Scotland is being pressured to legalize assisted suicide. They need to care not kill.

Dr Gordon Macdonald, the parliamentary officer for Care for Scotland, wrote an excellent article that was published in the Scotsman on April 19, explaining why assisted suicide should not be legalised.

Dr Gordon Macdonald

Macdonald begins his article by discussing why the previous assisted suicide bill was defeated.

A new campaign has been launched in the ­Scottish Parliament by a ­cross-party group of MSPs to ­legalise assisted suicide. They plan to bring forward proposals for a new law before the next Scottish parliament election in 2021. 

The last time MSPs voted on the issue of assisted suicide in 2015, they rejected Patrick Harvie’s Assisted Suicide Bill by 82-36. It was a clear, ­comprehensive victory. If you listen back to the speeches made during that debate, it was clear that MSPs did not think the law could be made safe. 

Most members realised then that the risks of legalising assisted suicide were too high and would put vulnerable people at risk of harm. 

But pro-assisted suicide advocates, including a few MSPs, are determined to change the law in Scotland. The well-funded, London–based campaign group Dignity in Dying are taking their campaign to ­Scotland. They are saying that if they can change the law in Scotland, it will put huge pressure on the rest of the United Kingdom to follow suit. They are fundraising so they can buy ­billboards, posters and placards in order to pressurise MSPs to change the law.

Macdonald argues that legalizing assisted suicide will affect their caring society

Scotland has a long and proud ­history as being a compassionate, caring society where we look after each other. Assisted suicide would undermine this heritage in a radical and unalterable way. 

It would also undermine palliative care, put vulnerable people at risk and put doctors in an invidious ­position. It would heap ­pressure on some of the most vulnerable in ­society to end their life, perhaps ­prematurely because they feel as though they are a burden to loved ones or caregivers. Such an outcome is unavoidable. Instead of encouraging suicide, we should be ­helping ­people to see that they are valuable and of worth to ­family, friends and society, even in old age or ­experiencing ill-health.

Macdonald then explains how assisted suicide laws have expanded in other jurisdictions:

When introduced, assisted suicide laws might be focused on a certain, set of circumstances. As time goes on, the categories of eligibility extend to include more and more people. It can quickly expand from the terminally ill to include those with chronic illnesses, but not terminal conditions; from adults to children; from those with physical illness to include those who have psychiatric and psychological problems and even dementia. 

There are proposals in some ­countries to extend laws to include elderly people who are just tired of life and suggestions that elderly ­people over a certain age should not get significant medical assistance if they are unwell. 

There is a case at the European Court on Human Rights where three doctors are being investigated after a 64-year-old Belgian ­woman in good health with depression was ­euthanised, despite there being no official diagnosis. Her son only found out about it when the ­hospital ­contacted him to arrange the ­disposal of her remains. 

In the USA there are instances of people been denied health insurance for cancer treatment whilst being offered funding to commit suicide. We would be naïve to assume that such cases will not also ­happen here.

Macdonald then explains why assisted suicide safeguards don't work:

It’s not good enough to talk about safeguards when the ­evidence ­suggests there is no way assisted ­suicide legislation could ever be made fully safe from abuse. Is this really the sort of society in which we want to live? In Scotland, our Christian tradition has left a legacy of concern for the most vulnerable and a sense of responsibility to look after those unable to care for themselves. 

Sadly, our culture too readily equates dependence and vulnerability with weakness. But being vulnerable helps us to realise our dependence upon other human beings.

Dr Gordon Macdonald has been a long-time promoter of the belief that society needs to care for its citizens, not kill.

2018 Netherlands euthanasia deaths are lower. We are concerned about euthanasia for "completed life."

Alex Schadenberg
Euthanasia Prevention Coalition

The Dutch media reported that, the 2018 euthanasia report indicates that there were 6126 reported euthanasia deaths in 2018 down from 6585 reported euthanasia deaths in 2017. 

Annemarie de jong, writing for the Nordhollands Dagblad, quoted Jacob Kohnstamm, the Chairman of the Regional Review Committee on Euthanasia, that the number of euthanasia deaths was "a fluctuation in the figures".

The article by de jong also suggests that there will be an increase in euthanasia deaths in 2019. She reported that the Nivel research institute stated:

It is striking that the number of euthanasia reports increased by 9 percent in the first quarter of 2019 compared to the same period last year

According to research 20% - 23% of the euthanasia deaths are not reported in the Netherlands. It is possible that some of the controversial euthanasia cases were simply not reported.

I am convinced that the lower number of reported euthanasia deaths is primarily related to the euthanasia cases that are being prosecuted in the Netherlands and Belgium. Doctors simply don't want to be brought before a tribunal or court to justify why they lethally injected a patient.

The number of euthanasia deaths for dementia and psychiatric problems also declined in 2018 while a new category of death causes me concern. The Dutchnews.nl reported:

Of the cases reported to the committee last year, 146 concerned people with dementia and 67 people had severe psychiatric problems. In 205 cases, patients had multiple problems derived from the ageing process.

In 2017, 169 people died by euthanasia for dementia (3 were advanced dementia) and 83 people died by euthanasia for psychiatric reasons.

The 205 people who had multiple problems derived from the aging process were part of a new category: "the completed life."

• She was euthanized without consent in the Netherlands.

There were several controversial Netherlands euthanasia stories in 2018.

In August 2017, a 5 year study sponsored by the Netherlands government showed significant increases in assisted deaths and continued abuse of the law.

In January we learned that Berna van Baarsen, who had been a euthanasia assessor for 10 years, resigned over cases of euthanasia for dementia.

In January, Aurelia Brouwers (29) died by euthanasia for psychiatric reasons. She was physically healthy.

In March we learned that the public prosecutor was investigating several controversial euthanasia deaths. The public prosecutor was also investigating a euthanasia group in the Netherlands after the death of a 19-year-old woman.

In July a Dutch doctor was reprimanded in the euthanasia death of a woman with dementia who had resisted.

In November, the Dutch doctor who euthanized a woman with dementia who had resisted, was prosecuted.

The euthanasia train left the station a long time ago in the Netherlands. Sadly, Canada is quickly riding the same euthanasia track and experiencing the same concerns.

Euthanasia was sold to the public as an "option" for people who are nearing death and suffering. It was then promoted for people who are not nearing death and fear possible future suffering. It was then extended to children and people with dementia. Finally it has extended to anyone who claims to have a "completed life."

Reject euthanasia. A culture that cares and not kills is the only way to go.

New Zealand lawyers oppose euthanasia bill.

The following statement can found at: Lawyers for Vulnerable New Zealanders.

We are lawyers and legal academics from across New Zealand, with experience in diverse fields of law, representing a variety of ideological and political views, and unanimous in our concern over the care of New Zealand’s vulnerable communities and the compassionate treatment of its sick, disabled and terminally ill.

We make this public statement to express our opposition to the End of Life Choice Bill (“the Bill”) and its proposed introduction of euthanasia and assisted suicide into New Zealand law, and to warn both Parliamentarians and New Zealanders against the dangers of voting the Bill into legislation.

If it is passed into law, the Bill will legalise what it terms “assisted dying”. Under the Bill’s provisions this will involve medical professionals, overseen by the Ministry of Health, ending the lives of their patients through lethal injection upon request (known as euthanasia), or assisting them in their suicide through the ingestion or intravenous delivery of lethal medication. Under current New Zealand law, as the case of Seales v Attorney General confirmed, “assisted dying” constitutes the offences of culpable homicide and aiding and abetting suicide under sections 160(2)(a) and (3) and 179 of the Crimes Act 1961. In order to further the interests of purportedly only a "small" number of New Zealanders,1 the Bill proposes to override these fundamental provisions in New Zealand criminal law by effectively permitting homicide and assisted suicide in some medical cases. In addition to impacting many other laws, this development would represent a profound shift in New Zealand law, the practice of medicine, and the field of medical ethics. It will also profoundly impact New Zealand society.

We acknowledge that this issue is fraught with complexity, and recognise the difficult choices that many of us in New Zealand must make when we are near the end of our lives. We also empathise with those New Zealanders who live with disabilities, chronic illnesses or mental illnesses; some of our number are amongst them.

We believe that the mark of our civilised society is measured by the manner in which we treat and protect our weakest and most vulnerable members. While the Bill purports to be targeted to a "small but significant group of competent adults who are not vulnerable and who wish to die without unbearable suffering and pain", we consider that it will in fact place many vulnerable members of our community (whether terminally or chronically ill, disabled or mentally ill) at greater risk of premature death by homicide or suicide as a result of neglect, coercion and other forms of abuse, as well as misdiagnosis or prognostic error and uncertainty. Its definition of a "person who is eligible for assisted dying" is so broad in its coverage of a range of conditions and illnesses that it could extend to New Zealanders with disabilities, relatively common chronic health conditions, and in some cases even mental health or psychological disorders such as depression, anorexia or bi-polar disorder. We concur with the New Zealand Disability Rights Commissioner’s assessment that the Bill undermines the position of disabled and vulnerable New Zealanders and poses significant risks to them, both as individuals and as a group. We are particularly concerned at its potential impact on Māori, who are over-represented in our suicide rates each year, in terminal, mental and chronic health illnesses, and in disabilities. We note that according to the Waitangi Tribunal, “many of these illnesses and problems are practically at epidemic levels"2 and that in December 2018 the Tribunal commenced an investigation into more than 200 claims that the Crown is operating a “sick, racist system that fails Māori”, leading to Māori dying earlier and suffering the worst health outcomes.

The Bill lacks important safeguards, and the purported safeguards that it does propose (such as its safeguard against coercion) are completely inadequate in protecting New Zealand’s vulnerable communities. We agree with the Disability Rights Commissioner that its safeguards are deficient, both procedurally and substantively, for both terminal and non-terminal conditions.

As lawyers working across a range of fields, we are keenly aware of the diversity of vulnerabilities which many New Zealanders experience, not only within their families and communities but also across the health system (including, for example, inequitable regional variances in palliative care resources and a lack of government funding for some life-prolonging medications). Given these very serious problems, and having considered the impact of euthanasia and assisted suicide laws on vulnerable populations in other countries, we have very serious misgivings over whether a safe regime for euthanasia and assisted suicide can be implemented in New Zealand. The risk of abuses resulting from the legalisation of euthanasia and assisted suicide through this Bill is very high. We are supported in this view by a reputable body of experienced opinion that has been informed by the harms which have resulted in the few overseas jurisdictions that have legalised these practices.3

We believe the implementation of the Bill could create harmful social pathologies, as well as result in the dangerously contradictory message being promoted within New Zealand society that suicide can actually be a good and dignified act. We note in this regard that the Bill will vest the Ministry of Health, the government department presently responsible for suicide prevention in New Zealand, with responsibility for overseeing the practice of helping some New Zealanders to commit suicide at the same time as advising others not to. Both of these groups will receive the message that our society and state endorse the ending of a person’s life as an appropriate response to suffering, the only difference being that those who are “ineligible” for assistance in their suicide will be left on their own to achieve it. This message will confuse New Zealand’s attempts to eliminate suicide.

We have many other concerns over the Bill, including its lack of any effective or meaningful oversight and the false or questionable assertions of fact in its Explanatory Note. One final, significant, concern of note is that it compels all New Zealand doctors to facilitate euthanasia and assisted suicide in violation of the rights of many doctors to freedom of conscience in section 13 of the Bill of Rights Act, and makes those conscientious objecting doctors who refuse to refer a patient to another doctor for help in ending their lives liable to prosecution, imprisonment or a substantial fine. We consider that to be an unacceptable intrusion into the personally-held beliefs which many of our doctors have regarding their duty to their patients: a duty to care for them, rather than to be complicit in killing them.

After 16 months of investigation and after reviewing some 39,000 submissions, the Justice Select Committee has now confirmed in its Report to Parliament that it has not even been able to agree that the Bill be passed and that it is unworkable in its present state.4 It appears the Committee has been left in considerable disarray over how to repair it. In the result, our Parliament has now been handed an extremely dangerous Bill with no real insight into how it might be remedied, or even if it can be remedied. Indeed, the Committee’s Report suggests very strongly that the Bill, to borrow from its own terminology, is irremediable.

As lawyers we believe the End of Life Choice Bill is not fit for purpose and is not salvageable. For many vulnerable New Zealanders this issue is literally a matter of their life and death. When it comes to safeguarding their wellbeing and safety, we consider the risks associated with the Bill to be unacceptably high.

• Legal analysis of New Zealand's End-of-Life Choices bill.
• 35 Fatal Flaws in New Zealand's End-of-Life Choices bill.

Assisted Suicide and “Failure of Unconsciousness”

This article was published by Nancy Valko on April 18, 2019

By Nancy Valko

As a nurse, I have seen patients assumed to be unconscious while in a coma or sedated on a ventilator later tell me about some memories and feelings during that time. This is why I always cared for such patients as if they were awake.

Now in a stunning February, 2019 Association of Anaesthetists article titled: “Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying”, a group of international doctors explore the difficulty in ensuring unconsciousness to death in lethal injection capital punishment and assisted suicide/euthanasia. (Note: Since the authors are international, some quoted terms here are spelled differently than here in the US)

• Assisted dying can cause inhumane deaths.
• Is lethal injection inhumane?
• Many assisted suicide deaths are slow and painful.

Believing that “A decision by a society to sanction assisted dying in any form should logically go hand‐in‐hand with defining the acceptable method(s)”, the authors reviewed the methods commonly used and contrast these with an analysis of capital punishment in the US. They “expected that, since a common humane aim is to achieve unconsciousness at the point of death, which then occurs rapidly without pain or distress, there might be a single technique being used.”

They were wrong.

They found that with self-administered lethal overdoses “with death resulting slowly from asphyxia due to cardiorespiratory (heartbeat and breathing) depression”, helium self-suffocation and the Dutch lethal injection that resembles US capital punishment, “there appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re‐awakening from coma (up to 4%), constituting failure of unconsciousness.” (Emphasis added)

Oklahoma Death Certificate Accuracy Act passes.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Great news: I have remained silent about Oklahoma Bill SB 108, The Death Certificate Accuracy Act, to not create unnecessary attention for this important bill. We can celebrate now that SB 108 passed in the Senate on February 25 by a vote of 35 to 10 and passed in the House on April 17 by a vote of 59 to 36.

SB 108, that was sponsored by Senator Gary Stanislawski and Representative Sean Roberts, is clear legislation that requires the cause of death to be accurately reported on the death certificate. Among other things SB 108 states:

A certifier completing cause of death on a certificate of death who knows that a lethal drug, overdose or other means of assisting suicide within the meaning of Sections 3141.2 through 3141.4 of this title caused or contributed to the death, shall list that means among the chain of events under cause of death or list it in the box that describes how the injury occurred. If such means is in the chain of events under or in the box that describes how the injury occurred, the certifier shall indicate "suicide" as the manner of death.

Oklahoma Death Certificate

The bill later states:

A certifier who knowingly omits to list a lethal agent or improperly states manner of death in violation of subsection E of Section 1-317 of this title shall be deemed to have engaged in unprofessional conduct as described in paragraph 8 of Section 509 of Title 59 of the Oklahoma Statutes.

The bill then declares that a violation of any provisions of this section constitutes a felony.

Assisted suicide is not legal in Oklahoma, but in states where assisted suicide is legal, the assisted suicide law requires the doctor to falsify the death certificate. When a person dies by assisted suicide, the doctor is required to declare the cause of death as the medical condition that the person was living with, rather than declare death by assisted suicide.

This is just one of the many lies and cover-ups that the assisted suicide lobby uses to hide the truth about assisted suicide.

Thank you to everyone who made this happen.

Australian Civil Liberties group supports child euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The legalization of euthanasia is being debated throughout Australia. Last year Victoria Australia legalized euthanasia. Similar to Canada, once euthanasia becomes legal people immediately begin to debate the expansion of the law.

Felicity Caldwell reported for The Sydney Morning Herald that Queensland Council for Civil Liberties president Michael Cope told the Queensland parliamentary committee that euthanasia should also be available to children as young as 12 years old. Caldwell reported:

Queensland Council for Civil Liberties president Michael Cope said the views of mature minors about voluntary assisted dying (VAD) should be respected. 

"We would define such a mature minor as a child over 12 years of age who ... has a sufficient understanding and intelligence to enable him or her to understand fully what is proposed," he said. 

"However, we do recognise that children are entitled to extra protection when making their decision."

Cope told the parliamentary committee that his position is based on the fact that 13 children have died by euthanasia in the Netherlands and 3 have died by euthanasia in Belgium.

Caldwell reported that Cope also said that he believes that doctors should be able to refuse to do euthanasia but they must refer:

Mr Cope said medical practitioners should be able to refuse to assist people with voluntary euthanasia, but they should be required to refer the patient to another practitioner who would provide the service.

Refering for euthanasia means that the physician is complicit in the act of killing.

Queensland Australia is debating euthanasia. The government is already being pressuring to expand the scope of euthanasia to include children and to force medical practitioners to participate.

German court hears case challenging the assisted suicide law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The assisted suicide issue has been debated in Germany for many years. In recent years  Swiss assisted suicide groups have been campaigning for assisted suicide in Germany.

Yesterday, Germany’s Constitutional Court heard a challenge to the 2015 legislation prohibiting commercial assisted suicide.

Reuters News reported:

The Karlsruhe-based tribunal is expected to rule on the case in the next few months. "We hope that with a decision from the Constitutional Court, we will return to (a situation where) we can help members in the way they want," plaintiff Roger Kusch, of lobby group Assisted Dying Germany, told Reuters. 

Arguing against a repeal of the law are palliative medics, who fear a change would risk premature action in cases not properly based on a wish to die. Only a few countries in the world have legalized euthanasia whereby a doctor administers lethal doses of drugs to patients willing to die, or people take the final action themselves.

In March 2017, Germany's federal Court decided that doctors could prescribe lethal drugs to their patients in "extreme" circumstances. The decision created a dilemma because article 217 of Germany's Criminal Code prohibits the promotion of suicide.

In July 2018, Germany's Health Minister Jens Spahn (CDU) requested that the Bonn Federal Institute for Drugs and Medical Devices (BfArM) "refuse applications" for euthanasia drugs.

Deutche Welle news  reported that deputy Health Minister, Lutz Stroppe wrote in a letter that:

In view of "fundamental and far-reaching questions, particularly constitutional questions … It cannot be the task of the state to actively support suicidal acts through the official, administrative approval of the acquisition of the specific suicide agent," deputy health minister Lutz Stroppe wrote. 

"This is not compatible with the purpose of the Narcotics Act to ensure the necessary medical care of the population. A suicide cannot be considered therapy," the letter continued.

According to Deutche Welle news 108 applications for lethal drugs have been submitted since the March 2017 court decision and at least 20 of those people died from lethal drugs.

Germany has been debating the issue of assisted suicide for many years. The German court should not permit assisted suicide. Legalizing assisted suicide gives physicians the right in law to be involved with causing the death of their patients. The possible abuse of euthanasia and assisted suicide should be self-evident considering Germany's past.

Germany's Jewish community opposes the legalization of assisted suicide.

Freedom of Conscience bill to be debated in Canada

David Anderson MP

Thank you again for your support of my Private Members Bill C-418: The Protection of Freedom of Conscience Act.

Two years ago, taking a patient’s life was culpable homicide. Although the law now permits physician assisted suicide, many doctors’ consciences will not. The Supreme Court of Canada has explicitly said that the legalization of euthanasia did not entail a duty of physicians to provide it.

However, regional associations have introduced regulations compelling conscientiously objecting physicians to provide effective referrals for physician assisted suicide, contravening this assurance. This happens, without any penalty.

I believe it’s time to stand up for doctors and health care providers who aren’t willing to leave their core ethics behind when they’re at a patient’s bedside. The protection of conscience rights for medical professionals is part of protecting the fundamental freedom of conscience and religion guaranteed to all Canadians in the Charter of Rights and Freedoms.

Bill C-418 amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or any other health care professional for compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or any other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.
I have enclosed a copy of my bill, a petition and an info sheet which includes a letter to Justice Minister David Lametti. We have received a large number of letters to the Minister from Manitoba, and from my own riding.

• Link to Bill C-418
• Link to the petition in english and french
• Draft letter to be sent to local MP. 
• Link to the info-sheet with letter to David Lametti.

I have also included a draft letter that can be sent to local MPs. I encourage you and your supporters to contact your Member of Parliament and MPs of all parties, to make them aware of the bill and to voice your support for this legislation.

The more people that know about C-418, the higher the likelihood that it will pass in the House of Commons.

Sincerely,

 

David Anderson, MP
Cypress Hills-Grasslands

Ethics Chair resigns over Royal College of Physicians change in position on assisted dying.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

T

Professor Albert Weale

he Telegraph news reported that Professor Albert Weale, the chair of the Royal College of Physicians (RCP) ethics committee, resigned his position over the RCP change of position on assisted suicide.

An article by Tim Wyatt in the Telegraph reported that:

The Royal College of Physicians (RCP) announced last month it was abandoning its formal opposition and would instead be neutral on the issue following a controversial survey of doctors’ opinions.

But now Albert Weale, an academic who chaired the RCP’s ethics committee, has resigned, arguing the decision was “not coherent” and “unfair”.

The Telegraph reported that Weale opposed the RCP change in position on assisted dying and how it conducted its "survey" that led to that change.

Prof Weale ... saw no reason why the RCP's governing body had decided to abandon its previous position, which stated the organisation could not support changing the law on assisted suicide.

the way the survey had been set up presented "considerable problems of procedural unfairness.

The RCP indicated that unless 60% of the respondents opposed assisted suicide that the council would move to a neutral position. The survey found that 43% opposed assisted suicide, 32% supported a change in the law and 25% were undecided.
 
A survey with three options that requires a 60% vote to maintain a current position is designed to obtain change.

The Ethics committee opposed changing the position on assisted suicide but the RCP ignored the advice of the ethics committee and established a survey that was designed to obtain a change in policy. Weale stated that there was no point in the committee offering reasoned positions on issues when the RCP ignores their reasoning.

French doctor who euthanized his patient cannot return to practice

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Nicolas Bonnemaison

The European Court of Human Rights ruled on Thursday that Nicolas Bonnemaison, a French doctor who was convicted in 2015 in the euthanasia death of a patient and acquitted in the alleged euthanasia deaths of six other patients, cannot be reinstated in his medical practice.

• Euthanasia doctor convicted in France.

According to an article by Sommer Brokaw for UPI news:

At issue was a decision by medical officials to strike Nicolas Bonnemaison from its medical register as a general practitioner following claims he caused the deaths of several terminally-ill patients years ago at a hospital in Bayonne, France. 

Bonnemaison challenged the decision after he was convicted in 2015 of causing the death of an 86-year-old woman -- but acquitted of six others -- and given a two-year suspended prison sentence. He argued he should be reinstated because the disciplinary divisions had not been independent, that the French Council of State wasn't impartial and because he wasn't given a fair trial. 

The court said in its ruling Thursday there's "no evidence to suggest that there had been any lack of impartiality" since the "judgment had been duly reasoned."

Euthanasia is illegal in France. In January 2011 the French Senate defeated a euthanasia bill by 170 to 142.

UN disability rights envoy urges changes to Canada's euthanasia law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Catalina Devandas Aguilar

Catalina Devandas Aguilar, the UN’s Rapporteur on the Rights of Persons with Disabilities met with Canadian government officials and disability rights advocates from April 2 - 12, 2019 investigating Canada's implementation of the United Nations rights of people with disabilities. (Link to the report).

• Candice Lewis was pressured to die by assisted death.

In her report, Devandas Aguilar challenged the Canadian government concerning the implementation of its euthanasia law. Her report stated:

I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying. I have further received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities. I urge the federal government to investigate these complaints and put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care.

CTV news reported Devandas Aguilar as stating:

Among her chief concerns were reports of patients allegedly pressured to undergo medically assisted deaths, a lack of community care that forces patients into nursing homes, and how the court system fails people with disabilities. 

Devandas Aguilar said she was “extremely concerned” about the implications of assisted dying legislation on people with disabilities after hearing multiple complaints. 

“I urge the federal government to investigate these complaints and put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care,”

This is important news that must not stop with this report. The fact is that Canada's euthanasia law employs undefined language with no effective oversight.

• Canadian man releases tapes of hospital urging man with disabilities to die by euthanasia.

The Canadian visit and the report by Devandas Aguilar opens the door to pushing back Canada's euthanasia law.

• UN disability rights envoy demands protection for people with disabilities from euthanasia in Canada.

UN disability envoy demands protection for people with disabilities from euthanasia in Canada.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Roger Foley was pressured
to request an assisted death

A United Nations disability advocate recently challenged Canada's federal and provincial governments to make systematic change to ensure that the rights of people with disabilities are upheld in Canada.

• Canadian man releases tapes of hospital urging man with disabilities to die by euthanasia.

One of the people with disabilities interviewed by the United Nations advocate was Roger Foley from London Ontario who was allegedly pressured by doctors to request euthanasia. Foley also launched a lawsuit after being denied self-directed home-care.

• Candice Lewis was pressured to die by assisted death.

Catalina Devandas Aguilar
UN Disability Advocate.

CTV news, Avis Favaro, reported that Catalina Devandas Aguilar, the UN’s first ever Rapporteur on the Rights of Persons with Disabilities met with Roger Foley and other disability advocates. According to Favaro:

Roger Foley suffers from cerebellar ataxia, a fatal neurological disorder that limits his ability to move his arms and legs. He launched a landmark lawsuit against a London, Ont., hospital, several health agencies, the Ontario government and the federal government, alleging that health officials would not provide him with an assisted home care team of his choosing. 

Instead, Foley alleges, he was offered, among other things, a medically assisted death.

Rhonda Wiebe

Favaro interviewed Rhonda Wiebe, the co-chair of the Council of Canadians with Disabilities Ending of Life Ethics Committee who stated:

“This is about ripping him from his home and family and community and sticking him far away in a place where he will die alone,”

Devandas Aguilar told Favaro that she was primarily concerned with the effect of medically assisted deaths on the disability community. She stated:

Among her chief concerns were reports of patients allegedly pressured to undergo medically assisted deaths, a lack of community care that forces patients into nursing homes, and how the court system fails people with disabilities. 

Devandas Aguilar said she was “extremely concerned” about the implications of assisted dying legislation on people with disabilities after hearing multiple complaints. 

“I urge the federal government to investigate these complaints and put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care,”

People with disabilities are being pressured to die by euthanasia in Canada. The cases we have heard about are the ones where the person refused. How many people with disabilities, and others, were pressured to die by euthanasia and succumbed to the pressure?

American Nursing Association's Draft Position Statement on Euthanasia and Assisted Suicide Is "Misleading and Dangerous"

This article was published by Choice Is An Illusion on April 6, 2019.

By Margaret Dore, Esq., MBA

The ANA Center for Ethics and Human Rights Advisory Board is seeking public comment on a proposed position statement, "The Nurse's Role When a Patient Requests Aid in Dying."

"Aid in Dying" is a traditional euphemism for assisted suicide and euthanasia. The first paragraph of the proposed statement is set forth below, followed by my responding submission.

The Nurse’s Role When a Patient Requests Aid in Dying

DRAFT ANA Position Statement

Purpose: The purpose of this position statement is to provide nurses with ethical guidance in response to a patient’s request for aid in dying (AID). This statement offers assistance with understanding nurses’ ethical obligations and responsibilities amidst social and legislative shifts which make this option legal in an increasing number of U.S. jurisdictions.

The entire statement can be viewed here.

My submission:

Lines 1-6 A professional statement should be clear as to its topic. The term, "aid in dying," implies that we're talking about palliative care for a person necessarily near death, which is not the case:

1. The term, "Aid in Dying" is a traditional euphemism for euthanasia. Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215 (“Subject: Active Euthanasia ....”) at: (Link). 

2. In the US, Oregon-style death with dignity laws have a six months to live criteria. In practice, this criteria applies to people with years or decades to live. One reason is that predictions of life expectancy can be wrong. See: (Link).  

Another reason is that the six months to live is determined without treatment. Consider, for example, my friend Jeanette Hall talked out of assisted suicide in Oregon 18 years ago: (Link).

In short, by the title alone, the statement is materially misleading.

Lines 7-22 As noted above, "aid in dying" means euthanasia. More importantly, deaths under current Oregon-style acts are not necessarily voluntary.

Perhaps these articles are helpful:

1. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, at: (Link).
2. Margaret Dore, "Preventing Abuse and Exploitation: A Personal Shift in Focus", ABA Senior Lawyers Division Newsletter, Vol. 25, No. 4, Winter 2014, at: (Link).

Lines 23-34 With regard to "end-of-life" conversations, I have had at least 10 people talk to me about their wanting to do legal assisted suicide/euthanasia.

• I was trained to always ask them "why?" Get them talking about what's really bothering them, and the answers have been all over the place. One was facing economic pressure, another blamed himself for the death of a friend, another seemed to have learning issues. Most, but not all, changed their minds just by talking about it.
• I have seen families torn apart and traumatized by legal assisted suicide/euthanasia, even when the death does not occur. This also happens with palliative dare/hospice abuse. See: (Link).
• Other people are afraid to go to the doctor or a hospital, they no longer trust the medical profession. 
• Allowing and/or encouraging your members to promote assisted suicide and euthanasia will make the situation worse. I urge you to reject the proposed statement, which is misleading and dangerous.

Thank you.
Margaret Dore, Esq., MBA
www.margaretdore.org
www.choiceillusion.org

“Starve Me” Advance Directive Is Immoral

This article was published by Evolution News on April 8, 2019.

Wesley Smith

By Wesley Smith

Not content with assisted suicide, the euthanasia movement wants people with dementia to be able to force caregivers to starve them to death when they become severely impacted — even when they willingly eat.

An assisted-suicide advocacy group in New York previously created an advance directive containing such instructions. And now the Hemlock Society — which today calls itself Compassion and Choices — boosts the “starve me to death” approach to dementia with instructions that would force caregivers to withhold spoon feeding:

I request that food and fluids in any form, including spoon-feeding, be stopped if, because of dementia, any of the following conditions occur: 

• I appear indifferent to food and being fed.  

• I no longer appear to desire to eat or drink.  

• I do not voluntarily open my mouth to accept food without prompting…  

• I turn my head away or try to avoid being fed or given fluids and am clearly repelled by food or fluids.  

• I spit out food or fluids.  

• I cough, gag, choke on, or aspirate (inhale) food or fluids.  

• The negative consequences or symptoms of continued feeding and drinking, as determined by a qualified medical provider, outweigh the benefits.

Many of these provisions are, to say the least, subject to interpretation. And people with dementia may refuse food one meal, and accept the next.

Eating as a Reflex

Starvation for someone who still eats would cause agony, so C & C suggests asking for sedation. But here’s the thing: If someone isn’t imminently dying, sedation is actually a request to be kept unconscious so the patient can’t change their mind.

The instructions would seek to handcuff surrogate decision-makers and force starvation even if the patient opens his mouth to eat — characterized as a mere “reflex” in the document (my emphasis):

I want the instructions in this provision followed even if the person who has the right to make decisions for me and/or my caregivers judge that my quality of life, in their opinion, is satisfactory and I appear to them to be comfortable. No matter what my condition appears to be, I do not want to be cajoled, harassed, or forced to eat or drink. I do not want the reflexive opening of my mouth to be interpreted as giving my consent to being fed or given fluids or misinterpreted as a desire for food or fluids. I have given considerable thought to this decision and want my wishes followed.  

Before I am admitted to a long-term care facility, I want that facility to affirm its willingness to honor these instructions. If the long-term care facility where I already reside will not honor these instructions, I want to be transferred to one that will.

No care facility should ever honor such instructions. This isn’t about the circumstance when a patient stops eating as a normal part of the dying process. It isn’t about force-feeding with a tube down the throat or surgically inserting a feeding tube. It is about withholding food and water by mouth even when the patient accepts nourishment.

Unenforceable Instructions

I don’t believe these instructions are enforceable. Advance directives control the provision or withholding of medical treatments. Spoon feeding is not treatment, it is humane care akin to being kept warm and clean.

But even if the law should, one dark day, permit such a horror — the suffering of the dementia patient would not be the only important matter at stake. So too would be the emotional health, consciences, and moral wellbeing of husbands and wives, children, nurses, doctors, aides, and the like who would be compelled by the instructions to starve the patient to death. Talk about causing nightmares! I’m sorry, that is too much to ask of anyone.