Canadian physicians warn Spanish Parliament about euthanasia

Media Release: October 23, 2018

As the Spanish Parliament debates the euthanasia and assisted suicide bill, Canadian physicians feel it is essential to bring to your attention the dangers and failures of the euthanasia and assisted suicide laws in Canada which have been in place since 2016. 

Link to this media release in Spanish (Link).

Since then, there has been constant pressure to normalize and expand these practices and to abandon the safeguards instituted to protect vulnerable people.

The Canadian government is now looking into extending euthanasia and assisted suicide to children, people with mental illness, and cognitive disorders.

Doctors and hospitals are under pressure to provide euthanasia or to refer cases to another clinician, even when it violates their fundamental principles to do so. 

(Euthanasia in Canada: A Cautionary Tale, World Medical Journal September 2018).

Dr Paul Saba

Dr. Paul Saba alleges that a patient’s consent to be euthanized cannot be free and informed if the patient does not have access to the proper health care including palliative care.

Dr. Saba’s argument is not theoretical given the report from the Quebec Commission on end of life care. It indicates that the euthanasia laws are not being respected. In Quebec, 52 cases not conforming to the law were performed in 2016-2017.

The lack of health services in the province and particularly palliative care, was denounced recently by the President of the College of Physicians which is the regulatory body for medical practice. The College reported some patients were seeking euthanasia because of the lack of palliative care.

Dr Saba states:

“The present Canadian laws are not safe. In the same way the proposed Spanish laws will have the same outcome. You cannot safely put into place euthanasia and assisted suicide without having a comprehensive palliative care system active and running. People need assistance in living and not assistance for suicide.”

Dr. Rene Leiva, a family physician contends that the present Canadian laws and proposed Spanish laws do not protect patients from ending their lives prematurely because of feelings of hopelessness, lack of future, feelings of being overwhelmed, being a burden and not having access to medical care which would treat their pain and suffering.

Dr Laurence Normand-Rivest

Dr. Laurence Normand-Rivest who is a palliative care physician reminds the world that Canada’s present legalization of euthanasia and assisted suicide and the proposed Spanish law are contrary to practices in the vast majority of countries around the world. These laws protect the lives of its citizens and particularly those facing disease, disabilities and conditions that could make them candidates for euthanasia and assisted suicide.

The World Medical Association, which comprises 114 countries worldwide, has consistently rejected euthanasia and describes this practice as unethical.

Presently only 6 countries of the world have laws legalizing either euthanasia or assisted suicide. This represents less than 2% of the world’s population.

Dr. Paul Saba, Dr. Rene Leiva and [mC1] Dr. Laurence Normand-Rivest are members of the Physicians’ Alliance against Euthanasia, representing more than 1100 Canadian doctors.

Contact information: Dr. Paul Saba 001-514-886-3447, pauljsaba@gmail.com
Link to media articles from Spain:

https://www.actuall.com/vida/medicos-canadienses-advierten-a-espana-sobre-el-peligro-de-la-eutanasia/

https://www.consalud.es/profesionales/medicos-canadienses-advierten-a-espana-del-peligro-de-la-eutanasia_56184_102.html

https://www.cope.es/actualidad/sociedad/noticias/medicos-canadienses-advierten-parlamento-espanol-sobre-peligro-eutanasia-20181023_281190

American Medical Association (AMA) Ethics Committee maintains opposition to assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The American Medical Association (AMA), at its annual meeting in 2016, passed a resolution requiring the AMA Council on Judicial and Ethical Affairs (CEJA) to examine the issue of assisted suicide and make recommendations concerning the AMA opposition to physician-assisted suicide.

At the AMA annual meeting in 2017, a resolution was referred to CEJA to examine the language used in the assisted suicide debate. The resolution asked CEJA to consider changing the language from physician-assisted suicide to 'Aid in Dying'.

CEJA submitted a report to the AMA before its 2018 annual meeting affirming the current position whereby the AMA opposes assisted suicide and also affirming the use of the term physician-assisted suicide.

At the 2018 AMA annual meeting some delegates wanted CEJA to reject using the term physician-assisted suicide and after debating the CEJA report they voted to refer the study back to the CEJA to review their previous stance on what language of the debate. 

The delegates did not change the AMA stance on physician-assisted suicide.

CEJA just released a new report recommending that the AMA uphold its opposition to physician-assisted suicide:

The Council on Ethical and Judicial Affairs therefore recommends that the Code of Medical Ethics not be amended, that Resolutions 15-A-16 and 14-A-17 not be adopted and that the remainder of the report be filed.

The updated CEJA report changed how it expresses its opposition to assisted suicide but it clearly maintains that the AMA continue to oppose assisted suicide. The CEJA report states:

... in the council’s recent Open Forum, both proponents and opponents of physician-assisted suicide observed that in the U.S., debate occurs against the backdrop of a health care system in which patients have uneven access to care, including access to high quality end-of-life care. They also noted that patients and physicians too often still do not have the conversations they should about death and dying, and that too few patients are aware of the range of options for end-of-life care, raising concern that many patients may be led to request assisted suicide because they don’t understand the degree of relief of suffering state-of-the-art palliative care can offer.

Patient requests for assisted suicide invite physicians to have the kind of difficult conversations that are too often avoided. They open opportunities to explore the patient’s goals and concerns, to learn what about the situation the individual finds intolerable and to respond creatively to the patient’s needs other than providing the means to end life—by such means as better managing symptoms, arranging for psychosocial or spiritual support, treating depression, and helping the patient to understand more clearly how the future is likely to unfold. Medicine as a profession must ensure that physicians are skillful in engaging in these difficult conversations and knowledgeable about the options available to terminally ill patients. The profession also has a responsibility to advocate for adequate resources for end-of-life care, particularly for patients from disadvantaged groups. The availability of assisted suicide where it is legal must not be allowed to interfere with excellent care at the end of life.

It is important to note that the AMA Council on Ethical and Judicial Affairs has maintained opposition to assisted suicide while the recent World Medical Association meeting also maintained a strong opposition to euthanasia and assisted suicide.
 
Legalizing euthanasia and/or assisted suicide essentially gives doctors the right in law to cause the death of their patients, a right that the majority of physicians don't want.

Spain to debate legalizing euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Spanish Legislature

Spain's socialist government introduced a bill, last June, to legalize euthanasia. The debate on the bill is scheduled for October 25.

The Conservative - Popular Party - strongly opposes the bill and their leader has announced that it will introduce alternative legislation to provide greater support for palliative care.

Media reports are suggesting that the bill has support from the majority in the 350 member Spain legislature.

Last May, a similar bill was expected to pass in the Portugal legislature but it was defeated after the Communist Party voted against the euthanasia bill.

In Canada, Euthanasia Yes — Palliative Care, Not so Much

This article was published by National Review online on October 16, 2018

Wesley Smith

By Wesley Smith

Canada has created a positive right to euthanasia — including coercing dissenting doctors into participating in the deed in Ontario. Yet, according to a study published by the Canadian Institute for Health Information, only 15 percent of dying Canadians have access to quality palliative care in their last year of life. But that dry statistic doesn’t reveal the true depth of the problem, according to Globe and Mail columnist, André Picard:

The numbers, as appalling as they are, don’t adequately convey how badly dying patients are treated by the failure to provide palliative care in the community.

They are, in dry academic language, “subject to multiple transitions of care.” That means very sick patients are shuffled – often repeatedly – from home/nursing home to emergency, then up to the ward, and back home again.

We all know that in Canada, an ER visit for a frail elderly person (the main clientele for palliative care) means lying on a gurney in a hallway for hours. That is the last place a dying person – often confused, incontinent and in pain – should be. This kind of humiliation is untenable and we should be ashamed at how commonplace it is.

Shortage of palliative care is pushing people to euthanasia.

Good grief! No wonder so many Canadians seem to be embracing euthanasia. They are being herded by poor-quality care into that awful choice — which in a single-payer system, not coincidentally, is also far less expensive.

The legalization of euthanasia didn’t cause this problem. But I suspect that its widespread availability will make it much more difficult to correct.

‘Flawless’ Fatal Flaws Reviews from around the World

Fatal Flaws Ad in Guernsey

Kevin Dunn
Director - Fatal Flaws

As screenings of Fatal Flaws continue throughout the world, we’ve been overwhelmed by positive responses from high-profile individuals from both medical and legal professions internationally.

For instance the screening in Guernsey helped to defeat an assisted suicide proposal.

Purchase the DVD or pamphlets include taxes and shipping: All orders can be made online (Link).

• We recently added the Vimeo On-Demand Rental Release providing 48 hours access for $5 US (Link).

• DVD: $15.
• DVD: online download $30 US (Link).
• Pamphlets: $25 for 100.

You can purchase Fatal Flaws as a download through VIMEO ON DEMAND for $30 US. (Link).

The Fatal Flaws pamphlet is based on the stories in the film. The pamphlet is excellent for distribution at a screening. (Inside of the pamphlet) (outside of the pamphlet).

Further Discounts: All orders can be made online (Link).

• 1 DVD + 100 pamphlets for $75,
• With any Fatal Flaws order, get The Euthanasia Deception documentary for $20.

Further bulk orders are available upon request.

Order the Fatal Flaws DVD with pamphlets online, or email: info@epcc.ca or call EPC toll free at: 1-877-439-3348

As you consider a screening of Fatal Flaws in your area, we invite you to read what others are saying about the film:

“Slippery slope arguments have often been criticized as philosophically weak. There could be no stronger evidence for the reality the slippery slope than Fatal Flaws. As both a psychiatrist and a palliative care physician, I cannot overemphasize the importance of this film as a spiritual call, a moral message, a social statement and a clinical intervention. Kevin Dunn is a modern day Cassandra who has produced a film that describes what would be terrifying science fiction, were it not already social fact: the legalization of the termination of the lives of the vulnerable, isolated, marginalized, and anguished in state after state and country after country. Even more disturbing those deaths come at the hands of physicians whom for millennia have sworn to heal and not to harm. Through interviews with patients, families and experts, Dunn gives a neglected and urgently needed critique of the euphemistic masking of suicide as compassion and in so doing exposed the dark side of the gilded claim that the relief of suffering lies in the affirmation of hopelessness, the embrace of futility, and the betrayal of the historic goals of medicine.”

Cynthia Geppert MD, MA, MPH, MSB, DPS, MSJ, DFAPA, FCLP, Professor of Internal Medicine and Psychiatry, Director of Ethics Education ,University of New Mexico School of Medicine, Adjunct Professor of Bioethics Albany Medical College, USA

• Fatal Flaws film will change the way you view assisted death.

“Fatal Flaws is more than just a great documentary film. It is a clarion call to restore decency to the House of Medicine. For every doctor or patient who wants to understand the difference between medical killing and medically-responsible caring, this humane and sensitive film is a must-see.”

Ronald W. Pies, MD, Professor Emeritus of Psychiatry, and Lecturer on Bioethics, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts U. School of Medicine; Editor-in-Chief Emeritus, Psychiatric Times, USA.

"This is a brilliant film that should be compulsory viewing for busy legislators who haven’t time to do their own research into how euthanasia is changing death and dying in countries such as Canada and the Netherlands. Kevin Dunn interviews supporters and opponents of euthanasia and physician assisted suicide in a non-judgemental way and the responses he gets are extraordinary."

Professor the Baroness Sheila Hollins, House of Lords, Past President of the Royal College of Psychiatrists, UK

• Order the Fatal Flaws film and pamphlets.

“Compelling, timely and moving. Physicians must see this film, especially those in training as the euthanasia movement is trying to redefine the ethics of medicine. ”

Steven S. Sharfstein, M.D., Former President The American Psychiatric Association, USA

“Fatal Flaws should be necessary watching for anyone considering the legalisation of medical assistance in dying.” 

David Albert Jones, Director of the Anscombe Bioethics Centre, Oxford, UK

“Sobering and contemplative, Fatal Flaws is a must-see, regardless of one’s personal views about the rightness or wrongness of medical assisted death. The film challenges us to think critically about our individual and social responses to vulnerability and suffering, and, in particular, the re-shaping of the ‘house of medicine’ through the logic of law.” 

Mary J Shariff, Faculty of Law, University of Manitoba, Canada

“There are three words that should never have come together: “Physician Assisted Suicide”. This important film shines a critical light on the perverse reality that we are now training our medical students how to kill some of their patients. The medical arts of comfort and palliation are being supplanted by the seduction of euthanasia and the murky language of rights. We should all see this film and carefully weigh whether we really want our society to slide into a mire that extols medical murder.” 

John Maher MD FRCPC, Editor-in-Chief, Journal of Ethics in Mental Health, President, Ontario Association for ACT & FACT, Canada. 

• Fatal Flaws: A must see film.
• Fatal Flaws: A must see doc on euthanasia and assisted suicide.

A hearty thanks to the above contributors for their positive and passionate reviews. 
Kevin Dunn, Director - Fatal Flaws

NDY & ADAPT Submit Public Comments To Virginia Commission Opposing Potential Assisted Suicide Legislation

The Virginia Joint Commission on Health Care has requested public comments by close of business on October 15 concerning several policy issues, including one option that would recommend the introduction of assisted suicide legislation. It’s called Policy Option 2, worded as follows:

Introduce legislation to amend the Code of Virginia to include a Medical Aid-in-Dying statute that mirrors California’s EOLOA statute, with the following additions: a. when informing patient of alternative to MAID, attending physician must include information about any possible treatments for the underlying disease, b. attending physician must attest that patient enrolled in hospice or was informed of EOL services, c. if patient is in nursing facility, one witness may be person designated by facility, d. adopt rules to facilitate collection of information regarding compliance, e. provide an online guidebook and establish training opportunities for medical community to learn about the MAID process and medications that may be used (NOTE: Language will be provided to members and placed on the JCHC website 5 business days prior to the November Decision Matrix meeting).

O n October 11, NDY President Diane Coleman submitted a comment (to jchcpubliccomments@jchc.virginia.gov) which began:

Diane Coleman

I am submitting this comment as a person with an advanced neuromuscular condition who uses breathing support 18-19 hours a day. I have personal experience with misdiagnosis and the uncertainty of terminal predictions by doctors. I am also the founder and President of Not Dead Yet, a national disability rights group, with members in Virginia, that opposes legalization of assisted suicide because it is discriminatory and poses unacceptable dangers to elders and people with disabilities with or without terminal diagnoses.

This comment uses the term “assisted suicide” for several reasons. Merriam Webster defines suicide as “The act or an instance of taking one’s own life voluntarily and intentionally.” As the AMA Council on Ethical and Judicial Affairs stated in its report on the issue this year, “The terms ‘aid in dying’ or ‘death with dignity’ could be used to describe euthanasia or palliative/hospice care at the end of life and this degree of ambiguity is unacceptable for providing ethical guidance.”[i] Assisted suicide proponents understandably prefer to call it “aid in dying” because it polls better. They attempt to justify the name change by asserting that the person is already dying. While some may be dying, others are not. More importantly, with assisted suicide, the cause of death is not a disease, but a lethal overdose.

My Personal Story of Mistaken Prognosis . . .

To continue reading the NDY comment, go here.

On October 12, Bruce Darling submitted a comment on behalf of ADAPT which stated:

Bruce Darling

As an organization working to ensure disabled people’s right to build our lives in the community, legislation making it legal for physicians to help end our lives is deeply troubling to ADAPT. While the proponents of this legislation will tell you that it is not about disabled people, only people with terminal illness, let me assure you that every single person who qualifies under that definition is a disabled person. Not every person with a disability is terminally ill, but every person who is terminally ill is or will eventually become a person with a disability. There is no person with a terminal prognosis who does not also have, or acquire, an impairment which significantly affects their ability to perform a major life function (such as eating, sleeping, toileting, or walking).

Accordingly, physician assisted suicide is only provided to people with disabilities, by definition. This is discrimination. People with disabilities have fought hard for the right to live as equals, to live and receive services in the community, to have equal access to housing and transportation and employment opportunities. In an ableist society, these rights are continually denied to us. Yet this same society wishes to extend to us the “right” to end our lives. Equal rights, means equal access to suicide prevention, not the false “compassion” of suicide assistance.

… Assisted suicide is not about relieving the suffering of the dying: it is an expression of the most toxic and deadly form of ableism, which holds that life with a disability is not worth living. The lives of people with disabilities, whether terminal or non-terminal, do matter, and are worth living. (Emphasis added.)  

To continue reading the ADAPT comment, go here.

If you would like to submit your own comment by October 15 at close of business (even just saying that you oppose Option 2), and/or support NDY’s and ADAPT’s comments, please email jchcpubliccomments@jchc.virginia.gov.

[i] REPORT OF THE COUNCIL ON ETHICAL AND JUDICIAL AFFAIRS 5-A-18, Page 2, https://www.ama-assn.org/sites/default/files/media-browser/public/hod/a18-ceja5.pdf

The assisted suicide bill was aimed at people like my husband.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Nancy Elliott is a former three-term elected representative from New Hampshire. As an elected representative she fought against the assisted suicide bills in her state. Nancy is now actively opposing assisted suicide bills throughout the USA.

Nancy explains why she opposes assisted suicide:

This is about state sanctioned suicide. This is about giving the government the right to decide who is deserving of death and who isn't.

 It was at the same time this bill came that my husband was very critically ill. He had heart disease, diabetes, Parkinson's, kidney disease, numerous diseases.

One of the reps had put in this bill the reasons why you might want to do this (assisted suicide). They had loss of autonomy, loss of dignity, loss of bodily control. And so I asked him, "What are you talking about?"

It was really pretty clear that they were aimed at people like my husband, who, in their opinion, shouldn't be living.

He would have been so hurt. It would be like saying:

"Your a piece of junk, you need to get out of the way, your taking up space, go kill yourself."

Join EPC USA and help Nancy defeat assisted suicide in your state.

This film clip was taken from the film - Fatal Flaws. Order Fatal Flaws today.

Canadian Physicians attend World Medical Association General Assembly

This report was published by the Physicians Alliance Against Euthansia on October 15, 2018.

Reykjavik, Iceland, October 3-6, 2018

A number of concerned Canadian doctors became Associate Members of the World Medical Association (WMA) and attended the October 2018 General Assembly (GA) of the WMA in Reykjavik, Iceland. This informal report summarizes some activities and experiences of the group.

1. We were at the GA because we wished to contribute to the discussion of a draft resolution entitled Proposed WMA Reconsideration of the Statement on Euthanasia and Physician Assisted Dying which was to be brought forward to the Ethics Committee of the WMA by the Canadian Medical Association (CMA) and the Royal Dutch Medical Association (RDMA). It was proposed as a replacement for the WMA Resolution on Euthanasia (2002), the WMA Declaration on Euthanasia, (1987) and the WMA Statement on Physician Assisted Suicide (1992, confirmed 2015). The proposal sought to move the WMA away from condemning euthanasia and physician assisted suicide (E/PAS) as unethical. It also moved away from the term physician assisted suicide, using instead either physician assisted death or assisted dying. We felt that this policy would facilitate legalization of E/PAS around the world and involvement of physicians in these procedures. We wished to uphold the WMA opposition to E/PAS and encourage a life-affirming approach.

2. Delegates from more than 50 national medical associations around the world were present at this GA. Many of the more experienced participants at the meeting provided us with good advice regarding WMA processes and how to ensure our effective participation. Others sought clarification about an article some of us had co-authored in the September 2018 World Medical Journal, entitled Euthanasia in Canada: a Cautionary Tale (French and Spanish translations available at: bit.ly/WMACanada). It was written to counterbalance the optimistic view of the introduction of euthanasia and physician assisted suicide (E/PAS) into Canada that the current representatives of the Canadian Medical Association (CMA) generally promulgate. While the CMA spokesperson at this meeting asserted that our article is a misrepresentation, many participants acknowledged that the extensive references provided would permit them to access primary sources and reach their own conclusions about our analysis of the Canadian situation.

3. At the meeting of Associate Members, a resolution was proposed that aimed at a greater consistency between policies of WMA and its National Medical Associations (NMAs). Our group argued that two paragraphs in that policy would weaken the role of WMA as a promoter of the highest standards of medical ethics, because WMA would be expected to “accommodate” NMA policies inconsistent with WMA policies. Our motion to remove the problematic paragraphs was carried.

4. At this GA, summarizing reports were presented by representatives of German, Nigerian, Japanese and Brazilian medical associations on the recent WMA Regional meetings, all opposing involvement of physicians in E/PAS. These consultations on E/PAS conducted by the WMA clearly underscored continued firm opposition to these acts by most member nations. Perhaps because of this, the CMA/RDMA proposal was withdrawn on short notice prior to the Ethics Committee meeting in Reykjavik. It was replaced by a compromise document, brought forward by the German Medical Association, which affirms the WMA’s opposition to E/PAS, but avoids altogether the use of the word unethical and substitutes the phrase physician assisted suicide with physician assisted dying. It was apparent, during the remainder of the meeting, that many at the WMA have serious concerns about these possible changes. Some reiterated that the WMA was founded, in large part, to refute the idea that making something legal also makes it ethical. The proposed substitute document will undergo study in the months ahead by all delegates and their written opinions are to be reviewed at the April 2019 meeting of the WMA in Chile.

5. Toward the end of the General Assembly, to everyone’s surprise, the CMA delegation accused the incoming president of the WMA, Dr. Leonid Eidelman, of plagiarism in his inaugural speech and moved that the WMA demand his resignation. This motion failed, not being supported by any other delegates. Subsequently, the CMA announced its withdrawal from membership in the WMA. Eidelman offered an explanation and apologized to the Council and the GA of the WMA, and his explanation and apology were accepted.

Sheila Rutledge Harding, MD, MA, FRCPC
Crossmount, Saskatchewan

P.S. Any physician or medical student may become an Associate Member, upon application to the WMA: https://www.wma.net/sign-up/. Associate Members are apprised of documents under consideration, given opportunity for input, and may attend WMA meetings to voice their opinions.

Canadian woman abandoned to death. Has euthanasia become the only option for some?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

I spoke to a woman, today, about the sad story of the death of her only daughter. Her daughter was dying with cancer and her care was so substandard that she decided that euthanasia was her only option.

Shortage of palliative care is pushing people to euthanasia.

She said, my daughter wanted to be cared for at home, but the home care was minimal and not good. Her daughter was dying from cancer but she was living with neglect.

Her daughter decided the euthanasia was her only option. She signed the forms for euthanasia and waited to be killed.

Her mother, who had cared for her parents when they died, was trying to care for her daughter, but she lived one hour away. She tried but failed to find good home care in the community.

In the end, her daughter died before the lethal injection was done. 

Her mother repeated that she only wanted to be cared for at home, she only wanted her pain controlled, instead she died a horrible death.

The Euthanasia Prevention Coalition supports excellent care. A recent news article indicates that Canada is not providing good end-of-life care, but euthanasia is available. 

No one should be abandoned to death by euthanasia or to dying a bad death.

Caring not Killing is the answer.

If you need to speak to someone about your experience with euthanasia or assisted suicide please call Compassionate Community Care at: 1-855-675-8749.

• Euthanasia in Canada: A cautionary tale.

The deadly advocacy of assisted suicide in Washington DC

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr G Kevin Donovan 

The Washington Times published an excellent analysis of the assisted suicide legislation in Washington DC by G. Kevin Donovan, a physician and director of the Pellegrino Center for Clinical Bioethics and professor at Georgetown University Medical Center.

Donovan is responding to public service announcements in Washington DC promoting assisted suicide. Donovan states:

It is no wonder that the assisted-suicide lobby has resorted to such tactics — this dangerous public policy is so unpopular here that in the first year after the District of Columbia enacted a law to allow assisted suicide, not one person killed themselves with a doctor’s help, as the new law sanctions. In fact, during that time only two out of nearly 11,000 licensed D.C. physicians were willing to participate, and just one hospital cleared doctors to be involved.

People in Washington DC clearly do not want assisted suicide. Donovan then explains how legalizing assisted suicide leads to discrimination for people in vulnerable conditions.

Despite so-called safeguards, the D.C. assisted-suicide bill fails to adequately protect the most vulnerable in society. The poor, people of advanced years, persons with disabilities, both physical and developmental, and people who experience depression all find themselves at a much higher risk of being placed, even against their will, in that “second class” of people who do not receive the equal protection of suicide prevention. 

This type of discrimination is a reality in places where assisted suicide is legal. We know because in Oregon (oregon.gov), where assisted suicide was legalized 20 years ago, feeling like a burden is among the top end-of-life concerns of people who asked for lethal drugs. Making suicide available to people who require significant care and resources conveys that dependency and the need for care is burdensome, perhaps even revolting.

Donovan continues by outlining the other negative effects associated with assisted suicide.

Assisted suicide also breaks down the patient-physician relationship. With these laws, a doctor is legally forbidden from listing suicide as the cause of death on the death certificate. Not only does that require a falsehood, it makes oversight nearly impossible and accurate disease data a thing of the past. These laws do precious little for patients, but they do ensure that doctors cannot be sued or subjected to criminal penalties when acting “in good faith” within this law. 

For centuries, a physician’s primary focus has been to cure and comfort. Assisted suicide is an aberration that distorts that focus, medicalizing suicide. The result is a breach of trust between physician and patient — and the real risk that normalizing suicide will lead to “suicide contagion” in others. There is no mystery behind why physicians in Washington are not lining up to participate: It undermines their credibility and runs contrary to their role as healer. And physicians should be wary of promoting suicide for any reason among their patients. More doctors themselves die of suicide than in any other profession.

Donovan concludes by challenging the suicide lobby from promoting assisted suicide rather than suicide prevention, patient's rights and protection of the vulnerable.

• NO DC assisted suicide deaths in the first year after legalization. DC doctors don't support assisted suicide.