Belgium euthanasia: accelerating down the slippery slope

By Michael Cook, Mercatornet.com - April 13, 2014 (Link to the original).

Involuntary euthanasia is acceptable medical treatment, according to a recent official statement by the Belgian Society of Intensive Care Medicine. Although voluntary euthanasia is legal is Belgium under some circumstances, involuntary euthanasia is basically illegal.

The Society has decided (decreed may be a better word) that it is acceptable medical practice to euthanase patients in critical care who do not appear to have long to live -- even if they are not suffering, even if they are not elderly, even if their relatives have not requested it, even if they have not requested it and even if it is not legal.

The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable”.

“Shortening the dying process” is a euphemism for administering a lethal injection.

Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia”. Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.

Effectively the Society has declared itself to be above the law. However, with the backing of the Society, it is unlikely that Belgian doctors would be prosecuted. It will be interesting to see how the government reacts.

The Society also says that intensive care doctors should inform relatives of a decision to euthanase a patient, but it does not instruct them to ask for the relatives’ permission. The policy applies to both adults and children. Furthermore, patients do not have to be suffering; “Shortening the dying process” can actually enhance death, the statement says.

The statement concludes by reassuring intensive care doctors that what they are doing is “not be interpreted as killing but as a humane act to accompany the patient at the end of his/her life.”

In February the lead author of the policy, Jean-Louis Vincent, a former president of the Society, published an op-ed in the leading Belgian newspaper Le Soir explaining the Society’s position. He complained that intensive care doctors were working in a “legal no man’s land” and that Belgium needs a law which bans overly aggressive therapy. He believes that advance directives are worse than useless and that doctors need to be able to give lethal injections to shorten lives which are no longer worth living, even if the patients have not given their consent. “The first purpose of medicine is to restore or maintain health, that is, the well-being of the individual, not life at all costs,” he wrote.

Does anyone need any more evidence to prove the existence of a slippery slope in Belgium?

Michael Cook is editor of MercatorNet.

Link to other recent article:
Belgium ICU doctors kill patients.

Voters in Quebec have spoken out against euthanasia, but that doesn't mean the issue has died.

The following article was pubished by OneNewsNow on Friday April 11, 2014.

Alex Schadenberg

Quebec lawmakers were considering legalizing euthanasia before the election was called.

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow the election this week does not reflect public opinion on just one issue.

"I think there were many issues that had Quebecers vote against this government," Schadenberg advises. "The fact is though is that it's a big victory for people opposed to euthanasia and assisted suicide because the ideological push for euthanasia has now been lessened in a serious manner."

OneNewsNow reported Wednesday that an effort by some to separate Quebec from Canada was defeated at the polls.

Even though the Quebec Liberals won a majority government over the separatists in the election, there are a few members of the Liberal Party that support euthanasia.

"The other sad factor in Canada is the issue of euthanasia will be going to the Supreme Court of Canada on October 14 this year," Schadenberg tells OneNewsNow. "So no matter what happens, the issue of euthanasia will be front and center in the Canadian context."

Also capturing the attention of Quebec voters was a proposal to bar government employees from wearing symbols of their faith such as the cross on the job.

Western Australian Legislative Motion: Opposing Euthanasia - Promoting Palliative Care

Hon Nick Goiran, Liberal MLC from the Western Australian Legislative Council, representing the South Metropolitan region presented the following motion and speech opposing euthanasia and assisted suicide and promoting palliative care.

Hon Nick Goiran

Hon Nick Goiran is also the co-convenor of the Parliamentary Friends of Palliative Care in Western Australia.

From Hansard: 

Euthanasia Motion 

HON NICK GOIRAN (South Metropolitan) [11. 37 am] without notice: I move: 

That this House:
(a) noting that:
(i) the Belgium Parliament has recently authorised the direct killing of children through euthanasia; 

(ii) euthanasia or assisted suicide is now routinely performed in Belgium and the Netherlands on persons with no terminal illness but with psychiatric disorders such as anorexia or depression or with disabilities such as blindness; and 

(iii) Dr Philip Nitschke during a recent visit to Perth offered instruction in methods of suicide including how to illegally obtain pentobarbitone, a schedule 8 poison, and how to use nitrogen as an undetectable means of ending life;  

(b) condemns the practice of child euthanasia;
(c) commends palliative care as an appropriate response to terminal and chronic illness;
(d) affirms the value of every human life including those with mental illness or disability; and
(e) endorses suicide prevention as the appropriate response to all those who for whatever reason may think life is not worth living. 

Hon Nick Goiran:
When I last spoke on the issue of euthanasia and assisted suicide in my contribution to the budget debate on 17 October last year, there was so much compelling evidence from Oregon on the dangers involved, there was insufficient time for me to address the situation elsewhere around the globe. On that day, the Tasmanian House of Assembly rejected the Voluntary Assisted Dying Bill 2013, dismissing the claim by proponents that legalised euthanasia was working well in Oregon, the Netherlands and Belgium as unfounded. 

Sadly, since then Belgium has legalised the killing of children by euthanasia, and Dr Philip Nitschke has brought his travelling circus to Perth, touting his latest deadly toy—the nitrogen cylinder.

Tom Mortier's mother

I turn to the issue of Belgium, where deaths by euthanasia have increased sixfold since it was legalised in 2003, from 235, to 1432 in 2012. In Flanders in 2007, nearly one-third of deaths by euthanasia were brought about without any explicit request from the patient. Although the law only authorises doctors to perform euthanasia, nurses administered the legal drugs in 12 per cent of cases involving an explicit request, and in 45 per cent of cases without an explicit request. Belgium allows organ donation after euthanasia, including from people with psychiatric disorders, such as a woman suffering from auto-mutilation, which is cutting to cause self-harm. Her consent was accepted as valid, despite her mental illness. Tom Mortier, whose mother was euthanased in April 2012 for chronic depression, wrote in an article on 4 February last year that: 

I was not involved in the decision-making process and the doctor who gave her the injection never contacted me. ...  

How is it possible that people can be euthanased in Belgium without close family or friends being contacted? Why does my country give medical doctors the exclusive power to decide over life and death? How do we judge what "unbearable suffering" is? ... Can we rely on such a judgment for a mentally ill person?  

After all, can a mentally ill person make a "free choice"? ... How can a medical doctor be "absolutely certain" that his/her patient doesn't want to live anymore?

In December 2012, deaf identical twin brothers were euthanased for distress at learning they were going blind. Dr Marc Maurer, president of the US National Federation of the Blind said: 

"This disturbing news from Belgium is a stark example of the common, and in this case tragic, misunderstanding of disability and its consequences. Adjustment to any disability is difficult, and deaf–blind people face their own particular challenges, but from at least the time of Helen Keller it has been known that these challenges can be met, and the technology and services available today have vastly improved prospects for the deaf–blind and others with disabilities. That these men wanted to die is tragic; that the state sanctioned and aided their suicide is frightening." 

In late 2012, 44-year-old Ann G was euthanased for unbearable psychological suffering. She had been treated for anorexia since her teenage years by psychiatrist Walter Vandereycken. In 2008 she accused him of sexually abusing her under the guise of therapy. In October 2012, Vandereycken admitted to sexually abusing his patients. Following this, Ann G spoke of temporary relief from "the cancer in her head", but subsequently persisted in her request for euthanasia. Sadly, she will not be able to testify against her abuser if charges are laid. 

In September 2013, Nathan Verhelst was euthanased for unhappiness following a sex change operation. Nathan, who was born Nancy, had been rejected by a family who hated girls. Verhelst's mother was quoted in the United Kingdom's The Telegraph at the time as saying: 

"When I saw 'Nancy' for the first time, my dream was shattered. She was so ugly. I had a phantom birth. Her death does not bother me."

Dr Wim Distelmans, who euthanased Verhelst, is co-chairman of the Belgium Euthanasia Control and Evaluation Commission, which examines all reported cases of euthanasia but has never reported a single case to the police for investigation. Distelmans has commented on how the commission handled the case. He said: 

"... we didn't discuss about the case for one minute. It was just passed like that," ... "We already have a tradition of 10 years. Should Nathan's case have been 10 years ago, maybe we would have discussed some time about the case. Now, it's like [just] another one." 

When there is not a terminal illness or specific psychiatric disorder, the reason for euthanasia is given as polypathology, which simply means that the sum of ailments and limitations is held to be unbearable. Last month it became legal in Belgium for emancipated minors to request euthanasia on the same terms as adults, including on mental health grounds, and for other children with the capacity for discernment to request euthanasia for a hopeless medical situation likely to result in death. For unemancipated minors, one parent must consent. 

I turn now to the situation in the Netherlands. Euthanasia was legalised in the Netherlands in 2003. The number of deaths there has more than doubled from 1,815 in 2003, to 4,188 deaths in 2012. Euthanasia now accounts for nearly three per cent of all deaths in the Netherlands. Euthanasia is routinely carried out for dementia, depression and other mental health issues. In 2012, there were 42 notifications involving patients with dementia, and 14 involving patients with psychiatric problems. The Royal Dutch Medical Association states that as the elderly experience: 

... various other ailments and complications such as disorders affecting vision, hearing and mobility, falls, confinement to bed, fatigue, exhaustion and loss of fitness take hold, ... The patient perceives the suffering as interminable, his existence as meaningless and — though not directly in danger of dying from these complaints — neither wishes to experience them nor, insofar as his history and own values permit, to derive meaning from them. ...  

such cases are sufficiently linked to the medical domain to permit a physician to act within the confines of the Euthanasia Law. 

In 2013, a woman was killed by euthanasia because of her blindness. She was distressed at not being able to see whether her clothes were stained or to see new clothes when shopping. She refused a guide dog on the grounds that she wanted to walk a dog, not be led by one. 

Case 15 of the "Dutch Regional Euthanasia Review Committees: 2011 Annual Report" concluded that the attending physician failed to accurately diagnose a woman‘s back pain and prescribed only limited pain-relief medication. Consequently, it could not be said that the woman's pain was definitively unrelievable. This woman is now dead from euthanasia and can get no relief from this finding of error.

What has been the response to this around the globe? I will start with the Council of Europe, the Parliamentary Assembly of which, in response to the out-of-control situation in Belgium and the Netherlands, resolved 41 to 9 on 25 January 2012: 

Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited. 

In April 2013, The World Medical Association in April 2013 noted that: 

... the practice of active euthanasia with physician assistance, has been adopted into law in some countries. ... 

The World Medical Association reaffirms its strong belief that euthanasia is in conflict with basic ethical principles of medical practice, and The World Medical Association strongly encourages ... physicians to refrain from participating in euthanasia, even if national law allows it or decriminalizes it under certain conditions. 

I turn now to the situation with the Australian and New Zealand Society for Palliative Medicine, which endorsed the World Medical Association's position in October 2013. Its position statement on this issue reads, in part: 

The discipline of Palliative Medicine does not include the practice of euthanasia or assisted suicide; ...  

ANZSPM opposes the legalisation of both euthanasia and assisted suicide. 

The World Health Organization's definition of palliative care, which has been adopted by Palliative Care Australia and on page 8 of its 2008 "Glossary of Terms" specifies that palliative care: 

intends neither to hasten or postpone death; 

also states: 

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. 

Dr Graham Jacobs +
Ms Margaret Quick MLA +
Dr Anil Tandon +
Hon Nick Goiran MLC

I am pleased to say that, along with my co-convenor of the Parliamentary Friends of Palliative Care, Margaret Quirk, MLA, I will at 1.00 pm today in the Aboriginal People's Room, host a briefing for members provided by Dr Yvonne Luxton, CEO of Palliative Care Australia, speaking on "National and International Developments in Palliative Care: Implications for Western Australians, including Aboriginal people." Meanwhile, this coming Monday Dr Patsy Yates, president of Palliative Care Australia, will present the new position statement on paediatric palliative care which, in sharp contrast to the Belgian approach of offering to kill children who are terminally ill, states on page 3 that it: 

... aims to provide the best quality of life through an holistic approach which supports the physical, emotional, social and spiritual aspects of the child and their family. "The goal is to add life to the child‘s years, not simply years to the child‘s life."  

... Children and adolescents need to experience the best life possible regardless of their prognosis, and especially if their time is limited. 

I will now briefly turn to the issue of elder abuse and people at the other end of life. Just last week the Minister for Seniors and Volunteering, Hon Tony Simpson, MLA, announced funding for an elder abuse hotline to assist the 12 500 seniors who are exploited or abused in Western Australia each year, mainly by their own children, partners and family carers. Financial abuse is the most common form of elder abuse, but emotional, social, physical and sexual abuse can also occur. Elderly people would be put at further serious risk of abuse by a law permitting euthanasia or assisted suicide, which could allow others to subtly coerce them into agreeing to die to free up the inheritance or rid others of a burden of care. 

I conclude by asking: suicide promotion or suicide prevention? In a 2001 interview when asked who should be given help to kill themselves, Dr Philip Nitschke answered that someone needed to provide this knowledge, training or recourse necessary to anyone who wanted it, including the depressed, the elderly bereaved or the troubled teen. He said that if we are to remain consistent and we believe that the individual has the right to dispose of their life, we should not erect artificial barriers in the way of sub-groups who do not meet our criteria. 

During his visit to Perth on 24 February 2014, Nitschke gave Western Australians detailed instruction in methods of killing, including how to illegally obtain the schedule 8 poison pentobarbitone and how to use nitrogen as an undetectable means of bringing about death. I am mindful of the prolonged and tragic death of Western Australian mother Erin Berg who, while suffering from postnatal depression, followed Nitschke's detailed instruction manual and travelled to Mexico to purchase and self-administer that drug, dying 12 days later in a Mexican hospital. Nitschke dismisses the deaths of those with mental illness who follow his detailed suicide instructions as mere collateral damage. He said that while young people and those with mental illnesses could access Exit's instructions on the internet, the risks of this had to be weighed against the benefits for many others. He said that there will be some casualties, but that this had to be balanced with the growing pool of older people who feel immense wellbeing from having access to this information. 

This is a cult of suicide and death that I want no part of. In response to the challenges of suffering and despair there is always a better way than killing.

Belgian ICU Doctors Kill Patients

The following article written by Wesley Smith and published on his blog on April 9, 2014.

Wesley Smith

By Wesley Smith (link to the article)

The Journal of Critical Care Medicine has published a statement by the Belgian Society of Critical Care Medicine giving ICU docs the right to kill patients–even though euthanasia in the country is supposed to only be consensual.

Under the document, futile care impositions of withdrawing or withholding care are up to the medical team–whatever a patient or family may want. Moreover, in such cases, doctors are allowed to kill! From the statement (my emphasis) :

This statement paper, developed by members of the Belgian Society of Intensive Care Medicine Council, is not about giving analgesics or sedative agents to combat pain or agitation, nor about the so-called double effect, wherein analgesics given to alleviate pain may have the adverse effect of shortening the dying process. The discussion here is about the administration of sedative agents with the direct intention of shortening the process of terminal palliative care in patients with no prospect of a meaningful recovery…

Moreover, we explain our belief in the concept that shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable.

In other words, kill the patient by intentionally overdosing with palliative drugs beyond what is needed for comfort–whether the patient wants it or not!

And note, the patient need not be actually suffering!

Shortening the dying process with use of medication, such as analgesics/sedatives, may sometimes be appropriate, even in the absence of discomfort, and can actually improve the quality of dying; this approach can also help relatives accompany their loved one through the dying process—such a decision should be made with due consideration for the wishes of family members.

The killing license also applies to children:

The present document applies to children as well as to adults

It’s only logical: Once killing is accepted as an answer to human suffering, what constitutes “suffering” expands like an elastic band to include that of society and the hospital having to care for lives defined as meaningless. And it can even include termination when patient suffering isn’t present.

As for choice: What’s that got to do with anything? Efficiency!

Links to similar articles:
- There is no smear campaign against euthanasia law in Belgium - it is just that the truth hurts.
- Belgian twins euthanized out of fear of blindness.
- Depressed Belgian woman dies by euthanasia.
- Botched sex change operation victim euthanized in Belgium.

Well-funded out-of-state group is pushing assisted suicide in California

An out-of-state special interest group has once again moved into California seeking to push assisted suicide legislation. Despite failed legislative efforts this year in New Hampshire, Connecticut and Massachusetts, Compassion & Choices, formerly the Hemlock Society, began a roll-out of online advertisements aimed directly at Californians. This same group sponsored California legislation in 1999, 2005 and 2007 which were all defeated with bipartisan opposition. 

Assisted suicide has long been opposed by disability rights organization across California and nationally. 

"If calculating dollars and cents, it does not take an economist to realize the frightening prospect that assisted suicide is for people living with a disability or serious illness; we are the logical target," said Marilyn Golden, Senior Policy Analyst for the Disability Rights Education and Defense Fund. "Assisted suicide is not progressive, in fact it puts many vulnerable people at risk; and we have already seen examples of that where it is legal."

Catherine Campisi, former California Department of Rehabilitation Director, wrote to the California Assembly Committee last year,  "...Assisted suicide legalization is a direct threat to anyone viewed as a significant cost liability to public or private healthcare providers."

The pro-assisted suicide organization Compassion and Choices was known formerly as the Hemlock Society is based in Oregon. The organization's president, Barbara Coombs Lee is a former HMO executive. According to the Hartford Courant newspaper, Compassion and Choices recently spent $190,000 on advertising and lobbying efforts for a failed effort in the Connecticut General Assembly. The Connecticut General Assembly is comprised of a House of Representatives (97 Democrats and 53 Republicans) and Senate (22 Democrats and 14 Republicans). 

Since 2005, Californians Against Assisted Suicide is a diverse, broad-based coalition working against assisted suicide legalization in California. The coalition is comprised of organizations including those representing disability rights, independent living, healthcare, faith-based, social justice, civil rights and medical professionals. 

For more information on Californians Against Assisted Suicide, please visit our website at: www.NoAssistedSuicideCA.org

Swiss Assisted Suicide to Save the Planet.

Wesley Smith published the following commentary on his blog on April 6, 2014.

Wesley Smith

By Wesley Smith

Assisted suicide is not about terminal illness.

Assisted suicide is not about disability.

Assisted suicide is not about mental illness.

Assisted suicide is about suicide!

All pretense otherwise was stripped off the movement as the Daily Mail reports that a healthy elderly woman flew to Switzerland to be made dead because she couldn’t handle how high tech has impacted society and, apparently, to save the planet. From the story:

A retired art teacher has ended her life at the Dignitas clinic in Switzerland after becoming increasingly disillusioned with modern life. In an interview before her death, the 89-year-old environmentalist, from Sussex, said she felt technology had taken the humanity out of social interaction. 

Anne, who asked to be referred to only by her first name, also said she was worried about the damage being inflicted on the planet through overcrowding and pollution.

The Trouble with Euthanasia

Alex Schadenberg

By Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

The recent video promoting the legalization of euthanasia and assisted suicide, as shown on Vision TV, tells the story of people who want to die by euthanasia.

When considering these stories it appears that opposing “assisted death” is irrational, but this video was designed to promote the legalization of euthanasia and not to provide full information on all sides of the issue.

To legalize euthanasia requires a change in the law to allow one group of people, most likely doctors, the right, in law, to kill another group of people in society.

When the euthanasia law is abused, it means that someone has died, who didn’t request it, who may have been coerced into it, who was depressed or mentally ill, or one of many scenario’s that occur.

To state that euthanasia, in the few jurisdictions where it is legal, has not been abused is a lie and to suggest that euthanasia would not be abused in Canada is to suggest that we live in a utopia, which we do not.

Legalizing euthanasia or assisted suicide is not safe and the negative outcome is lethal.

Some real life stories.

A healthy woman, who was becoming blind, died by euthanasia in the Netherlands because she thought that it would be intolerable to live without knowing if her clothes were clean.

A depressed woman died by euthanasia in Belgium, even after her psychiatrist thought that treatment was possible.

There are many more stories and studies that prove how legalizing euthanasia will have tragic, lethal outcomes.

A few facts:

In Belgium, one study found that 32% of the assisted deaths were done without request.

Another Belgian study found that only 53% of the assisted deaths were reported and 73% of the reported assisted deaths fulfilled the requirements of the euthanasia law.

A Netherlands study found that 23% of all assisted deaths are not reported. Euthanasia in the Netherlands has been extended to psychiatric conditions. In 2013, euthanasia for psychiatric reasons occurred 45 times.

Recently a former leader of a euthanasia group in the Netherlands stated that the Netherlands euthanasia law has derailed.

A study from Switzerland found that in 16% of the assisted suicide deaths, the person who died had no physical illness.

The Euthanasia Prevention Coalition has found that when people learn more about euthanasia and its consequences, they become more opposed to it.

Society needs to improve how we care for people, rather than approving how to kill people.

Alex Schadenberg is the Executive Director of the Euthanasia Prevention Coalition.

Link to similar articles:

• There is no smear campaign against euthanasia law in Belgium - it is just that the truth hurts.
• Assisted suicide abuse is inevitable.
• Belgium extends euthanasia to children without first dealing with the abuse of the euthanasia law.

I Want to Live

Alex Schadenberg spoke in Iowa where he met, Paula Graham, the author of the poem.

I want to live.

I want to live.

I have places to go

And faces to know.

I have talents to give.

I want to live.

I want to feel April showers

And smell the sweet spring flowers.

I want to spend lazy hours watching fleecy clouds

Drift hither and yon in a summer sky.

I want to walk through autumn leaves,

Orange, gold and red.

And listen to their whispering voices

As they drift from overhead.

I want to catch the swirling snowflakes

Tossed by fierce winter winds.

And watch as the water freezes

In the rivers and the lakes.

I want to live out the seasons of my life.

Spring, summer, fall, winter,

But ah! It isn't to be

For you can't be bothered with me.

I want to live.

I want to live.

I have places to go

And faces to know.

I have talents to give.

I want to live.

Dad’s death brought home the truth about palliative care.

The following article was written by Susan Martinuk and published in the Calgary Herald on April 3. 

The Euthanasia Prevention Coalition (EPC) asks its supporters to contact their Member of Parliament to support Motion 456. Link to the Member of Parliament contact information.

Susan Martinuk

By Susan Martinuk

This past week, the House of Commons spent one hour debating a motion that calls for the federal government to work with the provinces to establish a national palliative care and end-of-life strategy.

An entire hour. That’s rather disappointing given the hours dedicated to silly, unconstructive debate over internal government matters such as hirings and firings.

It appears that much of the government comment during the debate was an attempt to disconnect itself from any obligations in developing such a strategy. Fair enough, perhaps, since the feds have already prepared an in-depth parliamentary report (2011) and a major Senate report (2005). There have also been progress reports, fact sheets and $43 million dedicated to palliative care research.

We don’t need more reports or strategies — we just need action.

Taking the federal government out of the equation leaves the provinces to devise palliative care strategies that best suit their individual health networks, facilities and geography. But it can also be problematic. With no federal incentives for change, the only way to force provincial governments to create palliative care strategies is for people to actively call for their development.

The people who have had to deal with a system that provides little assistance to families of the gravely ill have to speak out for all the families who will soon be in that situation.

I’ve just spent an extended period of time with my father, watching him waste away from cancer.

Last June, my siblings and I determined that he could no longer function on his own and I temporarily moved home to be with him. Based on his condition, we thought it would only be two or three weeks; a month at most. But once I was home, living with him in the empty house where my mom had recently passed away, his health and mental well-being improved. As a result, my two or three weeks became a nine-month journey that ended on Feb. 16.

During that time, we had no access to palliative care or a hospice. In the last weeks of his life, we dealt with a doctor who had recently come to Canada from England. He didn’t touch, examine or even look at my dad. Instead, he spent 10 minutes telling my sister and me about the fabulous palliative care facilities that exist in Britain and his shock at not having such care here. Perhaps he missed the irony that his comments about the lack of available care came as he forgot to look at, acknowledge or care for my father and his palliative condition.

I can’t even begin to discuss the doctor who thought that palliative care meant no care.

Palliative care Motion 456 debated in Canadian parliament

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Charlie Angus

Tuesday April 1, Charlie Angus MP (Timmins - James Bay NDP) had his first hour of debate on his private members motion (M 456) for a National Palliative and End-of-Life Care Strategy in Canada.

I was fortunate to witness the first hour of debate in Ottawa in the House of Commons. Link to the debate in parliament.

The Euthanasia Prevention Coalition (EPC) wants its supporters to contact their Member of Parliament to ask them to support M 456. Link to the Member of Parliament contact information.

Motion 456:

That, in the opinion of the House, the government should establish a Pan-Canadian Palliative and End-of-life Care Strategy by working with provinces and territories on a flexible, integrated model of palliative care that: (a) takes into account the geographic, regional, and cultural diversity of urban and rural Canada; (b) respects the cultural, spiritual and familial needs of Canada’s First Nation, Inuit and Métis people; and (c) has the goal of (i) ensuring all Canadians have access to high quality home-based and hospice palliative end-of-life care, (ii) providing more support for caregivers, (iii) improving the quality and consistency of home and hospice palliative end-of-life care in Canada, (iv) encouraging Canadians to discuss and plan for end-of-life care.

Angus, the sponsor of M 456 spoke first to the Motion. He first thanked the many groups and individuals who have supported M 456 from across Canada he stated:

I would like to thank the medical leaders, medical organizations, front-line service providers who are serving people in need, and the social workers, pharmacists, nurses and doctors, for the support that we received. I would also like to thank members of the various spiritual communities of Canada who have supported this motion.

Not to be Forgotten

Angus then acknowledged the work of the Parliamentary Committee on Palliative and Compassionate Care who published an all-party report on these issue. Angus stated:

I would also like to thank the incredible work of the all-party committee. The Parliament of Canada is known as a relatively toxic place at most times, but members of all parties came together on this vital issue and worked hard. I would like to recognize the members of the Conservative, Liberal, and New Democratic parties who worked on the study and wanted to bring forward to Parliament the need for us to establish this pan-Canadian strategy on palliative care. I believe that the motion I am bringing forward is carrying forward the work of this all-party committee.

Angus then explained how Motion 456 came together. He stated:

One of its key recommendations (Parliamentary Committee on Palliative and Compassionate Care) is that the committee strongly urged that the federal government re-establish a palliative care secretariat for the sake of developing and implementing a national palliative and end-of-life care strategy. In honour of the work that my colleagues in the other parties and New Democrats did on that committee, we are bringing forward that motion tonight.

Jim Derksen is Not Dead Yet.

This article was originally published on March 4 in the Spring 2014 edition of Geez Magazine.

By Jim Derksen - A founder of the Council of Canadians with Disabilities.

Jim Derksen

Could it be that it follows after 20th century sterilizations of people with disabilities in Europe and North America and the various versions of “good death” (mass killings) administered to hundreds of thousands of people with disabilities through the Nazi eugenics program? Or is it Canadian farmer Robert Latimer’s claim to have been acting compassionately when he killed his 12-year-old disabled daughter in 1993 that sticks in my memory?

At first sight, helping someone who because of disability cannot commit any legal deed, including suicide, seems generous and righteous. Yet, it is disability rights activists, many of whom are eligible for assisted suicide under current and proposed legislation, who most vehemently oppose its legalization.

Most people think the eligibility criteria for assisted suicide is terminal illness and constant pain that cannot be relieved, but these are very slippery and difficult concepts. The concept of pain as expanded under permissive assisted-suicide legislation in European countries such as Belgium and the Netherlands includes existential and emotional pain. Broad definitions of terminality and pain include disabilities that do not necessarily prevent people from living full lives.

Mortal life is a terminal illness. Our ability to predict the duration of anyone’s life is notoriously inaccurate. Many disabilities, but not all, result in shortened lifespans. Disabilities such as Lou Gehrig’s disease (ALS) and multiple sclerosis, which are usually understood to be terminal, can be relatively stable for decades. For more than 60 years I have relied on wheelchairs to get around. In the past 30 years I have learned to live with ever greater and greater disabilities, sometimes called “post-polio syndrome.” I count myself blessed and very fortunate in my life, lived fully.

Many of us with visible “significant” disabilities have heard non-disabled people imply or directly state that they would rather be dead than live with our disabilities. The first time we are usually surprised, but after repeated incidents and some reflection, we see the danger.

The “better dead than disabled” attitude is pervasive, and public opinion on the severity and kind of disability that would be unbearable is a moving target that puts people with disabilities at risk. Our real-life experience of devaluation is probably our greatest reason to fear the legalization of assisted suicide.

Naturally, this devaluation is demoralizing and depressing for many of us, especially in our most vulnerable moments. Some of us integrate this devaluation and come to feel that our lives are not worth living. After all, the value and joy of just being over doing is largely out of favour in our culture.

Almost everyone experiences depression, sooner or later. The current consensus is that depression is treatable and that treatment is preferable to suicide. Counselling programs are in place, in part, to prevent suicide. I fear that with legalized assisted suicide, the reality for those of us with disabilities will become even more dangerous than it is now. Imagine this: a devalued disabled person becomes depressed and requests suicide counselling. The help-line service provider becomes aware of the disability factor and instead of counselling refers the disabled person for legalized (medicalized) suicide.

I do not assume that those who seek criminal-code changes to legalize assisted suicide are openly and consciously declaring their antipathy to persons living with disabilities, but the “Death with Dignity” movement does threaten our well-being. It is a profound insult to people with disabilities to assert that a person’s dignity requires that they remain non-disabled. Some people’s self-concept is so narrow that they cannot imagine having dignity if ever they were to need assistance in eating, washing or toileting. Those of us who require such assistance as part of our daily lives would disagree.

Disability-rights activists say each person has the right to their own definition of dignity, and we assert our dignity as more fundamental and self-generated than the dignity of the “Death with Dignity” crowd. After all, we allow babies their dignity in spite of their inabilities. Historically, we have not denied dignity to elderly people at the end of life, despite their need for intimate care. Is it unreasonable to demand the same respect for persons living with disabilities in their middle years?

The organized disability rights movement struggles to prevent legalized assisted suicide and all other forms of death-making for persons with disabilities. The Council of Canadians with Disabilities and the Canadian Association for Community Living, together representing hundreds of thousands of individual Canadians, are united on this issue. We may sometimes appear to be absolutist in this position. In fact, it is our devaluation that commands and sustains our resistance. Most of us respond not by choosing death but rather by pressing for the recognition of disability as a good and valuable aspect of the natural diversity found in human life.

For my part, once we achieve this major cultural transformation, I will no longer oppose the legalization of assisted suicide for all who freely choose it.

Euthanasia: Hard cases make bad laws.

This article was originally published by MercatorNet on April 3, 2014.

Paul Russell

By Paul Russell - Executive Director of HOPE: preventing euthanasia & assisted suicide and Vice Chair of the Euthanasia Prevention Coalition International.

The pro-euthanasia lobby often promotes media reports of people facing difficult prognoses who wish to end their lives rather than face inevitable deterioration. Such persons often become, for a short while, celebrities for a macabre cause. The media attention can even become addictive and provide, a distraction from their suffering or a raison d’etre.

But are these stories really a substantive reason for changing the law? I would argue, no.

In a debate in Launceston, Tasmania, a few years back a delightful woman on the other side of the debate told the story of her husband who had motor neurone disease and took his own life rather than face the trajectory of deterioration. She described the understood trajectory of MND in some detail. I imagine that she was describing a worst-case scenario.

One could easily understand the anguish of what her late husband was facing: he was a fascinating person with great achievements. When I met his wife and son I got the sense that he would have been a wonderful person to have met. I imagine the audience that night must have felt the same.

Yet, at the close of the evening when the audience had a chance to speak, a woman rose from the back of the auditorium and said that her husband had recently passed away after suffering with MND. She told the audience that his death was, “nothing like that”, referring, clearly to the earlier description.

More recently I received an email from a gentleman questioning how I could hold my opposition to euthanasia and describing the recent loss of his own mother. He said that she had been bereft of consciousness for the better part of seven years and that her passing was not dignified.

My mother-in-law had been similarly lacking consciousness for much longer than that, as I relayed by return email. Yet Mum had a very dignified passing. My conclusion was simply that his unfortunate experience was not, therefore, an argument for euthanasia at all.

Readers will recall the celebrated pleas of Englishman Tony Nicklinson a few years back which were played out in the British Courts over his wish to die. Nicklinson had locked-in syndrome. Yet at the same time a young man with the same condition told the media that while his life had significant limitations, he had a good life. He wanted to let people know that not all locked-in syndrome sufferers were like Nicklinson.

One can easily understand what might have been the young man’s concerns. If people think that all locked-in sufferers are desperate to die, then perhaps he won’t get the kind of care he would need to live if there were ever a medical emergency. Perhaps he simply wanted people to know that he wasn’t down in the dumps about his accident.

His motivation for speaking out was unclear but nonetheless poignant and timely. I doubt that people like Nicklinson would have considered the effect that their public cause would have on others with the same condition. Their focus is essentially on themselves. Understandable given the circumstances; but nevertheless, not the complete picture.

It is not the illness or the prognosis that is the driver for euthanasia in any of these cases. It has more to do with the person themselves and how they decide to cope with their pending or existing situation. It really is about their choices.

A few months back, another MND sufferer, Paul Chamberlain, became a cause celebre for the assisted suicide campaign in the UK. He was interviewed repeatedly on British media including a joint interview with Dr Kevin Fitzpatrick from the Euthanasia Prevention Coalition – Europe. Once again we find the counter position put by other MND sufferers including former Springbok Rugby player, Joost van der Westhuizen.

“It's been a rollercoaster from day one and I know I'm on a deathbed from now on. I've had my highs and I have had my lows, but no more... It's only when you go through what I am going through that you understand that life is generous.”

Then there’s the story of Alistair Banks. Throughout his MND and up unto his death he wrote inspiring messages of hope. He said:

“Everyone I know with MND is trying to do positive things, otherwise they would sink into despair. It's a coping mechanism. Doing things means that you can pull in friends and family to share something both fun and rewarding.”

I have no doubt that some people die better than others, just as people deal with the dying and death of a loved one in many different ways. But these are not arguments for euthanasia. Rather, they suggest that we need to continue to learn better ways of caring and to make sure that quality care is universally available.

Autonomy is a good thing, but should we burden society with a euthanasia or assisted suicide law because some people – probably only a handful in any disease cohort – wish to choose another path? We may have decriminalised suicide, but we should never endorse it. All of humanity is diminished by a law that tells us that some people’s lives are less worthy of life than others. No man is an island.

The heart-wrenching stories of a few are compelling. But as arguments they are false.