Thursday, December 29, 2022

The media are promoting Nitschke and Sarco again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Philip Nitschke, also known as Dr Death, is being promoted again for his Sarco suicide machine. 

Before making comments on the latest media promotion of Nitschke and Sarco, let it be known that Nitschke is in the business of suicide. He sells suicide kits, suicide substances, suicide instruction books, suicide gadgets and he provides online suicide advice. He is a suicide zealot.

Recently, the parents of two teens sued Amazon for selling a suicide substance with instructions that was being distributed by Philip Nitschke.

I have avoided commenting on Sarco because from its inception I viewed it as a gimmic to send people to Nitschke's suicide site to buy his suicide products.


Let's just say that Nitschke regularly floats a story to the media to gain more interest in his suicide selling website.
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Tuesday, December 27, 2022

2022 EPC Year in Review. Stories and changes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

2022 was a year of victories, defeats and changes. The most important victory was the Massachusetts Judicial Supreme Court decision that there is no right to assisted suicide in their state Constitution. Possibly the sadest defeat was Oregon agreeing to remove it's assisted suicide residency requirement, essentially extending assisted suicide nationally in the US. 

In Canada, 2022 will mark the year that Canadians woke up to the fact that, after passing Bill C-7 in March 2021, Canadians with disabilities are being killed by (MAiD) euthanasia because of poverty, homelessness and an inability to obtain necessary medical care. The stories related to euthanasia for disabled Canadians, veterans with PTSD and people who are unable to access proper care resulted in the government delaying the implementation of euthanasia for mental illness.


2022 Year in Review.

In January - We learned about assisted suicide being approved for anorexia nervosa (Link) and Andrew Coyne wrote about Canada's assisted suicide slippery slope (Link).






In July Dr Ramona Coelho wrote an excellent article on why Canada's euthanasia law is the most permissive in the world (Link). 

In August The National Post published an article on how  Canada is getting comfortable with killing people with disabilities (Link) and I wrote an article about a baby who was declared "brain dead" but began to breath on his own (Link).



In November an article was published about Roger Foley who was pressured to request euthanasia (Link) and an article promoting euthanasia featured Ellen Wiebe who has killed more than 400 people by euthanasia (Link).


In 2022, Amy Hasbrouck resigned as EPC President after many years of excellent service while Gordon Friesen became the new EPC President. 

The Euthansia Prevention Coalition continued to be the world leader opposing euthanasia and assisted suicide and we organized the first meeting at the European Parliament opposing euthansia.
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No Other Options. An exposé on euthanasia in Canada.

"euthanasia seems like the only way out"
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Alexander Raikin wrote an exposé on the experience with Canada's (MAiD) euthanasia exposé titled No Other Options . His exposé was published in The New Atlantis on December 16. Raikin provides important insights into Canada's experience with euthanasia that should be read by everyone concerned with the issue (Link to the article).

Raikin writes his article as an investigative reporter into Canada's Medical Assistance in Dying (MAiD) law. He begins the article by speaking with Dr Stefanie Green one of Canada's leading euthanasia doctors. Green tells Raikin that:
The procedure, she assures me on our call, is “100 percent effective.” If her patient asks to die, and if her schedule, her ethics, and the law permits it, she will administer a lethal injection.
To create context, Raikin quotes David Lametti, Canada's Justice Minister, who stated:
Supporters insist that this is not state-sanctioned suicide. Rather, it’s a dignified solution for those who no longer wish to suffer from terminal or chronic illness. MAID allows “for compassionate action, while also protecting those who are particularly vulnerable,” claimed David Lametti, the attorney general and minister of justice, in 2021.

Raikin then quotes from Prime Minister Justin Trudeau: 

Prime Minister Justin Trudeau has long promised to strike just this balance. In 2019, while pressing the need to expand access to euthanasia, he assured that people will be able to choose assisted death “in a way that isn’t because you’re not getting the supports and cares that you actually need.”
This is the promise of medical assistance in dying: that vulnerable people who want to die for the wrong reasons will be encouraged to live, as they always have been — while people who want to die for the right reasons will have their autonomous decision upheld. If even a single vulnerable person were pushed into assisted death, it would be a scandal to the system. That is why safeguards were put into place.
Raikin states:
As this article will show, in internal meetings, those close to the system have long talked openly about red flags that many people are choosing euthanasia because they’re not getting the “supports and cares” they need. The physicians in charge of the process not only know that this is happening, but they have discussed it in seminars, collected evidence, and then kept it quiet in public.

The safeguards promised by Trudeau and others to prevent vulnerable people from heading down the road to euthanasia turn out to be vague, pro forma, and easy to get around by doctor-shopping.
The quotes from Lametti and Trudeau are important considering the scandal of euthanasia for people with disabilities because of poverty, an inability to obtain needed medical treatment or care, homelessness, neglect and abandonment.

Raikin then comments on the number of people who have died by euthanasia.
One of the greatest reasons for concern is the sheer scale of Canada’s euthanasia regime. California provides a useful point of comparison: It legalized medically assisted death the same year as Canada, 2016, and it has about the same population, just under forty million. In 2021 in California, 486 people died using the state’s assisted suicide program. In Canada in the same year, 10,064 people used MAID to die.

...But the picture that emerges is not a new flowering of autonomy but the hum of an efficient engine of death.
Raikin's interview with euthanasia provider Stefanie Green continues:
Asked on a call about stories of abuse, she raises her voice and says, “you cannot access MAID in this country because you can’t get housing. That is clickbait. These stories have not been reported fully.”
Raikin reminds us that the Supreme Court of Canada, in the Carter decision that legalized euthanasia wrote that:
“a permissive regime with properly designed and administered safeguards” would be “capable of protecting vulnerable people from abuse and error.”
To add context, Raikin quotes from former Senator James Cowan who said:
“We have four or five years of experience now, and absolutely no indications, that I’m aware of, of alleged misuse or poor decisions,”
Helen Long, the CEO of Dying with Dignity told MacLeans magazine:
arguing that the stories that people “who are not able to access supports like safe and affordable housing are opting to have MAID instead” are “simply not true and there is no evidence that I’m aware of to support those claims.”
Raikin then points out that Green, Cowan and Long are denying what they know to be true. Raikin quotes euthanasia provider Madeline Li who testified to a parliamentary committee that:
...legislated safeguards are “impotent.”

“I believe the Canadian populace and maybe even the legislators are not aware of who has been qualifying for MAID.”
Raikin then proves that the euthanasia lobby are aware that people are dying by euthanasia because of poverty, access to medical treatment and housing. He writes:
The Canadian Association of MAID Assessors and Providers, the leading organization of Canadian euthanasia providers, has sat on credible evidence by its own members that people are being driven to euthanasia by credit card debt, poor housing, and difficulties getting medical care. These are people who do have some sort of medical condition but in many cases are using these conditions to check a box in the approval process, when the relief they are mainly seeking is from other forms of suffering. And the system is doing much more to help them down the path toward death than to protect them as the public was promised.
Raikin uncovers a presentation by Althea Gibb-Carsley, a retired care coordinator and social worker of the Vancouver Coastal Health’s assisted dying program. The title of her presentation asked, “What is the role of the MAID assessor when resources are inadequate?”

Gibb-Carsley describes several people who qualified for euthanasia. Mary (55) with fibromyalgia and chronic fatigue who can't afford the food and supplements that would lessen her health issues and identified poverty as driving her to MAiD. Nancy (68) a physician with chronic pain following a car accident who didn't save any money. Greg, 57, a writer who has diabetes, cardiac problems, anxiety and depression, and a history of trauma. Lucy, a 38-year-old trans woman, is an immigrant who has pain, osteoarthritis, depression, and anxiety.

Raikin reports that Gibb-Carsley concludes her presentation by stating:
these patients have “no other options” because of their poverty, their housing situations, their difficulty getting medical care. “I think you will find, and you know already,” she says to her audience of euthanasia providers, that if you want to offer your patients some alternative to MAID, “this will often mean a referral to not very much, and certainly not very fast.” It’s not that they are terminally ill or truly beyond help, but that they can’t get the help they need in the system right now, so euthanasia seems like the only way out.
Raikin then states that it is important what Gibb-Carsley didn't say:
Of Mary, the patient who identified “poverty as the driver of her MAID request,” we do not hear that the system discouraged and denied her application. Of Greg, who the slides say “identified housing as [a] driver” of his euthanasia request, we hear that he is “getting very close to needing to set a date” to be euthanized — and again, not that any effort is being made to stop him. Of Nancy, for whom “uncertain housing is the driver,” we hear of no effort to stop her.
Raikin then explains that people must be protected from abuse.
If the MAID system were working as promised, the presenters should be warning attendees that they must be vigilantly on the lookout for just the kinds of cases described in the seminar, scrupulously ensuring that they are not approved for euthanasia.
Raikin points out that the presenter and the audience understood that these were serious problems, in fact Gibb-Carsley states:
“Our silence is our complicity,”
Raikin shows how they were examining the problem from the wrong point of view. Rather than viewing these issues within the context of changing the implementation of euthanasia they were viewing it within the context of:
an opportunity to highlight the real problem: the inadequacy of the welfare state.
Gibbs-Carsley states that these assessments can be used to leverage the government for improved welfare. She then states:
Your Assessments provide a rare opportunity to hear from the typically disenfranchised patients about their experiences.” The subtext of this sunny euphemism is that giving a voice to the voiceless will, for many, ultimately mean killing them.
The euthanasia assessors are then told that they can withdraw from these cases but they will be obligated to refer those patients to assessors who will be willing.
 
Earlier in the interviews Stefanie Green referred to these stories of abuse as:
“clickbait” that “have not been reported fully.”
Raikin then examines why these deaths are happening in Canada. He writes:
A core reason that Canada’s assisted dying program has grown so much faster than any other program in the world is that it is the most permissive. Eligibility criteria began loose and are rapidly getting looser. You do not need to be terminally ill, only to have a “grievous and irremediable” condition, a standard that is open to significant differences in interpretation. In March 2023, mental illness alone will qualify as an acceptable medical reason to die. And the Quebec College of Physicians now suggests that Parliament expand euthanasia eligibility to minors and even newborns. (Euthanasia for mental illness alone will be delayed).
Raikin then states that the safeguards are clearly not working.

Raikin then interviews Dr Paul Appelbaum, a professor of psychiatry for 40 years, who developed the test to determine mental competency for medical decision making. Appelbaum commented about the test used to assess competency for euthanasia:
“it doesn’t strike me as a particularly well-thought-through evaluation process.” Among other things, “it’s not clear from these forms how an evaluator would decide that a condition is ‘grievous and irremediable,’” he says, quoting one of the key legal criteria.

Moreover, the initial screening questions for depression and anxiety “are not detailed enough to result in a diagnosis, and even if they did, the impact the answers to these questions are supposed to have on the final decision about authorizing MAID is unspoken.”
Dr Mark Komrad, a clinical psychiatrist and ethicist who helped craft the American Psychiatric Association’s statement against euthanasia for patients who are not terminally ill called the evaluation process as: 
“Death by checklist!”
Raikin continues by writing:
when I asked Stefanie Green how she decides whether a patient with a mental health condition has the competence to choose euthanasia, she said that she makes a judgment call about whether a patient has an “active” or “stable” case of mental illness. For “active” cases, she will consult a specialist; for “stable” cases, she proceeds on her own. Green is not a psychiatrist, so I asked Appelbaum about her framework. “It’s not a distinction that makes any sense to me,” he says.
Raikin points out that the law allows any doctor or nurse practitioner to assess someone for euthanasia without requiring further training.

Raikin then writes about how easy it is to die by euthanasia in Canada. He begins by pointing out that if an assessor rejects someone for euthanasia that all they need to do is go to another assessor. Raikin explains:
In another CAMAP seminar recording, we learn of a man who was rejected for MAID because, as assessors found, he did not have a serious illness or the “capacity to make informed decisions about his own personal health.” One assessor concluded “it is very clear that he does not qualify.” But Dying with Dignity Canada connected him with Ellen Wiebe, a prominent euthanasia provider and advocate in Vancouver. She assessed him virtually, found him eligible, and found a second assessor to agree. “And he flew all by himself to Vancouver,” she said. “I picked him up at the airport, um, brought him to my clinic and provided for him,” meaning she euthanized him.

Jocelyn Downie states in a seminar that you can ask as many assessors as you want or need disagreement doesn't mean you must stop.
Jocelyn Downie
Downie stated in euthanasia seminars that:
“There is no certainty or unanimity required. There is not perfection required,” says Downie. The result: There are many paths available to reach the end, and you only need to find one. The system makes it easy to die.
When asked by email how these statements reconcile with safeguard reassurances that have been offered to the public, Downie responded:
“This is an inaccurate characterization of what I said and did at the two seminars.” She did not specify the nature of the inaccuracy.)
The fact is that the rules surrounding euthanasia are subjective and enforcement of the procedure is lax. Nancy Hansen, the Director of the Disability Studies program at the University of Manitoba, told Raikin that in effect:
“there’s no consequences for non-compliance” with the law.
When asked for her response to her earlier comment, Weibe said:
“It is rare for assessors to have patients who have unmet needs, but it does happen. Usually these unmet needs are around loneliness and poverty. As all Canadians have rights to an assisted death, people who are lonely or poor also have those rights.”
Raikin continues his exposé by writing about Les Landry and Rosina Kamis.

Landry, was a truck driver who had a reaction to anesthesia in 2009, which led to his disability. When Landry was turning 65 he requested euthanasia based on poverty. Landry told Raikin:
“I turned 65 [and] lost all m[y] disabilities benefits and now a senior in poverty. I am not going to live my life like this.” On December 2, Les received his first approval for euthanasia. He is now waiting for the second and final approval. And he says he will doctor-shop until he gets it.
Rosina Kamis (41) requested euthanasia because she was in constant pain from her fibromyalgia, had chronic leukemia and a myriad of other mental and physical illnesses. But there was much more to her story. Raikin did an investigation and learned:
Oftentimes, Rosina was hungry. The artificial light in her room would make her migraines worse. It was loneliness driving her to MAID, that she “must suffer alone” with her service dog — which she could “easily lose,” as her landlord was trying to evict her and she had nowhere else to go. It was that she didn’t want her physicians to harm her by changing her pain medication, as they sometimes did. It was that she was “scared” of being institutionalized; that what she needed to live was not what she could reasonably expect to get; and that others would benefit from her death because MAID “is the best solution for all.” Her choices seemed slim. When her fingers hurt, she couldn’t make food. She would post a video of herself going to bed, in her dark room, hungry and crying.
Rankin then states:
Rosina showed one face of her suffering to the MAID system, and another to her confidants. To the latter, the reasons she gave for really wanting to die were not physical suffering. “Please keep all this secret while I am still alive because … the suffering I experience is mental suffering, not physical,” Rosina wrote in a message apparently intended for her powers of attorney. “I think if more people cared about me, I might be able to handle the suffering caused by my physical illnesses alone.” To her two dozen subscribers on YouTube, she said, “Sometimes all the pain will go away just by having another human being here.”
Raikin explains:
Rosina was approved, and specifically asked to die on the date of her ex-husband’s birthday. Rosina died in her shared basement apartment on September 26, 2021, after a doctor gave her a lethal injection.
Raikin further assesses the reality of euthanasia in Canada. He writes:
Whatever your view on euthanasia, stories like Les’s and Rosina’s are not entirely straightforward. In many cases it is hard to sort out the tangle of internal and external reasons someone might make a voluntary request to die. But that is precisely the problem. Canadians were promised a system that would distinguish a rational choice to die from a desperate cry for help. But in stories like Les’s, Rosina’s, and so many others, that distinction breaks down.

This is particularly true in cases where a patient seeking euthanasia has a history of depression. As the psychiatrist Paul Appelbaum told me: “People with depression can be extremely rational in explaining the reasons for the decisions that they’re making. And what is most difficult is to separate the effect of the depression on that decision from what their underlying non-depressed motivations might be.”
Raikin explains that the law requires that a person have an “incurable” and “irremediable” medical condition. Even the euthanasia lobby knows that this is often not the case. Raikin states:
According to an internal study of MAID assessments, presented to CAMAP in 2022, of 54 patients who were not terminally ill, two-thirds had concurrent mental illness. A fifth of the patients had difficulty finding “appropriate” treatment. And, most disturbingly, over a third of patients were “not offered appropriate / available treatments.”
Raikin refers to euthanasia doctor, Ellen Wiebe as an example.
Ellen Wiebe, the poster child for Canadian medical death — in 2016 Maclean’s covered her as a visionary. She has since become one of the most prolific MAID providers, having personally euthanized over 400 patients. In testimony to a parliamentary committee, Wiebe said that she would consider a patient on a five-year waitlist for an effective treatment to have “irremediable suffering.”

Elsewhere, in a public talk, Wiebe described a recent procedure she performed, saying, “It was a beautiful death.” And she admitted that the real difficulty is not protecting the vulnerable from abuse: “Angry family members are our greatest risk,” she says, and laughs.
Even the Simons euthanasia commercial, All Is Beauty, featured a woman who didn't want to die. Raikin explains:
an ad video by the Canadian fashion company La Maison Simons, titled “All Is Beauty,” went viral online. It told the story of Jennyfer Hatch, a 37-year-old-woman with Ehlers-Danlos syndrome who had chosen euthanasia. Slickly produced, the video showed slow-motion images of people gathered on beaches. At one point it describes “the most beautiful exit,” apparently referring to MAID. Hatch was euthanized the day before the campaign launched. She had told friends and interviewers that she wanted to live, but couldn’t afford it.
Raikin suggests that the tide is turning with relation to euthanasia and quotes from disability scholar Catherine Frazee who says:
has observed patients who become fixated on MAID, who under different circumstances, before MAID was a part of our culture, would have carried on living through difficult times, or who would have pursued treatment options with a reasonable chance of success even though doing so would be temporarily unpleasant or uncomfortable. Many people who are not at risk of suicide are nevertheless at risk of MAID, especially so because it has been so quickly embraced as an honourable, “dignified,” idyllic form of death.
Amy Hasbrouck, a disability advocate told Raikin:
MAID is a way to “get rid of disabled people.” It’s an extreme view. Yet it is possible to imagine a euthanasia system that is set up without that intention, even one that is nominally set up to protect the vulnerable — and yet that, step by step, becomes indistinguishable from a system deliberately designed to usher them to their deaths.
Euthanasia doctor Madeline Li told a Parliamentary Committee that:
“I’ve certainly had cases where I felt compelled to provide MAID against my better clinical judgment because the law did not adequately protect.”
While psychiatrist John Maher, editor of the Journal of Ethics in Mental Health, who told a Parliament committee that:
he has patients who could get better but “are now refusing effective treatment to make themselves eligible for MAID.”
Raikin ends his exposé by stating:
From Rosina, Les, Mary, Nancy, Greg, Lucy, and so many others across Canada, what we hear are the cries of people in despair asking for help. Just a few years ago they would have been textbook candidates for what a just society would say: Your life has value. In Canada today they hear something else: Your death will be beautiful.
Links to more stories of the euthanasia experience in Canada:

  • Toronto Star: We need to put the brakes on euthanasia (Link).
  • Globe and Mail: No to euthanasia for mental disorders (Link).
  • Veterans affairs worker advocates euthanasia for PTSD (Link).
  • Canadian man claims that he was pressured to request euthanasia (Link).
  • Why did they kill my brother (Link).
  • Manitoba woman died by euthanasia based on inadequate home care (Link).
  • Quebec man seeks euthanasia based on changes to home care (Link). 
  • Alberta man requests euthanasia based on poverty (Link).
  • Ontario man approved for euthanasia because he can't get medical treatment (Link).
  • Shopping for doctor death in Canada (Link).
  • Gwen is seeking euthanasia because she can't access medical treatment (Link).
  • Euthanasia for disability and poverty (Link).
  • Euthanasia for Long Covid and poverty (Link).
  • Canada's MAiD law is the most permissive in the world. (Link).
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Ontario Family Reeling from Loss of Love One.


FOR IMMEDIATE RELEASE

Ontario Family Reeling from Loss of Loved One: 

When the Medical Community Abandons Power of Attorneys (POA) and Substitute Decision Makers (SDM), the Fallout Affects Us All

[Toronto, Ontario. December 24th, 2022] 

On June 4th 2022, Nicola Angelo Marchione, a Guelph resident, died shortly after his feeding tube was removed, without his or his decision maker/POA’s consent at a hospital in Kitchener, Ontario. Mr Marchione dialysis was removed earlier the same day, also without his or his family or decision maker’s (POA’s) consent. Multiple requests for Mr Marchione’s medical records, and information concerning why informed consent was not obtained from either him nor his POA, were never responded to, nor any information or answers provided since.

Following multiple visits to a hospital in Fergus, Ontario, from January to May 2022, due to shortness of breath, followed by medical issues related primarily to the change of his medications and side effects from these, Mr Marchione was admitted to hospital in March for feelings of increasing heart rate after a medication was stopped cold turkey. He was given a new medication called Amiodarone, a drug which has substantial and significant side effects, none of which were disclosed to Mr Marchione upon admission, nor to the family. After concerns over the effects of the medication, numerous attempts to speak to the specialist who prescribed it were made, however all contact and efforts were ignored. In May, Mr Marchione returned to the hospital with symptoms of his leg feeling weak, this was his final readmission there, only this time he would leave that hospital with septic shock and renal failure. 

Abandonment of a patient, neglect, lack of informed consent, ageism, elder abuse, etc., these are the matters under investigation in Mr Marchione’s death. Why were this man’s concerns or his family concerns never addressed? Why should citizens have advance Power of Attorney established only to be overruled by the doctor on call or medical specialist in charge? This case has too many unanswered questions. It has become apparent that the nurses and medical team resonsible are not responding to valid concerns or requests for information. This matter has been escalated to the Directors of both hospitals, Patient Ombusdman, Chief Coroner’s Office, and local Police athorities for active investigation.  

This is the lasting memory that Nicola Marchione’s family has of him: Unattended, abandoned to his medications, pulling at a Kleenex box in a state of shock and unrest while at the hospital prior to transfer. His final words to his family were, “I’m having trouble breathing, I think I’m going to die.” He was clearly experiencing distress. Mr Marchione’s family deserve closure: His spouse and children deserve answers, and the larger public community and concerned citizens deserve answers and those responsible need to be held accountable.

To speak to the Marchione family for comment in relation to this case and its details, please contact Angela Marchione-Faragher at 519-831-4377 or email: angiefilms@yahoo.ca for interviews and comments. Additionally, media inquiries can be made to Kathy Matusiak Costa at 519-439-6445 or email info@beingwith.org

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Friday, December 23, 2022

The Uniform Determination of Death Act (UDDA)

By Sara Buscher, a lawyer and Chair, EPC - USA

The Uniform Law Commission writes model laws that states can adopt though their legislatures. A current effort is underway to revise the Uniform Determination of Death Act (UDDA) which created the concept of brain death. I and others observed the drafting committee’s two-day meeting in early December. If this project stays on schedule, a new model law will be adopted by the Commission in July.

The current uniform act has been adopted in some version by all 50 states. It says:
“An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.”
Reasons others have offered for seeking changes to the existing UDDA include:
 • Eliminating lawsuits by family members, especially by parents of children declared brain dead.

• Making it easier to ration medical care, especially Intensive Care Unit beds.

• Making somewhat more organs available for transplant.
What the revised law should say is controversial

A letter to the drafting committee signed by 107 experts in medicine, bioethics, philosophy and law (hereafter, “letter”) says the current brain death law was based on an assumption that the body would disintegrate without the whole brain functioning. This assumption is now known to be false. “Now it is widely accepted that brain dead bodies are biologically living organisms.” Those who signed the letter have four different ideas about how the law should be rewritten, ranging from eliminating brain death to recognizing it as a legal fiction. (Link to the "letter") 

Without a consensus about how to determine if a person is “brain dead”, the drafting committee is headed toward letting the physician at the bedside decide. Their current draft does this by defining medical standards as Guidelines issued by national medical organizations like the American Academy of Neurology (AAN). According to the letter, these Guidelines characterize brain death as a clinical diagnosis “…that can be made by bedside examination alone.” This does not address the significant variation in brain death determinations across the country. (Link)

By declaring the brain injured dead, we have not prioritized research on how to treat these injuries or heal brains. We now know that the brain can heal. Adrian Owen in his book, Into the Grey Zone describes how some brain injured people who appear to be unresponsive and unaware actually have intact minds within their injured brains and bodies. Even those who did not respond during his experiments proved to be thinking. One young man “woke up” and visited with Adrian. He had total recall of all the experiments but had appeared to be completely unaware. Early on his mother was told he was brain dead and yet he recovered and returned to school, even though he was disabled. See chapter titled “Back from the Dead” describing a patient named Juan.

Lawsuits and Family Roles

With the decision left to the physician at the bedside, there will be no statutory criteria by which to legally say a living patient has been misdiagnosed as dead, thereby making it more difficult for lawsuits to succeed. The committee is working on language about how families would be notified and their objections handled, including a “reasonably brief” time to gather at the bedside after death has been declared. This could limit the role of families.

Rationing and Discrimination

Rationing medical care would be made easier by just declaring a high cost patient dead, followed by removing life support. During the COVID pandemic the aging and disability communities responded to crisis standards of care that rationed care in a discriminatory way. These national efforts and resulting documents are housed at (Link) and (Link). The U.S. Department of Health and Human Services (HHS) Office for Civil Rights ruled on several complaints that were lodged with them. This office {The Office for Civil Rights (OCR) enforces Section 1557 of the Affordable Care Act (Section 1557), which prohibits discrimination on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, gender identity, and sex characteristics), in covered health programs (Medicare, Medicaid, and various health insurance policies) or activities. 42 U.S.C. 18116.]

It is fairly well known that organ donation and distribution discriminate on the basis of race. A review of the incidence of brain death found African Americans had the highest per capita rate of being declared brain dead of any race with whites being the lowest. Incidence of brain death in the United States, (Link) African-Americans comprise 12.9% of the population and 34% of the kidney transplant waiting list. (Link) The number of organ transplants performed on blacks in 2020 was 27.7 percent of the number of blacks currently waiting for a transplant. The number of transplants performed on whites was 47.6 percent of the number currently waiting. (Link)

Organ Donation

About twice as many organs are donated after brain death (9,189 in 2022) than are after circulatory death (4,338) according to the Organ Procurement and Transplantation Network (OPTN). Data extracted at: (Link). This only makes sense because in hospital circulatory deaths are 43 times more likely than brain death. (Link) at Table 1.

OPTN’s strategic plan has a goal of increasing the number of transplants by exploring ways to increase the use of organs after cardiac death and to facilitate emerging organ perfusion technologies. (Link) Significantly it does not call for increasing organs from brain dead people.

Research finding ways to manage diseases that cause organs to fail and to develop other sources of organs such as those grown from the patient’s own adult stem cells would be other ways to address this.

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Wednesday, December 21, 2022

Belgium euthanasia (2020-21 report). 2700 euthanasia deaths in 2021. 27,726 euthanasia deaths since legalization.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2020-21 Belgium euthanasia report was recently released indicating that there were 2445 reported euthanasia deaths in 2020 and 2700 reported euthanasia deaths in 2021. From legalization in 2002 until the end of 2021, there has been 27,726 reported euthanasia deaths.

Thank you to the European Institute of Bioethics (EIB) for providing a summary of the report.

I refer to reported euthanasia deaths because there is a significant percentage of unreported euthanasia deaths in Belgium. The Belgian report acknowledges the problem by stating:
As in its previous reports, the Commission “does not have the possibility of evaluating the proportion of the number of euthanasia's declared in relation to the number of euthanasia's actually performed. In other words, these figures only reflect part of the reality of euthanasia in Belgium.
New categories of information in the report including that 31 of the euthanasia deaths were approved based on an advanced request, meaning these people were incompetent at the time of death and 172 died by euthanasia while in palliative care and 79 of the euthanasia deaths were foreign citizens.

The European Institute of Bioethics (EIB) reported that:
The conditions at the origin of euthanasia were in a large majority of cases generalized or seriously mutilating cancers (63%). Among the other reasons for requesting euthanasia, multiple pathologies (18% or 900 people), diseases of the nervous system (8%), diseases of the circulatory system (4%), diseases of the respiratory system (3%), psychiatric conditions (1% or 45 people) and cognitive disorders (dementia) for 49 people (1%).
The report indicates that 29 people died by euthanasia based on variable symptoms related to Long Covid. 
One may suggest that only 45 people with psychiatric conditions and 49 people with dementia died by euthanasia. Euthanasia for psychiatric conditions and dementia is an acceptance of killing people with questionable competency and ability to consent.

The Belgian report indicates that of the 45 people who died by euthanasia based on psychiatric conditions, 18 people had mood disorders (depression, bipolarity, etc.); 10 people had personality and behavioral disorders; 6 people had neurotic disorders, stressor-related disorders and somatoform disorders; 3 people had schizophrenia, schizotypal disorder and delusional disorder, and 4 people had organic mental disorders such as autism; 2 people had behavioral syndromes such as anorexia.

I have an autistic son. I am always shocked when someone is killed by lethal injection based on Autism. 

The EIB summary indicates that the euthanasia report stated:

The report states that in young psychiatric patients, "the unbearable and persistent pain was frequently associated with past experiences" such as abuse sexual, abandonment as a child, rejection by parents, behaviors self-harm and suicide attempts. The Commission added that “failed suicide attempts have made those affected aware that there is another, more dignified way to end one's life. We may be surprised at this presentation of euthanasia as a “more dignified” form of suicide.

The multiple pathologies category includes people who are not terminally ill but have chronic conditions. Nearly one-third of these deaths were people who were diagnosed with cancer, but were not terminally ill. Many of these people died by euthanasia but had treatable conditions.

The EIB summary indicates that the report stated:

However, rehabilitation and recovery are very limited in the elderly. Many patients could not accept living with severe and permanent disabilities. Dependence, loss of autonomy and the feeling of futility to wait for death were important factors that triggered their request euthanasia.
In relation to euthanasia for symptoms related to blindness/macular degeneration, the EIB stated that the report said:
...All of this created a feeling of loneliness, a feeling of being a burden to others, and the feeling that continuing to exist no longer makes sense.
The EIB summary states that more than a third of those who died for the reason of multiple pathologies, were not expected to die soon. The report indicates that 741 (14.4%) of the people who died by euthanasia, that their death was not expected soon.

The role of the euthanasia clinic (LEIF-EOL) in Belgium. According to the report, 33% of the consultations include doctors who are connected to LEIF-EOL and 19% of the first requests for euthanasia are made to doctors who are connected to LEIF-EOL.

The EIB concludes their summary by stating:

As a reminder, the Commission sticks to the statements given to it by the doctor and therefore has no no means of verifying the veracity of these declarations. In 30% of the files, the Commission decided to lift the anonymity of the declaration in order to ask additional information to the reporting physician. These were imperfections in the responses, errors of interpretation concerning the procedures followed, on several points badly, insufficiently or not completed, procedural points that have not been followed correctly,... Each time, the Commission considered that "the essential conditions of the law (voluntary, considered and of a conscious and capable patient, constant, unbearable and unrelievable suffering, resulting of a serious and incurable condition, the medical situation being hopeless)” seemed to have been respected.

There are significant issues related to the Belgian euthanasia law beyond the fact that the law gives doctors the right to kill people. 

  1. The number and reasons for killing by euthanasia continues to rise. 
  2. The law lacks significant oversight because the Commission includes several euthanasia doctors and in fact the Chair of the Commission, Dr Wim Distelmans, also operates the LEIF-EOL euthanasia clinic. 
  3. The Commission admits that there are unreported euthanasia deaths, but the Belgian government has not done anything to rectify this problem. When I wrote my book, Exposing Vulnerable People to Euthanasia and Assisted Suicide, I was able to prove that the unreported euthanasia deaths tended to be the deaths that were more controversial, such as euthanasia without request or consent.

Similar to the Netherlands and Canada, the expansion of euthanasia is not a slippery slope, but rather it is inevitable. If it is acceptable to kill someone with one condition, it is hard to justify why you can't kill someone else for a similar but different condition. The report even referred to euthanasia as a "more dignified form of suicide."

Once again I thank the European Institute of Bioethics (EIB) for providing a summary of the report.

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Monday, December 19, 2022

Supreme Judicial Court of Massachusetts decides that there is no right to assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Supreme Judicial Court of Massachusetts decided on December 19 to reject a challenge to the Massachusetts state prohibition of assisted suicide by finding that there is no right to assisted suicide in the Massachusetts Constitution.

EPC-USA is incredibly pleased by this decision. EPC-USA was the only group to submit a friend-of-the-court brief and also provide an oral argument before the Supreme Judicial Court of Massachusetts.

Mark Pratt, in writing for the Associated Press reported Chris Schandevel from ADF who represented the Euthanasia Prevention Coalition as stating:

“Patients should be able to trust their doctors to support and care for them,” said Chris Schandevel, senior counsel for the nonprofit Alliance Defending Freedom, which filed a friend-of-the-court brief in the case on behalf of Euthanasia Prevention Coalition. “Offering terminally ill or disabled patients a ‘quick exit’ through death-inducing drugs destroys that trust.”
The Massachusetts case known as Kligler v Healy concerns Dr Roger Kligler who is living with prostate cancer and seeking death by assisted suicide and Dr Alan Steinbach who is willing to prescribe a lethal drug cocktail for Kligler to die by assisted suicide. Kligler who claimed to be terminally ill when the case began in 2016 is very much alive today.

Kligler and Steinbach argued that doctors cannot be prosecuted for prescribing lethal drug cocktails for assisted suicide to competent terminally ill persons because there was a right to assisted suicide under the Massachusetts state constitution.

The Supreme Judicial Court of Massachusetts decided that:

Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide. We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.
As to the question of whether assisting a suicide can result in a charge of manslaughter which is described as wanton and reckless behavior. The Supreme Judicial Court of Massachusetts stated that:
As the motion judge concluded, physician-assisted suicide could constitute wanton or reckless conduct. Our case law demonstrates that knowingly providing someone who has expressed an interest in ending his or her life with the means to do so may be considered wanton or reckless behavior. ... That a doctor's intent in providing the lethal medication was to alleviate a patient's suffering is irrelevant, as conduct may be wanton or reckless even where the actor "meant no harm to the victim." ... (motive is irrelevant to crime of manslaughter).
Dr Steinbach argued that prescribing lethal drugs for assisted suicide is not proximate to the death and therefore cannot result in a charge of manslaughter. The Supreme Judicial Court of Massachusetts referred to the February 2019 decision upholding the voluntary manslaughter conviction of Michelle Carter for assisting the suicide of Conrad Roy (18). Carter, who was 17 at the time of the death, pressured Roy to die by suicide by urging him during the act while on her cell phone. She was sentenced to 15 months in prison.

The Supreme Court of Massachusetts settles the argument that assisted suicide is not proximate to the death by stating:
Steinbach argues that, regardless, doctors who provide physician-assisted suicide cannot be the proximate cause of a patient's death because the patient's decision to ingest the medication is a superseding event that extinguishes proximate cause. We do not agree. It is entirely foreseeable that a terminally ill patient who requests medication intended to bring about death may use the medication for such a purpose.

...In sum, under our existing law, doctors who engage in physician-assisted suicide may risk liability for involuntary manslaughter.
The question as to whether the Massachusetts Constitution could be interpreted to include a right to assisted suicide the Supreme Court of Massachusetts stated:
In sum, the history of suicide in general, and physician assisted suicide in particular, provides no support for the conclusion that physician-assisted suicide is an individual right protected by the Massachusetts Declaration of Rights.
Steinbach argued that the right to assisted suicide is a natural outgrowth to the right to refuse medical treatment. The Supreme Court of Massachusetts decided that:
We do not agree, but, rather, recognize an important distinction between the refusal of medical treatment and physician-assisted suicide, which lies in fundamental legal principles of cause and effect; whereas withdrawing or withholding medical care is not the primary cause of a patient's death, physician-assisted suicide is.
The Supreme Court of Massachusetts further analyses the question of the right to refuse treatment and states:
In medical ethics, "the right of competent, informed patients to refuse life-prolonging interventions . . . is firmly established," whereas the right to physician-assisted suicide is a matter of "ethical . . . controversy."

The American Medical Association has opined, for example, that although physicians should "honor patients' informed decisions to refuse life-sustaining treatment," physicianassisted suicide "is fundamentally incompatible with the physician's role as healer."
In their conclusion, the Supreme Judicial Court of Massachusetts states:
In sum, given our long-standing opposition to suicide in all its forms, and the absence of modern precedent supporting an affirmative right to medical intervention that causes death, we cannot conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights. Thus, application of the law of manslaughter to physician-assisted suicide would not impinge on an individual's right to substantive due process.

The Supreme Judicial Court of Massachusetts then states:

Application of the law of manslaughter to physician assisted suicide passes constitutional muster because the law is reasonably related to the State's legitimate interests in preserving life; preventing suicide; protecting the integrity of the medical profession; ensuring that all end-of-life decisions are informed, voluntary, and rational; and "protecting vulnerable people from indifference, prejudice, and psychological and financial pressure to end their lives."

As much as the Supreme Court of Massachusetts reject a right to assisted suicide they do keep the issue open to a legislative change by stating:

These questions are best left to the democratic process, where their resolution can be informed by robust public debate and thoughtful research by experts in the field.

The Euthanasia Prevention Coalition and EPC-USA would like to thank Christopher P. Schandevel from Alliance Defending Freedom (ADF) for representing us before the Supreme Judicial Court of Massachusetts.

EPC-USA not only submitted an excellent friend of the court brief but we were the only group that provided a friend-of-the-court brief that was also asked to provide an oral argument before the Massachusetts Supreme Judicial Court.

Links to more articles on the Massachusetts assisted suicide Kligler court case:

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Psychiatric Times: The Harms of Assisted Death Are Not Just a “Disabled Thing”

This article was published by the Psychiatric Times on December 19, 2022.
“The mere legalization of MAID creates a serious and discriminatory danger…”
Gordon Friesen
By Gordon Friesen

This article is in response to the series, “MAID and the Disabled” by Douglas W. Heinrichs, MD.

It is with the greatest pleasure I learn that Douglas W. Heinrichs, MD, has accorded me the honour of replying to my criticism of his views on assisted dying.

Dr Heinrichs incorrectly surmises that I support medical aid in dying (MAID) for patients at the end of life. I do not. However, I do believe that to usefully discuss MAID at the present time, we must stipulate a wider context; for this is how MAID is now increasingly defined and practised.

As the reader may recall, my principal argument (which Dr Heinrichs has not attempted to refute) concerns the inherently harmful effect upon the disabled and chronically ill of decriminalizing assisted suicide and euthanasia.

Simply stated: This decriminalization requires the selective removal of otherwise universal criminal code protections.(1) The mere legalization of MAID, therefore, creates a serious and discriminatory danger. That the danger is serious, we must certainly agree. Because, otherwise, we would have no prohibition, and no need for an exception. That the danger is discriminatory, appears in the fact that its burden falls upon one group alone.

In addition, I have made a second claim: that this discriminatory, lethal danger, has been imposed upon the members of that group, against their will. It is instructive, in this light, to review the recently successful passage, in Canada, of Bill C-7 (2021),(2) enacted to extend euthanasia to individuals not at the end of life.

Every single one of the testimonies and briefs introduced before Parliamentary Committee,(3) by disabled individuals and their organizations, was opposed to the expansion. Moreover, in a theatrically orchestrated Open Letter,(4) the Vulnerable Persons Standard(5) presented the signatures of no less than 147 nationally representative disabled organizations (and their allies) in opposition to the Bill.

If informed and engaged opinion are to be our guide, it can be confidently stated that the "disabled community" is unconditionally opposed to euthanasia eligibility for its members. And yet this legislation was carried, 213 votes to 106.(6)

What, we must ask, can possibly explain these facts?

Many of my disabled friends would point to the concept of ableism,(7) a highly developed social theory of injustice based upon systemic discriminatory oppression. Others, prefer to remain within the bounds of common language, in identifying an extremely negative exterior perception of disabled life.

Whatever explanation is chosen, the essential harm suffered by individual patients (faced with the unbridled subjectivity of individual doctors as noted by Susan Stefan, JD) results from the unfortunate expression of such prejudices under the cloak of legitimate medical care.

Sadly, also, we must remember that this is not just a disabled thing.(8) All of the above-noted concerns apply with equal force to assisted death at the end of life:
  1. Mere legalization creates a discriminatory danger for the nonsuicidal patient. 
  2. This poisoned privilege is provided contrary to majority desire. For even in the Netherlands, among terminal cancer patients—who account for 70% of all euthanasia in that country—less than 1 in 10 will consent to die in that manner.(9) 
  3. The push to "inform" all eligible patients, is a clear reflection of projected prejudice towards imperfect life.
On this point, Dr Heinrichs opens the door to a semantic rabbit-hole, where terms like "worth" are challenged in their common usage, and where it is suggested that the mystery of personal choice might permit a particular life to be terminated without implying negative judgment thereon. I will respectfully decline that discussion.

Allow me simply to conclude by reaffirming my own conviction (regardless of words or intention): that those who insist it is somehow appropriate for one class of persons to be deprived of criminal protections enjoyed by everyone else (and this against their clearly expressed collective wishes), would seem to have a fairly settled opinion as to the pertinence of continuing such lives; an opinion, I must add, which is very different from that of the people who are actually living them.

Gordon Friesen is a disabled individual who has followed the assisted death question closely since the early 1990s, and is currently President of the Euthanasia Prevention Coalition.

References

1. Statues of Canada: Bill C-14. An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying) (2016). Accessed December 19, 2022. https://www.parl.ca/DocumentViewer/en/42-1/bill/C-14/royal-assent

2. Statues of Canada: Bill C-7. An Act to amend the Criminal Code (medical assistance in dying) (2021). Accessed December 19, 2022. https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent

3. Standing Committee on Justice and Human Rights. House of Commons, Canada. Accessed December 19, 2022. https://www.ourcommons.ca/Committees/en/JUST/StudyActivity?studyActivityId=10983212

4. Open Letter in opposition to Bill C-7. Vulnerable Persons Standard. Accessed December 19, 2022. http://www.vps-npv.ca/stopc7

5. Vulnerable Persons Standard. Accessed December 19, 2022. http://www.vps-npv.ca/

6. 3rd reading and adoption of Bill C-7. An Act to amend the Criminal Code (medical assistance in dying). December 10, 2020. Accessed December 19, 2022. https://www.ourcommons.ca/Members/en/votes/43/2/39

7. Dr. Heidi Janz testifying before the Standing Committee on Justice and Human Rights, Parliament of Canada. November 10, 2020 (presentation at 12:19:00). Accessed December 19, 2022. https://parlvu.parl.gc.ca/Harmony/en/PowerBrowser/PowerBrowserV2/20201110/-1/34218?Embedded=true&globalstreamId=20&viewMode=3%20(testimony%20at%2012:19:00)

8. Friesen G. Lessons from the Canadian euthanasia debacle: utilitarian death-medicine piggy-backing on the power of choice—why (and how) to deconstruct the medical “narrative.” August 4, 2022. Accessed December 19, 2022. http://euthanasiadiscussion.com/wp-content/uploads/2022/11/connecticut_pdf_form_publish_v1.pdf

9. Note on Dutch cancer patients who consent to euthanasia.

Total Dutch deaths (2020): 168,678

https://www.statista.com/statistics/520011/total-number-of-deaths-in-the-netherlands/

Dutch cancer deaths (2020): 49,008

https://gco.iarc.fr/today/data/factsheets/populations/528-the-netherlands-fact-sheets.pdf

Total Dutch euthanasia deaths (2020): 6938

Cancer euthanasia deaths (2020): 4480

Euthanasia as fraction of total deaths (2020): 0.041

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwij-cCK8_77AhVfxikDHZ6xC6wQFnoECCYQAQ&url=https%3A%2F%2Fwww.euthanasiecommissie.nl%2Fbinaries%2Feuthanasiecommissie%2Fdocumenten%2Fjaarverslagen%2F2020%2Fapril%2F15%2Fjaarverslag-2020%2FRTE-jaarverslag2020_Engels.pdf&usg=AOvVaw0lnNcwldC9d12ycGWfjLg1

Cancer deaths as fraction of total deaths: 49,008 / 168,678 = 0.29

Cancer euthanasia as fraction of total euthanasia deaths: 4480 / 6938 = 0.65

Cancer euthanasia as fraction of total deaths: 0.65 * 0.041 = 0.027

Cancer euthanasia as fraction of total cancer deaths: 0.027 / 0.29 = 0.09 “less than 1 in 10”
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