). 
  2. Euthanasia (Medical Aid in Dying) is guaranteed as a "universal right" to all legally eligible patients regardless of doctor opinion (beyond the mere evaluation of eligibility). 
  3. It is mandated that euthanasia shall be practiced in all medical institutions, of any description whatsoever (including, notably, long term and palliative care facilities), with only a trivial number of faith-based exceptions (the total of which, throughout the entire nation, can be counted upon one's fingers). 
  4. It is assumed (although still disputed by some) that all medical professionals must either provide euthanasia themselves (with the narrowest of conscience based exceptions), or that (in any case) they must provide an effective referral to those who will. 
  5. It is decreed, in the ethical guidance provided to doctors by state established governing bodies, that all eligible patients be (proactively) informed of that eligibility. 
  6. For medical professionals in the next generation, it is assumed that the willingness to participate in assisted dying practices will become a requirement of professional certification, and has already become a requirement: for most institutional employment, and even for entrance to professional training. 
  7. Beyond obligation (for those professionals who actively support assisted dying as medical care), the freedom is now granted to proactively recommend (that is in medical terms: to prescribe) such treatment to any patient legally eligible for such (without first receiving a request from the patient themselves); which recommendation, considered from a classic perspective of suicide prevention, represents an unconscionable psychological aggression.

The case for maintaining that all such measures are not medically justied

Clearly, all of the above innovations (currently being normalized throughout the entire Canadian medical industry), are entirely dependent upon the definition of assisted dying (ie. euthanasia) as standard (even essential) medical care. And yet there is no reason why any such definition should be admitted.

On the contrary: there are not, and never have been, agreed, objectively verifiable medical indications for the prescription of assisted dying to any particular patient (which is the first requirement of clinical medicine); the fundamental justification for all assisted dying has always been the autonomous desire of the individual patient. Nothing in the possible permission granted to medical professionals, to practice assisted dying, could possibly be construed as justifying the professional rights and obligations associated with typical medical treatment.

The institutional support for such a position

At the present time, the Swiss medical association (in a country where access to assisted suicide is not only legal but has allowed the creation of a tourist-based industry) still considers assisted dying to be fundamentally at odds with the medical mission. The Dutch Medical Association (where euthanasia has been legal for 20 years) calls the practice medically "exceptional". The American Medical Association (where several States have legalized assisted suicide) flatly condemns assisted suicide and euthanasia. The British Medical Association has only lately amended their traditionally oppositional stance, to a merely "neutral" policy. Most tellingly of all: the World Medical Association recently (2019) felt it necessary, after a prolonged and extensive exercise of formal consultation on all the continents, explicitly reaffirmed their policy, to the effect that assisted dying is medically unethical. The Canadian Medical Association, to their shame, were notably isolated in resigning from the WMA subsequent to that decision.

The question must be asked: Why on earth should any credence be given to the interpretation of assisted dying as benign, standard, (even essential) medical care, which has been injected by judicial and legislative action, not in response to true medical opinion, but demonstrably in opposition thereto? And how can this fictitious definition of assisted suicide and euthanasia, as "medical aid in dying" be prevented from creating the pernicious professional rights and obligations observed above?

A suggested strategy of disallowing the medical justification for assisted dying

It the present situation nothing, other than opposing assisted death as such, can be considered as important as opposing the medical justification of such practice.

Even though the historical context of these debates has ensured that assisted death (where legalized) be restricted to the actions of medical professionals only; and even if medical criteria are invoked to determine who may or may not be legally permitted to seek such assistance: there is no reason to accept the assertion that assisted death is, in fact, medically justifiable.

Therefore, it is the duty of all those who oppose these practices, to see that this pernicious connection be snipped in the bud.

A proactive legislative agenda

One proposed method of attaining this goal is through deliberate, consistent, legislative action:

  1. Each time that legislation is introduced, for either the legalization or the expansion of assisted death, amendments should be introduced which expressly deny the medical justification of same. This is not the same as opposing adversarial bills as such. At the appropriate time, all of our allies must argue and vote against any such initiatives on principle. However, as a separate and equally important practical matter, even if such legislation should pass, it should also (ideally) contain language expressly disavowing any assumed medical legitimacy, or obligation. 
  2. To the extent that resources are available, proactive initiatives should also be undertaken to amend existing legislation to this effect.

A proposed model for future legislation

The following text is intended as a first draft in the elaboration of such a general case clause, to be inserted in all existing and future assisted death legislation:

"Because assisted suicide (and euthanasia) are purportedly justified, above all, by personal choice; because (in the general case) there is no agreement on the medical legitimacy of assisted suicide, or euthanasia; because (in the particular case) there is no agreement on the objective conditions which would indicate the use of assisted suicide, or euthanasia (not as a right of choice, but as a true, objectively justified medical treatment); because, therefore, the term "medical assistance in dying" signifies only a "death facilitated or caused by medical professionals", but not a "death facilitated or caused as an objectively indicated medical procedure"; and because of the public and personal interest in limiting the propagation of suicidal suggestion: be it resolved that,

1. Assisted suicide (and or euthanasia) be allowed (if allowed at all) by permission only, creating no obligation of any kind to provide (or to assist in the provision of) these services, whether such obligation be portrayed as public, private, or institutional. And in particular:
    a) i) the public powers of government, and administration, shall have no obligation, and no mandate (express or implied) to provide or to insure access to assisted suicide, or to euthanasia.
        ii) no public resources shall be directed towards the provision of such services, or of information facilitating same
    b) no institution, whether public or private, shall have any obligation to provide assisted suicide (or euthanasia), nor obligation to permit such practices in premises under their administration.
    c) no individual, whether doctor, medical professional, or other, shall have any obligation to provide assisted suicide, or euthanasia; nor to provide information pertaining thereto; nor to provide any referral for the provision of such service, or of such information.

2. Regardless of any permission for medical professionals to provide assisted suicide, or euthanasia, pursuant to a properly expressed patient choice: it shall remain a criminally culpable act for such professionals (or any other individual) to proactively prescribe assisted suicide (or euthanasia); to proactively counsel a recourse to assisted suicide (or euthanasia); or to proactively provide any information, whatsoever, concerning assisted suicide (or euthanasia).

Gordon Friesen, Montreal, January 15, 2022

Friday, January 14, 2022

Assisted suicide becomes a wider option in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Halifax Examiner published an article on January 13 by Yvette d'Entremont concerning new options for assisted suicide in Nova Scotia and Canada. The article outlines how nearly every (MAiD) assisted death is done by euthanasia (lethal injection) in Canada. A lethal drug cocktail has now been approved to enable an "oral option" otherwise known as assisted suicide.

d'Entremont reported Jocelyn Downie, Canada's leading pro-euthanasia academic, as stating:
“Ultimately it’s grounded in the twin values that should be behind our MAID decisions, which is respect for autonomy, so the capacity for self-determination, for charting the course of your own life and death, and then the alleviation of suffering,” Downie said in an interview.

“This is just another element in respecting autonomy. It’s providing another pathway for people to realize their goal of alleviating their suffering on their own terms. It’s not the kind of development that we’ve seen in the past few years. It’s not seismic. But I think it’s consistent and it’s a completion.”
Memorial University medical ethics professor Daryl Pullman who published an Impact Ethics piece last November comparing the number of MAID deaths in Canada in 2020 to the “dramatically lower” number that occurred in California under its assisted suicide law. d'Entremont reported Pullman as stating:
…Given the significant number of patients in California who meet the criteria for an assisted death, who receive the lethal prescription, but then never follow through, for some simply knowing they have the option seems sufficient,” Pullman wrote.

“The decision not to follow through with ending one’s life is also a matter of autonomous choice. But it is a choice that seems all too rare in the Canadian context, and we should worry that some who initiate the MAiD process might then feel compelled to follow through.”

My anecdotal experience from talking with friends and family members of people who have died by (MAiD) euthanasia in Canada is that there is pressure to complete the act. I refer to it as getting on the euthanasia train. There are very few places where the train stops in Canada.

Concerning the radical difference between the number of assisted deaths in California as compared to Canada, Pullman states: 

“Doesn’t this disturb anybody that these numbers are so blatantly different,”
Pullman expresses further concern about the expansion of Canada's law to permit euthanasia for mental illness alone. d'Entremont reports:
“The Canadian Parliament seems more interested right now in waxing the runners on the sleigh than in actually trying to assess whether or not the hill we’re going down is pretty steep. We seem to be rushing headlong for a precipice here,” Pullman said.

“We’re medicalizing suicide in Canada, effectively, so that people who, for whatever reason, judge their life to be unacceptable they can, under this legislation, get medical assistance in ending their life and that’s a little bit disturbing.”
The approved protocal for assisted suicide (oral option) requires that an IV be inserted first in case the assisted suicide drug cocktail doesn't work.

Downie disagreed with Pullman, but that is not surprising because she has radically promoted euthanasia for years.

The article concludes by stating that according to Nova Scotia Health, since 2018, of the 1,389 patients, 29 (2.1%) who were referred for MAID have paused or withdrawn their MAID requests.

When only 2.1% of the people in Nova Scotia who ask for euthanasia change their mind, clearly the mantra's of choice and autonomy ring hollow.

Thursday, January 13, 2022

Assisted suicide lobby knows that the lethal drug cocktail causes a painful burning sensation.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In October 2021 I published the article - Assisted Suicide deaths are not what you think they are where I explained the recent research by Dr Joel Zivot proving that assisted suicide is neither painless nor dignified and I outlined the research that is being done by the assisted suicide lobby to find a cheap effective way to kill.

Assisted suicide activists have been experimenting with lethal assisted suicide drug cocktails, for years, to find a cheaper way to cause death.

An article published in USA Today in February 2017 reported on the experiments that were done on people to find a cheaper lethal drug cocktail for assisted suicide. The article stated that assisted suicide researchers were experimenting on new generations of lethal drug cocktails. The results of the first two lethal drug cocktails were:

The (first) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.
Link to video by Dr William Toffler of Oregon on this topic (Link).

An article by Lisa Krieger published by the Medical Xpress on September 8, 2020 also reported on the lethal drug experiments. Krieger wrote:

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."
The American Clinicians Academy on Medical Aid in Dying recognizes that one of the compounds used in the assisted suicide drug cocktail will cause a burning of the throat.

The assisted suicide lobby has advised the following:

The most important factor in working with this is to advise the patient in advance that there may be burning. If the patient is surprised by the burning, it is much more severe and upsetting. As with any medical procedure, detailed information and calm reassurance before, during, and after ingestion are essential. And in this case, also advise the patient that any discomfort is quite brief -- typically only a few minutes before analgesia and unconsciousness. (If a clinician is not present at the bedside, this information should be conveyed by verbal and written instructions before ingestion.)

Calmly instruct the patient that stopping the ingestion mid-way only makes it worse by creating a more prolonged mucosal exposure to the amitriptyline. ...Encourage the patient to continue swallowing and relief is on the way as soon as full ingestion of the medications is completed.

The following comment re-enforces the goal of the assisted suicide lobby:

Yes, I know this all sounds terrible, and makes one wonder why we use the amitriptyline. First, extensive data shows that having amitriptyline as part of the aid-in-dying medications leads to more reliable results, significantly decreasing the risk of prolonged deaths. When patients are offered medications that are less reliable but taste somewhat better and don't burn, they invariably select reliability.

Remember, assisted suicide drug experiments are being done to find a cheaper, effective way to kill and are being done without ethical oversight.

These experiments appear to lack proper consent. When someone consents to die by assisted suicide that does not mean that they are also consenting to be part of a lethal drug experiment.

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.