Australia - Euthanasia lobby is attempting to legalize euthanasia on two fronts.

I just learned the euthanasia bill that is sponsored by Steph Key passed 2nd reading today in the South Australian lower house. This is shocking considering the wide-open language of the bill.

My analysis of the South Australian euthanasia bill from last March concluded that:

"The South Australian parliament needs to kill the bill. The bill gives physicians near absolute power to directly and intentionally cause the death of their patients. The bill steers people with disabilities and others who live with chronic conditions to euthanasia. These are the people who the current law protects from those who believe that the lives of some people are not worth living.

The bill must be seen for what it is. It is a law that is designed to impose death on the most vulnerable in society. The bill is not concerned with the veneer of choice or autonomy because it is designed to give the power over life and death to physicians. This bill will turn healers into killers and it will redefine the nature of medical care in South Australia. The bill is a travesty of justice."

Read my analysis of the South Australian bill.

The South Australian bill had significant momentum last March until Philip Nitschke, Australia's Dr. Death, announced that he was planning to open a euthanasia clinic in Adelaide South Australia to take advantage of the wide-open language of the Steph Key bill. Link to an article.

Today's vote came forward without the public being informed probably as another political manoeuvre as the South Australian politicians attempt to legalize euthanasia before their citizens know what happened.

Paul Russell, the director of HOPE in Australia, stated that this bill is being touted as an end-of-life decisions act and not a euthanasia bill. Russell stated:

"It is becoming increasingly clear that the bill is being touted by its supporters as simply a protection for doctors if they removed burdensome treatment or if they raised the pain medication to relieve suffering and the patient died a little earlier than expected as a result; what is commonly known as the double effect where the intention is to relieve pain and/or to provide comfort at the very end, which would not be euthanasia. In fact, it is already covered extensively and well under the Consent to treatment and Palliative Care Act 1995 in SA. ... In short, doctors already enjoy such protection. Some MPs simply don’t get the distinction."

Link to Paul Russell's blog comment.

After re-reading the South Australia bill I can assure you that it is a euthanasia bill.

At the same time the Australian federal parliament is facing a bill that is being sponsored by Greens leader Bob Brown, to give power to the Territories that would enable the Northern Territory to once again legalize euthanasia.

Australia's Northern Territory legalized euthanasia in 1995. The Australian federal government overturned that law in 1997. The bill that Bob Brown is proposing would allow the Northern Territory to legalize euthanasia once more.
Link to the information from HOPE.

Paul Russell gave a fabulous talk at the Third International Symposium on Euthanasia and Assisted Suicide concerning the victories that HOPE was able to achieve. Russell, who is the Vice Chair of the Euthanasia Prevention Coalition - International is facing the battle of his life if he is to maintain the legal protection for everyone in Australia from having euthanasia imposed on them.

Previous article by Paul Russel concerning the South Australian euthanasia debate.

Euthanasia and Assisted Suicide: What in the World is Going On?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Euthanasia and assisted suicide are legal in a few jurisdictions in the world, but most countries have rejected their legalization.

Most recently, legislation to legalize euthanasia and/or assisted suicide has been rejected in France, Israel, England, Scotland, Australia, Canada, Bulgaria, etc. In the U.S., where there have been well over 100 legislative proposals to legalize physician-assisted suicide (PAS) since 1994, California, Hawaii, New Hampshire, Vermont, Connecticut, and more have recently rejected it. (1)

In the United States, assisted suicide was legalized by voter initiatives in Oregon in 1994 and Washington State in 2008. (2) A 2009 Montana Supreme Court ruling did not legalize assisted suicide but it did create a potential defense, based on consent of the patient, for physicians who are prosecuted for assisted suicide. In 2011, a bill to prohibit PAS and a bill to create regulations for PAS were both introduced in the MT legislature. Neither bill had enough votes for passage. (3)

In May 1995, Australia’s northern territory became the first jurisdiction in the world to legalize euthanasia. The law went into effect in June 1996 but was overturned by the Australian government in March 1997. (4)

The Netherlands officially legalized euthanasia and assisted suicide in April 2002. Previous to that, the Dutch Courts approved the practice of euthanasia and assisted suicide. Some people suggest that there are no problems with the Dutch euthanasia law, but in fact there is significant abuse and the slippery slope has been very steep. (5)

In the beginning, the Dutch euthanasia law applied only to people who were terminally ill and suffering uncontrolled pain. Now the law applies to people with physical and mental pain, people with chronic conditions, infants with disabilities (Groningen Protocol), people with dementia or Alzheimer’s, and the current push is to allow euthanasia for people who are 70 years old and “tired of living.” (6) The most recent Dutch government study found that every year there are approximately 550 intentionally caused deaths without request or consent and approximately 20% of euthanasia deaths are not reported. (7)

In Belgium, euthanasia was legalized in 2003. Recent studies have revealed significant abuses of euthanasia and signs that it is “out-of-control.” Independent studies, published in May 2010, looked at the practice of euthanasia in the Flanders region. They revealed that 32% of the euthanasia deaths in that region were done without request or consent (8) and that 45% of all euthanasia deaths done by nurses in Belgium are without request or consent. (9) Another highly disturbing study published in October 2010 found that nearly half of the euthanasia deaths in the Flanders region are not reported and that “controversial” euthanasia deaths are usually not reported. Under-reporting explains why the “official” Belgium government report suggests that few if any problems exist. (10)

When looking at the studies concerning euthanasia in the Netherlands and Belgium, one must conclude that choice and autonomy (self-determination) are only the sales slogans for gaining societal acceptance of euthanasia; that in fact euthanasia has become a way to eliminate human lives deemed, by others, to be not worth living. (11)

Much research proves a direct connection between depression and requests for euthanasia or assisted suicide. Published in 2005, a study by a Dutch doctor who supports euthanasia found that people who had cancer were 4.1 times more likely to request euthanasia if they were depressed or experiencing feelings of hopelessness. (12) A similar study in Oregon, published in 2008, found that 26% of the people who requested euthanasia were depressed or experiencing feelings of hopelessness. The Oregon PAS law has a “supposed” safeguard that requires physicians to refer for psychological assessment anyone who requests assisted suicide and has signs of depression. (13) Nevertheless, of 124 people who died by assisted suicide in Oregon (2009 and 2010), only one was sent for a psychiatric or psychological assessment. (14) Yes, depressed people in Oregon are dying by assisted suicide.

Then there is the growing scourge of elder abuse in our culture. Legalizing euthanasia or assisted suicide creates new paths of abuse. Elder abuse is rarely reported because it is most often perpetrated by a person upon whom the victim is dependent. In the same way, a vulnerable person who is experiencing abuse can be steered to suicide when the law allows doctors to prescribe death. (15)

The euthanasia lobby promotes death on demand based on choice and autonomy. (16) This is an illusion. The legalization of euthanasia and assisted suicide does not give you the “right to die.” It gives another person, usually a physician, the right to intentionally and directly cause your death.

The proper use of Palliative Sedation is not Euthanasia.

By Alex Schadenberg

Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

This article was published in its original format on July 20, 2011.

I have been wanting to learn more about palliative sedation since the Quebec College of Physicians and Surgeons (Quebec College) stated in February 2010, that Canada needs to legalize euthanasia because doctors are “doing it already.” The Quebec College stated that everyday people are sedated (palliative sedation) and everyday people are given large doses of analgesics, which the Quebec College stated was the same as euthanasia.
Link to an article on the position of the Quebec College of Physicians on Euthanasia:

Last week I attended a 4 day conference on palliative sedation. It was fascinating to learn important facts concerning palliative sedation techniques, and the current practice of sedation.

Euthanasia is an action or an omission of an action that directly and intentionally causes the death of a person to relieve suffering. If an action or omission of an action is not the direct and intentional cause of death, then it is not euthanasia. Euthanasia is a form of homicide and is prosecuted as homicide.

The Euthanasia Prevention Coalition (EPC) responded to the Quebec College by stating that the proper use of sedation techniques and the proper use of large doses of analgesics (pain killers) is not euthanasia. 

Since the proper use of sedation techniques and the proper use of large doses of analgesics is not euthanasia, therefore the Quebec College must be suggesting that everyday Quebec physicians abuse the proper use of palliative sedation and abuse the proper use of analgesics. If this is true, then how does the Quebec College expect that euthanasia, if legalized, would not be abused?

The proper use of palliative sedation

The Canadian Palliative Sedation Therapy Guideline working group was particularly bothered by the statement of Quebec College comparing palliative sedation to euthanasia. They stated:

“Palliative sedation therapy, correctly practiced, neither aims at death nor shortens life. Palliative sedation therapy is the use of a sedative medication to control severe and untreatable suffering at the end of life when other measures have been exhausted. It does not shorten life.”

Link to an article from the Palliative Sedation Therapy Guideline working group:

The Palliative Sedation Therapy Guideline working group is working on “national guidelines” to ensure the proper use of palliative sedation.

What constitutes an abuse of palliative sedation making it an act of euthanasia?

Palliative sedation is defined as: neither aiming at death nor shortening life. Euthanasia constitutes the direct and intentional cause of death, Sedation, when abused can be the direct and intentional cause of death of a person, therefore terminal sedation can be an act of euthanasia.

Euthanasia by dehydration or "slow euthanasia" occurs when deep continuous sedation is done to a person who is not otherwise death, combined with the withdrawal of hydration and nutrition, whereby the cause of death is dehydration. In this circumstance, the death was not caused by the medical condition but rather the intentional decision to dehydrate the person to death. This is often referred to as “slow euthanasia” because the death is intentionally caused by dehydration and yet it takes longer to complete the act of euthanasia than giving a person a lethal injection. People who question that this act is euthanasia need to consider that by employing deep continuous sedation the person has been denied the opportunity to take fluids naturally by mouth.

When a person, who is not otherwise dying, is deeply and continuously sedated and hydration and nutrition is withdrawn, that the outcome is clear. This person will die of dehydration.

When a person is terminally ill and actually nearing death, the withdrawal of hydration and nutrition is not euthanasia because the person will die of their medical condition.

In the Netherlands, the abuse of palliative sedation appears to be a common practice. The five year report from the Netherlands (2005), indicates that number of euthanasia deaths had declined, possibly due to: “the increased application of other end-of-life interventions, such as palliative sedation.” The report stated that deep continuous sedation represented approximately 8.2% of all deaths in the Netherlands. Recent reports have indicated that the use of deep continuous sedation is increasing. Link to the Netherlands study.

EPC welcomes the work of the Palliative Sedation Therapy Guideline working group and we encourage the proper use of palliative sedation. Many people have falsely stated that euthanasia needs to be legalized to relieve suffering. Traditional palliative care practices can effectively control more than 95% of pain symptoms. When the proper use of sedation is included in the palliative care arsenal it becomes possible to effectively control all pain and symptoms.

Some people state that the proper use of sedation will cause a person to sleep through their final days of life and they claim that this is no different than causing a persons death by euthanasia. This is false. 

The proper use of sedation is not the same as killing a person by lethal dose or injection.

Recommendations:

Sedation guidelines should encourage the use of light or moderate sedation and the practice of intermittent sedation. The proper use of sedation does not necessitate that the person be permanently sedated.

1. Before deep continuous sedation is done, the person must be actually dying. Since the practice of deep continuous sedation usually includes the withdrawal of hydration and nutrition, therefore the method cannot be done on a person who has a terminal or significant condition, but who is not otherwise dying.

2. The decision to withdraw hydration and nutrition must be separate from the decision to apply deep continuous sedation. Death by dehydration can be “slow euthanasia” especially since the person who has been sedated has been denied the opportunity to sip or request fluids. The intention of sedation must be to relieve suffering and not to cause death.

3. To ensure the proper use of sedation, palliative sedation must be considered a last resort. It is important that other techniques of controlling pain are given a reasonable chance of success before resorting to sedation.

4. The person must be experiencing refractory symptoms. It is not ethical to sedate a person who can have effective pain relief without losing consciousness. To deny a person consciousness also means that the person is denied the option of changing their mind, of saying goodbye to others, or even indicating that their pain has been relieved.

5. The intention of the palliative sedation therapy is centrally important. The intention must be to relieve the refractory symptom. There is a concern that sedation is being used for people who are experiencing existential pain that may be effectively treated without denying the person consciousness.

6. The use of sedation must be proportional to the symptoms that the person is experiencing. If a person can be comfortable after light sedation then it is an abuse of the use of sedation to immediately employ deep sedation. Once again, deep continuous sedation denies a person consciousness, which should be always seen as a serious decision.

EPC encourages the proper use of palliative care and we encourage the use of palliative sedation when it is necessary and not abused. Palliative care is the care of the “whole person.” EPC encourages the continued development of patient centered care.

More research needs to be done on the alleviation of refractory symptoms. We recognize the need for Compassionate Community Care models that are oriented to the psychological, social and spiritual needs of people who are nearing death based on a model of being with the other. Compassionate Community Care should be developed in every local community.

EPC recognizes that human suffering may cause people to request euthanasia or assisted suicide, but those requests are usually a “cry for help”. Society need to care for people, even when caring is difficult, and not kill the person who it is difficult to care for.

Bill to outlaw euthanasia by dehydration passed by Italy’s lower house

LifeSiteNews reported today that a bill to outlaw euthanasia by dehydration passed in the Italian lower house. The bill is based on the case of Eluana Englaro, like Terri Schiavo, Eluana died in February 2009. Hilary White reported:

This week, the lower house of the Italian legislature voted 278-205 to pass a bill that would exclude the possibility of starving and dehydrating vulnerable patients to death. The Advance Directives Bill opens with a specific prohibition of euthanasia or assisted suicide and requires that patients, who are not otherwise dying, not be denied food and hydration.

The bill, which has been high on the agenda of both anti- and pro-euthanasia campaigners for two years, is called in Italian, “Dichiarazione anticipata di trattamento” (Dat), or Anticipated Declarations of Treatment, also known as living wills.

The national debate in Italy over advance directives and euthanasia by omission follows the dehydration death of a young cognitively disabled woman, Eluana Englaro, in 2009. Despite the law against euthanasia, Eluana’s father, Beppino Englaro, fought for ten years through the courts to have his daughter killed by dehydration.

The case caused a national uproar when the Court of Cassation, Italy’s highest constitutional court, in November 2008 ruled that Eluana could be moved by her father’s order to a nursing home that would be willing to remove her food and hydration to cause her death. Despite the fact that Eluana was not terminally ill, this was routinely described in Italy’s national newspapers as “allowing her to die naturally.”

Since his daughter’s death, Beppino Englaro has used his notoriety to engage in a campaign to legalize euthanasia by dehydration.

Undersecretary of Health, Eugenia Roccella, announced this week that the final vote on the advance directives bill will follow third reading in the Senate, which will likely happen in October. Roccella said, “I think it is a good law and can withstand the attacks of propaganda.”

Under current Italian law, patients can refuse medical treatment even in cases where refusal could tend to shorten their lives. However, nowhere is the artificial provision of food and hydration defined either as “medical treatment” that can be withdrawn, or as a necessity of life – a legal void that euthanasia activists have been attempting to exploit. Should the bill pass, it would specifically close that loophole, which enabled the court decision that led to the death of Eluana Englaro.

The only exception the bill allows to the hydration rule is when a patient, in the extreme “terminal” stages of illness, is no longer capable of assimilating food or water. The bill also retains the right of patients to refuse extraordinary or extreme and aggressive measures of a “disproportionate or experimental nature.”

The bill establishes the principle of a “therapeutic alliance” between doctor and patient in the end stages of life. In its passage through parliament, deputies added the right for terminally ill patients or those whose death is imminent to be assisted with adequate pain management in accordance with the protocols of care.

The legislation “recognizes and protects human life as inviolable” and guarantees the right to life “in the terminal phase of life and in the event that the person is no longer capable of understanding and will, until his death ascertained.” Under the proposed law, the doctor is also obliged to inform the patient on the prohibition of euthanasia.

“Advance directives,” also called a living will or personal directive, are instructions specifying what actions should or should not be taken in the event a person is no longer capable of making decisions due to illness or incapacity. They have been widely used by the euthanasia lobby around the world as a foot-in-the-door to introduce legalized active euthanasia or euthanasia by omission.

In many countries, including Canada and Britain, provision of food and hydration is specifically defined as “medical treatment.” In the UK, advance directive laws allow, and in some cases even mandate doctors to withdraw hydration to patients whose potential “quality of life” is judged to render such treatment “futile.” A recent UK government directive made it illegal for doctors to refuse to dehydrate patients to death if the patients or their legal guardians request it.

It is interesting that today I have commented on the practise of dehydrating to death people who are supposedly living in a Persistent Vegetative State and two days ago I wrote about the success of therapies that are allowing people who are supposedly living in a Persistent Vegetative State to recover.

The tragic reality of euthanasia

Today, an article was published in the National Post that was written by Derek Meidema, a researcher in Ottawa Ontario, under the title: The tragic reality of euthanasia. Meidema's article follows:

The tragic reality of euthanasia

Over the past few months, a Quebec government commission has been studying euthanasia and assisted suicide. At the end of June, its members flew to Europe to examine the issue in countries where the practices are legal (such as the Netherlands and Belgium) and in a country that rejected legalized euthanasia (France).

What is the commission likely to hear? Proponents of euthanasia will undoubtedly stress that the practice is conducted only within tight guidelines. As a recent study by a Canadian doctor shows, however, these guidelines keep shifting and are of little value in protecting the rights of patients. In fact, according to an article published in Current Oncology by Dr. José Pereira, medical chief of palliative care at Bruyère Continuing Care in Ottawa, safeguards are routinely ignored and abused.

Dr. Pereira addresses the safeguards one by one. In the Netherlands, where assisted suicide and euthanasia became legal in 2002, the law states that individuals must give written consent that they want to die. In spite of this, a 2005 study of deaths by euthanasia in the Netherlands found that almost 500 people are killed annually without their consent.

Belgium has the same safeguard. Nonetheless, a 2010 study found that in the Flemish part of the country, 32% of euthanasia cases were carried out without request or consent. Some were cases where a person couldn't give consent due to their medical condition. Others were cases where a person could have given consent but didn't. In the latter cases, doctors proceeded with euthanasia because they felt it was in the best interest of the patient, or because they thought discussing it would be too harmful to the patient.

Another suggested safeguard is mandatory reporting: All cases of euthanasia must be reported to the proper authorities so that they can ensure the other safeguards are being followed. This safeguard is weak from the start. Why would a doctor abusing patients report his abuse to the authorities? Nonetheless, the Netherlands and Belgium maintain this requirement. In Belgium, nearly half of all estimated cases aren't reported. In the Netherlands, at least 20% of all cases aren't reported.

The third safeguard is the guarantee that assisted suicide or euthanasia be carried out only by doctors. Yet a 2010 study of 120 Belgian nurses found that they administered life-ending drugs in 45% of assisted suicide cases without the patient's consent.

The fourth safeguard is a second opinion: If a doctor approves you for assisted suicide or euthanasia, you must obtain the go-ahead from another physician. This safeguard is easily circumvented. In Oregon, for example, public reports show that a physician tied to a pro-assisted suicide lobby group provided consultations in 58 of 61 cases of assisted suicide in Oregon. It appears that if you can't find a second doctor to approve your request, a lobby group will gladly provide one.

History shows that when it comes to euthanasia, safeguards, however well intentioned, do not work. Once the law defines assisted suicide and/or euthanasia as a personal right, there is always a push for the law to expand its ambit.

In the Netherlands, for example, the initial reason for legalizing euthanasia was as a last resort for adults with terminal illness facing intolerable suffering. Today, there exist medical circumstances in which newborn infants can be killed. There's even a group in the Netherlands called "Out of Free Will" who ran a successful campaign that had the Dutch parliament debating a measure allowing anyone over 70 who is merely tired of life to die by euthanasia.

The idea of safeguards sounds comforting, but it's important to know that the globe over, they have not worked to protect patients. Let's hope the Quebec delegation travelling in Europe this summer gains a robust understanding of the issue. One thing's certain: They won't hear from those who died when safeguards were abused and ignored.

Rediscovering consciousness in PVS patients

The recent edition of Discover Magazine is reporting on new research that is showing that the human brain can regenerate after traumatic injury and it is proving that certain types of stimuli has had some success at restoring consciousness for people who are thought to be in a Permanent Vegetative State (PVS).

Before explaining some of the findings in the article I question why this news is being reported as new or revolutionary. In 2004, I attended a conference in Europe on Persistent Vegetative State. At that conference there were two presentations on the success of "Awakening Centers" in Europe.

Awakening Centers didn't use electrical impulses, such as those being used by the team at Cornell Medical Center, but rather they focused on physical stimuli. The Awakening Centers would physically stimulate all the parts of the human body by simulating crawling or simulating walking as well as they would have physiotherapists stimulate all the main muscles of the body. These Awakening Centers had significant success with people who were abandoned as PVS patients.

I also question why there are no Awakening Centers in North America and there has been no information reported about the success of the Awakening Centers in Europe.

The article in Discover Magazine explains the success that Dr Giacino is having by using electrical stimulation on people who are diagnosed as PVS. The success of this work is turning our understanding of PVS up-side-down.

The article states:

The old verdict was harsh but clear-cut: Mourn your loved one, because he or she is gone.

“These are human beings who seem to have lost their humanity,” Giacino says. “The question is, is that really the case?”

The article describes the case of a man who was beat up and had been beat-up and was believed to be in a PVS state. After stimulation was applied to the brain the article stated:

As soon as the researchers switched the stimulator on, the man’s eyes opened. The doctors were not yet sure that it worked; they waited two months for the patient to completely heal from surgery before beginning their cognitive tests. The real moment of drama came during one of those first sessions, when the patient had the electrodes fully switched on for several hours. Schiff and Giacino showed him a picture of a red Radio Flyer, and before Schiff even remembered what the toy was called, the patient said, “Wagon.”

As months passed his repertoire increased; with the stimulator switched on, he could swallow, hold a cup, name objects, speak short sentences, and smile. The real impact of the stimulation is best described by his mother, who had been told the night of his beating that he would never be more than a vegetable. “My son can now eat, speak, and watch a movie without falling asleep,” she said through tears at a press conference announcing the results of the study. “He can express pain. He can cry and he can laugh. The most important part is, he can say ‘Mommy’ and ‘Pa.’ He can say, ‘I love you, Mommy.’ ”

Research concerning the rediscovering of consciousness is important because today we warehouse people in care homes who are determined to be in PVS or we abandon them to death by dehydration. They are treated as non-humans or the living dead.

The case of Terri Schiavo was even refered to in the article which stated:

In 2005, just as the deep brain stimulation patient was making his first forays into awareness, the fate of Terri Schiavo, a Florida woman who had been in a vegetative state since 1990, sparked an ideological war. Her husband wanted her feeding tube removed, ... her parents disagreed. Eventually, everyone from the governor of Florida to the U.S. Congress took sides. The arguments hinged on different impressions of how much awareness Schiavo still retained. A clip of Schiavo smiling was shown over and over again on TV. Senate majority leader Bill Frist (a heart surgeon) insisted that the video meant she was still conscious. ... Eventually her feeding tube was removed and she died

The future holds much hope for people who are declared to be PVS. The article refers to one successful case that appeared from the outset to be impossible. The article stated:

One of the Schiff group’s recent subjects was 23 years old when he sustained a severe head injury in a car crash. CT scans showed that his brain was ravaged, with a huge shadow of fluid where neural flesh should be. He spent three months in a vegetative state. A year after the accident, a physical therapist realized the patient could voluntarily move his head. The therapist trained him to use a letter board, in which a helper points to letters until the patient reacts, spelling out a message one letter at a time. His IQ turned out to be normal, and apparently his personality survived too; after several hours of being queried and quizzed by Schiff’s team, he used the board to spell G-E-T O-U-T.

Schiff’s team helped him acquire a head mouse, which allows him to use a computer by moving his head to control the cursor. He slowly continued to improve. Last winter, this man—who not long ago might have been abandoned as hopeless—sent Schiff’s group an e-mail. "Hi," it said; "I’m doing well." It was a telegram from a future world.

There is hope that many more people will soon be able to be brought out of coma to once again be treated as a human being and not as the living dead.

The Euthanasia Lobby is trying legalize euthanasia and assisted suicide in Canada through the courts.

The Euthanasia lobby has turned its attention to trying to legalize euthanasia and assisted suicide in Canada through the courts. Last April (2010), Bill C-384, sponsored by Francine Lalonde (BQ), that would have legalized euthanasia and assisted suicide in Canada, was defeated by 228 to 59 in parliament. The resounding defeat for the euthanasia lobby indicated that it was unlikely, anytime soon, that doctors would gain the right to cause the death of their patients through democratic means.

Several cases that have been launched in British Columbia with the intent of striking down the laws that protect vulnerable people from euthanasia and assisted suicide by having those laws declared unconstitutional.

The Farewell Foundation:
In February 2011, the Farewell Foundation of BC applied for incorporation status as a group that would assist the suicides of its members. The Farewell Foundation was formed as a corporation based on the principles of the Dignitas suicide center in Switzerland.

The Farewell Foundation considers the assisted suicide act in Canada to be unconstitutional.

The Registrar of Companies rejected the Farewell Foundation’s application for incorporation based on the fact that they existed for the purpose of breaking the law.

On April 8, 2011, the Farewell Foundation challenged the rejection of incorporation status and suggested that the assisted suicide law (Section 241b of the criminal code) is unconstitutional and therefore is not binding on the Registrar of Companies.

The BC Civil Liberties Association (BCCLA):
The BCCLA launched the Carter case on April 26, 2011 to strike down, as unconstitutional, Canada’s criminal code provisions that protect people, at the most vulnerable time of their life, from euthanasia and assisted suicide.

The Carter case focused the family of Kay Carter who accompanied her when she died by assisted suicide at the Dignitas suicide center in Switzerland.

The claim stated that Kay Carter’s rights were violated by an unconstitutional law that prevented her from dying by euthanasia or assisted suicide in Canada.

The claim also stated that Lee Carter (daughter) and Hollis Johnson (son-in-law) claim to have broken the law by aiding their mother by planning and possibly encouraging her to go to the Dignitas suicide center in Switzerland. Lee & Hollis are challenging the constitutionality of Canada’s laws that prevent euthanasia and assisted suicide because they could potentially be prosecuted under those laws.

The Carter case clearly intends to legalize euthanasia and assisted suicide in Canada by challenging the constitutionality of Sections 14, 21, 22, 222, 241 of the criminal code.

Section 222 is the homicide provision in the criminal code. Euthanasia is a form of homicide because it is the act of actually causing the death of another person. It is very concerning when anyone challenges provisions of the homicide Act.

Section 241 is the assisted suicide Act in the criminal code. Assisted Suicide means to aid, abet (encourage) or counsel another person to commit suicide.

After several case management meetings where the Attorney General considered the Farewell Foundation case and the Carter case to be the same legal issue, where standing for the BCCLA and the Farewell Foundation were questioned and where it was suggested that the case lacked urgency. The BCCLA went back to the drawing board and amended their case.

On June 28, 2011; the BCCLA launched an amendment to the Carter case by adding Gloria Taylor (63) to the statement of claim. Taylor, who lives with ALS, claims that she would like to die by euthanasia or assisted suicide and the laws that prevent someone else from causing or aiding her death by euthanasia or assisted suicide are unconstitutional.

Taylor’s condition, as stated by the BCCLA, creates a greater level of urgency for the case because she may be entering the terminal phase of her condition.

The amendment to the case also asks the court to grant an exemption for Taylor and her doctor so that she can be killed by euthanasia or have her suicide assisted in a manner approved by the court.

To create even greater urgency to the case, the BCCLA has requested that if the court is not able to come to decision in a timely manner or grant Taylor an exemption to the law, that the court must pay all costs related to the case and the required care for Taylor.

From this point forward we will refer to the case as the Carter case.

The Carter case, if successful, would give doctors the right to directly and intentionally cause the death of another person by lethal injection and it would give doctors the right to prescribe lethal doses to their patients, knowing that their patient intends to commit suicide.

It is sad how this case uses the stories of people with chronic degenerative conditions and disabilities to remove protections in law that exist for vulnerable Canadians. People with disabilities are more likely to be steered toward assisted suicide or euthanasia.

Disability activist, Mark Pickup, (picture) from Alberta stated to EPC:

"the newspaper described Kay Carter (89) as a Right to die proponent. She developed spinal stenosis in 2008 which causes "pain, lack of coordination, numbness, loss of bladder and bowel control and paralysis." That was enough reason to overturn laws against assisted suicide? I disagree. I've had those very same symptoms (and many others) throughout my 27 year journey with multiple sclerosis. I want our laws prohibiting assisted suicide to stay in effect and enforced, in case I despair and happen to meet someone like Kay's daughter and son-in-law who agrees with killing me."

The BCCLA emphasizes in their statement that euthanasia and assisted suicide would be limited to people who have voluntarily requested and consented to be killed.

Only parliament is able to devise rules to ensure that “safeguards” will be upheld in Canada. Where euthanasia and assisted suicide has been legalized in other jurisdictions safeguards have failed to protect people who did not consent or qualify for death by lethal injection.

When euthanasia was legalized in the Netherlands it was limited to people who were terminally ill and experiencing uncontrolled suffering. The most recent Euthanasia report includes as a category the deaths of people with dementia or Alzheimer disease. The Groningen Protocol was instituted in the Netherlands several years ago permitting death by lethal injection for infants with disabilities. It is estimated that 550 deaths occur each year in the Netherlands without request or consent and it is also estimated that 20% of all euthanasia deaths go unreported.

Recent studies concerning the practice of euthanasia in Belgium, where euthanasia became legal in 2003, shows that 32% of euthanasia deaths are done without request or consent and 47% of euthanasia deaths go unreported.

The safeguards in the State of Oregon that are promoted by the euthanasia lobby as being full-proof are illusory at best.
• The Oregon law does not require a witness at the time of death and the physician who prescribes the lethal dose is only present at the death about 20% of the time. If a person changes their mind or if the lethal dose is administered without consent, who would know?
• The Oregon statistics are invalid because the report comes from the physician who prescribes the lethal dose. The physician will not self-report abuse. The forms are submitted after the death. The information concerning the death is anecdotal at best because the physician is rarely present at the death.

The Euthanasia lobby insists that in Oregon, a physician only prescribes suicide based on the free choice of the patient.

Barbara Wagner and Randy Stroup, who had different forms of cancer, were offered assisted suicide by the Oregon Health Plan but denied treatment. We don’t want Canada’s universal health plan to steer people to suicide by offering assisted suicide or euthanasia as a “plan of treatment” to patients who are denied treatment.

When considering the scourge of elder abuse in Canada, the BCCLA should not be so sure that people will not be steered into an unwanted or unsuspecting death. Canadian statistics show that elder abuse is a growing problem with approximately 70% of all abuse being carried out by friends or family members. Elder abuse is often not reported because the victim is usually dependent on the abuser or believes that they have, in some way, caused the abuse or fear that, if reported, the abuse will become worse.

Elder abuse is often experienced as financial, psychological or physical abuse, but there have been cases of homicide. The Oregon assisted suicide statistics are consistent with the demographic that are most likely victims of elder abuse.

To give the power over life and death to another person, even a doctor, such as a law that legalizes euthanasia and assisted suicide, can be used by unscrupulous family members and medical care-givers as the ultimate form of elder abuse or to eliminate problem patients.

The Carter/Taylor factum states that a person who is “grievously and irremediably ill” only limited by the capacity to consent would be eligible to die by lethal dose.

The term, irremediably ill is not limited to a person with a terminal illness. This definition would include anyone with a terminal condition. Having a terminal condition does not make you terminally ill.

A person who has diabetes and is insulin dependent may qualify as irremediably ill.

Grievously ill would include most types of disability or chronic conditions. I have a friend with MS who is not terminally ill. He is very productive, but given different circumstances he could easily be considered grievously ill. I have another friend who has brain cancer, but is now in remission. He is well aware that the cancer is likely to return.

Another friend broke his back in two places 25 years ago in a vehicle accident. He lives with chronic pain, but he is not terminally ill. He has difficulty dealing with his pain when he is alone and feeling abandoned by the world. He is grievously ill and would be a candidate for euthanasia, especially when he is going through a difficult period.

The laws that prevent euthanasia and assisted suicide are designed to protect a person at the most vulnerable time of life. Society is already experiencing many pressures to control the cost of health care and people with disabilities and those with chronic conditions are already being made to feel like they are a burden on society.

Legalizing euthanasia and assisted suicide, for any circumstance, does not grant new rights to the individual but rather it provides doctors with the right to directly and intentionally end your life and it removes the protections that exist in law for people at the most vulnerable time of their life.

Bulgarian Parliament Committee resolutely rejects euthanasia bill

The Health Committee of the Bulgarian Parliament has overwhelmingly rejected a proposed bill to legalize euthanasia. The bill was tabled last week by socialist MP Lyuben Kornezov.

An article that was published today by the Novite.com news agency stated:

The committee voted with 12 members against and 1 abstention, with Kornezov's fellow MPs from the Bulgarian Socialist Party also being widely against.

Vanyo Sharkov and Hasan Ademov from arch-rivals rightist Blue Coalition and ethnic Turkish Movement for Rights and Freedoms united in an all-out rejection of euthanasia as going against the principles of beneficence in medicine.

Ruling center-right GERB party Djema Grozdanova said that euthanasia could be introduced only after an extensive and deep debate within the whole society, something which has not happened in Bulgaria.

Socialist Yanaki Stoilov argued that euthanasia could be introduced only in a country where the health system is at a sufficiently high level, which he saw as plainly not being the case in Bulgaria.

Kornezov defended his legislative proposal, arguing for the right to die with dignity, and defending it as a case of well-doing in extreme cases.

Committe MPs nevertheless were firmly against the bill and went on to reject it.

Euthanasia is falsely sold to society as a "freedom of choice". In fact, legalizing euthanasia does not grant an individual freedom but rather it gives doctors the right to lethally inject their patients.

Euthanasia and assisted suicide threaten the most vulnerable in society by enabling family members and medical care givers to steer people towards death by lethal dose.

The Health Committee of the Bulgarian parliament has made the right decision.

Toronto Star agrees with Rasouli decision.

The Toronto Star published an excellent editorial article on the Rasouli decision under the title: Keeping Hope Alive.

The editorial supports the position of the Euthanasia Prevention Coalition and the decision of the Appeals Court of Ontario which recognizes that withdrawing life-sustaining medical treatment is done as part of a "Treatment Plan" and therefore requires the consent of the person or the substitute decision maker.

The article even recognizes the concerns of the Euthanasia Prevention Coalition by stating:

This is wise given the pressures on hospitals to allocate scarce resources among many deserving patients. No one wants life-and-death decisions to be shaped by the need to cut corners.

The editorial states:

The family of Hassan Rasouli has been enduring a situation that any family can relate to. Their husband and father has been lying in Sunnybrook Health Sciences Centre for almost nine months, in what his doctors describe as a vegetative state. He has no hope of recovery, they say. Rasouli’s wife and children disagree: they see flickers of recognition when he blinks his eyes.

The question is: who decides? Who has the right to say whether Rasouli and patients like him be kept alive or allowed to die? Doctors or families?

Ontario’s Court of Appeal has decided that, in Rasouli’s case at least, doctors do not have the unilateral right to pull the plug — even if they believe that keeping him on life support serves no medical purpose. In the absence of comprehensive legislation governing end-of-life situations, the court’s ruling will guide the debate and tip the balance toward giving families a voice.

Rasouli has been in Sunnybrook since October, when he went in to have a benign brain tumour removed. Complications developed, leading to severe brain damage. He has been on a ventilator and feeding tubes ever since. His doctors wanted to remove life support and let nature take its course. His wife, Parichehr Salasel, who was a doctor in her native Iran, argued that giving up on him would violate his values and beliefs. “His look is full of meaning for me,” she says.

The case turned on the meaning of “treatment” under provincial law. The doctors argued that while patients have the right to refuse treatment, they do not have the right to insist on treatment that their physician believes is “medically ineffective or inappropriate.”

The judge who first considered the case decided in favour of the family, ruling that a “plan of treatment” under Ontario law includes the “withholding or withdrawal” of medical care — and therefore the family must consent to that. The appeal court agreed. Doctors may withhold treatment they believe to be useless in cases where death is not imminent, for example where more chemotherapy will do no good for a cancer patient. But withdrawing treatment (such as life support measures) that would result in a quick death is different. The family must have a voice.

This is wise given the pressures on hospitals to allocate scarce resources among many deserving patients. No one wants life-and-death decisions to be shaped by the need to cut corners.

Fortunately, sad cases like the one being lived by the Rasouli family rarely result in such sharp faceoffs with physicians. As the appeal court noted, “in most situations, life-ending decisions are worked out over time through a combination of patience, understanding, professional guidance and counselling.” When all that fails, however, patients and their families must have their voices heard.

We hope that the Rasouli decision and the support it has received, will lead to a change concerning attitudes towards health care and the need to have effective collaboration on issues that will result in the death of a person.

Euthanasia of people with dementia in the Netherlands

The Daily Mail paper in the UK reported on June 29, the for the first time euthanasia of people with dementia has been included in the official statistics of euthanasia in the Netherlands.

The article reported that:

A total of 21 patients with early-stage dementia, including Alzheimer’s, died by lethal injection last year, according to a forthcoming annual report. ...

The figures have caused alarm among critics who say the pool of patients who qualify for euthanasia in the Netherlands is expanding.

The figures, which are due to be formally released later in the summer, were leaked on NOS, the state television news channel.

The NOS television news channel featured video footage of Guusje de Koning (63) explaining to her children why she wanted to die by euthanasia. The article stated:

Euthanasia advocates are using her story to promote the idea that euthanasia for dementia sufferers is a suitable way to avoid suffering and the expensive healthcare.

The article suggested the euthanasia of people with dementia is controversial. It stated:

the practice of assisted suicide for dementia patients remains controversial. While some 95 per cent of Holland’s population support the country’s euthanasia laws, only 33 per cent of Dutch doctors agree with offering lethal injections to dementia sufferers.

The article concluded by pointing out that the number of euthanasia deaths in the Netherlands continues to rise. There were approximately 2700 reported euthanasia deaths in 2010, which is up from 2636 reported euthanasia deaths in 2009.

It is important to note that the euthanasia numbers do not include the approximately 550 deaths without request or consent, the approximately 400 deaths by assisted suicide and the fact that it is estimated that 20% of the euthanasia deaths are not reported.

British Medical Association denounces Euthanasia Commission in the UK

Peter Saunders, a leader of the Care Not Killing Alliance in the UK published a blog comment concerning the British Medical Associations denouncing of the Falconer Euthanasia commission in the UK.

Saunders wrote:

The British Medical Association, representing 140,000 British doctors, has this morning (June 30) questioned the stated impartiality and independence of Lord Falconer’s Commission on Assisted Dying, supported the BMA leadership’s stance in not giving evidence to it and called on the British Medical Journal Editorial team to present a balanced and unbiased coverage of the Commission.

Delegates at the BMA annual representative meeting in Cardiff overwhelmingly voted this morning for a five part motion proposed by Dr Mark Pickering of the Yorkshire division (watch the debate here - listen from 1h56m)discrediting the independence of the commission in a move that will seriously undermine its credibility (Hear Peter Saunders podcast here)

Falconer’s commission was set up last November 2010 at the instigation of Dignity in Dying (formerly the Voluntary Euthanasia Society) to investigate how the law might be changed to allow assisted suicide and euthanasia. The commission has said it will take oral and written ‘evidence’ throughout this year and produce a report in the autumn.

DID’s hope was that the conclusions, when published, might influence parliament. This now looks very unlikely. DID was forced to go down the route of a private commission when its attempts to get a parliamentary committee to look at this issue failed.

There have already been three attempts to legalise assisted suicide in Britain over the last six years but all have been singularly unsuccessful resulting in defeats of 148-100 (Joffe Bill), 194-141 (Falconer amendment) and 85-16 (Macdonald Bill) in 2006, 2009 and 2010 respectively.

Falconer’s commission has already received a lot of bad press on the grounds that it was unnecessary, unbalanced and lacking in transparency.

Nine of Falconer’s twelve commissioners have publicly supported a change the law to allow assisted suicide and the remaining three are certainly not against it.

Of the first eleven expert witnesses originally invited to give evidence (I was one) six declined to do so.

The British Medical Association is one of over 50 organisations which have subsequently refused to give evidence.

The motion, all five parts of which were passed by a clear majority on a show of hands, reads as follows:

* 305 Motion by THE AGENDA COMMITTEE (Motion to be proposed by the YORKSHIRE REGIONAL COUNCIL): That this Meeting:
i) notes that the significant majority of members of Lord Falconer’s Commission on Assisted Dying are publically in favour of assisted suicide and euthanasia;
ii) supports the BMA’s stance in not giving evidence to the DEMOS Commission on Assisted Dying;
iii) questions the stated impartiality and independence of the Commission on Assisted Dying;
iv) requests the BMA Ethics Committee to make the Association’s opposition to assisted suicide and euthanasia clear to the Commission on Assisted Dying;
v) requests the BMJ editorial team to present a balanced and unbiased coverage of the Commission on Assisted Dying.

Legalizing assisted suicide is a mistake

The following letter was published in the Vancouver Sun, in response to the article concerning the BC Civil Liberties Association's attempt to strike down Canada's laws protecting people from euthanasia and assisted suicide through the courts. The letter by Dr. William Toffler states:

Legalizing assisted suicide is a mistake

Vancouver Sun - July 4, 2011

Re: Westbank woman joins court fight to die with dignity, Column, June 29

I am a doctor in Oregon where physician-assisted suicide is legal. In my practice, I have discussed assisted suicide with more than a dozen patients. One of the first was with a man in a wheelchair with a progressive form of multiple sclerosis who asked me for assistance with his suicide.

I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good path for him.

At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available.

I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his suicide.

He simply said: "Thank you."

How we respond to someone requesting suicide can either reflect the person's inherent worth or can cause the person even deeper desperation. Patients can even feel pressured to proceed.

Under our law, there is no assurance that the deaths are voluntary. Don't make our mistake.

William L. Toffler
Portland Oregon

Where euthanasia meets organ harvesting.

At the Bottom of the Slippery Slope:
Where euthanasia meets organ harvesting.

By Wesley Smith

The Weekly Standard - July 4, 2011, Vol. 16, No. 40

In 1992, my friend Frances committed suicide on her 76th birthday. Frances was not terminally ill. She had been diagnosed with treatable leukemia and needed a hip replacement. Mostly, though, she was depressed by family issues and profoundly disappointed at where her life had taken her.

Something seemed very off to me about Frances’s suicide. So I asked the executor of her estate to send me the “suicide file” kept by the quintessentially organized Frances and was horrified to learn from it that she had been an avid reader of the (now defunct) Hemlock Quarterly, published by the aptly named Hemlock Society (which was since merged into the assisted-suicide advocacy group, Compassion and Choices). The HQ taught readers about the best drugs with which to overdose and gave precise instructions on how to ensure death with a plastic bag​—​the exact method used by Frances to end her life.

I was furious. Frances’s friends had known she was periodically suicidal and had intervened to help her through the darkness. The Hemlock Society had pushed Frances in the other direction, giving her moral permission to kill herself and then teaching her how to do it. This prompted the first of the many articles I have written over the years against assisted-suicide advocacy. It appeared in the June 28, 1993, Newsweek and warned about the cliff towards which assisted suicide advocacy was steering our society:

We don’t get to the Brave New World in one giant leap. Rather, the descent to depravity is reached by small steps. First, suicide is promoted as a virtue. Vulnerable people like Frances become early casualties. Then follows mercy killing of the terminally ill. From there, it’s a hop, skip, and a jump to killing people who don’t have a good “quality” of life, perhaps with the prospect of organ harvesting thrown in as a plum to society.

The other shoe​—​“organ harvesting”​—​has now dropped. Euthanasia was legalized in Belgium in 2002. It took six years for the first known coupling of euthanasia and organ harvesting, the case of a woman in a “locked in” state​—​fully paralyzed but also fully cognizant. After doctors agreed to her request to be lethally injected, she asked that her organs be harvested after she died. Doctors agreed. They described their procedure in a 2008 issue of the journal Transplant International:

This case of two separate requests, first euthanasia and second, organ donation after death, demonstrates that organ harvesting after euthanasia may be considered and accepted from ethical, legal, and practical viewpoints in countries where euthanasia is legally accepted. This possibility may increase the number of transplantable organs and may also provide some comfort to the donor and her family, considering that the termination of the patient’s life may be seen as helping other human beings in need for organ transplantation.

The idea of coupling euthanasia with organ harvesting and medical experimentation was promoted years ago by the late Jack Kevorkian, but it is now becoming mainstream. Last year, the Oxford bioethicist Julian Savulescu coauthored a paper in Bioethics arguing that some could be euthanized, “at least partly to ensure that their organs could be donated.” Belgian doctors, in particular, are openly discussing the nexus between euthanasia and organ harvesting. A June 10 press release from Pabst Science Publishers cited four lung transplants in Leuven from donors who died by euthanasia.

What’s more, Belgian doctors and bioethicists now travel around Europe promoting the conjoining of the two procedures at medical seminars. Their PowerPoint presentation touts the “high quality” of organs obtained from patients after euthanasia of people with degenerative neuro/muscular disabilities.

Coupling organ donation with euthanasia turns a new and dangerous corner by giving the larger society an explicit stake in the deaths of people with seriously disabling or terminal conditions. Moreover, since such patients are often the most expensive for whom to care, and given the acute medical resource shortages we face, one need not be a prophet to see the potential such advocacy has for creating a perfect utilitarian storm.

Some might ask, if these patients want euthanasia, why not get some good out of their deaths? After all, they are going to die anyway.

But coupling organ harvesting with mercy killing creates a strong emotional inducement to suicide, particularly for people who are culturally devalued and depressed and, indeed, who might worry that they are a burden on loved ones and society. People in such an anguished mental state could easily come to believe (or be persuaded) that asking for euthanasia and organ donation would give a meaning to their deaths that their lives could never have.

And it won’t stop there. Once society accepts euthanasia/organ harvesting, we will soon see agitation to pay seriously disabled or dying people for their organs, a policy that Kevorkian once advocated. Utilitarian boosters of such a course will argue that paying people will save society money on long-term care and allow disabled persons the satisfaction of benefiting society, while leaving a nice bundle for family, friends, or a charitable cause.

People with serious disabilities should be alarmed. The message that is being broadcast with increasing brazenness out of Belgium is that their deaths are worth more than their lives.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism, a lawyer for the Patients Rights Council, and a special consultant for the Center for Bioethics and Culture.