Sunday, October 22, 2017

Australian Medical Association (AMA) opposes bill to legalize euthanasia and assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

On Thursday, October 19, the Victoria Australia State Lower House passed an assisted dying bill by a vote of 47 to 37. The bill will now be debated by the Victoria State upper house.

Michael Gannon President
Australia Medical Association
The President of the Australian Medical Association (AMA) is clear that physicians who kill their patients are contravening the code of ethics.

Michael Gannon, who was the chair of the AMA ethics committee while they debated euthanasia, and who is now the AMA President, explained the position of the Australian Medical Association in an article published in the Australian on October 20. Gannon wrote:
The AMA’s statement contains several key points. Most important, it is a positive piece, an advocacy document that calls for better end-of-life care. It calls for better education of the community on advanced care planning and the “doctrine of double effect” — that is, the notion that a death hastened by a treatment to ease suffering does not constitute euthanasia. 
Importantly, it calls for much greater investment in palliative care. 
There are similar sentiments in recommendations one to 48 of the Victorian upper house committee inquiry into end-of-life choices. Overall, this is a good report, but it was written by a group of parliamentarians known to favour EPAS. MPs did not visit jurisdictions that had elected not to implement euthanasia. They would have done well to read the detailed and careful deliberations of the House of Lords in Britain. 
It is so important that conversations on EPAS do not fail to take into account the impact such laws would have on the rest of the health system and society as a whole.
Gannon continues by emphasizing that doctors should never kill their patients.
The AMA’s statement acknowledges the diversity of opinion in the community. It acknowledges the diversity of opinion within the medical profession. 
But at its heart is a clear statement that “doctors should not be involved in interventions that have as their primary intention the ending of a person’s life”. 
I do not doubt the compassion or motives of most people promoting the bill in Victoria. I have heard numerous moving stories of the helplessness people feel when they watch a loved one die. 
Compassion is what drives doctors. It is at the heart of our code of ethics. I do not lack compassion for those who have watched a loved one die. ... 
The Victorian parliament has other opportunities to improve the end-of-life care it provides its citizens. That people suffer painful or prolonged deaths should be a clarion call to improve end-of-life care.
Gannon then focuses on the almost unanimous opposition to euthanasia held by national medical associations. Gannon writes:
At the recent World Medical Association meeting in Chicago, we endorsed what was only the fourth editorial revision of the 1947 Declaration of Geneva. At the heart of medical ethics is the sanctity of human life. 
It is not surprising that 107 of 109 national medical associations affiliated with the WMA have statements opposing EPAS. This includes the US and Germany, nations with one form or another of EPAS law.
Gannon finishes his article by emphasizing that euthanasia and assisted suicide contravene the code of ethics for physicians.
Euthanasia and physician-assisted suicide are at odds with modern and ancient codes of medical ethics. Every life is precious: the 10-year-old boy in Roebourne with foetal alcohol spectrum disorder and severe autism, the 36-year-old veteran with post-traumatic stress disorder, the 68-year-old woman in Morwell with metastatic cancer and no children to be with her as she dies. 
I do not seek to diminish or demean the opinions of those doctors who hold a different view to AMA policy. This debate is vexed. It is difficult. 
But the AMA’s position statement — which I was elected to prosecute, protect and promote — is the result of thousands of hours of work supported by generations of wisdom and ethics.
The Victoria Australia upper house needs to reject the euthanasia bill.

Friday, October 20, 2017

Second Interim Report on MAiD in Canada Released

This text is from the webcast that was broadcast today by Toujours Vivant - Not Dead Yet

On October 6, Health Canada’s second interim report on medical assistance in dying was published. It adds statistics from January to June 2017 to the earlier report, which covered the period from June to December 2016.

The data indicates that 1,179 people died between January and June 2017, bringing the total deaths in Canada to 2,149 since the Québec program launched in December, 2015. All but five of those died by euthanasia. The January to June numbers represent 0.9% of deaths across Canada. This is more than the most recent percentages available for Oregon (0.37%) but less than the numbers for Belgium (1.83%) and the Netherlands (3.75%). The number of deaths increased by 46.8% compared to June to December 2016; 803 people died during that period.

We know that the average age of people who died by euthanasia is 73 years. Cancer was the most frequently cited underlying health issue, followed by neurodegenerative conditions. Over 80% of the deaths took place in hospitals or homes. The number of women versus men is about the same; there were slightly more women last year, and more men this year.

The more important information is what’s missing – and once again, quite a bit has been left out. There is no data for the Yukon, Northwest Territories and Nunavut, due to the territories’ small population. Neither Ontario nor British Columbia, the two provinces with the largest number of AS/E deaths, reported how many requests for assisted suicide were received, and how many were refused. As well, Health Canada did not include information about people who received court permission for euthanasia before the law came into force in June 2016.

There is no information about the living situation or other circumstances of the people who are killed (only the location where euthanasia took place). Did people have the pain relief and supports they needed to live well at home? Was anyone pressured to die? Were all safeguards followed? We have no way to know.

More information is supposed to be available once a monitoring system is put in place. Future reports under this system should include:

  • a broader set of data 
  • a statistical overview of all requests and their outcomes  
  • medical and demographic information;
  • information about whether eligibility criteria and safeguards were followed.

Wednesday, October 18, 2017

Ontario family is asking for more time to prove that their daughter is alive.

Taquisha McKitty's parents
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Taquisha McKitty (27) of Brampton Ontario was declared brain dead on September 20 after having a cardiac arrest on September 14 related to a drug overdose. Her parents immediately sought a court injunction to prevent the William Osler Health System in Brampton from removing her life-support.

On September 28 Ontario Superior Court Justice Lucille Shaw granted an injunction in order to allow Taquisha to be evaluated by another doctor.

Hugh Scher
On October 17, Hugh Scher, the lawyer for Taquisha's family, asked the court for more time for medical tests to prove that Taquisha is alive. Paola Loriggio, reporting for 
The Canadian Press wrote:
Scher says McKitty's family believes she is still showing signs of life. 
The family wants the death certificate revoked and obtained a temporary injunction from the court late last month to keep her on the respirator while its legal challenge continues. 
Court heard Tuesday that a series of tests has been conducted but McKitty's family is asking for at least one more to be performed, which would require the court to extend the injunction. 
The test would involve filming McKitty for 72 hours to capture her movements and better assess whether they represent a sign of consciousness or simply a reflex, Scher said.
Lawyers for the doctors are trying to dismiss Dr Paul Byrne, an American expert physician, who contends that McKitty is alive. Paola Loriggio wrote:
Lawyers for McKitty's doctor are taking issue with the family's expert witness, an American doctor who told the court Tuesday he does not believe lack of brain function is enough to declare someone dead.
Hugh Scher is a successful Toronto lawyer who has helped several patients and families experiencing difficult healthcare decisions.

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.

Elderly Dutch couple: Euthanasia is not the answer.

This article was published by OneNewsNow on October 9, 2017

Alex Schadenberg
One opponent of euthanasia is disappointed to see that the Netherlands has taken yet another step toward approving the practice for any reason.

A case in point is the recent euthanasia of 91-year-old Nic and Trees Elderhors, a couple who had been married for 61 years. The two suffered frailty typical of older people and decided to commit suicide together. Alex Schadenberg of the Euthanasia Prevention Coalition says their deaths are another indication of how off-track euthanasia has gone.
"Further, I think that this represents a whole other issue, which is the promotion in the Netherlands of the concept of completed life, meaning that somebody doesn't need to be terminally ill and dying in order to have euthanasia," Schadenberg continues. "They simply have to decide that they think their life has been completed, however you might define that."
Schadenberg raises the question of what society is doing that would give elderly people the impression that death by lethal injection is better than life.
"I ask that question for a significant reason, because I think our society also has a problem with how it treats people who are getting elderly," he poses. "I find there's far too much loneliness and depression within our culture."
He suggests one solution to that is to change the culture.

Schadenberg adds that another problem is how the media painted such a rosy picture of the couple holding hands as they died in order to advance euthanasia to its obvious conclusion of committing suicide at any time and for any reason.

Saturday, October 7, 2017

1,982 reported assisted deaths in the first full year in Canada.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The data from Health Canada's 2nd Interim Report on assisted dying states that there were 1982 reported assisted deaths (1977 reported euthanasia deaths and 5 reported assisted suicide deaths) in the first year (June 17, 2016 - June 30, 2017) since legalization.

There were 167 reported euthanasia deaths in Québec prior to the federal government legalizing assisted death, therefore as of June 30 there have been (1982 + 167) 2149 reported assisted deaths in Canada.

Canadian governments have established a self-reporting system, meaning the doctor who carries out the death is the same doctor who reports the death (no oversight of the law) therefore it is possible that under-reporting and abuse of the law occurs. Based on the first Québec government euthanasia report 14% of the assisted deaths did not comply with the law.

Candice Lewis
There have been several stories indicating that there are problems with Canada's euthanasia law. For instance, 
Candice Lewis was pressured by doctors to die by euthanasia. Now she is feeling much better.

In late September 2016, Dr Will Johnston reported on two British Columbia deaths that appear to abuse the euthanasia law

In November I was contacted by a man who stated that his Aunt, who died by euthanasia, may only have had a bladder infection.

Canada's euthanasia law does not protect conscience rights for medical professionals. The Coalition for HealthCare and Conscience launched a legal challenge to the Ontario College of Physicians policy that forces physicians, who oppose killing, to "effectively refer" their patients to a physician who will kill.

Effective referral is defined as referral for the purpose of the act. The court case was heard (June 13 - 15) in an Ontario court.

A Canadian bioethicist published an article promoting euthanasia / organ donation and a study was published stating that up to 138 million dollars can be saved by euthanasia.

Meanwhile a Toronto study that was published in the New England Journal of Medicine found that requests for euthanasia are based on existential distress and not physical pain.

To make matters worse, in June 2017 an Ontario judge extended euthanasia to non terminal people by redefining the phrase "natural death must be reasonably forseeable" in his decision and Canadian euthanasia doctors are demanding more money to kill.

The number of Canadian euthanasia deaths is high when compared to Belgium where there was 235 reported assisted deaths in the first year (2003), 349 in the second year and 393 in its third year after legalization. In 2015, there were 2021 reported Belgian assisted deathsBelgium has approximately 1/3 of Canada's population.

Data from a study published in the New England Journal of Medicine (March 2015) indicates that more than 40% of the assisted deaths in Belgium were not reported in 2013.

In the Netherlands there were 6091 reported assisted deaths in 2016 representing 4% of all deaths. Data from a study published in the New England Journal of Medicine indicates that 23% of the assisted deaths in the Netherlands were not reported in 2015. 

Based on the number of reported assisted deaths, it is possible that Canada will quickly surpass the Netherlands and Belgium.

The Euthanasia Prevention Coalition continues to oppose euthanasia. 
  • EPC has successfully produced the Euthanasia Deception documentary focusing on personal stories by people with direct experience with euthanasia,
  • EPC is distributing the Caring Not Killing pamphlet explaining why euthanasia and assisted suicide are not necessary and what you can do to make a difference,
  • EPC is working with the Compassionate Community Care service that offers advice and direction for family and friends of people who are considering dying by assisted death or people facing difficult end-of-life decisions. Contact CCC at: 1-855-675-8749. 
The euthanasia debate must go beyond theory and buzz words and focus human reality. People usually ask for euthanasia when they are emotionally or psychologically distraught by their medical or personal situation. Euthanasia abandons people at the most vulnerable time of their life.

The answer to euthanasia is to care for people and not to kill people.

Dangers of Assisted Suicide: The Latest Data from Washington State

This article was published by HOPE Australia on October 5, 2017

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

The latest annual report with data from 2016 was published in September 2017.

This latest data confirms that once assisted suicide is legalised use of it increases from year to year, seemingly without limit.

In 2010, the first full calendar year of operation, some 87 prescriptions for lethal drugs were provided under the Act. By 2016 this had nearly tripled (285%) to 248.

Prescriptions for lethal drugs increased by 15% from 2015 to 2016.

Deaths from lethal drugs prescribed under the Act have nearly quadrupled (376%) from 51 in 2010 to 192 in 2016, increasing by 13.6% from 2015 to 2016 alone.
Not all of those who are prescribed lethal drugs end up taking them. Some die of natural causes. 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 1184 prescriptions for lethal drugs issued since 2009 only 846 (71%) have been reported as used leaving some 338 doses of lethal drugs unaccounted for in the community. 

Some 59% 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, 87% cited concerns about loss of autonomy and 51% cited concerns about being a burden on family, friends or caregivers.

Significantly, 8% cited concerns about the financial implications of treatment.

Only 5% of those given a lethal prescription were referred to a psychiatrist or psychological for evaluation. 

In some cases the prescribing doctor knew the patient for less than a week before writing the prescription, and in more than half the cases (53%) the doctor knew the patient for less than 25 weeks.

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, one person in 2015 dying nearly two years later (95 weeks) and one person in 2016 dying more than two years (112 weeks) later. 

In 2016, one person took 11 hours to lose consciousness after ingesting the lethal dose and one person took 22 hours to die after ingesting the lethal dose. 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. In 2014, one person suffered seizures after ingesting the lethal medication.

At least 16 patients have regurgitated the lethal medication. Seven of these cases occurred in 2016 alone.

This may be related to the use of new experimental cocktails of lethal drugs being used since the price of the previously used drugs, secobarbital and pentobarbital (Nembutal), escalated.
The first of the new cocktails is a mix of phenobarbital, chloral hydrate and morphine sulfate. It was used in 88 cases in 2015 and 44 cases in 2016.

The second experimental cocktail includes morphine sulfate, propranolol, diazepam, digoxin and a buffer suspension. It has been used in 2 cases in 2015 and 22 cases in 2016.

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 200 cases where no health-care provider was present when the lethal dose was ingested and a further 104 cases where it is not known if a health-care provider was present.

In other words, in some 304 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.