Will future Canadians apologize to people with disabilities for euthanasia?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Charles Lane

Charles Lane wrote an insightful opinion article that was published by the Washington Post on August 17, 2022 titled: Will future Canadians owe the disabled an apology for euthanasia? Lane bases his article on the recent apology by Pope Francis to Canada's Indigenous community and relates it to the recent cases of people with disabilities who are living in poverty or with mental illness dying by euthanasia.

Lane writes:

These permissive standards may be resulting in avoidable death or distress for vulnerable people, and disability rights advocates are expressing concern, as Maria Cheng of the Associated Press reported Aug. 11.

She told the story of 61-year-old Alan Nichols, who requested — and received — euthanasia less than a month after entering a British Columbia hospital in June 2019 suffering from suicidal thoughts, dehydration and malnutrition. The decision was apparently based on a medical history that included serious but typically non-life-threatening conditions such as depression and hearing loss.

His grief-stricken family has sought explanations as to how doctors could have found their loved one competent to “choose” death much less needful of it. “Somebody needs to take responsibility so that it never happens to another family,” Trish Nichols, Alan’s sister-in-law, told Cheng.

Cheng described the case of a man with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig’s disease, who felt driven to seek euthanasia because British Columbia officials would not provide him adequate support to live at home. In a case separately reported by Canadian media this year, a 31-year-old Toronto woman with a disability sought and received approval for euthanasia after what she said was a futile search for safe housing — only to decide to continue living after private parties helped her find an appropriate dwelling.

Lane also reports Cheng as writing that Canada does not require people to attempt effective treatments before dying by euthanasia, which is likely to lead to euthanasia for people who could have got better. Lane also refers to Cheng stating that:

Last year, a top United Nations disability rights official wrote to Trudeau advising him that legalizing euthanasia for the non-terminally ill creates an implied negative judgment on “the value or quality of life of persons with disabilities.”

There have been more sad stories of people with disabilities or those with mental illness or poverty, being urged to consider, being approved for, and/or dying by euthanasia.

Here are some links to some of these stories:

• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

Lane then writes that Canada is expanding euthanasia to people with mental illness alone which he says is "a practice that has led to controversy over alleged abuses in Belgium and the Netherlands." Lane concludes:

"One of the most haunting aspects of the Canadian Indian Residential School system was that one of Canada’s worst historical crimes was managed and defended by people who fervently believed they were doing the right thing for ‘the Indian,’” Tristin Hopper wrote in the National Post last year.

As they expand euthanasia today, Canadians should bear in mind that they, too, are subject to the law of unintended consequences and to the judgment of future generations.

Either future Canadians will apologize for euthanizing people with disabilities, mental illness, the poor and the chronically ill, or our culture will become hardened to the needs of others and the culture will expect people in these circumstances to die.

Child euthanasia has claimed the lives of three in Belgium

This article was published by Aleteia.org on August 27, 2018.

An ethicist in Antwerp expresses alarm that the practice of terminating the lives of seriously ill minors is going mainstream.

John Burger

By John Burger

A recent report in Belgium noted that legal euthanasia there has claimed the lives of three children in the past two years.

The response in Belgium? A big yawn.

“The report of the control commission has provoked not one article in the press, and no comments at all,” said Willem Lemmens, Professor of Modern Philosophy and Ethics at the University of Antwerp.

Lemmens was referring to a July 17 report from the commission that regulates euthanasia in Belgium, which noted that between January 1, 2016, and December 31, 2017, Belgian physicians gave lethal injections to three children under 18. In 2014, Belgium amended its already permissive euthanasia law to allow children of any age to request the procedure.

Euthanasia deaths in Belgium have risen from 2,021 in 2015 to 2,309 in 2017.

Richard Egan: Child euthanasia in the Netherlands and Belgium.

Charles Lane, writing for the Washington Post, reported that the three euthanasias of children included an 11-year-old who had cystic fibrosis (CF).

“This congenital respiratory disease is incurable and fatal, but modern treatments enable many patients to enjoy high quality of life well into their 30's or even beyond,” Lane wrote. “Median life expectancy for new CF cases in the United States is now 43 years, according to the Cystic Fibrosis Foundation.”

The others were a 17-year-old with Duchenne muscular dystrophy and a 9-year-old with a brain tumor.

“Doctors must verify that a child is ‘in a hopeless medical situation of constant and unbearable suffering that cannot be eased and which will cause death in the short term.’ After a child makes his or her wish for euthanasia known, in writing, child psychiatrists conduct examinations, including…intelligence tests, to determine that the youngster is capable and ‘not influenced by a third party’. Parents can, however, prevent the request from being carried out.”

But Lane was unconvinced. “What, exactly, convinced doctors that these children’s cases were hopeless, that their deaths were imminent—and that the kids fully understood not only euthanasia but also the treatment options that might have alleviated their condition?” he asked.

“These questions are no longer asked in the Belgian press,” Lemmens said.

In an interview on Friday, Lemmens said he sees a process of normalization going on in Belgium. “On the one hand, people take it more and more for granted for somatic diseases like cancer, or terminal diseases of neurological origin…And there’s discussion going on whether the law will be enlarged for people with dementia or for elderly who are not terminal but are just tired of living.”

Most of Belgium’s 4,337 euthanasias in 2016-2017 involved adults with cancer.

And yet, Lemmens reports, doctors overall are, “Very concerned and very eager to address needless suffering at the end of life, and some doctors really try to avoid euthanasia. They don’t like the procedures for it. If they apply palliative sedation they don’t need to go through all these procedures that the law requires.”

Palliative sedation is the use of narcotics to the point of suppressing the body’s respiratory system. The controversial practice relieves pain, but usually hastens death.

“There’s a discussion about the proper way to do palliative sedation,” he said. “The pro-euthanasia doctors will say that palliative sedation is always a means to hasten death in a way that is not so different from euthanasia. The only difference is that with palliative sedation the doctors avoid external control and act, according to pro-euthanasia doctors, in a paternalistic way. These discussions are going on between doctors, and I think the discussions prove there has been an increase in what I would call a gray zone in end of life practices.”

But Lemmens rejects the idea that the overall care for dying patients in Belgium is decreasing. “Overall, Belgium has quite a good health system,” he said.

He affirmed that there is pressure on Catholic hospitals to cooperate with euthanasia requests, partly due to the mergers between Catholic and secular institutions in recent years and the secularization of Belgian culture. The euthanasia law does allow an objecting physician to opt out, but it’s generally expected for such a physician to refer a patient to another doctor, even though the law does not require it.

Alex Schadenberg: Belgium euthanized three children aged 9, 11 and 17.

Alex Schadenberg

For Alex Schadenberg, Executive Director of the London, Ontario-based Euthanasia Prevention Coalition, the mass media has been complicit in the advance of Belgium’s euthanasia laws. “The more cases that get promoted through the media, the worse it will become," he said. “Recently there was a case in the Netherlands of Aurelia Brouwers, a 29-year-old who died by euthanasia. She was physically healthy but was going through psychiatric issues. She intentionally went to the media; she became a media darling before she died in January this year. And the reason was: the more we hear about it, the more it is considered acceptable. What someone would never think of doing in the past, once we hear of others doing it, suddenly it becomes acceptable for somebody to do this.”

What troubles Schadenberg about Belgium’s euthanasia law is that even a 9-year-old’s “consent” to a doctor euthanizing him is accepted. “I don’t know how capable my 9-year-old was about consent, and now we’re talking about death,” he said. “In law we recognize there are limits to consent, for these very reasons, that there’s a certain level of ability, and yet we’re allowing death to be done in these cases.”

Schadenberg said child euthanasia is being talking about it in Canada right now. He said that in 2016 the government instituted committees to look at child euthanasia, euthanasia for people with dementia, and euthanasia for people with psychiatric conditions alone. “We’re expecting the reports in December,” he said. “I’m assuming that euthanasia for children will be considered very seriously.”

Belgium euthanized 3 children aged 9, 11 and 17.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A 2014 Belgian protest opposing child euthanasia.

When Belgium extended euthanasia to children in February 2014, by eliminating the age limit for lethal injection, we had hoped that no child would die in this manner. The first official child euthanasia in Belgium was reported in September 2016.

The 2017 Belgian euthanasia data showed that the number of euthanasia deaths continues to increase, euthanasia deaths for conditions related to aging have skyrocketed and three children died by euthanasia.

• Belgian 2017 euthanasia report. Euthanasia deaths are rising, children are being killed.

A recent news report has provided more information about the child euthanasia deaths in Belgium. Charles Lane reported in the Washington Post that the 17 year-old was living with muscular dystrophy, the nine year old had a brain tumour and the 11 year-old had cystic fibrosis. Lane reported:

We do know the 11-year-old euthanized last year had cystic fibrosis. This congenital respiratory disease is incurable and fatal, but modern treatments enable many patients to enjoy high quality of life well into their 30s or even beyond. Median life expectancy for new CF cases in the United States is now 43 years, according to the Cystic Fibrosis Foundation. 

Luc Proot, (a member of the Belgian commission) assured me that everything was in order, not only with the 11-year-old’s case but also with the other two: a 17-year-old with Duchenne muscular dystrophy and a 9-year-old with a brain tumor. 

Proot was, of course, relying on reports by the anonymous physicians who participated in the euthanasias, and we, in turn, must take Proot at his word: Journalists and other members of the public are not permitted to review the case files independently, even in redacted form.

Dr Ludo Vanopdenbosch
resigned in protest.

Lane then questions the application of the Belgian euthanasia law:

Such questions seem especially pertinent for Belgium, given the problems it has experienced since legislators allowed euthanasia for patients with cognitive and psychiatric illnesses, such as dementia, depression or schizophrenia, even if they have no terminal physical ailment. 

Last year, a member of the euthanasia commission resigned in protest because it refused to recommend prosecution when a woman with dementia who had not requested euthanasia was nevertheless put to death at her family’s request. 

Since then, 360 Belgian doctors, academics and others have signed a petition calling for tighter controls on euthanasia for psychiatric patients.

Recently Fatal Flaws was screened in Guernsey (UK) while their legislature was debating assisted suicide. One of the sponsors of the assisted suicide bill watched Fatal Flaws. The next day he stood up in the legislature and said that he changed his mind after watching Fatal Flaws. Guernsey then defeated the assisted suicide bill by 24 to 14.

The Fatal Flaws film and pamphlets can be purchased (Link) and the Fatal Flaws Film can be purchased and downloaded (Link).

Sadly, under-reporting of euthanasia and euthanasia without request is common in Belgium. Lethally injecting people without request are considered criminal acts in every jurisdiction in the world, but under the banner of assisted death these acts becomes a difficult but necessary part of protecting the "human right" to kill in a post-post-modern society.

How many botched cases will it take to end euthanasia of the mentally ill?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

T

Charles Lane

he Washington Post published an excellent article on January 24, 2018 by Charles Lane. Lane, a respected editorial columnist who asks: How many botched cases would it take to end euthanasia for the mentally ill and cognitively impaired?

In his article, Lane examines several documented cases of euthanasia of incompetent or mentally ill people. The first case Lane refers to is the shocking story of a woman with dementia in the Netherlands who resisted dying by euthanasia:

The patient, referred to in official documents only as “2016-85,” had made an advance directive requesting euthanasia in case of dementia. But the directive was ambiguously worded, and she was no longer able to clarify her wishes by the time she was placed in a nursing home — though her husband did request euthanasia for her. 

Despite the lack of a clear expression from the patient, a physician concluded her suffering was unbearable and incurable — though there was no terminal physical illness — and prepared a lethal injection. 

To ensure the patient’s compliance, the doctor gave her coffee spiked with a sedative, and, when the woman still recoiled from the needle, asked family members to hold her down. After 15 minutes were spent by the doctor trying to find a vein, the lethal infusion flowed. 

Neither voluntary, painless nor dignified, this physician-assisted death was referred to prosecutors by the Dutch regulatory commission — with, so far, unknown consequences.

Aurelia (Sarah)

Lane then focuses on the case of Sarah (Aurelia) a physically healthy 29-year-old woman who is scheduled to die by assisted death for on January 26 in the Netherlands. Lane writes:

Nevertheless, a 29-year-old woman, “Sarah,” whose sole medical complaint is serious, nearly lifelong depression and self-harming behavior, has received permission for euthanasia, to take place Friday, according to the RTL Nieuws, a Dutch media outlet . 

29 year old Dutch woman approved for euthanasia for psychiatric reasons. 

She was released from prison in December 2016 after serving 2½ years for arson. She received no therapy while incarcerated and, 12 months later, she persuaded doctors her psychological suffering was unbearable and untreatable. 

“It was a long and difficult road before she finally got permission,” RTL Nieuws observed. “And that is why Sarah wants attention for her story. Not for herself, but for others who also find life psychologically too heavy, have no chance of healing and want to die in a dignified way.”

Lane then focuses on the psychiatric euthanasia deaths in Belgium:

Joris Vandenberghe, a psychiatrist at the University of Leuven, is calling for stricter controls.He complained last year that psychiatric patients have died at the hands of doctors who failed to meet criteria set forth in Belgian law: “I’m convinced that in Belgium, people have died where there were still treatment options and where there was still a chance for years and even decades of life.” 

Support for the practice is still strong, so strong that the Brothers of Charity, a Roman Catholic organization that operates the largest group of psychiatric hospitals in Belgium, has agreed to acquiesce to euthanasia requests — contrary to Vatican policy.

This decision came after a Belgian court ordered a different Catholic institution to pay damages to the family of a 74-year-old terminally ill woman because administrators required her to leave the facility for euthanasia. Religious conscience was no defense, the court ruled.

Lane concludes his article by stating that the World Psychiatric Association has ducked the issue of euthanasia for psychiatric reasons.