Monday, February 27, 2023

Stephen Mendelsohn: Strong opposition to Connecticut Assisted Suicide Bill SB 1076

By Stephen Mendolsohn

Stephen is a leader of the disability rights group, Second Thoughts Connecticut and a member of the EPC-USA board.

Senator Anwar, Rep. McCarthy Vahey, and members of the Public Health Committee:

“If assisted suicide is legal, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.” —Marilyn Golden (1954-2021), Senior Policy Analyst at the Disability Rights Education and Defense Fund

I am an autistic adult and one of the leaders of Second Thoughts Connecticut, a coalition of disabled people opposed to the legalization of assisted suicide. I also serve on the board of directors of Euthanasia Prevention Coalition-USA and previously served on the Connecticut MOLST Task Force.

Notwithstanding the attempt to add additional and mostly unworkable “safeguards” from previous iterations of this legislation, SB 1076 is fatally flawed and should be rejected. 

These added safeguards are part of a deliberate bait and switch tactic by proponents to get a bill passed and then come back to amend it to gut these and other safeguards. This was openly acknowledged by J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, who was quoted on a similar bill in his state, saying, “Once you get something passed, you can always work on amendments later.” This incrementalist strategy is also confirmed in Kim Callinan’s testimony for Compassion & Choices, who describes these changes from previous assisted suicide bills as “unnecessary” and claims they “will result in more patients being unable to access the law.”

Some of the new provisions are likely to be immediately challenged in court. The enhanced residency requirement in SB 1076 is at odds with lawsuits filed by Compassion & Choices in Oregon and Vermont claiming that all such residency requirements are unconstitutional. The provision in Section 21 requiring an attending physician to meet every thirty days with a patient who has been prescribed lethal drugs to either certify the patient still qualifies or to dispose of the drugs is either unworkable, unconstitutional, or both. Once a patient receives a lawfully obtained lethal concoction of DDMAPh costing nearly $1000 from a mail-order compound pharmacy, there is no way to control what happens to it. You cannot compel a patient to meet with their doctor, and it would require a search warrant to enter the patient’s private home. Moreover, seizing a lawful prescription without compensating the patient who just forked over a significant amount of money for it would violate the Due Process and Takings Clauses of the Fifth Amendment, which respectively require due process and just compensation before the government seizes someone’s property.

We are in the midst of a serious opioid epidemic, yet we do not authorize searching the private homes of people lawfully prescribed opioids for unused pills and seizing them. Simply put, no safeguard can prevent lethal drugs from being ingested by people who may have originally qualified but no longer do, nor is there any way to prevent misuse by others once lethal drugs are prescribed. In one recent case from Colorado, after the intended patient took a swallow and exclaimed “Man it burns!” (as amitriptyline in the lethal compound burns the throat), a bystander also swallowed the lethal concoction and nearly died before being rescued by EMS personnel.

The mandatory counseling provision can be met my a brief consult with a social worker affiliated with Compassion & Choices for this purpose. If the attending physician is a psychiatrist prescribing for someone whom he/she/they have diagnosed as having “terminal anorexia,” there appears to be nothing in SB 1076 to prevent this psychiatrist from self- referring the patient, as a psychiatrist can qualify for both roles.

As you are probably aware, people with a sole diagnosis of anorexia nervosa have been prescribed and have died from lethal prescriptions in both Colorado and Oregon. This has even led to Compassion & Choices finally admitting to an abuse of the law. Kevin Díaz, C&C’s Chief Legal Advocacy Officer, states on the organization’s website that “This law does not and was never intended to apply to a person whose only diagnosis is anorexia nervosa.” Yet in her testimony for this bill, Kim Callinan appears to state otherwise: “There have been no documented or substantiated incidents of abuse or coercion across the authorized jurisdictions...” Does Ms. Callinan thus approve of assisted suicide for people with a sole diagnosis of anorexia? And can we really believe a single word she says when she makes this astonishing and demonstratively false claim?

The definition of “terminal illness” in Section 1 (21) was tweaked once again, this time to read “physical medical condition.” Nothing here would exclude anorexia nervosa from qualifying, as the main symptom is physical—the patient is emaciated. Indeed, biological psychiatrists have long claimed that “mental illnesses” are “physical medical conditions,” and NAMI asserts that “mental illnesses are physical illnesses.”

Nor would the mandatory counseling requirement exclude people with anorexia from receiving lethal prescriptions, as most would meet the definition of “competent” in Section 1 (4). As psychiatrist Dr. Angela Guarda, director of the Johns Hopkins Eating Disorders Program, has testified elsewhere:

Patients with anorexia appear rational in all ways but one: they lack the capacity to accept the care they most need. Yet they meet the definition of capacity in this [assisted suicide] bill. Instilling hope is crucial for a positive therapeutic stance. How as a physician do I hold this view when I do not know which, if any of my patients are incurable? I oppose this bill because there’s too much room for error. It risks endangering the most vulnerable and the one in five Americans who suffer from a treatable mental condition.
Last year, the definition of “terminal illness” in Section 1 (21) added the words “... if the progression of such condition follows its typical course.” As Cathy Ludlum demonstrated in her powerful l testimony, she qualifies for lethal drugs under this definition. As Fabian Stahle notes, so do people with chronic conditions like insulin-dependent diabetes who reject treatment. So do people who have treatment denied by their insurance company or are otherwise unable to afford it. So do people with anorexia nervosa. Without nutrition, the “typical course” for anorexia is death in under six months. The American Clinicians’ Academy on Medical Aid in Dying (ACAMAID) has a case report in which their “Ethics Consultation Service” stated,
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.
Less than two months ago, ACAMAID’s “Ethics Consultation Service” published another case report, this time on Voluntary Stopping of Eating and Drinking and Medical Aid in Dying, pushing the boundaries of “terminal illness” to its logical extreme. Their members found that “Legally, there is nothing in the letter of the law of any of the U.S. states’ aid in dying bills that explicitly prohibits accepting voluntary stopping of eating and drinking as a terminal diagnosis to qualify for aid in dying.” They further note that allowing VSED to qualify for lethal prescriptions would “essentially eliminate the criteria of terminal illness to qualify.”

Thus virtually anyone at least 21 years old who is depressed, unhappy, traumatized, or lacks the will to live can qualify as “terminally ill” for a lethal prescription simply by electing to use VSED. It should be noted that some ACAMAID team members were not willing to support this position, arguing that “[e]mbarking on this could imperil the currently existing laws that allow access for terminally ill patients.” It is clear that what matters to ACAMAID, C&C, and the rest of the assisted suicide lobby is how far they can expand the law, whether by amendment or reinterpretation, without encountering pushback.

All of the ostensible safeguards in SB 1076 are rendered unenforceable and meaningless by the mere “good faith” standard in Sections 14(f) and 19. This “good faith” standard creates an unacceptable carve-out from the prevailing professional standard of care required for all other patients under Section 52-184(c) of the Connecticut General Statutes. As it is virtually impossible to prove that a medical provider did not act in “good faith,” providers granted legal immunity under this statute can use creative interpretations of the law, as ACAMAID has already done, to reinterpret and expand the law without resorting to amending it.

Regarding falsification of the death certificate, Section 9 (6) (b) from the 2013-2021 bills, stating “The person signing the qualified patient's death certificate shall list the underlying terminal illness as the cause of death,” has been removed from SB 1076. In no way does this mean that death certificates will not continue to be falsified. Previous bills demonstrate clear intent to do so, as does last year’s oral testimony from death certificate certifier Shannon E. Stanford, MD, who said that “people are free to write what they want on the death certificate” (on YouTube starting at clip position 5:25:55).

In Oregon, language mandating death certificate falsification is not in statute but is in regulations, and that is certain to be the case in Connecticut. The only way to correct this is to specifically include language similar to Oklahoma’s Death Certificate Accuracy Act, §63-1- 316b. It states in part:

A certifier completing cause of death on a certificate of death who knows that a lethal drug, overdose or other means of assisting suicide within the meaning of Sections 3141.2 through 3141.4 of this title caused or contributed to the death, shall list that means among the chain of events under cause of death or list it in the box that describes how the injury occurred. If such means is in the chain of events under or in the box that describes how the injury occurred, the certifier shall indicate "suicide" as the manner of death. 
A certifier who knowingly omits to list a lethal agent or improperly states manner of death in violation of subsection E of Section 1-317 of this title shall be deemed to have engaged in unprofessional conduct as described in paragraph 8 of Section 509 of Title 59 of the Oklahoma Statutes.

It is deeply disheartening that a bill to require honest death certificates, HB 5486, was not granted a public hearing by this committee. That proposed bill would have enacted similar language here in Connecticut to the aforementioned Oklahoma statute:

That the general statutes be amended to require, upon legalization of any provision allowing the prescribing of medication to a terminally ill patient that the patient may self-administer to bring about death, a medical certifier completing cause of death on a death certificate, who knows that a lethal drug, overdose or other means of assisting suicide caused or contributed to the death, shall list such means among the chain of events under cause of death, and, if such means is in the chain of events, the certifier shall indicate "suicide" as the manner of death.
The actual purpose here is to avoid covering up foul play in a potential murder prosecution, which is the real problem with death certificate falsification as noted by previous testimony from the Division of Criminal Justice.

The “accordance” language in Section 14 (c) and (d) of SB 1076 also mandates falsification of the manner of death. According to the Office of the Chief Medical Examiner, the choices in Connecticut are “homicide,” “suicide,” “accidental,” “natural,” “therapeutic complication,” or “undetermined.” The “accordance” language rules out homicide and suicide as a matter of law. “Accidental,” “therapeutic complication,” and “undetermined” are clearly ruled out, as the manner of death is both intentional and of known cause. Thus as in other states, the death will be deemed “natural,” even if it was unnaturally caused by an intentional overdose of lethal drugs. This would also interfere with a potential murder prosecution.

This “accordance” language would also interfere with our state’s suicide prevention plan, which calls this act suicide and notes the intersection between assisted suicide and suicide prevention, particularly in regard to suicide prevention for disabled people (pp. 57-59).

No amount of change in bill language can change the fact that some people will suffer prolonged and agonizing deaths from the experimental lethal drug cocktails, with some even regaining consciousness only to die of their terminal illness. Medical science cannot guarantee the peaceful death proponents claim. If lethal injections administered for capital punishment have resulted in inhumane deaths, oral ingestion of lethal drug compounds is far more likely to do so. We may put our pets down without their consent and for bad reasons—because they are unwanted or have behavior problems—but at least we do not make them ingest these experimental lethal compounds and make them suffer even more in the process.

No change in language can change the deadly mix between assisted suicide and a broken health care and home care system. As the cheapest “treatment,” assisted suicide diminishes choice, and especially so for people of color, disabled people, and others who have been historically marginalized in our health care system.

No change in language can change the problem of misdiagnosis or the unreliability of terminal prognosis. Jeanette Hall, John Norton, and Rahamim Melamed-Cohen have outlived ostensibly terminal prognoses by decades. All three became staunch opponents of assisted suicide.

No change in language alters the fact that offering suicide prevention to most people while offering suicide assistance (redefined as “aid in dying”) to an ever-widening subset of disabled people is lethal disability discrimination.

The definition of “attending physician” in Section 1 (3) was modified last year, and of “consulting physician” in the current bill, to exclude someone whose practice is “primarily comprised of evaluating, qualifying and prescribing or dispensing” the lethal drugs. This is apparently an attempt at discouraging doctor shopping. It will not work because anyone can just set up a 50-50 practice with half devoted to curative or palliative care and half to assisted suicide. Moreover, the limitation does not appear to be enforceable and there are no sanctions for setting up a practice primarily devoted to assisted suicide. It also does not pertain to the person providing counseling under Section 8 of SB 1076.

The definition of “competent” allows social workers to perform capacity evaluations, and still allows someone else to speak for a patient with a communication disability. Section 3 follows the 2015-2020 and 2022 bills in requiring two written requests and disallowing heirs and other interested parties from being witnesses to the dispensing of the lethal prescription. Nonetheless, an heir can still bring two close friends to be witnesses to a pair of faxed-in requests and allows the examination to occur via telehealth. The attending and consulting physicians may have no idea that the patient is being pressured into dying faster by an abusive heir. Moreover, there is no required independent witness at the time the lethal drugs are ingested. Many people change their minds, yet all “safeguards” end once the prescription is dispensed.

Beyond the failure of any changes to the bill language to protect against mistakes, coercion, and abuse, there is the issue of expansion. We only need to look at what Compassion & Choices and other proponents are saying, and the bills and lawsuits they have been pushing in other states. We can all remember when Compassion & Choices’ president emerita Barbara Coombs Lee came to Hartford in October 2014 declaring support for assisted suicide for people with dementia and cognitive disabilities unable to consent; in her words, “It is an issue for another day but is no less compelling.”

We can also look at recent expansion legislation and court cases being pushed by Compassion & Choices in other states, particularly those in states that already have legalized assisted suicide, including Oregon, Washington, California, Vermont, Hawai‘i, and New Mexico. Bills have provisions that would dramatically shorten and/or waive the mandatory waiting period, allow APRNs and PAs to prescribe lethal drugs, waive the requirement for a second doctor to confirm the ostensibly terminal diagnosis, allow almost anyone who does counseling for a fee to qualify in the rare case that the patient is referred for a mental health evaluation, eliminate residency requirements, allow mail-order delivery of lethal overdoses, and compel objecting providers to refer patients to other providers who will dispense lethal prescriptions.

This last provision, enacted two years ago as California SB 380, is a threat to patient safety, as noted by the example of Jeanette Hall, who sought to die under Oregon’s law but was persuaded by her doctor to accept cancer treatment and is still alive more than 20 years later. Under a “do or refer” regime supported by Compassion & Choices, people like Jeanette Hall would have their lives cut short by years or even decades as ethical doctors will be forbidden to use their professional judgment to encourage their suicide-minded patients to seek lifesaving treatment.

So when Compassion & Choices’ president Kim Callinan testifies about all of the “safeguards” in SB 1076, please remember she and her organization are working diligently to gut these same provisions in the aforementioned states that have already enacted this legislation.

Moreover, once the concept of certain people having a right to assistance with their suicides to end their suffering is codified into law, there is no limiting principle to prevent it from being extended to other disabled people who also may claim to be suffering. If SB 1076 were enacted, further expansion will move into the hands of judges. While we in the disability-rights community view legalizing assisted suicide as a violation of the Americans with Disabilities Act and the disability equal protection clause (Article XXI, amending Article V) of the Connecticut Constitution—people with certain disabilities are thus denied the benefit of suicide prevention services—judges could easily use both of these provisions to require extending the “benefit” of this “end of life option” to other disabled people. The limitations of “six months,” “terminally ill,” “mentally competent,” and “self-administer” in SB 88 all discriminate on the basis of disability. Indeed, back in 1999, former Deputy Attorney General of Oregon David Schuman wrote this response to state senator Neil Bryant regarding the issue of self-administration:

“The Death with Dignity Act does not, on its face and in so many words, discriminate against persons who are unable to self-administer medication. Nonetheless, it would have that effect....It therefore seems logical to conclude that persons who are unable to self-medicate will be denied access to a ‘death with dignity’ in disproportionate numbers. Thus, the Act would be treated by courts as though it explicitly denied the ‘benefit’ of a ‘death with dignity’ to disabled people....”

Indeed, the Connecticut Supreme Court’s ruling in State v. Santiago, striking down a prospective repeal of the death penalty in favor of full repeal, shows how our courts can expand laws beyond the intent of this legislature using equal protection grounds. The same principle is at work with SB 1076, which gives suicide assistance to some while others get suicide prevention, and the arbitrary difference is what disability they have.

So what about the person with ALS who has a six month prognosis, but has lost the ability to self-administer? What about the person with Parkinson’s disease, who will have tremors for years before dying? What about people with communication disabilities who may not be able to make the request on their own? What about Grandma with dementia, or the person with a severe psychiatric disability? Once the door to assisted suicide is pried open, Compassion & Choices will seek to open it further through the courts, going from six months terminal to one year, to perhaps five years; from assisted suicide to euthanasia; and from euthanasia for terminal illness, to chronic illness, to mental suffering. This is how we go down the same road as Canada, which has enacted Bill C-7 to allow euthanasia even for non-physical conditions, which is contemplating extending euthanasia to minors without parental involvement, and where hospitals routinely deny treatment to disabled people while offering euthanasia instead. For Compassion & Choices, these are merely issues for another day, and for them, no less compelling.

Legislators and the public should not be fooled by a privileged lobby that seeks to sell suicide as a solution to their own disability-phobia. We should follow the recommendations of the National Council on Disability’s report, “The Danger of Assisted Suicide Laws,” and reject codifying lethal and systemic disability discrimination into law. 

Canadian Blood Services promotes documentary linking organ donation to euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Canadian Blood services are promoting a documentary film that was created by Nova Scotia Health Services and the Canadian Blood Services to promote organ donation after euthanasia.

In the past Organ and Tissue donation services could claim that organ donation after euthanasia was only an option. Now that the documentary film - Her Last Project - is being promoted, clearly organ donation after euthanasia is being viewed as more than just an option.

Her Last Project is a documentary film about the (MAiD) euthanasia death of Halifax NS doctor, Shelly Sarwal, who was diagnosed with Multiple System Atrophy. Sarwal was the first person in Nova Scotia to die by euthanasia with the intention of donating her organs.

The website connected to the Canadian Blood Services, that is promoting the film, states that approximately 20% of the euthanasia deaths could be eligible for organ donation.

The 2022 Ontario euthanasia statistics indicated that there were 3934 reported Ontario euthanasia deaths with 20 of those deaths followed by organ donation. The Canadian Blood Services is promoting the film - Her Last Project - in order to increase the rate of organ donation after euthanasia.

Linking euthanasia to organ donation is an ethical concern because euthanasia becomes promoted as a "good act" when it leads to organ donation.

Another concern with linking euthanasia to organ donation is because it leads to "ethics" journals debating the concept of euthanasia by organ donation. "Ethicists" are asking - why first kill the person by euthanasia and then remove the organs for donation when it is easier and more effective to remove the organs from a person who has consented to euthanasia. 

The dead donor rule is being debated. The Uniform Determination of Death Act is currently being revised to make it easier to declare a person brain dead for organ donation and a new organ donation procedure, known as normothermic regional perfusion (NRP) appears to violate the dead donor rule.

The Euthanasia Prevention Coalition does not oppose organ donation but we are concerned that organ donation after euthanasia leads to euthanasia becoming a "good" act and it leads to euthanasia by organ donation.

Sunday, February 26, 2023

Government euthanasia committee ignored disability rights group concerns.

By James Schadenberg

On February 16, the disability rights group Inclusion Canada released a press
statement in response to the final report of the Special Joint Committee on Medical Assistance in Dying (AMAD). This press release, titled Surprise, Surprise – Harmful Committee Work leads to Harmful Report on MAiD (Link), claims that AMAD did not merely ignore people with disabilities and their allies but that they were disrespected and, in some cases, denied requested accommodations to deliver their testimony.

As Inclusion Canada’s press statement begins:

Inclusion Canada has received and reviewed the final report of the Special Joint Committee on Medical Assistance in Dying (AMAD). It can’t be sugar coated – people with disabilities and their allies were ignored. We asked for equality-preserving changes to the law; MPs and Senators decided they knew better.

This isn’t surprising. People with disabilities were disrespected by committee members. Their lived experience was discredited and dismissed. Many were also denied requested accommodations to deliver their testimony.

Their press statement includes a video to illustrate this point, titled AMAD Responds to Disability Advocates (Link).  

In this video, multiple people with disabilities and people representing those with disabilities explain how euthanasia expansion has harmed those who live with physical and intellectual disabilities, as well as their families and communities. The video then shows Senators and MPs dismissing these concerns, calling them a “moral panic” and “intellectually incoherent” and stating that some witnesses are not “qualified to comment on this.” A clip shows a Liberal MP trying to rush the testimony of a witness. A clip shows a witness stating outright that “there is no evidence that vulnerable people are at risk for MAiD” despite well-documented evidence to the contrary (the names of some of these victims are mentioned at the end of the video).

The press release continues, stating that it’s unsurprising that this committee process resulted in a discriminatory report. As the press release states:
The committee’s final report is a discriminatory disaster.

“It is clear that the members of the AMAD committee made up their mind about expanding MAiD before consulting with the disability community,” says Krista Carr, Executive Vice President of Inclusion Canada, “Committee members failed to heed the numerous warnings and concerns raised by people with disabilities and their allies.”

Minister of Justice David Lametti’s decision to delay the expansion of medical assistance in dying (MAiD) for people with mental illness does not go far enough. The sunset clause must be removed indefinitely and we demand the government roll back the expansion of assisted dying on the basis of disability. Bill C-7 must be repealed.

“Sadly, these recommendations aren’t surprising coming out of this committee process,” says Robin Acton, President of Inclusion Canada, “This report, if implemented, makes people with disabilities even more vulnerable to state-assisted death. This report suggests expanding MAiD to mature minors and by advanced requests, both of which will put people with intellectual disabilities at even greater risk.”
Disability rights organizations are right to call the government out for putting people with disabilities at risk. Canada’s MAiD law has resulted in vulnerable people, many of whom have disabilities or live in poverty, dying by MAiD when they could've otherwise lived if given the proper support.

The press release concludes:
You need look no further than the video above to see how persons with disabilities were treated in this process. We encourage you to reflect on the conduct of Parliamentarians and how the voices of the disability community have been silenced. This committee’s recommendations do not reflect the voices of the very people track two MAiD targets. People with disabilities deserve better.

Further reading:

Friday, February 24, 2023

Connecticut assisted suicide bill 1076 must be defeated.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Cathy Ludlum, Second Thoughts Connecticut
Last year I celebrated the defeat of the Connecticut assisted suicide bill by one vote in the judiciary committee. That bill was the 10th consecutive assisted suicide bill in Connecticut to fail. But I also told my supporters that the battle in Connecticut may return for an eleventh straight year in 2023.

This year's Connecticut Assembly Bill 1076 has been amended to appear specifically tighter in its wording, than previous bills because the assisted suicide lobby has failed to legalize assisted suicide for 10 consequtive years. The New York assisted suicide bill is also written in a tighter manner, based on the fact that the assisted suicide lobby has failed to legalize assisted suicide in New York.

The assisted suicide lobby has no intention of leaving the bill restrictions in place. The assisted suicide lobby has two strategies, the first is to do what is necessary to legalize assisted suicide and the second is to expand those bills once legal.

A few years ago, Hawaii was a state that had rejected assisted suicide bills over consequtive years. The Hawaii legislature legalized assisted suicide in 2018. The very next year the assisted suicide lobby was pressuring the Hawaii legislature to expand their law. Hawaii is currently debating House Bill 650 to expand their assisted suicide law.

Members of the Connecticut legislature must reject the current bill, because assisted suicide is always wrong and they assisted suicide lobby are trying to legalize assisted suicide and, if passed, they will amend it in the coming years.

The bills to legalize assisted suicide in Minnesota, a state that has not debated assisted suicide every year, is a wider bill than Connecticut.

The Minnesota bill:

  • Allows non physicians to assess, approve and prescribe lethal assisted suicide drugs. Minnesota defines a "Provider" as: a doctor of medicine or osteopathy, and an advanced practice registered nurse. 
  • Allows lesser trained mental health professionals to assess competency. "Licensed mental health provider" is defined as a psychiatrist, psychologist, clinical social worker, psychiatric nurse practitioner, or clinical professional counselor. 
  • There is no waiting period for being approved for assisted suicide. It is possible that a person request assisted suicide and die the same day.
  • Allows the lethal drug cocktail to be delivered by mail or messenger service. 
  • Allows a healthcare facility to prohibit assisted suicide but the facility cannot prohibit information about assisted suicide or referrals for assisted suicide.
  • Does not require the person requesting death by lethal drugs to be a resident of Minnesota. Oregon withdrew their residency requirement in 2022. There is now an assisted suicide clinic and suicide tourists in Oregon. 
  • Creates a "standard of care" for assisted suicide, Medical care that complies with the requirements of this section meets the medical standard of care. Assisted suicide is not medical care.

By reading the articles by the assisted suicide lobby and assisted suicide bills that are being promoted by the assisted suicide lobby, they are clearly moving to allowing an easier approval process and to enable more people to qualify for assisted suicide.

Recently Oregon withdrew their residency requirement for assisted suicide and Vermont has a bill to also remove their residency requirement. Oregon, Vermont and California lessened their waiting periods for assisted suicide and Hawaii and Washington state currently have bills that will lessen their waiting periods.

So lets call a spade a spade. Connecticut has rejected assisted suicide for 10 consecutive years and in response the assisted suicide lobby has presented a tighter bill. If Connecticut passes Assembly Bill 1076, within a year or two, the assisted suicide lobby will be expanding it.

The only way to protect vulnerable people is to reject assisted suicide completely.

Wednesday, February 22, 2023

#IamthefaceofMAID twitter trend connects us to victims of Canada’s euthanasia laws.

By James Schadenberg

Since February 14, the Twitter hashtag #IamthefaceofMAID has been used to highlight the stories of people with disabilities who've been victimized by Canada's euthanasia (MAiD) laws. The trend started when a Twitter user who goes by @chydorina posted the following tweet:
I am the face of #MAID (assisted-death) in Canada.

As a single, 50 yr old female with a genetic condition and a disability pension I will only cost the 'system'. I would be approved for untreatable pain if I applied - except my pain IS treatable - the gov just wont cover it.
This post inspired many other users with physical and mental disabilities to use the hashtag #IamthefaceofMAID to share their stories about how the Canadian government is offering them aid in dying rather than aid in living. These tweets have since received thousands of likes and millions of views.

Twitter user @arianek posted the following:
I am the face of #MAID (assisted-death) in Canada.

As a 42 year old woman with a rare complication of lupus + iatrogenic injuries I will only cost the 'system'. I want to live but can’t get the care I need + I have been approved for MAID.

#IamthefaceofMAID #Iamthefaceofhumanity
Twitter user @Nat_Alycia posted the following:
I am the face of #MAID (assisted-death) in Canada.
As a 41 yr old woman with fibromyalgia & chronic widespread pain, I will only cost the 'system'. I receive nerve block to keep me moving. I would be approved for death if I applied. #IamthefaceofMAID #Iamthefaceofhumanity
Some of the other #IamthefaceofMAID stories can be found here:

All of these stories give a human face to the systemic problems that have arisen from Bill C-7. The Canadian government has told people with physical disabilities that they will help them kill themselves, while flaws in our healthcare system prevents them from being given sufficient aid in continuing their life. The MAiD system makes it increasingly easier for them to die and harder for them to live.

As some of the #IamthefaceofMAID tweets point out, many of these people feel like they are a “cost to the system.” Though politicians who support euthanasia will justify it with arguments about liberty and autonomy, one cannot ignore the utilitarian aspect of euthanasia in Canada. 

When Bill C-7 was being debated, the Office of the Parliamentary Budget Officer released a document highlighted the cost reductions that would result from allowing doctors to kill patients whose deaths were not reasonably foreseeable. The #IamthefaceofMAiD tweets put human faces to the issues that arise when a government sees killing as a method to reduce healthcare spending.

Many of the #IamthefaceofMAID tweets show that these problems will be exacerbated if the government expands MAiD to those with mental illness. The Canadian Senate may soon vote to pass Bill C-39, which will delay until March, 2024 the expansion of MAiD to those whose sole underlying medical condition is a mental illness. But a delay is not enough. The systemic abuses that arose from expanding MAiD to those with physical disabilities who were not terminally ill cannot be fixed. We should not even be discussing expanding MAiD to those with mental illnesses.

The Hon Ed Fast MP has introduced Bill C-314, a bill that would prohibit euthanasia for mental illness. EPC supports Bill C-314 since it amends the Criminal Code to prohibit euthanasia for people with a mental disorder.

Montana Bill to prohibit assisted suicide fails in the Montana Senate.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Joshua Margolis reported on February 21 for NBC Montana that Bill SB 210, a bill that would prohibit assisted suicide in Montana, passed in the Senate at Second reading by a 26 to 24 vote.

Mara Silvers reported for The Montana Free Press on February 22, that SB 210 was defeated at third reading was defeated by a narrow margin after a few Senators flipped their votes.

Over the past few years Montanans have had a confusing situation concerning assisted suicide.

In 2009, the Baxter court decision declared that Montanans had a right to assisted suicide. The Baxter decision was appealed to the Montana Supreme Court where it was decided that Montanans do not have a right to assisted suicide but the Court found a defense of consent. Therefore, if a Montana physician assists a suicide the physician must prove that there was consent.

Senator Carl Glimm
In 2023, Montana State Senator, Carl Glimm sponsored Bill SB 210 to reverse the Montana Supreme Court decision by clarifying that consent is not a defense for homicide or assisted suicide.

Margolis reported:

Senate Bill 210 would change Montana code to state that a physician “purposefully and knowingly prescribing a lethal dose of medication to a patient” is against public policy. It also states that a patient’s consent cannot be used as a defense if the physician is charged with homicide.
Margolis quoted Senator Carl Glimm, the sponsor of the bill that:
“This needs to be the solution. We need to be consistent in our message and tell the citizens of Montana that suicide is not the answer,”
Margolis also reported that:
The bill had its initial committee hearing on Feb. 1 in the Senate Judiciary and passed its first reading along party lines the following week. A third reading is expected on February 22, and it would then head to the House if approved.
Efforts to pass similar bills in previous legislative sessions have been unsuccessful, but this bill has the vocal support of Lt. Gov. Kristen Juras.

EPC-USA supported SB 210 and thank Senator Glimm for standing up against assisting a suicide.

Tuesday, February 21, 2023

Minnesota assisted suicide bills provide legal immunity to kill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The Minnesota legislature will be debating companion assisted suicide bills HF 1930 and SF 1813.

For many years I have writen about assisted suicide and the language of the assisted suicide bills. In 2021, New Mexico passed the most extreme assisted suicide bill in America. Minnesota's assisted suicide bills contains some of the measures that are found in the New Mexico law. 

"To learn more about the status of this bill and what you can do to stop assisted suicide, visit and take action."

The Minnesota assisted suicide bill is more permissive than the Oregon assisted suicide law. The bills:

  • Allows non physicians to assess, approve and prescribe lethal assisted suicide drugs. Minnesota defines a "Provider" as: a doctor of medicine or osteopathy, and an advanced practice registered nurse. 
  • Allows lesser trained mental health professionals to assess competency. "Licensed mental health provider" is defined as a psychiatrist, psychologist, clinical social worker, psychiatric nurse practitioner, or clinical professional counselor. 
  • There is no waiting period for being approved for assisted suicide. It is possible that a person request assisted suicide and die the same day.
  • Allows the lethal drug cocktail to be delivered by mail or messenger service. 
  • Allows a healthcare facility to prohibit assisted suicide but the facility cannot prohibit information about assisted suicide or referrals for assisted suicide.
  • Does not require the person requesting death by lethal drugs to be a resident of Minnesota. Oregon withdrew their residency requirement in 2022. There is now an assisted suicide clinic and suicide tourists in Oregon. 
  • Creates a "standard of care" for assisted suicide, Medical care that complies with the requirements of this section meets the medical standard of care. Assisted suicide is not medical care.

The Minnesota bills requires that assisted suicide not be listed as the cause of death on the death certificate. The bills states:

When a death has occurred in accordance with section 145.871, the death shall be attributed to the underlying terminal disease.
Further to that, a death by assisted suicide cannot be designated as a suicide or homicide. The bills states:
Death in accordance with section 145.871 shall not be designated suicide or homicide.
This is significant because when a person dies by assisted suicide, sometimes the person was administered the lethal drug cocktail rather than it being "self administered." The bill states that it shall not be designated a homicide.

The Minnesota assisted suicide bills provides complete legal immunity for "Providers" who are willing to prescribe lethal drugs. The bills states:

  • No person or health care facility shall be subject to civil or criminal liability or professional disciplinary action, including censure, suspension, loss of license, loss of privileges, loss of membership, or any other penalty for engaging in good faith compliance.

Good faith compliance is the lowest standard.

The bills end by providing more legal protection for those who participate in assisted suicide. The bills states:

(a) Nothing in sections 145.871 to 145.878 authorizes a provider or any other person, including the qualified individual, to end the qualified individual's life by lethal injection, lethal infusion, mercy killing, homicide, murder, manslaughter, euthanasia, or any other criminal act.

(b) Actions taken in accordance with sections 145.871 to 145.878 do not, for any purposes, constitute suicide, assisted suicide, euthanasia, mercy killing, homicide, murder, manslaughter, elder abuse or neglect, or any other civil or criminal violation under the law.
Section (a) states that the bill does not authorize a person to kill by lethal injection... but it doesn't prohibit it either. Section B states that actions in accordance with... do not, for any purposes, constitute... In other words, if the lethal drug cocktail was used to kill the person, the law states that it is not euthanasia, mercy killing, homicide, murder, manslaughter, elder abuse or neglect...

The immunity that these bills provide the "Providers" who assess, approve and prescribe lethal drug cocktails, should cause concern for every legislator and lead them to reject the bill.

The wording of the bills ensures that no one who participates in assisted suicide will ever be subject to any civil or criminal liability. Let's be clear, when the family of a person who dies by assisted suicide have a strong case that something very wrong occurred, the family will not achieve justice because the law grants complete immunity.

A Provincial Remedy for the Ills of Medical Assistance in Dying

The following article was published by the Frontier Centre for Public Policy on February 21, 2023.

Gordon Friesen
By Gordon Friesen
President, Euthanasia Prevention Coalition

When “Medical Assistance in Dying” (MAID) was decriminalized in 2016, that result apparently confirmed a powerful social bias in favour of personal freedom. Presented as a free choice — affecting no one else — euthanasia seemed acceptable to most Canadians.

However, this tells only part of the story, for euthanasia is not only about death-by-choice, it is also defined as high-priority medical care. Unfortunately, like a new organism released in an established ecosystem, the arrival of euthanasia could not fail to affect every detail of the medical environment.

First of all, it is an ethical requirement for doctors to inform patients of all available treatment options. This means informing each patient of their “right” to access euthanasia (MAiD). The typical non-suicidal patient is thus immediately confronted with the possibility of assisted death, in the same way that one is confronted by an open elevator shaft, or by a missing guardrail. Suddenly a danger exists which must be consciously avoided.

Nor does the threat end there. Doctors are expected to proactively prescribe optimal treatment (to which the patient will normally consent), but there are doctors who are very partial to euthanasia. It is thus to be expected that many patients will succumb to the suggestion of these “professionals,” even though they would never have spontaneously thought, themselves, to request assisted death.

Indeed, it is not easy to fix a clear boundary between the legitimate professional duty to convince recalcitrant patients of what is truly best for them, and the abusive application of “undue influence” in proposing death as treatment. Certainly, this is a slippery slope!

Roger Foley, for example, eloquently describes being offered euthanasia on multiple occasions during a prolonged hospital stay caused by his inability to obtain sufficient care at home. Eventually, hospital staff informed Mr. Foley that he would either have to pay an exorbitant daily fee or be discharged without the care he needed to survive. Accounts of this situation were naturally greeted with outrage by the press. But there also remains a sort of perverse logic in defence of the hospital based on the medical definition of MAID. By refusing euthanasia, Mr. Foley had effectively refused the proposition of a perfectly legitimate medical treatment, a fact that would normally lessen the hospital’s responsibility towards him considerably.

Similarly, in the now-famous scandal of Canadian veterans being offered MAID for PTSD, we must remember that Bill C-7, has indeed authorized euthanasia for mental illness without any physical issues. Therefore, while many Canadians might agree that the offending caseworker behaved with misguided enthusiasm, no one in authority has actually affirmed that veterans will not be euthanized for PTSD. Quite the contrary, in today’s legal and medical setting, it is a virtual certainty that they will be offered MAiD.

More generally, also, to suggest that human life should be ended according to medical criteria, is a completely different proposition from saying that people might, of their own free will, be allowed to seek assistance in death. As euthanasia is increasingly institutionalized, and as a younger generation of professionals becomes fully adjusted to its “medical” use, we must expect that typical patients will face an increasingly hostile clinical environment if they do not accept the recommended treatment. For what we are witnessing is the transition of our entire healthcare system to a new utilitarian model that is totally at odds with traditional assumptions of life-affirming care.

Obviously, this is not what Canadians thought they were getting. And more importantly, there has been no serious debate about making such a radical change.

Happily, one glimmer of hope is to be found in the fact that health is a Provincial responsibility; that just as Quebec was able to define euthanasia as medical care, so other provinces can revisit their decision. And without being able to prohibit euthanasia entirely (which is an exclusively Federal power), each Province and Territory is free to permit or to forbid euthanasia in any institution under its authority. They are free to decide whether their funds will support euthanasia, and free to regulate the behaviour of health professionals.

These are obviously very serious concerns. Healthcare consumes nearly a full third of all government spending. Do we Canadians wish to pay for a system that will care for us when we need it? Or, do we want to pay for a system that is designed to bury us at the lowest possible cost?

Gordon Friesen has been following the assisted death question closely since the early nineteen-nineties and is currently President of the Euthanasia Prevention Coalition.

The cruelty of assisted dying.

Prue and Danny's Death Road Trip.
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Prue Leith and Danny Kruger
Kevin Yuill, an emeritus professor of American history, wrote about the Channel 4 UK program titled: Prue and Danny's Death Road Trip. The program featured Prue Leith, who has a UK show - Great British Bake Off - and her son Danny Kruger, who is a UK Tory MP. Yuill explains in his article published by Spike-online:
The catch is that Prue and Danny are on different sides of the debate. Prue is an atheist, while Danny is a conservative Christian. Prue has been a member of Dignity in Dying, a well-funded pro-assisted dying campaign group, ever since her older brother died a long and ‘most horrible death’ in 2012. Danny, a fervent opponent of legalising assisted dying, is chair of the All-Party Parliamentary Group for Dying Well.
Kevin Yuill
Yuill states that he considers this documentary as one of the best ever produced on the topic because it is not one-sided, but balanced and it considers the social ramifications of treating death as a from of healthcare. Yuill explains:
Prue and Danny go first to the state of Washington, where it is legal for a doctor to assist a patient in ending his or her life by prescribing lethal doses of medication. Euthanasia – where a doctor ends a patient’s life, usually via lethal injection – is still outlawed. This is Prue’s opportunity to impress upon Danny the case for legalising assisted dying. A woman called Sher talks movingly about how her parents chose to die together after they were both diagnosed with Parkinson’s disease and terminal cancer. This is powerful stuff.

In fact, nearly all of the first section of the documentary gives Prue’s side the upper hand in the argument. That is, until they travel from Washington to Atlanta. Here, they interview a doctor who questions whether assisted suicides are any more peaceful than executions. Prue sees this as a red herring. She asks whether different drugs could be prescribed to allow for a more peaceful death. And she suggests Danny is ‘scaremongering’ by exaggerating the pain caused by a lethal dosage of medication. To this he replies: ‘I think you’re scaremongering.’ He points out that, in general, ‘People are unlikely to die terrible and agonising deaths’, if they are allowed to die of natural causes. Touché. Even according to the campaigners at Dignity in Dying, just over one per cent of people suffer as they die in the UK. That gives most of us good odds.
From this point on Yuill explains that Danny's arguments against assisted dying prevail. Prue and Danny now go from Washington state to Vancouver Island Canada. Yuill writes:
Over the past year or so, horrific stories have been coming out of Canada about people being offered MAID rather than medical care. This has made Canada a no-go area for proponents of legalised assisted dying. In the UK, Dignity in Dying mentioned Canada 88 times in its tweets between 2016 and May 2022. But since stories have emerged of Canadians being offered euthanasia because they were poor or homeless, Dignity in Dying has been silent about Canada. Until Prue and Danny’s Death Road Trip documentary this week, the liberal media in Britain had largely steered clear of it, too.
Prue and Danny meet with Dr Stefanie Green who has done at least 300 euthanasia deaths. Yuill writes:
In British Columbia, we meet Dr Stefanie Green. She comes across well, despite the fact that she has dispatched at least 300 people. Unlike in Washington, Canadian doctors are able to inject their patients with poison, rather than simply prescribing it. This was the preferred method of death for all but seven of the 10,064 MAID cases in 2021.

Green seems like a good and caring doctor. She is hesitant about approving MAID for Jan, a retired carpenter living with advanced Parkinson’s, at his first consultation. As the programme notes at the end, however, Jan has now been approved for an assisted death.

It is in Prue and Danny’s meeting with Green that we begin to see the self-deception involved in the case for assisted dying. When Danny asks Green about the Hippocratic oath and whether she is violating its prohibition on killing, she squirms. ‘I don’t believe I’m killing patients. I believe the illness and disease are killing the patients. We don’t say killing’, she says. She then demonstrates how to inject lethal substances into a patient.
Roger Foley
Prue and Danny go to Toronto where they meet with Roger Foley, a disabled man who was offered euthanasia rather than care. Yuill continues:
Prue and Danny also meet Dr Ramona Coelho who thinks the Canadian legislation has gone too far. In her view, MAID threatens the disabled, vulnerable and old. She tells Prue and Danny of other cases where MAID has been offered to patients with curable diseases who had previously expressed no interest in dying.

If all that weren’t troubling enough, Canada is currently proposing to extend its MAID programme to allow people suffering from a mental illness to qualify. Prue says that she’s ‘on the fence’ about assisted dying for cases of mental illness alone. Danny isn’t. ‘If someone was trying to jump off a bridge’, he says, ‘the natural inclination would be to try and stop them. So why is this any different?’
Prue and Danny then met John Scully, a former BBC and CTV journalist, who has suffered with extreme depression and PTSD for 30 years and wants to have an assisted death when it becomes legal with mental illness. Yuill explains:
He (Scully) has attempted suicide twice, but he says he can’t try it a third time. ‘It’s a mess’, he explains, ‘I screw it up, and it is terribly devastating to the families’. Prue, obviously rattled, says she is conflicted. Danny concludes – correctly, in my view – that Scully’s story goes to the heart of the debate. It forces us to reckon with the question of whether an individual patient’s wishes trump the wider impact on society. What does it mean for people’s families and loved ones if suicide is made so easily available? And what message does it send to those with suicidal thoughts – that it is right to act on them?
Yuill concludes with his position:
Prue and Danny’s Death Road Trip deserves great credit for exploring the grim situation in Canada. After all, Canada is the logical endpoint of legalising assisted death. If death comes to be seen as medical treatment for suffering, how can it be denied to anyone who suffers? Earlier this month, Canada moved to delay the expansion of MAID to patients with mental-health difficulties for a year, but the federal government is still committed to the principle.

The best safeguard against the kinds of horror stories appearing in Canada would be not to legalise any sort of assisted dying in the first place. In the UK, all forms of assisted dying are illegal, but the Isle of Man is currently considering legalisation. Meanwhile, Jersey has approved legalisation in principle and is currently taking steps towards setting up an assisted-dying service.
Yuill, who is an athiest and the author of the book: Assisted Suicide: The Liberal Humanist Case Against Legalization - is right. The only way to prevent the horror stories of what is appearing in Canada is to not legalize euthanasia.