Reject Massachusetts End of Life Option Act

This article written by Margaret Dore and published by Choice is an Illusion.

Sign the petition: Reject Massachusetts Assisted Suicide bill S.1208/H.1926. (Link).

There has been an amended assisted suicide bill introduced in Massachusetts. S.2745 / S.1208.

I. Introduction

I am an attorney in Washington State where assisted suicide is legal.[1] The proposed bills seek to legalize “aid in dying,” a traditional euphemism for active euthanasia and physician-assisted suicide.[2]

Most states reject these practices.[3] Other states have strengthened their laws against them.[4] If enacted, the bills will apply to people with years or decades to live. Individuals with money, meaning the middle class and above, will be especially at risk. I urge you to reject the proposed bills.

II. Definitions (Traditional)

A. Physician-Assisted Suicide, Assisted Suicide and Euthanasia

The American Medical Association defines physician-suicide as occurring when “a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.”[5] For example:

[T]he physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.[6] Assisted suicide is a general term in which an assisting person is not necessarily a physician. Euthanasia is the administration of a lethal agent by another person.[7]

B. Withholding or Withdrawing Treatment

Withholding or withdrawing treatment (“pulling the plug”) is not euthanasia if the purpose is to remove burdensome treatment, as opposed to an intent to kill the patient. More importantly, the individual will not necessarily die. Consider this quote from Washington State regarding a man removed from a ventilator:

[I]nstead of dying as expected, [he] slowly began to get better.[8] 

III. Assisting Persons Can Have an Agenda

Persons assisting a suicide or euthanasia can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by legal assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[9] Consider also Graham Morant, convicted of counseling his wife to kill herself in Australia, to get the life insurance.[10] The Court found:

[Y]ou counselled and aided your wife to kill herself because you wanted ... the 1.4 million.[11] Medical professionals too can have an agenda. New York physician, Michael Swango, got a thrill from killing his patients.[12] Consider also Harold Shipman, a doctor in the UK, who not only killed his patients, but stole from them and in one case made himself a beneficiary of the patient’s will.[13]

IV. Patients will have Years or Decades to Live

The bills apply to persons who are “terminally ill,” which is defined as an illness or condition expected to cause death within six months.[14] Such persons may in fact have years or decades to live. This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[15]

Indeed, doctors can sometimes be very wrong. Consider John Norton, who testified before this body in 2012. Diagnosed with ALS at age 18, he was told that he would get progressively worse (be paralyzed) and die in three to five years.[16] Instead, the disease progression stopped on its own. His affidavit states:

If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[17] 

V. How The Bills Work

The bills have an application process to obtain the lethal dose, which includes a lethal dose request form. Once the lethal dose is issued by the pharmacy, there is no oversight. No doctor, not even a witness, is required to be present at the death.[18]

VI. The Bills are Stacked Against the Individual

Proponents claim that bill passage will assure individual choice, which is not true. See below.

A. Patient Protections will not be Enforceable

The bills set forth multiple patient protections, for example, that the attending physician “shall” refer the patient to another physician prior to prescribing the lethal dose.[19] The bills also say that actions are to be carried out in “accordance” with the bills.[20]

The bills do not define “accordance.”[21] Dictionary definitions include “in the spirit of,” meaning in thought or intention.[22] In other words, a mere thought or intention to comply is good enough. The protections will not be enforceable.

B. The Bills will Allow Other People to Communicate on the Patient’s Behalf
.
The bills describe patients as being “capable.”[23] This is a specially defined term, in which other people will be allowed to communicate on the patient’s behalf during the lethal dose request process, as long as the communicating people are “familiar with the patient’s manner of communicating.” The bills state:

"Capable” means having the capacity to make informed, complex health care decisions; understand the consequences of those decisions; and to communicate them to health care providers, including communication through individuals familiar with the patient’s manner of communicating if those persons are available. (Emphasis added).[24]

 Being familiar with a patient’s manner of communicating is an extremely low standard for something so important. Consider, for example, a doctor’s assistant who is familiar with the patient’s manner of communicating in Spanish, but she, herself, does not understand Spanish. That, however, would be good enough for her to communicate on his behalf during the lethal dose request process. The patient would not be in control of his fate.

C. “Even if the Patient Struggled, Who Would Know?”

The bills have no required oversight over administration of the lethal dose.[25] In addition, the drugs used are water and alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[26] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:

With assisted suicide laws in Washington and Oregon [and with the proposed bills], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).[27] 

VII. The Bills Will Allow Euthanasia as Traditionally Defined

The bills state that patients may choose to “self-administer” the lethal dose.[28] This is a specially defined term, which paradoxically allows other people to administer the lethal dose to the patient. The bills state:

"Self-administer” means a qualified patient’s act of ingesting medication [the lethal dose] ....(Emphasis added)[29] 

The bills do not define “ingest.”[30] Dictionary definitions include:

[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing.” (Emphasis added).[31] 

With these definitions, someone else putting the lethal dose in a patient’s mouth qualifies as self-administration if the patient swallows the lethal dose, i.e., ingests it. Someone else placing a medication patch on the patient’s arm will similarly qualify as self-administration because the patient will then be “absorbing” the dose, i.e., “ingesting” it. Gas administration initiated by another person will also qualify because the patient will be “inhaling” the dose, i.e., ingesting it. With self-administer defined as mere ingesting, someone else is allowed to administer the lethal dose to the patient, which is euthanasia as traditionally defined.

VIII. Legally, Deaths Will Be Due to a Terminal Disease, not Euthanasia or Homicide

The bills require deaths via the lethal dose to be listed on the patient’s death certificate as caused by a terminal disease, not euthanasia or homicide. The bills state:

The attending physician may sign the patient’s death certificate which shall list the underling terminal disease as the cause of death. (Emphasis added).[32]
[and]

Actions taken by health care providers and patient advocates supporting a qualified patient exercising his or her rights pursuant to this chapter, including being present when the patient self-administers medication, shall not for any purpose, constitute elder abuse, neglect, assisted suicide, mercy killing [euthanasia] or homicide under any civil or criminal law or for purposes of professional disciplinary action. (Emphasis added).[33] 

IX. Death Certificates Will Report Deaths as “Natural”

Massachusetts’ death certificates have seven categories for reporting the manner of death, five of which are substantive: natural cause; accident; homicide; suicide and therapeutic complication.[34]

As noted in the previous section, euthanasia deaths will be reported as caused by a terminal disease, not euthanasia or homicide. The death is also not an accident due its being intentionally performed; it is not suicide due to it’s being performed by another person; it is not a therapeutic complication. This leaves “Natural.”

With this situation, the manner of death for a traditional euthanasia must be reported on the death certificate as Natural. The significance is that doing so will create a legal inability to prosecute for murder. The official legal manner of death will be natural, not homicide, as a matter of law. The bills will create a perfect crime.

X. Dr. Shipman and the Call for Death Certificate Reform

Per a 2005 article in the UK’s The Guardian newspaper, there was a public inquiry regarding Dr. Shipman’s conduct, which determined that he had “killed at least 250 of his patients over 23 years.”[35] The inquiry also found:

that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners.[36] Per a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates, so as to improve patient safety.[37] Instead, the instant bills move in the opposite direction to require a legal coverup in which doctors and other perpetrators will be empowered to kill with impunity.

XI. Perpetrators will be Allowed to Inherit

Slayer statutes block persons from receiving an inheritance when they murder a person from whom they stand to inherit.”[38] The rational is simple.[39] No one should financially benefit from his or her own crime.”[40]

In Massachusetts, the slayer statute applies when there is a murder conviction for homicide. Actions taken pursuant to the bills, however, are not homicide.[41] Again, the bills state:

Actions taken by health care providers and patient advocates supporting a qualified patient exercising his or her rights pursuant to this chapter, including being present when the patient self-administers medication, shall not for any purpose, constitute elder abuse, neglect, assisted suicide, mercy killing [euthanasia] or homicide under any civil or criminal law or for purposes of professional disciplinary action. (Emphasis added).[42]

With this situation, the slayer statute will not apply to deaths pursuant to the bills because legally there will be no homicide, and therefore no murder. It won’t matter that the lethal dose was administered to the decedent against his or her will or that he or she was tricked into taking it. Perpetrators will be allowed to inherit.

XII. Participants will be Traumatized

A. The Swiss Study: Physician-Assisted Suicide can be Traumatic for Family Members

A European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[43] The study found that one out of five family members or friends present at an assisted suicide was traumatized. These people, 

experienced full or sub-threshold PTSD [Post Traumatic Stress Disorder] related to the loss of a close person through assisted suicide.[44] 

B. My Clients Suffered Trauma in Oregon and Washington State

I have had two cases where my clients and their family members suffered severe emotional trauma due to legal assisted suicide. One case was in Oregon, the other case was in Washington State.

In the first case, one side of the family wanted the father/patient to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client, his adult daughter, was severely traumatized. The father did not take the lethal dose and died a natural death.

In the other case, it’s not clear that administration of the lethal dose was voluntary. My client, although he was not present, was severely affected by the incident and also by the sudden loss of his father.

XII. Conclusion

If enacted, the bills will apply to people with years or decades to live. Some assisting persons, including doctors and family members, will have an agenda, with the more obvious reasons being inheritance and life insurance, but also, as in the case of Dr. Swango, the thrill of seeing someone die.

The bills’ lack of required oversight at the death, coupled with the mandatory falsification of the death certificate will provide cover for murder and create a perfect crime. Families and individuals will be traumatized.

I urge you to vote “No” on H. 1926 and S. 1208. 

Click here to view pdf version.
 
Margaret Dore, Esq., MBA
Law Offices of Margaret K Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
Footnotes:

[1] A copy of my bio is in the appendix, at page A-1.
[2] Craig A. Brandt, Model Aid-in-Dying Act, Iowa Law Review,
1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”); and
Maria T. CeloCruz, “Aid-in-Dying: Should We Decriminalize
Physician-Assisted Suicide and Physician-Committed Euthanasia?,”
summary pages, in the appendix, at A-2 & A-2A.
[3] Patient’s Rights Council, “Assisted Suicide Laws in the United States,”
http://www.patientsrightscouncil.org/site/assisted-suicide-state-laws/
[4] In the last nine years, at least eight states have strengthened their laws against assisted suicide and/or euthanasia. These states include: Alabama, Arizona, Georgia, Idaho, Louisiana, New Mexico, Ohio and Utah. See backup documentation in in the appendix, at pages A-3 to A-7. See also https://www.choiceillusionnewmexico.org/2016/07/new-mexico-upholds-assisted-suicide.html (regarding a New Mexico Supreme Court decision overruling legal assisted suicide); http://codes.ohio.gov/orc/3795 (regarding Ohio’s statute) and https://le.utah.gov/~2018/bills/static/HB0086.html (regarding Utah bill).
[5] The AMA Code of Medical Ethics, Opinion 5.7, in the appendix, page A-8.
[6] Id.
[7] Opinion 5.8, “Euthanasia,” attached in the appendix, at page A-9.
[8] Nina Shapiro, “Terminal Uncertainty: Washington’s new ‘Death With Dignity’ law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?,” Seattle Weekly, 01/13/09, attached in the appendix, at pp. A-10 to A-12; quote at A-12.
[9] "Sawyer Arraigned on State Fraud Charges," KTVZ.COM, 08/16/16, attached in the in the appendix, at page A-13.
[10] R v Morant [2018] QSC 251, Order, 11/02/18, excerpts in the appendix, at pp. A-14 and A-15. Full opinion available here: https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf
[11] Morant opinion, ¶ 78, attached in the appendix, at A-15.
[12] Charlie Leduff, “Prosecutors Say Doctor Killed to Feel a Thrill,” The New York Times, 09/07/00, attached in the appendix, at pages A-16 to A-18, https://choiceisanillusion.files.wordpress.com/2019/03/ny-times-killed-to-feel-a-thrill-1.pdf (“Basically, Dr. Swango liked to kill people. By his own admission in his diary, he killed because it thrilled him.”) See also: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor,” 07/12/00, https://www.cbsnews.com/news/life-in-jail-for-poison-doctor
[13] David Batty, “Q & A: Harold Shipman,” The Guardian, 08/25/05, at https://www.theguardian.com/society/2005/aug/25/health.shipman. (Attached in the appendix, at A-19 to A-21). See also Fiona Guy, “Healthcare Serial Killers: Doctors and Nurses Who Kill,” Crime Traveler, (2015, Sept 09), available at https://choiceisanillusion.files.wordpress.com/2019/03/doctors-and-nurses-who-kill.pdf
[14] The bills state:
“Terminally ill" means having a terminal illness or condition which can reasonably be expected to cause death within 6 months, whether or not treatment is provided. H. 1926 and S. 1208, lines 78 to 79. A copy of H. 1926 is in the appendix, at pages A-22 to A-38.
[15] See: Jessica Firger, “12 Million Americans Misdiagnosed Each Year,” CBS NEWS, April 17, 2014, attached in the appendix, at A-39; and Nina Shapiro, “Terminal Uncertainty ...,” supra, excerpts attached hereto in the appendix, at A-10 to A-12.
[16] Affidavit of John Norton, attached in the appendix, at A-40 to A-42.
[17] Id., ¶ 5.
[18] See the bills in their entirety, which are currently identical. Bill H. 1926 is attached in in the appendix, at pages A-22 to A-38.
[19] The bills, § 6, lines 151 to 179, attached in in the appendix, at A-30 & A-31.
[20] The bills state:
(1) The attending physician shall: ...
(k) ensure that all appropriate steps are carried out in accordance with this chapter before writing a prescription for medication for a qualified patient .... (Emphasis added). The bills, line 152, and lines 178 to 179, attached in the appendix, at A-30 and A-31.
[21] See the bills in their entirety.
[22] Definitions attached in the appendix, at pages A-45 to A-46.
[23] The bills, § 1, lines 14-17. (Attached in the appendix, at A-23).
[24] Id.
[25] See the bills in their entirety.
[26] In Oregon and Washington State, reported drugs include Secobarbital, Pentobarbital, Phenobarbital and Morphine Sulfate, which are water and/or alcohol soluble. See excerpts from Oregon’s and Washington’s annual reports, in in the appendix, at pp. A-43 and A-44. See also http://www.drugs.com/pr/seconal-sodium.html, http://www.drugs.com/pro/nembutal.html and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013
[27] Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010.
[28] The bills, Section 1, line 10, attached in the appendix, at A-22
[29] Id., lines 76 to 77.
[30] See the bills in their entirety.
[31] Attached in the appendix, at A-47.
[32] The bills, §6(2), lines 189 to 190, attached in the appendix, at A-32.
[33] The bills, lines 252 to 256.
[34] See Massachusetts “Death Certificate Medical Certifier Worksheet,” attached in the appendix, at A-48.
[35] David Batty, attached in the appendix, at A-19.
[36] Id., attached hereto at A-21.
[37] Press Association, “Death Certificate Reform Delays ‘Incomprehensible,” The Guardian, January 21, 2015, attached in the appendix, at A-49 to A-50.
[38] Cushing and Dolan, PC, Attorneys at Law, “What are Slayer Statutes,” January 28, 2015, in the appendix, at A-51 to A-52.
[39] Ilene S. Cooper and Jaclene D’Agostino, Forfeiture and New York’s “Slayer Rule,” NYSBA Journal, March/April 2015, attached in the appendix, at A-55.
[40] Id.
[41] Cushing and Dolan, in the appendix, at A-52. See also “Taking from deceased victim’s estate prohibited,” attached in the appendix, at A-53. The bar to inheritance applies “only to murder in the first degree, murder in the second degree or manslaughter.”
[42] The bills, lines 252 to 256.
[43] “Death by request in Switzerland: Post-traumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf (Cover page attached in the appendix, at A-56).
[44] Id.

Media Release: Danger of Massachusetts Assisted Suicide Bill

This media release was published by Not Dead Yet on June 2, 2020.

For Immediate Release: June 2, 2020
Contact: John B. Kelly 617-952-3302, SecondThoughtsKelly@Gmail.com, @2ndThoughtsMA

Bill Legalizing Assisted Suicide Remains Dangerous, Targets the Vulnerable

Second Thoughts Massachusetts issues the following statement in opposition to the favorable report given by the state legislature’s Joint Committee on Public Health to Bill S.1208/H.1926, legislation that would legalize assisted suicide in Massachusetts.

John Kelly

“I’m amazed and disappointed that as a deadly virus is stalking and killing older, ill, and disabled people, and systemic racism and healthcare disparities lead to disproportionate deaths of Black people, the Public Health Committee decides now would be the time to further endanger the same groups of people. Assisted suicide legislation sends a message of ‘better dead than disabled’ while completely immunizing doctors, heirs, and stressed caregivers who can encourage or even engineer a person’s death without fear of prosecution,” said Second Thoughts Director John B. Kelly.

“It is wrong to move a bill at a time when those who will be harmed are on lockdown due to COVID-19, depriving us of the opportunity to fully address in person this threat to our health and well-being,” Kelly continued.

Anita Cameron, Director of Minority Outreach for Not Dead Yet, said “I am utterly disgusted that as COVID-19 ravages the Black community due to the results of racial disparities in healthcare, the Public Health Committee has decided to try to slip this bill through. COVID-19 has disproportionately affected the Black community; we are dying at frightening rates. This bill promotes death over life, and by pushing it, the legislature is sending a clear message to us Blacks that we are burdens and should die by suicide.”

Diane Coleman, Not Dead Yet’s President and CEO, said “The doctors who decide who’s eligible for assisted suicide are the same doctors who have been perfectly comfortable putting older, ill and disabled people at the back of the line for receiving COVID-19 treatments. Why should anyone think they will move us to the front of the line for other life-saving treatments if assisted suicide is legal?”

Five months ago, Suffolk Superior court Judge Mary K. Ames in Kligler, et al. v. Healey, et al. ruled against any state constitutional right for assisted suicide, holding that at the point of a patient ingesting the lethal drugs, they would be vulnerable to improper persuasion. “In such a situation, there is a greater risk that temporary anger, depression, a misunderstanding of one’s prognosis, ignorance of alternatives, financial considerations, strain on family members or significant others, or improper persuasion may impact the decision.”

“The Massachusetts legislature should heed this warning by the court. If assisted suicide is legal, some people’s lives will be ended without their consent, through insurance denials, mistakes, and abuse. No safeguards have ever been enacted, or even proposed, that can prevent this outcome which can never be undone once it is put into effect,” Kelly concluded. Second Thoughts Massachusetts is a group of disability rights advocates opposed to the legalization of assisted suicide. We testified against the bill S.1208 at the hearing in June of 2019 and held a well-attended legislative briefing a few days after. It is the state affiliate of Not Dead Yet, the national grassroots group opposed to assisted suicide and life and death discrimination against disabled people.

Does Bill C-7 prevent euthanasia for mental illness?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Petition: Reject euthanasia Bill C-7 (Link).

Many people have stated that Bill C-7 prevents euthanasia (MAiD) for mental illness alone. Recently the Canadian Bar Association End of Life Working Group, that support euthanasia for mental illness, recommended that:

Mental illness should not be excluded from the definition of “serious and incurable illness, disease or disability”.

I am convinced that Bill C-7 already permits euthanasia for mental illness. 

People have said, Bill C-7 does appear to prevent euthanasia for "mental illness". Section (2.‍1) of the bill states:

For the purposes of paragraph (2)‍(a), a mental illness is not considered to be an illness, disease or disability.

This section of Bill C-7 will not prevent euthanasia for mental illness or psychological reasons alone because it does not define the terms "mental illness" or "psychological suffering."

Let me explain.

Previous to the Quebec Truchon court decision, a person didn't qualify for MAiD based on psychological reasons alone since the law required that a person's "natural death be reasonably foreseeable," which was not defined.

Canada's euthanasia law states that a person qualifies for euthanasia (MAiD) if:

the illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable.

By eliminating the "reasonably foreseeable death" requirement, the court decision eliminated the "terminal illness" requirement but also expanded euthanasia to people with psychological conditions alone. Unless defined, mental illness will be defined to be a form of psychological suffering.

What does Bill C-7 do?

1. Bill C-7 removes the requirement in the law that a person’s natural death be reasonably foreseeable in order to qualify for assisted death. Therefore, people who are not terminally ill can die by euthanasia. The Quebec court decision only required this amendment to the law, but Bill C-7 went further.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by euthanasia.

3. Bill C-7 waives the ten-day waiting period if a person's natural death is deemed to be reasonably foreseeable. Thus a person could request death by euthanasia on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

4. Bill C-7 creates a two track law. A person whose natural death is deemed to be reasonably foreseeable has no waiting period while a person whose natural death is not deemed to be reasonably foreseeable would have a 90 day waiting period before being killed by lethal injection.

5. As stated earlier, Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The euthanasia law permits MAiD for people who are physically or psychologically suffering that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. However, mental illness, which is not defined in the law, is considered a form of psychological suffering.

More Articles on Bill C-7:

• Stop the extension of euthanasia by Bill C-7 (Link).
• More than 15,000 Canadians have died by euthanasia (Link).
• Canadians oppose euthanasia for mental illness and child euthanasia (Link).

Doctors Now Assist Suicides via Zoom

This article was published by National Review online on June 2, 2020

*Sign the petition: Healthcare regulations must not permit assisted suicide approvals by telehealth (Link).

By Wesley J Smith

We are always told that “strict guidelines will protect against abuse.”

It’s always been baloney. As sold, assisted suicide was supposed to only be engaged between doctors of long-standing and patients well known to the prescriber.

* Stop assisted suicide by telehealth (Link).

That was violated in the very first legal assisted suicide in Oregon. The doctor in that case — referred by an assisted-suicide advocacy organization — only met the patient two weeks before she received her poison pills.

Very quickly, death doctors began to assist the suicides of patients they have never treated. In California, a part-time ER doctor — who spent most recent years as a photojournalist — quickly set up a suicide practice after assisted suicide was legalized. There have also been many cases of oncologists assisting the suicides of ALS patients, and other similar out-of-specialty death facilitations.

Now, death doctors are assisting suicides of patients they may never have met via Zoom and other telehealth — talk about an oxymoron in this circumstance! — means of communication. From, “Dying Virtually,” published in The Conversation:

Parrot says she sees 90% of her patients online, visually examining a patient’s symptoms, mobility, affect and breathing. 

“I can get a great deal of information for how close a patient is to death from a Skype visit,” Parrot explained. “I don’t feel badly at all that I don’t have a stethoscope on their chest.” 

After the initial visit, whether in person or online, aid-in-dying physicians carefully collate their prognosis with the patient’s prior medical records and lab tests. Some also consult the patient’s primary physician.

Did you catch the last bit there? Some “consult” the patient’s primary physician. That also means some don’t. And that means some people are assisted in suicide by doctors they have never met in the flesh and who have never examined them.

This is a breach of all the assuring promises that were made when assisted suicide was legalized. But those promises were never meant to be kept. Only to give false assurance.

It is amazing to me how legalizing assisted suicide transforms peoples’ thinking. Making people dead quickly becomes the overriding imperative and suicide prevention for the seriously ill goes into total eclipse. The easier it is to get people dead, the better.

Those with eyes to see, let them see.

*Sign the petition: Healthcare regulations must not permit assisted suicide approvals by telehealth (Link).

Rethinking nursing homes. Supporting community based care.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The recent reports of nursing home abuse and the horrific number of COVID-19 nursing home deaths, and other nursing home deaths, should make not only think about improving nursing home care but to rethink nursing homes.

A Canadian military report recently uncovered disturbing conditions in Ontario nursing homes from unsanitary conditions to an alleged choking death that was caused by improper feeding practices.

The response that we are hearing is that we need to improve nursing homes. I agree that existing nursing home care is often substandard, but the answer to the problem is to move to a system of home care.

Canada appears to be committed to providing institutional care for our elderly citizens even though the system of institutional care is broken, expensive and does not provide the care that people want or need.

Fiona Whittington-Walsh in her article published in Rabble.ca examines the problem by comparing the experience with COVID-19 in Denmark to Canada. She writes:

Denmark has a home-based care policy priority for seniors, and has transformed its senior care delivery model into a community-based model -- and has not invested in new congregate facilities since 1987. Reducing the number of nursing homes was matched with a steady increase in the number of home nurses. The decline in long-term congregative facilities for seniors in Denmark is evident in the fact that as of April 24, 2020 only 33 per cent of confirmed COVID-19 deaths were connected to these facilities, while in Canada, 62 per cent of all confirmed COVID-19 deaths are connected to such facilities.

Whittington-Walsh then refers to an Ontario study  suggesting that home care provides better care and is also economically a better option. 

Paul Caune

Whittington-Walsh explains the benefits of home care with stories of people with disabilities. Paul Caune, a disability advocate who was born with muscular dystrophy was at one point in his life forced to live in the George Pearson Centre in Vancouver. Whittington-Walsh writes:

Caune's experiences at Pearson were traumatic. For two years he lived in an environment of fear and abuse. He and the other residents lost their autonomy, lacked basic rights, were forced to abide by curfews, were confined to their beds on scheduled bowel movement days, were only allowed one transfer in or out of bed per day, and were forced to take anti-psychotic drugs to keep them placid. It is the institutional model that is the problem, and Caune's experiences are consistent with the current and historical examples discussed in the first article. 

Caune's battle to ensure home care for people with disabilities is also relevant for people living in nursing homes.

The report of the Parliamentary Committee on Palliative and Compassionate Care that was published in November 2011 is a fundamental guide to moving healthcare systems forward. 

In its recommendation XV on page 52, concerning Palliative and End-of-Life care the report states:

Home care is foundational to transforming Canada’s health care system. In reality it is a paradigm shift in our vision of health care. Allowing patients to stay at home has pronounced benefits for everyone involved, not least of which, the person being cared for in their own home and community. This is important as our nation seeks ways to improve the care of the elderly and vulnerable. 

...A continuing care system can relieve burdens on the acute care system, in a way that doesn’t harm quality of care and perhaps even enhances it. This is not to deny the importance of surgical, diagnostic and specialist interventions, clearly the domain of the hospital. We now know that the majority of care that can be delivered to a person with chronic conditions in an institution can be delivered just as well at home. Home, family and community are too fundamental to the identity of the person, to be ignored in the basic care of the chronically ill or dying person.

The recent military report on nursing home abuse in Ontario confirms the truth of what the community living movement believes, that it is essential for all human beings to have equality and inclusion in society. Institutionalizing people with disabilities or the elderly leads to exclusion and discrimination and eventual abandonment.

I believe in the philosophy of the community living movement and I recognize that the needs of people with disabilities can be very similar to the needs of the elderly.

Canada needs to stop building institutional care that requires people to fit into a model of care that does not provide them with the options that they want and does so in a restrictive and expensive manner.

Canada needs models of compassionate community care. A model that cares for people in their home and community that doesn't segregate people and provides them with the respect and dignity that they deserve.

Did the Massachusetts assisted suicide lobby change its tactic or are they just lying?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Massachusetts legislature

Last Friday, the Massachusetts Joint Committee on Public Health, sadly advanced assisted suicide bills S.1208 and H.1926. I do not think there is time, in this legislative session to pass these bills into law, but the fact that they passed in committee is concerning.

It is also concerning that a commentary that was published in a Massachusetts newspaper causes more confusion as to what assisted suicide is. The article titled: In support of passing death with dignity law states:

There is nothing mandatory in this bill. No doctor may prescribe terminal sedation (my emphasis) requested by a patient unless the patient:
■ is mentally capable, and not suffering from clinical depression or anxiety severe enough to impair his/her judgment;
■ can take the prescribed medication by him or herself;
■ has requested the medication orally and in writing, with two witnesses, one of whom cannot be included in the patient’s will;
■ has met with two physicians and one mental health professional who each attest first to the patient’s understanding and awareness of the full consequences of her/his request, and second to the diagnosis of a terminal illness that will in all likelihood end her/his life within six months.

First, terminal sedation is not assisted suicide. Terminal sedation is a medical act to sedate a person who is experiencing uncontrolled symptoms. Terminal sedation can be abused, by intentionally overdosing or by sedating a person and then dehydrating the person to death, nonetheless terminal sedation is not assisted suicide.

Assisted suicide is to intentionally prescribe lethal drugs, knowing that the person intends to use the lethal drug cocktail to die by suicide.

Is equating terminal sedation with assisted suicide a way to change the way assisted suicide is viewed?

Secondly, people who die by assisted suicide in Oregon, where assisted suicide has been legal for more than 20 years, are rarely sent for a psychological assessment, even though a study found that more than 25% of patients who request assisted suicide are experiencing depression or feelings of hopelessness. 

According to the 2019 Oregon assisted suicide report, that out of 188 reported assisted suicide deaths only one of those people were sent for a psychological assessment.

Finally, the assisted suicide lobby promotes assisted suicide as a "peaceful death." The fact is that many assisted suicide deaths are prolonged and painful deaths.

Legalizing assisted suicide gives doctors who agree to cause the death of patients complete legal protection for doing so.

There are many more problems with assisted suicide. We believe in caring, not killing.

Starvation led to approval for euthanasia in Canada.

This article was published by Toujours Vivant - Not Dead Yet on May 29, 2020.

By Amy Hasbrouck

In June of 2016, just as medical aid in dying (MAiD) was adopted in Canada, a British Columbia woman known as Ms. S. who had Multiple Sclerosis was evaluated for MAiD by Dr. Ellen Wiebe. According to Jocelyn Downie, Dr. Wiebe concluded that Ms. S. met most of the eligibility criteria (incurable condition, advanced state of decline in capability, and enduring and intolerable suffering) but the doctor did not believe Ms. S. would die “in the foreseeable future,” so she was determined ineligible. 

As we reported in March of 2018, the Final Disposition Report of the Inquiry Committee of the College of Physicians and Surgeons of British Columbia, found that Ms. S. was “suffering from … trigeminal neuralgia and gastrin [sic] intestinal symptoms for which treatment had been only minimal [sic] effective.” Elsewhere in the report, another physician said Ms. S. had declined “potentially effective” treatment.

Dr. Wiebe exchanged correspondence with Ms. S. in December of 2016 and January of 2017, to the effect “that the patient’s life expectancy was not short enough to qualify for medical aid in dying.” Then in mid-February of 2017, “Ms. S decided to starve herself to death at home, with the support of palliative-care nursing.”

Her husband called Dr. Wiebe two weeks later, and Dr. Wiebe visited Ms. S. on March 3. At that time, Dr. Wiebe determined that she met all eligibility criteria, and she was euthanized on March 6, 2017.

The Inquiry Committee, in its final disposition report of February 13, 2018, found that:

• “MAiD is intended to be restricted to those individuals who are declining toward death, allowing them to choose a peaceful death, as opposed to a prolonged, painful or difficult one.”
• “In view of the foregoing standard, a patient cannot be forced to take treatment they do not consider acceptable.” 
• “Ms. S. met the requisite criteria and was indeed eligible for medical assistance in dying despite the fact that her refusal of medical treatment, food, and water undoubtedly hastened her death and contributed to its ‘reasonable foreseeability’.” 

Ms. S.’ suicidal act highlights a basic flaw of assisted dying: governments have put their efforts toward the goal of ending lives, rather than ending suffering. 

From the information provided, we don’t know what symptoms Ms. S. had, how her family and friends reacted to her disability, whether she had peer support, whether she’d received specialist care for her multiple sclerosis, what treatment(s) had been tried, and whether she had received effective palliative care and mental health services. But when the government, in the person of a euthanasia provider, puts its thumb on the scale in favour of death, it makes the struggle to live well with a disability just that much harder.

At the same time, the public policy conclusion drawn by this case is that the person asking to die should not be burdened with the obligation of first trying to improve their quality of life. This might make sense if there were no social costs from assisted suicide and euthanasia (AS & E). But there are very significant social costs, not just to those who choose to die, their families and medical practitioners, but to all people whose lives are devalued and put in danger by the practice.

For more information on the subjects we discuss:

Facebook.com/toujoursvivantnotdeadyet
Website – https://tvndy.ca
Email – info@tv-ndy.ca Twitter – @tvndy.

4500 New York patients who tested positive for COVID-19 were sent to nursing homes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Governor Andrew Cuomo

On May 13 I reported that New York Governor, Andrew Cuomo, had just rescinded a policy forcing nursing homes to accept Covid-19 positive patients.

I stated that a policy forcing nursing homes to accept residents who are infected with a deadly virus that spreads was a policy that would lead to many deaths.

On May 22, Bernard Condon, Jennifer Peltz and Jim Mustian reported for the Associated Press that more than 4500 COVID-19 patients were sent to nursing homes in New York. The report stated:

More than 4,500 recovering coronavirus patients were sent to New York’s already vulnerable nursing homes under a controversial state directive that was ultimately scrapped amid criticisms it was accelerating the nation’s deadliest outbreaks, according to a count by The Associated Press.

AP compiled its own tally to find out how many COVID-19 patients were discharged from hospitals to nursing homes under the March 25 directive after New York’s Health Department declined to release its internal survey conducted two weeks ago. It says it is still verifying data that was incomplete.

The AP article quoted Daniel Arbeeny, who took his 88-year-old father out of a nursing home that had 50 COVID-19 deaths. Arbeeny stated:

“It was the single dumbest decision anyone could make, ...This isn’t rocket science,... We knew the most vulnerable -- the elderly and compromised -- are in nursing homes and rehab centers.”

Gurwin Jewish home.

The AP article reported that nursing homes were flooded with COVID-19 positive residents. 

Gurwin Jewish, a 460-bed home on Long Island, seemed well-prepared for the coronavirus in early March, with movable walls to seal off hallways for the infected. But after the state order, a trickle of recovering COVID-19 patients from local hospitals turned into a flood of 58 people.

More walls were put up, but other residents nonetheless began falling sick and dying. In the end, 47 Gurwin residents died of confirmed or suspected COVID-19.

Tobias Hoonhout, in his article published by the National Review, suggests that the New York Department of Health is hiding the fact that the order existed. Hoonhout wrote:

The New York Department of Health has apparently deleted a March order issued by Governor Andrew Cuomo that forced nursing homes to admit Covid-positive residents.

The order, which was implemented on March 25, stated that “no resident shall be denied re-admission or admission to a nursing home solely based on a confirmed or suspected diagnosis of COVID-19,” and also prohibited nursing homes from requiring testing prior to admission or readmission. But the order is no longer visible on the state’s website.

The AP article reported that the March 25 directive was based on a fear that the hospital system would be overwhelmed.

There must be an independent investigation into the March 25 order by Governor Cuomo that possibly led to thousands of nursing home resident deaths.

A recent Canadian military nursing home report uncovered disturbing conditions. COVID-19 positive residents sharing a room with healthy residents, COVID-19 positive residents wandering the hallways, staff not following infection control rules and more.

Based on the number of COVID-19 New York nursing home deaths, silence is unconscionable,  the truth must be known. 

This may be the worst case of elder abuse in the history of America.

Military reports disturbing conditions in Ontario nursing homes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have been writing about the tragic COVID-19 nursing home deaths. On April 14 I wrote about COVID-19 Triage guidelines and nursing home deaths and on May 13 I wrote about the New York State policy that may have led to thousands of nursing home resident deaths. 

In Ontario, nursing home residents comprise more than 75% of the COVID-19 deaths.  The Canadian military was called in to provide needed care and support in nursing homes that were strained by the COVID-19 outbreak.

According to a Global news report:

A total of 285 military members were working in Ontario care homes. In Quebec, more than 1,500 soldiers were sent to 25 long-term care homes, with up to 60 at each facility. More than two dozen Canadian soldiers have now tested positive for COVID-19.

This military intervention not only provided care for vulnerable people, it also provided an impartial witness to the care (or lack thereof), that the residents were receiving.

Military member providing care

Military personnel who were caring for nursing home residents released an horrific report of systemic nursing home elder abuse. According to the CBC News Report by Nick Boisvert:

Military service members, who have been providing assistance at the homes since April 28, say they have observed numerous forms of unhygienic and dangerous behaviour. 

The list of allegations includes:

• Repeated use of medical equipment between COVID-19 patients and others who had not tested positive, without it being disinfected.

• Improper use of personal protective equipment (PPE) by staff and doctors.

• Housing of COVID-19 patients with residents who had not tested positive.

• Staff reusing gloves or not washing hands between resident interactions.

• Staff being aggressive with residents during medical procedures.

• Residents calling for help with no response for up to two hours.

• The presence of insects, including cockroaches and ants.

Ontario Premier Doug Ford

Boisvert reported Ontario Premier Doug Ford stating in his press conference:

"It was so disturbing ... It was the worst report, most heart-wrenching report I have ever read in my entire life"

A Global News report stated:

The soldiers reported witnessing cockroaches, flies, rotten food, as well as residents left in soiled diapers or crying out for help for lengthy periods, the documents allege. At one facility, residents had not been bathed in weeks, they said. 

At a facility in Etobicoke, residents who tested positive for COVID-19 shared rooms with uninfected residents, separated only by a curtain, the documents said. 

It found “major concerns” at Eatonville about care, infection control and narcotics abuse. 

The Orchard Villa home had cockroaches and flies, and residents were “left in beds soiled in diapers.” New staff were not trained adequately, nor was protective gear used properly. 

It said staff were not always sitting residents up before feeding them, and that this may have contributed to the death of a resident who choked after being fed “while suppine.”

All of this and more is occurring in Ontario where we have universal healthcare. Please read the Global news report.

The horrific incidents outlined in the report reveal a culture disrespect and dehumanization towards people needing care. Philosophers like Peter Singer, who teach that people with certain cognitive conditions cease being persons have contributed to this epidemic of disrespect and harm.

This military report confirms the truth of what the community living movement believes, that it is essential for all human beings to have equality and inclusion in society. Institutionalizing people with disabilities or the elderly leads to exclusion and discrimination and eventual abandonment.

The abusive behaviour, mismanagement and dehumanizing conditions is heart breaking and leads me to state that: 

1. Doctors and nurse practitioners, who kill people by euthanasia make decisions based on societal attitudes towards living with physical and psychological needs.
2. The concept of "freedom of choice" does not apply to conditions and attitudes that lead someone to believe that people living with certain conditions are better off dead. Subtle and overt social pressures creates a cultural shift from a "choice to die" to an expectation to die.
3. Some people have asked to die by euthanasia to avoid living in a nursing home. This report may lead to a "clean-up of nursing, it will also lead to more euthanasia deaths.

We need a caring culture: a culture that does not institutionalize the elderly, infirm or people with disabilities, but rather offers compassionate community care. 

Policies that promote home care and enable people to live independently need to be implemented. For people experiencing dementia or Alzheimer's, a community such as Hogeweyk, in the Netherlands provide an excellent example of how this is done.

Institutionalizing and warehousing people results in a culture of abandonment, abuse and often death. 

Let's rethink the concept of nursing homes.

More articles on this topic:

• Report into nursing home deaths will not protect people from suspicious euthanasia deaths (Link).
• New York policy may have led to the deaths of thousands of nursing home residents (Link).
• COVID-19 Triage guidelines and nursing home deaths (Link).
• Pandemic palliative care protocol. Selecting people to die and abusing the purpose of palliative care (Link).
• Euthanasia doctor developed COVID-19 Triage guidelines (Link).

Oklahoma Bans ‘Quality of Life’ Health-Care Rationing

This article was published by National Review online on May 26, 2020

By Wesley J Smith

Wesley Smith

As many in the bioethics movement push various schemes to ration health care based on “quality of life” — such as the odious QALY (quality adjusted life year) system beloved of the New England Journal of Medicine — some are pushing back and insisting that health-care coverage and treatment public policy be predicated on the intrinsic equal dignity and moral worth of all patients.

Toward that end, Oklahoma’s governor just signed into law a bill that outlaws such invidious and bigoted discrimination. From HB 2587:

The Legislature finds and declares that:

1. Physical and mental disabilities, age or chronic illness should in no way diminish a person’s right to life, human dignity and equal access to medical care;
2. Historically, persons with disabilities, advanced age or chronic illness have faced discrimination in the health care system, including the denial of access to life-sustaining care;
3. Such discrimination is inconsistent with our society’s commitment to human dignity and the full inclusion of persons with disabilities throughout society;

Such discrimination is now legally prohibited:

An agency shall be prohibited from developing or employing a dollars-per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual’s disability, including age or chronic illness, as a threshold to establish what type of health care is cost effective or recommended. 

An agency shall be prohibited from utilizing such adjusted life year, or similar measure, as a threshold to determine coverage, reimbursement, incentive programs or utilization management decisions, whether it comes from within the agency or from any third party.

More of this please, the sooner the better! Considering how shamefully and lethally New York and some other states treated the elderly residing in long-term care facilities during the worst days of the COVID-19 crisis, it is very clear that these laws are desperately needed.

Uruguay bill would legalize wide open euthanasia and assisted suicide.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

A bill to legalize euthanasia and assisted suicide was introduced on March 11 in the Uruguayan Congress. The Uruguay bill lacks definition allowing it to be have a wide interpretation.

My commentary of the bill is based on a google translation of the text of the bill.

Article one of the bill provides legal protection for doctors who are willing to cause the death or assist the suicide of:

“a person of legal age, psychologically fit, ill with a terminal pathology, irreversible and incurable or afflicted by unbearable suffering, kills you or helps you kill yourself.”

It is clear that the bill legalizes euthanasia and assisted suicide because it states that the doctor will kill you or help you kill yourself makes.

Euthanasia is an intentional act to kill a person, upon request, who is disabled, sick or suffering. In most countries, euthanasia is prohibited by homicide or murder laws.

Assisted suicide is to intentionally provide the means for another person to kill oneself.

The Uruguay bill allows for a wider interpretation because it does not define the terms terminal pathology or unbearable suffering. 

The bill does not require a person to try effective treatments. There are many terminal conditions, where the person, with treatment may have years to live.  The term unbearable suffering is subjective. Some people find their condition to be unbearable but once they have received pain or symptom management, they change their mind. If terms are not defined or subjective, the doctors who participate in euthanasia will interpret the meaning of these terms over time.

Article two of the bill requires a second doctor to examine and confirm the medical diagnosis of the person requesting death.

Article three of the bill requires the primary doctor to confirm that the person requesting death is competent, free from coercion, has a continuous desire to die, and knows about alternatives. This article requires a second interview be done at least 30 days after the first request. The bill allows someone else to sign for the person requesting death. Allowing another person to sign-off is inappropriate and dangerous.

Article four of the bill requires the formal request for death to be made 3 days after the second interview. Once again, the bill allows someone else to sign. The bill also allows one of the witnesses to be a beneficiary. In most jurisdictions, a beneficiary is unable sign a will. This issue deals with life and death, rather than property and finances.

Article five of the bill states that the request is revocable.

Article six of the bill requires that the doctor who prescribes the lethal drugs (assisted suicide) must assure that the drugs are only used by the person who they are prescribed for. If the prescribing doctor is not present at the time of death, how will the prescribing physician assure that this happens?

Article seven of the bill requires the doctor who does the act or prescribes the lethal drugs to report the death to the Commission on Bioethics and Integral Quality of Health Care of the Ministry of Public Health, whether the doctor was present at the death or not.

This bill provides the physician with the: power to decide if the person should die, legal protection to cause the death, and then legal oversight to self-report the death to the authorities. Self-reporting systems provide the perfect legal cover since the only person who would know if the law was broken is the person who is dead.

Comments: The bill does not define the key terms, therefore the Uruguay euthanasia and assisted suicide bill can be interpreted in wide manner. For instance, most US states define terminal illness with a six month prognosis. 

The bill does not require a person to at least try effective treatments. There are many medical conditions that, if untreated, become terminal. Unbearable suffering is a subjective term. A person may be depressed or experiencing suicidal ideation and decide that their health condition is unbearable in order to be put to death.

Canada’s euthanasia law does not define key terms, creating a natural slippery slope with the number of euthanasia deaths and reasons for killing expanding very quickly.

The bill gives the power to decide life or death to the primary doctor with confirmation by a second doctor. Nowhere does the bill prohibit doctor shopping which is common in jurisdictions that have legalized medical killing.

This bill is accurate when it states that the doctor can kill you or help you kill yourself. Most jurisdictions employ softened language such as assisted death or medical aid in dying.  We must call it what it is.

Legalizing euthanasia permits medical murder. It kills the patient, who is in need of care not killing, and it changes the doctor who turns from healing to killing.

Uruguay needs to rejects this bill.