Wednesday, October 18, 2017

Lessons from Canada. Don't legalize assisted suicide.

This article was published by HOPE Australia on October 18.

Candice Lewis
Candice Lewis is a 25 year old Canadian woman who happens to have cerebral palsy.

In September 2016 Candice went to the emergency room at Charles S. Curtis Memorial Hospital in St. Anthony after having seizures.

Dr. Aaron Heroux told her she was very sick and likely to die soon. He offered her assisted suicide.

The doctor also proposed assisted suicide for Candice to her mother Sheila Elson.

This offer was repeated despite both Candice and her mother making it clear that this was not an option Candice would consider. Dr Heroux told Sheila she was being selfish by not encouraging her daughter to choose assisted suicide.



Candice describes how bad it made her feel that a doctor was offering her assisted suicide.

More than twelve months later Candice has recovered well and her health is much improved.

Candice hasn’t been having any seizures, is now able to feed herself, walk with assistance, use her iPad. She is more alert, energetic and communicative.

She was able to walk down the aisle as a bridesmaid at her sister’s wedding in August 2017. She is doing what she loves most, painting and being with her family.

Candice and her mother Sheila have been interviewed by Kevin Dunn, who is producing a film on euthanasia and assisted suicide called Fatal Flaws. The interview can be viewed here.

There are several take home lessons from Candice’s experience:

  • Doctors can get the prognosis wrong. Candice was told she was dying but is flourishing twelve months later. A wrong prognosis can lead to assisted suicide or euthanasia. A life can be thrown away needlessly;
  • People with a disability already suffer discrimination in health care. When assisted suicide and euthanasia are legal, people with a disability are more at risk of being offered death as a solution because doctors and others consider that they would be better off dead;
  • Once doctors are authorised by the law to provide assisted suicide and euthanasia some of them will feel empowered to offer it to anyone they think would be better off dead. This undermines patients’ trust in doctors and can cause great distress.
Legalising assisted suicide and euthanasia puts people at risk of being wrongfully killed due to errors in prognosis or discrimination. It subverts the nature of the medical profession and destroys trust in doctors.

Tuesday, October 17, 2017

BC Court opens door to hearing new evidence on 'MAiD' in Canada

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Only days after Canada legalized euthanasia and assisted suicide under the term "MAiD" the BC Civil Liberties Association launched the first court case to expand Canada's euthanasia law.

The Lamb case concerns the fact that Canada's MAiD legislation attempted to limit euthanasia to people with terminal conditions. The legislation states that a person qualifies for lethal injection when they have a "grievous and irremediable medical condition" and that their "natural death must be reasonably forseeable." (Section 241.2(2)d)

In the Lamb case, the BC Civil Liberties Association is attempting to strike down the requirement that a person's "natural death must be reasonably forseeable."

Because the Supreme Court of Canada Carter decision did not indicate that a person who qualifies for euthanasia should be terminally ill, therefore Canada's federal government is expected to prove that the terminal illness definition is a reasonable limit.
By Chief Justice Christopher Hinkson of the British Columbia Supreme Court enabling the government to introduce new evidence to establish their position, the government, and intervenors, in a limited manner, can attempt to overcome some of problems with the Carter decision.

CTV news reported that Justice Hinkson stated:
The federal government's legislation, which came into effect last year, needs to be assessed on "relevant, current evidence,"  
Barring the courts from considering the most up-to-date information would prevent a judge from being able to decide what evidence is important and how much weight it should be given.
It is concerning that a June 2017 Ontario Court decision defined "natural death must be reasonably forseeable" as not needing to be imminent or within a specific time frame or be the result of a terminal condition.

The Council of Canadians with Disabilities says the conversation around end-of-life practices ignores the point of view of disability rights advocates.

The organization created a campaign against euthanasia, Toujours Vivant-Not Dead Yet.

The Euthanasia Prevention Coalition will ask the court for intervention standing in this case.

An Open Letter to the Members of Parliament opposing assisted suicide by Australian Palliative Care Professionals

This article was published by HOPE Australia on October 17, 2017

We, the undersigned Australian Palliative Medicine professionals, do not support the introduction of medically assisted suicide or euthanasia in the states of Victoria and New South Wales. We are also writing to address claims made about Palliative Care by assisted suicide advocates, including Mr Andrew Denton, to the public and in the media. We do not intend this response as an attack on Mr Denton, and wish him well with a good recovery in his present illness.

We work every day with people who are seriously ill and dying, to support them and their families and carers when burdened by their illness or condition, and in their time of need.

Although the standard of Australian Palliative Care services, whether in the home or in the medical setting, are currently rated second in the world, this is not widely known in our community, and these services and our care are not well understood.

Our work is a good news story that should provide the public with great confidence.

Instead, in the current debates on euthanasia and assisted suicide, we frequently observe that public confidence in Palliative Care is being actively and deliberately undermined. Assertions include that Palliative Care doctors either cannot or will not relieve suffering and that assisted suicide, and in some cases euthanasia, is needed to address this.

This is simply false.

Thursday, October 12, 2017

Canada's Euthanasia Saves Millions (Dollars Not People)

This article was published by Mark Pickup on his HumanLifeMatters website on October 11, 2017

Mark Pickup with Kevin Dunn
By Mark Pickup

Prolific Canadian documentary film maker Kevin Dunn has embarked upon his latest production FATAL FLAWS. In conjunction with the Euthanasia Prevention Coalition, Mr. Dunn explores, amongst other things, the short step from physician assisted suicide to euthanasia.[1] This is exactly what is happening in Canada in the 14 months since physician assisted suicide became legal. 

More than 2,000 Canadians have died with medical assistance since 2015 (including Quebec).[2] Cancer represented 64% of assisted deaths, followed by circulatory/respiratory and neurodegenerative diseases of amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS).[3]

How did the numbers break down? (Excluding Québec, and the Territories) From June 17 - December 31, 2016, 507 people received medical assisted death, of which 503 were administered by doctors or nurse practitioners. Only 4 were self-administered suicides. From January 1st - June 30th 2017 there were 875 medically assisted deaths of which 874 were administered by a physician or nurse. One was self administered suicide. Of the 1,482 assisted death for the year, only 5 were self-administered suicides (0.0033%). In practice what Canada legalized in 2016 was not assisted suicide, it legalized euthanasia by another name.

What makes things worse is that pressures are starting to mount on sick and disabled people -- or their families -- to sign DNR orders or agree to euthanasia, and ideally organ donation.[4] Why might that be? There a number of reasons:

  • There is a shortage of organs for transplantation.
  • Up-to-date palliative care is an area of specialty in which many family doctors are not particularly skilled. 
  • The last six months of life can be very expensive whereas euthanasia is cheap. 
  • Some people with disabilities can be difficult, peevish and bothersome patients. They may require frequent and expensive hospitalization. Many do not get better.
  • Hospitals and nursing homes are overcrowded and care for the sick is so expensive.
Could it be mere coincidence that 6 months after medical assisted death was legalized in Canada a study came out of the University of Calgary and published in the Canadian Medical Association Journal heralding the cost savings of killing dying patients? Drs Aaron Trachtenburg and Braden Manns proclaimed it could save up to $139-million annually! Of course, they took pains to state they were not suggesting people be euthanized to save money. The illustrious doctors noted that 
"as death approaches, health care costs increase dramatically in the final months. Patients who choose medical assistance in dying may forego this resource-intensive period."[5] (How considerate of patients.)

Wednesday, October 11, 2017

Australian health professionals say NO to assisted suicide.

This was published by HOPE Australia on October 11, 2017

From around Australia, 383 health professionals have signed a statement rejecting assisted suicide and euthanasia, reaffirming the role of doctors, nurses and allied health as saving lives and providing real care and support. ​

Read their statement below:

We endorse the views of the World Medical Association that physician assisted suicide and euthanasia are unethical, even if made legal. We endorse the Australian Medical Association position that "doctors should not be involved in interventions that have as their primary intention the ending of a person’s life." 
We also endorse the World Health Organisation definition of Palliative Care, which has been re-affirmed by the Australia & New Zealand Society of Palliative Medicine, that Palliative Care aims to deliver impeccable holistic and person centred care without the aim of foreshortening life. 
We are committed to the concept of death with dignity and comfort, including the provision of effective pain relief and excellence in Palliative Care. 
We uphold the right of a patient to decline treatment. 
We know that the provision of pain relief, even if it may unintentionally hasten death of the patient, is ethical and legal. Equally the withdrawal or withholding of futile treatment in favour of Palliative Care is also ethical and legal. 
We believe that crossing the line to intentionally assist a person to suicide would fundamentally weaken the doctor-patient relationship, which is based on trust and respect. The power of the clinician/patient relationship cannot be over-estimated. 
We are especially concerned with protecting vulnerable people who can feel they have become a burden to others, and are committed to supporting those who find their own life situations a heavy burden. We believe such laws would undermine the public perception of the dignity and value of human life in all its different stages and conditions. Government focus should be on the compassionate and equitable provision of Social Services, Health Care and Palliative Care. 
Doctors and Healthcare Professionals are not necessary for the legalisation or practice of assisted suicide. Their involvement is being sought only to provide a cloak of medical legitimacy. Leave doctors, nurses and allied health professionals to focus on saving lives and providing real care and support for those who are suffering.

Can there really be a "safer" physician-assisted suicide?

This article was published by Nancy Valko, on her blog on October 11, 2017

Nancy Valko
Nancy Valko

In August, I wrote a blog “Physician-assisted Suicide and the Palliative Care Physician” about Dr. Jessica Nutik Zitter, a palliative care doctor in California who approved of physician-assisted suicide, would want it for herself but had still had serious some qualms about actually writing for the lethal overdose herself.

In the end, Dr. Zitter decides that assisted suicide can be rendered “safe” by being rare and practiced by specially trained medical practitioners as “just one tool in the toolbox of caring for the dying-a tool of last resort.”

Thus, Dr. Zitter, perhaps unknowingly, gives support to the Compassion and Choices goal of “normalizing” and “integrating” physician-assisted suicide into standard medical practice. Note their own description of their activities:

“We help clients with advance directives, local service referrals and pain and symptom management. We offer information on self-determined dying when appropriate and provide emotional support through a difficult time. We employ educational training programs, media outreach and online and print publications to change healthcare practice, inform policy-makers, influence public opinion and empower individuals. Compassion & Choices devotes itself to creative legal and legislative initiatives to secure comprehensive and compassionate options at the end of life.” (Emphasis added)
Now in her new article “De-Medicalizing Death”, Dr. Zitter is excited about a new University of California, Los Angeles (UCLA) Health Centers’ program where “only” 25% of patients went on to commit physician-assisted suicide after an “intake process…conducted by trained psychotherapists (psychologists and clinical social workers) instead of physicians”.

Ironically, current physician-assisted suicide laws tout the “safeguard” that “If, in the opinion of the attending physician or the consulting physician, a patient may be suffering from a psychiatric or psychological disorder or depression causing impaired judgment, either physician shall refer the patient for counseling.” (Emphasis added), But that only means evaluating a patient’s competence, not the diagnosable mental disorders that afflict more than 90 percent of people who die by suicide, is required. Thus, it should not be surprising that only 3.8% of people using physician-assisted suicide in Oregon were even referred for psychiatric evaluation in 2016, unlike the standard of care for other suicidal people.

Tuesday, October 10, 2017

Fatal Flaws Film: The Candice Lewis interview. Candice was pressured to die by assisted death.

By Kevin Dunn
Director of the film Fatal Flaws

Wherever you stand on the issue, it’s impossible to ignore the cultural shift in attitude towards euthanasia and assisted suicide. What was once considered murder under the law is now being accepted as medical ‘treatment’ in many countries. However, even the most ardent promoters of these laws are now saying the ‘genie is out of the bottle’ and are severely questioning where these laws have taken society.


In this first sneak preview, we travelled to St. Anthony, Newfoundland, Canada to interview 25 year old Candice Lewis and her mother Sheila Elson. Here they tell me how, during an emergency hospital stay, doctors pressured Candice into an assisted death. One year later, Candice – who lives with Cerebral Palsy – is back doing what she loves most, painting and being with her family.
We’ve all heard the tragic and much publicized stories of people who died by an assisted death. Tragic indeed. However, Fatal Flaws will focus on stories seldom heard in mainstream media: testimonies from those whose lives have been dramatically affected by a culture that sees ‘killing’ as a form of ‘caring.’ To be clear, the pro-euthanasia lobby cringes when I use words like ‘murder’ or ‘killing’ in my interviews. One group asked me not to use the term ‘assisted suicide’ as it might offend. One national broadcaster didn’t want me using the term ‘euthanasia’. However, I prefer to stay away from euphemisms when dealing with such important issues as life and death. Especially after hearing stories such as Candice’s.

UK High Court rejected assisted suicide but it also rejected part of Canada's Supreme Court euthanasia decision.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition



On October 5, the UK High Court rejected assisted suicide in its Conway decision by rejecting the claim that prohibiting assisted suicide and euthanasia was a breach on Mr. Conway's human rights.

In the Conway decision, the UK High Court also rejected parts of Canada's Supreme Court Carter euthanasia decision. Paragraphs 122 and 123 dealt with issues relate to Carter:

Mr Gordon also referred to the decision of the Supreme Court of Canada in Carter v Canada [2015] SCC 5, in which the court held that the ban on assisted dying in Canada was invalid under the Canadian Charter of Rights and Freedoms. He relied in particular on [114]-[115], in which the court referred to concerns about decisional capacity and vulnerability and observed that these concerns already arise in all end-of-life medical decision-making, including in relation to refusal by an individual of life support treatment. 
We did not find the decision in Carter to be of assistance. It turned critically on provisions of the Canadian Charter (section 1 and section 7) which are in different terms from Article 8 of the ECHR and which engage a different analysis: see in particular [76]-[78]. It also turned critically on findings by the trial judge in the proceedings on evidence before her in relation to the effectiveness of safeguards for vulnerable people which the Supreme Court held could not be challenged on appeal: [108]-[121]. The evidence before us is different and we have made our own findings in the light of it. Our reasoning in relation to the comparison with cases where an individual refuses life support treatment, such as In re B, is set out above. Moreover, the decision in Carter was concerned with the category of people who face unbearable suffering, rather than the category which Mr Conway identifies of people who face death within six months.
Conway also upheld the long held position that there is a clear difference between killing and letting die. Canada's Carter decision rejected this logical position. Conway stated:
Moreover, in our opinion it is clearly legitimate for parliamentarians to take the view that there is a crucial distinction between cases where medical treatment is withdrawn because it can no longer be justified, with the result that the patient dies, and the present case where Mr Conway seeks to have steps taken actively to assist him to end his life. It is a distinction which they are entitled to regard as similar to the “crucial distinction” referred to by Lord Goff in Bland at p. 865D between cases where medical treatment is being withdrawn and cases in which steps are taken actively to end a person’s life. Parliamentarians are entitled to conclude that the cases on either side of this principled dividing line are and should be treated as legally and morally distinct.

The Care Not Killing Alliance noted that the decision also found that doctors cannot determine, with certainty, whether or not someone has six months to live. Conway found:
'Mr Strachan says that the criterion that assistance for suicide would only be available to individuals with less than six months to live would not be capable of being applied with any certainty. Medical science does not permit such an assessment to be made with any degree of accuracy. There is force in this point... [as in] Baroness Finlay's assessment that time of death for a particular individual with MND cannot be predicted with any reasonable accuracy. Professor Barnes confirmed that it is not possible to find it out from testing simple biomarkers and that prognostication of time of death would be a very difficult matter of clinical judgment. Professor Stebbing also gave evidence that "a clinician's prediction is not a very reliable or robust method of predicting survival."'
In conclusion, Conway stated that parliament has the right to legislate on these matters:
It is legitimate in this area for the legislature to seek to lay down clear and defensible standards in order to provide guidance for society, to avoid distressing and difficult disputes at the end of life and to avoid creating a slippery slope leading to incremental expansion over time of the categories of people to whom similar assistance for suicide might have to provided.
The UK court has consistently opposed assisted suicide and has upheld the right of parliament to legislate on euthanasia and assisted suicide.

Washington State 2016 assisted suicide report. Assisted suicide deaths increase again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The 2016 Washington State Department of Health DWD report, states that there were 192 reported assisted suicide deaths, up from 166 in 2015 which was up by 31.7% from 126 in 2014. Assisted suicide deaths continue to increase.

Out of the 248 lethal prescriptions in 2016 there were 192 reported assisted suicide deaths, 36 deaths from other causes, 12 deaths where the "ingestion status" is unknown, and 11 people remained alive.
Dangerously, when the ingestion status is unknown, then the status of the lethal drugs is also unknown. It is possible that the 12 deaths where the ingestion status is unknown could represent the under-reporting of assisted suicide. No information is known in 8 of the 12 cases where the ingestion status is unknown.

The assisted suicide report states that 16% of the lethal prescriptions were based on other illnesses. The report stated that other illnesses, including heart and respiratory disease, and "unknown illnesses." IOregon other illnesses has included diabetes.

In 2016 uncontrolled pain was not even listed as a reason for prescribing assisted suicide.


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

The American College of Physicians recently passed a position opposing assisted suicide. A resolution opposing assisted suicide is currently being debated in Congress.

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

Monday, October 9, 2017

Will assisted suicide always provide a quick and gentle death?

This article was originally published in BioEdge, on October 7, 2017


By Michael Cook

The gold standard for human experimentation is a randomly-assigned double-blind placebo-controlled study. Unfortunately for researchers, organising such a study to assess the effectiveness of the lethal medications used for executions in the United States and for physician-assisted suicide (PAS) has significant ethical issues. They need to rely upon historical data.

In the latest issue of the Journal of Law and the Biosciences, Sean Riley, an end-of-life researcher currently studying in the Netherlands, reviews the patchy record of the drugs used in executions and PAS. He summarizes his findings as follows:

The pervasive belief that these, or any, noxious drugs are guaranteed to provide for a peaceful and painless death must be dispelled; modern medicine cannot yet achieve this. Certainly some, if not most, executions and suicides have been complication-free, but this notion has allowed much of the general public to write them off as humane, and turn a blind eye to any potential problems. Executions or PAS have never been as clean as they appear, even with the US’s medicalization efforts during the 1980s.
He discusses several issues:

Supplier boycotts. Under pressure from anti-death penalty activists, pharmaceutical companies refused to supply prisons with lethal medications. Efforts to circumvent this by going to shady middlemen eventually failed. Most states have ceased to import the key ingredients needed for executions.

Price gouging for PAS drugs. Because of the drought of lethal medications for executions, the price of secobarbital or pentobarbital for PAS has skyrocketed. “Before 2012, patients would pay about $500 for a sufficient lethal dose of the drug, but by 2016, prices had inflated to figures upwards of $25,000.”

Compounding pharmacies. Faced with the huge cost of assisted suicide, prisons and patients began to turn to compounding pharmacies where pharmacists create the drugs from raw materials. “As the past 3 or so years have seen a dramatic increase in the use of compounded drugs,” writes Riley. “There has been a corresponding rise in ‘botched’ executions, though the secrecy laws have neutered most attempts to link failed executions to compounded drugs.”

The drugs made in compounding pharmacies risk being too powerful, not powerful enough, or contaminated. In Massachusetts a former pharmacist is currently on trial for supplying contaminated drugs which caused a nationwide outbreak of meningitis. Prosecutors told the court that he had used expired ingredients, falsified documents, neglected cleaning, failed to properly sterilize the drugs, shipped products before they were tested and ignored mould and bacteria in manufacturing areas. So buying from small firms has its issues.

Last-minute complications. It is difficult to define what a “botched execution” is, but the last moments of some prisoners were clearly agonizing. And for complications with PAS, there is a lack of clear data. “According to data published by Oregon, 5% of patients experienced difficulties, such as regurgitation or seizures, after ingestion of the medication, since the inception of the law in 1997,” says Riley. However, in only 51% of the cases were the details reported. And “there are six reported instances where patients ingested the lethal medications, went unconscious, and awoke sometimes days later.” This is not a feature of assisted dying which supporters speak much about.

Riley concludes that “The processes of death will always, to some extent, be a mystery. For now, whether a death is peaceful and painless can only be assumed.”

Michael Cook is editor of MercatorNet. This article was originally published in BioEdge, which he also edits.

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