Elder abuse rates are rising in Oregon.

By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Oregon Stateman Journal published an article, by Carol McAlice Currie indicating that the Oregon Office of Adult Abuse Prevention and Investigations (OAAPI) had a 10% increase in allegations (38,000) for elder abuse in 2014. The OAAPI also reported that the number of elder abuse investigations increased by 10% to 18,185 in 2014. The State attributes much of the increase in allegations to the aging population and greater awareness of how to report it.

The report didn't specify the number of financial abuse allegations as opposed to the number allegations for physical abuse or neglect, nonetheless, the prevalence of elder abuse is a significant scourge on society.

The other interesting fact is that allegations were more likely to be received from people who were not obligated to report, as opposed to those who are obligated to report. According to the Statesman Journal article:

non-mandatory reporters in communities, such as bankers and financial service workers, continued across the board to outnumber mandatory reporters in reporting possible abuse or neglect by a 51 to 49 percent margin, said Joe Merrifield, who manages the research and prevention unit of OAAPI.

The Euthanasia Prevention Coalition recognizes that scourge of elder abuse is a sad reality in our culture that is hard to detect, even by professionals who are obligated to report the abuse. The fact is that legalizing assisted suicide, such as the Oregon assisted suicide act, creates new paths to abuse. The only difference is, in the case of assisted suicide is the victim always ends up dead and the doctor calls the death "personal autonomy."  

• Physician-Assisted Suicide: A recipe for elder abuse and the illusion of personal choice.

New York court upholds law protecting people from assisted suicide.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

A New York State judge rejected a legal challenge to the state laws that protect people from assisted suicide. The New York Daily News reported that:

state civil judge Joan Kenney said that while she was sympathetic to their plight, their doctors would have to stay on the sidelines. 

Kenney said in her ruling that the U.S. Supreme Court has already found that New York state laws prohibit assisted suicide, and the statutes are not in violation of a patients civil rights. 

“In New York, as in most states, it is a crime to aid another to commit or attempt suicide,” Kenney said in her ruling. “But patients may refuse lifesaving medical treatment.” 

Doctors could face prison time if convicted of aiding a suicide.

The case was based on three people who are seeking to die by assisted suicide in New York.

Judge Kennedy joins three other judges in upholding state assisted suicide laws. In the past few months, a Tennessee Judge upheld the state assisted suicide law, the New Mexico court of appeal and two California judges have upheld laws that protect people from assisted suicide.

Statement of Not Dead Yet (USA) to Canadian Panel on Carter Case Decision

Submitted by

Diane Coleman, J.D., M.B.A., President/CEO

Stephen Drake, M.S., Research Analyst

Not Dead Yet

497 State Street Rochester, New York 14608 USA

October 14, 2015

This statement was originally published by Not Dead Yet on their website.

Executive Summary

Not Dead Yet is a national, grassroots disability rights group that opposes legalization of assisted suicide and euthanasia as deadly forms of discrimination against old, ill and disabled people. Not Dead Yet helps organize and articulate opposition to these practices in the United States based on secular social justice arguments. Not Dead Yet also demands the equal protection of the law for the targets of so called “mercy killing” whose lives are seen as worth-less.

This submission to the External Panel on Options for a Legislative Response to Carter v. Canadawill focus on the Panel’s “key issue” in Terms of Reference Section 3.2 (c): “Risks to individuals and society associated with physician-assisted dying.” We will discuss the evidence coming from Oregon, the earliest of the four U.S. states to legalize assisted suicide, and outline the concerns of the disability community.

Regardless of our abilities or disabilities, none of us should feel that we have to die to have dignity, that we have to die to be relieved of pain, or that we should die to stop burdening our families or society. The realities of assisted suicide implementation in Oregon and three other U.S. states demonstrate the urgency of limiting the harms done by the Canadian Supreme Court ruling.

With that goal, we have two recommendations:

Adopt the detailed Goals, Principles and Recommendations submitted by the Council of Canadians with Disabilities (CCD),[1] which demonstrate a well-informed, evidence based and reasoned approach to reducing the dangers that will inevitably flow from implementation of Carter v. Canada. In order to completely incorporate CCD’s recommendations, direct consultation with a representative of CCD in drafting the legislation is necessary.

Provide training, guidance and encouragement to law enforcement agencies to exercise their existing level of authority to prosecute physicians and others involved in an assisted suicide or euthanasia death, while allowing those prosecuted to defend themselves by proving that the guidelines submitted by the Council of Canadians with Disabilities were met.

Introduction

Not Dead Yet is a national, grassroots disability rights group that opposes legalization of assisted suicide and euthanasia as deadly forms of discrimination against old, ill and disabled people. Not Dead Yet helps organize and articulate opposition to these practices in the United States based on secular social justice arguments. Not Dead Yet also demands the equal protection of the law for the targets of so called “mercy killing” whose lives are seen as worth-less.

This submission to the External Panel on Options for a Legislative Response to Carter v. Canada will focus on the Panel’s “key issue” in Terms of Reference Section 3.2 (c): “Risks to individuals and society associated with physician-assisted dying.”

In 1997, the U.S. Supreme Court ruled that a federal constitutional right to assisted suicide does NOT exist[2], but noted that individual states might be able to experiment with laws pertaining to the practice. Since then, four of the 50 states have legalized the practice by statute, beginning with Oregon in 1997 by ballot referendum. In addition, the high court in the state of Montana declined to find a state constitutional right to assisted suicide, but ruled that physicians may raise the defense of a victim’s consent if they are prosecuted for homicide in an assisted suicide case[3]. While we disagree with much of the Baxter court’s decision, it’s approach has the benefit of denying to those involved in the death of an old, ill or disabled person the blanket legal immunity that is characteristic of the four state statutes that have been enacted. This ruling forms the basis of our second recommendation to the External Panel.

An Analysis of Claims About Assisted Suicide in Oregon

In view of the frequent claims by assisted suicide proponents that Oregon’s experience demonstrates that there have been no problems of mistake, coercion or abuse of the state’s assisted suicide law, our analysis begins there.

Assisted suicide proponents claim that the data from Oregon on implementation of its assisted suicide law demonstrate that there are no problems. The Oregon “Death With Dignity Act” Reports,[4] and now the Washington Reports[5] as well, provide the appearance of scientific data, but little substance. They leave the most significant questions unasked and unanswered, mostly providing an annual excuse to announce through the press that everything’s fine, no problems, nothing to see. Nevertheless, as the Reports repeatedly admitted, the state is unable to assess the extent of under reporting and noncompliance with the law’s requirements.[6]

Beware of Assisted Suicide Bullies.

This article was published in the National Post on October 19, 2015.

Will Johnston

By Will Johnston

Dr Will Johnston is a family physician in Vancouver and the chair of the Euthanasia Prevention Coalition of BC

For at least a few more months, the Canadian medical system will continue to be a safe space, free of assisted suicide and euthanasia. But all that is about to change. In order to ensure our hospitals and palliative care centres remain places where patients feel safe and secure, we must respect doctors’ conscience rights, rather than listen to activists who seek to impose their one-size-fits-all policy on the rest of us.

For instance, the palliative care centres in Quebec that refuse to have anything to do with euthanasia, for reasons of medical judgment and ethics, have apparently angered Jean-Pierre Menard, the lawyer who helped write Quebec’s euthanasia law, Bill 52. The act specifically states that palliative care centres are not required to provide euthanasia service — but maybe to Menard, those were just soothing words to get the bill passed. Now Menard says money should be taken away from palliative services that won’t provide euthanasia on their premises. And the minister of health, Gaetan Barrette, has threatened to revoke the hospital privileges of doctors who won’t comply.

This is wrong. The doctors and nurses who devote themselves to the care of dying people reject euthanasia because it is a tempting substitute for diligence and creativity. People with exceptionally difficult end-of-life illnesses can have reversible palliative sedation, which preserves their life and completely alleviates their symptoms. This makes intentionally killing the patient an unnecessary, dangerous and irreversible intrusion.

Quebec’s hospice workers are wary of the risks and harms, which include causing distress among many dying patients and their family members who want safe spaces with no risk of interaction with euthanasia-minded doctors or nurses. (The broadly worded law would seem to allow for disabled or depressed people who are not dying to be killed as well, but these people are living in the community, not in palliative care centres.)

So why the temper tantrum from the euthanasia enthusiasts who designed Bill 52? We are seeing a winner-takes-all mentality among the activists who recently celebrated the Supreme Court’s carter decision legalizing assisted suicide and possibly euthanasia. These activists are far from planning a peaceful coexistence with those many doctors and nurses who want nothing to do with killing or suicide.

After years of agitation by publicly funded activist Jocelyn Downie, an assault on the objectors’ rights to exist as doctors and nurses in the Canadian health-care system is underway. Downie and others claim that unless their version of medical ethics reigns, a patient’s choice to undergo euthanasia and assisted suicide is threatened.

But many patients would choose against having suicide pills and lethal injections available in their hospital. And Downie and company seem oblivious to the demoralization of doctors and nurses who are being told to do what they think is wrong because tax dollars pay for the buildings.

It is alarming to see an activist assault on medical judgment inside Quebecois politics, but truly dangerous when officials in the provincial colleges of physicians and surgeons buy in. Using bits of Downie’s preferred “model conscience policy” word-for-word, the college in Saskatchewan has been angling to coerce its members into referring patients for assisted-suicide and euthanasia services, just as Ontario’s college did a few months ago. This arm-twisting is notable for its pointlessness. In our totally connected world, suicidal people and others under their direction will have no more trouble contacting euthanasia providers than ordering pizza.

With a little creativity and a spirit of fairness, it would be easy to design a system that allows legal but unsavory practices like euthanasia without bullying those who want to continue providing actual medical care. Our hospitals and hospices are national treasures that are awaiting an invasion by bitterly contentious new practices. This is faced with deep foreboding by many of us.

• Euthanasia lobby pressures College of Physicians and Surgeons of Manitoba to force doctors to refer for euthanasia.
• Quebec doctors are told that they will be made to practice euthanasia.
• Canadian psychiatrists are concerned that they will be forced to kill their patients.
• Assisted suicide: Respect the conscience rights of all.

Euthanasia lobby pressures College of Physicians of Manitoba to force doctors to refer for euthanasia.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

An article published in the Winnipeg Free Press, today, explains that Dying with Dignity, Canada's leading euthanasia lobby group, is pressuring the College of Physicians and Surgeons of Manitoba to require doctors to refer patients for euthanasia.

The Manitoba College is seeking input concerning guidelines for euthanasia in Manitoba. These guidelines do not require physicians who oppose euthanasia and assisted suicide to refer their patients to a physician who is willing to lethally inject their patient.

According to the Winnipeg Free Press article Shanaaz Gokool from Dying with Dignity is upset that the Manitoba College is not requiring doctors to refer patients for euthanasia:

"There are two main problems with the Manitoba statement," Gokool said. "There isn't a duty to refer and there's also not a duty to provide a patient with information about physicians who would assist with dying.

The article explains that Colleges of Physicians and Surgeons in Manitoba and Alberta are not requiring physicians to refer patients while the Ontario College is requiring physicians to refer.

The Euthanasia Prevention Coalition considers conscience rights for healthcare workers to be of paramount importance.

When physicians have the right to say - I will not kill you and I will not refer you to death - then physicians also have the right to say - I will protect you in your time of need.

• Winnipeg doctors speak out against assisted dying.
• Assisted suicide: respect the conscience rights of all.
• Canadian Psychiatrists are concerned that they will be required to kill their patients.

Assisted Suicide Coercion Happens Behind Closed Doors

This article was published by Wesley Smith on his blog on September 18, 2015.

Wesley Smith

By Wesley Smith

Assisted suicide propagandists insist that doctors will never assist suicides if they think a person is being coerced to die. 

How in the hell would they know? Family pressure isn’t exerted with a gun to the head that can be seen on an X-ray. It occurs in daily nudges and winks–subtle pushes–that drive the vulnerable person toward the abyss. 

One such example appears in the New York Times Magazine today, in a first person account of Carlos Framb, who pushed his mother–growing blind and debilitated with old age–into assisted suicide in Colombia. From, “Jumping the Wall” (my emphasis) 

For me, it has always been clear: Life is worth it only if you want it. And my mom didn’t. 

So I started talking to her. I wanted to lead my mom from her belief that suicide is a sin to my own view that suicide is a sovereign right every person has. 

But for my mom, religion was company, comfort. It would be wrong of me to try and convince her of something different. So I was just trying to lead her to the notion of a compassionate God, a merciful one. 

He didn’t finish the sentence: “Who would approve and understand when she committed suicide.”

Framb eventually got his way, as the mother’s resistance finally collapsed. He made the poison for her and gave it to her to drink.

He then tried to kill himself, but with no one there to make sure he died, he failed. 

And then Framb makes a pro-suicide pitch of the kind we often see in the ilk of the New York Times these days: 

I enjoy my life now, but I don’t see why I have to for the pleasure with a quota of pain at the end. 

When the conditions of life are no longer golden, which will come, obviously, then I will be more than willing to leave the way I want. 

Because that cocktail can be very sweet if you put enough sugar in it. 

This is proselytizing for suicide. I don’t see any other way to look at it. 

Culture of death, Wesley? What culture of death?

Physicians Pledge Against Assisted Suicide & Euthanasia

My Pledge To My Patients

I will treat the sick according to my best ability and judgement, always striving to do no harm. Whenever I care for a terminally-ill patient, I will provide optimal comfort care until natural death.

I will also support my patients' wishes not to prolong the dying process with futile care. I will never give a deadly drug to anyone if asked, nor will I suggest suicide.

I will always affirm and guard these ethical principles with integrity, recognizing that every human life is inherently valuable.

My Pledge To My Patients from the Euthanasia Prevention Coalition will be sent out, at no cost, to any physician who agrees with its principles. Email EPC at: info@epcc.ca.

How the assisted suicide lobby won in California.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Not Dead Yet protest image in Britain.

Michael Cook wrote a very insightful article today titled: How the assisted suicide lobby won in California that was published in the online bioethics site Careful. 

Another good analysis of the assisted suicide lobby was titled: Subversive strategies to sell assisted suicide, by Dr Jacqueline Harvey.

Cook bases his analysis on information from the assisted suicide lobby group, Compassion & Choices, formerly the Hemlock society. Cook writes:

According to Barbara Coombs Lee, the head of America’s leading assisted suicide lobby group, Compassion & Choices (C&C), it was Brittany Maynard, the just-married woman who drank a lethal dose of barbiturates on November 1 last year, a few weeks short of her 30th birthday. She died in Oregon because assisted suicide was illegal in her home state of California. 

Brittany, who had an aggressive brain tumour, wanted to use her death to send a message pleading for the legalisation of assisted suicide. A C&C video about her did exactly that. On October 6 last year it was released on YouTube; on October 5 this year, Governor Jerry Brown signed a bill legalising assisted suicide, a measure which had failed six times since 1988.

Defeat in America's biggest state has been a bitter pill for opponents of assisted suicide. But if you're handed a lemon, make lemonade. It’s also an opportunity to learn the lessons in propaganda which are exemplified so brilliantly in Brittany’s video. 

Hire professionals. Until Brittany, C&C videos attracted only a few hundred or a few thousand views. But hers has been seen about 12 million times. Dustin Hoffman’s daughter Allie, a well-known Hollywood figure who runs a New York public relations firm, put together a multi-platform media campaign called Twenty Nine Years (Brittany’s age). A professional story-telling consultant was employed to create the video. 

Create a religious frame for the story. Paradoxical as it may seem, Brittany’s video was deeply spiritual in its rhetoric and language. Just as Christ’s suffering redeemed the world, Brittany’s “passing” (another Christian term) would relieve the suffering of many others. In other words, she was a martyr. Barbara Coombs Lee reinforced that in her commentary. She vowed to Brittany before she died that C&C would be “her good and faithful servants”, a phrase taken straight from the Bible. 

Find a star who is young, attractive and articulate. And preferably and white. Being young is just a marketing ploy, as most of the people who take advantage of assisted suicide are elderly. Being white probably helped C&C, too, as the assisted suicide movement is largely WWW – worried, well and white. They could identify with Brittany. If you survey the C&C videos and the C&C Board, you will see only white faces and Anglo-Saxon names... 

Smile. Never criticise. Celebrate love. Despite Brittany’s tears, a pensive smile kept breaking through. She radiated resigned happiness. She never criticised opponents of assisted suicide, at least not directly.

Make it a family affair. Key to the success of the video was the support of Brittany’s mother and husband. She spoke of dying at home, in her own bed, surrounded by family and friends. The video subtly created parallels between her wedding and her death – both were celebrations.

Make it a feast for the emotions. The insistent tinkle of a piano score in the background underlined the sincerity and serenity of Brittany’s decision as she dabbed at her eyes. 

In short, the video depicts assisted suicide as a joyful, faith-filled, family-friendly, fulfilling choice. Compassion & Choices stole the playbook of its opponents.

Michael Cook provides an analysis that is important for opposing euthanasia and assisted suicide everywhere. 

When watching the Brittany Maynard youtube video it is clear that it was professionally produced. It is also true that there were several youtube video's produced by people opposing assisted suicide, such as Maggie Karner, that were not professionally produced but very honest, straight forward and effective.

The reality is - the assisted suicide ran campaigns to legalize assisted suicide in more than 20 states. All of those campaigns failed. The only victory for the assisted suicide lobby was in California and that only happened after using subversive strategies to get the assisted suicide bill passed.

The most effective coalitions against assisted suicide have been organized by people who share a wide range of political and social beliefs, who have come together to defeat a common enemy, that being assisted suicide. The weaker coalitions have been overly managed in an attempt to reduce the messages of those who oppose assisted suicide rather than running an inclusive campaign.

The Euthanasia Prevention Coalition will not stop. Legalizing assisted suicide and euthanasia gives physicians the right to be intentionally involved with causing the death of people who are at the most vulnerable time of their life. This is simply wrong.

California Governor vetoes right to try and live bill, but signed assisted suicide bill.

This article was published by National Review online on September 12, 2015

Wesley Smith

By Wesley Smith

This makes zero sense. Last week, Jerry Brown signed assisted suicide into law in California. 

This week, Brown vetoed a bill that would have allowed dying patients to access experimental drugs in an attempt to live. From the Sacramento Bee story: 

Less than a week after signing legislation allowing California doctors to prescribe their dying patients lethal drugs, 

Gov. Jerry Brown on Sunday vetoed a bill that would have let terminally ill people petition pharmaceutical companies for access to experimental drugs before they are approved by the Food and Drug Administration. 

The so-called “right-to-try” legislation had gained support in more than a dozen states, and it sailed through the Legislature with nearly unanimous support. 

We see the same death-over-life pattern in Oregon, which rations Medicaid so as to prevent some terminal cancer patients access to life-extending chemotherapy, but never rations assisted suicide. 

Good grief: A “right to die,” but no “right to try and live.”

Netherlands 2014 euthanasia report - another 10% increase in euthanasia.

By Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

The 2014 Netherlands euthanasia report was released indicating that there was another 10% increase in assisted deaths. There were also 41 assisted deaths for psychiatric reasons and 81 assisted deaths for dementia. The term assisted death refers to deaths by euthanasia and assisted suicide.

The 2014 report stated that there were reported 5306 assisted deaths up from 4829 reported assisted deaths in 2013. These numbers do not include the unreported assisted deaths.

Based on the 5306 reported assisted deaths, there were 5064 euthanasia deaths, 242 assisted suicide deaths and 4 reported cases that did not comply with the law.

Every five year the Netherlands has a meta-analysis euthanasia study. In 2010 the Lancet study indicated that 23% of all assisted deaths were unreported in the Netherlands.

The number of assisted deaths in the Netherlands continues to increase.

• There were 2331 reported assisted deaths in 2008.
• There were 2636 reported assisted deaths in 2009.
• There were 3136 reported assisted deaths in 2010.
• There were 3695 reported assisted deaths in 2011.
• There were 4188 reported assisted deaths in 2012.
• There were 4829 reported assisted deaths in 2013.
• And now 5306 reported assisted deaths in 2014.

Last year, Theo Boer, a Dutch ethicist, and a 9 year member of a Netherlands regional euthanasia review committee, changed his mind about euthanasia. Earlier this week Professor Boer wrote:

Theo Boer

Whereas assisted dying in the beginning was the odd exception, accepted by many — including myself — as a last resort... Public opinion has shifted dramatically toward considering assisted dying a patient’s right and a physician’s duty. A law that is now in the making obliges doctors who refuse to approve assisted dying to refer their patients to a willing colleague. Pressure on doctors to conform to patients’ or relatives’ wishes can be intense. 

Other developments have taken place as well. The Dutch Right to Die Society founded a network of traveling euthanizing doctors, thus taking assisted dying out of the patient-doctor relationship. There is a strong public movement toward legalizing euthanasia for children 1 to 11 years of age. Whereas in the first years hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering of those given assisted dying consisted of being aged, lonely or bereaved.

A recent study examining the first year at the Netherlands euthanasia clinic found that "tired of living" and dementia were common reasons for euthanasia. The study found that:

Of the 162 who died by an assisted death, the data indicates that 6 assisted deaths were done for psychological reasons, 21 assisted deaths were done for cognitive decline, such as dementia and 11 assisted deaths were done based on "tired of living." Tired of living means that the person does not have a specific illness.

The Netherlands euthanasia clinic has also been implicated in several controversial deaths:

• An incompetent woman with dementia died by euthanasia, even after the nursing home opposed it.
• A healthy 63 year old autistic man who was depressed and soon to retire felt he had no reason to live.
• A healthy woman with Tinnitus died by euthanasia.
• A woman died by euthanasia because she didn't want to live in a nursing home.

On February 6, the Supreme Court of Canada struck down Canada's assisted suicide law and in its decision it used language that would allow euthanasia. 

The Netherlands experience with euthanasia is frightening. The Canadian government must either use the notwithstanding clause to prevent the legalization of euthanasia or to pass new legislation that is designed to make euthanasia and assisted suicide non-existent.

French court decision enables Vincent Lambert to receive food and water.

Vincent Lambert

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

A French court decided to enable Vincent Lambert to continue to live. The court decision supported the position of Lambert's parents, was that Lambert would continue to receive food and water. Lambert's wife wanted feeding to cease which would cause him to die by dehydration.

Lambert has been living with a significant cognitive disability since his motorcycle accident in 2008.

Vincent Lambert's mother

According to the RFI news, the judges said:

Lambert's doctors were within their rights, based on their "professional and moral independence," to suspend an earlier court decision that would have seen them cut the intravenous food and water keeping him alive. 

...the decision to stop intravenous feeding can be undertaken "solely by the doctor in charge of care." The hospital may not oppose it. 

The judges also ruled that the previous medical decision could not be imposed on a new doctor. 

This judgement throws the burden of responsibility back on to the doctor, 

On June 5, 2015; the European Court of Human Rights decided that Vincent Lambert, a cognitively disabled man, could have his food and water withdrawn causing his death by dehydration. Lambert's parent's appealed the ruling of the European Court of Human Rights.

To intentionally withdraw fluids from a person who is not otherwise dying is a form of euthanasia by omission because the person directly and intentionally dies from dehydration and not from a medical condition.

Winnipeg doctors speak out against assisted dying.

By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Winnipeg Manitoba doctors Mark Kristjanson and Larry Rados will not participate or refer for euthanasia or assisted suicide. According to CBC News:

Dr Mark Kristjanson

Kristjanson has 30 years experience in family medicine, palliative care, working with the disabled and oncology.

Kristjanson believes the number of doctors who are promoting assisted suicide across the country are in the minority. He believes those doctors want to see all physicians obliged to at least refer a patient for assisted suicide if they don't want to participate. 

But that is something neither Kristjanson or Dr. Larry Rados are prepared to do.
Rados is an acute care doctor with more than 25 years experience. He says assisted suicide is clearly at odds with his conscience and the Hippocratic Oath to not cause harm. And if a patient requests it, he says he won't refer that patient to another doctor. 

"I will take the view that a referral to another doctor would be equivalent to a recommendation for the procedure. Why would I make a referral for assisted suicide if I don't think it is in the patient's best interest?" 

Larry Rados

Rados says some people seem to take the view that a doctor should be a glorified waiter in a restaurant who should take a patient's order, no matter what they ask.

"Every doctor that has been around for a while knows there are times when you say no. We say no when a patient asks for narcotics and doesn't need them. We should be allowed to say no in this case as well with regard to referring patients," Rados says. 

Kristjanson says he's not prepared to budge. 

"I wouldn't quit voluntarily," he says. "But if the College takes a firm stance that I must refer to another colleague, I still would not make a referral. If that would risk losing my license, that would be a risk I would take. Although that would not be the route I would prefer." 

Rados says he too will follow his conscience and accept the consequences. 

"This isn't why I or some or my colleagues went into medicine. It's to wear the white coat of the healer not the black coat of hastening someone's death. I would subject myself to whatever discipline that is necessary to follow my conscience," Rados says. 

Both are hoping it won't come to that. 

"The College has always carved out space for conscientious objection. It has always been very good about respecting the right or ability of a physician to practice within the bounds of their own conscience and to not stray into an ethically problematic territory," says Kristjanson.

If legalized, physicians will be pressured to kill their patients or refer their patients to be killed, by euthanasia or assisted suicide. At the recent CMA national meeting 63% of the physicians stated that they would not participate in assisted dying while only 29% stated that they would not refer for assisted dying.

If euthanasia is going to be imposed on Canadian society, physicians must have the right to opt out.

Theo Boer: California Governor should have talked to Holland before signing assisted suicide bill

By Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Theo Boer

Professor Theo Boer, who was a member of a regional euthanasia review committee for 9 years, and then changed his mind to now oppose legalizing euthanasia, wrote an opinion article that was published in - The Press Democrat in California.

Boer argues that California Governor Jerry Brown should have talked to Holland before he signed the assisted suicide bill. Boer wrote:

Now that Gov. Jerry Brown has signed the End of Life Option Act, my thoughts go back more than 20 years to the early days of assisted dying in the Netherlands. And I can’t help but feel we — the Dutch — were naïve on this issue. 

In 1994, the Dutch were the first in the world to officially legalize assisted dying. It was a modest beginning, just as California’s is now. With no country going before us, assisted dying was formalized in a special clause in the Burial and Cremation Act. If a number of safeguards were kept, doctors acting in accordance with them would not be prosecuted. A separate euthanasia law followed in 2001, not differing much from the 1994 clause and with Belgium following its northern neighbor in 2002. 

Five regional review committees, consisting of a lawyer, a physician and an ethicist, keep an eye on the practice and assess whether each case of assisted dying has been in accordance with the law. I served on one of the committees from 2005-2014 and reviewed around 4,000 cases. Given the widespread support for assisted dying in the Netherlands, I was convinced that legalizing assisted dying was the wisest and most respectful route.

Boer explains what happened to the culture in the Netherlands:

In the first 13 years following 1994, the Netherlands seemed to have found the means to organize assisted dying. Then, for unknown reasons, the numbers started going up, year after year, from 2007 on. It was as if the country had needed the first decade to get used to the whole idea of an organized death. 

In the years of my membership, the review committee saw a rise in the number of reports from 1,800 to close to 5,500 last year. Now about one in 25 deaths in the Netherlands is the consequence of assisted dying with, by the way, suicide rates going up as well.

Boer then discussed how euthanasia has become common:

Whereas assisted dying in the beginning was the odd exception, accepted by many — including myself — as a last resort, it is on the road to becoming a preferred, if not the only acceptable, mode of dying in the case of cancer. Public opinion has shifted dramatically toward considering assisted dying a patient’s right and a physician’s duty. A law that is now in the making obliges doctors who refuse to approve assisted dying to refer their patients to a willing colleague. Pressure on doctors to conform to patients’ or relatives’ wishes can be intense. 

Other developments have taken place as well. The Dutch Right to Die Society founded a network of traveling euthanizing doctors, thus taking assisted dying out of the patient-doctor relationship. There is a strong public movement toward legalizing euthanasia for children 1 to 11 years of age. Whereas in the first years hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering of those given assisted dying consisted of being aged, lonely or bereaved.

Boer then reflects on California Governor Brown signing the assisted suicide bill.

Hearing of Brown’s decision, and without doubt any of his good intentions, my thoughts go back to our own pioneering years. As I said, I think we have been naïve. 

The Dutch and Belgian examples show that a law that makes possible an assisted death may well create its own dynamics. Clearly the “supply” of assisted dying creates new “demand.” Right to die advocates see the Dutch law not as a respectful compromise but as a first step toward more radical rights, such as a lethal pill for anyone over 70. The Dutch Right to Die Society now offers course material to high schools, where my teenage kids go, intended to broaden their support for euthanasia as a normal death. This would be unthinkable were it not for the existence of the present law. 

Of course, I, too, know of exceptional cases that may justify a decision to shorten a patient’s life. But I am no longer convinced that a law is the best way to deal with such cases. The governor might have visited the Netherlands first, before signing the act.

Theo Boer is a professor of health care ethics at Kampen University in the Netherlands.

Study: The Supreme Court of Canada was wrong on assisted dying.

By Alex Schadenberg
International Chair, Euthanasia Prevention Coalition

For several years the Oregon suicide statistics seemed to indicate that legalizing assisted suicide had a suicide contagion effect. 

The assisted suicide lobby argue that legalizing assisted suicide prevents desperate people from dying by suicide and they argue that legalizing assisted suicide enables people to live longer because they do not need to die earlier by suicide in order to be capable of causing their own death. The second argument was wrongly accepted by the Supreme Court of Canada in the Carter decision.

The data is clear. A study published by the Southern Medical Association (October 2015) concludes:

Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.

The study examined the suicide rates in Oregon, Washington State, Montana and Vermont, where assisted suicide is permitted. After taking into account factors that are known to effect suicide rates, the data indicates that:

PAS is associated with an 8.9% increase in total suicide rates (including assisted suicides), an effect that is strongly statistically significant (95% confidence interval [CI] 6.6%Y11.2%). Once we control for a range of demographic and socioeconomic factors, PAS is estimated to increase rates by 11.79% (95% CI 9.3%Y14.1%). When we include state-specific time trends, the estimated increase is 6.3% (95% CI 2.7%Y9.9%).

Therefore legalizing assisted suicide is associated with at least a 6.3% increase in the rate of suicide deaths.

The other assertion is that legalizing assisted suicide enables people to live longer since they do not need to die earlier based on being able to commit suicide. The study considered this argument as attributed to Richard Posner.

Richard Posner has conjectured that legalizing PAS may have the effect of reducing the total number of suicides and postponing those that do occur. The knowledge that PAS is available for people who are physically incapacitated could enable such patients to delay their decision to attempt suicide. Furthermore, some may be contemplating suicide because of an overly pessimistic belief about the progress of their disease and/or about their ability to cope with their declining condition. If people delayed their attempt at suicide they might then come to see that they had been mistaken. As a result, "if physician-assisted suicide in cases of physical incapacity is permitted, the number of suicides will be reduced. Moreover, in the fraction of cases in which suicide does occur, it will occur later than if physician-assisted suicide were prevented." An implication of Posner’s conjecture about delays to suicide is that there would be an increase in the average age of suicide.

The Supreme Court of Canada agreed with Posner's assertion:

In 2014 "evidence of premature death" resulting from the lack of access to PAS was presented before the Supreme Court of Canada. In February 2015 the court concluded that "the prohibition deprives some individuals of life."

The study found no evidence that people delay death when assisted suicide is legal:

The evidence from suicide rates in states that have legalized PAS is not consistent with Posner’s conjecture that such legal changes would lead to delays and net reductions in suicide. Rather, the introduction of PAS seemingly induces more self-inflicted deaths than it inhibits. Furthermore, although a significant proportion of nonassisted suicides involve chronic or terminal illness, especially in those older than age 65, the available evidence does not support the conjecture that legalizing assisted suicide would lead to a reduction in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide or that it acts in this way in some individuals but is associated with an increased inclination to suicide in others.

Therefore the Supreme Court of Canada was wrong when it asserted that prohibiting assisted death was an infringement of Section 7 of the Charter, the right to life. The data does not uphold this dangerous and irresponsible conclusion.

Canada's parliament will need to respond by either using the Notwithstanding Clause (Section 33 of the Constitution) to put aside the Supreme Court decision or to protect Canadians with robust legislation that prohibits euthanasia and assisted suicide.

California seniors group file papers to challenge assisted suicide law on the 2016 ballot.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

A California group called Seniors Against Suicide, who opposed the California assisted suicide bill that was signed into law by Governor Brown on October 5, filed papers with the California Attorney General's office to put the issue of assisted suicide on the State ballot in 2016, as reported by the Associated Press.

According to the LA Times, a letter from clinical psychologist, Dr Mark Hoffman stated:

“Illness is never a reason for ending a life,” 

He said that he is:

"working with other opponents of medically killing depressed and ill patients."

According to California law, opponents of legislation have 90 days (January 3, 2016) to collect 365,880 signatures to place the issue on the 2016 ballot. 

The Euthanasia Prevention Coalition (EPC) supports all legal measures that will protect people from euthanasia and assisted suicide.

Ezekiel Emmanuel

Meanwhile, the Tyler Morning Telegraph reported that the California assisted suicide law will be abused. The article quoted Dr Ezekiel Emmanuel, a long time advisor to President Obama, who studied the experience with legalized assisted death in the Netherlands and found widespread abuse. According to Dr Emmanuel:

“The Netherlands studies fail to demonstrate that permitting physician-assisted suicide and euthanasia will not lead to the non-voluntary euthanasia of children, the demented, the mentally ill, the old, and others,” he wrote for The Atlantic. “Indeed, the persistence of abuse and the violation of safeguards, despite publicity and condemnation, suggest that the feared consequences of legalization are exactly its inherent consequences.”

Legalizing assisted suicide authorizes physicians to prescribe a lethal dose to patients who are at the lowest time of their life.

Groundbreaking study links legal 'assisted dying' to an increase in suicide rates

Media Release - October 7, 2015

Some advocates claim that the legalisation of physician-assisted suicide (PAS), also known by the euphemisms 'assisted dying' and 'end of life choice', could lead to a reduction in total suicides and delay suicides that do occur. Until recently these claims had not been tested by research.

A groundbreaking study published in this week’s Southern Medical Journal counters these claims. The study examined the association between the legalisation of assisted suicide and state-level suicide rates in the United States between 1990 and 2013.

It concluded that the legalisation of physician-assisted suicide is associated with a 6.3% increase in total suicides (including assisted suicides) and not at all associated with a decrease in non-assisted suicides.

“This suggests either that PAS does not inhibit (nor acts as an alternative to) non-assisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals,” the researchers concluded.

In the New Zealand context a 6.3% increase in suicide rates would represent an additional 35 deaths, based on the 2014-2015 statistics.

“I’m not at all surprised by the study's findings”, says Renee Joubert, Executive Officer of Euthanasia-Free NZ. “Assisted suicide laws communicate the message that the deliberate ending of one’s life is an acceptable solution to life’s problems.”

“There is essentially no difference between suicide and ‘assisted dying’, apart from the number of people involved in the act. Suicide is a person ending their own life without help from anyone else. Assisted suicide, by definition, is a person ending their own life with the help of someone else. Both result in premature death. 

“The slogans employed to justify 'assisted dying' also apply to suicide. Suicidal people may also feel they are ‘suffering unbearably’ and without hope. They may also feel it’s ‘their body, their choice’ and that they want to ‘choose when to die’. They may also feel they are exercising their ‘right to die’. Indeed, rights apply to everyone, regardless of health status or age.

“'Assisted dying’ slogans are counter-productive to our quest to lower the suicide rate in New Zealand,” says Ms Joubert.

The Health Select Committee is currently investigating the legalisation of 'assisted dying' within the wider context of suicide. More information about how to make a submission is available at suicideinquiry.nz.

Not Dead Yet Denounces California Governor’s decision to sign Assisted Suicide Bill

This article was published by Not Dead Yet on October 5, 2015.

Diane Coleman

By Diane Coleman, the President and CEO of the disability right group Not Dead Yet.

Today, NDY was devastated and disgusted to learn that California Governor Jerry Brown signed into law the assisted suicide bill that proponents rammed through a “special” session of the legislature convened to address the state’s Medicaid budget.

Governor Brown’s message accompanying his action states that he “carefully read” materials from opponents such as “those who champion disability rights,” but he nevertheless seems to have missed key facts.

For one, he says that “the crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life . . ..” Suicide is not a crime under California law (nor in other states), but assisted suicide proponents love to confuse people about that. The crime is when physicians and other third parties, such as the individual’s heirs, assist in suicide.

When confronted with that fact, proponents then often argue that old, ill and disabled people need help to commit suicide, which is another falsehood. As proponents promote on their website, any old, ill or disabled person can already commit suicide legally and peacefully in any state. So it is not a crime for a dying person to end his or her life peacefully, and Governor Brown’s stated “crux of the matter” is therefore mistaken.

Near the end of his short statement, Governor Brown said:

“In the end, I was left to reflect on what I would want in the face of my own death. 

I do not know what I would do if I were dying in prolonged and excruciating pain.”

This reveals that he didn’t really learn very much about the advances in palliative care when it comes to physical pain. At this point in time, palliative care physicians are able to relieve physical pain, even if that may in some instances require palliative sedation. Some people may feel that they don’t want to be made unconscious to relieve pain, but that’s a psycho-social issue. The implication that assisted suicide is needed to relieve physical pain is mistaken.

The Governor’s stated reasons are based on fallacies and his action must be denounced. When held up alongside the factually based and well considered reasons that disability rights organizations oppose legalization of assisted suicide – mistaken prognoses, insurance denials, family coercion and abuse, among others – his failure to veto the bill amounts to a breach of his duty to protect all Californians, not just the privileged few who can count on high quality health care and the support of a loving family.