CBC interviewer fails to ask tough questions on Senate euthanasia bill.

This article was published on the Protection of Conscience Project blog on January 6.

By Sean Murphy, the administrator of the Protection of Conscience Project.

A bill has been introduced in the Canadian Senate by Conservative Senator Nancy Ruth to legalize physician assisted suicide and euthanasia. Bill S-225’s definition of of “assist” is of particular interest. It means “to provide the person with the knowledge or means to commit suicide, or to perform an act with the intent to cause the person’s death.” Consistent with this, an “assisting physician” is one “who provides assistance” to a patient seeking euthanasia or physician-assisted suicide.

This indicates that indirectly facilitating suicide even by providing information for that purpose is equivalent to more direct forms of assistance, like providing a lethal prescription. Further, it implies that both providing information to facilitate suicide and actually killing someone are of comparable legal or moral significance. Many physicians and health care workers who object to assisted suicide and euthanasia would agree, and, for that reason, would refuse to refer or otherwise help a patient find someone willing to kill him or assist him in committing suicide.

The point was overlooked during an interview of Senator Ruth by Evan Solomon on CBC Television’s Power and Politics (2 December, 2014). After discussing the contents of the bill in general terms and asking Senator Ruth about her reasons for introducing it, Solomon raised the issue of conscientious objection:

Evan Solomon: A doctor might be watching this, and say, you know, “Great piece of legislation. What do you do if, what will you do to me if I don’t want to do this?” 

Senator Ruth: Nothing. No doctor is coerced to do this, no patient is coerced to do this. This is about choice. The choice of doctors who want to assist in it and their protection ...

Solomon failed to ask the tough questions. Among them: 

1. If physicians will not be forced to kill patients, will they, nonetheless, be forced to help patients find someone who will? 
2. Why is it that the bill is about the choice and the protection of doctors who want to help to kill patients, and not about the choice and protection of those who refuse? 
3. When abortion was legalized, politicians and activists promised that no physician would be forced to provide abortions, but refused to include a protection of conscience provision in the law.1 Now the College of Physicians of Ontario is proposing a policy that would compel physicians to provide abortions or help patients obtain them.2 Dr. Marc Gabel, chair of the working group that produced the draft policy, warns that physicians who refuse to do this should get out of family practice.3 As written, the policy could be applied equally to euthanasia and assisted suicide. Why does Senator Ruth think that objecting physicians will not be coerced – if not sooner, then later?

Notes:

1. Murphy, S. “Promises, promises. Canadian law reformers promise tolerance, freedom of conscience:What happens after the law is changed is another story.” Protection of Conscience Project

2. “Ontario physicians to be forced to do what they believe to be wrong: Draft policy demands that objectors provide or refer. Policy would apply to euthanasia, if legalized.” Protection of Conscience Project news release, 10 December, 2014

3. Swan, M. “Catholics doctors who reject abortion told to get out of family medicine.” The Catholic Register, 17 December, 2014. (Accessed 2014-12-19)

Bill S-225 isn’t good

This article was published on December 11, 2014 on the Living with Dignity blog.

Bill S-225 was recently introduced in the Senate of Canada. This bill aims to legalize euthanasia and assisted suicide. It would do this by amending sections 14 and 251 of the Criminal Code of Canada. We oppose the legalization of euthanasia and physician assisted suicide because they are not needed. Efforts should go towards improving proper access to pain and symptom management to everyone who needs it. Efforts should also go towards improving suicide prevention and appropriate access to services for people with disabilities.

It is important that we all speak to our Senators to ask them to vote NO and reject Bill S-225.

Senate Bill S-225 is based on MP Stephen Fletcher's own bills in the House of Commons (C-581 and C-582). While neither C-581 nor C-582 is likely to be reach First reading in the House, Bill S-225 will be debated in the Senate early in 2015. The language on the bill is open to interpretation and opens the door for abuse. Safeguards don't protect people from abuse of euthanasia or physician assisted laws, but this bill is particularly bad news.

It would be easy, although erroneous, to think the so-called safeguards in the bill are solid. A closer look and analysis show significant problems.

Some of significant problems with Bill S-225

Andrew Coyne: Assisted Suicide, What begins in compassion seems to end in eugenics.

This article was written by Andrew Coyne and published in the National Post on December 9, 2014.

Andrew Coyne

By Andrew Coyne - National Post Columnist

The case for assisted suicide and euthanasia, at least as it has been presented, is that we may freely dispense with certain moral distinctions, once considered of some importance — between killing yourself and having someone else kill you; between refraining from prolonging life and deliberately ending it — while continuing to insist on any number of others.

The issue is thus invariably cast as if the practice would be reserved for adults of sound mind, in the final stages of a terminal illness, suffering unbearable physical pain, freely consenting to have done to them what they would surely choose to do themselves were they not so disabled. In its most complete form, the patient must not only consent, but actually initiate the process in some way (hence “assisted” suicide, versus euthanasia, where someone else does the deed). At all events we are assured the task would be performed by a licensed physician, no doubt with a sterilized needle.

So it is that a cause advanced in the name of a limitless individual freedom (self-annihilation, it is said, being the ultimate assertion of personal autonomy) defends itself with reference to how acutely limited that freedom would actually be. Advocates, impatient with such arbitrary distinctions as that between suicide and assisted suicide — of what use is the right to kill oneself, they ask, if you are physically incapable of carrying it out? — are nevertheless at pains to preserve the distinction between terminal illness and mere depression, between adults and children, between the mentally competent and incompetent, between personally consenting and having someone else consent on your behalf.

But it cannot be. By erasing the one distinction, they eviscerate the rest. For the right asserted in this case is not merely a negative right, in the old-fashioned sense of the right to be left alone, but a positive right, a claim on others, entitling one to their assistance. It is not a civil liberty, such as the right to vote, implying a degree of competency or at least free will such that it might justifiably be restricted to adults, but a more fundamental sort of right, like the right not to be tortured, that does not hinge upon agency in the rights-holders, but inheres in them simply as human beings (or even animals).

A critique of Canadian Senate Bill S - 225 - An Act to Amend the Criminal Code (physician-assisted death)

By Alex Schadenberg, 

Executive Director - Euthanasia Prevention Coalition

Alex Schadenberg

Senate Bill S - 225 is designed to legalize euthanasia and assisted suicide by amending Section 14 and Section 251 of the Criminal Code of Canada.

The Euthanasia Prevention Coalition (EPC) opposes the legalization of euthanasia and assisted suicide for several reasons including the fact that legalizing physician-assisted death gives physicians, in law, the ultimate power to cause or assist the death of their patients. When abused, the result is the death of a vulnerable Canadian.

EPC supports measures to improve: disability rights, pain and symptom management and suicide prevention.

The bill was originally written by Stephen Fletcher MP for his own potential death, and thus it is written for a person who is not terminally ill, who requires a wide application for euthanasia and assisted suicide.

• The bill specifically allows euthanasia and assisted suicide for people with disabilities. 
• The bill is not limited to terminal illness. 
• The bill allows euthanasia or assisted suicide for "psychological suffering," which is not defined.
• The bill requires physicians to self report the death after it has occurred. This assumes that physicians will self-report abuse of the law and it does not provide protection for the patient. 

Bill S-225 is particularly concerning because it specifically focuses on intentionally causing the death of people with disabilities who already lack equality and acceptance within Canadian culture.

Our concerns related to the conditions in Bill S-225 are:

Section 3(a) be eighteen years of age or more;

• This is only a temporary “safeguard.” It will be considered a form of discrimination to deny assisted death to someone because of their age if the person claims to be physically or psychologically suffering. 

Section 3(c) have been diagnosed by a physician as having an illness, a disease or a disability, including a disability arising from traumatic injury,

• The language in this section will be widely interpreted. Many people have an illness, a disease or a disability. The UN Convention on the Rights of Persons with Disabilities recognizes that disability is an evolving concept. 

Section 3(c)(i) that causes the person physical or psychological suffering that is intolerable to that person and that cannot be alleviated by any medical treatment acceptable to that person,

• This section provides uncontrollable access to euthanasia and assisted suicide. Physical or psychological suffering that is intolerable to that person and cannot be alleviated by any medical treatment acceptable to that person is completely subjective. This section offers no objective reasons for a physician to say no to a lethal injection.
• The term psychological suffering was interpreted in the Netherlands to enable a 63-year-old healthy man who had worked all of his life, who never married, to die by euthanasia because he was retiring, depressed and lonely.
• The term psychological suffering was interpreted in Belgium to enable a healthy 70-year-old woman to die by euthanasia because she became very depressed after a long-term relationship ended.
• Psychological suffering is not defined and no “safeguard” can protect people from the abuse that may occur and from the expansion of the law that will occur, as is the case in the Netherlands and Belgium.

Section 3(c)(ii) that results in the person being in a state of weakened capacities with no chance of improvement;

• This section is so wide that you can drive a hearse through it. What does it mean to be in a state of weakened capacities with no chance of improvement? Many people with disabilities and other frail people fulfill this criteria.

Section 3(d) be of sound mind and capable of fully understanding the information provided to him or her under subsection (6)

• a study from the Journal Clinical Oncology (September 20, 2005) found that people in the Netherlands experiencing feelings of depression were 4.1 times more likely to request euthanasia. The study found that depression is a primary risk factor for requests for euthanasia.

Section 3(e) be acting voluntarily, free from coercion or undue influence.

• Elder abuse and the abuse of other vulnerable persons are growing problems that are under-reported. You cannot assume that all assisted deaths will be voluntary and free from coercion or undue influence.
• A study published in the CMAJ (June 2010) found that people who died by an assisted death without request tended to be over the age of 80, in a hospital and incompetent to make decisions for themselves. The study stated:

“Our finding that the use of life-ending drugs without explicit patient request occurred predominantly in hospital and among patients 80 years or older who were mostly in a coma or had dementia fits the description of “vulnerable” patient groups at risk of life-ending without request.”

Section 13 An assisting physician must, not later than 30 days after the death of a person to whom the physician has provided assistance with dying, submit to the Minister of Health, for the purpose of data collection and analysis, a report in the form prescribed by the regulations that includes the following information:

• The reporting system requires the doctor who does the act to report the death after the person has died. This does not represent a “safeguard” for vulnerable persons. Since the person has already died when the report is submitted, if an abuse of the law occurred, it is too late to protect the person.

Doctors will not self report abuse. The information gathered by the reporting system will only have statistical value.

• You cannot assume that every assisted death will be reported. The Lancet (September 8, 2012) reported that 23% of all assisted deaths in the Netherlands (2010) were not reported. The BMJ (October 5, 2010) reported that 47% of the assisted deaths in the Flanders region of Belgium (June - November 2007) were not reported.

This bill gives physicians the power, in law, to directly and intentionally cause the death of their patients. People need support and protection, not lethal injections. People with disabilities seek equality in living not more ways to die.

This bill is written with language that can be interpreted widely. We do not live in a utopian society, a place where elder abuse does not exist, coercion is unheard of, and people with disabilities do not experience discrimination. 

Whether or not you support euthanasia or assisted suicide, this bill is deadly. 

Please vote no and reject Bill S - 225.

Links to more articles on this topic:

• Canadian Senate to debate dangerous euthanasia bill.
• Legalizing euthanasia and assisted suicide is not safe. Patient safety must come first.
• Death is not preferable to living with a significant disability.
• Why I'm afraid of Stephen Fletcher's assisted suicide bill.
• Euthanasia undermines protections in law for me.
• Wesley Smith comments on Stephen Fletcher's euthanasia bill.

Canadian Senate to debate dangerous euthanasia bill

By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A critique of Canadian Senate Bill S - 225.

Senator Nancy Ruth and Senator Larry Campbell introduced Senate Private Bill S 225, a bill that legalizes euthanasia by lethal injection and assisted suicide by lethal prescription. This bill is based on the private members bills that were introduced by Stephen Fletcher MP earlier this year.

The Euthanasia Prevention Coalition (EPC) welcomes an open debate based on the facts.

Canada has debated euthanasia and assisted suicide on many occasions with the most recent vote in parliament (April 2010) where bill C-384 was defeated by a vote of 228 to 59.

The language of Senate Bill S 225 is intentionally permissive. The bill is designed to protect physicians who act by lethally injecting or assisting the suicide of their patients. It is not designed to protect the patients. 

• The bill specifically allows euthanasia and assisted suicide for people with disabilities. 
• The bill allows euthanasia or assisted suicide for "psychological suffering." Psychological suffering is not defined. 
• The bill is not limited to terminal illness.
• The bill requires the physician to self report the death after it has already occurred. This assumes that physicians will self-report abuse of the law. Since the patient is dead, when the act is reported, therefore no actual protection exists for the patient.

People with disabilities generally oppose euthanasia and assisted suicide. The Council of Canadians with Disabilities (CCD) intervened at the Supreme Court of Canada case concerning euthanasia and assisted suicide. In its media release CCD spokesperson, Catherine Frazee stated:

In jurisdictions where assisted suicide/euthanasia is legal the leading reasons given for dying are not pain related, but rather “losing dignity and autonomy” and “becoming burdensome for family and friends”. 

To endorse these as valid reasons to die can only reinforce and entrench fear of disability and prejudice about the value of disabled people’s lives

Since bill S 225 does not define "psychological suffering" we must consider how this term has been applied in the Netherlands where euthanasia for psychological suffering already occurs. For instance:

• A healthy blind woman died last year by euthanasia in the Netherlands.
• A healthy 63 year-old man who had worked all of his life, was depressed and died by euthanasia.
• The 2013 Netherlands statistics indicate that there were 4829 euthanasia deaths, of which 97 were people with dementia and 42 were people with psychiatric problems.

Professor Theo Boer, a 9 year member of a Regional Euthanasia Review Committee in the Netherlands, changed his mind and now opposes euthanasia. In a recent article, Boer stated:

I used to be a supporter of legislation. But now, with twelve years of experience, I take a different view.  

At the very least, wait for an honest and intellectually satisfying analysis of the reasons behind the explosive increase in the numbers. Is it because the law should have had better safeguards? Or is it because the mere existence of such a law is an invitation to see assisted suicide and euthanasia as a normality instead of a last resort? Before those questions are answered, don’t go there. Once the genie is out of the bottle, it is not likely to ever go back in again.

EPC welcomes an open debate on euthanasia and assisted suicide, so long as it is an open debate. Ignoring the facts will be at Canada's peril. 

Links to further information.