World Medical Association: Physicians must not be complicit with Capital Punishment.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The current Journal of the World Medical Association (WMJ) (p 14 - 16) published an insightful article by Rania Mansour re-affirming the World Medical Association (WMA) position that Physicians must not be complicit with Capital Punishment. The article was written in response to the complicity of Iranian physicians with Capital Punishment.

The article explains the long-held WMA opposition to physicians complicity with capital punishment goes back to the Nuremberg revelations: The article states:

Following the violations of medical ethics committed by physicians during the Nazi regime and immediately after the Nuremberg revelations, the World Medical Association adopted two documents that embodied the Hippocratic Oath and asserted the prohibition of physician complicity in antihumanitarian acts.

The Declaration of Geneva affirms the medical professional’s pledge “to dedicate their lives to the service of humanity” and “to not use medical knowledge to violate human rights and civil liberties, even under threat”. The International Code of Medical Ethics sustains the physician’s duty to provide “competent medical service in full professional and moral independence, with compassion and respect for human dignity”.

The article explains that physicians are expected to uphold medical ethics, even when the law contravenes medical ethics. The article states:

These documents not only make it explicit that medicine is a therapeutic and compassionate field but also that the medical professional has a duty to uphold medical ethics in the face of contravening laws or regulations. This idea is portrayed clearly in the WMA Council Resolution in the Relation of Law and Ethics. 3 It follows then that physician involvement in the administration of capital punishment is ethically proscribed because it violates the ethical principles of the profession.

The Canadian and Dutch Medical Associations are lobbying the WMA to change their positions on euthanasia and assisted suicide because, what is true about the ethics of Capital Punishment must alos be true for the ethics of euthanasia and assisted suicide.

It's important to state that the WMA Declaration on Euthanasia and WMA Statement on Physician Assisted Suicide are: 

‘Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical’. 

‘Physician assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically’.

Since euthanasia and assisted suicide are unethical and condemned by the WMA therefore physicians must not be complicit by participating in killing their patients by euthanasia or assisting their patients suicide deaths.

To protect their patients and their profession the medical professional has a duty to uphold medical ethics in the face of contravening laws or regulations and not be complicit with acts of euthanasia and assisted suicide.

Australian man, convicted of assisting his wife's suicide for $1.4 million.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

Jennifer Morant

An Australian man who was accused of having $1.4 million reasons to assist his wife's suicide was found guilty. Graham Morant was convicted of the crime in order to collect his wife's life insurance. According to 9News.com report:

Morant, 69, was today convicted by a Brisbane Supreme Court jury of aiding and counselling Jennifer Morant to kill herself on the Gold Coast in 2014.

Morant was the sole beneficiary of her three life insurance policies totalling $1.4 million when she took her own life in November that year.

The evidence confirmed that Jennifer Morant had back pain, but Graham Morant persuaded her, over several months, to die by suicide. According to the report:

Morant claimed to police his wife wanted to die, but two witnesses close to her testified she did not want to kill herself and was scared by his pressure on her to do so.

The Judge will sentence Graham Morant on October 19.

More articles concerning the Morant court case:

• Australian man had $1.4 Million reasons to assist the suicide of his wife.
• Australian man denies assisting his wife's suicide for $1.4 Million dollars.
• Australian man charged with assisting his wife's suicide. Her friend said she didn't want to die.
• Australian man accused of assisting his wife's suicide for her Life Insurance says she wanted to die.

WMJ - Euthanasia in Canada: a Cautionary Tale

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On the eve of the World Medical Association (WMA) conference in Iceland, where the Canadian and Dutch Medical Associations are pressuring the WMA to change its opposition to euthanasia and assisted suicide, the Journal of the World Medical Association (WMJ)  published an article titled: Euthanasia in Canada: a Cautionary Tale (pages 17 - 23).

Link to the Spanish and French translations of the article.

This in-depth article was written by seven leading Canadian physicians and endorsed by another 57 Canadian physicians including Dr Balfour Mount, the father of palliative care in Canada.

It's important to state that the current WMA Declaration on Euthanasia states:

‘Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical’.

The current WMA Statement on Physician Assisted Suicide declares:

‘Physician assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically’.

The article begins with the physicians stating that they are considering leaving Canada or withdrawing from Medicine based on their concern with practice of euthanasia and issues related to their personal integrity and professional conscience. They state:

All of us are deeply worried about the future of medicine in Canada. We believe this transformation will not only be detrimental to patient safety, but also damaging to that all-important perception by the public – and by physicians themselves – that we are truly a profession dedicated to healing alone. Thus, we are alarmed by attempts to convince the World Medical Association (WMA) to change its policies against physician participation in euthanasia and assisted suicide.

After explaining how the euthanasia laws works in Canada they outline how the law is already expanding. They wrote:

Within a year of the ruling, the pressure for “Carter Plus” had become so great that the federal government legally committed itself to consider allowing euthanasia and assisted suicide for adolescents and children, for indications caused by mental illness alone, and by advance directive (for those who lack capacity, like patients with dementia). In ... Canada we have observed that even the prospect of legalization whets the appetite for it, and the appetite is not satisfied by legalization alone.

The writers explain that the Vulnerable Persons Standard was developed to establish effective oversight of the law, but the "safeguards" are now beingconsidered a barrier to access rather than a protection for people at a vulnerable time of their life. They wrote:

Even supplemented by provincial and professional guidelines, current criteria are so broad as to have permitted lethal injection of an elderly couple who preferred to die together by euthanasia rather than at different times by natural causes.

The article then explains why physicians are being pressured to collaborate in killing by euthanasia. They wrote:

EAS practitioners also claimed that there was “a crisis” because so few physicians were willing to provide euthanasia or assisted suicide. Their alarm seems to have been triggered by a 46.8% increase in EAS deaths in the second half of the first year of legalization.

They then explain how their conscience rights are being trampled upon:

It is true that nothing in the Criminal Code requires physicians to personally kill patients or help them commit suicide. However, nothing in the Criminal Code prevents compulsion by other laws or policies. Thus, for example, Canada’s largest medical regulator demands that physicians who are unwilling to personally provide euthanasia or assisted suicide must collaborate in homicide and suicide by referring patients to colleagues who are willing to do so. 

We categorically refuse. Such collaboration would make us morally responsible for killing our patients; if not for the Carter decision, it would make us criminally responsible and liable to conviction for murder, just as it still does in most parts of the world. For refusing to collaborate in killing our patients, many of us now risk discipline and expulsion from the medical profession.

The pressure to force physicians to participate in killing is based on two principles. Access to euthanasia is viewed as an entitlement and access to euthanasia is being re-defined, as a "human right"

Part of the explanation is that Canada’s state-run health insurance system pays for “medically necessary hospital and physician services” from public funds. ... many Canadians now believe we are state employees, and we face an entrenched attitude of entitlement. Since taxpayers pay for “medically necessary” health services, many people think it is unacceptable for physicians to refuse to provide those. 

Quebec law allows hospices to opt out of providing euthanasia, but when Quebec hospices opted out, the Minister of Health denounced them for “administrative fundamentalism,” declaring their refusal “incomprehensible.” Notwithstanding the law, a prominent Quebec lawyer urged that their public subsidies be withdrawn, accused them of compromising the right of access to care, and warned that allowing refusal was a slippery slope. A similar situation is also being faced by the hospices in other provinces such as British Columbia.

Quebec physicians and health care practitioners now work in environments characterized by an emphasis on a purported ‘right’ to euthanasia. The notion that access to euthanasia and assisted suicide is a fundamental human right has spread across Canada since the Supreme Court of Canada ruling in Carter. We are accused of violating human rights – even called bigots – because we refuse to kill or collaborate in killing our patients.

Pressures have led to providing euthanasia as being a professional and "ethical" obligation. They wrote:

By redefining euthanasia and assisted suicide as therapeutic medical services, the (Canadian Medical Association) CMA made physician participation normative for the medical profession; refusing to provide them in the circumstances set out by law became an exception requiring justification or excuse. That is why public discourse in Canada has since centred largely on whether or under what circumstances physicians and institutions should be allowed to refuse to provide or collaborate in homicide and suicide: hence the “long debate” about conscientious objection at the CMA’s 2015 annual meeting.

The CMA does uphold conscience rights, even though the Ontario Medical Association does not, but medical students require support when they are told not to apply to medical school if they oppose euthanasia. They wrote:

To be fair, our pleading has not been in vain. The CMA does support physicians who refuse to provide or refer for euthanasia and assisted suicide, asserts that the state should develop mechanisms to allow patients direct access to the services without violating physicians’ moral commitments, and rejects discrimination against objecting practitioners. But this advice can be ignored and, when it is, Hippocratic practitioners face the state in court and foot the bill for expensive constitutional challenges. Further, public calls from influential voices have been heard for those medical students who are personally opposed to the euthanasia imperative, to either abandon, or refrain from applying for, medical training.

Why has euthanasia grown so quickly in Canada?

In Canada, however, access to euthanasia and assisted suicide is seen as a tax-paid entitlement, is described as a “constitutionally protected civil and human right,” and homicide and suicide are legally and professionally defined to be therapeutic medical services. Moreover, a physician’s conviction that there are other reasonable and efficacious alternatives is irrelevant; patients can insist upon lethal injection. Finally, the criterion of intolerable suffering is entirely subjective, established unilaterally by the patient.  

Small wonder, then, that the onus seems increasingly to lie on physicians to show why euthanasia should be refused, and that health care administrators may be more anxious about being accused of “obstructing access” than about “killing people who really ought not to be killed.”

Even the Secretary of the Québec Medical Association (CMQ) was concerned when he stated:

“If anything has become apparent over the past year, it is this paradoxical discourse that calls for safeguards to avoid abuse,” he wrote, “while asking the doctor to act as if there were none. … [W]e sees the emergence of pressure demanding a form of death à la carte,” he warned.

The writers then expressed their concern that the number of palliative care physicians has dropped after euthanasia was legalized:

We are disturbed that the number of Quebec practitioners entering palliative care dropped after legalization of euthanasia, and the CMQ and the Quebec Society for Palliative Care are concerned that patients are choosing euthanasia because adequate palliative care is unavailable.

They then shared three stories of patients who were pressured to die by euthanasia.

We are disturbed and grieved by the story of a 25-year-old disabled woman in acute crisis in an Emergency ward, pressured to consider assisted suicide by an attending physician, who called her mother “selfish” for protecting her. 

We are disturbed and angered to hear that hospital authorities denied a chronically ill, severely disabled patient the care he needed, suggesting euthanasia or assisted suicide instead. 

And we were astonished to hear that some emergency physicians in Quebec were, for a time, letting suicide victims die even though they could have saved their lives. The incidents came to light at about the time the Quebec euthanasia law came into force, and the president of the Association of Quebec Emergency Physicians speculated that the law and accompanying publicity may have ‘confused’ the physicians about their role.

Euthanasia is transforming the medical culture in Canada. They wrote:

However, when emergency physicians refuse to resuscitate patients who attempt suicide and urge disabled patients in crisis to request euthanasia, such “changes in the medical culture” are not, in our view, consistent with ensuring patient safety, nor with maintaining the trust essential to preserving the Hippocratic physician-patient relationship. 

And when physicians are told to write ‘natural death’ instead of ‘euthanasia’ on the death certificates – and, by extension, to misrepresent facts – “changes in the medical culture” may make physicians comfortable, but we do not believe that they will sustain trust in the medical profession. Even newly released federal guidelines for monitoring euthanasia lack any emphasis on prevention of EAS, in favour of merely regulating these practices. 

Finally, when a Jewish nursing home forbids euthanasia and assisted suicide on its premises out of respect for Jewish beliefs and concern for its residents (who include Holocaust survivors), “changes in the medical culture” may encourage applause for the EAS practitioner who crept in at night to lethally inject someone, but we do not applaud; we are aghast.

They concluded the article by stating:

As Canadians, we are saddened by this situation, but we hope that our experience and observations will serve as a warning for our colleagues in other countries, and their patients. Most important: The World Medical Association must recognize that accommodating the kind of radical change in medical culture underway in Canada is ill-advised. Mindful of the legacy of past WMA leaders, such as former Secretary General, Dr. Andre Wynen, who, based on his personal experience, stood courageously against any minimization of the dangers of euthanasia to patients and physicians, we advise against any compromising additions or modifications to existing WMA declarations, and strongly support a full defence of established policy against euthanasia and assisted suicide.

Links to other articles concerning the World Medical Association euthanasia debate:

• A letter from a leading psychiatrist to the World Medical Association opposing euthanasia and assisted suicide.
• Canadian and Dutch Medical Associations pressure the World Medical Association to change its policy on euthanasia.

New Jersey Law Journal endorses Canadian-style Euthanasia law, saying Assisted Suicide is not enough.

This article was published by EPC - USA on October 2, 2018.

Nancy Elliott

By Nancy Elliott

Chair – Euthanasia Prevention Coalition USA

The New Jersey legislature may be voting in October on whether to legalize assisted suicide. While this would be a sweeping change to the medical landscape, there are others who want this law to have even more power to end people’s lives. 

The New Jersey Law Journal’s Editorial Board on September 3, 2018 wrote they do not think bill #A-1504 and S-1072 go far enough. The assisted suicide bill has not even passed yet and these lawyers want it to include more. What they are looking for is the bill to include euthanasia. That is pretty scary stuff, to think that a doctor or nurse could lethally inject their patient. 

Euthanasia has not worked out that well in the Netherlands where they had a case of a doctor who had the family hold down a struggling woman who did not want to be Euthanized, while the doctor injected her with the lethal dose. (Link).

Not only do these lawyers want euthanasia, they want people who are not fatal to be included in the definition of who can be euthanized. They mention people who may have as long as 20 years to live. They also say people with “no quality of life” should be candidates for euthanasia. My question is who will be making these decisions? People with disabilities, who fear these laws, will be pushed toward euthanasia just like in Canada, where they do not want to give a disabled man the help he needs, but have suggested euthanasia for him. (Link).

One thing I thought strange was that lawyers were asking for this expansion. What is their motivation? It brings me back to when lawyers were asking someone close to me to sign an Advance Directive to limit care saying, “Do you want your estate eaten up?” This is the way many lawyers think. It is about the money, but that is not the way to have the best medical care. Where assisted suicide or euthanasia become law, rationing follows. If euthanasia is the “cure” for a certain ailment, then everyone with that ailment should have euthanasia.

I hate the term “slippery slope” but that is what happens with this kind of law, it is constantly expanding. In the Netherlands and Belgium they now euthanize children. They also euthanize otherwise healthy depressed patients. Once we go down that road it is ever expanding. One may say, who am I to tell someone they can’t commit suicide? Saying no will stop doctors and nurses from killing their patients and keeps the government out of saying who is worthy to die and who is not.

The World Medical Association should not follow the lead of the Canadian Medical Association concerning euthanasia

This article was published by Mercatornet with the title: Who will protect Canadian doctors if they are forced to refer for euthanasia, on September 29, 2018

By Sean Murphy, the administrator of the Protection of Conscience Project.

In December, 2013, the Canadian Medical Association (CMA) Board of Directors decided to shape the debate and law concerning euthanasia and assisted suicide and revisit CMA policy opposing physician participation in the procedures. By the summer of 2014 it was clear that the overwhelming majority of physicians supported the existing policy. However, it appears that the Board decided the policy should be changed before the Supreme Court of Canada decided the case of Carter v. Canada.

The Board sponsored an ostensibly neutral resolution affirming support for the right of physicians to follow their conscience in deciding whether or not to provide euthanasia/assisted suicide if the law changed. The resolution was overwhelmingly approved. Unnoticed at the time was that the resolution was not conditional upon eligibility criteria, such as decision-making capacity or terminal illness.

The CMA intervention at the Supreme Court of Canada in the Carter case emphasized that existing CMA policy against euthanasia and assisted suicide would be changed to reflect the resolution. It conveyed the message that the Association would support physicians who decided to participate in euthanasia or assisted suicide no matter how broadly the Court or legislatures might cast the rules governing the procedures.

The Board reversed CMA policy about two months before the Court ruled. It formally approved physician assisted suicide and euthanasia, subject only to legal constraints. The policy did not exclude minors, the incompetent or the mentally ill, nor did it limit euthanasia and assisted suicide to the terminally ill or those with uncontrollable pain. It classified both as "end of life care," promising support for patient access to the procedures should they be legalized. Support for physicians refusing to participate in euthanasia or assisted suicide was qualified by the statement that there should be no "undue delay" in providing them. Implicit in all of this was a new ethical paradigm: that in some circumstances, physicians have a professional obligation to kill patients or to help them kill themselves.

The new policy effectively wrote a blank cheque for the Supreme Court of Canada to legalize euthanasia and physician assisted suicide on any terms acceptable to the judges. After the Court struck down the law CMA officials expressed concern about the criteria set by the Court. It was implied that the Supreme Court was to blame for anxiety and profound discomfort among Canadian physicians because it had imposed upon them an obligation to kill, contrary to centuries of medical ethics and practice.

However, the concerns voiced by CMA officials after the Carter ruling existed when the CMA intervened in the case, and the CMA did not raise them then. In fact, the Supreme Court gave legal effect to a policy the CMA had already adopted, and the criteria the Court set for the procedures were actually more restrictive than anything the CMA had proposed. The Court cannot be blamed because CMA leaders were ill-prepared to deal with the consequences of a ruling entirely consistent with their own policy.

The consequences fell most heavily upon physicians who refused, for reasons of conscience, to provide euthanasia and assisted suicide or to collaborate in providing the services by referral or other means. Since Carter, the debate in Canada has been largely about whether or under what circumstances physicians and institutions should be allowed to refuse to provide or facilitate the services. While it is generally agreed that physicians should not be compelled to personally provide them, there are strident demands that physicians unwilling to kill their patients or help them commit suicide should be forced to refer patients to someone who will.

This review demonstrates that the CMA Board of Directors focus in 2014 was on the role physicians would play in providing euthanasia and assisted suicide should the law change. The Board knew that the overwhelming majority of Canadian physicians would refuse to participate in euthanasia or assisted suicide. The fundamental conflict presented by imposing an obligation to kill upon unwilling physicians was foreseeable and had been foreseen by CMA officials. Attacks upon physician freedom of conscience, particularly with respect to referral, were predictable.

However, the Board failed to consider physician freedom of conscience in relation to assisted suicide and euthanasia except the extent that it could be used to further its policy goals. As a result, after the Carter ruling, CMA officials were quite unprepared to mount a cogent, articulate and persuasive defence of physician freedom of conscience, especially in relation to referral. They discovered that state authorities and the public were often unreceptive and even hostile to physicians unwilling to arrange for patients to be killed by someone else. Negotiating at a significant disadvantage of their own making, they were desperate to find a policy "acceptable to the regulators" and to objecting physicians whose fundamental freedoms they had rashly jeopardized.

The CMA has since produced a strong defence of physician freedom of conscience in relation to referral for euthanasia and assisted suicide, and sound protection of conscience provisions have been incorporated into a revised CMA policy on the procedures. However, by the time these statements appeared, objecting physicians were on the defensive in a treacherous and even hostile environment, compelled to launch an expensive constitutional challenge to defend fundamental freedoms of conscience and religion. The outcome of that case will determine if they will be able to continue to practise medicine if they refuse to collaborate in killing their patients.

The World Medical Association (WMA) national medical associations are free to decide to change their policies on physician participation in euthanasia or assisted suicide. This review demonstrates that they should not follow the example of the Canadian Medical Association if they wish to safeguard the fundamental freedoms of physicians and health care workers.

Child Euthanasia without Parent Approval Pushed for Canada

This article was published by National Review online on October 2, 2018.

Wesley Smith

By Wesley Smith

I always say that if you want to know what is likely to go wrong in healthcare (and society) in the coming years, you should read ethics articles in professional journals.

Case in point: With lethal-injection euthanasia now legal in Canada for patients age 18 and over whose deaths are “foreseeable” (a vague limitation sure to be erased eventually), eager bioethicists describe a proposed protocol to govern child euthanasia once legal authority expands to include minors (as it has in the Netherlands and Belgium). From “Medically Assisted Dying in a Paediatric Hospital,” published in the Oxford-based Journal of Medical Ethics:

In all other regards [than who initiates the euthanasia discussion], our working group has, at present, elected to conceptualise MAID as practically and ethically equivalent to other medical practices that result in the end of life. This theorisation of MAID is justified on the grounds that these practices share a common purpose of alleviating unendurable suffering and facilitate the patient dying on their own terms…and is reflective of our concern that the conceptualisation of MAID should not place additional burdens on the patient or function to limit the rights and freedoms to which patients are typically entitled.

Remember, the issue here is whether doctors should be allowed to kill children.

Valentina Maureira asked for euthanasia
in 2015. She later changed her mind.

One would think that — at a bare minimum — such homicides should require parental permission. But no. If the child is considered mature enough to make decisions, parents can be kept out of the death discussions. Indeed, the authors envision scenarios in which parents aren’t even notified by doctors that they are going to kill their child!

If, however, a capable [legally underage] patient explicitly indicates that they do not want their family members involved in their decision-making, although healthcare providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected. If we regard MAID as practically and ethically equivalent to other medical decisions that result in the end of life, then confidentiality regarding MAID should be managed in this same way.

Can you imagine visiting your sick child, only to learn that hospital doctors killed her because she asked to die and wanted you kept in the dark? The rage and agony would be unimaginable.

And of course, we must do away with any stigma by turning child euthanasia into just another ho-hum medical procedure:

In order to protect staff members from potential violence and social harassment, we will not make public the names of the healthcare providers at The Hospital for Sick Children who have volunteered to provide MAID, nor will we disclose a full list of persons who comprised our working group. 

We will, however, as an institution, publicly discuss the provision of MAID in an effort to normalise this procedure and reduce social stigma for everyone involved. It is right and appropriate for this duty to fall to a well-resourced institution rather than rest on the shoulders of individual patients and providers.

The article is long, complete with flow charts for euthanasia protocols. But the gist is that the ground is being prepared to change the law to allow Canadian doctors to kill minors — and apparently doctors have already volunteered to do the killing.

Horrific. Immoral. And written in such dispassionate and sterile prose that reading the article chills the blood.

Is Canada expanding euthanasia?

The following article was published by OneNewsNow on October 1, 2018.

America's neighbors to the north are waiting for news from a panel of experts that is considering ways to develop euthanasia beyond current practices.

Alex Schadenberg

Shortly after the Canadian Supreme Court forced doctor-assisted suicide on the nation by judicial fiat, the government asked the Council of Canadian Academies to generate a report on the euthanasia of children, the mentally ill, and people who have lost the capacity to request it themselves.

Alex Schadenberg of the Euthanasia Prevention Coalition (EPC) tells OneNewsNow the report will not be released until December, but he already has his concerns.

"My concern is that it appears that there's some sort of decisions already being made," he says. "We're seeing in the journal articles -- different ethics journals or in the case of the pediatric journals -- this heated discussion about how they're going to now do the euthanasia of children and things like that."

He points out that the latter is technically illegal, but based off what the EPC is learning, it appears decisions have already been made on the matter; the discussion now is just how to do it.

Schadenberg is further concerned this means assisted suicide will be expanded in Canada.

"Obviously speaking, I don't know," he admits. "I haven't seen the report, but it certainly is my concern that the direction of things is the expansion of euthanasia."

Meanwhile, however, distinguished American psychiatrists have printed articles making a very strong case against euthanizing mental patients, and a top psychiatrist in the Netherlands is raising legitimate questions about the practice.

• Laying the groundwork for child euthanasia in Canada. 
• Dr Mark Komrad: Submission to New Zealand government committee.

Canadian Physicians Who Won’t Kill

For immediate release:

Canadian Physicians Won’t Kill

The Physicians’ Alliance against Euthanasia, representing more than 1100 Canadian doctors, is holding a press conference to present its position and answer questions:

Tuesday October 2, 2018, 10:30 A.M.

HEKLA Meeting Room
CentreHotel Plaza 
Aðalstræti 4 – 101 Reykjavík

As World Medical Association (WMA) delegates gather in Reykjavik, Iceland, for its Medical Ethics Conference and Annual General Assembly, Canadian doctors are speaking out against a so-called neutral ethical stance on euthanasia. Canadian physicians say neutrality on euthanasia is a license to kill.

The Canadian Medical Association (CMA) and the Royal Dutch Medical Association (RDMA) are presenting a motion asking the WMA to take a neutral stance on the ethics of euthanasia and assisted suicide. The WMA has long rejected these acts as unethical. Only 6 of 200 countries (3%) worldwide permit doctors to intentionally cause death, and the vast majority of national medical associations oppose it.

* Canadian and Dutch Medical Associations pressure World Medical Association to change their policy opposing euthanasia (Link).

As Canadian physicians, we affirm that the CMA position does not reflect our views and experience, and that a neutral stance is illogical and untenable.

The CMA abandonment of its long-standing policy against euthanasia and assisted suicide, and adoption of a neutral position, influenced Canada’s 2015 Supreme Court ruling leading to 2016 legislation permitting euthanasia and assisted suicide.

Since then, there is constant pressure to normalize and expand these practices and to abandon the safeguards instituted to protect vulnerable people. The government is looking into expanding euthanasia and assisted suicide to children and to people with mental illness and cognitive disorders. Doctors and hospitals are under pressure to provide euthanasia or to refer for it, even when it violates their fundamental principles.

Dr. Paul Saba, a Montreal family physician states: “People need assistance in living and not for suicide.”

Dr. Catherine Ferrier, President of the Physicians’ Alliance against Euthanasia, warns the WMA against a neutral stance on euthanasia and assisted suicide noting that “neutrality” at the CMA led immediately to the promotion of euthanasia and assisted suicide in national and international forums.

******************************

The Physicians’ Alliance against Euthanasia seeks to ensure quality medical care and respectful decision-making for vulnerable patients, especially those at risk of pressure to end their lives prematurely through euthanasia or assisted suicide, and to protect the professional integrity of all health care workers. www.collectifmedecins.org/en

For further information in Canada:
438-938-9410 info@collectifmedecins.org

In Iceland:
Dr. Sheila Harding: +1 (306) 229-5379 and Dr. Paul Saba: +1 (514) 886-3447

An Open Letter to Representative of the World Medical Association opposing euthanasia and assisted suicide from a leading psychiatrist..

This letter was published by the Psychiatric Times on October 3, 2018.

Dr Mark Komrad

Dr Mark Komrad

I am writing to WMA representatives who may be going to Reykjavik this week. I would like to communicate my concern about the current effort of the Royal Dutch Psychiatric Association to try and influence the WMA to “go neutral” on the issue of medical euthanasia and physician assisted suicide. This is an effort by elements in the WMA that have been normalizing a remarkably slippery slope for over 16 years. It is an attempt to export to the world medical community a uniquely extreme and problematic distortion in the history of medical ethics. The living laboratory of the Netherlands and Belgium demonstrates that a “slippery slope” is not just a theoretical concern. It is a profoundly disturbing reality that has developed after these countries allowed the killing of certain patients on request to be a “treatment plan” in the House of Medicine in 2002. In that year, these countries removed any distinction between terminal/nonterminal conditions and physical/mental suffering, in the criteria for medical euthanasia. That development opened euthanasia to people with psychiatric disorders. Now, well over 100 psychiatric patients are euthanized on request each year in Benelux, supported by the same treating psychiatrists who had previously been trying to prevent their suicides.

* Canadian and Dutch Medical Associations pressure World Medical Association to change their policy opposing euthanasia (Link).

As a clinical psychiatrist and medical ethicist of 35 years I have been quite active, both nationally and internationally, lecturing and speaking against physician-assisted suicide and euthanasia. I have been especially concerned about and arguing against the extension of these practices to include psychiatric patients in Belgium and the Netherlands. Along with a colleague, I crafted and shepherded through to approval the new Position Statement on Medical Euthanasia of the Non-Terminally Ill by the American Psychiatric Association (APA) and its strong ethical stance against psychiatrists participating in bringing death to non-terminally ill patients. [The APA remains, with the AMA, opposed to all physician assisted suicide and medical euthanasia, but we needed a special policy statement regarding the non-terminally ill, in light of what is happening with psychiatric patients in Benelux].

The WMA is keeper of the covenantial Community of Medicine. which has carefully evolved and “professed” a clear ethos since our Hippocratic origins. Our “profession” has a venerable history in its stance against euthanasia and related practices, which has been thoughtfully cultivated throughout the history of countries that have arisen and fallen, some of which now exist as part of the WMA. The WMA's current stance against euthanasia and assisted suicide is a strong protection against contemporary attempts to bend medical ethics to social demands—attempts we have seen before in the era of eugenics, forced sterilization, the Nazi T4 program, and the Holocaust—all which were done with the complicity of medical organizations and the participation of the leading physicians of their time. These examples remind us that medical ethics are indeed vulnerable. It is vital that the WMA preserve its current, principled, and enduring stance against physicians providing death to their patients, not merely getting out of the way of natural death while ministering to patients’ suffering. The words of Margaret Meade to a psychiatrist friend are worth remembering:

“The followers of Hippocrates were dedicated completely to life under all circumstances, regardless of rank, age, or intellect—the life of a slave, emperor, foreign man, defective child. . . This is a priceless legacy which we cannot afford to tarnish. But society has repeatedly attempted to make the physician into the killer… It is the duty of society to protect the physician from such requests.”

I hope that as representatives to the WMA you would consider that organization's ongoing mission to protect physicians from such requests. Please utilize your presence at the WMA to sustain this 2300-year-old Hippocratic ethos.

I am a psychiatrist on the faculty of Johns Hopkins and the University of Maryland, as well as the Ethicist-in-Residence for the Sheppard Pratt Health Systems in Maryland (the largest nonprofit provider of psychiatric care in the region). In my travels throughout North America and Europe to address this issue, I speak about the venerable history of medical ethics, and I particularly articulate the fundamental ethos of psychiatry— we prevent suicide, not provide it.

I urge you and other WMA representatives to spend a few minutes listening to the two-part podcast I did for Psychiatric Times on this issue:

Part I: Focus on Belgium and the Netherlands, which reviews what is happening in those countries which rapidly moved beyond euthanasia for the terminally ill to the non-terminal, and are now on the verge of removing any medical criterion— pushing for physicians to be able to voluntarily euthanize those who are “tired of life,” or feel they have “completed” life.

Part II: Focus on Canada, which also reviews attempts to thwart physician conscientious objection in Ontario.

I would welcome further correspondence on this matter.

Regards,

Mark S. Komrad M.D., DFAPA, DACP Faculty of Psychiatry, Johns Hopkins and University of Maryland Author of: "You Need Help: A Step-by-Step Plan to Convince a Loved One to Get Counseling."

www.komradmd.com

New Jersey may vote on assisted suicide bill in October.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The New Jersey legislature may vote on a bill to legalize assisted suicide in October. According to News 12 New Jersey, Assembly Bill 1504, which is sponsored by Assemblyman John Burzichelli is expected to be voted on in October. News 12 reported that Gov. Phil Murphy has expressed support for the assisted suicide bill.

The bill, that is called Aid in Dying for the Terminally Ill Act, gives doctors the right in law to prescribe lethal drugs. 

Patients who ask for assisted suicide are seeking support and care in response to fear of suffering, depression and loneliness. This bill allows doctors to abandon their patients to death by lethal drugs.

John Kelly, Not Dead Yet.

A Coalition of groups and individuals oppose assisted suicide. In his testimony opposing the New Jersey Assisted suicide bill, John Kelly, the New England Regional Director for Not Dead Yet, a national disability rights organization, told the hearing that the assisted suicide bill:

...threatens you and every single resident of New Jersey, because all of us are vulnerable to misdiagnosis. “Terminally ill” is defined as:

“Terminally ill” means that the patient is in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six months or less.”When it comes to life and death, there is no such thing as “reasonable medical certainty.” Of the millions of misdiagnoses every year, many are terminal misdiagnoses. We know this because of the thousands of people who “graduate” from hospice each year. Every year in Oregon, people have lived longer than their six-month terminal diagnosis.

Every year in New Jersey, it is estimated that 1/10 people over the age of 60 are abused, almost always by adult children and caregivers. Although “self administration” is touted as one of the key “safeguards”, in about half of Oregon program deaths, there is no evidence of consent or self-administration in the death. If the drugs were administered by others without consent, no one would know. The request form constitutes a virtual blanket of legal immunity covering all participants in the process.

Assisted suicide laws inevitably take the lives of innocent people through mistakes, coercion, and abuse. Please reject this bill.

Legalizing assisted suicide gives doctors the right in law to be directly involved with intentionally causing the death of their patients.

France ethics committee opposes euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

The French National Consultative Committee on ethics released its long awaited report today. The ethics committee opposed the legalization of euthanasia or assisted suicide and it opposed gestational surrogacy while it supported medically assisted procreation for all women.

According to a media report, the government of France didn't want euthanasia to be part of the ethics report, nonetheless, the ethics committee decided that the euthanasia laws should not be changed.

Previous articles:

• French ethics committee rejects the legalization of euthanasia (July 2013).