Wednesday, August 24, 2016

New Documentary The Euthanasia Deception Exposes the Shocking Truth of Assisted Suicide

Media Release: Nashville Publicity Group.

The film explores Belgium’s 15-year experiment with euthanasia, the long-term implications of assisted dying laws and offers a dire warning for the rest of the world.

Wednesday, August 24, 2016 — (NASHVILLE, Tennessee)

The Euthanasia Deception, a one-hour documentary that explores Belgium’s 15 year experiment with euthanasia, will be available on September 12th. This thought-provoking, emotionally gripping film is a dire warning for the rest of the world, featuring powerful testimonies from Belgium and beyond of those devastated by the false ideology of ‘mercy killing.’

The film exposes three main deceptions of assisted suicide. First, that euthanasia and assisted suicide are a form of compassion. The second is the myth of autonomy: that decisions made between doctor and patient operate in a vacuum. And finally, that government ‘safeguards’ can truly protect the vulnerable.

With expert analysis from both medical and legal professions, The Euthanasia Deception reveals the serious, long-term implications of assisted suicide laws, and proves that all of us become vulnerable when end-of-life care is handed over to lawmakers.

Numerous people whose lives have been affected by euthanasia and assisted suicide are interviewed for the film, including: Professor Tom Mortier, whose depressed mother was euthanized without his knowledge; “Hendrick,” whose grandfather’s death was hastened without request; “James,” who regrets family pressure to euthanize his mother; “Lionel,” who is asked by Belgian strangers why he will not euthanize his severely disabled daughter; “Mark,” an MS survivor, grateful that there was no law allowing him to die by assisted suicide when he was diagnosed; and “Kristina,” a nurse who shares her remorseful experience with assisted death.

The release of The Euthanasia Deception marks the launch of, a new global resistance movement that utilizes the power of film and social media to combat and resist the acceptance of euthanasia while providing jurisdictions with data to resist its legalization. It is also dedicated to providing support and assistance to through Compassionate Community Care services - to help people who need advice concerning medical treatment issues or need protection from euthanasia and assisted suicide.

The Euthanasia Deception is directed by Kevin Dunn and produced by the Euthanasia Prevention Coalition in association with DunnMedia & Entertainment and supported by thousands of like-minded organizations and individuals throughout the world.

Watch the official trailer at

Visit the official website at

Assisted Suicide - A lifestyle choice?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Bill Peace PhD teaches at Syracuse University.
Disability rights leader and academic, Bill Peace, recently wrote an article concerning the assisted suicide death party by Betsy Davis. Davis. It is culturally significant that some media outlets turned her death party into celebration turning assisted suicide into a culturally "cool" act.

Peace states in his article:

No physician could force a patient to accept a feeding tube. No physician could force a patient to use a ventilator. These are choices Davis chose to make. At any point after she was diagnosed with ALS she had the choice to refuse treatment. Physicians could be opposed to Davis refusal to utilize life extending care but that would be her choice. The operative word here is choice. Davis made many choices post ALS diagnosis. In June of this year Davis made the choice to live long long enough to end her life via assisted suicide. She made these choices and many more. But there is a difference between making these choices and her human rights. Choice are not the equivalent to rights. Given the severity of ALS any one of a number of choices Davis made could have led to her death. Instead, she made a choice to die a very public and misleading death. In her effort to advocate for assisted suicide legislation she has had predecessors who also had public deaths on behalf of Compassion and Choices. The emotional rhetoric found in tabloids such as People sells. Sympathetic television news segments generate ratings. Again, this misleading emotional made for mass media consumption works. The fact it is wrong is lost in the flow of tears. I too cry but not for Davis but for all those whose lives are at risk. 
Having been through the medical mill as a morbidly sick child and narrowly escaping death from a severe wound that took over a year to heal, I will readily admit I have suffered. That suffering has taken the form of gut wrenching pain and serious debilitating depression. Suffering is decidedly unpleasant but to expect to avoid suffering throughout one's life is not realistic. I do my best to avoid suffering but I can freely states I have suffered far more the average human being. Not to revert to my Catholic upbringing but I can state with certainty that suffering has made me a stronger human being. In an effort to eliminate suffering we are being foolish. I don't want others to suffer but like it or not all humans will suffer. Suffering is part of the human condition. The effort to avoid suffering is understandable but unrealistic and there is more than a bit of narcissism involved. Hence the death selfie. 
I am sure my words will be met with disgust by those who support assisted suicide legislation. How dare I criticize a person's "right to die". How dare I impose my beliefs on others. Some will proclaim I am an opponent of individual freedom. Others will proclaim I want to undermine autonomy. This makes good fodder for debate. Typical others thoroughly enjoy such a debate. A perfect example of such a "good natured debate" can be found the edited volume Cognitive Disability and its Challenge to Moral Philosophy. Read Chapter 22 and the exchange between Eva Kittay, Jeff McMahon, and Peter Singer that illustrates we are talking about a two tiered morality in which some lives have more value than others. I know this two tiered system all too well. Most of my life typical others have made it abundantly clear my life is inherently less. Paralysis is a fate worse than death. My body in Davis estimation has been entombed. This viewpoint is wildly wrong. I know this. Liz Carr knows this. My paralyzed peers know this. My blind and deaf friends know this. Our ability to thrive in the face of a myriad of bodily deficits should be celebrated as human adaptation at its finest. Instead, we get the message loud and clear. We are inherently less human. We are a burden. We are a drain on limited health care resources. All things considered, it would be in the best interest of society if we did live. This is couched in polite language of course. Everyone is kind to the handicapped. We cripples are special. We have your best interests in mind I am told. When I hear these words, "we have your best interests in mind", I am certain of one thing: I shudder in fear and get as far away as humanly possible from the person that uttered those dangerous words. Believe me, I can take care of myself. I have thrived in a hostile world for over 35 years. Don't be fooled by emotional rhetoric surrounding the right to die. See it for what it is. Needlessly premature death to lives worth living.
Peace recognizes that legalizing and now promoting assisted suicide will effect the attitudes towards people with disabilities. The Betsy Davis campaign is part of a plan to turn assisted suicide from a criminal act of medical killing to a cultural "avant garde" act.

Sunday, August 21, 2016

We all have a role to stop euthanasia. But the task is monumental. Be ready.

By Charles Lewis

Over the past few years many of us have written and spoken about the evils of euthanasia. Part of me always has wondered why this was such tough sell. After all, our basic instincts tell us that those who are hurt and sick should be cared for.

There is nothing radical in this. Even in war enemy combatants will often tend to the enemy's wounded out of a sense of some basic decency.

Those healing instincts are born of morality. It does not have to be religious morality but some code that is ingrained that, like a compass, always points in the same direction.

So perhaps the problem is that we are becoming immoral. Whatever foundation was there is crumbling under the weight of cynicism.

A moral society assumes certain things: When we talk to each other we are more or less speaking the same language based on the same basic ethos of our community. Anyone who has tried in the past few years to argue against euthanasia, even among religious people, will know that this commonality is fading fast.

In most of the discussions I had ended I ended up feeling as if I was speaking in a strange tongue. This was not a case of simple disagreement but something far beyond that. It was as if two separate conversations were going on with nothing linking the participants except animosity and confusion.

In other words it was two people coming from different cultures without either side being able to relate to the other.

For those of us of a certain age and persuasion it is akin to feeling lost. I ask myself all the time how did we slip so far into an abyss in which basic morality, a clear definition of what is right and what is wrong, has become so muddled.

When I was growing up, in the 1950s and 60s, there seemed to be some things that were considered wrong: these were premises agreed on by people who were Jewish, Protestant, Catholic and even those thoroughly secular.

The idea of killing someone who was sick would have seemed barbaric. All these were seen as failures against the common good. There was a sense of a community standard that everyone had a stake in. No doubt this could turn judgmental and possibly even cruel but those attitudes were the extreme.

My own view it is the decline of religion and a belief in God. That cannot be the only answer, however.

We grew up in Brooklyn. Their history was typical of the people I grew up with. Our grandparents and parents lived through the Depression. Our fathers fought in the Second World War. In the 1950s they were happy to be alive and enjoyed a success that in the midst of the 1930s or at the height of the war were impossible to imagine.

Those experiences forged comradery. People were pro-life, in the broadest sense of the term because they knew what misery looked like especially those who survived the war. Everywhere there were European refugees; many with numbers on their arms who were simply thankful to not have the state classify them as subhuman and unworthy. And many families, like mine, had relatives that did not come back from the war, a constant reminder of sacrifice for all.

Now we have a society, in general, that has little time for religion. It sees morality as artificial and a hindrance to freedom. We live in a culture that has more gadgets that is causing isolation. We are bombarded with tons of information that is essentially useless for leading a good, moral life.

Try to be serious and someone makes a joke because being serious gets in the way of fun.

Of course, there are many people who are the exception to what I have described and thank God for them.

For those of us who believe the battle against euthanasia is not over, as I do, I write this as a reminder of what we are up against. It is not just a matter of disagreement over an issue. If only it were so.

We can still stop people from being abandoned to death by assisted suicide and euthanasia. We must see each person who opts for the needle as a personal defeat. Nothing is in isolation. A man who is killed with the help of a physician will have sent a message to friends and family that medical murder is fine.

We all have a role to stop this. But the task is monumental. Be ready. Otherwise you will be speaking into the wind.

Charles Lewis is an anti-euthanasia speaker and writer. He writes a column twice a month for Toronto’s Catholic Register newspaper.

Friday, August 19, 2016

The Euthanasia Deception documentary.

The Euthanasia Prevention Coalition (EPC) in association with DunnMedia is pleased to announce that the International release of The Euthanasia Deception will be August 29, complete with interactive website and resource materials at:

Purchase The Euthanasia Deception for $30 for 1 copy or $100 for 4 copies or $200 for 10 copies. You can pay (online) or order by emailing: or by calling toll free: 1-877-439-3348.

The fifty-two minute documentary features powerful testimonies from Belgium and Canada, exposes the three main deceptions used by the assisted dying lobby:

  • Euthanasia & assisted suicide are falsely promoted as a form of compassion or mercy.
  • Euthanasia & assisted suicide are falsely promoted as a form of autonomy. 
  • The myth that safeguards can protect people is exposed. 
Tom Mortier
The Euthanasia Deception features; 
  • Professor Tom Mortier, a Belgian man whose depressed mother died by euthanasia,
  • Hendrik Reitsma, whose grand-father died by an assisted death without request in the Netherlands,
  • Dr Catherine Dopchie, a palliative physician in Belgium,
  • Dr Benoit Beusselinck, a Belgian oncologist and palliative care doctor in Leuven Belgium,
  • Carine Brochier, the co-ordinator of the European Institute of Bioethics in Belgium,
  • Professor Etienne Montero, Dean of the Faculty of Law, Namur Belgium,
  • Kristina Hodgetts, a nurse speaks about her experience with assisted death in Canada.
  • Lionel Roosemont, a Belgian man who is the father of a significantly disabled child,
  • Amy Hasbrouck, a lawyer and a disability rights leader in Québec Canada,
  • Mark Pickup, a disability rights activist and public speaker in Alberta Canada,
  • Steven Passmore, a disability rights activist in Ontario Canada,
  • Alex Schadenberg, the International Chair of the Euthanasia Prevention Coalition
We are all vulnerable at different times in our lives. This documentary is a dire warning for Canada and the rest of the world.

Your donations to EPC enable us to continue our commitment to resisting the acceptance of euthanasia while providing jurisdictions with data to prevent its legalization.

Purchase The Euthanasia Deception by (paying $30 by credit card or paypal) or order by emailing: or calling toll free: 1-877-439-3348.

Thursday, August 18, 2016

Three-Quarters of Submissions Oppose Assisted Suicide in New Zealand.

Euthanasia-Free NZ welcomes an analysis finding that 78% of submitters are opposed to legalising assisted suicide and voluntary euthanasia.

In an unprecedented number of unique submissions, more than three-quarters have indicated that they don’t think changing the law is the solution to suffering.

“It’s premature and defeatist to suggest that state-sanctioned suicide is the best the government can offer to address the suffering that some New Zealanders experience,” says Renée Joubert, Executive Officer of Euthanasia-Free NZ. “The causes of suffering are complex and a range of possible solutions need to be examined, including better accessibility to existing physical and psychological care options.”

“The legalisation of assisted suicide and euthanasia would affect society as a whole, including people who would prefer to die of natural causes. Emotionally vulnerable people could easily feel pressured to request death, making legal assisted suicide the ultimate vehicle for elder and relationship abuse.”

Euthanasia-Free NZ supports the call for David Seymour to withdraw his untimely End of Life Choice Bill from the ballot and allow the current Health Select Committee investigation to run its course.


The cost of legalizing assisted suicide.

This article was written by Vancouver Pharmacist, Christina Alarcon, and published by Impact Ethics on August 18, 2016.

Christina Alarcon
Christina Alarcon questions the social costs of legalizing medical assistance in Dying.

In June 2016, Bill C-14 (the legislation on medical assistance in dying) received royal and assent and a new medical service became available to Canadians. This legislation provides some Canadians (patients) with the legal option to request medical assistance in dying and other Canadians (physicians and nurse practitioners) with the legal authority to provide that assistance. But at what cost?

The financial costs related to medical assistance in dying are relatively inexpensive. Physician’s fees have not yet been determined, but an interim document lists the cost at $440.05 for a general practitioner and $519.08 for a specialist. The drugs themselves will cost about $300. In British Columbia, for example, participating drug stores will charge a $60 to $100 “clinical services” fee for dispensing the oral or IV drug regimen plus a backup- in case the patient fails to die.

The social costs of medical assistance in dying might be higher.

First, much has already been said about safeguards that may never be. Already a BC court case seeks to “strike down” as unconstitutional the provision in C-14 that states a person’s “natural death must be reasonably foreseeable” to qualify for death by lethal injection. In time, treatable chronic illnesses may become eligible for this irreversible “treatment.”

Second, there are concerns about harm to vulnerable persons. For example, in 2004, a British nurse tried to murder four of her elderly patients in a ruthless drive to free up hospital beds. In April 2015, a Czech nurse admitted to killing six patients to decrease her workload. A 2015 Ontario coroner’s report that examined deaths at long-term care facilities, included 13 that were considered homicide in 2013 and 2014. Will legalized killing become the precarious road we take to unburden an overtaxed Canadian healthcare system? I have witnessed first-hand the ways that the Government tries to claw back on medical costs. I worry that medical assistance in dying might offer them an easier and faster way of reducing the cost of healthcare services.

Third, poor quality healthcare might lead some individuals to request assistance in ending their lives prematurely. The Montreal Gazette recently reported that a 52-year-old long-term care patient would rather end his life than live at a facility that he says is treating him inhumanely.

In 2015, the CBC reported that Ontario long-term care system is “a system in crisis,” and that the province’s chief coroner urged the Ontario government to take action against increasing violence in care homes.

Fourth, what will happen to the physicians or nurse practitioners who do the deed and experience guilt or to those who are forced to refer against their conscience? Will the healthcare professions lose their way?

Finally, as a pharmacist, the legalization of medical assistance in dying will impact my professional world. Some of my colleagues have jumped on the medical assistance in dying band-wagon, but I have refused to do so. This is because I’m concerned about the implications for myself, my patients, and society more generally.

My regulatory college, the College of Pharmacists of British Columbia, does not currently require that I dispense the drugs for medical assistance in dying nor that I provide a referral to someone who will. But, it does require that I provide information about this service to patients. Patients rely on me to catch any prescribing errors that could hasten their demise. I work to ensure that patients are not poisoned and that they remain as healthy as possible until their natural death. Often, my elderly patients are alone and have no one to advocate for them. Those who don’t have a family doctor, usually turn to me for medical advice and I wouldn’t want to direct them towards their demise. So, I worry that performing an action contrary to ethic, such as providing information about medical assistance in dying, might desensitize my conscience or corrupt me as a professional.

Further, as the manager of a community pharmacy that services long-term care homes, I know that residents sometimes want to die. I remember one woman asked me how many pills of a particular drug she would need in order to kill herself. I worry that such suicidal wishes are always present in our society.

In a post C-14 Canada there is much at risk. Will we ever get adequate palliative care? Will we continue research into better pain medication? Will Alzheimer’s research become less relevant? Will we forget how to treat chronic conditions that are not terminal in themselves? There may be so much that we will never know or see because we choose to end life prematurely.

The decriminalization of assisted suicide and euthanasia – euphemistically “medical assistance in dying”—may give some patients the semblance of control but at a considerable cost to themselves and society in terms of true well-being or choice.

Cristina Alarcon is a community pharmacist and a clinical instructor of pharmacy practice for the faculty of Pharmaceutical Sciences at the University of British Columbia.

It is assisted suicide not "medical aid in dying."

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

An assisted suicide question will be on the Colorado election ballot in November. The Colorado Secretary of State recently confirmed that enough signatures were collected for the assisted suicide question to be on the ballot.

The assisted suicide lobby is urging the media to replace the term assisted suicide with "medical aid in dying." 

The term is assisted suicide. Assisted suicide is understood by the public and it is used by institutions such as the American Medical Association which states in its policy on Physician-Assisted Suicide that:
Physician-Assisted Suicide is fundamentally incompatible with the physicians role as healer, would be difficult or impossible to control, and would pose serious societal risks.
Brandon Rittiman from 9News published a clear report explaining: Why 9News uses the words assisted suicide. Rittiman states:
Supporters of that law have asked 9NEWS not to call it assisted "suicide." They'd rather we call it "medical aid in dying." 
What follows is our explanation of why we are not going to grant that request: 
First off, 9NEWS has no position on this ballot question. Nor do we take the issue lightly. 
We have a duty to tell you about it in simple, direct language. That’s why we’re not going to stop using the word “suicide.” 
Supporters of the measure argue the word “suicide” is too friendly to the opposition because it may make you think of someone who ends their life for no good reason. 
In contrast, the proposed law does require a reason: you’d need to be diagnosed with a terminal illness to get a life-ending prescription. 
But in plain English, that’s still “suicide.” 
Merriam-Webster defines suicide as:
“The act or an instance of taking one's own life voluntarily and intentionally especially by a person of years of discretion and of sound mind.”
The Oxford Dictionary puts it more simply:
“The action of killing oneself intentionally” goes with:
“The intentional taking of one's own life.”
All three definitions have something in common: they don’t depend in any way on the reason a person chooses to end their life, just that they do so on purpose. 
Supporters of this proposal want to change the dictionary definition of suicide. They might succeed one day. 
Changes in the law can end up changing our language. 
But it’s not our job in the news business to change the dictionary. 
It’s our job to use plain language that’s current and accurate-- and that’s what we’ll keep doing.

The New Mexico Supreme Court recently decided that "aid in dying" is assisted suicide, in a case that challenged the New Mexico assisted suicide law.

Wednesday, August 17, 2016

This blog does not publish Anonymous comments.

During the last few days there have been many excellent comments posted to my blog. As the moderator I did not publish those comments because they were Anonymous.

I will only publish comments from people who give their name with their comment. Anonymous comments will not be published on this blog.

Also: comments that attack a person, have dangerous, illegal, or unethical content will also not be published on this blog.

Comments will be published when you provide your name with your comment. 

Alex Schadenberg

Monday, August 15, 2016

Washington State 2015 assisted suicide report: assisted deaths increase by 31.7%.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2015 Washington State Department of Health dwd report, up by 31.7% to 166 in 2015 from 126 in 2014 and 22% increase in lethal prescription in 2014 to 213.

Out of the 213 lethal prescriptions in 2015 there were 166 reported assisted suicide deaths, 24 deaths from other causes, 12 deaths where the "ingestion status" was unknown, and 11 people remained alive. 

Dangerously, when the ingestion status is unknown, then the status of the lethal drugs is also unknown.

A greater number of illnesses are leading to assisted suicide. The assisted suicide report states that deaths from other illnesses increased to 10 from 6 in 2014. The report did not list what other illnesses represents but in Oregon other illnesses includes diabetes.

Several years ago Wes Olfert was pressured to die by assisted suicide in Washington State after inquiring about assisted suicide.

Legalizing assisted suicide creates new pressures upon people who are terminally or chronically ill and is a recipe for elder abuse.

Assisted suicide deaths increase by 31.7% in Washington State (2015). What about the complications?

This article was written by Richard Egan and published on his blog on August 15, 2016

By Richard Egan

Washington State’s Death With Dignity Act, based on Oregon’s, came into operation on 9 March 2009.

Lethal prescriptions up 22% in one year - more than doubled since 2010

In the first full calendar year of operation, 2010, some 87 prescriptions for lethal drugs were provided under the Act. By 2015 this had increased by nearly two and a half times (244.8%) to 213.[1] Prescriptions for lethal drugs increased by 22% from 2014 to 2015.[2]
Deaths from assisted suicide up 31.7% in one year - more than tripled since 2010
Deaths from lethal drugs prescribed under the Act have increased three and a quarter fold (325%) from 51 in 2010 to 166 in 2015, increasing by nearly one third (31.7%) from 2014 to 2015 alone. 
Not all of those who are prescribed lethal drugs end up taking them. Some die of natural causes.
285 doses of lethal drugs unaccounted for in the community
There is no tracking of lethal drugs that are not used by those for whom they are prescribed so these lethal drugs are available in the community and could be used accidentally or intentionally to cause death. Of the 936 prescriptions for lethal drugs issued since 2009 only 651 (71%) have been reported as used leaving up some 285 doses of lethal drugs unaccounted for in the community.
Main concerns are loss of autonomy and burden on family rather than pain control
Some 65% of those for whom a prescription for lethal drugs was provided did not cite any concern about pain control as a reason for asking for the prescription. 
However, 86% cited concerns about loss of autonomy and 52% cited concerns about being a burden on family, friends or caregivers.
Assisted suicide to save money
Significantly, 13% of those for whom a doctor wrote a prescription for lethal drugs cited concerns about the financial implications of treatment.[3]
Very few referrals for expert psychiatric evaluation
Only 4% of those given a lethal prescription were referred to a psychiatrist or psychological for evaluation.
Doctors who barely know the patient but are prepared to assist suicide
In some cases the prescribing doctor knew the patient for less than a week before writing the prescription, and in just over half the cases (51%) the doctor knew the patient for less than 25 weeks.[4]
A peaceful death - what about the complications?
In 2013 one person took 3 hours to lose consciousness after ingesting the lethal dose and one person took 41 hours (1 day and 17 hours) to die after ingesting the dose. In 2015 one person took 72 minutes (1 hour and 12 minutes) hours to lose consciousness after ingesting the lethal dose and one person took 30 hours (1 day and 6 hours) to die after ingesting the dose. In 2009 two people awakened after initially losing consciousness. At least 9 patients have regurgitated the lethal medication. In 2014 one person suffered seizures after ingesting the lethal medication.[5]  
Doctors getting the prognosis wrong and assisting suicide for people with years to live
Although the Act specifies that only persons with “six months or less to live” may request lethal doses of medication from a physician, the data shows that in each year between 5% and 17% of those who die after requesting a lethal dose do so more than 25 weeks later with one person in 2012 dying nearly 3 years (150 weeks) later, and one person in 2015 dying nearly two years later (95 weeeks).[6]
In 226 cases we do not who gave the person the lethal drugs or even if they struggled
There is no requirement under the Act for a physician or any other person to be present when the lethal dose is ingested. Since 2009 there have been 175 cases where no health-care provider was present when the lethal dose was ingested and a further 51 cases where it is not known if a health-care provider was present.[7] In other words in some 226 cases people have died ingesting a dose of lethal medication, legally prescribed under Washington law, and nobody knows whether the person freely ingested the lethal dose or they were cajoled, coerced or forced to do so by another person.
Assisted suicide may increase the overall suicide rate
Proponents have claimed that legalising physician assisted suicide would actually prevent, or at least delay, suicides by giving those faced with a terminal illness an assurance that the means for obtaining peaceful death was legally available. However, a study of comparative rates of suicide in US states found that for the states, like Oregon and Washington, which had legalised physician assisted suicide there is an increase in the overall suicide rate of 6.3% compared to all other states and of the suicide rate of those aged 65 and over of 14.5%. There is no reduction in either the rate of non-assisted suicides or in the mean age of suicide.[8]
As the above analysis shows assisted suicide is far from well in Washington State.

[1] Washington State Department of Health 2015 Death with Dignity Act Report, p. 4, (link to the report).
[2] Ibid.
[3] Ibid., Table 2 on p. 7
[4] Ibid., Table 3 on p.8
[5] Washington State Department of Health, Death with Dignity Act Reports, 2009-2015 available at: (link to the data).
[6] Ibid.
[7] Ibid.
[8] David Albert Jones and David Paton, How does legalization of physician-assisted suicide affect rates of suicide?, SMJ: Southern Medical Journal, Vol. 108, Issue 10, p. 599-604, (link to the study).