Thursday, March 26, 2015

Doctor Death Nightmare

Published on March 24.

By Deborah Rankin

Margaret Somerville
law professor at McGill University says that a recent decision of the Supreme Court of Canada overturning the ban on assisted-suicide and euthanasia is a "nightmare" and "full of errors". Margaret Somerville, the Founding Director of the Centre for Medicine, Ethics and Law at McGill made these remarks recently to a rapt audience at a public forum organized by the Newman Centre for Catholic students and faculty.

She said that the SCC decision goes farther than simply striking down the ban against aiding someone to commit suicide, permitting euthanasia by physicians in certain circumstances, while cautioning that the ruling is unclear in this regard.

In physician assisted-suicide the doctor prescribes drugs that the patient takes, whereas in euthanasia the doctor administers a lethal injection - in either scenario, ostensibly at the patient's request. However, in jurisdictions where assisted-suicide has been legalized, there are multiple examples of abuse with people being euthanized without their consent.

This is especially true in the case of children and incompetent adults who can't give informed-consent: for example, the Groningen Protocol of the Netherlands permits so-called "voluntary euthanasia" of babies at the parents' request. Pro-euthanasia advocates refer to this gruesome practice as "post-birth abortion" while opponents say that it is really a form of "closet eugenics" - if the child is born with congenital defects the parents can request euthanasia on the pretext of preventing the child from suffering.

Wednesday, March 25, 2015

The Atlantic - Pushing Killing for Organs

This article was published on Wesley Smith's blog on March 24, 2015.
Wesley Smith
By Wesley Smith

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. 

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:” 
A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”  
If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.  
Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs. 

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

Monday, March 23, 2015

Almost half of the Belgian euthanasia deaths may not have been reported in 2013.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The New England Journal of Medicine (NEJM) published  a new study concerning the Belgium euthanasia experience titled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

Similar to previous studies, researchers sent a four page questionnaire to 6188 physicians who had certified death certificates in the first half of 2013 in Flanders Belgium. The study received a 60.6% response rate with 3751 returned questionnaires. The data represents about 6% of all deaths.

The data indicates that:

1. 4.6% of all deaths were euthanasia.
2. .05% of all deaths were assisted suicide.
3. 76.8% of the requests for euthanasia or assisted suicide were granted.
4. 1.7% of all deaths were hastened without explicit request.
The data did not include information concerning the number of unreported euthanasia deaths.

With help from a researcher in Belgium I learned that in 2013 there were 61,621 deaths in Flanders Belgium. Since the data from the 3751 questionaires indicated that 4.6% of all deaths were euthanasia, therefore there may have been as many as 2834 assisted deaths in Flanders in 2013.

Since the official Belgian euthanasia report stated that there were 1807 reported euthanasia deaths in Belgium, of which, 1454 were from the Flanders region, therefore about 1380 assisted deaths may not have been reported in Flanders Belgium in 2013. 

This means that almost half of all euthanasia deaths may not have been reported in Flanders in 2013.

The study also found that 1.7% of all deaths were hastened without explicit request. Since there were 61,621 deaths in Flanders, therefore about 1047 deaths may have been hastened without explicit request in Flanders Belgium in 2013.

The recent Supreme Court of Canada assisted death decision suggested that abuse of euthanasia laws in other jurisdictions was only anecdotal. Canada needs a Royal Commission to set the record straight. 

Euthanasia is out-of-control in Belgium.

To learn more about the abuse and extension of euthanasia in the Netherlands and Belgium purchase my book: Exposing Vulnerable People to Euthanasia and Assisted Suicide.

Chilean girl who asked for euthanasia, changes her mind.

Alex Schadenberg
Euthanasia Prevention Coalition

Valentina Maureira
A 14-year-old Chilean girl, who asked the Chilean President, to allow her to die by euthanasia, has now changed her mind and wants to live.

Valentina Maureira, who lives with Cystic Fibrosis, created a youtube video last month asking the Chilean President, Michelle Bachelet, to allow her to die by euthanasia. Valentina got the idea from the Brittany Maynard assisted suicide campaign.

On February 28 President Bachelet met with Valentina. Presidential spokesman Alvaro Elizalde stated that 'it's impossible not to be overcome by emotion with the girl's request, it's impossible to grant her wish,' because it's not allowed under Chilean law.

Valentina has changed her mind after meeting with a family from Argentina who also have children with Cystic Fibrosis.

Maribel Oviedo
Valentina's father said that his daughter was moved by a visit from a Argentina family, whose children also have Cystic Fibrosis.

He said Valentina was given hope by meeting someone who had survived beyond age 20 with the disease.

Maribel Oviedo and her father Ernesto traveled to Santiago to 'convey a message of hope.'

Maribel, 22, watched her sister Marisol die of cystic fibrosis in 2013. Mirabel received a lung transplant in 2012 and told Valentina that she now lives a normal life.

Mirabel offered to go to a doctor's appointment with her because she wanted to encourage her to live.

Valentina's story is emotionally charged. If Valentina had died by euthanasia, her options, potential treatment and opportunity to change her mind would have ended.

Now Valentina has hope.

Saturday, March 21, 2015

Euthanasia doctor justifies death for depressed people.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Godelieva De Troyer died by euthanasia in 2012.
An interview with Wim Distelmans, the chairman for the federal euthanasia commission in Belgium, was published in HLN.BE   (google translated) on March 15. where Distelmans explains that there were 50 - 60 psychiatric patients who died by euthanasia in 2013 - 2014. Distelmans states:

"It is a small group, 50 to 60 patients. But it is not a negligible number:. 2 to 3 percent of the 1,924 people who were euthanized last year."
Distelmans then states:
"usually they are not old, but they suffer long. They do not belong in this world, they think.."
Distelmans promotes euthanasia for depressed people. He states (google translated):
"Manic-depressive patients are in their manic moments capable of the most improbable things, They spend their bank loot, for weeks at a five-star lodge, buy several cars one day. At that stage they are not competent. But in moments of depression they by their exhaustion come back to the baseline and are indeed competent. Then they can for instance say, "I live for thirty years crazy highs and lows, I've tried everything to break that infernal cycle Now that I'm back on the baseline, and I know that I have a couple of weeks left, back I for a dip in the depth or a jump in height. " These are people who are eligible for euthanasia."
Once euthanasia has become an acceptable solution to human suffering the only question that remains is what conditions will death become the solution for life.

Lethal injections for people with psychiatric conditions is based on a false compassion. Distelmans appears to be reacting to his fear of living with chronic depression.

New Euthanasia Bill in Tasmania

This article was published on the HOPE Australia website on March 20.

Paul Russell and
Alex Schadenberg
in Tasmania.
By Paul Russell, the director of HOPE Australia.

The Tasmanian MPs who tabled and pushed the last Euthanasia bill defeated in 2013, have said that they will try again later this year.

The then Premier, Lara Giddings MP and her then deputy, Nick McKim MP, now on the opposition benches made the announcement in The Examiner Newspaper on the 14th of March.

But bringing the issue to a vote in this new bill will not be as easy as it was when the then Premier and her Deputy were in control of the parliamentary debate from the treasury benches.

Moreover, whereas the vote in 2013 was resolved by 13 votes to 11, a cursory look at the chamber post the 2014 election suggests that the numbers are at least at that level if not more strongly against.

When Giddings and McKim had the privilege of office behind them, a faux discussion paper arising out of the Premier's Office and full control of the timing of the debate, they still could not find a majority on the chamber.

It is always possible that votes change and we must ever be vigilant, but I cannot help but observe that this seems more like grandstanding than it does about anything else.

Thursday, March 19, 2015

Organ donation, euthanasia and assisted suicide.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Several days ago I received a phone call from Sharon Kirkey who was writing an article concerning the practice of organ donation after assisted death, an article that was published in the National Post. Kirkey asked me my thoughts on whether organ donation would occur after assisted death? It is interesting that she didn't include any of my quotes in the article. I said:
Sharon, you are asking the wrong question. Any person who signs their organ donor card and who dies by assisted death would be eligible for organ donation.
I then said to her:
The real question is whether or not, in the future, organ donation and assisted death will be coupled.
There was some silence on the other end of the phone. I continued.
If a person has signed their organ donor card and if they have been approved for assisted death, why wouldn't the organs be donated? Once assisted death becomes more common, why wouldn't they remove the organs before lethal injection? Death by lethal injection and death by removal of vital organs is the same thing, simply done in a different way.
Sharon questioned me further and I said:
My concern is that in the future euthanasia will be sold to the public as "good for society."
By coupling organ donation with assisted death, new social pressure will be created for people with healthy organs who are living with disabilities, depression or chronic conditions. They will be subtly encouraged to "voluntarily" die by "assisted death" for the "common good."
Whether I like it or not, if "assisted death" becomes legal, organ donation will soon be subtly promoted as a "good outcome" of assisted death and later become overtly promoted especially for people who are living with disabilities, depression, or chronic illnesses. The healthiest organs make for the best transplants.

Wednesday, March 18, 2015

More than 1000 deaths were hastened without explicit request in 2013 in Belgium.

Alex Schdenberg
By Alex Schadenberg
Executive Director Euthanasia Prevention Coalition.

Contrary to the recent Supreme Court decision striking down Canada's laws that protect people from assisted death, in Belgium, where euthanasia has been legal since 2002, a significant number people are being killed without request. In fact a recent study showed that 1.7% of all deaths in 2013 in Belgium were intentionally acts to cause death without request. A similar study in 2007 indicated that 1.8% of all deaths were hastened without explicit request, no change.

Yesterday I wrote an article about the new study that was published in the NEJM on March 17, 2015  on the experience with euthanasia in the Flanders region of Belgium. The Belgian study was done by sending questionnaires to the physician who certified a death certificate in 6188 deaths in the first half of 2013. The data indicated that euthanasia represented 4.6% of all deaths and assisted suicide represented .05% of all deaths.

The Supreme Court of Canada assisted dying decision last month stated that abuse of euthanasia laws are anecdotal, but the previous Belgian study in 2007 stated that 1.8% of all deaths were hastened without explicit consent and the new Belgian study stated that 1.7% of all deaths were hastened without explicit consent in 2013.

The Associated Press article interviewed Belgian ethicist Freddy Mortier. The article stated:
Mortier was not happy, however, that the 'hastening of death without explicit request from patients,' which can happen when a patient slumbers into unconsciousness or has lost the capacity for rational judgment, stood at 1.7 percent of cases in 2013. In the Netherlands, that figure was 0.2 percent.
Since there are 61,621 deaths in 2013 in Flanders and according to the study 1.7% of the deaths were hastened without explicit request, therefore, it is possible that more than 1000 deaths were hastened without explicit request in 2013 in Flanders.

People need to recognize that euthanasia or assisted suicide laws will be abused.

Will assisted death be your choice?

John Kelly: Say 'no' to assisted-suicide expansion in Oregon

This article was published by Oregonlive on March 17.

John Kelly, is a director of the disability rights group Not Dead Yet and founded Second Thoughts.

John Kelly
Even as the Oregon-based Death with Dignity National Center and other assisted suicide proponents continue to insist that "there have been no efforts to expand either (Oregon or Washington's) law beyond their strict guidelines," here comes House Bill 3337, which would stretch the meaning of terminal illness from six months to 12 months.

Oregon became the first state to legalize assisted suicide in part by highlighting so-called "safeguards" like the requirement that people have a "terminal disease" -- the prediction by two doctors that "within reasonable medical judgment" a person would die inside six months. But even at six months, the death knell of "terminal" was arbitrary and approximate. Studies have shown that 15 to 20 percent of the supposedly "terminally ill" outlive their prognosis, leading to our current situation whereby six-month hospice programs discharge 200,000 people yearly for living too long!

The Oregon Health Authority has participated in this "terminal" charade by not disclosing how many program participants lived longer than six months, giving instead a range of survival after the initial request for prescribed suicide. Nevertheless, every report this century has included someone who lived longer than a year -- one person living almost three years after first request. Under the new proposal, it is guaranteed that innocent people would lose years of their lives under the mistaken belief they were dying when they were not.

Tuesday, March 17, 2015

Deep Sedation: France is in danger of buying a deadly illusion.

Dr Kevin Fitzpatrick OBE, is the director of EPC International and lives near Avignon France.

Dr Kevin Fitzpatrick
France is in danger of buying a deadly illusion: that terminal sedation is neither assisted suicide nor euthanasia. In the Netherlands it can be both, and the numbers of people being terminally sedated there are growing at an alarming rate. From the minute the Assemblée Nationale should pass any such legislation, terminal sedation will become the lie to hide the practice of euthanasia throughout France too.

On Tuesday March 17, 2015 the French parliament overwhelmingly voted to give people the right to demand terminal sedation – that is, for them to be made unconscious in their last hours and days. We have been warning about the steep rise in the use of terminal sedation in the Netherlands, as a form of ‘back-door’ euthanasia.

In the Netherlands, only informed adults who meet all the criteria of the Dutch law are counted as euthanasia deaths. None of those who are unable to give informed consent, a key element of the Dutch law, are counted. So no neonates killed because of their disabilities, no older people with dementia, or those in persistent coma, no-one who finds some doctor willing to ‘grant’ them a euthanasia death because they fail to meet Dutch legal criteria. Those who die through terminal sedation are not generally counted either, but the rise in their numbers is frightening.[1]

Even in those cases where deep sedation is a serious consideration, for those few individual people whose refractory symptoms cannot be managed by modern palliative medicine, profound questions remain to be answered. But in the 1990s this group was estimated at below 5% of all cases.[2] Today palliative care specialists, and advances in their field, mean that fewer than 2% of patients are faced with terminal sedation as their only option.[3] Of course every individual deserves our best response, but if their numbers are falling why then should terminal sedation be on the rise at all? In the Netherlands or anywhere else?

To create a specious ‘right’ to die by terminal sedation as the French propose, is yet another hoodwink – it allows a larger public to believe this is all being done so maturely, with such compassion, and somehow manages to avoid all the thorny questions about assisted suicide and euthanasia. It does no such thing. And simply claiming that such deaths will be neither assisted suicide nor euthanasia cannot change the fact that, often, this is exactly what they are.

Administering a lethal dose in order to bring about death is killing, it is murder, and many French doctors have spoken out against the latest proposal having no wish to be drawn over to this sinister side of the debate. Administering a dose to relieve pain which may have the double effect of ‘hastening death’ is not always subtly different. The question is: who can tell? A doctor, a nurse, a pharmacist? The relevant information is usually guarded or hidden, but we may hope to be able to find out. Hidden intentions are so much more difficult to unearth. Protesting doctors know that from their own experience.

President Hollande is said to have been convinced of the need for legalised euthanasia by the death of his mother Nicole in 2009. The Claeys-Leonetti proposal that calls for terminal sedation on demand has garnered cross-party support, something the beleaguered leader needs after other failures have seen his popularity drop below that of any previous incumbent of the highest office in France. The point here is that political careers can be built or can fall on such ‘opportunties’ – this is never a clean debate.

The Dutch and the Belgians openly admit their legal frameworks were intended to ‘regularise’ already existing and illegal practice, they say ‘so as to avoid abuse’. Yet those illegals acts, so prevalent it took new legislation to accommodate them, were never prosecuted. And avoiding abuse is so far from what has happened in either country, when under-reporting remains at nearly a quarter of all euthanasia deaths in the Netherlands. Research suggests the rate of unreported deaths is even higher in Belgium. But in Belgium the leading euthanasia practitioner heads up the oversight committee, which has never referred one euthanasia death reported to it for investigation. It is easy to see why doctors might not even be bothered to report. Or why nurses are committing euthanasia, which is also illegal. [4]

The Belgians also openly admit their law was framed to support suicide for disabled people, and insist this is a matter of patient choice. The inherent discrimination against disabled people is exacerbated by entirely removing patient choice into the hands of a third party, usually a doctor. In another terrible irony, the lobby for assisted suicide/euthanasia argue that no-one should be ‘forced’ to spend their last moments unconscious. They cannot have it both ways.

In France, the debate has spilt Assemblée deputies – 121 of them co-signed an amendment to legalise ‘active medical assistance to die’ which would come worryingly fast – the patient’s demand for euthanasia would be confirmed over 2 days, and 3 doctors’ opinions would see the person dead in just 4 more days, with no serious controls in place apart form a mention in their medical notes.

The choice will be between "double-effect sedation" and barely disguised euthanasia. It is not cynicism that makes me say the majority of the sedation deaths will be euthanasia deaths, it is experience. I bitterly regret that part of human nature which will move so swiftly and seamlessly to the worst edges of practice – the fact is, once it ‘becomes legal’ so many who stop now, pause and ask themselves ‘Is this really right?’ will simply shrug and say instead ‘Well, it’s legal now’ – that is one of the conditions those people need to bury the last vestiges of their consciences in ‘I’m only following orders.’ Now where have we heard that before? In that other great and most destructive illusion…
  1. Agnes van der Heide, et al ‘End-of-Life Practices in the Netherlands under the Euthanasia Act’ New England J Med 2007; 356:1957-1965 May 10, 2007 DOI: 10.1056/NEJMsa071143
  2. Heintz, A P M (1994) 'Euthanasia can be part of good terminal care' British Medical Journal vol 308, p1656
  3. From private conversation with a palliative care specialist
  4. Alex Schadenberg Exposing vulnerable people to euthanasia and assisted suicide ISBN 978-1-897007-27-3