Tuesday, August 22, 2017

Should we starve Alzheimer's patients to death?

This article was published by Wesley Smith on his website on August 20.

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y Wesley Smith


The idea of starving a helpless elderly person to death used to be thought of as the most egregious crime. An abhorrence.

Now, for some, it is merely another form of “death with dignity.”

The assisted suicide advocacy organization Compassion and Choices–formerly the more honestly named Hemlock Society–teaches people (with a prime focus on the elderly) how to starve themselves to death, a form of suicide they call “voluntary stop eating and drinking” (VSED). 

But many in bioethics wish to take that avenue to dying further, requiring nursing homes to starve dementia patients to death if they so stated in an advance directive.
Now, as these things are wont to do, the idea has gone from the professional literature into the popular media. USA Today has a story about a man trying to force his wife to be starved because she has Alzheimer’s–this even though she willingly eats snacks and her meals. From the story
Across the U.S., the more than 5 million people living with dementia are typically encouraged to put their end-of-life wishes into writing early and to pick a trusted person to carry them out, said Beth Kallmyer, vice president of constituent services for the Alzheimer’s Association. 
That’s no guarantee, however, that those requests can — or will — be honored. In Nora Harris’ court case, her advance directive and testimony from her husband, her daughter and two close friends all indicated that she wouldn’t want anything to prolong her life. 
“That court decision basically condemned Nora to the full extent of the Alzheimer’s disease,” Bill Harris said. “They gave her no exit out of this situation.” 
The “exit” is to refuse medical treatment, such as antibiotics or a feeding tube when it becomes needed–which under the law, is deemed a medical treatment.

Feeding is care. not treatment.
But spoon feeding and handing out snacks, willingly eaten, is not medical treatment. It is humane care, the kind owed to every human being.


Advance directives govern medical treatments desired or to be refused when the signatory becomes unable to make her own decisions. It does not require caregivers to violate the fundamental rules of humanity.

Think of it this way: If a dementia patient had requested to be left in bed in front of an open window without a blanket on a winter’s night in order to die by hypothermia, should the nursing facility be forced to do that? Of course not! They owe the patient a duty to be kept warm. 

Ditto if a patient asked not to be turned to avoid bed sores. Or directed that their linens never be changed.

The same must go to spoon feeding and offering liquids, or we are no longer a moral country. That isn’t to say forced feeding, but if a patient willingly takes nourishment, that must control. 

The article goes on to describe VSED and says it can be a peaceful death without suffering. No–unless a doctor participates in the suicide with heavy palliative interventions. But even then, VSED committers can always change their minds.

That would not be true of a nursing home patient from whom food and water was withheld. 
Of course I understand that no one wants to go through Alzheimer’s. Of course I understand the grief families feel and the many sleepless nights caused by having a beloved stricken with this dread affliction.

But life is what it is. We should mitigate suffering as much as we can, but there are just certain lines that must not be crossed, both because others could be victimized–ever hear of elder abuse?–and because some acts and omissions are inherently wrong. 

On a more practical level: How many nursing homes would close their doors if the operators–many of which are religiously focused–knew they would be forced to starve some of their patients to death? 

How many loving and caring people would opt out of dedicating their lives to the people who live and are cared for in such facilities rather than risk killing their patients by a means that would now be branded criminal neglect, at best?

And no more of people saying that I don’t know what it is like to have people I love suffer. My mother died of Alzheimer’s in my home last year. My uncle died of it several years ago. Believe me, I know what Alzheimer’s is like, up close and personal!

Thursday, August 17, 2017

The New York Times and Assisted Suicide

This article was published by William Peace on his Bad Cripple blog on August 16.

Bill Peace pictured with some of his students.
About a week ago the New York Times published an opinion piece I can't get out of my mind. The title was provocative—“Should I help My Patients Die”. Written by Jessica Nutik Zitter, a physician, she discusses end of life issues and specifically the law in California that empowers physicians to end the life of their patients. So called death with dignity laws, have been passed in five states. The New York Times position on assisted suicide is very clear. For years the editorial board has been a staunch advocate of assisted suicide. (Link).

In terms of assisted suicide, there is no pretense of objective journalism at the Times. The New York Times is far from alone because when it comes to end of life issues a major cultural shift has taken place in the last two decades. In the post Jack Kevorkian era, most major newspapers in the United States are in favor of assisted suicide. If polls are any indication, the majority of Americans support assisted suicide legislation. The problem, as I perceive it, is that the discussion of assisted suicide is reliant upon a simplistic notion that one should not die in pain and person should be in control of how they die. This seems reasonable. Proponents of assisted suicide and legislatures rely upon the fact few people discuss end of life with their loved ones and physician in detail. Even fewer people read death with dignity legislation nor consider its larger implications. For well over twenty years those that advocate for assisted suicide or death with dignity as they phrase it are reliant on the implication of the phrase itself. Death with dignity implies that physician assisted suicide is the one and only way to insure a dignified death. This is patently false. The public has been sold a false bill of goods. There is the notion death with dignity legislation is all about pain—no person should die in agonizing pain. If one were faced with an agonizing death a person has the “right” or “control” of when to die. End of life is not this simple. People access assisted suicide because they fear a loss of autonomy and being a burden upon others.

The significant shift as I see it is cultural. There is a notion that people deserve a good death. What a good death is, I have no idea. But this phrase, a good death, is as misleading as death with dignity. A good death is now akin to a designer dress or enviable life style. Planned orchestrated deaths are the rage. What I find remarkable is even those that support assisted suicide legislation are concerned. For instance, Franklin G. Miller, a physician that supports assisted suicide legislation was disturbed by a long New York Times photo essay about a carefully scripted death. In “At His Own Wake, Celebrating Life and the Gift of Death Catherine Porter and photos by Lesley Davis lavish praise upon the end of John Shields life. There is no question the Canadian Shields led an interesting life. But that is not the point. The piece reads like a New York Times style section essay about a celebrity wedding. Like Miller, I found this essay deeply disturbing. In the Hastings Center Bioethics Forum he wrote:

Presented to the readers, in lavish detail, as the “Gift of Death,” with a very appealing protagonist, this article romanticizes the death of John Shields. More importantly, I see it as describing, and prescribing, a model for the good death in North America today. The article prominently features various quotes from Shields: “I think this is a mark of our humanity,” “What could be more meaningful than planning for the end of your life?” These are Shields’s own legitimate opinions, but I read them as being given a prescriptive force. 
Physician-assisted death remains ethically controversial. The end of life is an arena for diverging values. Commitment to pluralism means recognizing a variety of good or legitimate ways to face death and dying. Presenting the planned death of John Shields as a model for dying in our era uncritically places a premium on the choice and control of the sovereign individual. Letting death happen, with the aid of palliative care, is no less good than making it happen. We should beware of prescribing a particular form of “death with dignity” as a model for the end of life and not acknowledging other perspectives (Link). 
I understand talking about death is hard. Believe me I get it—in recent years I have had to deal with the death of a parent, siblings, and a beloved pet. I have also had to face my own mortality when I had a heart attack in June. We do not need assisted suicide legislation. What we need is a nuanced discussion of end of life issues and options. Here Miller and I are in agreement despite the fact we are on opposite sides of the debate about assisted suicide. Death with dignity need not involve assisted suicide yet that is exactly what one is led to believe if reliant on mainstream news outlets such as the New York Times.

Here I return to the New York Times opinion that I cannot get out of my mind. At first glance “Should I let My Patients Die” appears to be a nuanced view by a physician that has struggled with the new death with dignity law in California. Jessica Nutik Zitter, author of Extreme Measures: Finding a Better Path to End of Life is a critical care and palliative medicine doctor. In her opinion Americans die badly and many people needlessly suffer at the end of life in intensive care units. This is not new ground. What makes her opinion different is how she hooks the reader in the first paragraph of her essay: she tells a story about a colleague who tapped her on the shoulder and said, “I have a patient who is asking about the End of Life Option Act”…”Can we even do that here”. For half the essay Zitter plays the part of objective commentator and insider. It is not until she wrote about her own family, specifically her mother, that her real feelings become evident, as does her ableist bigotry. After discussing the first patient who asked her about assisted suicide she admitted she wanted this option for her family. She wrote:
I have seen much suffering around death. In my experience, most of the pain can be managed by expert care teams focusing on symptom management and family support. But not all. My mother is profoundly claustrophobic. I can imagine her terror if she were to develop Lou Gehrig’ disease, which progressively immobilizes patients while their cognitive faculties remain largely intact. For my mother, this would be a fate worse than death.
Replace the condition ALS with any other neurological calamity as a means of justifying death with dignity. This indicates just how deeply ableism is entrenched into the fabric of society. Alzheimer’s is a fate worse than death. Quadriplegia is a fate worse than death. Multiple Sclerosis is a fate worse than death. Muscular Dystrophy is a fate worse than death. Parkinson’s disease is a fate worse than death. Yes, the medical model of disability is quite clear—many conditions people live with for decades if not their entire life is a fate worse than death. I know this from personal experience; some think my existence is indeed a fate worse then death for strangers and more than one physician have expressed this to me directly.

Zitter goes on to state she does not feel comfortable shortening the life of any patient and wonders if this makes her a hypocrite. In search of an answer she turned to the “defacto specialist in our area on this issue for counsel. Dr. Lonny Shavelson, an emergency medicine and primary care physician in Northern California, who has been grappling with the subject for many years.” I find this is a remarkably unusual choice. Shavelson operates an unorthodox medical practice, Bay Area End of Life Options, that has gotten quite a bit of attention in the last year. Shavelson specializes in consulting with patients and physicians who are deemed terminally ill and are interested in or have requested assisted suicide in the state of California. This sort of practice is well out of the norm even in states where assisted suicide is legal. To be clear: in California it is legal to request assisted suicide if one is diagnosed as terminally ill, is able to self administer a lethal prescription, and retain the mental capacity to make such a decision. For more on the law here is a link:

Shavelson is not your average physician. He is coauthor of “Physician-Hastened Death” guidelines published in the Western Journal of Medicine and has written amicus briefs for the Supreme Court (1996 Quill vs. Vacco case). Shavelson, like many, believes in the idea of a “good death” and is a staunch advocate of assisted suicide legislation. In A Chosen Death: The Dying Confront Assisted Suicide Shavelson wrote about “death anarchy” and came to believe assisted suicide had to be legalized and regulated. In Forbes he stated: 


what I found during the 1990s was a horror show--people hoarding medicine, afraid of how they were going to die; doctors secretly assisting people in dying; family members tortured by the memory of helping someone in their family die. It was the equivalent of back alley abortions. I was calling it dark bedroom suicide. Link:
For Shavelson, assisted suicide “is not about being a death doctor. This is about being a good death doctor”. This sort of double speak reminds me of Jack Kevorkian. Dr. Death as he was called is largely forgotten (college students do not even know who Kevorkian was). In his place, physicians across the nation are calling for or establishing protocols, procedures and outcome measurements in states that have passed assisted suicide legislation. Thus Zitter argues that medical procedures all require training and thinks the process of dying is no different. Zitter wants physicians specifically trained to end the lives of patients. 

I shake my head in wonder. All week I have come back to the flip answer to the question “Should I Help My Patients Die”. The answer is an obvious no. Hastening the death of others is ethically objectionable. How we mange end of life, that is the process of death, speaks volumes about who we are as human beings. I am worried about the future of humanity for I believe life is precious.

Canadian euthanasia doctors want more money to kill.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Canadian euthanasia doctors are pressuring the provincial governments to pay them more money for euthanasia. Supposedly, some euthanasia doctors have stopped killing people based on money.

An article by Kelly Grant published in the Globe and Mail, appears to pressure governments to pay more for euthanasia. The article insinuates that access to euthanasia has been impeded by the money doctors make to do lethal injections:
Dr. Pewarchuk, an internal medicine specialist in Victoria who has presided over 20 assisted deaths, took his name off the list of willing physicians last month after the body that sets doctors’ pay in British Columbia approved new fees that he and some of his fellow providers say are so low they could chase away even the most committed physician supporters of assisted dying.
Maclean's magazine published an article by Catherine McIntyre stating that physicians in the Netherlands are paid more money to kill:
In the Netherlands, for example, where physician-assisted dying has been legal since 2002, providers are paid a flat rate of about 1,500 euros. That’s $2,200 Canadian dollars and at least five times more than what MAID providers can earn in Canada. On top of that, Dutch physicians are given a paid day off after assisting a death to take care of themselves emotionally. 
(Correction: Professor Theo Boer sent me a message stating that Maclean's magazine was wrong. He said that doctors receive 227 euro per euthanasia. (227 euro is currently $337 Canadian) 
In her article, Grant explains the BC government fee schedule for euthanasia:
Under the new fee schedule, B.C. physicians will now be paid $40 for every 15 minutes, up to a maximum of 90 minutes, to conduct the first of two eligibility assessments required by law. Each of the assessments has to be provided by a different clinician. That works out to $240, a significant increase from the $100.25 interim assessment fee that has been in place in B.C. since shortly after assisted death became legal. 
For second assessments, the time is capped at 75 minutes. 
In the case of providing an assisted death, the province has set a flat fee of $200, plus a home-visit fee of $113.15. 
Therefore, the price on a life in British Columbia is up to $553.15 ($240 + $313.15). 

In her article, Grant compared the fee for euthanasia in several Provinces:
By comparison, if a doctor spent three hours start to finish on an assisted death – excluding the formal eligibility assessment – he or she could bill $621.60 in Alberta, $600 in New Brunswick, $499.80 in Quebec, $480 in Manitoba and $465.60 in Saskatchewan. If doctors in those same five provinces billed for two hours, they could still earn more than B.C.’s $313.15 in every province but Saskatchewan, though not by much.
In January the Journal of the Canadian Medical Association published an article indicating that the Canadian healthcare system could save up to138 Million dollars now that euthanasia is legal.

Wednesday, August 16, 2017

I Oppose Assisted Suicide and Euthanasia Because It Is Ableist

This article was published by the disability rights group - Not Dead Yet on August 15, 2017

By Carol Cleigh Sutton

The very heart of the argument for assisted suicide/euthanasia (AS/E) is that an individual may be better off dead than disabled.

The fact that this argument can be made in respectable public forums demonstrates just how ableist this society is. How deeply the severely abled fear and loathe those of us who live with disability.

Ableism, like racism and sexism, is an ugly prejudice that society holds towards its minority members.

What does ableism look like? First you exclude us from nearly all public life and especially gainful employment and instead put us ‘on the dole.’ Then, periodically, you cut those supports from under us or make us try to prove that we’re ‘worthy’ of such supports. You openly stare at us and your comments and prurient questions make public spaces hostile. If we object, you accuse us of being maladjusted or just not being able to take a joke. A disabled man in the Netherlands is constantly told that it is ‘his fault’ that he lives with a disability; after all, he could kill himself. Where AS/E has become the norm, disabled people are even more outcast.

Our lives are seen as not worth living, but these are the lives we have.

This ideology, which we call BDTD (Better Dead Than Disabled), permeates ableist society, but even more deeply infects the medical system, and the more society in general accepts it, the more we encounter it every time we have to deal with medicine. My husband, who was nearly 80 and disabled, was brought to the hospital by ambulance after a heart attack. Until I arrived and started raising the roof, they put him in a dark room in the back. He should have been connected to an EKG and given aspirin, and IV lines should have been established. But because he was disabled, he received none of this. They assumed he’d want to die. Thankfully, we had years after that, but if I’d been held up in traffic? Would their killing him have been prosecuted? Investigated?

Are you really wanting to create this ‘special class’ of people who can be killed and no one prosecuted? A class whose deaths won’t even be investigated? Is your ableism so strong that you’d change the law to allow others to kill us without consequence? That is what happens in Oregon. Thomas Middleton’s death was not prosecuted. Did he ingest the poison willingly or was his death part of the real estate fraud for which his ‘caregiver’ was prosecuted? It’s already all too easy for those who would inherit, or steal, our property to arrange our deaths. Do you really want to make it easier? In US jurisdictions, assisted suicide laws give immunity to those who kill so long as they choose their victims from among the old, ill and disabled.

Before you say that this isn’t about disability, it’s only for those who are imminently dying, let me remind you of two things: First, physicians are notoriously bad at predicting when we’ll die. Oregon state data show that people outlive their 6 month prognosis every year; one lived for 1009 days. (2016 report, page 11) I’m 10 years past my last expiration date, and more than 60 years past the first, and still going strong. Secondly, and perhaps more importantly, there has never been an instance where this is legalized that it hasn’t expanded far beyond those at whom it was originally aimed, sometimes with breathtaking speed. Canada is already moving to use it on people who are not imminently dying and they legalized it just a year ago and, in the Netherlands, even those who advocated for it say that it is out of control.

Because the argument is based on BDTD, all who are considered disabled are at risk.

Tuesday, August 15, 2017

Double euthanasia in the Netherlands

This article was published by Wesley Smith on August 14, 2017

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Wesley Smith
emember when society considered it a tragedy when old people killed themselves? 

Now, apparently, it is celebrated as a splendid “death with dignity” choice. From the Telegraph story
An elderly couple died holding hands surrounded by loved ones in a rare double euthanasia. 
Nic and Trees Elderhorst, both 91, died in their hometown of Didam, in the Netherlands, after 65 years of marriage. The couple both suffered from deteriorating physical health over the past five years, with Mr Elderhorst left with reduced mobility after a stroke in 2012. 
Walking had also become increasingly difficult for his wife, who had also suffered from memory loss. 
“It soon became clear that it could not wait much longer,” the couple’s daughter told The Gelderlander [translated]. “The geriatrician determined that our mother was still mentally competent. However, if our father were to die, she could become completely disoriented, ending up in a nursing home. 
“Something which she desperately did not want. Dying together was their deepest wish.”
There you go again, Wesley “slippery sloping away!” 

No. Facts on the ground. Joint euthanasia or assisted suicides of elderly couples have also taken place in Switzerland and Belgium

This is the thing: Once a society accepts killing as an acceptable answer to current and feared future suffering, then what constitutes sufficient difficulty to qualify to be made dead becomes very elastic. 

Et voila, before you know it, the children of elderly parents attend and celebrate their joint euthanasia killings–instead of urging them to remain alive and assuring them that they will be loved and cared for, come what may. 

Euthanasia corrupts everything it touches, including the perceptions of children’s obligations to aging parents and society’s duties toward their elderly members. 

Don’t say you weren’t warned.

Monday, August 14, 2017

Why was a woman with disabilities urged to accept assisted death, instead of assistance to live?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Carmela Hutchison who is the President of the DisAbled Women's Network (DAWN) Canada), an executive member of the Council of Canadians with Disabilities and a mental health advocate, wonders why a woman with disabilities, such as herself, was urged to die by assisted death, rather than offered assistance to live, in her article that was published by Rabble on August 1. This is what Hutchison wrote:
People with disabilities and their caregivers are at risk for being made to say yes to medical assistance in dying when they don't want to. 
On July 24, 2017, CBC reported a story about a 25-year-old woman living in Newfoundland who has many disabilities. While she was hospitalized for illness, the doctor made a suggestion to her mother that she could consider medical assistance in dying (MAiD) as a choice for her daughter's future. Her mother was reminded that assisted suicide is now legal in Canada. 
Just over a year ago, the federal government passed a law allowing medical assistance in dying, after the Supreme Court of Canada struck down the ban on assisted suicide. 
The disability community was gravely concerned about the medical assistance in dying law. The Newfoundland case is exactly the kind of situation many of us were afraid would happen. 
One of the problems with this legislation is that it exists in a society that is deeply ableist. Abelism is the belief that a disabled person's body is worse than the able person's body. The worst of this point of view is evident when people with disabilities are told that it is better to be dead than to be disabled. 
Like the young woman in Newfoundland, I have multiple disabilities. Last year, I was put in hospital for an infection and put into a coma so my body could rest. When I first came out of the coma, after telling me I was restrained so I would not pull out the breathing tube, my nurse's first words were "I know the tube is miserable, I'd kill myself if I had to have one." She was trying to be understanding and, to be fair, many people worked really hard to save my life. But the words still hurt my feelings, because I had been very afraid to go to ICU because of MAiD. People with disabilities need to trust their doctors and nurses. We need to feel safe when we go to the hospital. 
People with disabilities often have higher rates of other illnesses such as cancer, heart disease or diabetes, along with their original disabilities. This is often called complex care or multiple barriers. Yet they are often made to feel ashamed for needing more care when they have more disabilities or health conditions at the very time they need the most support. 
The Vulnerable Persons Standard (VPS) was made to help protect people like us from being forced to choose MAiD when we might not want to. The VPS was also made to try to protect people with disabilities from people who might try to abuse MAiD. 
Developed by advisers qualified in medicine, law, politics, ethics and advocacy for people with disabilities, the Standard says that: 
"Extensive research shows that a wide range of factors related to social, financial, psychological and spiritual suffering can lead patients to request Medical Aid in Dying (MAiD)…" 
It warns us about using MAiD instead of giving the right care to people with disabilities and serious illnesses. 
My experience, and that of the woman in Newfoundland, are like the experiences of many women with disabilities across Canada. Women are the majority of people with disabilities who are choosing MAiD. In the 1995 publication Don't Tell Me to Take a Hot Bath: Resource Manual For Crisis Workers by Shirley Masuda, the author correctly predicted that the "right to die" would become the "duty to die." Women with disabilities are being seen as burdens. 
But women with disabilities do not seek MAiD because they are disabled. It is because we lack access to suicide prevention services, trauma-informed treatment, addiction services, and are often trapped -- in isolation, poverty and abuse. We fall into despair because within society and sometimes within our own families we are not valued and we lack the services and supports we need to lead safe and effective lives. 
People with disabilities, especially women, need accessible medical care, home care, community-based supports, employment, and support in being active and engaged members of our communities. 
We need assistance in living.
Further information


Saturday, August 12, 2017

Vatican Says NO To Euthanasia - to Belgium Catholic Psychiatric Institutions.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Last April, Belgian Catholic psychiatric hospitals that are operated by the Brothers of Charity, announced that they would allow euthanasia to be done in their institutions.

Soon after, Brother Rene Stockman, the superior general of the Brothers of Charity order, said he was devastated by the news and he asked the Vatican to intervene in this case.

According to Zenit news, the Vatican sent a letter to the Belgian Brothers of Charity condemning euthanasia and ordering them to stop euthanasia in their psychiatric institutions. Zenit news reported:
Vatican Radio reported August 11, 2017 that the Vatican Press Office confirmed that the Pope ordered the Brothers of Charity in Belgium to stop allowing euthanasia in the 15 psychiatric hospitals the group operates. The order came in a letter in early August. 
The decision to allow euthanasia at Catholic psychiatric hospitals in Belgium was condemned by the Vatican through the Congregation for the Doctrine of Faith and the Brothers of Charity superior general in Rome, Bro. René Stockman.
The American Psychiatric Association recently condemned euthanasia for psychiatric reasons. The APA statement says:
The American Psychiatric Association, in concert with the American Medical Association’s position on medical euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.


Popular articles against euthanasia and assisted suicide.

1. Margaret Dore: Physician-Assisted Suicide: A Recipe for Elder Abuse and the Illusion of Personal Choice - Feb 17, 2011.

2. Declaration of Hope – Jan 1, 2016.

3. Healthy 24 year old Belgian woman was scheduled for euthanasia - June 24, 2015.

4. Kitty Holman: 5 reasons why people devalue the elderly – May 25, 2010. 

5. Emily “Laura” the healthy 24-year-old Belgian woman who was approved for euthanasia, has chosen to live. Nov 12, 2015.  

6. Boycott Me Before You - "disability death porn" - May 26, 2016. 

7. Depressed Belgian woman dies by Euthanasia – Feb 6, 2013.

8.  Euthanasia is out-of-control in the Netherlands – Sept 25, 2012.

9. Kate Kelly: Mild stroke led to mother’s forced death by dehydration – Sept 27, 2011.

10. Belgian twins euthanized out of fear of blindness. – Jan 14, 2013.

11.  The Euthanasia Deception documentary. - Sept 30, 2016.

12. Assisted suicide law prompts insurance company to deny coverage to terminally ill woman - Oct 20, 2016. 

13. Nitschke promotes lethal veterinary drugs – June 22, 2010.

14. South Africa Supreme Court rejects euthanasia - Dec 6, 2016.

15. Woman dies by euthanasia, may only have had a bladder infection - Nov 14, 2016.

16. Opposing the Supreme Court of Canada assisted death decision - Feb 17, 2015.

17. Woman with Anorexia Nervosa dies by euthanasia in Belgium – Feb 10, 2013.

18. Belgium warns - Medical Assistance in Dying - Don't Go There - April 26, 2016.

19. Netherlands euthanasia review committee decides that a euthanasia done on a woman with dementia was done in "good faith" -  Jan 28, 2017.


20. New Jersey Senate may vote on assisted suicide - Dec 16, 2014.

21.  Trisomy 18 is not a Death Sentence. The Lilliana Dennis story – May 29, 2012.

22. Mother upset after doctor urged her to approve assisted death for her daughter with disabilities - July 26, 2017.

23. Oregon 2012 assisted suicide statistics: An analysis - Jan 25, 2013.

24. Dutch ethicist changed his mind - Assisted Suicide: Don't Go There - July 16, 2014.

25. Supreme Court of Canada euthanasia decision is irresponsible and dangerousFeb 7, 2015.

Become a member of the Euthanasia Prevention Coalition ($25) membership.

Wednesday, August 9, 2017

Is euthanasia corrupting transplant ethics?

This article was published by Wesley Smith on his blog on August 8, 2017.

Wesley Smith
By Wesley Smith


In my very first anti-euthanasia column, published by Newsweek in 1993, I worried that once medicalized killing became accepted, it would soon be joined by “organ harvesting as a plum to society.” 

“Alarmist!” I was called. “Slippery slope arguer!” It will never happen, I was assured. 

Until it did. 

Now in both Netherlands and Belgium, mentally ill and disabled patients are voluntarily euthanized and their organs harvested after being killed. Canada is discussing joining the infamous duo. 

I have waited for the organ transplant community to rise up and reject conjoining killing and organ donation. It has been a wait mostly in vain. 

Indeed, a letter in the current Journal of the American Medical Association merely warns against haste in widely instituting such a policy due to safety concerns: 
I urge caution before this practice is widely accepted. First, only short-term functional outcomes immediately after transplantation and at 6 months are available. Second, warm ischemia, an inevitable consequence of organ donation after cardiac death, results in greater risk for transplanted organs…  
There is a need to study long-term outcomes of transplanted organs resulting from euthanasia so that truly informed consent can be obtained. 
How starkly utilitarian can you get? 

If all that matters is consent–the clear implication of this letter–why would donors have to be suffering sufficiently to qualify for euthanasia? 

Indeed, why not let healthy people who simply want to die and believe others–who want to live–have a greater claim on their livers and hearts volunteer to be killed and harvested? 

The authors of the original article make in an equally bloodless, technocratic reply: 
Euthanasia is performed according to local protocol by injection of a drug to induce coma, followed by a muscle relaxant. After circulatory arrest, a waiting time of 5 minutes is respected before the patient is transferred to the operating room for organ removal.  
Compared with other donations after cardiac death, the process of dying is short (often less than 10-15 minutes), and death is not preceded by medical deterioration in the intensive care unit.  
Euthanasia donors are, on average, younger than other cardiac death donors. Better transplant results may therefore occur in organ donation after euthanasia compared with donation after other causes of cardiac death, but additional studies are required. 
Where are we as a society that killing and harvesting are respectfully discussed in one of the world’s most respected medical journals–and no one brings up crucial issues of right and wrong? 

As just one quick example: What could be more dangerous than letting despairing people believe that their deaths could have greater value than their lives? Becoming a donor could be the final factor that induces them to opt for euthanasia or assisted suicide. 

For that matter, how dangerous would it be if society ever came to accept that the hastened deaths of the despairing could offer a “plum?” 

Euthanasia corrupts everything it touches–including, it would seem, the ethics of organ transplant medicine.

Monday, August 7, 2017

The worst doctors can become death doctors.

The article was published by Wesley Smith on his blog on August 6, 2017.

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Wesley Smith
y Wesley Smith


The New York Times is on an assisted suicide/euthanasia promotion juggernaut. Recently, it had a magazine-length, front page story swooning story about a euthanasia party in Canada. 

Today, a major front-page opinion section column by a doctor supporting assisted suicide–but hand-wringing about it being done carefully. First, Jessica Nutik Zitter admits she might have assisted the suicide of a patient whose motive for wanting to die now was resentment and a feeling of abandonment from his sister. From, “Should I Help My Patients Die?“: 
His despair had given way to rage. “Let’s just end this,” he said. “I’m fed up with my lousy life.” He really didn’t care, he added, that his sister opposed his decision. His request appeared to stem from a deep family wound, not his terminal illness… 
At our second meeting, with more trust established, he issued a sob, almost a keening. He felt terrified and powerless, he said. He didn’t want to live this way anymore. I understood. I could imagine my own distress in his condition — being shuttled like a bag of bones between the nursing home and the hospital. It was his legal right to request this intervention from me. But given how uncomfortable I was feeling, was it my right to say no? 
It seems to me it was her duty to say no–just as she would if the patient didn’t have a terminal illness. 

Indeed, as a palliative care doctor, she should declare her practice an assisted suicide free zone to make sure there is never any public confusion between pain and symptom control and intentionally participating in suicide. 

Also notice the man’s intent to commit suicide was not due to physical suffering caused by the disease. Indeed, actual suffering–much less suffering that can’t be alleviated–isn’t required by assisted any suicide laws either. One just needs the terminal diagnosis–sometimes mistaken–to qualify for the lethal pills. Actual suffering has nothing to do with it. 

This was Zitter’s first time being asked to assist suicide, and she was troubled. (Good for her. She should have been.) So, she made a deal with the patient to go on four weeks of anti-depressants. He later changed his mind and he died naturally three months later. 

But note: She could have lethally prescribed. Some doctors–particularly those ideologically predisposed to assisted suicide–would have. 

And the patient might not have lived long enough to change his mind. Even Zitter implies she would have-despite her knowledge of his reasons–had he made another request in four weeks after taking the anti-depressants. 

I know some readers will choose to miss the point and say this story shows the law working because the man didn’t kill himself. 

But there will be others who will kill themselves before sufficient time passes to change their minds–and we will never know who they are because they will be dead. 

Indeed, I have met several people who would have killed themselves if assisted suicide were legal but were so glad it wasn’t because they eventually changed their minds. 

But note, Zitter then points to Lonnie Shavelson as the epitome of committed death doctors that society should trust to do assisted suicide right. 

She describes Shavelson as an emergency room and primary care doctor. That overstates his credentials. For most of his medical career, Shavelson was a part time, contract ER doc. He also did some health clinic work for poor immigrants. 

But he is not a board certified specialist in providing ongoing care for cancer patients, kidney disease patients, diabetics, or indeed, other serious conditions. Indeed, until California legalized assisted suicide, he was mostly out of medicine, pursuing a career as a photo journalist and author. He certainly isn’t a specialist in caring for dying patients. He’s no hospice doc.  

When assisted suicide was legalized, he started “practicing medicine” again–as a death doctor, willing to help make people dead for $2000. Moreover, he has a deep ideological commitment to assisted suicide. How deep is it? He once watched a Hemlock Society leader murder a stroke victim who had asked to die but changed his mind. Instead, she holds a plastic bag over his head. From page 92 of Shavelson’s book: A Chosen Death: 

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