Monday, July 31, 2023

Canadian Transgender Person Denied Euthanasia Request over Post-Surgical Pain and Regret

This article was published by National Review online on July 29, 2023.

Warning: This article includes controversial topics but the reality is that a transgender person is seeking death by euthanasia based on complications and regret related to having had transgender surgery.

Wesley Smith
By Wesley Smith:

At least one transgendered individual has been legally euthanized because of profound regret over transitioning. The killing took place in in Belgium ten years ago. From my piece on the tragedy at NRO, quoting the Daily Mail story about the case:
In the hours before his death he told Belgium’s Het Laatse Nieuws: ‘I was ready to celebrate my new birth. But when I looked in the mirror, I was disgusted with myself. ‘My new breasts did not match my expectations and my new penis had symptoms of rejection. I do not want to be… a monster.’…
The “treatment” for that despair? A lethal jab. Compassion, right?

Lois Cardinal
Now, there’s a similar story out of Canada. A transgender woman named Lois Cardinal wants to be euthanized because of terrible pain being experienced from–and deep remorse over–having been transitioned surgically. From the Daily Mail story:
An indigenous transgender woman has slammed Canada‘s healthcare system for rejecting her euthanasia request despite the pain she endures from a surgically-built vagina.

In social media posts, Lois Cardinal, a self-proclaimed ‘sterilized First Nations post-op transsexual’ said regret over her medical transition led her to apply for a lethal injection in January.

Cardinal, who lives on a native reserve near St. Paul, Alberta, posted her medical records from the request online this week to draw attention to radical gender ideology.
The surgery sounds just awful:
‘It’s taking this psychological burden on me. If I’m not able to access proper medical care, I don’t want to continue to do this.’ Cardinal underwent a vaginoplasty in 2009, but developed complications and quickly regretted the procedure.

She told that she feels constant pressure, pain and discomfort now, many years after the original surgery. The difficult procedure involves inverting the penis into a neo-vagina. Most recipients suffer pain and discomfort afterward, according to a recent study from the University of Florida.

Pain during intercourse and bladder problems are common. Neo-vaginas must also be dilated regularly to stop them from collapsing.
I find it telling that we don’t hear too much about such severe and chronic post-surgical complications in the debates over “gender-affirming care.” This is another reason why medical conscience laws should apply in this area. Transition surgeries should not be viewed as a “civil right,” if only because they have the potential to cause so much harm to the patient.

Canadian euthanasia license is so liberal, one would think Cardinal would qualify to be killed. After all, the pain and despair caused by the surgery are long-standing, as is Cardinal’s regret.

But the doctor refused, stating that there remain treatment options that could ameliorate Cardinal’s suffering. But that is almost always the case with euthanasia cases — and indeed, Canadian law doesn’t require those who want to be killed to access such care. To the contrary, “irremediable suffering” is based on the patient’s perspective, not the unavailability of palliative or treatment interventions. (This is also true under US assisted suicide laws.) Indeed, the Canadian Supreme Court’s ruling that conjured euthanasia as a constitutional right expressly stated that the term that includes “psychological pain,” disability, and suffering that is deemed irremediable only because alleviating treatment is refused by the patient.

Cardinal believes the euthanasia request was denied because of political and cultural concerns involving the contentious issue of gender ideology:
Her rejection for MAiD amounted to a ‘human rights concern,’ she said. Doctors are more interested in finding out what pronouns she uses than easing her pain, she told ‘I’m not getting any better and nor am I experiencing better medical care, or any medical care,’ Cardinal said. ‘It’s so captured by gender ideologies, that they care more about my pronouns.’
Alas, the death doctor remains open to killing the patient:
Unless her referrals to specialists help to ease her pain, she will re-apply for assisted suicide in the coming months, she added.  In other social media posts, Cardinal slams the transgender ideas that led to her to bottom surgery 14 years ago. She could be ‘reassessed’ for MAiD in the future if there is a ‘change in clinical status.’ ‘The patient is aware she can contact me again for her ongoing journey for an assisted death,’ added the practitioner.
“Ongoing journey:” We’re talking about a potential homicide! What a load of crapola.

Some would say that this is a case of the guidelines working to protect the vulnerable. I disagree. People have been euthanized in Canada experiencing far less distress that which Cardinal bears. Rather, in my view, euthanasia was denied because the transgender issue is so volatile, and also, because Cardinal is a member of a First Nations tribe. Killing Cardinal, in other words, would ignite a firestorm that would pose significant challenges to transgender and euthanasia ideologies, along with emphasizing the difficulties First Nations residents of reserves have accessing good medical care.

Don’t get me wrong. I am very pleased Cardinal isn’t going to be killed (yet). No one should be euthanized but greater care always extended to suicidal people to help them remain with us. Indeed, the tragedy here–beyond the awful consequences of the transition surgery–isn’t that Cardinal was refused a lethal jab but that doctors don’t always refuse such requests, and instead help patients access care to alleviate their pain and existential suffering so they don’t want to be killed.

Americans with Disabilities Act - Celebrating 33 years

Meghan is an autistic person who is an instructor at E4 Texas at the University of Texas (Austin) and a EPC-USA board member.

By Meghan Schrader

Meghan Schrader

In these last few days of Disability Pride Month following the July 26th anniversary of the Americans with Disabilities Act, I feel inspired to write about justice for disabled people in general. 

I appreciate the opportunity to write about assisted suicide on the EPC blog because I regard assisted suicide as being on a continuum of human rights violations against disabled people. On a spectrum of disability rights abuses, assisted suicide for disabled people is right at the bottom-right next to the idea of “let’s kill disabled people.” (Article Link)

However, in honor of this past anniversary of the Americans with Disabilities Act, I note that opposition to assisted suicide is an important disability justice issue, and I want to encourage readers of the EPC blog to work hard at addressing the other issues.

I am very grateful for the Americans With Disabilities Act, and very proud to live in a country whose civil rights legislation for disabled people often serves as a model for the rest of the world. For instance, the ADA played a significant role in inspiring the United Nations Convention on the Rights of People With Disabilities. (Link to the article). Although the Americans with Disabilities Act certainly has not extricated systemic ableism from our society, disabled people in the United States have more protections then disabled people in many other parts of the world, even in other developed countries. And, for that I can thank the disability rights activists who crawled up the Capital Steps to demand the ADA be signed in 1990, and the disability rights advocates who occupied the HEW headquarters in 1975 to demand the implementation of the ADA’s predecessor law, Section 504 of the Rehabilitation Act. Those are the kinds of events that we commemorate and celebrate during Disability Pride Month. 
(Link to the video).

But, I’m sorry to say that more than three decades after the ADA, disabled people still have to deal with antipathy from people who see the ADA as a bother or an injustice against able-bodied people. In fact, a recent poll of disabled people indicated that the majority of disabled voters believe that most politicians do not care about us, and I fall into that camp. (Link to article). I’ve seen ableism everywhere being refracted through the prism of whatever political ideology individuals happen to hold. That is why some disability justice advocates refer to Disability Pride Month as “Disability Precarity Month.”

In my time growing up in the USA’s Special Education system and seeking accommodations as an adult, I’ve seem conservatives refer to the ADA as “liberal fascism” and whine about the impact of the ADA on schools and small businesses (Link to the article). I’ve had libertarian relatives ask me why we really need the ADA, and why we can’t just trust the free market to winnow out inaccessible buildings, schools, doctors offices, etc. I’ve seen Democrats show up at disability voting events to make what are often token gestures to the disabled community, and Republicans not bother to show up at all. I’ve seen progressives treat the ADA as a “third class” civil rights issue that social justice discussion’s almost never address. I’ve seen progressives pit the money spent on disabled people’s needs against the needs of other disenfranchised groups, portraying disabled people’s basic accommodations as “privileges” that take money away from ablebodied poor people who need the money more. And, of course, this kind of thinking foments bitterness between disabled people and people of other disenfranchised groups, who should be working together to meet the needs of disabled people from those groups, and to pool our collective insights about how to improve the world for everyone.

I have contemplated whether maybe the disabled community should take the Benedict Option. Often the world’s treatment of disabled people is so bad, and seems so hopeless to me, that I really think the best idea would be for us to buy an island in the Pacific somewhere and set up our own society. Just think of it: Disabled People Island, where we can base policies off of the social model of disability, appoint a carefully selected oligarchy of disability justice thinkers to leadership positions, and set up accessible education, housing, transportation, worship, recreation and employment for everyone. Our society could be sure that we keep intersectional justice in mind. We could honor the voices of LGBT persons and BIPOC people with disabilities and create social policies that meet their needs (Link to article). We could work with clergy who have training in disability justice and theology to make sure that disabled people have a breath of accessible faith communities to choose from (Link to article). We could have hospitals staffed by disabled doctors and doctors of all abilities who are trained to provide effective, person-centered healthcare to all disabled patients. We can have schools with the highest pedagogical standards for instructing disabled young people. And, while autonomy would certainly play an important role in this society, we would focus policies primarily on the values of love, justice and equality.

Since setting up a separate society is not practical (after all, people in the disability justice community aren’t saints either), we in the human community need to do what we can to make this world better. And, I firmly believe that we can do that. I have met people from all over the political spectrum who do care about disabled people and our rights; mentoring from allies with all different kinds of belief systems has essentially saved my life. Historically, there has been bipartisan action to advance disability rights; the Americans with disabilities act, for instance, had both Democratic and Republican sponsors. People from all over the political spectrum are disabled or have disabled relatives and friends. In these last few days of disability pride month, 

I want to exhort the EPC blog’s readers to remember that opposition to assisted suicide is only one disability justice issue. Please make sure you’re doing what you can to mentor, empower and employ people with disabilities, both those you meet in your communities and in respect to the public policies you support. Listen to disabled people and make decisions that put our needs first.

(Unless you are one of the people proudly making a living killing disabled people or advocating for those policies; then you can go cackle in a dark tower where villains belong.)

Happy Birthday, ADA!

Wednesday, July 26, 2023

Netherlands Psychiatrist reprimanded in two euthanasia deaths

"the disciplinary committee condemns the behavior of a healthcare provider but that the person can continue to practice their profession."
Alex Schadenberg
Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An unnamed psychiatrist in the Netherlands has been reprimanded in two euthanasia deaths. 

The NL Times reported on July 26 that The Regional Disciplinary Court for Healthcare in Amsterdam ruled that the healthcare provider was reprimanded for not acting with due care in two euthanasia deaths.

The NL Times reported that in the first euthanasia death:
The reprimanded psychiatrist is accused of ignoring a colleague’s second opinion in one case. That fellow psychiatrist found that the patient involved was not mentally competent, among other things, “because the reason for wanting to die lies in a psychotic conviction.” There were also further treatment options available for the patient, the colleague said.

The psychiatrist did continue to treat her patient. But when that process was completed, she took up the request for euthanasia again. After consulting her team and another expert, she concluded that the patient was mentally competent. When she represented this to the colleague psychiatrist, who previously ruled that the patient was not mentally competent, the colleague did not understand her conclusions. According to the disciplinary committee, the reprimanded psychiatrists did not properly substantiate why she stuck to her own opinion.
The NL Times reported that in the second euthanasia death:
the psychiatrist did not ask for a second opinion at all. She herself also admitted that this was contrary to the guideline used in psychiatry “and was therefore incorrect.”

The disciplinary committee said it considered the "complexity of the matter" with which the psychiatrist had to deal when imposing the reprimand. The Board also said that it had not been shown that patient safety had been compromised. A reprimand means that the disciplinary committee condemns the behavior of a healthcare provider but that the person can continue to practice their profession.
The NL Times did not name the psychiatrist but it reported that the psychiatrist can continue to practice.

Two inappropriate euthanasia deaths resulted in a slap on the wrist for the psychiatrist.  
 How many wrongful deaths are acceptable?

Afghanistan veteran slams Canadian government for euthanasia of veterans

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kelsi Sheren
Will Potter reported for the Daily Mail on July 9 that Kelsi Sheren (right), a Canadian military veteran who served in the Afghanistan war, is disgusted with the Canadian government's attitude to euthanasia including making it available to veterans who are suffering from PTSD. Potter writes:
Army veteran Kelsi Sheren was a fresh-faced 19-year-old when she first set foot on the combat field in Afghanistan. It proved to be a life-altering experience.

Six months later the Canadian artillery gunner was 'still shaking' on a military helicopter heading home after witnessing one of her comrades being blown to pieces after he set off an IED in the field as their battalion moved from compound to compound.

'That was my first exposure to watching someone die. And that was my first exposure to having to clean up what was left of someone,' Sheren told
Sheren said that witnessing that horrific death "broke part of her brain" and when she got home she started therapy for post traumatic stress disorder (PTSD).

Potter explains that Sheren has become an outspoken critic of the Canadian government's relaxed attitude to euthanasia - including its push to make it available to veterans plagued by PTSD. Sheren told Potter:
'It's disgusting and it's unacceptable,' she said, arguing that authorities would rather euthanize a soldier than foot the bill for their recovery.
Potter then states:
Sheren is enraged by the 'unacceptable' and 'infuriating' law. She says she personally knows almost a dozen veterans who have been offered euthanasia by authorities, a 'disgusting' approach to 'people who were willing to put their lives on the line... then you have the audacity to tell them it's better if you just die'.
Potter reported that:
Canada has the world's most permissive assisted suicide program. The country is on track to record some 13,500 state-sanctioned suicides in 2022, a 34 percent rise on the 10,064 in 2021, according to Canada's Euthanasia Prevention Coalition's analysis of official data.

Canada's politicians are currently weighing whether to expand access to include children and the mentally ill.
Potter reported that Sheren - whose experience is detailed in her new book, 'Brass and Unity', published by Knox Press - has made it her mission to help other veterans.

CTV News publishes irresponsible suicide article

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kenneth Law
An article written by Aisling Murphy and published by CTV News on July 25 appears to focus on the case of Kenneth Law who was arrested on May 2, 2023 for allegedly selling 1200 suicide kits online. In reality, the article promotes suicide.

The article interviews family members of victims who died by suicide after allegedly obtaining a suicide kit from Law. The article names the suicide substance and provides justification for elder suicide.

Suicide prevention guidelines clearly state that it is inappropriate to describe suicide methods or instructions or appear supportive of suicide deaths.

The article begins by stating:
Law was arrested by Peel police on May 2 and charged with two counts of counselling or aiding suicide. It’s possible more charges could follow from additional police jurisdictions – a Dutch man by the name of “Alex S.” was sentenced to three-and-a-half years in prison last week for similar charges in the Netherlands.

Over 40 countries and 11 Ontario police forces are now involved in the investigation against Law, who briefly appeared in court on Friday.

The prosecution of Kenneth Law is proving to be a flashpoint in two major online movements: the “pro-choice” suicide advocates, who run forums with detailed guides on how to take one’s own life, and the parents of children who lost their lives in part due to information gleaned from those sites, often with the help of people selling suicide devices online. has studied these sites extensively, and Law’s alleged businesses were frequently recommended to at-risk users before his arrest in May.
Last week, Alex S was convicted in the Netherlands for aiding suicide in at least 10 suicide deaths and sentenced to 3.5 years after he sold online 1600 packages of a suicide substance. 

Murphy interviewed Kelli Wilson and Catherine Adenekan, located in the U.S. and U.K. respectively, who are mothers of children who died after receiving the suicide substance through pro-suicide forums. Murphy writes:
“This trial is monumental in so many ways,” said Wilson. “These sites sell to vulnerable people. It’s aiding and abetting suicide, which is akin to murder.Law weaponized mentally ill people against themselves, and that can’t be allowed to continue. It’s a no-brainer. He needs to be held accountable for what he’s (allegedly) done. And the lawmakers, as well – they’ve facilitated these havens for crime.”

“What he’s (allegedly) done is one of the worst things you could possibly do,” added Adenekan. “The root cause of the problem, though, is [pro-suicide forums], which is how sellers like Law get their customers.

“We’re hoping that each and every person he has (allegedly) assisted will get justice for what he’s done,”
I applaud Murphy for interviewing families of suicide victims. However, she is irresponsible and unprofessional by naming the substance used for suicide, including an image of the package of the substance. 

Murphy also interviews Philip Nitschke, a long-time suicide and euthanasia activist, who makes a living selling his suicide book and suicide materials. 

Nitschke essentially says that Law wasn't careful because he was selling the suicide substance to everyone, including teenagers but then Nitscke justifies elder suicide. Murphy states:
While Nitschke advocates for seniors hoping to end their own lives, he says Law acted short-sightedly by allegedly selling sodium nitrite to younger individuals.
It is interesting that Nitschke is concerned about teen suicide considering he told Kathryn Lopez in a 2001 interview that he would provide the "peaceful pill" to troubled teens. Lopez reported in 2001:
I do not believe that telling people they have a right to life while denying them the means, manner, or information necessary for them to give this life away has any ethical consistency. So all people qualify, not just those with the training, knowledge, or resources to find out how to “give away” their life. And someone needs to provide this knowledge, training, or recourse necessary to anyone who wants it, including the depressed, the elderly bereaved, [and] the troubled teen. If we are to remain consistent and we believe that the individual has the right to dispose of their life, we should not erect artificial barriers in the way of sub-groups who don’t meet our criteria.

Nitscke is happy to do these interviews because it directs people to his suicide website.

Murphy and CTV  are irresponsible by publishing an article that essentially promotes suicide.

“Study on Disabled Children’s Access to Healthcare Shows Just How Badly Society Has Failed People With Disabilities.”

[I asked Meghan Schrader, a person with autism and an instructor at E4 Texas at the University of Texas (Austin) and a EPC-USA board member, to comment on the following study (Link) and I sent her this commentary on the study (Link). This is Meghan's response. - Alex Schadenberg]

By Meghan Schader

Doctors refusing to work with autistic children. Doctors telling the parents of physically disabled kids not to treat their treatable cancer, which would result in the children’s deaths. Doctors not knowing how to treat complex medical conditions that it’s their job to treat. Clinics with no wheelchair ramps. Deep apathy towards bothering to treat disabled children because they are collectively “not worthy” of treatment. All of this exists in the United States, despite the fact that it’s supposed to be forbidden by the thirty-three-year-old Americans with Disabilities Act. And, of course, the United States is not unique, disabled people all over the world report similar encounters with medical personnel.

As the disability rights movement has pointed out, a lot of this antipathy is empowered by utilitarian bioethics. Doctors taking ethics classes in medical schools and reading pieces in journals like The New England Journal of Medicine are being trained to think of disabled people as a threat to resource equity. So, the study’s findings anger me, but I am not surprised.

I have limited experience with the life-threatening discrimination that the children in the study experienced. Despite a life-threatening infection at birth that required pretty significant medical intervention in a neonatal intensive care unit, I was a very healthy child growing up. I had yearly monitoring of a mild seizure disorder in the form of a blood test and an EEG, and I was followed by a neurologist for that, and I needed academic accommodations for my learning disorder and ADHD, but other than that I had little interaction with the medical sphere until I found myself needing to seek inpatient treatment for refractory depression in my early 30s. (I did not get an autism diagnosis or have MRI evidence of a brain injury until adulthood) So, although I occasionally did run into a childhood doctor who said something obnoxious about my neurological disabilities, I didn’t experience the medical oppression that this study on the experiences of disabled children in the medical sphere documents. No doctor would’ve told my parents to let me die if I had gotten a treatable cancer.

But, I do see parallels between what the physically disabled children experience in the medical system and what I experienced in the Special Education system, that similarity being that some of the people in charge of those systems resent the people that it’s their job to assist. In the study the doctors complain about how taxing it is to care for disabled children in much the same way I grew up hearing some Special Ed teachers complain about what a burden it is to teach disabled children. Indeed, until the 2001 No Child Left Behind Act, Special Education teachers weren’t required to be certified in the subjects they taught or to know how to do evidence-based interventions, and teachers groups fought the NCLB so that unskilled teachers could keep their jobs, just like the doctors in this study didn’t bother to learn about how to treat complex physical disorders. For some reason, people who resent some children with disabilities sometimes become Special Education teachers, and apparently many people who resent some disabled children become those children’s doctors. So, please, potential doctors and teachers, if you hate disabled people so much that you wish we didn’t exist, at least do us the courtesy of not becoming a teacher or a physician. Go find some other job to do, where you won’t be in charge of disabled people’s lives.

I wonder if there has to be a better screening system in place to ensure that medical schools don’t admit people with an ethic of, “Oh, I want to be a doctor, but I don’t want to do anything icky like care for a child with a complex medical condition.” The powers that be need to stop behaving like they think disabled people exist to serve them. Why should disabled people have to experience cruddy education, cruddy jobs, cruddy healthcare and even death just to please you?

One thing that really lights my anger on fire, and will be the main focus of the rest of this essay, is the response the study creators got from the coordinators of a hospital equity and diversity event when they tried to present a panel on their findings. The equity and diversity leader apparently said, “That's not the kind of inequity we're looking for. We are focusing on more relevant issues, such as race and ethnicity.”

It is not necessary for MAiD to be legal for the diversity coordinator’s statement to be llogical. Not everyone with a disability is white. Equity and inclusion officers concerned with racial equity should be able to anticipate that disabled children of color will experience even more complexities and difficulty when trying to circumvent medical ableism, and that, therefore, fighting medical ableism is a racial justice issue. Disabled children of color may need specific interventions to interact successfully with an ableist medical system, in much the same way that there are evidence-based techniques created to meet the pedagogical needs of children of color with disabilities in the Special Education system. Being cognizant of how systemic racism and systemic ableism intersect with one another is what contemporary diversity and equity initiatives are supposed to be all about.

Yet, whoever was in charge of equity and inclusion at the hospital where the authors presented a panel idea decided that those needs weren’t worth her time. More generally, not intervening while disabled children are encouraged to forgo treatment for treatable cancer and suffer other forms of abuse and oppression from medical personnel is a very clear case of “silence is violence.” The disabled community-which includes people of all races, genders, sexual orientations, religions, classes and ideologies-simply cannot and will not wait quietly in the back of a line while society busies itself with solving every other social problem. That’s like forcing a group of people to constantly stand at the back of the line for water in a desert. That situation is leading to disabled people dying while we’re waiting in the line. 

MAiD is one of the most extreme manifestations of that trend. Even if MAiD vanished off the face of the earth, the disabled community would still be facing other extreme forms of oppression that need to be addressed by diversity and equity programs.

Leaving disability out of discussions about diversity is a constant historical pattern in society, and it is hypocritical for any equity program to exclude disabled people from its agenda. So, I would say the same thing to prospective equity and inclusion program directors that I said to prospective doctors and teachers: if you hate disabled people so much that you wish we didn’t exist, or if you just don’t care enough about our right to exist to talk about it even once at a conference about equity, then at least do us the courtesy of not becoming a diversity and inclusion officer.

All of these dynamics contribute to the creation of a world where euthanizing disabled people is understood as a mercy rather than for what it is: society killing members of a disenfranchised people group because they are members of that group. Because equity-minded individuals ignore disability rights, the normal social safeguards against inequality and discrimination disintegrate. For instance, reporter Alexander Raikin noted on Twitter, “For all the talk about cancel culture, if you’re an academic, you can say whatever you want about people with disabilities. You can say that their lives aren’t valuable, that being dead is an improvement. You won’t get penalized for these views-it’ll help you get published.”

Indeed, and academia allowing that bigoted speech is leading to life-shattering oppression against people with disabilities. That sense of permission that academics feel to say hateful things about people with disabilities is directly tied to the fact that our culture’s vanguards of equity and inclusion ignore disability justice.

Disability and equity programs need to look at this study on medical care for disabled children and do sober reflection on the consequences of leaving disability ought of mainstream discussions about diversity. If disability justice were regularly included in social justice spaces, more people would respond to the rhetoric Raikin cites for the hate speech that it is. Otherwise, disabled people are in a no-win position politically. Then disabled children wind up being treated like obnoxious animals when they go to a doctor.

Meanwhile, Canada is absolutely encouraging its disabled children to die by assisted suicide, either when they grow up, or if euthanasia is legalized for “mature minors.” Why? Often because mainstream diversity and equity officers all over the world just sit there while disabled children trying to get healthcare are treated like worthless, resource-sucking leeches.

The findings of this study reflect a world where disabled children experience fourth class citizenship. Disabled people deserve a better world than that. 

Previous articles by Meghan Schrader (Articles Link).

Tuesday, July 25, 2023

Slovenia debates assisted suicide. Doctors and medical groups oppose the bill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Slovenian legislature

On June 19 I reported that Slovenia was debating euthanasia and assisted suicide. A Slovenian group called Silver Thread collected signatures and were demanding the legalization of assisted dying. The bill proposed by Silver Thread was to be introduced in the Slovenian legislature. 

A Slovenian news article indicated that an assisted dying bill was introduced in the Slovenian legislature on July 17.

The Slovenian Times reported on July 21 that the bill would legalize euthanasia and assisted suicide and was similar to the Spanish euthanasia law. The article reported:

Jurist Peter Golob said that the bill was the closest to the Spanish law that recognised both procedures, which were tied to the obligation of a certain person to perform the assistance.

He said that the Slovenian proposal was bad as it presented the procedures as a right instead of a possibility, while jurist Urban Vrtačnik added that the proposal lacked a comparable legal analysis and a broader debate on social and legal terms.

There is also a lack of debate on “how to properly balance out values such as the value of life, possibility of making decisions about oneself and inviolability of life in order to obtain a socially and legally coordinated solution,” he added.

On July 25 Representatives of doctors and medical organisations held a press conference to express opposition to the proposed bill to legalise assisted dying, arguing that it is inconsistent with medical ethics and the constitution.

On May 4 the Medical Ethics Commission at the Health Ministry issued an opinion opposing the bill, which it said entails a high level of ethical risk.

Woman who died by euthanasia included as victim of Brussels terrorist attack

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In October 2022 I wrote about the Belgian euthanasia death of Shanti De Corte (23) who was approved for euthanasia after living with PTSD related to a ISIS bombing attack 7 years earlier at the Brussels airport.

I also reported on the controversy surrounding De Corte's euthanasia death after a local neurologist told authorities that the decision to euthanize Shanti De Corte "was made prematurely."

BBC news reported on July 25 that the Belgian terrorist bombers were found guilty in the deaths of 35 people. The BBC article by Paul Kirby states that 32 deaths were immediately related to the bombing and three people who died in the years following the bombings were also considered victims of the attacks. According to Kirby the 35 deaths included:

Shanti De Corte

Shanti De Corte, 23, who suffered years of unbearable psychological illness before she died by euthanasia last year.

Xavier Legrand died of cancer in 2017 after being forced to halt treatment because of the wounds caused by the metro bombing.

Mathieu Fischer took his life in 2021 after suffering years of post-traumatic stress.

A study published in the psychiatric journal 
Rivista di Psichiatria in November 2022 concluded that:

Belgian legislation provides for euthanasia for patients suffering from mental disorders who, like those suffering from somatic disorders, experience a condition of constant, unbearable and incurable suffering. But the case in question raises numerous perplexities both on the clinical and ethical coherence of Belgian legislation and on the ways in which the rules of this legislation have been observed in this specific situation.
Killing by euthanasia is promoted and approved based on "hard" cases. Once killing becomes an acceptable solution to human suffering, soon there are many more reasons, or types of human suffering, that killing becomes the solution for.

We need a caring society not a society that kills.

Fake news about fake news on child euthanasia in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Melissa Goldin reported for AP Fact Check on July 24, 2023 that:
Social media users are misrepresenting a screenshot of the advocacy organization’s website (DWD) as proof that the Canadian government is pushing its youth to cut their lives short.
The article titled: Canada isn't pushing minors to end their lives. Current euthanasia laws don't apply to them anyway refers to a social media post that appears to suggest that euthanasia already applies to minors in Canada.

Euthanasia in Canada does not yet apply to minors (but the government is considering it).

Canadian government committee released a report on February 15, 2023 recommending (among other things) to expand euthanasia to "mature minors" in Canada. The report, Medical Assistance in Dying in Canada: Choices for Canadians, which was composed by 10 Members of Parliament and 5 Senators, can be viewed here: (Link).

The article by Goldin appears to support the group Dying With Dignity, a euthanasia lobby group that supports child euthanasia. The article states:
THE FACTS: Social media users are misrepresenting a screenshot of the advocacy organization’s website as proof that the Canadian government is pushing its youth to cut their lives short.

The screenshot shows the top of a page titled “Mature minors” on the website of Dying With Dignity Canada, a charity focused on end-of-life quality and rights. It includes a photo of a child in bed and states: “With the appropriate safeguards in place, mature minors should be allowed the right to choose MAID.”
Goldin later states that Health Canada spokesperson Anne Genier told the AP:
“The Government of Canada has no plans to alter the minimum age requirement to access MAID,... Health Canada is considering undertaking research to understand the views and perspectives of young people, and their parents/caregivers, about suffering and end of life options, including Medical Assistance in Dying.”
The Canadian government is studying euthanasia for "mature minors" but has not yet introduced legislation to expand the law. This is very different than saying that the Canadian government has no intention of introducing changes to the law.

Goldin is trying to rehabilitate the euthanasia lobby's "misleading" comment on child euthanasia. Goldin refers to DWD as a charity focused on end-of-life quality and rights. Perhaps Goldin considers killing someone by euthanasia as a form of "end-of-life quality and rights."

My response? It's fake news about fake news.

Canada's Euthanasia Horror Story

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Spectator published an indepth article by Douglas Murray concerning Canada's euthanasia law that entitled: Canada's Euthanasia Horror Story.

He begins by refering to the novel, Time's Arrow, by Martin Amis that follows the Nazi Holocaust but in reverse, meaning, he records the end to the beginning.

Murray, who opposes Canada's euthanasia law, states his concerns:
As long-term readers will know, this is a slope that I have worried about for some time, for there is a slipperiness to it. Sure enough, two years ago Canada expanded the law to encompass people who had non-terminal conditions. As of next year the criteria will expand again, this time to take in people whose sole underlying condition is mental illness.
Murray explains that politicians and celebrities have been raising awareness of how debilitating mental illness and stress can be:
But that ground starts to move awfully fast once a state has said that incurable physical ailments are enough to send you to the knacker’s yard.
Murray focuses on the story of Lisa Pauli (47) who lives with anorexia and wants to die by euthanasia. He writes:
Lisa Pauli this week spoke to the media to announce her desire to take advantage of the new law. The 47-year-old suffers from anorexia, and has done since the age of eight.
Murray acknowledges that a 47-year-old with anorexia clearly needs help, but in Canada her help may be death by euthanasia. Murray refers to death by euthanasia as a "cure." He writes:
You can expect Canada to find a lot of other ailments to cure in the years ahead. Just last year a Canadian armed forces veteran who has been suffering from post-traumatic stress disorder (PTSD) sought support from Veterans Affairs Canada. An employee of the agency asked him if he had considered taking advantage of the new euthanasia options available in Canada. The veteran in question said that this was suggested unprompted.
Shanti De Corte
Murray tells the story of Shanti De Corte, who at the age of 17 survived the Belgium Airport terrorist attack. Last year De Corte died by euthanasia to escape the PTSD that she had been living with after the terrorist attack. Murray continues:
And so it does seem likely that at some point after March Canada will be able to go down a similar hell-path. As well as being able to kill the victims of crime and terror, they will be able to kill (or award ‘medically assisted suicide’) to people of any age who suffer from anorexia, depression, PTSD or a growing smorgasbord of other debilitating ailments. And in time a temptation will linger over Veteran Affairs Canada, and among many other organisations and medical professionals.
Murray statement, "people of any age [can obtain euthanasia]" is incorrect. In February, a government committee supported expanding euthanasia to "mature minors" but the government has not introduced legislative change yet.

Murray ends his article by stating:
Naturally I must stress, as does the Canadian government, that this ‘complex and deeply personal issue’ will ‘reflect Canadians’ needs’ and ‘protect those who may be vulnerable, and support autonomy and freedom of choice’. It all starts from such a kindly place. It’s all about bodily autonomy, you see, and freedom – including freedom of choice... And perhaps it is These bodies and souls are, after all, horrifically disfigured, mangled things. Perhaps it is right to wonder whether it’s worth the effort involved in bringing them to life?

Further reading:

Monday, July 24, 2023

Compassionate release from jail or euthanasia?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Avis Favaro, the CTV News Medical Correspondent, reported that Ed Speidel, who who was rejected by the parole board for a compassionate release so that he can die in a half-way house rather than jail, is now seeking death by (MAiD) euthanasia. Favaro reported:
"My biggest fear is dying in jail. I don’t want to die in jail," said Speidel in a phone interview with CTV News from an office in the Matsqui Institution, a medium-security prison in Abbotsford, B.C.
Favaro explains that Speidel is living with end-stage chronic obstructive pulmonary disorder (COPD) along with chronic pain and rheumatoid arthritis. According to tests Speidel has less than 20% lung function. Favaro reports:
He requires oxygen 24 hours a day. Yet just prior to his phone interview with CTV, he said he had to struggle to get staff to provide him with a portable oxygen unit to make the trip to the room where the interview would take place.

Speidel, who uses a walker and spends most of his time in his cell, says he is in no way a threat to the public.

"(I did) robberies. But I didn't hurt anyone," he said. "I have done 41 years. I’ve done my time. Nothing is being served by keeping me here."
Speidel received a letter from the doctor at the institution recommending compassionate release and his lawyer asked the parole board to expedite their decision. On July 8 the parole board rejected an expedited hearing.

Lisa Crossley, the lawyer for Speidel, told CTV News that her client is terminally ill and doesn't pose a risk to society. Crossley said that this is the first case of its kind in the country.

Ivan Zinger, the correctional investigator of Canada told CTV News that a 2019 review created concern. Favaro reported Zinger as saying:
"We saw an inordinate amount of prisoners who were either terminally ill or had dementia or Alzheimer's, who had severe mobility restrictions, who were bedridden. And all these individuals, you scratch your head, saying, 'What are they doing in a prison setting?'" he said in an interview from his office in Ottawa, Ont.

"Prisons and penitentiaries were never designed to be nursing homes or long-term care facilities or hospices. And this is what they've turned out to be. And it's just not acceptable," Zinger added.
Favaro ends the report by stating:
With no indication he will get out any time soon, Speidel has applied for medical assistance in dying (MAID), and is awaiting a medical assessment. The process usually takes three months or less.

He says he'd much prefer dying a natural death in a supervised halfway house. But his next regular parole hearing could be in 2024.

"What it looks like is that it's easier to kill myself here, with their (medical) help, than it is to try and convince them to let me back out. And I don't understand why," Speidel said.
A previous CTV News report indicated that the rate of euthanasia among inmates in Canada is increasing. 

Inmates who are dying and who are not a threat to the public safety of others should be provided a place to die, whether that be a half-way house/hospice setting or a secure location where they can receive visitors.

Nonetheless, the concept of inmates "freely choosing" to die by euthanasia is an oxymoron at best.

Wednesday, July 19, 2023

Research: The Reality of Medical Assistance in Dying in Canada

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Cambridge University Press published an important research article on the realities of Canada's (MAiD) euthanasia law, on July 18, 2023. The research article, by Drs. Ramona Coehlo, John Maher, K Sonu Gaind, and Trudo Lemmens, provides clear research and explanations as to why other countries and jurisdications must reject the legalization of euthanasia and assisted suicide. 

Read the full article and acquire links to all references (Article Link).

Parliament legalized MAiD in June 2016 and expanded the legisation by passing Bill C-7 in March 2021. Bill C-7 expanded the law in the following way:

The legislation introduced a regime of 2 MAiD pathways. Several safeguards from the initial regime were removed from what was now called “Track 1,” a pathway for which an applicant still has to have an (Reasonably Foreseeable Natural Death) RFND. Bill C-7 added “Track 2,” a new pathway for those with a serious disease, illness, or disability and an irreversible decline of capabilities, but who are not approaching their natural death. This means de facto persons with disabilities. A delayed implementation clause for Track 2 (“sunset clause”) stipulated that those with sole mental disorders would become eligible for MAiD in March 2023.

The Truchon court decision, that led to Bill C-7, and the Supreme Court of Canada Carter decision, that led to the legalization of euthanasia in 2016, did not deal with the issue of euthanasia (MAiD) for mental illness. This is important because the Canadian government now claims that the Carter decision permitted euthanasia for mental illness.

The article discusses the increase in Canadian euthanasia deaths by comparing Canada to California. Canada and California have a similar population and both jurisdictions legalized assisted dying in June 2016. In 2021, Canada had 10,064 reported MAiD deaths and California had 486 reported assisted suicide deaths. Quebec now has the highest euthanasia rate in the world.

They then analyse Canada's experience with euthanasia by examining several categories.

They first analyse Canada's inadequate data collection:

The data are acquired from the MAiD providers via self-reporting. There is no mechanism for objectively, prospectively, or retroactively identifying or uncovering any errors or abuses of the process. Providing assisted suicide and euthanasia outside the parameters of the law remains prohibited. MAiD providers filling out the forms know that any deviation of the key criteria may result in criminal prosecution, making self-declarations of error or deviation unlikely.

Cases of non-compliance have been reported in Québec, Ontario, the Office of Correctional Investigator, and through several news articles. Yet, none of these stories or data appear in Health Canada's Annual reports. 

Under the heading, Lack of Oversight, they examine several known cases.

Donna Duncan's daughters.
They first examine the death of Alan Nichols. Alan died by euthanasia in Chilliwack BC in August 2019. Alan (61) had lived with recurrent episodes of depression. When entering care he was diagnosed as suicidal, but soon he was deemed capable of requesting MAiD.

The researchers then explain the case of Donna Duncan. Here is a link to the story of Donna Duncan's euthanasia death (Article Link).

Read the full article and acquire links to all references (Article Link).

The researchers state:

Rather than the government accepting responsibility for setting up procedures for investigation, the Justice Minister stated that oversight must be provided by family members complaining after the fact to initiate disciplinary actions or police investigations. Yet, the experiences of family members who have tried to pursue concerns suggest that cases cannot be transparently reviewed, and health authorities have invoked “best interest exceptions” to rebuff requests for access to medical records.

They show how Canada is Prioritizing access to MAiD over patient safety and needs:

Sathya Dhara Kovac, 44, ended her life through the MAiD program. Kovac lived with a degenerative disease and her condition was worsening, but she wanted to live. However, she lacked the home care resources to do so. “Ultimately it was not a genetic disease that took me out, it was a system,” Kovac wrote in an obituary to loved ones.

The researchers point out that  Canada's promotion of MAiD contravenes the Supreme Court of Canada Carter decision:

The Supreme Court’s decision that spurred the partial legalization of MAiD did not create an explicit “right to die with dignity” and left it to the legislature to design a “strict regulatory regime”. Regardless, the decision is being interpreted by many as creating a positive right of access to MAiD, even when other forms of medical care are available and when psychosocial suffering can be ameliorated.

This is an important section of the article. Use this link to read the full article (Article Link).

Christine Gauthier
The researchers write about how MAid is proactively offered to patients as though it is one of many standard treatment options. The case of Christine Gauthier:

A military veteran and former Paralympian who has been trying to get a wheelchair ramp installed at her home for the past 5 years testified that she was offered MAiD by her caseworker, and it has been confirmed that at least 4 other veterans were also offered the option of MAID when trying to access resources and care.

The researchers explain:

In Canada, the Canadian Association of MAiD Assessors and Providers (CAMAP) recommends that all those who “might qualify should be offered MAiD” as part of the informed consent process. No other country in the world has normalized assisted suicide or euthanasia in this way as a potential first line therapeutic option to address suffering. Offering MAiD to a patient who has not raised it could be interpreted as an indication that their suffering will likely become intolerable, and that MAiD is the recommended way out, impacting patient hope and resilience.

No other country in the world has normalized euthanasia or assisted suicide as a potential first line therapeutic option.

Read the full article and acquire links to all references (Article Link).

The problem of undefined terminology in the legislation:

The language in the Canadian MAiD legislation is imprecise and makes clear determinations and consistent implementation of clinical practice standards for MAiD difficult. Due to the imprecise term, “reasonably foreseeable natural death” (RFND), physicians’ interpretations of eligibility have been challenged in the courts.

They provide the following case as an example:

A man had a small stroke, affecting his balance and swallowing. The prognosis was that this man would be able to eat normally and regain most of his balance. The patient was depressed and isolated due to the COVID-19 outbreak on his ward. He declined all therapy and requested euthanasia. Neither of his MAiD assessors had expertise in stroke recovery. In this acute phase, while struggling with his mood and isolation, and with no therapy to gauge his final level of function, he received MAiD. He had no terminal diagnoses, but due to the fact that he was temporarily slightly undernourished, his MAiD assessors considered him Track 1 eligible. 

Track 1 eligible means he could have an immediate death.

Suffering is subjectively defined and can be rooted in psychosocial distress. The euthanasia lobby group Dying with Dignity states that people do not qualify for euthanasia on the basis of inadequate housing, disability supports, or home care. Whereas this statement is true it is also false.

The researchers refer to the story of Sophia:

A national CTV News story recounted how “Sophia” was unable to secure affordable housing compatible with her chemical sensitivities. She chose MAiD because she could not find a healthy and affordable place to live given her meager disability support income, and prior to her death by MAiD recorded a video where she stated “the government sees me as expendable trash”

People are qualifying for euthanasia based on their medical condition, but they are requesting euthanasia based on their social condition. The researchers explain the problem of how assessments are done:

To qualify for MAiD, a patient must be in a situation of irreversible decline of capability and experience intolerable psychological or physical suffering. These terms are not further defined by the legislation, and suffering is treated as purely subjective. If the patient says their suffering is intolerable, there is no requirement for further validation or requirement for clinicians to agree that there are no other options to address the suffering.

No standard treatments have been tried first or even been available to qualify for euthanasia:

In Belgium and the Netherlands, 2 other jurisdictions that allow euthanasia outside the end-of-life context, before euthanasia can be provided the physicians must agree that there are no further medical or social support options that can relieve a patient’s suffering. In Canada, patients are required to be advised of treatment options that may exist. For Track 2 cases, physicians have to verify that patients considered all other options, but it is left unclear what “considered” really means. There is no requirement that standard best-practice treatments have been appropriately attempted, or even that they are accessible. Tragically, some people are choosing to die while on wait lists for potentially effective treatment or because they are refused care.

Jennyfer Hatch
The researchers then write about the euthanasia death of Jennyfer Hatch:

A short film, titled “All is Beauty,” along with its advertising trailers, was promoted by Simons (an upscale department store in Canada). In the series, a young woman is encircled by people on a beach, in a candle-lit forest, and in other settings that depict a romantic and lovely tableau of her final days before MAiD. “Even now, as I seek help to end my life, … there is still so much beauty,” says Jennyfer Hatch. However, a national news agency has revealed that Jennyfer was the same woman who spoke up earlier (under a pseudonym) about her difficulties accessing treatment, prompting her to seek MAiD as a last-ditch effort for access to palliative care. Hatch died by MAiD in October 2022 at age 37. She was unsuccessful in her attempts to receive other care.

The issue of Suicide contagion:

We have long known that publicized suicides can lead to more people choosing suicide. Well-known is how suicide rates went up when Robin Williams completed suicide. This can also be seen in suicide clustering among Indigenous youth where 1 suicide can set off a series of suicides in a community. As well, literature has shown that increased exposure to lethal means increases rates of suicide.

Canada's Justice Minister stated that legalizing euthanasia is a more humane way to die than suicide. The researchers respond:

In reality, the evidence from reviews does not support the hypothesis that introducing MAiD reduces rates of (non-assisted) suicide. Further, data on suicide rates would not factor in people who may have been ambivalent and would never have attempted or completed suicide, but who chose to receive MAiD following social normalization of assisted suicide. In our view, the Justice Minister should be concerned about suicide contagion rather than normalizing what he acknowledges MAiD to be: “a species of suicide”.

MAiD in Canada is a Human rights outcry:

Three United Nations human rights experts, over a 100 Canadian disability and social justice organizations, Indigenous advocacy groups, and hundreds of medical and legal experts have argued that Canada’s euthanasia and assisted suicide laws put the lives of marginalized and vulnerable Canadians at risk.

Criticism is growing as an increasing number of media reports regarding worrisome MAiD stories are emerging in the Canadian press. Yet, those who support the expansion of MAiD tend to reject the claim that social service failures can create and sustain the predicaments that can make death an attractive choice.

Dr. Stephanie Green, President of CAMAP admits, “Our health system is woefully inadequate in serving our population with these resources.” Even so, she adds, “I do not think we can hold these patients hostage”. She seemingly condones the use of MAiD despite the lack of political will to provide necessary psychosocial supports. Bioethicists supporting MAiD expansion have argued that limiting MAiD for reasons of psychosocial suffering “would translate into removing the agency of decisionally capable patients without offering them a way out of their predicament” and have remarkably claimed that providing MAiD in response to social suffering caused by “unjust social circumstances” is a form of “harm reduction”. This is particularly troubling considering that harm reduction strategies precisely aim at saving lives. In addition to distorting the concept of “harm reduction,” from an equity and diversity point of view, the claim reflects a perspective based on privilege. This wrongly suggests MAiD is supporting the autonomy of marginalized people who are rather being driven to death by poverty and lack of care, despite knowing how to address poverty and improve care. Dr. Ellen Wiebe, a prolific MAiD provider (430 people as of May 2022) has said she will provide MAiD while people are on waitlists for medical treatment. 

They are concerned about the expansion of MAiD to those for the sole reason of mental illness. Euthanasia for the sole reason of mental illness was originally scheduled to be implemented by March 2023 but has been delayed until March 2024. They write:

Therefore, patients with mental illness, a population known for a high prevalence of psychosocial suffering, will be wrongly informed, during periods of despair and hopelessness, that their conditions are “irremediable” and will not improve, despite this being impossible to predict. In response to concerns that irremediability of any individual’s mental illness could never be predicted (a legal requirement to provide MAiD for mental illness in Canada), Dr. Justine Dembo, a MAiD activist and psychiatrist who sat on the 2022 federal panel on MAiD for mental illness, suggested she would simply advise the patient of the uncertainty that they could recover so they could make their own “informed decision” to receive MAiD, despite the fact that legal reporting forms require indicating that the medical condition is irremediable.

On top of offering MAiD under false pretenses for mental illness, equally concerning is the fact that in the few European countries that provide euthanasia for mental illness, the majority of those requesting it are women and marginalized individuals disproportionately seeking relief from suffering, not from their mental illnesses per se, but because of marginalization, including unresolved social and economic suffering and loneliness, all of which are remediable problems.

The researchers then ask the question, "What is next?"

A parliamentary committee released a report supporting euthanasia for "mature minors" and euthanasia by advanced directive. Quebec's Bill 11 expanded euthanasia by obliging all palliative care homes to provide MAiD and allows for MAiD by advance request for situations of dementia.

The researchers don't offer the reader signs of hope. They recognize the political pressure for further expansions of euthanasia. 

Read the full article and acquire links to all references (Article Link).