Colombia's Health Ministry sets euthanasia guidelines.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 1997 Colombia's Constitutional Court ruled that: "the State cannot oppose the decision of an individual who does not wish to continue living and who requests help to die when suffering from a terminal illness that causes unbearable pain, incompatible with his idea of dignity".

Since that time, euthanasia has been technically legal in but rarely done in Colombia.

An article by Merco Press reports that Colombia's Health Ministry has set out guidelines for euthanasia. According to the Merco Press article:

Colombia's Health Ministry has issued Resolution 971, setting out the guidelines regarding the carrying out of euthanasia procedures, which has sparked some controversy among national lawmakers.

According to the document from the health authorities of the only country in South America so far to have legalized the right to death with dignity, the patient must make this request directly (verbal or written) or indirectly, through an advance directive document (DVA). The request must be voluntary, informed, unequivocal and persistent.

The resolution states that patients wishing to exercise their right to die with dignity will have to submit ”a clinical condition at the end of life, (...) present secondary suffering, be in a position to express the request directly.”

Once the patient makes the request, the doctor must immediately include it in the medical record and activate the interdisciplinary scientific committee that will study the request within the first 24 hours.

The document also establishes that “health providers (IPS) that have enabled the medium or high complexity hospitalization service for oncological hospitalization, institutional care for chronic patients or home care for chronic patients, that have protocols of management for palliative care, will make up within each entity a scientific-interdisciplinary committee for the right to die with dignity through euthanasia.”

The committee must study the applications within the first 10 days and will be made up of a lawyer, a doctor with the speciality of the pathology suffered by the patient and a psychiatrist or clinical psychologist, and when the committee is formed, it must be declared that none is a conscientious objector.

A bill to regulate euthanasia failed to pass in Colombia in April.

Eugenics: The root of the assisted dying movement.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In response to attacks against the Care Not Killing Alliance in the UK, Jamie Gillies, in spiked-online focuses on the eugenics roots of the assisted dying movement. Gillies writes about Killick Millard who founded the leading assisted dying group in the UK. Gillies states:

Scotland’s media class seems quite happy to spare prominent groups on the other side of the assisted-suicide debate from scrutiny. The Record, for instance, has failed to mention that Dignity in Dying, the group leading the charge for assisted suicide in the UK, was founded and funded by eugenicist politician Killick Millard.

Millard is said to have been ‘informed by a coherent philosophy… underpinned by eugenic ideas about the importance of maintaining the calibre of the racial stock’. He was what, in modern terms, we might call ‘ableist’, arguing in 1931 that the ‘feeble-minded and mentally deficient’ – those with mental-health problems – ‘should be sterilised’.

And he was also anti-working class. In 1911, in an essay on poverty, Millard celebrated the fact that ‘slum dwellers’ had a high rate of infant mortality, stating that ‘this consideration goes a long way towards allaying the fear that the falling birth-rate of the superior classes, and the comparatively high birth-rate of the very lowest class, threatens the quality of the race’.

It must be noted that in March 2020, a UN disability rights expert stated that she is concerned about euthanasia, assisted suicide and the new eugenics.

The American media also ignore the fact that the leading assisted suicide lobby group in the US, was also founded by hard core eugenics proponents.

Historian, Ian Dowbiggin, in his ground breaking book: A Merciful End: The Euthanasia Movement in Modern America. proves beyond a doubt that the founders of the euthanasia lobby were wedded to the eugenics movement. His book was so clear that Compassion and Choices appears to have destroyed its historical archives.

In November 2015 Dowbiggin wrote about his concern that the historical records of the euthanasia lobby were destroyed. He wrote:

One thing is clear: if the euthanasia movement’s records have indeed been destroyed, a lot of history has vanished, Orwell-like, down a cavernous memory hole. And with it, information the right-to-die movement doesn’t want you to know.

I should know, because I saw these records and I know what was in them. I wrote up my findings in my 2003 book on the history of the movement, published by Oxford University Press.

The story of my involvement in these valuable records begins about fifteen years ago when I was given permission to explore the archives of what used to be called Partnerships for Caring, Inc. PFC was a successor organization to the defunct Euthanasia Society of America (ESA). The ESA records, housed in a law firm in Baltimore, consisted of 15 large cardboard boxes holding correspondence, financial records, press releases, published materials and minutes of meetings, much of it uncatalogued.

There were literally thousands of items in these boxes documenting the entire 20th c. history of the U.S. and non-American activists who advocated the legalization of various forms of euthanasia. The ESA archive contained materials relating to the careers of noteworthy social activists such as Derek Humphry, the founder of the Hemlock Society (now called Compassion and Choices), Joseph Fletcher, the founder of “situation ethics,” Alan Guttmacher (after whom the population-control Guttmacher Institute in New York City is named), and the birth control pioneer Margaret Sanger who, unbeknownst to all her biographers, was also a vocal proponent of legalized euthanasia.

Not only did these activists urge governments to permit voluntary mercy-killing and physician-assisted suicide, many also supported the involuntary mercy-killing of handicapped people. For example, despite his knowledge of widespread Nazi murder of people with disabilities, in 1943 the ESA’s president thought it was a good idea to legalize euthanasia in time for returning veterans who suffered from mental and physical wounds.

Dowbiggin then explains how he learned that the euthanasia lobby destroyed their history. Dowbiggin states:

But the story did not end there. About five years after the book’s publication, I was contacted by a US graduate student researching the history of euthanasia. She told me that in trying to track down the ESA records she had been informed that the collection had been intentionally destroyed.

 Just this year another US graduate student got in touch with me, also trying to locate the ESA archives. She too has been told the records no longer exist, although she is still investigating.

Of course, it might be that the ESA records are sitting somewhere safe and sound. Yet why do groups like Compassion and Choices ignore my own requests for information? Why, when a published scholar in the history of medicine enquires about the whereabouts of this important archive, is there a resounding silence?

The euthanasia lobby, world-wide, was intertwined with the eugenics movement and its leadership continues to be suspicious in its ideology today.

Let's be clear. Removing the requirement of consent at the time of death, extending euthanasia to people with dementia, and in the Netherlands, the approval of the Groningen Protocol, which permits killing of babies with disabilities, are all eugenic ideolical positions.

Should psychiatrists assist the suicide of their patients, even if it is legal?

This article was published by the Psychiatric Times on July 8, 2021

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Doctors Ronald W. Pies, MD, Mark S. Komrad, MD, Cynthia M.A. Geppert, MD, MA, MPH, MSBE, DPS, and Annette Hanson, MD tackle the difficult question in the Psychiatric Times, that being should psychiatrists assist the suicide of their patients, even if if is legal?

All of the writers have been published on issues concerning their professional obligations and why psychiatrists should never participate in assisted suicide, but now they have written about a more nuanced questions concerning the participation in acts of suicide.

This article is a response to the article "A New Question in End-of-Life Ethics" by Strouse, Battin, Bostwick, et al. Their article in turn addresses an earlier essay on suicidal ideation and behavior in oncology patients.

The response by Pies et al breaks down their concerns into several key issues.

Dr Ronald Pies

The first issue is - What is legal vs what is right. Pies et al state:

The mere fact that some state legislatures have passed statutes redefining suicide, such that MAID is not suicide, does not prove that this redefinition is conceptually or ethically justified...

While redefining suicide averts legal liability for physicians providing MAID, it does not change the essentially unethical nature of the act itself. The term medical aid in dying fundamentally means helping patients kill themselves. This is why the American College of Physicians rejects the term and explicitly endorses the term physician-assisted suicide/PAS. Perhaps even more significant, following a comprehensive evaluation by the Council on Ethical and Judicial Affairs, the American Medical Association (AMA) House of Delegates rejected the term aid in dying and elected to retain the term physician assisted suicide in all AMA documents and references. Indeed, the process typically described as MAID in no sense aids dying; on the contrary, it rapidly converts an ill individual into a dead one. This is substantively different than the withdrawal of heroic but nonbeneficial or inappropriate measures, such as the use of ventilators that merely prolong the dying process in the final stages of a terminal illness.

Finally, statutorily declaring that self-induced death via a physician’s assistance is not suicide may soothe the consciences of legislators and allow payouts on life insurance policies; but, perversely, it may also incentivize some terminally ill patients to kill themselves.

Dr Annette Hanson

Pies et al then clarify that Taking One's Own Life is Suicide:

Redefining suicide to exclude PAS in the context of terminal illness represents a radical linguistic maneuver that flies in the face of ordinary language, expressed over thousands of years. The Latin suicidium—from which the English word suicide is derived—means the act of killing oneself intentionally or voluntarily. To be clear: we do not deny that there are often psychological and motivational differences between those with terminal illnesses who take their own lives and those who do so in the context of severe psychiatric illness, as the AAS statement details. But in both instances, the act is that of suicide.

As philosopher Gerald Dworkin, PhD, has put it

[A] s a philosopher, I feel an obligation to point out that, as a conceptual matter, there is nothing inaccurate or false about stating that a person who takes a drug, knowing that it will cause her death, and takes it because it will cause her death, is committing suicide on any reasonable conceptual analysis of what suicide is.

Dr Mark Komrad

They then discuss the issue of patients with Cognitive Distortions, who are not mandated to accept treatment:

Furthermore, most MAID laws do not require treatment for serious medical conditions, even when it is available to the patient. For example, a patient whose metastatic cancer stands a reasonably good chance of remission with aggressive treatment, but who nevertheless chooses MAID, is not required by state laws to undergo the treatment. Choosing assisted suicide in such a scenario may superficially appear to be a rational choice; but may instead represent a decision grounded in certain cognitive distortions that also characterize so-called conventional suicide. Importantly, this may be so, even in the absence of a diagnosed psychiatric disorder.

For example, Tomer T. Levin, MD, and Allison J. Applebaum, PhD, noted that some cancer patients may make erroneous assumptions, like, “No one can help me” or “No one understands what I am going through.” Such cognitive distortions may respond favorably to cognitive behavioral interventions and potentially avert or abort a request for PAS. Indeed, it has been found that “Requests for physician-assisted suicide are unlikely to persist when compassionate supportive care is provided.”

Unfortunately, in almost every US jurisdiction where PAS is allowed, no attempt to offer treatment by a mental health professional is required by law; and the psychiatrist’s role is typically relegated to ruling out mental illness and certifying competency for PAS.

Dr Cynthia Geppert

They then discuss why the Issue is not about intractable pain and suffering:

As Daniel P. Sulmasy, MD, PhD, noted, “Despite public arguments that PAS is needed to avoid excruciating pain and other symptoms, the reasons attributed to patients who seek PAS are not uncontrolled symptoms but lost autonomy, independence, and control.” These are forms of psychological distress which, in our view, are best managed with supportive and empathic counseling and/or cognitive behavioral interventions, provided to patients and their families—not by prescribing lethal drugs.

They then discuss the often forgotten but essential - Precautionary Principle:

This means erring on the side of caution and treating MAID requests from patients with terminal illnesses with the same degree of psychiatric scrutiny and concern that we would bring to any patient’s expressed wish to die. However, in most states, psychiatric assessment is not mandated in the MAID process and does not occur unless specifically requested by the evaluating physician who has initiated the MAID process.. This rarely happens. For example, in Oregon in 2020, only 0.8% of patients who were prescribed lethal medication were referred for psychiatric evaluation.

Moreover, the fairly subtle cognitive distortions described by Levin and Applebaum are unlikely to be detected in a superficial assessment of mental competence. It is no contradiction or paradox to argue, as we have, that pronouncing a patient qualified or competent for MAID is a violation of psychiatric ethics, since this unethically colludes with the process of aiding a patient’s suicide. Psychiatric involvement in end-of-life care is indeed essential, but it should remain well outside the procedures and processes involved in MAID deliberations.

They then discuss the stigma of suicide and how assisted suicide shifts it to "other" suicides:

Indeed, as numerous suicide prevention websites note: “Most suicidal people do not want to die. They are experiencing severe emotional pain, and are desperate for the pain to go away.” We would suggest that the same may be said of at least some individuals with cancer who seek MAID. Whenever complex ethical dilemmas are formulated as black-and-white categories, the many grey instances are often misclassified, with tragic consequences.

In short, the AAS position may have the perverse effect of merely shifting societal stigma from one group—those with terminal medical conditions—to those whose suicidal behavior occurs in the context of psychiatric disorders. We do not need such a 2-tiered classification, in which there are good and bad methods of taking one’s own life.

...We believe that efforts to promote MAID would be better directed toward destigmatizing the mental illnesses that underlie the majority of suicides and toward bolstering the availability of state-of-the-art palliative care.

Pies et al then conclude their article with the following statement:

Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support legalization of physician-assisted suicide. … However, through high-quality care, effective communication, compassionate support, and the right resources, physicians can help patients control many aspects of how they live out life's last chapter.

More articles on this topic:

• Psychiatrists must prevent suicide not provide it (Link).
• 12 myths about assisted suicide and medical aid in dying (Link). 
• Psychiatrists prevent assisted suicide not provide it (Link). 
• Euthanasia and physician-assisted suicide are unethical acts (Link).
  

Euthanasia: Look to the past, not the future.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

James Eglinton, who was published in The Times of Scotland on July 8, argues that opponents of euthanasia should look to the past and not try to predict the future. 

There is a lot of wisdom in Eglinston's arguement. I have always been careful with comparing the past to the present, nonetheless, Eglinton is commenting on human experience. 

Eglinton has several excellent arguements opposing euthanasia. He starts by questioning the ability to maintain a tight law that permits euthanasia. He states:

If bodily autonomy makes it undignified to have no choice in one’s death, why should that choice be restricted to those with terminal illness? Why not make it available to the disabled, the depressed, the healthy elderly who feel they are a financial burden, or the young and healthy who do not want to experience the indignities of old age and infirmity? Arbitrary restrictions hold water only until others see them as arbitrary discrimination.

In fact Eglinton is right. If euthanasia is about autonomy, which it is not, then how can it remain limited to the dying. Eglinton then turns to his premise that opposition to euthanasia should be argued from the past. He states:

The future is, of course, hard to predict, but we can move reliably from our present moment to the past that shaped it. What does it mean for us today that Scottish culture seems to be increasingly fertile soil for euthanasia?

The most thought-provoking answer came from the outstanding Jewish sociologist Philip Rieff, who described the modern West as a culture centred on psychology and therapy that affirms death rather than life.

Eglinton explains that Rieff borrowed his insights from his grandfather who was a Holocaust survivor. Eglinton explains:

Rieff’s explanation of his grandfather’s intuition was that Hitler normalised a doctrine of “life unworthy of life” — in that context, first practised “hospitably to the hopelessly ill and handicapped” before being applied to others. His norms changed ours.

Rieff’s reminder of our cultural history is far more uncomfortable than any warning about the future. It takes us from speculation about the world we will give our grandchildren to the question, “Who gave us the world of today?” If Rieff is right, the answer should shock us to the core.

Based on personal experience with the attitude towards people with disabilities and the elderly, sadly I agree with Rieff's grandfather and I am dismayed by the lack of shock toward the implementation of Canada's euthanasia laws. 

I am most saddened by the people who champion euthanasia who have been unwilling to accept the testimony of people with disabilities who, in this case, are like the canaries in the coal mine.

Dutch Death Doctors Pitch the Euthanasia Bull

This article was published by the National Review online on July 7, 2021

Wesley Smith

By Wesley J. Smith

Dutch euthanasia enthusiasts always pretend that doctors there commit homicide by lethal injection “only as a last resort” when nothing else can be done to eliminate “unbearable suffering.” What a pile of manure!

As I have been documenting over the past 28 years (!), euthanasia in the Netherlands has metastasized from killing the terminally ill, to the chronically ill, to people with disabilities, to the elderly, to people with dementia, to the mentally ill, to children of any age, and babies born with serious disablities. Yes, under the bureaucratic “Groningen Protocol,” Dutch doctors commit infanticide.

The latest apologia is published in JAMA Internal Medicine in response to an article demonstrating that the “slippery slope” in the Netherlands is very real. (Me, not a slippery slope. Facts on the ground.) Three Dutch doctors respond that “the slippery slope is nonexistent.” Good grief. From their letter:

On performing EAS [euthanasia, assisted suicide], physicians invoke force majeure, a legal concept based on an emergency situation instigated by a conflict of duties. This moral conflict consists of a physician’s duty to protect life and a physician’s duty to relieve suffering. . . . As such, physicians’ assessment of unbearable suffering ensures due care in carrying out EAS. . . .

According to the due care requirements, the patient’s request should not only be voluntary, but also well considered. This again pinpoints narrative ethics that enable patients’ clear insight into illness to make careful assessment of their story based on sufficient information provided by the physician.

Oh, please. Here’s a recent example of a so-called “emergency situation” (hit the links for greater details). A dementia patient had indicated she would want euthanasia, but she wanted to decide when. After becoming incompetent, she never asked to be killed. Moreover, when the doctor brought it up, she repeatedly said no.

So what happened? Her doctor drugged the patient — and when she woke up and resisted the lethal jab, she had the family hold her down so the killing could be completed! How a woman who clearly fought to live — and indeed, who, according to the killing doctor, said no three times — was experiencing “unbearable suffering” is beyond me.

The response of the courts? Praise for the doctor. And then, the government expanded legal euthanasia practice to include drugging dementia patients and killing them when the doctor wants — even if the patient does not agree as to time and method — if the patient had asked for euthanasia in an advance directive.

That’s what always happens when Dutch doctors push beyond the supposed strict boundaries. The boundaries are just erased. In fact, prosecutions of euthanasia doctors who violate guidlines are very rare and never significantly punished. I don’t know of any doctor who violated the euthanasia law who ever went to jail, or indeed, was even suspended from practicing medicine. A nurse who euthanized a patient — nurses aren’t allowed to do that — did only two months.

I could go — and have gone — into example after example of the “nonexistent slippery slope.” But I will allow psychiatrist Boudewijn Chabot to explain. Who is he? A euthanasia advocate who assisted the suicide of a woman who asked to die because her children were both deceased. The Dutch Supreme Court applauded.

But now, Chabot thinks things have, shall we say, gotten out of hand. Here is what he wrote, as I reported in this Corner post:

Where did the Euthanasia Law go off the tracks? The euthanasia practice is running amok because the legal requirements which doctors can reasonably apply in the context of physically ill people, are being declared equally applicable without limitation in the context of vulnerable patients with incurable brain diseases.

In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required. In the case of dementia, such a restriction disappeared by making the written advance request equivalent to an actual oral request.

And lastly, it really went off the tracks when the review committee concealed that incapacitated people were surreptitiously killed.

As I wrote previously, it was all so predictable. Heck, I predicted it.

Euthanasia consciousness changes mindsets. It alters societal morality. It distorts our views of the importance of vulnerable lives. It leads to abandonment and various forms of subtle and blatant coercion.

Over time, it can’t be controlled. But sophists, such as the three Dutch death-doctor correspondents, point to the dry wording of statutes rather than grapple with the reality of the killing going on.

British Columbia woman prepares to die by euthanasia. She can't afford the cost of care.

"I shouldn't have to beg for my life."

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Moira Wyton titled: "I Shouldn't Have to Beg for My Life" is the story of a woman known as "Madeline" who is planning to die by (MAiD) euthanasia, not because she wants to die, but because she cannot afford the cost of her treatment and care.

Wyton explains:

Madeline has been preparing for medical assistance in dying, or MAID, for over a year, and says she could choose to die as soon as late July if she does not come up with the money to cover treatments for her complex mitochondrial and post-viral conditions.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multisystem disease that affects patients in myriad ways, leaving many with profound fatigue, cognitive and mobility challenges, trouble sleeping and in extreme pain. It can impact nearly all systems in the body, including respiratory, muscular, nervous and immune systems.

Madeline tells Wyton that she cannot afford the cost of her treatment and care that she estimates at $100,000 per year, on a disability assistance benefit of $1,358 per month.

Madeline told Wyton:

“They would rather see me die than recognize my illness and pay for the treatments that keep me alive,”

“My death is no more inevitable than a diabetic’s who can’t get insulin.”

Wyton explains that approximately 600,000 Canadians have ME/CFS and yet there are only 6 specialists in Canada. Wyton warns that more of these people may soon die by euthanasia.

"Madeline" which is not her actual name, started a podcast to discuss the health issues and her euthanasia dilemma at I Am Madeline.

Wyton reports that the podcast was created to save Madeline's life. She writes:

The podcast was born not just of Madeline’s desire to save her own life, but also to prevent others from experiencing the same neglect that she says leaves her with no choice but to prepare to die.

Madeline was reluctant but decided to participate after speaking to a close friend and realizing she doesn’t want to die “even more than I don’t want to do the podcast, that I don’t want to do the GoFundMe, that I don’t want to have to bare my soul and beg for my life.”

Madeline said that she wants to live and that she shouldn't have to beg for her life, but Madeline also said:

“MAID isn’t giving up; it’s just being brutally practical about what’s happening and that it’s because the larger system has abdicated on my whole disease.”

Madeline may be right, but she clearly explains how euthanasia is not about freedom, choice or autonomy but rather an abandonment of people at their time of need.

 

California 2020 Assisted Suicide report - 435 "reported" deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2020 California assisted suicide report which was released on July 1, 2021 indicates that there were 435 reported assisted suicide suicide deaths and 677 prescription for lethal drugs written in 2020 in California.

The assisted suicide lobby may focus on the data in the report stating there were 463 reported assisted suicide deaths in 2019 and 435 in 2020. 

It is very likely that the number of assisted suicide deaths were as high as 500 in 2020. Why do I think that?

The 2019 California assisted suicide report stated that there were 405 reported assisted suicide deaths in 2019 but the 2020 report states that there were 463 reported assisted suicide deaths in 2019.

The under-reporting in 2019 is based on the fact that the 2019 report stated that the ingestion status was unknown for 150 people who received lethal drugs while 82 of them were known to have died but no information was received. The 150 people with an unknown ingestion status likely comprised late reports, unreported assisted suicide deaths and some natural deaths.

The 2020 report handled the concern about the unknown status of people who received lethal drugs by stating:

The ingestion status of the remaining 164 individuals is unknown. Of the remaining 164 individuals, 83, ... have died, but their ingestion status is unknown because follow up information is not available yet. For the remaining 81 individuals, ... both death and ingestion status are pending.

Based on the fact that the 2020 report increased number of reported 2019 assisted suicide deaths by 58, I wouldn't be surprised if the 2021 report states that almost 500 people died by assisted suicide in 2020.

Under-reporting and abuses of the law are covered-up by the reporting system. The California assisted suicide data comes from reports submitted by the doctors who carry-out the assisted suicide death. Since this is a self-reporting system, it will never be known if a doctor does not send in a report or does not confess to abusing the law.

Order the pamphlet - Shedding light on assisted suicide in America.

At the same time, California legislators are debating the expansion of the assisted suicide law. Bill S.B. 380 removes safeguards and regulations in the law such as:

• Reducing the mandatory 15-day waiting period between the two oral requests for to 48 hours. 
• Forcing doctors who oppose assisted suicide to refer the person who requests it to a medical professional who will comply with the law. 
• Eliminating the original law’s sunset clause, which means they are eliminating the requirement to review the law.
  

S.B. 380 has not yet passed but it has received strong support at every legislative level.

I sadly predict that the 2021 California assisted suicide report will show a vaste increase in the number of assisted suicide deaths and that the 2020 report under-reported the number of reported assisted suicide deaths.

More information:

• California Assisted Suicide deaths increase by 20%. 405 reported assisted suicide deaths in 2019 (Link).
• California assisted suicide expansion bill will force physicians to refer patients to death (Link). 
• Assisted suicide deaths may not be quick or peaceful (Link).
• Suicide doctor conducts human experiments in killing people (Link).
  

Scottish medical professionals group oppose assisted suicide bill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Humza Yousaf published by the Scottish Legal news on July 5, 2021 concerns 200 Scottish medical professionals who signed a letter opposing the Scotland's latest bill to legalize assisted suicide.

Yousaf explains who signed the letter:

Signatories to the letter, sent as part of a campaign by Our Duty of Care (ODOC), include David Galloway, former president of the Royal College of Physicians and Surgeons of Glasgow and palliative medicine expert Professor Marie Fallon.

ODOC is an umbrella body of UK healthcare workers who oppose the intentional killing of patients by assisted suicide or euthanasia.

Yousaf report what the letter stated:

“We write with great concern regarding the introduction of a bill to legalise assisted suicide in Scotland. The shift from preserving life to taking life is enormous and should not be minimised. The prohibition of killing is present in almost all civilised societies due the immeasurable worth of every human life.

“Everyone has a right to life under Article 1 of the Human Rights Act 1998 such that no one should be deprived of that life intentionally. Some patients may never consider assisted suicide unless it was suggested to them. The cruel irony of this path is that legislation introduced with the good intention of enhancing patient choice will diminish the choices of the most vulnerable.

“As health care professionals, we have a legal duty of care for the safety and wellbeing of our patients. We the undersigned will not take patients’ lives - even if they ask us to. But for the sake of us all, we ask that the law remains unchanged.”

“Currently the law prohibits the intentional taking of life by an individual or by the state. Why is that? Because of the incredibly high value and worth that society places on all human life, without exception.

“We are encouraged that ordinary doctors and nurses from across Scotland have joined together to send a definite message to the Health Secretary.

Yousaf then quotes from Dr Gillian Wright, a former palliative medicine registrar now working in medical ethics who stated:

“We do understand that there is suffering at the end of life but this should drive us as a society, not to provide assisted suicide, but instead well-funded, accessible, high quality palliative care for all.”

Recent articles concerning the assisted dying bill in Scotland.

• Scotland to debate assisted dying bill (Link).
• Scottish politician claims assisted suicide bill doesn't legalize assisted suicide (Link).
• Care Not Killing Alliance comments on Scotland's assisted suicide bill (Link).

Computer Program Developed in Canada to Predict When Seniors Have 6 Months to Live

This article was published by the National Review on June 5, 2021

Wesley Smith

By Wesley Smith

As if we needed further evidence that medicine is growing increasingly impersonal, the Canadian Medical Association Journal has published a study that claims a computer program can predict when seniors have six months to live. From the Global News story:

Amid a lack of proper support for Canadians receiving home-based support towards the end of their lives, a new risk calculator is helping predict how long seniors have left to live.

The Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool — dubbed ‘RESPECT’ for short — can predict death within six months, and was developed using data from more than 491,000 community-dwelling adults aged at least 50 years who used home care between 2007 and 2013.

Always with the acronyms to hide utilitarian protocols and procedures. Euthanasia in Canada is called MAID (medical assistance in dying), and now, RESPECT. Good grief.

“The RESPECT calculator allows families and their loved ones to plan,” said Dr. Amy Hsu, investigator at the Bruyère Research Institute and lead author of the study.

“For example, it can help an adult [or] child plan when to take a leave of absence from work to be with a parent or decide when to take the last family vacation together.”

Or it could be used to restrict care and/or push euthanasia. As one Canadian bioethicist noted:

If the calculator would ever be introduced to Canada’s healthcare system, Bowman believes that it would be interfaced with the country’s medical assistance in dying (MAiD), and could possibly shape the attitude of palliative care and end of life decisions.

“It will also shape the attitude of health care workers and it also raises a deeper question of who will interface with the broader question of what types of life are worth living and who decides, which is profoundly important stuff,” he said.

Ya’ think?

People don’t die by the numbers. Much depends on the kind of care they receive, their mental states, and individual differences that can be immeasurable. Even the study’s authors note a very big problem.

As with many prediction models, RESPECT is less well-calibrated at the extremes of the distribution. In particular, we found that RESPECT overpredicted the mortality risk of patients in our top 3 risk bins.

Oops.

The idea that crucial and intimate decisions about patient care could soon be driven by a computer-modeling system — rather than individual assessments — is very alarming. And it will often be wrong. I know of several patients given six months or less to live who got kicked out of hospice because their health improved unexpectedly. This includes the humorist Art Buchwald, who left hospice when he didn’t die from kidney failure and lived long enough to write his last book.

But then, with the quality-of-life ethic taking hold in medicine throughout the West, a “follow the science!” approach would make it much easier for clinicians, socialized-medicine bean counters, and family to abandon frail patients to comfort-care-only regimens — or worse — and still get a good night’s sleep.

The disturbing campaign to legalise assisted dying.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill, the author of the book - Assisted Suicide: The Liberal, Humanist Case Against Legalisation, was published on July 4 in the Australian Spectator with his article: The disturbing campaign to legalise assisted dying.

Kevin Yuill

Yuill writes about recent campaigns to legalise euthanasia and assisted suicide and challenges the claims of the euthanasia lobby. Yuill writes:

It is hard not to agree that people should have the option to end their lives. But assisted dying should not be treated as a glorified painkiller. Though campaigners are undoubtedly sincere in their desire to alleviate distress, the history of the assisted dying campaign suggests that often there are those with a more worrying goal: the use of assisted dying to create a more ‘efficient’ society.

Campaigners claim assisted dying should be reserved solely for the terminally ill and mentally competent. But those countries in which it has already been legalised have seen its availability expanded, with worrying implications for how we treat the sick, disabled and elderly.

Yuill then comments on Canada, the Netherlands and Belgium:

Canada legalised medically assisted death five years ago, but new legislation has already repealed safeguards requiring a person’s natural death be ‘reasonably foreseeable’. Disabled people could now be euthanised. Belgium legalised euthanasia in 2002. It is now available for terminally ill children. The Netherlands also legalised assisted dying in 2002. Two decades on, it is already now accessible to those suffering from blindness, tinnitus, autism, dementia and mental illness. Extending access to healthy over-75s has already been proposed. Ever-widening obtainability is an inevitable consequence of treating euthanasia as only another way of reducing pain.

Yuill then comments on the history of the euthanasia lobby in the UK:

The leading campaign group for legalising assisted dying in the UK are Dignity in Dying. They first emerged as the Voluntary Euthanasia Society in 1936. The voluntary part was a concession designed to help assisted dying legislation through parliament, but economic concerns featured predominantly when it was debated in the 1930s. The founding member of the Voluntary Euthanasia Society, the Labour peer Lord Arthur Ponsonby, put forward the Voluntary Euthanasia Bill in 1936, arguing against the ‘mistaken notion’ that the Bill was about sparing people pain, insisting that it was really about ‘being a burden’, intended for those who ‘are no longer of any use’. His rhetoric reflected a society where the brutal utilitarianism of eugenics had not yet been discredited by the Nazis’ horrors.

The group’s decision to change their name to ‘Dignity in Dying’ in 2005 reflected shifting attitudes to death and suffering. The modern language of a ‘right to die’ reflects worries about the consequences of an aging society. Advances in medical science have ensured people are living longer than ever. But as lifespans have grown, so have fears of spending our last years with an ever-diminishing quality of life.

Yuill concludes his article by challenging the euthanasia lobby:

Assisted dying campaigners are often not to be trusted. The underlying logic has pushed for assisted dying to be continually extended beyond the terminally ill to anyone suffering from a debilitating condition. If assisted dying is legalised, we will find ourselves in a society where the elderly, sick or disabled are increasingly treated as burdens for simply wanting to continue to live. Politicians should hesitate before their sympathetic intensions push society even closer towards this nightmare.

Historian, Ian Dowbiggin, has also written several articles and a book on the euthanasia lobby (Link).

Killing to cure loneliness. Canada's euthanasia experiment

This article was published by the Australian Care Alliance on July 5, 2021.

• Canada's 2020 euthanasia report: Almost 8000 died by lethal injection, 1412 people died because of loneliness and 4% of deaths in BC were euthanasia (Link).
  

Hon Patty Hajdu Minister of Health

According to the Second Annual Report on Medical Assistance in Dying proudly presented by the Hon Patty Hajdu, Canadian Minister for Health among the 7,595 Canadians whose lives were ended in 2020 by the lethal injection of a deadly poison by a medical or nurse practitioner there were:

• 4,120 Canadians euthanased because they had cancer but with no discussion with an oncologist about this course of action; 
• 2,650 people who perceived they were a burden on their family, friends or caregivers;
• 1,412 people who requested that their lives be ended because they felt isolated and lonely; 
• 1,253 with non-terminal conditions;
• 227 people who were put to death because they were frail;  
• 322 people who needed disability support services but did not receive them; 
• 126 people who needed, but could not access, palliative care were given access to the lethal jab; 
• 59 people who the practitioner assessed as requesting a lethal injection "voluntarily" determined the alleged voluntariness without directly consulting with the person.

None of this has raised any alarm bells for the Minister for Health.

The fatally flawed euthanasia experiment forced on Canada by its seven Supreme Court justices in a 2015 decision is perverting medical and health care across Canada.

In 2020 in Canada, 1274 physicians and 71 nurse practitioners actively killed at lest one person with 200 of them directly ending the lives of ten or more people.

2,532 people were lethally injected less than ten days after requesting it - with the then legally required 10 day "reflection period" waived for 905 people who were not imminently dying but who, two practitioners claimed, could lose their decision making capacity within the 10 day period.

This raises real questions about the validity of the original request. If a person is on the verge of losing capacity what degree of certainty can there be that the person currently has full capacity?

However, under the changes to the law from 21 March 2021 the 10 day reflection period is abolished for anyone whose "death is reasonably foreseeable" so same day lethal injection on request is now just business as usual.

For people with non-terminal chronic conditions and disabilities there is a 90 day waiting period - but this too can be waived entirely if the two practitioners assert that decision-making capacity could be lost within that period.

And from March 2023, mental illness alone will also be grounds for receiving a lethal injection.

 

Euthanasia by telehealth is being pushed in Australia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Charles Corke, Associate Professor of Medicine at Deakin University and the Deputy Chair of the Victorian Voluntary Assisted Dying Review Board, that was published in the Conversation states that (Assisted Dying) euthanasia has been legal in the Australian State of Victoria since June 2019 but the law does not permit euthanasia approvals by telehealth. Corke writes:

Unfortunately, while Victorians have the right to request voluntary assisted dying under Victorian law, a Commonwealth legal impediment makes it unduly difficult to access this service.

Commonwealth law makes it a crime to use a “carriage service” for the purposes of conveying “suicide related material”.

Corke explains that the law prohibiting the conveying of suicide related material via a carriage service was passed in 2005 to prevent things such as incitement to commit suicide by cyber bullies or the promotion of suicide methods to those who are vulnerable and depressed. 

Corke is not completely accurate. The 2005 law was also to prevent Dr Philip Nitschke from promoting assisted suicide via the internet. Nonetheless Corke states:

But in relation to voluntary assisted dying, the practical effect is that using modern communication to respond to a patient who requests voluntary assisted dying is a potential Commonwealth crime — even though it may be legal under state law. When laws conflict, federal legislation trumps state law.

Based on these issues Corke wants the Commonwealth law either overturned or ignored. He writes:

It seems clear the Commonwealth Criminal Code needs to be amended, but this will take time. In the interim the Commonwealth Director of Public Prosecutions needs to issue a guideline that, where a person is acting in accordance with state voluntary assisted dying legislation, offences in the Commonwealth Criminal Code will not be prosecuted. To date, requests by Victoria that this assurance be provided have proved unsuccessful.

The problem with approving euthanasia (assisted death) by telehealth is that the physician approves death by lethal drugs for a person the doctor has never examined and likely never met.

 
Considering the problem of medical misdiagnosis and the fact the some people experience suicidal ideation, the facts are that allowing euthanasia by telehealth undermines the supposed safeguards that claim to prevent abuse of the law.

Whether the law concerning the delivery of suicidal material is amended or not, euthanasia should never be approved via telehealth.

Does Ireland really want or need euthanasia?

The following letter by Dr Will Johnston was published by the Irish Times on July 5, 2021.

Dr Will Johnston

Sir, – Contrary to the assertion by Alan Tuffery (Letters, June 28th) that expanding the grounds of euthanasia “has always been as a result of public discussion and legislative scrutiny”, as Canadian physicians we are sorry to report this has not been the experience here.

A review of the first five years of our euthanasia laws here was promised by the government. Before it had even begun, earlier this year we expanded our euthanasia legislation targets to include those suffering from mental illness alone. There was precious little meaningful public debate surrounding this significant legislative change, with the voices of the marginalised communities most affected by the new law being ignored.

For example, the most recent expansion of euthanasia eligibility was condemned by the Council of Canadians with Disabilities, yet its concerns had no weight with the ideologues running this issue. The United Nations Special Rapporteur on the Rights of Persons with Disabilities was unequivocal regarding her concerns about the consequences of the Bill. In her testimony to our parliament she said that “even if safeguards would be strengthened to ensure genuine consent, the damage is still done by portraying – not directly but effectively nonetheless – that the lives of persons with disabilities are somehow worth less than others”.

The grass may always appear greener, but it is best to face reality. The “stringent safeguards” once promised for Canadian euthanasia are an empty ritual. Euthanasia numbers bound upwards, 34 per cent higher in 2020 than in 2019. The system is not reliably engaged in suicide prevention. You have an illness – soon a purely mental illness, you want to die, whatever coercion there might be is not perceived, a doctor is found to end your life.

Does Ireland really want or need this? 

Dr Will Johnston
Vancouver Canada

Imagine a world where every hour counts.

This article was published by the Catholic Register on June 30, 2021.

By Charles Lewis

I have thought a lot about euthanasia over the years. I have thought about it too much.

I was at the National Post covering religion and ethics when I first read a story about assisted suicide in Oregon, one of the first jurisdictions to offer such a service. That was about 12 years ago. At the same time polls in Canada were showing a majority of Canadians wanted something similar.

My faith aside, the idea of putting down human beings struck me as something out of the Third Reich. I sensed that if Canada legalized state-sponsored death there would be a huge slippery slope. Unfortunately, I was right.

But one element of this just recently crossed my mind: Legalized euthanasia reveals a society that lacks creativity, imagination and courage. Killing patients is the lazy way out. Because of our own aversion to suffering and death we conclude it’s best handled through a syringe filled with poison. Problem solved.

For centuries medicine was intent on getting better at curing and comfort. And those efforts bore fruit. In the early 1970s, a system of care was developed to deal with those who were terminal. Dr. Balfour Mount of Montreal coined the term “palliative care.” His intent was to provide quality of life up until the moment of death.It affirmed that every hour of life, even the last hours, was important.

What we have now instead is a belief that life in the days, weeks and months before death is meaningless. Instead of finding better ways to help the sick and the dying, we now prefer to snuff out that life before things get messy.

It is easy to blame those politicians who brought in the legislation that made killing patients legal. I’ve done that many times. However, they are able to get away with it because most Canadians think it’s a great idea.

In the five years since the first euthanasia bill was passed it has evolved from a system meant for those near death to one in which pain alone is requirement. In two years, it will be available to the mentally ill. Beyond that my guess is teens will be next.

All of us are going to die. It sounds ridiculously obvious to say that but it’s an absolute reality that most of us never want to give a thought to. To talk about death is considered morbid. Yet, I believe that it is death that haunts all of us. Not so much the act of dying but the fear of what might come first — pain, the lack of independence and loss of dignity.

Over the years I have talked to palliative doctors who have said that it’s the fear of pain rather than pain itself that worries those who are dying. I have dealt with severe and at times crippling pain for years. I’m no hero but I amazed myself in my ability to handle it and even learn from it.

The worry about losing independence and dignity, to me, is off. Many of us will take care of family and friends when they need us most and never judge them because they are no longer as independent as they once were. Nor would most of us think they now lack dignity. So then why is it when we are gravely ill we think we’ll be a burden or lose our dignity if someone helps us?

Those who support euthanasia argue it is their choice and the rest should keep morality out of it. They say they are autonomous but they forget that when they go they will leave behind others who will miss them terribly. And those friends and family left behind will ask themselves whether they could have done more. They will feel guilt.

The truth is, we could have done more. We could have demanded of our leaders first-class palliative care, rather than death as a solution. Why in a rich country is palliative care only available to 30 per cent of those who want it?

Imagine a system in which state-approved suicide would be a last resort not the norm. Imagine what it would be like to know that when our time comes we would be well taken care. In that world we would eventually lose our fear of death. We would see those who are going before us cared in a way that would give us comfort too.

In the meantime science can develop better pain medication. Cancers that once were lethal will more easily go into remission or be cured. The last hours of our life would be just as important as the first hours. Life would be viewed once again as sacred.

Imagine that world.

 

Canada's 2020 euthanasia report: Almost 7600 people died by lethal injection, 1412 people died because of loneliness and 4% of deaths in BC were euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On June 30, Health Canada released the second annual report on (MAiD) euthanasia and assisted suicide. The data was gathered from the reports submitted by the medical or nurse practitioners who caused the death. There is no requirement that a third party or neutral person submit the euthanasia reports to ensure their accuracy.

The report does not even attempt to uncover potential abuse of the law. The data in Québec's report indicated that at least 13 assisted deaths did not comply with the law.

• British Columbia cancer patient was pushed toward euthanasia (Link).

The 2020 Canadian MAiD report indicates that the number of assisted deaths increased more than 34% in 2020:

In 2020, there were 7595 reported assisted deaths up from 5,660 in 2019 and up from 4,478 in 2018.

(MAiD) euthanasia deaths represented 2.5% of all deaths in 2020.

The number of MAID deaths in 2020 increased by more than 34% from 2019. The increase in 2019 from 2018 was more than 26% with every province experiencing an increase in the number of MAID deaths.

When all data sources are considered, the total of number of (MAiD) deaths reported in Canada from legalization until December 31, 2020 is 21,589.

Based on the fact that the Ontario data, which is published monthly, indicates increases in assisted deaths in 2021, I estimated that at least 4000 assisted deaths occurred in the first 6 months of 2021, meaning more than 25,000 MAiD deaths have happened in Canada since legalization.

British Columbia has the highest percentage with 4% of all deaths by (MAiD).

There is significant difference with the number of euthanasia (MAiD) deaths in each province. The data indicates that British Columbia has the highest percentage of (MAiD) deaths (4% of all deaths) and Quebec has the second highest percentage (3.1% of all deaths), while Newfoundland has the lowest percentage of deaths by euthanasia (0.9%).

British Columbia has been the most aggressive province to promote euthanasia and is forcing healthcare institutions to facilitate killing their patients. For instance:

• A recent story from BC concerned a cancer patient who was being pushed to euthanasia (Link). 
• In February, the Delta Hospice Society was defunded by the BC Ministry of Health because they refused to be complicit with euthanasia (Link). 
• In 2019, Alan Nichols died by euthanasia in Chilliwack BC, even though he was not dying but deeply depressed. His family begged the doctors to re-assess Alan based on the fact that Alan had lived his life with chronic depression, but they refused (Link).

Nature of suffering among MAID recipients

Practitioners reported that suffering among MAID recipients was closely tied to a loss of autonomy.

The most frequently reported reason for the patient asking to be killed was loss of ability to engage in meaningful life activities (84.9%) followed closely by loss of ability to perform activities of daily living (81.7%). Inadequate control of pain, or concern about it (57.4%), loss of dignity (53.9%) and inadequate control of symptoms, other than pain, or concern about it (50.6%).

I am particularly concerned that 18.6% or more than 1412 people listed loneliness and isolation as a reason to die by MAiD.

If Canadians had access to excellent end-of-life care then 57% would not state that inadequate control of pain or concern about it and 50% would not state that inadequate control of symptoms, other than pain, or concern about it are reasons to be killed.

On March 17, 2021 the Federal Government passed Bill C-7. The government has predicted that Bill C-7 will lead to a 20% increase in the number of MAiD deaths in Canada. Based on the fact that there were 7595 euthanasia deaths in 2020, it is possible that there will be more than 9100 deaths by lethal injection in 2021. Recent Ontario data suggests that this is exactly what is happening (Link). 

Canada's federal government and the Québec government have both established committee's to discuss the further expansion of euthanasia in Canada. 

The current Canadian government is committed to more death by euthanasia.

There is more information in the Second Annual Report on Medical Assistance in Dying that I will cover in future articles.