Monday, October 23, 2017

Victoria Australia euthanasia bill, not certain to pass.

This article was published by Mercatornet on October 23, 2017

By Michael Cook

On Friday afternoon, it seemed that Australia was just a whisker away from legalising assisted suicide. A marathon 26 hour sitting of the lower house of the Victorian state parliament on Thursday and Friday ended on Friday morning with a majority of 47 to 37 voting for the Voluntary Assisted Dying Bill 2017.

Although MPs have a conscience vote, the Labor Premier of Victoria, Daniel Andrews, and his Minister for Health, Jill Hennessy, have given it their full support. As a measure of how perfect they believe their bill is, 141 amendments failed.

Analysts believe that the result of the Victorian bill will have a massive impact on the outcome of euthanasia debates in other Australian States and territories. New South Wales is currently debating very similar legislation to that proposed in Victoria, and Western Australia has convened a parliamentary committee to examine “end of life choices”. In Tasmania and South Australia the issue is very much alive.

The bill permits assisted suicide and euthanasia for terminally ill patients with less than 12 months to live.

However, it no longer looks certain to pass in the Upper House when it is debated next week. Supporters of the bill have been calculating that it would pass by a margin of 23 to 17. However, according to a report in today’s Australian, two or three members of the Upper House have decided to oppose the bill after reading an essay by former Labor Prime-Minister Paul Keating in the Sydney Morning Herald. A politician known for his savage demolition of opponents and their policies, Keating described the bill as “bald utopianism”. The column has sparked “intense debate” in Labor circles, according to The Australian. Here are a few paragraphs from Keating’s column:
The justifications offered by the bill's advocates – that the legal conditions are stringent or that the regime being authorised will be conservative – miss the point entirely. What matters is the core intention of the law. What matters is the ethical threshold being crossed. What matters is that under Victorian law there will be people whose lives we honour and those we believe are better off dead. 
In both practical and moral terms, it is misleading to think allowing people to terminate their life is without consequence for the entire society. Too much of the Victorian debate has been about the details and conditions under which people can be terminated and too little about the golden principles that would be abandoned by our legislature... 
An alarming aspect of the debate is the claim that safeguards can be provided at every step to protect the vulnerable. This claim exposes the bald utopianism of the project – the advocates support a bill to authorise termination of life in the name of compassion, while at the same time claiming they can guarantee protection of the vulnerable, the depressed and the poor... 
Opposition to this bill is not about religion. It is about the civilizational ethic that should be at the heart of our secular society. The concerns I express are shared by people of any religion or no religion. In public life it is the principles that matter. They define the norms and values of a society and in this case the principles concern our view of human life itself. It is a mistake for legislators to act on the deeply held emotional concerns of many when that involves crossing a threshold that will affect the entire society in perpetuity.
The head of the Australian Medical Association, Michael Gannon, also expressed his staunch opposition to the bill last week:
We have all experienced loss. Many of us have suffered the tragedy of watching a parent, child or spouse die. This grief never leaves people. It informs their opinions. 
However, highly emotional stories of the grief felt subsequent to watching a loved one die do not constitute an intellectual argument in favour of EPAS. ... 
Euthanasia and 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.”
Michael Cook is editor of MercatorNet.

Sunday, October 22, 2017

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

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

On Friday, October 20, after 26 hours of debate, 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.