Kevin Yuill - Assisted Dying: A failure of Psychiatry.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill

Kevin Yuill, who is an academic who has written extensively about euthanasia and assisted suicide wrote an interesting article that was published by Spiked titled: Assisted Dying: A failure of Psychiatry.

In his article, Yuill comments on the death of Aurelia Brouwers, the 29-year-old Dutch woman who died by euthanasia for psychiatric reasons and the research by Fabian Stahle, from Sweden, uncovering hidden problems with the Oregon assisted suicide law.

Yuill comments on Brouwer's death:

Brouwers had carefully planned her death – in her pyjamas, listening to Hugh Laurie, with her beloved pink T-Rex cuddly toy, Dido – ‘[he] has been my support since I was four-years-old’, as Aurelia put it. She asked her parents to care for Dido, who is to get ‘a spot on the coffin’ at her funeral. 

Brouwers told an interviewer: ‘I think that after such a rotten life I am entitled to a dignified death – people who have a serious illness get a chance for a worthy ending, so why is it so difficult for people who are psychologically ill?’

• 29-year-old Dutch woman scheduled to die by assisted death for psychological reasons. 

Yuill asks the question: at what stage do psychiatric professionals admit defeat and sanction the death of a patient? Yuill states

In the Netherlands as it stands, nine per cent of requests for euthanasia due to ‘unbearable’ and ‘hopeless’ psychological suffering are granted, although it is rare that the patients are as young as Brouwers. Brouwers had decided long ago that her treatment was not working and that her suffering was too great to bear. And her doctors eventually gave her the green light. But when is psychological suffering deemed ‘unbearable’? When is it adjudged ‘hopeless’? These seem to be incredibly subjective criteria.

Yuill challenges the UK assisted dying group Dignity in Dying who have stated that Brouwers would not qualify for assisted death based on the proposed UK legislation.

In the UK, Dignity in Dying and other campaigners for assisted dying insist that cases like Brouwers’ could never happen under their proposed legislation. Citing assisted-dying legislation in Oregon, they claim that similarly ‘robust safeguards’ would be implemented in the UK, preventing cases similar to Brouwers’. 

But, if assisted dying is legalised, is it realistic to expect ‘autonomy’ and ‘compassion’ to be reserved only for those who suffer from life-shortening physical diseases? Although Dignity in Dying denies it, assisted-dying laws are always extended beyond their original justifications. Indeed, in every nation where euthanasia has been legalised, the parameters in which assisted dying is permitted eventually always stretch beyond those with ‘less than six months to live’.

Yuill comments on the recent research by Fabian Stahle, into the Oregon assisted suicide law based on the proposed safeguards in the UK as being similar to the Oregon assisted suicide law:

Stahle had asked the Oregon Health Authority whether a diabetic person who was only dying because they refused treatment would qualify for an assisted death. The OHA’s answer was a straight ‘yes’, and it admitted that this had always been the case. 

Indeed, Oregon oncologist Dr Charles Blanke noted a difficult case regarding a young woman with Hodgkin’s lymphoma who had a 90 per cent chance of survival with treatment but refused it. Blanke acceded to her demand for an assisted death, despite the fact she was likely to lose potentially ‘seven decades’ of life. Opportunities for self-induced terminal illness are numerous. Anyone with anorexia nervosa, for example, can bring themselves to a terminal condition, thus qualifying for an assisted death in Oregon. 

... In Oregon, for example, pain does not figure in the top five reasons why citizens choose assisted death. Instead, it is fear that dominates the reasoning of those seeking to end their lives: fear of not being able to participate in enjoyable activities; fear of loss of autonomy; fear of loss of physical capabilities; fear of loss of dignity; and fear of being a burden. Fear, however, is curable, even if the underlying physical condition is not.

• Oregon Health Authority reveals hidden problems with the Oregon assisted suicide model.

Yuill ends his article by recognizing how legalizing assisted suicide corrupts society:

... But when society legalises assisted dying, it surely corrupts the fundamental belief in the value of life that underlies all medical treatment. Compassion in the past meant doing what we felt was best for a patient. It meant disagreeing with a suicidal patient who felt her life was worthless. Today, compassion seems to mean respecting someone’s requests, even when we don’t feel that those requests are in his or her best interests. As Brouwers declared in her blog in January: ‘Respect that I will die Friday.’ 

Brouwers’ sad case is a grim reminder that a society that sanctions suicide is a society that has given up on certain people. It is a society that has lost its moral bearings. An individual may lose all hope and may feel that life is no longer worth living. She may even take her own life, and there is little we can do to prevent that. But, surely, if a fellow human being expresses the wish to die, we must be loyal to her life, not her wishes.

Kevin Yuill teaches American studies at the University of Sunderland. His book, Assisted Suicide: The Liberal, Humanist Case Against Legalisation, is published by Palgrave Macmillan.

2018 Conference of the Physician's Alliance Against Euthanasia

When: March 24th, 2018 9:00 am  to 5:00 pm

Location: Holiday Inn 999 Saint Urbain Street, Montréal, Québec H2Z 0B4 Canada

Event Fees: Physicans $200, Others $100, Students $25

With legal euthanasia and assisted suicide now a reality in Canada, we turn our attention to helping doctors and other health professionals improve their skills so as to better care for patients at risk of requesting death. This conference is an opportunity to learn from experts in palliative care and psychiatry, as well as to meet colleagues from across the country who share your concerns about the direction medicine is taking under these new laws.

The learning objectives for the conference are as follows:

• Improve knowledge and skills related to analgesia at the end of life
• Recognize existential distress in terminally ill patients
• Knowledge of the indications and method for prescribing palliative sedation
• Recognize and treat treatment-resistant depression in terminally ill patients
• Recognize and address the biological, psychological and social factors underlying a patient's desire for hastened death
• Understand the barriers to the development of palliative care at the societal level

Register for the English sessions here.

Please note: If you would like to attend the French sessions, click here to register.

Veuillez noter: Ceci est la page d'inscription pour les sessions en anglais. Si vous souhaitez assister aux sessions en français, veuillez cliquer ici pour vous inscrire.

Click here to download a PDF document of the poster to share.

If you would like to register by mail, please download and fill out the registration form by clicking here. Cheques may be sent to the address in the form.

Wisconsin bill AB216 forces doctors to participate in assisting a suicide.

Wisconsin AB216 sponsors want to put doctors out of business who will not Assist Suicide.

Nancy Elliott

By Nancy Elliott

Chair - Euthanasia Prevention Coalition - USA

Wisconsin's assisted suicide bill AB216 will implement Assisted Suicide, and it will also revoke the licenses of doctors who are unwilling to participate in causing the death of their patients. 

AB 216 Section 156.21(a) states:

failure of an attending physician to fulfill a request for medication constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication.

Therefore a physician could be found liable for unprofessional conduct if he/she refuses to prescribe lethal drugs or refer the patient to a willing physician. Referring your patient to another doctor, who you know will complete the death is the same as writing a prescription for that patient. Both are a dereliction of the physicians duty to do no harm.

The sponsors want to punish doctors who will not be a party to ending their patients lives and they want to force all doctors to have their hands dirty. 

Surprisingly the bill grants immunity to those who participate. In the same section it states no health care facility or health care provider may be charged with a crime, held civilly liable, or charged with unprofessional conduct for fulfilling the act and prescribing poison to end the life of their patient. The bill states that next of kin is not required to be notified, so you can find out that a family member took their life by a suicide drug prescribed by their doctor without input from family members and there is no legal recourse, not criminally nor civilly.

Not only do the sponsors harm innocent doctors and deny families input or justice, this bill takes away the choice of citizens who do not want to be treated by a doctor that kills their patients. 

As ethical doctors lose their licenses or flee the state, there will be only one type practicing. 

Wisconsin is not the first state to attempt to force doctors to refer for assisted suicide. Vermont also forced doctors to refer for assisted suicide but in May 2017, a Vermont court decision upheld physicians conscience rights.

2017 Oregon assisted suicide report. The number of deaths increase again.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The 2017 Oregon annual assisted suicide report is similar to prior years. The report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

According to the 2017 Oregon assisted suicide report.

• There were 143 reported assisted suicide deaths up from 138 in 2016. 
• 129 of 130 people who reportedly ingested lethal drugs in 2017, died from it, 
• one person survived and died of natural causes.
• 14 of the deaths, the drugs were prescribed in previous years.
• There were 218 lethal prescriptions obtained, up from 204 in 2016.

There may be more assisted suicide deaths.

According to the 2017 Oregon report, the ingestion status was unknown in 23 deaths. 

When the ingestion status is unknown the authorities do not know if the person died by assisted suicide. It is possible that some or all of the 23 unknown deaths were assisted suicide deaths. These deaths may represent unreported assisted suicide deaths.

In December, Fabian Stahle, a Swede who is concerned about assisted suicide, communicated by email with a representative of the Oregon Health Authority.

• Oregon Health Authority reveals hidden problems with the Oregon assisted suicide law.

Stahle confirmed that the definition of terminal illness, used by the Oregon Health Authority includes people who may become terminally ill if they refuse effective medical treatment.

• Hidden problems with the Oregon assisted suicide law.

The responses to Stahle from the Oregon Health Authority also confirmed that there is no effective oversight of the Oregon assisted suicide law. 

• The Oregon assisted suicide act is designed to deceive.

The yearly Oregon DWD reports are based on data from the physicians who approved the assisted suicide death and the data is not independently verified. Therefore, we don't know if the information from these reports is accurate or if abuse of the law has occurred.

Oppose New Hampshire assisted suicide study bill SB 490

Opposition to SB490 establishing a commission to study end-of-life choices.

I

Nancy Elliott
Chair of EPC - USA

am opposed to SB490 because it is a thinly veiled effort to study Assisted Suicide, also known as death with dignity, medical aid in dying, euthanasia and mercy killing, with the intent to legalize it in New Hampshire. Our state has a long standing bipartisan opposition to Assisted Suicide. This practice is discriminatory to the disabled and elderly, sending them the message that they are not as valuable as able bodied people. While young and healthy individuals receive suicide counseling, the elderly, sick and disabled are steered to take their lives.

I know this bill is for a STUDY, but studying things that would be harmful if passed is a waste of taxpayer money and runs the risk of giving legitimacy and momentum to this practice. If we look down the road where legal we see people's lives being ended who are not necessarily dying, such as an individual with diabetes, who refuses to take his insulin, using this on people with psychological problems and forcing this on people who object as in the Dutch woman who was held down by her family while her doctor forcibly euthanized her.

This particular study seems biased as to its makeup. Instead of having legislators who would be able to weigh the input from different points of view, this committee is made up of "stakeholders". I find it interesting that there are no grassroots organizations representing the disability or elderly communities, who this topic most affects. Why is there no representative from Not Dead Yet? And why is the elderly representative a lawyer, which tend to be more interested in wealth preservation for the estate. And the two religious members are coming out of a grouping of churches in which many support Assisted Suicide. By designating this organization the state is eliminating influence from churches that are not members and may be more in the best interest of our citizens.

I believe that this commission is dangerous to our citizens because the report that will come out, will indicate an imaginary mandate for Assisted Suicide. We all know that these reports are taken very seriously. This report could very well replace the scrutiny that typically takes place on a bill in committee. As legislators, do not replace your position as protectors of society with "Stakeholders". 

Please vote SB490 Inexpedient to Legislate. Thank you. 

Sincerely,
Nancy Elliott
Former NH State Representative
Chair of Euthanasia Prevention Coalition - USA

Delaware assisted suicide bill amendment is a misdirect

This article was published by the disability rights group, Not Dead Yet, on February 7, 2018

B

Diane Coleman

y Diane Coleman, President of Not Dead Yet

The sponsor of the Delaware assisted suicide bill introduced an amendment apparently designed to address disability related concerns. It’s always good to know that disability opposition has gotten their attention, but this amendment is a total failure and completely misses the point, any point we’ve made. A disability response to the amendment is below. The battle in Delaware wages on.

• Delaware assisted suicide for people with intellectual disabilities.

The IDD amendment is a “clever” but deceptive attempt to address concerns about assisted suicide and people with IDD. Here is the key provision:

“(b) If the patient has a documented intellectual disability, the attending physical shall refer the patient to a licensed clinical social worker who shall ensure that the patient fully understands the information provided pursuant to § 2504B(3). No medication to end a patient’s life in a humane and dignified manner may be prescribed unless the licensed clinical social worker has confirmed in writing to the attending physician that the patient understands the information provided pursuant to § 2504B(3).”

This indicates that people with IDD who are found to understand the (minimal) disclosures provided under the assisted suicide law are eligible.

First, nothing in the proposed bill ensures that people actually have access to the pain relief, palliative care and home and community based personal care services they need. Lack of access to services is a pervasive problem in the disability community.

Moreover, just like all of the proposed bill, it utterly fails to prevent coercion. Coercion to request lethal drugs, like any form of abuse, occurs behind closed doors. The Delaware bill, and the Oregon law on which it is based, do nothing to prevent or discover coercion, nor even to define it. The attending physician need not know the person well; the median duration of the patient-physician relationship in Oregon is 13 weeks. The witnesses to the lethal drug request form need not know the person at all, but can simply check their ID. Yet these are the people who “certify” that there is “no coercion.” Then the patient request form serves as an alibi, covering up any form of foul play and granting blanket legal immunity to the perpetrator(s).

Utah House passes bill criminalizing assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On February 7, the Utah house passed HB 86, a bill that criminalizes assisted suicide by placing it within the Utah manslaughter statute.

Utah was one of several states that did not have an assisted suicide law.

HB 86 was introduced in response to the horrific death of a teenage girl:

It’s what one Utah lawmaker calls a “sick case” — a teenager is accused of encouraging a friend to kill herself, buying her the materials to do so and then filming the 16-year-old girl’s suicide on a cellphone. 

After the girl’s May 2017 death, prosecutors charged 18-year-old Tyerell Przybycien with first-degree felony murder.

Representative Michael McKell, amended HB 86 to deal with the critics concerns that the bill may criminalize physicians or family members who accidentally overdosed someone.

Bill HB 86 clearly defines the act of assisted suicide. The substituted version of HB 86 was passed by the House on a 51-18 vote even though Rep. Rebecca Chavez-Houck (D) who has introduced a bill to legalize assisted suicide in Utah, attempted to derail the bill.

Medical professionals have resigned due to euthanasia laws.

This article was published by HOPE Australia on February 2, 2018

In Belgium and the Netherlands, medical professionals are resigning in considerable numbers due to the lack of regulation surrounding the practice of euthanasia. This phenomenon is specifically peaking in the palliative care field, as nurses and doctors find their roles reduced to that of reluctant executioners.

Professor Benoit Beuselinck, a consultant oncologist, has been studying the corrupting effect of legalised euthanasia on Belgian medical care for years. He writes that hospital doctors, to avoid having to administer a lethal injection, will refer elderly or ill patients to a palliative care unit. The assumption is that, since palliative care professionals already deal with end-of-life issues, they will be more equipped to handle such a procedure.

However, this is far from the case. Instead, it has effectively driven away highly trained personnel, leaving palliative care units minimally staffed:

“Some Belgian palliative care units that have opened their doors to patients requesting euthanasia have seen nurses and social workers leaving the unit because they were disappointed that they could no longer offer palliative care to their patients in an appropriate way.” 

“They were upset that their function was reduced to preparing patients and their families for lethal injections.”

But medical professionals are not just upset about the change in job description. For many of them, euthanasia laws pose a moral quandary. According to Willems Lemmens, member of the Belgian Bioethics Advisory Committee:

More and more doctors are "testifying to the moral pressure they are experiencing. Since euthanasia is increasingly perceived by the general public as a right over the death of an individual and family members, the practitioners' therapeutic freedom and conscience are actually being put to the test".

Berna van Baarsen

The Netherlands faces similar challenges, as the definition of euthanasia is being more loosely interpreted in order to include dementia patients. During an interview, Berna van Baarsen, a Dutch euthanasia regulator, explained her reasoning for quitting her profession:

"I do not believe that a written declaration of intent can replace an oral request for incapacitated patients with advanced dementia…" 

“In people with a terminal illness like cancer, in whom euthanasia has already been agreed but who suddenly ended up in a coma because of their illness, that's fair.” 

"However, dementia is a very different kind of ailment. That disease is more erratic and patients often live longer. A lot of things can happen during that period. For instance, a patient might say that she would want euthanasia if she no longer recognises her relatives."

"This could happen. But at a next visit she can still recognize her partner or her children. What is the right moment to grant euthanasia?"

We anticipated that euthanasia and assisted suicide laws would drastically impact the most vulnerable of society, as in the cases that Berna van Baarsen described above. It is taking its toll.

Furthermore, with doctors and nurses fleeing their professions, the consequences of legalised euthanasia have started to affect all Belgian and Dutch citizens as their system of care crumbles before their eyes.

The fact that those who were once willing participants in euthanasia are fleeing because of how it is being practiced demonstrates just how dangerous and uncontrollable the process is.

It lends credence to the fact that, ultimately, euthanasia laws hurt everyone, regardless of their status. With this in mind, we must oppose this policy in all of our states and let our politicians know that legalised killing will never be safe.

Wisconsin Prescribe or refer: Proponents of assisted suicide show their true nature.

This article was published by Choice is an Illusion on February 7, 2018

Margaret Dore

By Margaret Dore Esq., MBA

The Wisconsin bill seeking to legalize assisted suicide and euthanasia includes a provision requiring doctors to "prescribe or refer," i.e., to perform a requested assisted suicide or euthanasia, or to make an effective referral to another doctor, who will do it. 

The bill, AB 216, also says that the attending physician's failure to comply is "unprofessional conduct" such that the physician would be subject to discipline. The bill states:

[F]ailure of an attending physician to fulfill a request for medication [the lethal dose] constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).*

A significance of prescribe or refer is that it's anti-patient, by not allowing doctors to use their best judgment for individual patients.

Think of Oregonian Jeanette Hall. In 2000, she made a settled decision to use Oregon's assisted suicide law in lieu of being treated for cancer. Her doctor, Kenneth Stevens, who personally opposed assisted suicide, thought that her chances with treatment were good. He stalled her request for assisted suicide and finally convinced her to be treated for cancer.

Dr Stevens with Jeanette Hall

Yes, Dr Stevens was against assisted suicide, but he also thought that Jeanette was a great candidate for treatment, and indeed she was. She has been cancer free for 17 years. In a article from last year, Jeanette states: 

I wanted to do our law and I wanted Dr. Stevens to help me. Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!

With "prescribe or refer," Dr Stevens would have been risking his license or even his livelihood to help Jeanette understand what her true options were.

Is this what we want for doctors, to have them be afraid of giving us their best judgment, for fear of losing their jobs?

This is a particularly sensitive issue for me because it happened to me, but in another context.

When I was in law school, I went to an optometrist who knew what was wrong with my eyes and also where to refer me for treatment with another optometrist. He didn't refer me because he worked for ophthalmologists and had been disciplined for giving a similar referral.

I spent the next six months of my life on a wild goose chase trying to find someone to help me so that I could get back to school. I finally found an optometrist, but with the delay, I had further damaged my eyes. I graduated two years late.

As for assisted suicide, the proposed bill is promoted as safe, in part because it requires a second doctor to review each case.

But what is the purpose of the second doctor, if he or she can only say "yes." (Do or refer)

With "do or refer," assisted suicide proponents show us their true nature. They don't want to give us choice, they want to railroad us to death.

I hope that Wisconsin will reject the proposed assisted suicide bill.

• Massachusetts assisted suicide bill may force doctors to refer for assisted suicide.

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 and euthanasia worldwide. See www.choiceillusion.org and www.margaretdore.org  

The Oregon assisted suicide Act is designed to deceive.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last month, a concerned Swedish citizen wrote - Oregon Health Authority Reveals Hidden Problems with the Oregon Assisted Suicide model.

Fabian Stahle became concerned with the Oregon assisted suicide model after the Swedish National Council on Medical Ethics published the report, "Assisted death: A Knowledge Compilation which supported the legalization of "Oregon Model" assisted suicide.

• Hidden problems with the Oregon Assisted Suicide law - uncovered.

Stahle communicated by email (December 2017) with Craig New, an analyst for the Oregon Health Authority. New states that the definition of "terminal disease" used by the Oregon Health Authority was wider than the regular definition of terminal disease and he confirmed that people who are chronically ill can be approved for assisted suicide in Oregon, even if they do not have a terminal disease when they refuse effective treatment.
 
New confirms that diabetics can be approved for assisted suicide if they refuse the insulin and he also confirms that even if the person became "terminally ill" by being denied effective medical treatment by an insurance company or state health plan, they could be approved for assisted suicide. (Link to the article).

•  Diabetics can be approved for assisted suicide in Oregon.

But there is more. Recently Stahle shared the email conversation with the Oregon Health Authority. The email exchange confirms that Oregon citizens who voted for assisted suicide during the voter initiative, 20 years ago, were deceived.

Stahle asked:

Do you know if the meaning of terminal disease has been interpreted in the same way (without administration of life-sustaining treatment/medication) from the very beginning when the law came into force or is it an interpretation that has come gradually since one have realized the meaning of what the law actually says and does not say?

Craig New responded:

My understanding is that the language of the law has not changed since it was passed. There has been discussion and debate among advocates on both sides of the law, but none of this has materialized into changes (or clarifications) to the law itself.

We at the Public Health Division (which is directed by the law to monitor compliance) have always held this interpretation of “terminal illness.”

Stahle, then asks:

I happened to find the "State of Oregon Official Voters' Pamphlet November 1994". From page 123 I read about Measure 16 and find in the section Definitions that "terminal disease" means an incurable and irreversible disease, that has been medically confirmed and will, within reasonable medical judgement, produce death within six (6) months. In the absence of further definition in the pamphlet of the terms "incurable and irreversible disease" it seems to me as the most straightforward and immediate interpretation of "incurable and irreversible disease" should be a disease for which there is no treatment or medication - in the meaning that all hope is gone. Neither in the Explanatory Statement, nor in the Arguments - Favour or in Opposition, are there any language suggesting a wider interpretation. And then, looking at "State of Oregon Official Voters' Pamphlet November 1997", Measure 51 about repealing DWDA according to previous Measure 16, I cannot find among all Arguments in Favour of repealing the DWDA any suggestions that "terminal disease" could be interpreted wider than the obvious interpretation as stated above.

Craig New responds:

I think the key for us is that the patient is not compelled (by law or any other reason) to begin or continue treatment for any disease.

Craig New states that the definitions have not changed and then later states that the definition includes refusing treatment for any disease. A clear deception was perpetrated by the assisted suicide lobby to hide the wider application of the Oregon assisted suicide law.

Legislators are also being deceived because they are not being told the wider application of the assisted suicide legislation.

Another deception is the lack of oversight of the assisted suicide law. Stahle asks:

How does the Public Health Division/Oregon Health Authority check that the eligibility criteria are really fulfilled?

New responded:

The attending physician indicates whether the eligibility criteria have been met on his/her compliance form, which they submit to the Public Health Division as required by the law. The consulting physician does the same, and acts as a check on the first physician. We (the Public Health Division) do not independently verify the eligibility of the patients.

New responds to a later question by stating:

If a physician believes that a patient meets the criteria (and a second physician agrees), then (technically) that patient does meet the criteria.

The response from Oregon Health Authority confirm what I have previously stated, that their is no effective oversight of the Oregon assisted suicide law. The yearly Oregon DWD reports are based on information from the physicians who approved the assisted suicide death and the information is not independently verified. Therefore, we don't know if the information from these reports is accurate.

Stahle concludes his original article by stating:

Proponents want to sell the Oregon model along with the assurance that medically-assisted suicide only applies to dying patients where all hope is lost. But it is completely misleading. Surely vulnerable people in Sweden and all over the world deserve better than laws with such inherent dangers hiding beneath the surface.

Last year more than 20 US States debated the legalization of assisted suicide. Nearly all of those legislative proposals were based on the deceptive Oregon assisted suicide model. Legislators need to reject these assisted suicide bills, not only because they are dangerous, but also because these bills employ deceptive, ill defined and expansive language.

Thank you Fabian Stahle for uncovering Hidden Problems with the Oregon assisted suicide model.

Oregon legislation deceptively dehydrates incompetent people to death.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

(HB 4135 passed on February 27, 2018)

The Oregon legislature is debating a deceptive bill (HB 4135) that is reported as simply "cleaning-up" the Oregon advanced directives legislation, but in fact HB 4135 promotes the withholding or withdrawal of nutrition and hydration (food and water) from people who are incompetent and not necessarily dying.

Even though Oregon legalized assisted suicide 20 years ago, euthanasia is a prohibited. Euthanasia is an act whereby one person directly and intentionally causes the death of another person, whereas assisted suicide is an act whereby one person directly and intentionally assists another person in causing their own death. HB 4135 opens the door to euthanasia of incompetent people in Oregon.

• Oregon 2016 assisted suicide report.

HB 4135 is deceptive and dangerous piece legislation because it is sold as a bill to update current legislation but in fact it changes current legislation to ensure that incompetent people, who may or may not be otherwise dying, can be intentionally killed by dehydration.

Advanced directives are only relevant when a person is incompetent to make decision for themselves. Therefore HB 4135, by definition, does not ensure that competent people can die by dehydration, but rather that incompetent people can be dehydrated to death.

HB 4135 states:

____ I do not want my life to be prolonged by life support. I also do not want tube feeding as life support. I want my health care provider to allow me to die naturally if my health care provider and another knowledgeable health care provider confirm that I am in any of the medical conditions listed below.

So what are the conditions that are listed below?

a. Close to Death.   

b. Permanently Unconscious. 

c. Advanced Progressive Illness.

d. Extraordinary Suffering.

If a person is incompetent then the person cannot consent to death by dehydration. To withhold fluids, even if the person while competent expressed this desire, dehumanizes the person by denying that person the basic necessaries of life. Withholding or withdrawing fluids from a person, who is not otherwise dying, will cause the person to die by dehydration. Dehydration is often a horrible death, even when the symptoms are masked by analgesics. It is also a form of abandonment to deny a person the basic necessaries of life.

If a person is actually dying and nearing death, withholding or withdrawing fluids may be appropriate but this decision must be based on a factual assessment that providing fluid has ceased to benefit and may harm the person. We do not oppose withholding or withdrawing fluids from a person, when providing it has become useless, burdensome or without benefit.

• The Life-Protecting Power of Attorney for Personal Care will protect your life.

HB 4135 opens the door to euthanasia by dehydration of incompetent people in Oregon.

HB 4135 must be defeated. It is dangerous to incompetent people and it specifically promotes death by dehydration. 

Massachusetts assisted suicide bill may force doctors to refer for assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Massachusetts Doctors are actively opposing the bill to legalize assisted suicide. 

Dr. Tom Sullivan, a former president of the Massachusetts Medical Society, along with 20 other physicians urged lawmakers in Massachusetts to oppose the assisted suicide bill which does not provide conscience protection for doctors who oppose assisted suicide. 

Bill McMorris, in writing for the Washington Free Beacon wrote:

The current bill includes no such protections, which would force any doctor in the state to refer patients seeking assisted suicide to a willing physician. A Massachusetts Medical Society spokeswoman told the Washington Free Beacon that the current bill language will not alter the stance of the society. Some doctors are upset at their refusal to lobby for protections for members who do not agree with the practice.

Dr Mark Rollo

Massachusetts primary care doctor Mark Rollo told the Washington Free Beacon: 

"This is not giving the patient the right to die. It is giving the doctor the right to kill," 

"We are mandated by this current bill to transfer a patient to someone else. I don't want to be complicit in killing a patient."

Rollo, a former Air Force doctor also stated:

"The legislature should not feel comfortable passing this because it's encouraging people to die and feel like they're a burden—their ‘right to die' soon becomes a duty to die."

A recent court decision in Canada will force doctors to directly refer patients for assisted death.

In May 2017, a Vermont court upheld physicians conscience rights after Vermont physicians were pressured to directly refer patients for assisted suicide.

Assisted suicide was defeated on the ballot in Massachusetts in November 2012.

African physicians reject euthanasia and assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A

Professor Mike Ogirima

t the African Regional Meeting of the World Medical Association meeting on Saturday February 3, 2018 in Abuja Nigeria, physicians agreed to improving palliative care while clearly rejecting euthanasia and assisted suicide.

The report by Felicia Imohimi published by NAN news  stated that Professor Mike Ogirima, President of the Nigerian Medical Association (NMA) rejected euthanasia and assisted suicide as contrary to the physician's oath. Imohimi reported Prof Ogirima as stating:

The oath stipulates “I will not use my medical knowledge to violate human rights and civil liberties even under threat’’,  

Euthanasia is ending the life of another person through various actions which included injecting the person, giving an overdose and withdrawal of food. 

...physician assisted suicide is a practice where doctor provide patients with the knowledge to kill themselves which could be in form of drugs among others.

Professor Ogrima further stated:

“We Africans reject Euthanasia and physician-assisted-suicide. We cannot assist patients, who may wish to end their lives, because the law of the country and WMA ethics of physicians does not permit us to take life.’’

The African physicians understand the issues of euthanasia and assisted suicide in a clear manner. They recognize that to intentionally kill or intentionally assist in a suicide is always wrong.

The Euthanasia Prevention Coalition promotes caring for people and never killing.

Canadian court tells doctors they must refer for euthanasia. Will they be hounded out of their profession?

This article was published by Mercatornet on February 2, 2018

By Michael Cook, editor of Mercatornet.

For years bioethicists of a utilitarian cast have argued that conscientious objection has no place in medicine. Now Canadian courts are beginning to put their stamp of approval on the extinction of doctors’ right to refuse to kill their patients.

The Superior Court of Justice Division Court of Ontario ruled this week that if doctors are unwilling to perform legal actions, they should find another job.

A group of five doctors and three professional organizations were contesting a policy issued by Ontario’s medical regulator, the College of Physicians and Surgeons of Ontario (CPSO), arguing it infringed their right to freedom of religion and conscience under Canada’s Charter of Rights and Freedoms.

However, Justice Herman J. Wilton-Siegel wrote on behalf of a three-member panel:

“the applicants do not have a common law right or a property right to practise medicine, much less a constitutionally protected right."

“Those who enjoy the benefits of a licence to practise a regulated profession must expect to be subject to regulatory requirements that focus on the public interest, rather than the interests of the professionals themselves.”

At issue is the policy of “effective referral”. A doctor who objects to participating in euthanasia cannot be forced to do it. But he is expected to pass the patient to another doctor who will. The CPSO argues that effective referral is necessary “to protect the public, prevent harm to patients and facilitate access to care for patients in our multicultural, multifaith society, by guiding all physicians on how to uphold their professional and ethical obligations of non-abandonment and of patient-centred care within the context of Ontario’s public health-care system.”

Without the policy of effective referral, equitable access would be "compromised or sacrificed, in a variety of circumstances, more often than not involving vulnerable members of our society at the time of requesting services," Justice Herman Wilton-Siegel wrote. People in remote communities might request euthanasia. If their doctor refused, they might suffer needlessly and taxpayers would have to foot the bill to subsidise the refusnik’s conscience.

It is remarkable how closely Justice Wilton-Siegel’s text hews to the arguments of bioethicists who have been chipping away at the right to conscientious objection for years.

In 2005 American legal scholar Alta Charo described conscientious objection as “an unfettered right to personal autonomy while holding monopolistic control over a public good ... an abuse of the public trust—all the worse if it is not in fact a personal act of conscience but, rather, an attempt at cultural conquest’.

In 2006 Oxford’s Julian Savulescu argued in the BMJ that “when conscientious objection compromises the quality, efficiency, or equitable delivery of a service, it should not be tolerated”.

More recently, Canadian bioethicist Udo Schuklenk and a colleague contended in the BMJ that:

“If at any given time a doctor is unable to continue practicing due to their—ultimately arbitrary—conscience views, nothing would stop them from leaving the profession and taking up a different vocation. This happens across industries and professions very frequently. Professionals can be expected to take responsibility for the voluntary choices they make.”

Responding to the ruling, Larry Worthen, executive director of the Christian Medical and Dental Society of Canada, said: “We heard from our members and other doctors with conscientious objections over and over again that they felt referral made them complicit and that they wouldn’t be able to live with themselves or stay in the profession if effective referral is still required.”

The case is sure to be appealed, but if the doctors championing conscientious objection fail, the consequences will be dire.

Throughout Canada, doctors would be required to refer for euthanasia. If they refuse, they will be hounded out of their profession, or, at best, shunted into specialties where the question will not arise, like pathology or dermatology.

This ruling shows how quickly tolerance vanishes after euthanasia has been legalised. In the Carter decision which legalised it, Canada’s Supreme Court explicitly stated that legalizing euthanasia did not entail a duty on the part of physicians to provide it. Now, however, 18 months and more than a thousand death after legalisation, conscientious objection is at risk.

It also shows how vulnerable religious-based arguments can be. The plaintiffs contended that referring patients violated their right to religious freedom. While this is true, is this the main ground for conscientious objection? As several doctors pointed out in the Canadian Medical Association Journal last year, “Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.”

Michael Cook is editor of MercatorNet.

Ontario Court decides to force doctors to refer patients to death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sean Fine, Globe and Mail Justice writer  reported that Ontario's Divisional Court (3 - 0) decided that doctors in Ontario, who oppose killing their patients, must provide an effective referral to a physician who will kill their patient.

Click here to view the decision.

Effective referral means a referral for the purpose of the act. Fine reported that Justice Herman Wilton-Siegal wrote that:

"The evidence in the record establishes a real risk of a deprivation of equitable access to health care, particularly on the part of the more vulnerable members of our society, in the absence of the effective referral requirements,"

Paula Loriggio reporting for the Canadian Press stated:

the divisional court said that though the policy does limit doctors’ religious freedom, the breach is justified.

Sign up to support the Coalition for Healthcare and Conscience (Link). 

Fine reported that Albertos Polizogopoulos, an Ottawa lawyer representing 4700 doctors who were challenging the Ontario regulations argued that the effective referral mandate violates the freedom of conscience and religion protected in Section 2 of Canada's Charter of Rights and Freedoms:

"Our position is doctors who opposed assisted suicide or physician-assisted death are put in a position now where they either need to violate their conscience and their religious and moral belief or face being disciplined by the college – and that's not a good place to be," 

...most provinces do not require referrals to willing physicians. Alberta, for example, co-ordinates requests and referrals through a centre that patients can call on their own. The faith groups do not object to referring patients to the centre. Manitoba has a team of physicians willing to help the severely ill end their lives. Ontario has now set up a co-ordinating centre but faith doctors say they are still concerned that they are responsible for an "effective referral."

Fine reported that this case is the first to test the constitutional rights of doctors who object to assisted death on grounds of conscience. and the decision comes as doctors opposing assisted suicide struggle to find a middle ground. Some hospitals run by Catholic, Jewish or other religious groups have declined to offer assisted dying. In those cases, patients are transferred to other facilities.

Recently a Jewish care home in British Columbia accused a euthanasia doctor of sneaking-in and killing a resident.

Fine reported that, as of December 31, Ontario's chief coroner has recorded 1,030 deaths by physician-assisted death in Ontario.

The Supreme Court of Canada struck down the previous law on assisted dying in February 2015. The court said nothing in its ruling compelled physicians to provide assistance in dying. It added that it was up to governments and regulatory colleges to reconcile the Charter rights of patients and physicians.

Parliament legalized assisted death on June 17, 2016. The legislation stated in its preamble that doctors have a right to freedom of conscience, and are not required to perform or assist in the provision of an assisted death.

The decision by Ontario's Divisional Court will need to be appealed.

• Dr Ramona Coelho: We are a nation of Laws and Conscience.
• Alex Schadenberg: Ontario doctors will leave the Province if they are forced to participate in assisted dying.
• Alex Schadenberg: Health professionals opposing euthanasia require conscience protection.
• Alex Schadenberg: Ontario doctors shouldn't be forced to refer their patients for euthanasia.