Not Dead Yet: Articles concerning "mobile euthanasia teams" is inaccurate

Stephen Drake, the research analyst for the Disability rights group, NOT DEAD YET, published an excellent commenary on their blog, last Thursday, about the article in the Associated Press concerning the new push in the Netherlands for "mobile euthanasia teams." It appears that the Dutch euthanasia lobby believes that people with disabilities would benefit from "mobile teams" coming to a persons home and lethally injecting them.

NOT DEAD YET not only comments on the concept of "mobile teams" that will euthanize the unfortunate people with disabilities, but they also commented on the clearly false statements by the Associated Press. Please read the following article that is reprinted for your pleasure.
------------------------------------------

Canadian Cancer Society Welcomes Caregiver Support and Palliative Care Recommendations in Report Released by Parliamentary Committee on Palliative and Compassionate Care

Canadian Cancer Society Welcomes Caregiver Support and Palliative Care Recommendations in Report Released by Parliamentary Committee on Palliative and Compassionate Care

TORONTO, Nov. 17, 2011 /CNW/ - The Canadian Cancer Society applauds recommendations about family caregiver support and palliative care in a report released today by the Parliamentary Committee on Palliative and Compassionate Care (PCPCC) and urges the federal government to take action.

The report - Not to be forgotten: care of vulnerable Canadians - focuses on elderly, dying and vulnerable Canadians and provides recommendations for improving palliative care, family caregiver support, elder abuse and suicide prevention. The PCPCC is an ad-hoc, all party group of federal MPs who formed the committee on their own initiative. The report reflects testimony from hundreds of people at 24 hearings and local round tables across Canada.

"The spirit of non-partisan collaboration shown by the MPs on this committee is a great example of Parliament working at its best - MPs working across party lines on issues of concern to Canadians," says Dan Demers, Director, Public Issues, Canadian Cancer Society.

Professor Tom Koch responds to Royal Society of Canada one-sided report.

Professor Tom Koch, a consultant in bioethics and gerontology in Toronto and Vancouver and works in chronic care and hospice, responded to the Royal Society of Canada pro-euthanasia propaganda report, in an article that was printed in the Toronto Star on Wednesday, November 16, 2011.

The article follows:

Confusing the issue

By Tom Koch
Forget issues of terminal illness and the end of life. The court case that began Monday in the B.C. Supreme Court is not about the right to die (you will die) or a right to life (you’ve got that). It is not about the right to be free of pain in the midst of an illness. Palliative care, all agree, is the basis of good chronic care medicine.

One of the confusions in the case and in the Royal Society of Canada’s report on end-of-life decision-making released Tuesday is that they pretend to concern termination by physicians in the late stage of inevitably terminal illness. They are, however, framed to include potentially anyone who, dissatisfied by life, seeks state approval for a medically assisted termination.

Doctor-assisted suicide is dangerous for us all

Licia Corbella

The following article was written by Licia Corbella and published in the Calgary Herald on November 19, 2011.

It’s been a sickly couple of weeks for life. This past Monday, a B.C. Supreme Court case kicked off in which five people are seeking the right to choose to be killed by a physician. The very next day, the Royal Society of Canada (RSC) released a report that urges the federal government to legalize assisted suicide in Canada. A summary of the End of Life Decision Making report states:

“The evidence from years of experience and research where euthanasia and/or assisted suicide are permitted does not support claims that decriminalization will result in vulnerable persons being subjected to abuse or a slippery slope from voluntary to non-voluntary euthanasia.”

Wow. The RSC panel members must be really lousy researchers. At the very least, someone should teach them how to use Google. Why? Because on Nov. 9, it was announced that a woman with advanced Alzheimer’s disease was euthanized in the Netherlands in March. In Holland, this was not even big news.

The horror stories in the Netherlands, where euthanasia was legalized in April 2002, but where it was practised for years prior to that without censure, go way back and prove that there is not just a slippery slope, but a veritable vertical skating rink. Two comprehensive studies, headed up by the Attorney General of the High Council of the Netherlands — Prof. J. Remmelink — reveal utterly shocking examples of abuse, or rather, murder.

Parliamentary Committee on Palliative and Compassionate Care offers great hope to Canadians.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition 

A great gift was given to Canada yesterday. The Report of the Parliamentary Committee on Palliative and Compassionate Care was released yesterday in Ottawa. The report titled: Not to be Forgotten: Care of Vulnerable Canadians, focusses on improving palliative care for all Canadians, suicide prevention strategies and protecting people from elder abuse.

The Parliamentary Committee on Palliative and Compassionate Care is an all-party committee that grew out of a common goal of identifying concrete ways to improve the care and protection for all Canadians when they are experiencing difficult circumstances.

The Euthanasia Prevention Coalition (EPC) stated in our media release that we endorsed the recommendations of the Parliamentary Committee on Palliative and Compassionate Care. Our legal counsel, Hugh Scher, stated:

"Implementation of the recommendations of this Parliamentary report should eliminate any further call for legalized assisted suicide or euthanasia in Canada by vastly improving care for every Canadian, especially those who are vulnerable."

At the press conference, in Ottawa, for the release of the report, Joe Comartin (NDP) - Windsor Riverside, Harold Albrecht (CPC) - Kitchener Conestoga, and Frank Valeriote (Lib) - Guelph, spoke on the different areas within the report.

Joe Comartin

Joe Comartin spoke on the palliative care recommendations in the report. He stated that only 16 - 30% of Canadians have access to palliative care. Palliative care services are a patch-work quilt with varying levels of care within every region. Even within Toronto there are regional disparities of access to palliative care.

Joe Comartin emphasized the need for: 
* a new palliative care secretariet, 
* the need to improve chronic care for people who live with pain and 
* he emphasized the need for greater flexibility in the provision of compassionate care benefits,
* the importance of building a greater infrastructure of local palliative care services to enable people to receive care and support in their own communities.

Harold Albrecht

Harold Albrecht spoke about the suicide prevention section within the report. He explained how suicide is almost always preventable but that the resources, information and support is simply not available in Canada. Canada does not have a national suicide prevention strategy, even though the Canadian Association for Suicide Prevention has developed a national strategy for suicide prevention, the resources to implement the strategy have not been provided.

Harold Albrecht emphasized that * a coordinating body would be required to implement a National Suicide Prevention Strategy.


Frank Valeriote spoke on the recommendations related to elder abuse. He spoke about the fact that 4 - 10% of elders experience abuse and some recent studies are suggesting that the rate of elder abuse may be as high as 20%. Most elder abuse is carried out by care-givers, family members and friends. The reason elder abuse remains under-reported is the fact that the person is often dependent on the abuser.

Frank Valeriote

Frank Valeriote emphasized the need for * an elder abuse awareness and prevention office, * an elder abuse prevention strategy that would focus on prevention and intervention.

Rene Ouimet from the Canadian Association for Suicide Prevention (CASP) spoke next about the progress that is being made towards implementing a  suicide prevention blueprint. She stated that CASP supports the recommendations in the report.

Dan Demers from the Canadian Cancer Society stated that they supported the recommendations within the report. He spoke about how some patients are still suffering needlessly. He emphasized that people, at the end of life, are vulnerable and must not be abandoned. He decried the fact that less than 30% of Canadians have access to excellent palliative care.

Jean Guy St. Gelais from the Canadian Network for the Prevention of Elder Abuse spoke next. He supported the need for an elder abuse prevention strategy and thanked the committee for the report.

Dr John Haggie

The final speaker was Dr John Haggie who is the current President of the Canadian Medical Association. He stated that the improvement in palliative care required urgent attention. He spoke in favour of the emphasis on patient centred care that the report promotes. He suggested that fixing palliative care can be used as a model for transforming health care in Canada.

The media then asked a series of questions.

The first question concerned the fact that many of the areas that the report was concerned with were within provincial jurisdiction. Joe Comartin answered the question by emphasizing the importance of the report being implemented by all levels of government. He then emphasized how some of the recommendations would lead to significant cost savings. He stated that too many people were dying in acute care hospital settings. If there were palliative care placements available, the cost would be significantly less. He also stated that excellent pain management will provide significant savings for the economy. Frank Valeriote then emphasized the need to share information especially to serve the needs of minority communities.

The second question concerned the decriminalization of euthanasia and assisted suicide. Dr Haggie, the President of the CMA stepped forward and stated that euthanasia is a complex issue but access to good palliative care would change the euthanasia debate. Dr Haggie then stated:

"requests for euthanasia usually reflect a failure to access adequate palliative care." 

Dr. Haggie then stated that Canada needs a national palliative care strategy. We need to transform the medical system with best practises and we need innovation funds to improve care.

The next question concerned the national suicide prevention stragegy. Harold Albrecht spoke about the fact that CASP has developed a blueprint strategy and he stated that government leadership is needed. He then mentioned his private suicide prevention members bill that is before parliament.

It was then stated that the blueprint strategy that was developed by CASP has been implemented in other countries resulting in the lowering of suicide rates in their countries.

Harold Albrecht then mentioned how progress is already occurring. The #10 recommendation in the palliative care section of the report has already been inserted in the current government budget.


EPC would like to thank the 55 MP's who supported the Palliative and Compassionate Care committee. We would like to thank Michele Simson, who was the Liberal co-chair of the committee but was defeated in the last election. We would like to thank George for writing the report.

Anti-suicide laws have served him well

John Coppard

By John Coppard, Times Colonist - November 18, 2011

Link to the article in the Times Colonist.

The editorial "Time to talk on right to die" asserts the time is now right to discuss this critically important topic (Nov. 16).

I submit that the time passed a little over a year ago, when parliamentarians overwhelmingly rejected private member's bill C-384 seeking to legalize physician-assisted suicide and euthanasia by a vote of 228 to 59.

Representatives of all parties recognized the dire risks to public safety of giving physicians the legal right to take their patients' lives, and our health-care system, and even friends and relatives, the legal right to steer ill people toward suicide. Our democratic representatives correctly saw this as open to abuse, and bad public policy.

The "Carter case" now ongoing in Vancouver is an attempt to end-run Parliament.

As a person who is "grievously and irremediably ill" with Grade IV brain cancer, I would be affected should this case succeed. Two and a half years after being given a 20 per cent chance of surviving five years, I am doing very well on a medication approved by Health Canada only a year ago, within a week of my cancer coming back.

Had I been given the legal choice of assisted suicide when I first received my terrible prognosis, or when my cancer returned, when I felt hopeless, I don't know what I would have done.

Now I'm doing very well, thanks to medical advancements that are coming faster than at any time in our history. Our anti-suicide laws protected me and gave me a chance for a long and happy life, just as they were intended to do.

John Coppard
Victoria BC

Euthanasia Prevention Coalition Endorses Recommendations of Ad Hoc Parliamentary Committee

TORONTO, Nov. 17, 2011 - CanadaNewsWire

The Parliamentary Committee on Palliative and Compassionate Care released its report entitled: NOT TO BE FORGOTTEN: CARE OF VULNERABLE CANADIANS.

The Euthanasia Prevention Coalition endorses the recommendations made by the committee in respect of improved palliative and end-of-life care, suicide prevention strategies, and the prevention of elder abuse.  EPC executive director Alex Schadenberg states:

The Parliamentary report represents a blueprint of proactive positive steps that will improve end-of-life care for all Canadians.

EPC-BC chair Dr. Will Johnston states:

I see elder abuse in my family medical practice.  There is a clear need for action and the Parliamentary report sets out a blueprint for action.

EPC legal counsel, Hugh Scher states:

Implementation of the recommendations of this Parliamentary report should eliminate any further call for legalized assisted suicide or euthanasia in Canada by vastly improving care for every Canadian, especially those who are vulnerable.

For further information:
Alex Schadenberg, EPC Executive Director: 519-439-3348, info@epcc.ca
Dr. Will Johnston, EPC-BC Chair: 604-220-2042, willjohnston@shaw.ca
Hugh Scher, EPC Legal Counsel: 416-816-6115, hugh@sdlaw.ca

Link to the report.

Council of Canadians with Disabilities hopes court will rule no on killing

Media Release - November 17, 2011

CCD hopes court will rule no on killing

The Council of Canadians with Disabilities (CCD), a national organization of people with disabilities working for an accessible and inclusive Canada, is alarmed by the case, Carter v. Attorney General of Canada, which is a constitutional challenge to Canadian law prohibiting physician-assisted suicide. Legalized assisted suicide is a recipe for lethal abuse.

In 2010, the House of Commons voted (228 to 59) against legalizing assisted suicide, striking down Bill C-384, which would have removed Criminal Code provisions against assisted suicide. CCD applauded the defeat of Bill C-384 and believes nothing in the intervening time has occurred that necessitates the overturning of a law designed to protect Canadians from being killed. With their vote on C-384, our elected representatives said no to killing; we urge Canadian judges also to say no to killing.

Dr. van der Wal of Holland testified before the Senate Committee on Euthanasia and Assisted Suicide that people who had not made an explicit request for an assisted suicide nevertheless were being killed under the auspices of that country’s assisted suicide provisions.

Through personal experiences, people with disabilities know that we are often perceived to be suffering pain and enduring lives that are not worth living. Such misconceptions can lead to unwanted assistance in dying. Many of us with disabilities want the protection afforded by the Criminal Code’s prohibition against assisted suicide to continue.

The assisted suicide debate is a conflict between some individuals’ desires for an extreme form of personal autonomy—assistance in executing their own death at a time of their own choosing—and other individuals’ desires to prevent the lethal abuse of people, particularly those who are socially devalued, such as people with disabilities. One unwanted death due to misconceptions about quality of life is too many.

An important first step to preventing lethal abuse of our human right to life is preservation of the Criminal Code’s prohibitions against assisted suicide. Canada’s legislators got this question right in 2010. We hope that the court, when deciding the Carter case, pays heed to the decision taken by Canada’s Members of Parliament on the question in 2010.

-30-

For more information contact:
Rhonda Wiebe, Co-chair, CCD Ending of Life Ethics Committee, Cell: 204-952-1514
Dean Richert, Co-chair, CCD Ending of Life Ethics Committee, Cell: 204-951-6273
Jim Derksen, Member, CCD Ending of Life Ethics Committee, Tel: 204-786-7937
Laurie Beachell, CCD National Coordinator, Tel: 204-947-0303

Vivre dans la Dignité/ Living with Dignity's Media Release on the Quebec Consultation

FOR IMMEDIATE RELEASE

Montreal, November 16, 2011
Quebecers have overwhelmingly told the provincial government to respect existing laws banning euthanasia and focus instead on providing high quality palliative care, a study of submissions to the Special Commission on Dying with Dignity shows clearly.

“The numbers are black and white. In the presentations to the Commission there was 99 per cent agreement that palliative care is the dignified choice Quebecers want available at the end of life.

At the same time, 60 per cent of the submissions opposed any opening for euthanasia. The government’s democratic direction should be clear,” said Linda Couture, director of the nonpartisan, grass roots group, Living With Dignity.

Couture said an exhaustive Living with Dignity independent analysis of the 427 oral presentations and written submissions to the Commission, shows a mere two per cent of the submissions support assisted suicide.

Four per cent of those who made submissions did not have a clear position.

Only about a third of those who submitted to the commission were either somewhat or strongly in favor of euthanasia, Couture said: “This is a far cry from the inflated survey numbers often used in the media by advocates for legalizing or decriminalizing euthanasia in Quebec.”

A further analysis of the content of the submissions of those who apparently favored euthanasia showed significant confusion between directly taking a patient’s life – outlawed under the Criminal Code – and ceasing futile treatment, which is universally acknowledged as ethical and proper.

Legalizing Assisted Suicide 'a recipe for elder abuse,'

John Coppard

The Vancouver Province published a thorough article by Sean Sullivan today about the protest that was organized by EPC-BC on the steps of the court house in Vancouver. The article is titled: Legalizing Assisted Suicide 'a recipe for elder abuse.' says protesters.

The article also featured John Coppard, who was diagnosed with brain cancer two years ago. Coppard contacted us with his story. The following is a reprint of the article:

Legalized Assisted Suicide 'a recipe for elder abuse,' says protesters

Protesters opposed to changes in Canada’s suicide law gathered in front of the Vancouver Law Courts Monday morning, warning that legalizing assisted suicide would open the floodgates for elder abuse.

A court challenge launched in B.C. Supreme Court has the B.C. Civil Liberties Association and Gloria Taylor, a 63-year-old woman suffering from ALS, challenging Canada’s laws that forbid doctor-assisted suicide for the terminally ill.

Opponents, however, argue that physician-assisted suicides will see the medical system steer patients toward suicide and allow greedy children intent on inheriting their parents wealth will force them into choosing death.

“In the messy real world that I work in as a family physician, I have no illusions but that improper inducement to end their lives prematurely would be given to a lot of the elderly,” Dr. Will Johnston said.

“We need a strong law that prevents people urging or facilitating others to commit suicide.”

Speaking in his experience as a doctor who provides capability assessments on “frail, elderly people,” Johnston said it’s typical to see victims who have been induced to do things that are completely against their self-interest. Gutting the law against assisted suicide will do more harm than good, he said.

“Sadly, children are the worst abusers of the elderly. We have a national problem with suicide and a natural problem with elder abuse.

“And here we have a case that would undercut our efforts to constrain both of those problems.”
About 70 people, holding signs with messages such as “Assisted suicide a recipe for elder abuse,” braved the brisk, fall wind to stand on the steps of the Law Courts Monday.

Among them was John Coppard, 45, who was diagnosed with an aggressive form of brain cancer, glioblastoma multiforme, in 2009. A new medication helped him recover, though he said that at his “lowest points,” he may have chosen assisted suicide had it been offered to him.

“I wouldn’t be here if it weren’t for the law that disallowed assisted suicide,” Coppard said. “The illnesses people are talking about inside (the court) are not death sentences any more.

“People (diagnosed with a terminal illness) can live for decades,” he said.

Afghanistan veteran with brain cancer urges Canadians to support laws against assisted suicide

Afghanistan veteran with brain cancer urges Canadians to support laws against assisted suicide.

Nov. 14 – At the Vancouver Law Courts this morning, a trial begins that may result in the legalization of assisted suicide. The Euthanasia Prevention Coalition of B.C., an intervener in the case, is staging a demonstration to help inform Canadians about what such laws will mean for individuals.

Media are invited to attend today’s demonstration at the corner of Nelson and Hornby, from 9:30 to 10:30 a.m. Onsite, EPCBC offers people who can explain why legalized assisted suicide would be bad for Canadians.

Afghanistan and Bosnia vet John Coppard, 45, is one of those people. Diagnosed with an aggressive form of brain cancer two years ago, a Glioblastoma Multiforme, the Victoria resident became depressed when he realized his career was over, he’d probably never be a father or a grandfather, and his chance of surviving even five years was just 20 per cent.

If assisted suicide had been legal at the time, he believes he may have considered killing himself. But since then his condition has stabilized on a newly-approved medication. He even bought a sailboat.

“For those of us living with life threatening conditions, the system as it is offers us incredible hope,” Coppard said. “New therapies are discovered all the time. Everyone knows someone who was offered a terrible prognosis that turned out to be wrong. Doctors work hard to offer us the best chance at a long life and sometimes, recovery. I know mine are”

Assisted suicide, he said, undermines Canadians’ relationship with care providers.

“When you’re diagnosed with something like brain cancer or ALS, your treatments are very complex. You put a lot of trust in your doctors, your health care system and those closest to you to steer you through your illness. In my case I trust them completely. If assisted suicide is on the table, however, who will I be able to trust?” 

“I don't want any heroics. I'll go when it's time for me to go. But not when my medical system thinks it's too expensive to keep me alive, or when my doctor thinks I'm too much work.”

EPC BC’s spokespeople will be available for comment throughout the four-week trial.

Media contacts:

Cancer patient John Coppard 250-508-3446

Will Johnston, MD, president of EPCBC www.epcbc.ca, willjohnston@shaw.ca 604-220-2042

Alex Schadenberg, executive director of EPC Canada www.epcc.ca, info@epcc.ca 519-851-1434

Royal Society of Canada one - sided euthanasia report to be released tomorrow.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Jocelyn Downie

EPC was shocked in October 2009 when the Royal Society of Canada announced that they had established an "expert panel on end-of-life decision making" that appeared to be made up of advocates from the euthanasia lobby.

When reading the media release, it appeared that this "expert panel" was assembled by long-time euthanasia advocate Jocelyn Downie. When we further investigated the panel members it was clear that when this report would be a pro-euthanasia propaganda report.

When the Royal Society of Canada announced the formation of this "expert panel", EPC suggested that they should have at least appointed members who supported euthanasia and members who opposed euthanasia and allow them to offer two equal perspectives. But this did not happen. Wesley Smith, a leading American bioethicist stated that the Royal Society panel had "stacked the deck".

Tomorrow, the Royal Society of Canada "expert panel" on end-of-life decision making will release its report.

We expect that it will suggest - for the most part - that all is fine and good with euthanasia in jurisdictions where it is legal, that there is more abuse in jurisdictions where euthanasia is illegal, that concerns about death without consent or the euthanasia of infants with disabilities or euthanasia of people with dementia are rare and overblown and that Canada, and other nations, should go ahead and legalize euthanasia and assisted suicide and treat it like a form of medical treatment.

If I am accurate, it is because it is what I expected from the beginning. Simply read the EPC November 2009 newsletter.

Jocelyn Downie, who has written a book to promote the legalization of euthanasia in Canada, who has stated in speaking engagements that she has designed the "perfect law" for legalizing euthanasia and assisted suicide in Canada, recently sent this letter to the Deans of Medicine across Canada stating:

"I am working (pro bono) on the British Columbia Civil Liberties Association challenge to the Criminal Code prohibition of euthanasia and assisted suicide in Canada."

The BCCLA Carter case, is currently being heard in the BC courts to decriminalize euthanasia and assisted suicide in Canada.

If this report is similar to the Margaret Battin report from a few years ago, it will be designed to prove its hypothesis, and it will miss, ignore or simply write off as a non-issue any study or legitimate concern that disproves their hypothesis.

The most recent media release states that: "the Royal Society does not have an opinion on these matters." If this report were a thorough, independent and honest examination of the facts, then the Royal Society would be happy to place their seal of approval on it.

In other words, this report represents the long-held opinion of its key members.

I wonder how the "expert panel" will write off the study published last year that stated that 32% of the euthanasia deaths in the Flanders region of Belgium were without explicit request or consent?

What about the study published last year that stated that only 52.8% of all euthanasia deaths in the Flanders region of Belgium are reported?

What about the study by the pro-euthanasia Dutch Oncologist Marije van der Lee that was published in 2005 that showed that depressed people were 4.1 times more likely to request euthanasia?

How will they discount the disability perspective? Consider the article by Marilyn Golden titled: Killing us Softly. They will probably ignore the disability perspective.

What is even more crazy is that the media is likely to treat this report as scholarly.

I am interested in reading the verbal gymnastics in this report.

BC Court case seeks to legalize Euthanasia and Assisted Suicide

EPC Media Release

The Carter vs. Attorney General of Canada (Carter case) will begin to be heard on Monday, November 14, 2011 in a Vancouver court.

The Euthanasia Prevention Coalition (EPC) and EPC – BC have intervener standing in the Carter case.

EPC – BC is organizing a demonstration on the steps of the Vancouver courthouse from 9:30 am – 10:30 am on November 14.

EPC – BC chair, Dr Will Johnston states:

“I see elder abuse in my practice, often perpetrated by family members and caregivers. A desire for money or an inheritance is typical. To make it worse, the victims protect the abusers. In one case, an older woman knew that her son was robbing her blind and lied to protect him. Why? Family loyalty, shame, and fear that confronting the abuser will cost love and care.” 

“Under current law, abusers take their victims to the bank and to the lawyer for a new will. With legal assisted suicide, the next stop would be the doctor’s office for a lethal prescription. How are we going to detect victimization when we can’t do it now?”

EPC legal counsel, Hugh Scher notes:

“Concerns about safety, security and equality of people with disabilities and seniors will be central to the arguments advanced by EPC before the court, as will concerns about medical ethics and the proposed change in the doctor-patient relationship.”

EPC executive director, Alex Schadenberg states:

“The issue was debated last year in parliament and consistent with the earlier Senate Committee reports, parliament defeated Bill C-384, a bill that would have legalized euthanasia and assisted suicide in Canada, overwhelmingly by a vote of 228 to 59.

For further information contact:
Will Johnston, MD, willjohnston@shaw.ca, (604) 220-2042
Alex Schadenberg, info@epcc.ca, (519) 851-1434 or (519) 439-3348
Hugh Scher, hugh@sdlaw.ca, (416) 816-6115

Links to previous articles:
* Assisted suicide/euthanasia case is a recipe for elder abuse and a threat to individual patient rights
* The Carter Case and Assisted Suicide: A Recipe for Elder Abuse and a Threat to Individual Rights
* The Carter case seeks to legalize euthanasia and assisted suicide in Canada.

Canadians want good end-of-life care, not euthanasia or assisted suicide.

A recent Environics Research Group poll focussed on Canadian attitudes towards euthanasia. The poll was part of the Environics Research Group Omnibus survey that asks questions to 2000 participants from across Canada.

The poll found that:

* 66% of Canadians want the government to place a greater priority on improved access to palliative care. What was important about this result is that a majority of people in every region or political affiliation wanted the Provincial and Federal governments to place a greater priority on access to palliative care.

* 76% of Canadians expressed concern that elderly persons in abusive situations would be pressured to consent to euthanasia. The Canadian government has made elder abuse prevention a national priority. The poll found that Canadians are concerned about elder abuse and that they recognize that people who are experiencing elder abuse are vulnerable to being pressured into consenting to euthanasia, if it were legal. It is interesting to note that Conservatives were more likely to be concerned about elder abuse than other political affiliations. 

* 74% of Canadians are concerned that, if legal, people with disabilities, people who are sick or elderly would be euthanized without consent. 

* 82% of Canadians oppose the legalization of euthanasia, when the person does not give their consent. 

Politicians should take notice, especially since the Netherlands is now openly supporting euthanasia for people with dementia and they have allowed euthanasia on children born with disabilities, under the Groningen Protocol. It is also important to note that a study published in May 2010, on the practice of euthanasia in Belgium found that 32% of all euthanasia deaths were without explicit request or consent.

It is interesting that in Quebec, where the government established a commission to examine the issue of euthanasia, the poll found that:

* 67% want the government to place a greater priority on improved access to palliative care. 

* 76% were concerned the elderly persons in abusive situations would be pressured to consent to euthanasia. 

* 74% were concerned that, if legal, people with disabilities, or people who are sick or elderly would be euthanized without consent. 

* 79% oppose the legalization of euthanasia, when the person does not give their consent.

Canadians are concerned, that if euthanasia is legalized, vulnerable Canadians, such as those experiencing elder abuse and people with disabilities will be pressured to consent or euthanized without consent.

The Carter Case & Assisted Suicide: Talking Points for the Public & the Media

 The Carter Case & Assisted Suicide:

Talking Points for the Public & the Media 

For more detailed information and references, see “The Carter Case and Assisted Suicide: A Recipe for Elder Abuse and a Threat to Individual Rights,” - link.

1. Is it true that Canada has rejected assisted suicide and euthanasia?

Yes. Just last year, Parliament defeated Bill C-384, which would have legalized physician-assisted suicide and euthanasia in Canada. The vote was 228 to 59.

2. What is the Carter Case?

Carter vs. Attorney General of Canada is a constitutional challenge to Canada's laws prohibiting physician-assisted suicide and euthanasia. Carter also seeks to legalize these practices as a medical treatment.

3. When was Carter filed?

Carter was filed on April 26, 2011. On August 15, 2011, Gloria Taylor was added as an additional plaintiff via an Amended Notice of Civil Claim.

4. What is assisted suicide?

“Assisted suicide” means providing a person with the knowledge or means to commit suicide. When the assistance is provided in whole or in part by a doctor, the practice is “physician-assisted suicide.”

5.  How does Carter define physician-assisted suicide?

Carter's Amended Notice of Civil Claim states:

"'physician-assisted suicide' means an assisted suicide where assistance to obtain or administer medication or other treatment that intentionally brings about the patient's own death is provided by a medical practitioner . . . or by a person acting under the general supervision of a medical practitioner . . ."

6. Would a family member be allowed to participate in a patient's suicide under this definition?

Yes. In the context of medical treatment, a person acting "under the general supervision of a medical practitioner" includes a family member. This would typically be in a home setting. An example would be an adult child who administers medication to his parent under the general supervision of a doctor.

7. Would a family member be allowed to participate in a patient's suicide without direct supervision?

Yes. Carter's Amended Notice of Civil Claim requires "general supervision" of  a person who is not a medical practitioner: No witnesses or other direct oversight is required when the lethal dose is administered. The medical practitioner is not required to be present when the lethal dose is administered and/or at the time of death.

8. Would legalization of assisted suicide under Carter's Amended Notice of Civil Claim apply to people who are not dying?

Yes. Carter's Amended Notice of Civil Claim seeks to legalize assisted suicide for people who are "grievously and irremediably ill." The Amended Notice of Civil Claim does not define this term, but gives these examples: "cancer, chronic renal failure and/or cardiac failure, and degenerative neurological diseases such as Huntington's disease and multiple sclerosis." People with these conditions can experience good quality lives for years and even decades. Doctors can also be wrong about disease prognosis. Some people, for example with cancer, recover with treatment.   

9. Is it true that most states in the United States have rejected assisted suicide?

Yes. There are just two states where physician-assisted suicide is legal:  Oregon and Washington. In a third state, Montana, there is a court case that gives doctors who assist a patient's suicide, a potential defense to a homicide charge. In the United States, no law to allow assisted suicide has made it through the scrutiny of a legislature despite more than 100 attempts. This year, assisted suicide laws were defeated in the states of Montana, New Hampshire and Hawaii. This year, the state of Idaho enacted a statute to strengthen its law against assisted suicide. The vote was nearly unanimous.

10. If Carter were to limit assisted suicide to "terminal" patients, would the practice be limited to people who are dying anyway?

No. "Terminal" patients are not necessarily dying.  Consider, for example, Oregon resident Jeanette Hall, who was told that she had six months to a year to live and who wanted to die via assisted suicide. It is now over 11 years later.  She states:

"I wanted to do what our [assisted suicide] law allowed, and I wanted my doctor to help me. Instead, he encouraged me not to give up, and ultimately I decided to fight my disease. . . . If my doctor had believed in assisted suicide, I would be dead."

11. What is elder abuse?

Elder abuse includes physical, psychological and financial abuse.

12. What is the most commonly reported type of elder abuse?

Financial abuse is the most commonly reported type. Elder abuse is, however, largely unreported and can be very difficult to detect. This is due in part to the reluctance of victims to report. The Government of Canada website states:

"Older adults may feel ashamed or embarrassed to tell anyone that they are being abused by someone they trust."

13. How would legalizing assisted suicide in Canada cause elder abuse?

If assisted suicide were to be legalized under Carter's Amended Notice of Civil Claim, new paths of elder abuse would be created. A more obvious path is due to Carter's lack of oversight at the time of administration (no requirement for witnesses or other direct supervision). This situation creates an opportunity for the family member to administer the lethal dose to the patient without his consent. Even if he struggled, who could know?

Consider also, the comment of Will Johnston, a Vancouver physician who sees elder abuse in his practice:

"Under current law, abusers take their victims to the bank and to the lawyer for a new will.  With legal assisted suicide, the next stop would be the doctor’s office for a lethal prescription.  How exactly are we going to detect the victimization when we can’t do it now?"

14. Does Canada have a policy to prevent elder abuse?

Yes. Preventing elder abuse is official Government of Canada policy.

15. How would legal assisted suicide empower the Canadian healthcare system to the detriment of individual rights?

Consider this example from Oregon where legalization of assisted suicide has allowed the Oregon Health Plan to steer patients to suicide. 

The most well known cases involve Barbara Wagner and Randy Stroup. Each wanted treatment. The Plan offered them assisted suicide instead. Neither saw this scenario as a celebration of their individual rights. Wagner said: “I'm not ready to die.” Stroup said: “This is my life they’re playing with.”

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering. If assisted suicide were to be legalized in Canada, the Canadian health care system would be similarly empowered to steer patients to suicide.

With legal assisted suicide, the healthcare system, doctors and the government would be empowered, not individual patients.

16. How does the Carter case propose to protect doctors and family members at the expense of individual patient rights?    

In Carter, the Amended Notice of Civil Claim argues that doctors and other persons assisting a suicide should have a constitutional right to do so. The Amended Notice of Civil Claim states:

"The right to liberty of persons who assist or support a grievously and irremediably ill person to obtain physician-assisted dying services [physician-assisted suicide and euthanasia] must necessarily be protected in order to give meaning to the s. 7 life, liberty and security of the person rights of grievously and irremediably ill persons."

With doctors and other assisting persons protected with a constitutional right, a patient subjected to their actions would likely be left with little or no recourse.

Physician-assisted suicide is not legal in Montana

Senator Jim Shockley

The following article was written by Montana Senator Jim Shockley and published in the current edition of the Montana Lawyer. Senator Shockley is arguing that physician-assisted suicide is not legal in Montana.

"No, physician-assisted suicide is not legal in Montana: It's a recipe for elder abuse and more". [1] 

By State Senator Jim Shockley and Margaret Dore
Published in The Montana Lawyer - The State Bar of Montana

There are two states where physician-assisted suicide is legal: Oregon and Washington. These states have statutes that give doctors and others who participate in a qualified patient’s suicide immunity from criminal and civil liability. (ORS 127.800-995 and RCW 70.245). 

In Montana, by contrast, the law on assisted suicide is governed by the Montana Supreme Court decision, Baxter v. State, 354 Mont. 234 (2009). Baxter gives doctors who assist a patient’s suicide a potential defense to criminal prosecution. Baxter does not legalize assisted suicide by giving doctors or anyone else immunity from criminal and civil liability. Under Baxter, a doctor cannot be assured that a suicide will qualify for the defense. Some assisted suicide proponents nonetheless claim that Baxter has legalized assisted suicide in Montana.

Legalizing assisted suicide in Montana would be a recipe for elder abuse. The practice has multiple other problems.  

If the idea of suicide itself is suggested to the patient first by the doctor or even by the family, instead of being on the patient's sole initiative, the situation exceeds "aid in dying" as conceived by the Court. If a particular suicide decision process is anything but "private, civil, and compassionate," . . . , the Court's decision wouldn't guarantee a consent defense. If the patient is less than "conscious," is unable to "vocalize" his decision, or gets help because he is unable to "self-administer," or the drug fails and someone helps complete the killing, Baxter would not apply. . . . 

No doctor can prevent these human contingencies from occurring in a given case . . . in order to make sure that he can later use the consent defense if he is charged with murder.

“Analysis of Implications of the Baxter Case on Potential Criminal Liability,” Spring 2010, at: http://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html

The 2011 Legislative Session

The 2011 legislative session featured two bills in response to Baxter, both of which failed: SB 116, which would have eliminated Baxter’s potential defense; and SB 167, which would have legalized assisted suicide by providing doctors and others with immunity from criminal and civil liability.

During a hearing on SB 167, the bill's sponsor, Senator Anders Blewett, said:  “[U]nder current law, ... there’s nothing to protect the doctor from prosecution.” (http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf). Dr. Stephen Speckart made a similar statement: 

"[M]ost physicians feel significant dis-ease with the limited safeguards and possible risk of criminal prosecution after the Baxter decision." (Id. at p.2)

Legalization would create new paths of abuse

In Montana, there has been a rapid growth of elder abuse. Elders' vulnerabilities and larger net worth make them a target for financial abuse. The perpetrators are often family members motivated by an inheritance. See e.g. www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf.

Preventing elder abuse is official Montana state policy. See e.g., 52-3-801, MCA. If Montana would legalize physician-assisted suicide, a new path of abuse would be created against the elderly, which would be contrary to that policy. Alex Schadenberg, Chair of the Euthanasia Prevention Coalition, International, states: 

With assisted suicide laws in Washington and Oregon, perpetrators can . . . take a 'legal' route, by getting an elder to sign a lethal dose request.  Once the prescription is filled, there is no supervision over the administration. . . . [E]ven if a patient struggled, “who would know?

 http://www.isb.idaho.gov/pdf/advocate/issues/adv10oct.pdf, p. 14.

“Terminally Ill” Does Not Mean Dying

Baxter’s potential defense applies when patients are "terminally ill," which Baxter does not define. In Oregon, “terminal” patients are defined as those having less than six months to live. Such persons are not necessarily dying.  Doctors can be wrong. Moreover, treatment can lead to recovery. Oregon resident, Jeanette Hall, who was diagnosed with cancer and told that she had six months to a year to live, said:

I wanted to do our [assisted suicide] law and I wanted my doctor to help me.  Instead, he encouraged me to not give up . . .  I had both chemotherapy and radiation. . . . 

It is now 10 years later.  If my doctor had believed in assisted suicide, I would be dead. 

http://mtstandard.com/news/opinion/mailbag/article_aeef3982-9a98-11df-8db2-001cc4c002e0.html

Legal physician-assisted suicide empowered the Oregon Health Plan, not individual patients 

Once a patient is labeled “terminal,” an easy argument can be made that his or her treatment should be denied.  This has happened in Oregon where patients labeled “terminal” have not only been denied coverage for treatment, they have been offered assisted-suicide instead.

The most well known cases involve Barbara Wagner and Randy Stroup. (KATU TV, at: http://www.katu.com/news/26119539.html, ABC News, at: http://www.abcnews.go.com/Health/Story?id=5517492 Ken Stevens, MD, at pp. 16-17, at: http://choiceillusionoregon.blogspot.com/p/oregons-mistake-costs-lives.html. The Oregon Health Plan refused to pay for their desired treatments and offered to pay for their suicides instead. Neither Wagner nor Stroup saw this as a celebration of their “choice.” Wagner said: 

“I’m not ready to die.” Stroup said: “This is my life they’re playing with.”

Stroup and Wagner were steered to suicide and it was the Oregon Health Plan doing the steering. Oregon’s law empowered the Oregon Health Plan, not individual patients.

Oregon’s studies are invalid

Oregon’s statute does not require a doctor to be present when the lethal dose is administered. (ORS 127.800-995). During a hearing on SB 167, Senator Jeff Essmann made a related point, as follows: 

[A]ll the protections [in Oregon’s law] end after the prescription is written.  [The proponents] admitted that the provisions in the Oregon law would permit one person to be alone in that room with the patient.  And in that situation, there is no guarantee that that medication is self-administered. 

So frankly, any of the studies that come out of the state of Oregon’s experience are invalid because no one who administers that drug . . . to that patient is going to be turning themselves in for the commission of a homicide.

 Senate Judiciary Hearing Transcript, February 10, 2011, p.15, at:
http://www.margaretdore.com/pdf/senator_essmann_sb_167_001.pdf

Public confusion

In Montana, the moving force behind legalizing assisted suicide is Denver-based Compassion & Choices. On September 15, 2011, that organization’s president published an article on Huffington Post claiming that under Baxter physicians in Montana are “safe from prosecution.” (http://www.huffingtonpost.com/barbara-coombs-lee/aid-in-dying-montana_b_960555.html) This is clearly not the case and  propaganda. A physician relying on her advice could be charged with homicide.

Conclusion  

Baxter is a flawed decision that overlooked elder abuse. Baxter has created confusion in the law, which has put Montana citizens at risk. Neither the legal profession nor the medical profession has the necessary guidance to know what is lawful. 

Legalizing assisted suicide is bad public policy. Doctors’ diagnoses can be wrong and legalization is a recipe for abuse. Legalization would also allow the state government to encourage citizens to kill themselves. This is an area where the government does not belong. Montana consistently has one of the highest suicide rates in the nation.  Montana doesn’t need the “Oregon Experience.”


Legislation should be enacted to overrule Baxter and clearly declare that assisted suicide is not legal in Montana.        

* * *

Senator Jim Shockley, of Victor, is a Republican State Senator, probate lawyer, and an adjunct instructor at the University of Montana School of Law. 

Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted-suicide. (www.choiceillusion.org) She is a Democrat.  

* * *

[1] To read this article as published in The Montana Lawyer and the opposing article by Senator Anders Blewett, go here:

http://www.montanabar.org/associations/7121/November%202011%20mt%20lawyer.pdf

What is physician-assisted suicide?

The American Medical Association (AMA) states: “Physician-assisted suicide occurs when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” (Code of Medical Ethics Opinion 2.211). For example, a “physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.”  (Id.)

The Baxter decision

Baxter found that there was no indication in Montana law that physician-assisted suicide, which the Court termed “aid in dying,” is against public policy. (354 Mont. at 240, ¶¶ 13, 49-50). Based on this finding, the Court held that a patient’s consent to aid in dying “constitutes a statutory defense to a charge of homicide against the aiding physician.” (Id. at 251, ¶ 50).

Baxter, however, overlooked elder abuse. The Court stated that the only person “who might conceivably be prosecuted for criminal behavior is the physician who prescribes a lethal dose of medication.” (354 Mont. at 239, ¶ 11). The Court thereby overlooked criminal behavior by family members and others who benefit from a patient’s death, for example, due to an inheritance.

Baxter also overlooked caselaw imposing civil liability on persons who cause or fail to prevent a suicide. See Krieg v. Massey, 239 Mont. 469, 472-3 (1989) and Nelson v. Driscoll, 295 Mont. 363, ¶¶ 32-33 (1999). Baxter is, regardless, a narrow decision in which doctors cannot be assured that a suicide will qualify for the defense. Attorneys Greg Jackson and Matt Bowman provide this analysis: