Euthanasia and assisted suicide – Let’s not go there!

Syringue 8

Action Life sent this submission to the Provincial-Territorial Expert Advisory Group on Physician Assisted Dying, at the end of October 2015:

Action Life Ottawa is a non-denominational, non-profit, educational pro-life organization founded in 1971. We count 4,000 supporters in Ottawa and the surrounding region.  Our guiding principles are that the right to life is the basic human right on which all others depend and that society has a duty to uphold and protect that right.  We believe that life at every stage has inestimable value regardless of level of development, size, mental capacity, state of health and physical ability.  We hold that all human beings are equal before and after birth. Members of Action Life maintain that we must solve human problems using positive, constructive means without destroying human life.

Action Life is greatly concerned about the protection of vulnerable persons from euthanasia and assisted suicide in the aftermath of the Supreme Court decision in Carter v. Canada. A regime permitting euthanasia and assisted suicide will affect not only individuals but will have a profound societal impact as well.  Allowing the deliberate taking of a human life by physicians may undermine trust in the medical profession.  While euthanasia and assisted suicide advocates present lethal injections and prescriptions for a lethal dose of drugs as medical treatment, they are the very opposite. Euthanasia and assisted suicide are not medical treatment or health care, they are killing.  Permissive regimes also place at risk, the most vulnerable in society:  Persons with disabilities, elderly persons and persons with chronic and mental illness.  Behind these calls  for the ‘right to die’  lies the view that some lives are not worth living.

While much is said about autonomy and safeguards to advance the legalization of euthanasia and assisted suicide, they have been ineffective in protecting patients from euthanasia without explicit request or consent in the Netherlands and Belgium. The failure of safeguards has been amply demonstrated by the euthanasia experience in these jurisdictions.

Euthanasia Cases with no Explicit Request

Netherlands

 

The very first government commissioned report on euthanasia in the Netherlands, the 1990  Remmelink report found that 1,000 patients a year were “terminated without explicit request”.  Subsequent studies published in 1995 and 2001 showed that at least 1,000 euthanasia deaths a year were done without  explicit request.  Thousands of patients have been euthanized without explicit request in the Netherlands over the years.   An examination of later data reveals that this practice continues.  In 2005, there were approximately 550 deaths  without explicit request.  In 2010, there were 310 euthanasia deaths without explicit request. 23% of euthanasia deaths were not reported to the Review Committee in 2010 according to a 2012 Lancet study.

The Dutch experience shows that euthanasia is not limited only to those who ask and consent to it but it is also extended to those who did not make a request or give consent.  Even prior to the legalization of euthanasia in the Netherlands and Belgium, cases of neonatal and infant euthanasia by lethal injection occurred.  Infants cannot request or consent to being killed by lethal injection.

The promises of safeguards and strict controls are an illusion.

Reasons for euthanasia

Once euthanasia is allowed, reasons for euthanasia and the number of euthanasia requests granted  increase over time.  It is granted for psychological suffering, including  patients with depression, dementia and those tired of living.

In 2006, there were 1,923 reported euthanasia deaths. In 2013, there were 4,829 reported euthanasia deaths.

 

The  Belgium experience

Physician assisted deaths under the euthanasia law in Belgium: a population based survey- Canadian Medical Association Journal, June 2010.

This study identified a vulnerable patient group:

“Our finding that the use of life- ending drugs without explicit patient request occurred predominantly in hospital and among patients 80 years or older who were mostly in coma or had dementia fits the description of “vulnerable” patient groups at risk of life- ending without request.”

 

Euthanasia deaths without explicit request

Why was the decision for euthanasia not discussed with the patient? Reasons offered among others were that:

In 70.1% of cases, the patient was comatose.

In 21.1% of cases, the patient had dementia.

In 17% of cases, the physician thought “the decision  was clearly in the patient’s best interest. ”

In 8.2% of cases,  the physician thought “the discussion  would have been harmful to patient.”

So we ask where is consent and choice in these decisions? Choice and consent are an illusion: sometimes the physician decides when the patient dies. In some instances, it is also the wish of the family to end the patient’s life.  31% of euthanasia deaths were done without the patient’s explicit request in the Flanders region of Belgium.

Unreported euthanasia deaths

British Medical Journal, November 2010

Reporting of euthanasia in Medical Practice in Flanders, Belgium: Cross Sectional Analysis of Reported and Unreported cases

From this study, we know that:

47.2% of euthanasia deaths were unreported.

“According to these documents, physicians who reported cases, practiced euthanasia carefully and in compliance with the law, and no cases of abuse have been found. However, concerns exist that only cases of euthanasia that are dealt with carefully are being reported. ”

Reasons given for not reporting euthanasia death were:

In 11.9% of  cases, physicians responded that the “legal due care requirements had possibly not all been met. ”

9%  said that “euthanasia is a private matter between physician and patient.”

2.3% “did not report the case because of possible legal consequences.”

In 76.7% of the cases, “physicians answered that they did not perceive their act as euthanasia.”

Another ‘safeguard’ which was ignored in unreported cases of euthanasia was the requirement to consult another physician:

“Consultation occurred in almost all reported cases, whereas it occurred in only half of all unreported cases. This association was also found in the Netherlands where the most important reason for not consulting was the physician did not intend to report the case.”

 

It is our belief that only an absolute prohibition on euthanasia and assisted suicide protects patients.

The latest study on euthanasia in Belgium found:
The New England Journal of Medicine (NEJM) (March 19, 2015) Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

  1. An increase in the  percentage of euthanasia deaths: in 2007, 1.9% of all deaths were due to euthanasia.  In 2013, 4.6% of all deaths were due to euthanasia, which represents a substantial  increase in 6 years.

 

Euthanasia deaths without explicit request from the patient continue to happen in spite of safeguards.

In 2007, 1.8% of all deaths were euthanasia deaths without explicit request.

 

In 2013, 1.7% of all deaths were hastened deaths without explicit request.

 

Given a total of 61,621 deaths in 2013 in Flanders Belgium with  1.7% of all deaths being due to euthanasia without explicit request, this means at least 1,000 deaths were euthanasia deaths without explicit request.

Assisted Suicide

In the states of Oregon and Washington, where assisted suicide is legal, the primary end of life concerns mentioned in the annual reports are loss of autonomy and dignity and decreasing ability to participate in activities the individual once enjoyed.  Being a burden on family and friends is also a concern for some individuals. We need to reaffirm that dependence does not imply a loss of dignity. On the one hand we will have suicide prevention and on the other suicide affirmation. The two cannot co-exist.  Media reports have documented cases of violations of the assisted suicide law in Oregon.

Palliative care

Dame Cicely Saunders, who founded palliative care at S. Christopher’s Hospice in London said that “a request for euthanasia is primarily, the response to health care and social service systems that do not meet the needs of most people who are dying.”

When the reasons behind this cry for death are addressed, when the proper care is received, such demands usually dissipate.

Canada must increase and provide greater access to palliative care for all Canadians. At present, estimates are that only 30% of Canadians have access to palliative care. We are concerned that some are pushing for euthanasia and assisted suicide to be included in palliative care centres, a move which would cause some patients to fear these centres.

Suffering wears many faces: physical, emotional, and spiritual. A person’s request for death may be the result of loneliness, abandonment, poor pain relief, familial or financial pressure. Death with Dignity doesn’t come from a syringe or a prescription for a lethal dose of drugs.

Impacts on conscience rights

Lastly, we turn to the question of  conscience rights of physicians. The College of Physicians and Surgeons of Ontario in its new policy Professional Obligations and Human rights  states that in spite of conscientious, moral or religious objections, the physician must provide an effective referral to another physician. Asking a physician to refer for euthanasia or assisted suicide in spite of his moral objections  is a violation of his Charter right to freedom of conscience and religion.  We oppose any measure which would force physicians to refer for euthanasia and assisted suicide. The conscience rights of nurses must be respected as well.

The American Medical Association’s view on euthanasia is one we wholeheartedly agree with: “Euthanasia is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”

Canada should direct its energies to increasing access to palliative care rather than allowing euthanasia and assisted suicide. Again, we stress that only a prohibition on euthanasia and assisted suicide can protect vulnerable persons.   To die with dignity, patients do not need doctors to kill them.

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This Marine has the same brain cancer as Britanny Maynard but his response is priceless

From LifeNews.com, January 14 ,2016

Last year, as the media focused on a young California woman with terminal brain cancer who wanted to commit doctor-prescribed suicide, a young husband and father learned that he had the same horrible disease.

Doctors diagnosed J.J. Hanson with stage four glioblastoma multiforme, the same terminal cancer that young suicide victim Brittany Maynard had, Live Action News reports. Hanson, like Maynard, was told that the cancer was not treatable and he only had a few months to live.

“[Brittany] took her cancer story public, and it was used to headline a national effort to ‘normalize’ assisted suicide; a notion that had previously been rejected by dozens of states,” Hanson wrote in a recent column for the New Jersey Star-Ledger. “The message sent to patients across the country, who, like me, wanted to fight and live was now — ‘assisted suicide may be the best option for you.’ I recognized this as a huge danger.”

Hanson, a Marine Corps veteran, thought he was in good health, until one day at a business meeting in May 2014, when he “suddenly felt something go horribly wrong.” An ambulance rushed Hanson to the hospital, where doctors discovered that he had two lesions in his brain. Doctors told him and his wife, Kris, that the cancer was capable of doubling in size in two weeks – and inoperable.

Hanson said he refused to give up hope. He and his wife traveled to doctor after doctor until one agreed to treat him. The young husband and father had brain surgery, followed by radiation, chemotherapy and a clinical trial for a new experimental drug, he said.

“There were days when I completely lost all of my most basic physical abilities. I couldn’t talk, walk, read or write,” Hanson wrote in the recent column. “I fought for treatment that was so difficult there were times when I questioned if the struggle was worth the pain.”

It was. Just Christmas this year, Hanson posted a video on YouTube to announce that he was in remission – 20 months after being told he was going to die. In the video, Hanson encouraged other cancer victims to keep hoping.

If doctor-prescribed suicide had been legal in his state, Hanson said he easily could have succumbed to the same fate as Brittany Maynard, who committed suicide with a lethal drug prescribed by a doctor on Nov. 2, 2014 in Oregon.

Maynard campaigned for legalized assisted suicide before her death. Although cancer patients and pro-life groups tried to talk her out of the decision, it later appeared that Maynard may have either been used by assisted suicide advocates to promote their agenda or may have been a part of a plan working in concert with them to attempt to legalize assisted suicide in additional states. Her tragic death was used to push a new doctor prescribed suicide law in California.

Dozens more states have introduced assisted suicide legislation since Maynard’s suicide. A New Jersey bill to legalize doctor-prescribed suicide recently failed, while the New York bill is still being considered. Currently, doctor-prescribed suicide is legal in Oregon, Washington, Vermont and California.

Hanson said he sometimes wonders what would have happened if he had access to assisted suicide drugs.

“I would have lost the opportunity to make memories with my wife and son,” Hanson wrote. “I was terminal and I qualified under the New Jersey proposal, and a similar bill offered in New York. Assisted suicide is a decision that you can’t unmake. My wife would be without a husband and my son without a father.”

Hanson now serves as the president of the Patients Rights Action Fund, which works to protect vulnerable human beings from the threat of assisted suicide. He said he hopes his story will inspire others facing terminal illnesses to not lose hope or throw away their lives.

“Without a doubt, people similar to me facing desperate situations will feel like assisted suicide is their only option,” Hanson wrote. “In our society we should be focused on giving hope to the vulnerable and the sick at their greatest time of need, not taking hope away.”

jjhanson

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Let Life win!

10858637_700786330038646_4525379153038303274_nSharing from National Right to Life Committee

 

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Choose Life!

10552533_10152558050473728_6025571540558670619_nSharing from Live Action

 

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Provincial-Territorial Group seeks death on demand

Living with Dignity is an non-profit, non-religious organization based in Quebec which opposes euthanasia and assisted suicide.  It describes its mission as follows:

“… to protect the life and the inherent and inalienable dignity of people who have become vulnerable through illness, old age, or disability, by ensuring they receive compassionate support.”

Action Life shares with you their December 16th blog post about the report issued by the Provincial -Territorial Advisory Group on Physician Assisted Dying. Living with Dignity wrote:

Provincial-Territorial Group seeks death on demand for all, even for children

We read with dismay the final report of the Provincial-Territorial Advisory Group that was published on November 30. The 43 recommendations in the report clearly have no other goal than the unfettered promotion of euthanasia and assisted suicide throughout Canada. The report’s authors abandon all caution, make no attempt to prevent harm, and demolish all the safeguards, however minimal, that the Supreme Court of Canada included in the Carter decision, interpreting them all with the undisguised intention of mandating death on demand for everyone.

First, the report errs in its interpretation of the Carter decision by arguing that the definition of “adult” should include children because it “relates to a patient’s ability to give consent rather than a particular age cut-off [to] allow access to patients who are competent, regardless of age.”

Next, it recommends extending to nurses and physician assistants the power to cause death, and recommends obliging persons and institutions who refuse to participate to find someone willing to carry out the act in their place. According to the authors, the State should even finance all procedures for euthanasia and assisted suicide, and life insurance payments should be guaranteed for the relatives of the deceased, opening the doors wide to financial abuse and to pressure on those who are sick or elderly, and afraid of becoming a burden on those around them.

Among the long list of measures proposed to facilitate the path toward suicide or euthanasia for some, and forced compliance for others, we find one that is sufficient to remove any credibility that might remain. In their passion to expand the reach of the law, the authors propose that “Where there is limited physician supply, provinces and territories should enable virtual physician assessments and visits using telemedicine services (or other video-based consultations).” Such a recommendation shows contempt for both the crucial importance of human relations in medicine and the value of people who are living through vulnerable moments, in addition to threatening the lives of those whose symptoms are not well controlled for lack of access to medical treatment.

Finally, while the Belgians express their concern about the havoc caused by their law, the authors of the report seek to open the floodgates beyond anything that occurs elsewhere, even in the most permissive jurisdictions. All the recommendations in this report are open to the most subjective and potentially irrational interpretation, throwing medical expertise into the bottom of a trash can filled with legal vacuum.

In conclusion, this unconditionally pro-euthanasia and pro-assisted suicide report contains such outrageous proposals that Canada would lose all credibility on the international stage if it were to serve as the basis for any federal, provincial or territorial legislation. Its approach, campaigning for universal access to death on demand instead of for high quality health care, relegates the care and safety of sick Canadians to the bottom of the priority list.

In addition to its endorsement of death on demand for all, the report also recommends establishing a national program to actively promote it, so as to sustain the myth of death as a public benefit.

To read more go to www.vivredignite.org/en/

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Censoring freedom of speech on campus

image 025Freedom of speech is difficult to find on some university campuses in Canada when it comes to pro-life students forming groups to express their point of view on abortion. They have a right to present information to fellow students. Yet, pro-life students’ groups encounter obstacles from student unions and at times university administration.  We share with you the latest announcement from National Campus Life Network :

University of Toronto Mississauga Student Union sued over censoring free expression on campus
After fighting since August to have their club status renewed for this school year, students from University of Toronto Students for Life (UTMSFL), with the representation of the Justice Centre for Constitutional Freedoms, have filed a lawsuit against their student union. National Campus Life Network has been supporting UTMSFL throughout the process as they have been combating the immature and discriminatory behaviour of their student union. Our staff have been impressed and encouraged by their perseverance in this case, and continued dedication to sharing the pro-life message on their campus.

 

From the Justice Centre for Constitutional Freedoms:Wednesday, January 20, 2016

University of Toronto Mississauga Students’ Union sued over censoring free expression on campus

The Justice Centre for Constitutional Freedoms has filed a court action against the University of Toronto Mississauga Students’ Union (UTMSU), to defend the free expression rights of a pro-life student group that is being denied registered club status by UMTSU.

UTMSU has refused to renew the club status of Students for Life for the 2015-16 year, effectively barring the student group from using the student centre and accessing student union resources.  As a result, in September of 2015, Students for Life could not join other campus clubs in setting up a table during clubs’ week—a key event for recruiting new members.

UTMSU had granted club status for Students for Life in the 2014-15 school year, but changed its mind specifically because of Students for Life’s “stance on Abortion”.  UTMSU’s mission statement includes a commitment “[t]o safeguard the individual rights of the student, regardless of race, creed, sex … or personal or political beliefs,” and lists “strength in diverse voices and opinions” as a “fundamental belief.”

“It appears that UTMSU sees diverse opinions as good for most topics, but not abortion,” stated Calgary lawyer John Carpay, president of the Justice Centre for Constitutional Freedoms.

After receiving a legal warning letter from the Justice Centre in October 2015, Russ Adade, UTMSU Vice-President, changed his previous rationale for denying club status to Students for Life, namely, the club’s stance on abortion.  Adade instead told Students for Life that the reason their club was denied status was “violations and discrepancies we found within your constitution in relation to the clubs handbook and UTMSU operational policy as it pertains to clubs.”

Students for Life immediately made the required changes to their constitution, but UTMSU has continued to deny club status, necessitating court action.

Students for Life has filed a court action against UTMSU for violating its own rules, for acting with bias and bad faith, for breaching the rules of natural justice and procedural fairness, and for failing to respect students’ fundamental freedoms of expression and association.

“The actions of UTMSU have demonstrated their disregard for their own rules, and for students’ freedom of expression and freedom of association,” stated Diane Zettel, President of Students for Life.

For more information, please contact:
 

Diane Zettel, President, UTM Students for Life
647-224-9339 or diane.zettel@mail.utoronto.ca

John Carpay, President, Justice Centre for Constitutional Freedoms
403-619-8014 or jcarpay@jccf.ca

 

UTMSFL Website

 

 

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Respect for Life Leadership Conference for students

SLL2015_Poster_WEB1

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An abortionist speaks about abortion

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Understanding euthanasia and assisted suicide

Action Life’s 2015 Annual General Meeting was held on November 24, 2015.  The meeting was well attended, and concluded with a presentation by Dr. Catherine Ferrier of the Physicians Alliance against Euthanasia.  Dr. Ferrier is a faculty member with McGill University’s Medical Health Centre, and practices at the Division of Geriatric Medicine at Montreal General Hospital.  She presented a comprehensive outline of the moral and legal issues surrounding euthanasia from a health practitioner’s perspective.  She also informed attendees of the history around euthanasia legislation in Canada.

The key principle of palliative care is that it neither hastens nor prolongs patient death.  By contrast, euthanasia is the act of directly and intentionally causing an individual’s death in order to put an end to his suffering.  Similarly, assisted suicide is the act of helping someone to end her life by providing her with the tools and/or information necessary to commit suicide.

Palliative care consists in controlling pain or other symptoms in dying patients.  With respect to patient control of their care during the palliative process, in Canada, any patient may refuse treatment or request withdrawal of treatment even if this hastens their death.  However, the right to refuse treatment is not the same as the so called  ‘right to die’.

Between 16 to 30% of people who die in Canada receive palliative care.  Of those who do receive palliative care, there are several groups vulnerable to euthanasia.  These vulnerable groups include: the frail elderly; persons with disabilities; patients and families in crisis because of a catastrophic event or illness; and patients suffering from depression, anxiety and existential distress.  These points have been discussed compellingly by many who oppose euthanasia.  For me, the most telling testimony came when Dr. Ferrier discussed the impact the suggestion of euthanasia may have on those who are transiently depressed (i.e., those who are not clinically or chronically depressed) or lonely.  For example, Dr. Ferrier presented that 20-50 % of terminally ill patients suffer from depression, but only 3% are treated for it.  Similarly, in cancer patients with a terminal prognosis, 45% express a desire to die at some time – but the desire only persists in 8% of cases.   How vulnerable these patients must be if euthanasia  is included as a palliative care option while they are depressed and feeling hopeless!  Similarly, what does it say about us as a society when the easiest “cure” for loneliness in terminal patients is death?

Dr. Ferrier argues that society has a duty to protect vulnerable people, and that (because of known abuses in jurisdictions that permit euthanasia (e.g., Buiting et al., 2009; Chambaere et al., 2010)) individual freedom ends where it impinges on the freedom and well-being of others.  Furthermore, she stressed that good control of pain and other symptoms is possible in almost all palliative cases, and there are no obstacles to refusing or withdrawing treatment.    As such the practices required of physicians when “medical aid in dying” and “physician assisted death” become legal are not only unnecessary for patient comfort, they are incongruent with palliative patient care.  They are euphemisms for the direct killing of patients by the physician by euthanasia.   Physician-inflicted death undermines palliative care and compromises physician conscience rights (63% of physicians in Canada oppose euthanasia (Fletcher, 2015)).  Those who lobby for euthanasia do not acknowledge the harm this practice causes to vulnerable patients, to physician conscience rights, and to society, in general.

Buiting, et al.  2009. Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study. BMC Medical Ethics. 10:18.

Chambaere K, et al. 2010.  Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey. CMAJ.  182: 895-901.

Fletcher.  2015.  Right to die in Canada: respecting the wishes of physician conscientious objectors.  CMAJ, 187:18.

 

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The heartbeat of an unborn child

10646921_10152718176278728_8761355747759740591_nSharing photo from Live Action.org

 

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