Ontario doctors shouldn't be forced to refer their patients for euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Ontario Standing Committee on Finance and Economic Affairs did a clause-by-clause consideration of euthanasia Bill 84, "An Act to amend various Acts with respect to medical assistance in dying" today.

The committee rejected all amendments to Bill 84 including an amendment to protect conscience rights for medical professionals.

Yesterday, a group of doctors held a press conference urging the Ontario government to protect conscience rights for medical professionals by amending Bill 84. CHCH news reported:

Doctors speaking out say they shouldn’t be forced to refer their patients to another doctor who is willing to help them die if they disagree with the practice. 

“None of us ever envisioned whether we took our hippocratic oath 40 years ago or 4 years ago that we would one day be legislated to cooperate in the death of our patients.”

Doctors who oppose killing patients by lethal injection will also oppose sending their patients to a doctor who will kill their patients. An "effective referral" to a doctor who will kill is similar to killing the patient yourself.

Since Ontario has a Liberal majority government and since the Ontario Liberal government policies have made them unpopular, it is time that the Liberal caucus wake up and buck the unpopular policies of the own government. Protecting conscience rights for medical professionals is a good place to start.

• Ontario's euthanasia Bill 84 does not protect physicians conscience rights.
• Ontario must amend its assisted dying legislation to recognize conscience rights.
• Ontario death hotline does not provide conscience protection for physicians.

Oklahoma Death Certificate Accuracy Act (HB 1495) passes.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In most jurisdictions where euthanasia and/or assisted suicide have been decriminalized, the statutes state that the physician must lie on the death certificate by listing the cause of death as the disease or injury that led the person to request death by lethal drugs.

For instance, Ontario's Bill 84 requires physicians and Coroners to lie on the death certificate by stating that the person died as a result of the injury or disease, and not medical assistance in dying (euthanasia). Bill 84 states:

Medical assistance in dying
2.2 For the purposes of this Act, a worker who receives medical assistance in dying is deemed to have died as a result of the injury or disease for which the worker was determined to be eligible to receive medical assistance in dying in accordance with paragraph 241.2 (3) (a) of the Criminal Code (Canada).

Oklahoma, where assisted suicide is prohibited, passed HB 1495 in the House (62 - 26) to counter the concept that physicians or coroners can / must lawfully lie on death certificates.

I have always stated that if there is nothing wrong with assisted suicide, why are doctors required to lie about it?

Thank you Oklahoma legislators for identifying one of the assisted suicide lobby lies. Lying on a death certificate denies effective oversight of the assisted suicide law.

Ontario's euthanasia bill - no physician conscience rights.

This article was published in the Toronto Sun on April 7, 2017.

Dr Mark D'Souza

Bill 84 is the Ontario government’s proposed legislation designed to implement Ottawa’s law on medically assisted dying.

It ignores the conscience rights of doctors like myself, who oppose euthanasia on ethical grounds and, in its current form, will decrease public access to palliative care.

In 2015, the College of Physicians and Surgeons of Ontario changed its human rights policy to say doctors who oppose euthanasia must refer their patients who want to be considered for it to another doctor to carry out.

Doctors like myself argue this provision — known as effective referral — involves us in the euthanasia process against our will.

This despite the fact the federal law encourages provincial legislation to uphold the conscience rights of doctors.

Every other jurisdiction in the world that offers euthanasia to patients — including the other Canadian provinces — protects the conscience rights of doctors.

Every major religion and even secular humanist organizations have denounced effective referrals.

The Canadian, American, and Ontario Medical Associations all say they are unnecessary.

And yet one Ontario university medical school is already screening candidates’ views on euthanasia in their interview process — a discriminatory filtering practice.

Isn’t freedom of conscience enshrined in the Canadian Charter of Rights and Freedoms?

Why pit doctors’ conscience rights and patients’ rights to treatment against each other?

The solution is simple. It is to establish a government service by which patients can initiate on their own their request to be assessed for a medically assisted death, and recognize it in Bill 84.

The irony is the Ontario government has said it intends to create such a service, but has not agreed to give this process legal recognition in Bill 84 as an alternative to effective referral.

I am one of a group of six doctors who visit palliative care patients in their homes in Scarborough.

We are all conscientious objectors, but we would have no problem giving our patients or their families considering euthanasia a central phone number or website to contact.

Last week I accepted my final palliative care patient.

I will not abandon my current patients but I will not accept new ones until I know my conscience rights as a physician are guaranteed in law.

Though we all find this work very meaningful, half of our group is considering leaving the field, a microcosm of what is to come in Ontario.

As it is, Scarborough’s palliative care system is grossly under serviced.

We reached a wait list high of 32 patients now living in their homes last month.

Imagine being told your days are numbered, you’re in severe pain, and now you’re 30 patients away from a doctor being able to take care of you in your home.

That number will multiply.

Much of this can be prevented with a simple amendment to Bill 84.

The government’s refusal to act will further compromise your already scarce right to basic palliative care at home.

Bill 84 will be voted on in the second week of April.

Let’s protect doctors’ conscience rights by removing mandatory effective referral, while providing patients with effective access to medically assisted dying, as does the rest of the world.

This government needs to remember that health care is delivered at the bedside, not at a bureaucrat’s desk, and that patients never come first when doctors are put last.

D’Souza is a family, ER and palliative care physician, a board director of Concerned Ontario Doctors and chair of OMA District 11 (Toronto)

Ontario “death hotline” does not provide conscience protection for physicians.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On April 2, the Canadian Press reported that the Ontario Ministry of Health was setting up a toll free number to provide access to “medically assisted death,” euthanasia and assisted suicide in Ontario.

The Associated Press reported Ontario Health Minister, Eric Hoskins saying:

…a “care co-ordination service” for medically assisted death will be up and running as early as May. 

The service will allow patients to contact central staff who will connect them with health-care providers prepared to handle requests for a medically assisted death. 

“That patient, or their family members or their caregiver would have the ability to be in contact with the care-co-ordination service directly,”

The article suggests that the death hotline will enable people to bypass doctors who conscientiously object to killing their patients, while protecting the conscience rights for healthcare professionals.

The death hotline does not protect conscience rights for medical professionals in Ontario, even though it will reduce the likelihood that doctors will face disciplinary hearings for not referring their patients to death doctors.

The Ontario College of Physicians and Surgeons still requires physicians, who will not kill their patients, to “effectively refer” their patients to a doctor who will kill.

Further to that, even though the death hotline will be promoted throughout Ontario by the Ministry of Health, doctors will be forced to provide information about the “death hotline” to patients who ask about euthanasia.

The Associated Press article also stated that from June 2016 - March 30, 2017 365 people died by euthanasia in Ontario.

The death hotline will accelerate the number of assisted deaths by streamlining the process of finding a doctor who will kill.

The death hotline will not protect conscience rights for medical professionals in Ontario and it will increase the number of euthanasia deaths by streamlining access to death by lethal injection.

Ontario must amend its assisted dying legislation to recognize conscience rights.

This article was written by John Milloy and published by National Newswatch on April 4.

John Milloy is a former Ontario Liberal MPP and cabinet minister

Canadians ask a lot of our physicians – years of education, long hours, complex cases and demanding patients (full disclosure – I am married to a doctor).

Since June of last year, we have also been asking them to help some of their patients take their own lives.

No matter how you feel about assisted dying, you have to admit that having a role in the act is a burden that few of us would never welcome. And yet as a society we seem to forget that doctors are no different. As Dr. Jeff Blackmer, a vice-president of the Canadian Medical Association, recently told the National Post: 

“The act is performed out of care and compassion … But for most [doctors], it doesn’t make the psychological impact of that final, very definitive act, any less than it would be for anybody …”

Should we not respect the fact that some doctors and other health-care providers simply don’t want to be involved in assisted dying for reasons of conscience?

In fairness, the current system does not force any medical professional actually to administer the procedure. But what happens when a patient under his or her care wants to access physician-assisted dying?

According to guidelines issued by the College of Physicians and Surgeons of Ontario, a doctor who objects must take steps to refer the patient to a physician or healthcare provider who is open to performing the procedure – what is technically known as an effective referral.

To some physicians this is tantamount to indirect participation. They have no interest in abandoning their patient and are prepared to work with them to try to address their concerns, including pain management, counselling and other measures. They do not, however, want potentially to be the starting point of the process that leads them to euthanasia or assisted dying and they refuse to be in involved in an effective referral.

The college has refused to recognize their concerns, resulting in a legal challenge from a number of physician groups.

The Ontario government recently introduced Bill 84, designed to bring provincial laws in line with the new federal law. Here was a perfect opportunity to clarify the rules around effective referrals and allow physicians to opt out fully due to reasons of conscience.

Yet the bill is silent on the matter.

This is not an impossible circle to square. Objecting physicians have asked the province to create a care co-ordination system that could be accessed by patients wishing to be assessed for medical assistance in dying, relieving their physician of the need to refer

It’s a system that has been established in Alberta. There, an objecting physician can simply provide patients with the contact information of a care co-ordination service that will provide them with assistance.

The irony of the situation is that the Ontario government recently announced its intention to establish a similar co-ordination service in Ontario, making it simple to adopt conscience protections mirroring those that exist in Alberta.

And it’s not just Alberta: A number of other provinces have adopted similar pathways for objecting physicians. In fact, experts in the field note that outside of Canada there is no jurisdiction allowing physician-assisted dying in the world that doesn’t allow doctors to opt out of any form of involvement.

It is unclear why the Ontario Liberals are refusing to take this step. The Progressive Conservatives have taken up the cause and are promising to introduce amendments to the bill at committee stage. Among the most vocal Conservative MPPs have been prominent social conservatives like Monte McNaughton. Many see this group as being on the “wrong side” of numerous hot button issues like abortion, LGBTQ rights and the new sex-ed curriculum.

Let’s not turn conscience rights into a “hot button” issue and dismiss the legitimate concerns of physicians.

Yes it is true that many physicians object to physician-assisted dying due to their religious faith – a faith whose tenets concerning care for the most vulnerable may have attracted them to the profession in the first place. Why should these beliefs be dismissed? What message is Ontario sending when we tell doctors that their religious faith or other deeply held values can’t be accommodated the same way it is in other jurisdictions?

I remember the outrage at Queen’s Park over the proposed Quebec charter of values. Aimed at further secularizing the government, the charter would have, among other things, banned those in the Quebec public sector, including doctors, from wearing religious symbols, such as turbans or hijabs.

Ontario’s Minister of Citizenship and Immigration at the time, Michael Coteau, put out a statement criticizing the legislation and confirming the Ontario government’s commitment to “freedom of expression and religion.” I remember that many of my colleagues cheered when an Ontario hospital blatantly tried to recruit Quebec doctors by highlighting Ontario’s respect for their beliefs.

Why did we try to persuade doctors that our province respects their freedoms back then and yet can’t take their freedom of conscience seriously now? What has changed?

John Milloy is currently serving as the co-director of the Centre for Public Ethics and assistant professor of public ethics at Waterloo Lutheran Seminary, and the inaugural practitioner in residence in Wilfrid Laurier University’s Political Science department. He is also a lecturer in the University of Waterloo’s Master of Public Service Program. John can be reached at jmilloy@wlu.ca

Québec pushes the euthanasia boundaries again.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition
 

Québec pushed the boundaries by legalizing euthanasia, through Bill 52, before the criminal code was amended by defining lethal injection as medical treatment.

Gaétan Barrette, Québec's Health Minister, is now considering incrementally extending euthanasia to incompetent people with Alzheimer's or Dementia, even though the law states that "medical-assistance-in-dying" is limited to competent people.
 
The Federal government is also examining extending euthanasia to persons under 18, people who are incompetent with Alzheimer's or Dementia and people who are "psychologically suffering" but not dying.

Konrad Yakabuski expressed his concerns with permitting "MAID" for incompetent people in an opinion article published in the Globe and Mail yesterday. Yakabuski stated:

On March 24, Health Minister Gaétan Barrette announced a three-pronged approach aimed at potentially broadening the eligibility requirements for medical aid in dying. First, a provincial commission will examine the more than 250 requests for the procedure that have been either rejected or withdrawn since the practice was legalized. A group of experts will subsequently re-examine the question of allowing advance consent for MAID by people diagnosed with degenerative diseases such as Alzheimer’s and other forms of dementia. Quebec’s Justice Ministry, meanwhile, will ask the courts to clarify the federal MAID law’s limit of the practice to only those facing a “reasonably foreseeable” death, which health professionals have complained is too vague.

When the Québec government was debating euthanasia, they insisted that they would implement the law carefully. Now that euthanasia is legal, the Federal and Québec governments are making plans to expand the law, just as we had predicted.

Yakabuski states his concerns:

None of this will make the path we have embarked on any less fraught with ethical red flags than it should be. There can be nothing ethically clear-cut about deciding when to end the life of an Alzheimer’s sufferer who is no longer cogent enough to consent. The whole notion of “unbearable suffering” (one of the federal law requirements for MAID) is in itself inscrutable when it comes to Alzheimer’s and dementia. Unbearable for whom? Just whose suffering is being alleviated when loved ones ask God or the state for their dementia-stricken ward to die?

For what it’s worth, the Alzheimer Society of Canada argues that “MAID should only be possible when a person is deemed competent at the time of MAID. … [P]eople with dementia need to be safeguarded as they will be extremely vulnerable at the end of their life [and] do not have the capacity to make an informed decision and consent to end their life at the later stages of the disease.”

Personally, that’s enough guidance for me.

When the government permits the killing of its citizens by lethal injection, it crosses the clear line, that killing a human being is always wrong. Now that one person can kill another person in Canada, the only question that remains is for what reason will it be permitted to kill. Incremental extensions are inevitable. 

The answer is to Care for people and not kill people.

Alaska Assisted Suicide bill HB 54 - Bad Things Happen in the Dark

This article was originally published on April 2, 2017 on the Choice is an Illusion website.

Margaret Dore

By Margaret K. Dore, Esq., for a pdf version, click here.

HB 54 legalizes physician-assisted suicide and euthanasia as those terms are traditionally defined. The bill is based on a similar law in Oregon, which has a near complete lack of transparency.

If Alaska enacts HB 54 and follows Oregon practice, there will be a similar lack of transparency. The safety and welfare of individual patients will be unverifiable from Alaska State sources.

DISCUSSION

A. If Alaska Follows Oregon’s Interpretation of “Not a Public Record,” the Department of Health & Social Services will be insulated from review, even by law enforcement.

HB 54 charges the Department of Health and Social Services with issuing an annual statistical report based on data collected pursuant to the bill.[1] The bill also states:

The information collected is not a public record under AS 40.25.110, and the department may not make the information available for inspection by the public. (Emphasis added).[2]

Oregon’s law has a similar provision, as follows:

Except as otherwise required by law, the information collected shall not be a public record and may not be made available for inspection by the public. (Emphasis added).[3]

In Oregon, this similar provision is interpreted to bar release of information about individual cases, to everyone, including law enforcement. Oregon’s website states:

[T]he Act specifically states that information collected is not a public record and is not available for inspection by the public (ORS 127.865 (2)). The protection of confidentiality conferred by the Death with Dignity Act precludes the Oregon Health Authority [which oversees Oregon’s Department of Health] from releasing information that identifies patients or participants, to the public, media, researchers, students, advocates, or other interested parties....[4]

Consider also this e-mail from Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, which states:

We have been contacted by law enforcement . . . in the past, but have not provided identifying information of any type. (Emphasis added).[5]

If Alaska enacts HB 54 and follows Oregon’s interpretation of “not a public record,” there will be a similar lack of transparency in which even law enforcement will have no access to information about individual cases. The bill will create a government entity above the law.

B. If Alaska follows Oregon’s data collection protocol, patient identities will not be recorded in any manner, source documentation will be destroyed

Oregon’s website describes the data collection protocol for its annual reports, as follows:

The identity of participating physicians is coded, but the identity of individual patients is not recorded in any manner. Approximately one year from the publication of the Annual Report, all source documentation is destroyed. (Emphasis added).[6]

Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, makes a similar representation as follows:

To ensure confidentiality, our office does not maintain source information on participants. (Emphasis added).[7]

The significance is that Oregon’s annual reports are unverifiable. If Alaska, based on its similar statutory language, follows Oregon, Alaska’s annual reports will also be unverifiable.

C. If Alaska follows Oregon, Compassion & Choices, a non-governmental entity, will displace the department of health and social services to become the defacto “agency” overseeing HB 54

Passage of HB 54 is being spearheaded by the suicide promotion group, Compassion & Choices. In Oregon, this organization has used the Oregon law to disable and largely displace the Department of Health as the entity overseeing Oregon’s law. See below.

1. In Oregon, the police officer assigned to the case was not able to get information from the State; the decedent’s death certificate was falsified; the officer obtained information from Compassion & Choices

In 2010, I had client who wanted to know if his father had died under Oregon’s law. I referred him to an Oregon attorney, Isaac Jackson, who asked the police to investigate. Jackson’s subsequent declaration states:

2. I write to inform the court regarding a lack of transparency under Oregon’s assisted suicide act. Even law enforcement is denied access to information collected by the State of Oregon. Moreover, according to the current Oregon State website, this lack of access is official Oregon State Policy. 

3. In 2010, I was retained by a client whose father had apparently died under Oregon’s law. The client wanted to know whether that was true. I therefore made inquiry on his behalf. However and unlike other deaths I have investigated, it was difficult to get information. . . . 

6. I . . . received a copy of the decedent’s death certificate, which is the official death record in Oregon. A true and correct, but redacted copy, is attached hereto . . . . The “immediate cause of death” is listed as “cancer.” The “manner of death” is listed as “Natural.” 

7. Per my request, a police officer was assigned to the case. Per the officer’s confidential report, he did not interview my client, but he did interview people who had witnessed the decedent’s death. 

8. The officer’s report describes how he determined that the [father’s] death was under Oregon’s assisted suicide law due to records other than from the State of Oregon. The officer’s report also describes that he was unable to get this information from the Oregon Health Authority, which was not willing to confirm or deny whether the deceased had used the act . . . . (Emphasis added).[]

I also read the officer’s report. According to the report, Compassion & Choices provided the records necessary for the officer to determine that the decedent had, in fact, died under Oregon’s law. In Oregon, Compassion & Choices, a non-governmental entity, has displaced the Department of Health as the agency overseeing Oregon’s law.

2. In Oregon, Compassion & Choices is like “the fox in the proverbial chicken coop” reporting to the farmer what’s happening in the coop

In 2008, the Editorial Board for The Oregonian, which is Oregon’s largest newspaper, urged Washington State voters to reject its then pending assisted suicide measure. The Editorial Board stated:

Oregon’s physician-assisted suicide program has not been sufficiently transparent. Essentially, a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know. (Emphasis added).[11]

Four days later, Oregon doctors, Kenneth Stevens and William Toffler, published a follow up article, stating:

The group promoting assisted suicide, so-called "Compassion and Choices (C&C)", are like the fox in the proverbial chicken coop; in this case the fox is reporting its version to the farmer regarding what is happening in the coop. . . .  

In 2006, C&C's attorneys intimidated the Oregon Department of Human Services (DHS) to change to euphemisms in referring to Oregon's assisted suicide law. The limited DHS reports of assisted suicides is another indication of this organization's influence. Information that is damaging to the "good public image" of Oregon's assisted suicide law is hidden or glossed-over in the DHS reports. . . . [12]

Conclusion

The proposed Oregon-style “oversight” is a sham and will create the opportunity for a non-governmental entity to displace a government agency. The safety and welfare of individuals will be unverifiable from state sources. 

I urge you to vote “No” on HB 54.

Footnotes:

[1] HB 54, Sponsor Substitute Version, Section 3, § 13.55.210.
[2] Id., § 13.55.210 (c).
[3] ORS 127.865 s.3.11(2) .
[4] Oregon Data Release Policy, copy attached in this link at page A-62.
[5] E-mail from Alicia Parkman to me, 01/04/12, copy attached in this link at page A-63.
[6] Oregon Health Authority, Frequently Asked Questions, copy attached in this link at page A-67. a
[7] Supra at note 5.
[8] Compassion & Choices is a successor organization to the Hemlock Society, originally founded by suicide promoter, Derek Humphry. See newsletter attached in this link at page A-73
[9] Isaac Jackson, Declaration of Testimony, 09/18/12, attached in this link at pages A-57 to A-58
[10] The Oregonian Editorial Board, “Washington state's assisted-suicide measure: Don't go there,” The Oregonian, September 20, 2012,
[11] Id.
[12] Kenneth Stevens MD and William Toffler MD, “Assisted suicide: Conspiracy and control,” The Oregonian, September 24, 2008.

Respectfully submitted this 31ST day of March 2017

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, Suite 4400
Seattle, WA 98154
206 697 1217

Medical Assisted Suicide Is Disability Discrimination

This article was written by Mark Pickup and published on his blog on April 2, 2017.

Mark Pickup

In 2015, Canada’s Supreme Court struck down the nation’s laws against assisted suicide. It sent shock waves across the country: People opposed to legalization of assisted suicide were appalled the high court would do such a thing; advocates of assisted suicide were shocked that the court went so far – even beyond their fondest dreams. The foundation beneath the high court’s ruling was the new high ideal of personal autonomy. Apparently, in Canada, people now have a right to assisted suicide if they have a “grievous and irremediable medical condition (including an illness, disease or disability that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

The Supreme Court said that self-defined grievous and irremediable medical condition ”does not require the patient to undertake treatments that are not acceptable to the individual.” Everything hinges on the patient’s perceptions and feelings -- and they need not take treatments they don’t like.

Something significant happened to shake the historical taboo of killing the sick and disabled. More than 700 years of Common Law, that discouraged, prohibited or otherwise punished assisting someone’s suicide was brushed aside by one judicial decree.[1] How did this happen?

If the Supreme Court was to rule in favour of assisted suicide they had to confront a problem: The Canada’s Charter of Rights and Freedoms – which acts as a constitution in Canada – states in Section 7 that “everyone has the right to life, liberty and security of the person …”. The judges’ had to suppress the ‘right to life’ and accentuate a false notion of liberty and emphasise ‘security of the person’. The problem with trying to suppress the right to life is that all other rights depend upon it. Liberty and security of the person become tenuous if the right to life is not guaranteed. Self-destruction eliminates liberty and assisting in a suicide is license, not liberty.

The Supremes paid obligatory but shallow homage to the concept of the sanctity of human life, then discounted the right to life in one paragraph. They wrote:

“…[W]e do not agree that the existential formulation of the right to life requires an absolute prohibition on assistance in dying, or that individuals cannot “waive” their right to life. This would create a “duty to live”, rather than a “right to life”, . . . The sanctity of life is one of our most fundamental societal values. Section 7 [of the Charter of Rights and Freedoms] is rooted in a profound respect for the value of human life. But Section 7 also encompasses life, liberty and security of the person during the passage to death. It is for this reason that the sanctity of life “is no longer seen to require all human life be preserved at all costs.”

Continuing in their cleaver distortion, the judges wrote: 

“Underlying both these rights [liberty and security of the person] is a concern for the protection of individual autonomy and dignity.” 

I do not believe the architects of the Canadian Charter envisioned a vehicle to autonomy and dignity included a right to suicide. The right to death is not mentioned in the Charter – the right to life is. Do you see how they were twisting things? They went on to say:

“The law has long protected patient autonomy in medical decision making.” 

Granted, but Canadian law has only recently sanctioned medical killing by assisted suicide or euthanasia.

The dramatic departure from legal and moral traditions went from the court to the Canadian Parliament and assisted suicide became legal in June 2016. The legislation (bill C-14) was enacted under the euphemistic and deceptive title “medical assistance in dying”. I used the words 'deceptive' because those who are eligible for ‘medical assistance in dying’ do not have to be dying. The odious new law defines grievous and irremediable medical conditions eligible for medical killing:

“A person has a grievous and irremediable medical condition only if they meet all of the following criteria:

(a) they have a serious and incurable illness, disease or disability;
(b) they are in an advanced state of irreversible decline in capacity;
(c) that illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and cannot be relieved under circumstances they consider acceptable; and
(d) their natural death has become reasonably foreseeable, taking into account all their medical circumstances, without a prognosis having been made as to the specific length of time that they have remaining.”

In the first 6 months after the law passed, at least 744 Canadians received “medical assistance in dying”. There’s that deceptive euphemism again! Not all recipients were dying. According to Canadian reporter, Graham Slaughter, (what an apt name!) most of the patients have cancer, ALS or multiple sclerosis.[2] Multiple sclerosis is rarely terminal. Life expectancy for people with MS is only 7 years shorter than normal life expectancy. I have had MS for over 32 years. I use an electric wheelchair but I’m hardly dying. Medical assistance in dying becomes medical killing.

It should be noted that in 2012 Canada’s Parliament gave UNANIMOUS support to the idea of developing a National Suicide Prevention Strategy. In 2016 they legalised assisted suicide for people who are sick or disabled. So let me get this straight: Healthy and abled-bodied Canadians who become suicidal get suicide prevention support, sick and disabled suicidal Canadians get help killing themselves? Yup.

Disability advocates have fought to advance equality and inclusion for over 40 years. Canada’s assisted suicide legislation caused a severe setback to those goals. This did not go unnoticed in America. Many American disability groups oppose legalization of assisted suicide, including the American Association of People with Disabilities, the National Spinal Cord Injury Association, and Not Dead Yet, just to mention a few. Diane Coleman and Stephen Drake of Not Dead Yet commented on the Canada’s Supreme Court Decision:

“The Canadian Supreme Court ruling openly targets people with non-terminal disabilities … The Canadian high court’s holding is a shockingly blatant mandate of lethal discrimination based on disability and should be rejected outright by any human society.” [4]

Is the Canadian situation Supreme Court decision a harbinger of things to come across America? Medically assisted suicide (MAS) has been legalised in 6 states under various parameters. Someone may say that the disabled are not eligible for MAS in most states. Proponents of MAS refuse to acknowledge almost all the people dying under these laws are disabled.

Not Dead Yet asserts 

“assisted suicide violates the Americans with Disabilities Act by establishing a system of unlawful discrimination whereby most suicidal people, those who reveal their intentions, receive suicide prevention services, while old, ill and disabled people receive suicide assistance instead.” 

They’re right.

Old prejudices against the disabled have appeared again under the guise of death with dignity. Can you hear a chorus calling out from a multitude of disabled people, “Must we die to find dignity?” I hope not.

If there is dignity to be found, it is found in life.

Mark Pickup
____________________________________
[1] Paraphrase of Chief Justice William Rehnquist on assisted suicide, Washington v. Glucksberg, 521 U.S.702(1997). http://www1.law.umkc.edu/academic/Spring2011/assignments/Washington%20v%20Glucksberg.pdf . Canadian and American law and legal traditions have deep roots in British Common Law, which dates back to the Middle Ages.

[2] Graham Slaughter, “At least 744 assisted deaths in Canada since law passed: CTV News analysis,” CTVNews.ca, 28 December 2016 (http://www.ctvnews.ca/health/at-least-744-assisted-deaths-in-canada-since-law-passed-ctv-news-analysis-1.3220382)

]3] See National Multiple Sclerosis Society website (http://www.nationalmssociety.org/About-the-Society/News/Study-Shows-Life-Expectancy-for-People-with-MS-Inc)

[4] Diane Coleman and Stephen Drake, “Statement of Not Dead Yet (USA) to Canadian Panel on Carter Case Decision”, 14 October 2015, (http://notdeadyet.org/statement-of-not-dead-yet-usa-to-canadian-panel-on-carter-case-decision)

Dutch doctors group rejects separate rules concerning euthanasia for "completed life."

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Last October we reported that the Dutch government were planning to expand their euthanasia law to include people who are not physically or psychologically suffering but who believe that their "life is complete."

The DutchNews.NL reported that the Dutch doctors association (KNMG) was not in favour of developing a section of the euthanasia law to prescribe lethal drugs for "completed life." The DutchNews.NL reported:

Last October, health minister Edith Schippers and justice minister Ard van de Steur said in a briefing to MPs that ‘elderly’ people with a consistent and well-considered wish to die – whether ill or not – should be able to take a drug to end their lives. 

The practice would not be considered euthanasia, in which the patient is said to be suffering unbearably, and in which doctors have an active role, and family members would not be allowed to administer the drug.

The KNMG stated that expanding the euthanasia law for reasons of a "completed life" would undermine the current euthanasia law. The DutchNews.NL stated:

However, separate legislation for people with ‘no medical grounds’ for the wish to die could have an undesirable social effect, by stigmatising the elderly, the KNMG said. Instead, the government should invest in measures to make sure the elderly do not feel their lives are pointless. 

The expansion of euthanasia rules are likely to become part of the current coalition government talks. D66 is the driving force behind the changes and the VVD have said they will support them. However, the Christian Democrats, who do not back change, are set to have a key role in the new government.

Once killing becomes an acceptable solution to social problems, the only remaining question is what problems will killing become a solution for?

Why did the Ontario Government Committee exclude EPC from the Bill 84 hearings?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On January 6, EPC published the article: Ontario assisted dying legislation (Bill 84) lacks any effective oversight of the law.

The Ontario Standing Committee on Finance and Economic Affairs is receiving written and oral submissions concerning Bill 84, the Medical Assistance in Dying Statute Law Amendment Act.

The Euthanasia Prevention Coalition (EPC) contacted the Committee and formally requested permission to provide oral submission to the Committee concerning Bill 84. The Clerk of the Committee was clearly told that EPC is Canada's leading group opposing euthanasia and assisted suicide and our voice should be heard.

The Ontario Standing Committee on Finance and Economic Affairs rejected the EPC request to make an oral submission to the committee concerning Bill 84.

We need you to contact:

Eric Rennie, the Clerk of the Standing Committee on Finance and Economic Affairs at: erennie@ola.org (416) 325-3506 and Peter Milczyn, MPP, Chair of the Standing Committee on Finance and Economic Affairs at: pmilczyn.mpp.co@liberal.ola.org and ask them:

Why did you decide to exclude the Euthanasia Prevention Coalition, the leading group that opposes euthanasia and assisted suicide, from the hearings?

Do you not want to know what is wrong with the bill? 

Democratic values include listening to all perspectives.

Bill 84 regulates euthanasia and assisted suicide in Ontario, but the language of the bill is dangerous because it lacks any effective oversight of the law.

UK High Court rejects challenge to assisted suicide law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Great news: The UK High Court decided to dismiss a request by Noel Conway to hear his challenge of the assisted suicide law.

The High Court decided that it is the role of parliament to make law and not the role of the Court. The UK Supreme Court made a similar ruling in the Nicklinson case, when it upheld the assisted suicide law in June 2014. In the Nicklinson decision the court asked parliament to debate assisted suicide.

One of the deciding factors in the decision was that the British parliament overwhelming rejected an assisted suicide bill by 330 to 118 in June 2015. Parliament debated assisted suicide and it decided to uphold the assisted suicide law.

Disability activists, in the UK, remain strongly opposed to assisted suicide.

Baroness Jane Campbell - Assisted suicide could lure me to the grave.
Kevin Fitzpatrick - Debating assisted suicide - Contempt for life with disability surrounds us.

The British Medical Association have debated assisted suicide on several occasions and have rejected the push to go neutral on assisted suicide.

The Care Not Killing Alliance stated that:

This was a troubling case that sought to usurp the democratic will of Parliament. 

"The current laws on assisted suicide and euthanasia are simple and clear. They exist to protect those who are sick, elderly, depressed, or disabled from feeling obliged to end their lives."

The UK Court is acting responsibly by limiting its role to interpreting law, but not making law. Conway is stating that he will appeal the decision.

Liz Carr: Address to Victorian Parliament on assisted suicide

This article was published by HOPE Australia on March 26, 2017.

British actress, comedian, broadcaster and disability activist, Liz Carr is in Melbourne with her show: Assisted Suicide: The Musical. This is an edited transcript of her address to Victorian Parliamentarians who will likely debate assisted suicide later this year.

Liz Carr - Disability activist, British actress and comedian

I don't come at this from a religious point of view. I'm not coming here to tell you what to do.

I'm telling you what I believe and how it worked in the UK, because in the UK, in 2015, the Rob Marris Assisted Dying Bill that was defeated in the House of Commons.

I'm stunned we defeated it. I'll be quite honest, because much like in Australia as a whole, because I know different states this is coming up as an issue, this comes up in the U.K. all the time as a subject.

It finally got to parliament. The first time in 16 years that there was a parliamentary vote on it, and it was a private member's bill and on a Friday afternoon. You know what Friday afternoons are like. We have 650 people in the House of Commons, MPs. 448 turned up, pretty unprecedented to be honest. That's how important. This is life and death. It really is. That's not just hyperbole.

The vote went 330 against legalising assisted suicide, to 118 who were for it. Almost three times! We didn't expect it to be that strong; the defeat of the bill. Ultimately what swung I think, and what was the concern is that nobody, nobody, wants another human being or themselves to have a bad death.

Whatever we think on this subject and wherever we meet on the subject, I'm assuming we all want a good death for everyone. We'd be ridiculous if we didn't want that. I want that too. I just don't believe that we should legalise and get states and medical involvement in that, or a more formalised medical involvement in that. That's the only difference, and I think what swung it, and where a lot of MPs were is that yes, in some respects we want this.

The autonomy aspect is massively compelling, but the risks and the sufficient strength and robustness of safeguards is so difficult. It's difficult to prove and they're difficult to establish. Are the benefits to the few outweighed by the risks to the many? They were viewed not to be. That's where we're at.

People are still trying to change the law. Just today there's the Noel Conway case in the U.K., where they're trying to introduce it by the back door via the courts. This will keep raging. It's important. It should.

I also got the Churchill Travelling Fellowship and worked then with BBC World Service and made a radio documentary, and I visited all the countries where assisted suicide was then legal. The only place I haven't been to is Canada. I've been there and I know what's going on now, but I made a documentary on that. A little bit like your Andrew Denton, where we're two of the few people who visited, and interestingly he thinks its fine. I don't think its fine, and we presumably saw some of the same things. There you go. Of course that's going to happen, but I come at it as a disabled person, and that's relevant here.

Let me tell you in a minute why many disabled people are opposed, and why we figure in this debate quite strongly, because I think it's important to know that not all opposition is religious.

Opposition to these bills is usually marginalised as being religious and that's very useful to do if you don't want to listen to it, but actually if we want to introduce a bill like this, we have to listen to all sides of course, and we have to not diminish their view.

Liz Carr being interviewed on Australian TV.

It's usually religion, but actually disability rights activists have quite a strong voice, and certainly have in the U.K. I'm also gonna talk about assisted suicide, not assisted dying. That's partly because I think we should call it what it is.

Now assisted dying, many people will come back at me and go, but this is just for people who are at the end of their life. Therefore it's about they're dying anyway, but what we've seen in other countries is that's not necessarily true. The trajectory is not about that they're actually dying. That that could be many, many months or years off, but also they are choosing to take their own life. It's still that act, so it should have the safeguards that you get when you do call it suicide, which are prevention strategies as well.

And what we do know is that when you change the language, and you start calling it assisted dying, and you don't use words like euthanasia and assisted suicide, then you increase public support. Assisted dying is far more popular than assisted suicide. It's equally a political choice, what we call it.

Why am I opposed? Well, I'm not opposed to suicide. I don't want people to feel that they have to end their life. I don't want them to be in that position. I believe in suicide prevention, but ultimately that's an act for an individual. Where it gets tricky for me is the issue of state involvement, and the issue of changing the criminal law, changing the law, and the issue of medical involvement, on a formal level.

At the moment the law acts as a deterrent. It does in the UK. And that's really useful that it's a deterrent.

What happens when we introduce a bill and looking at what the bill might look like? I know we don't know what it looks like yet, because it's not been created, but looking at the recommendation 49 and seeing what that might be. What it does is it allows, it indemnifies doctors, and it takes it a way away from being a crime and that can be a good thing, but it means that there's very little investigation.

It means that it then happens behind closed doors. It's very hard then to prove anything, because if a doctor, and this happens in Oregon, if a doctor has supported a person through this, and ticked the boxes, they also then facilitate the prescription process and they also evaluate that process to the Oregon Health Board. Therefore the person doing it, and assessing is also the person accountable for it.

Of course we're not gonna see if anything goes wrong. Of course we're not, and I'm not saying that there's Machiavellian doctors trying to kill people. I'm not. I'm just saying that it is very compelling that if somebody wants to die and they approach a doctor that maybe sometimes they'll do what they have to do. That happens now anyway.

We can all argue about that to what degree, and I know that's one of the arguments for legislation is well this happens anyway, why not? That actually happens less than we imagine that, and it's still very different than actively taking that role.

I have met with disabled people all over the world in this issue. Why does it involve us? Because it's very easy to shut up disabled people, and go this is not about you. This is about terminally ill people. In the public perception, in the media, and in medical terms there is such a fine line between disability and terminal illness, that we become one in the same.

There was a documentary on this week on ABC. There are regular documentaries on your TV channels and in the UK that show people asking for assisted suicide laws, and the right to die, and most of those people are not terminally ill, and that is often very confusing. We see people that look like us. We see people that can't do certain things, can't wipe their own bum or can't get dressed, or are worried about those things. Well they're often things around disability.

They're often around loss of autonomy; loss of dignity. There are things that I guess is why disabled people feel that they can contribute to that, because we have lots of experience in that. We've probably lived a life of that. It is in a way, in many ways, about us, and it will be, because we've heard stories from many disabled people about how complete strangers can tell you that they couldn't imagine what it would be like to be you, and surely you'd be better off dead.

I know that if I went to the doctor and said that I was having trouble, regardless of the fact of what I do for a living even, I think it would be easy to convince them that my life was not worth living. Far more than my non-disabled partner, and that's a big thing for me.

If there was a non-disabled person at a railway bridge about to jump, what do we do? Do we go up to them, and go: in the name of autonomy and self-determination, you do this. If this is your choice you do it. I don't think we do that usually. We usually stop them. We usually prevent them from doing it. We usually put in suicide prevention. We question why they're doing it. We question their mental health. We would see it as a tragedy if it occurred.

Now if that person was impaired, was disabled on that railway bridge, would we act the same? Now you might say yes we would, but my bet is a lot of people would not act the same. They would go: if that person wants to end their life I understand why, because if I was like that I'd feel the same, and of course, because it must be difficult. Then we start to call it about choice. Then it's different, and for me if you even see those two people as different and those two situations as different that suggests we do have an unconscious bias and discrimination.

Legislation is therefore unsafe already, because not everybody already starts out as having equal value under the law or in the medical profession or in public perception. I guess, and I remember Stella Young talking about this a lot, can we have death with dignity, until we have dignity in life?

That's one thought that was really crossed my mind when I've looked at the end of life review from Victoria, is that there are 49 recommendations. It feels to me you can't get to 49 until you've done 48. All 48. Then think about 49, but not before. Why put all the resources, and this effort and all this time, into 49. Recommendation 49, until you've done the others. Then I think I'd feel happier.

Maybe lots of us would feel happier, because people are not having good deaths now. People do not have choice in how they live, and the support that they might need in life. Ill and disabled and older people are not getting what they need now resource wise, health wise, pain wise, pain management, palliative care, housing, NDIS - that's in a mess.

Until those things are sorted, can we really trust that the reasons that people give for wanting to end their lives are the real reasons, or that really it is about pain and suffering, or is it because we're not doing what we should be doing to support those people in life. It's too easy to go: do you know what, if I couldn't do that A, B, and C, maybe I'd want to end my life. I can't imagine. I'm rubbish with pain. I wouldn't want that. It's too easy to therefore assume that that's why those people might want to die. Maybe they just need decent pain control and support, and we need to make sure first, all of that's dealt with. Absolutely.

There's 48 recommendations. Plough into them. Come back in 10 years.

Then let's look at it. When I said about the person on the bridge, I guess there's that sense for me that it does feel like a discrimination. Look; I almost feel that if you're gonna legislate, legislate for everyone, or legislate for no one. I'm a bit all or nothing, but actually why choose one group of people? Why is one type of suffering worse than another? What if you lose a child? I mean that must be the worst pain. It's the worst pain I can imagine is losing someone. Losing a child must be dreadful. Now that's suffering, but we don't support them to end their life. We give them what they need; but when somebody becomes ill or disabled we far more understand and then support them to end their lives.

Why are we choosing these groups of people? I understand why. Its okay, you don't need to tell me. The response on that is rhetorical; but we are selecting a group. Why? I just put that out to you. Why that group of people? I understand it too. In the UK, and I know Stella had a very similar experience, most people will tell you, a similar experience in the medical profession and it's why for me I don't want to give that group of people even more power and control over my life. That's it. I think when you rely on the state for your life and your existence, you probably don't want to give them more power over your death as well.

I'm not sure they can be trusted. I'm sorry. Not that I think somebody's gonna maliciously kill me, but I think if I was in the right frame of mind, and I cost loads to exist... Let's not take this out of the economic vacuum. Rationing and decisions around cost are being made already. Around who we treat, around whether somebody's too old. Do we bother with an operation? Somebody's too fat. You've gotta lose weight. Already we're thinking about resource allocations in terms of medical treatments.

Baroness Jane Campbell

What about when assisted suicide becomes a medical treatment? How does that fit into that? Baroness Jane Campbell - she's in the House of Lords. She's a disabled woman on a ventilator. A very successful disabled woman. She's tiny like me. She looks frail like I do. I know I wear the trappings of being ill as a child and as a disabled person. She ended up with a chest infection. We lose loads of our people over winter. It's horrible, as a disabled community, we lose loads of disabled people, and Jane was very ill with a chest infection, and she ended up in A and E, and her husband was there, and noted that on her note, she has a do not resuscitate order. She had of course not decided upon that. She did not want that, and her husband had to go and basically make sure there was 24 hour support for her. There was always somebody there who knew who she was, but then put photos around the bed of her getting her degree, of her joining the House of Lords, of their marriage.

Don't just see this figure, and make assumptions over this life. People are far more than they appear, but those doctors had assumed a level of value of that life, and that's happening already, and that of course is what drives many of us to be very fearful of being in that position. Now, we can say well there are safeguards, and I think safeguards are interesting in terms of a piece of legislation. They are fascinating because the fact that we know we need safeguards means we acknowledge there's risk. This is not a process that's without risk, and that risk comes in terms of can we be sure that person voluntarily wants this? That they're of sound mind, that they're consenting, and that they're not being coerced?

Now some of the difficulties here are that we're asking again, doctors to do that. That very same doctor that made the diagnosis and prognosis have to do all this other stuff as well - and how do they know? I'm not giving you answers about how to work that out, but these are the questions with these types of laws: How do we know someone's not being coerced?

Coercion is not about being dragged to your death. Coercion is worse than that usually. It's usually social coercion, and it looks in the form of you decide yourself, because life's so poor, but that's not always physical or mental. It can often be because you've not got the support you need or because you're with a family that you don't want to burden; and even if they say you're not a burden, the fact that you've got the kids to look after or you've got work and you've got life, you can feel that. How do we unpack all of that?

I went to all the countries, as I said, where assisted suicide and euthanasia are legal. Some of the highlights for me: I met fascinating people. I loved who I met, on both sides of this debate. It's tough. The people who were driven to pass these laws have seen some horrific things. They've seen people that they love, dying. We've probably, many of us have seen that I think. Legislation won't change that by the way. Legislation doesn't get rid of bad deaths, and assisted suicide isn't also necessarily a good death. They can be ugly. They're not always, but they can be. They can take hours.

I met someone whose husband has taken 21 hours to die. They were still happy with that actually, but it's not quick necessarily. In the Oregon model it's lauded. Where people get prescriptions. Its 100 capsules and they can make you sick and sometimes they don't work. This idea of it being a beautiful death or an easy or a quicker death; well it can be in some ways but it's not always the most pleasant, and that of course is it: death is always gonna be messy, whether we have assisted suicide laws or not.

In the Netherlands, we know, the Netherlands are ubiquitous for going too far with everything, aren't they, and everything's legal out there! The latest, when we were out there, we were given a pack of tablets. Me and my partner went to a conference of assisted suicide supporters and they gave us the last will pill. It was a little pack of mints, because their campaign is around completed life or being tired of life. That's now people who are over 70, who have basically gone: I've done all I want to do in life. That's it. They're not terminally ill. They've just had enough. That's where they're going.

People talk to me about the slippery slope. Firstly I don't go with that phrase. I don't agree with that phrase, because it suggests panic and fear and things that are out of control. It's much more controlled than that; the extension of these laws. It's much cleverer than that. It's done in the name of equality. If you introduce a law in this state for those with only terminal illness, tell you what will happen next is people with other conditions will want to be included in that definition. They will. That's already happening. The law hasn't even been enacted to its full extent in Canada yet, but already people with dementia or impending dementia are calling for that extension. Some disabled people are calling for it. You've excluded us.

Again, whether you want it, just be fair. It's like calling it assisted suicide. Be very clear what you're getting, and be very clear where it's going to go because it will. People laud Oregon. Oregon currently have an amendment before their courts to extend their law to people with dementia. It happens everywhere. This is not just about Europe where it's out of control. No. This is about in the states too. By a natural extension, an incremental creep, it will extend as I say. It's discriminatory for it not to. People will take you to court, if they can't use a law that you've brought in. They want it if it's a right. It's either a right for no one or a right for everyone. That's where it goes.

We probably know about Belgium. Belgium where just for being old, where children... There was the first death of a minor recently from euthanasia. Last November, there was somebody with alcoholism based on that extension that I've just mentioned.

Let's talk a tiny bit more about Oregon before I start to bring it together. I know that it's talked about here, particularly in the older community maybe that people are ending their life before they have to. People are killing themselves. Is that gonna change if you legalise assisted suicide? Not necessarily, because what's happened in the states where it's legal in the U.S., remember its only six states out of 50 where it's legal. (It's already been not voted for this year in four states.) We hear about the ones where it is, but there's many that have opposed it as well, and the majority have opposed it.

Again, it's not like it's happening everywhere in the U.S. But the states where it has, and particularly Oregon, there has been a massive increase in suicide since it was legalised. That could be around the state that it is; it's very particular, very peculiar state anyway. It's also not about pain. It's very rarely about pain, and I think that's useful to know.

In the tick box forms that you fill in in Oregon, the reasons that people give, the dominant reasons are about loss of autonomy, loss of dignity, loss of the ability to do day to day activities. Pain is the second to last reason. It's in the 30% as opposed to the 80% and 90% where the other figures sit. This is really about loss of autonomy and dignity. The safeguards: two doctors that have to analyse whether someone gives consent, whether that's voluntary. That's there's no duress. That there's no mental health issues. That they have prognosis, the diagnosis. It's a serious incurable condition.

There are questions over that, whether that's with or without treatment. You might have kidney failure and if you stop having dialysis that would make it an incurable condition. If you stop taking drugs for chronic heart failure, that would qualify. There's quite a fine line with lots of these and you're not gonna know that until you get the final bill to look at.

I guess one of the things is we don't need to make a choice necessarily between suffering and suicide. There is a lot that we can still do in terms of palliative care and hospice care and support for people, and often when people tell me about bad deaths and I've gone to the people I respect in those worlds and said well what can we do? Can we alleviate all pain? For most people yeah, but there will always be some people that we can't.

But do we change a law for those people, and remove protection for the others, and is it as straightforward as that? Is it about the benefits to the few? Is it about the risks of the many?

Laws should be about protecting the majority and safeguards are difficult: the acknowledgement that we need safeguards is an acknowledgement of risk in the first place. This is risky. I've always felt, always felt, I feel that's a compelling argument.

I know lots of people would disagree, but I feel that even the risk of getting it wrong in one case is too much. What strikes me as bizarre is that in terms of something like capital punishment we don't have that for that same reason and that's a much higher degree of accountability. We have an investigation, a court case, police involvement, and still there are miscarriages of justice. We want to check is that person of sound mind, not being coerced, whatever all of the safeguards we're gonna put in, and we have that happening with two doctors with limited time.

It's also okay to oppose assisted suicide, and I say that as someone that struggles to remember that when she's getting hated for it. Now I acknowledge to the other side that if you support assisted suicide, then you may be called, the murderers. None of us are in a happy place. This is rubbish and a difficult situation, because ultimately we all want the same thing. We want good deaths for everybody. It's just how we make that happen and how we think that should happen, but opposing is also okay. To have concerns is okay.

Many disabled people oppose. Many certainly in the states and what I hear from around the country too, many indigenous communities. In the states black and African American communities often oppose more than other communities as well. People who were dispossessed. People that have had a negative experience of the state involvement in their lives often are more reticent about these laws.

The people who usually want these laws usually look more like the lawmakers and the doctors implementing them, funnily enough. Obviously you have, and I know it's complicated within Victoria, but currently nationally, the AMA opposes assisted suicide, and in the U.K. we have the same situation. We have the BMA, the British Medical Association. Most of the medical colleges, oppose as well, and they're the people who would be implementing. That's happening in Canada, that doctors aren't sure about their involvement.

No doctor's going to be made to be involved, of course. There's a conscience clause and no one will be forced to do it, but I think we do have to talk to doctors. We do have to talk to all these communities who are concerned.

The AMA said, there needs to be much greater investment in quality end of life care, especially nationally; including palliative care services. It feels to me and why I oppose, is: is this the right time? Are we mature enough as a society? Do we treat our elders, our people who are ill, our disabled people, our communities, equally? Do we provide the right or sufficient health care? Or too much? Do we provide the resources for people to have a quality of life while they're alive and a quality of death? Are we doing that now?

To make assisted suicide into a medical issue changes everything. I watch TV and I see compelling arguments and compelling cases and people and individuals who want what's called 'the right to die'. But one person's right to die becomes another person's feeling that it's a duty to die, and I know, and you can say it to me, but nobody's gonna be dragged there. If you don't want it you don't have to have it. It's not as straightforward as that, because once it exists it exists, and as I say some of the worst coercion is choosing it yourself, because you feel you've got no option.

I made the show, I made Assisted Suicide: The Musical because I have done all of the serious political debates on this subject on TV in the UK. I hate the way that the debate is polarised in many respects and how we very rarely get the chance to properly discuss it in a grown up way, and we don't. TV wants you to have two opposing views and it to be great TV. That's what they want. That's what debate programmes want. In some respects of course that's how parliament works too unfortunately. The interesting bit - and where it's essential - is this middle area.

This isn't easy. It really isn't. It can't be rushed and it's very, very hard to get it right. I decided in the end that I could do all the news programmes in the world but actually the voices of those who oppose isn't often heard as loudly, I don't believe, or as often. There's very few documentaries of those who don't want assisted suicide. It's not as sexy. It's not as sexy calling for a better NDIS or hospice care. It's just not.

I mean we've got many documentaries in the UK of people traipsing off to Dignitas. Loads of them. We can't get enough of them in the UK. Can't get enough. It's the same story, and I'm not saying it's not an important one, but what we don't say is the other side, and that's a voice that needs to be heard obviously, so I made show, and the show despite the fact that really quite serious about the subject matter, is a comedy, but it's also really thought provoking. You'll hear some of the things I've said, but I also just wanted to open up this subject in a way that we're not often able to do and to think about it in a different way, and have more information and have more space, and laugh about it.

That might sound bizarre and counterintuitive but deaths, some of the funniest things that have ever happened to me have been around people who have been dying. In the Silent Witness show I do, I'm in forensics. I'm not in real life, obviously. The laugh, the humour in the darkness. We need to connect through that and music, as well, really helps with that and opens that up.

That's why I made a show I guess. I want to leave with a question in the words of Katherine McKinnon: There was a big, big debate down in Bristol in the U.K., around whether we should legalise assisted suicide, and I just liked her. Her words spoke to me anyway. She said: I'm not saying that palliative care is a panacea. There are always going to be people who want to die before their bodies do; but on balance the risks of harm of changing the law to me outweigh the risks of harm of leaving it where it is.

We mustn't be duped into believing the mantra that autonomy is king; that we can have whatever we want. This is a recipe for a dysfunctional society, but I will leave you with a question. What is worse, killing someone who does not want to be killed? Or not killing someone who does want to be killed? At the moment on balance, I think the former is worse. I think that's a useful question and that doesn't help your job, because you've got a really difficult job here, but it's a useful question. That's what I would like to leave you with.

You can view the video recording of the address by Liz and the address by local Victorian Disability Activist, Jax Brown HERE.