First Child Euthanized in Belgium

A terminally ill minor has become the first child to be euthanized in Belgium since age restrictions were lifted in the country two years ago, according to several sources.

A Belgian lawmaker told CNN affiliate VTM that the physician-assisted suicide happened within the past week.

The child, who was suffering from an incurable disease, had asked for euthanasia, Sen. Jean-Jacques De Gucht told VTM. The identity of the child and age are unknown.

"I think it's very important that we, as a society, have given the opportunity to those people to decide for themselves in what manner they cope with that situation," said Gucht, a supporter of euthanasia legislation.
Read it all here.

Killing of Disabled Girl: Hitler would be proud

The euthanasia of Nancy Fitzmaurice, a severely disabled child who was not dying, has made international waves with disability advocates especially outraged. Nancy’s mother had requested that her daughter be killed and was granted approval by the British legal system. While the 12-year-old Nancy had significant disabilities, she was able to breathe on her own and did not require life support.

Following the starving of Nancy through the withholding of fluids, the Autism Self Advocacy Network [ASAN] has released a statement slamming this decision, calling it “troubling” and “concerning”.

They said that:

The decision constitutes an extremely troubling legal precedent, representing the first time the British legal system has allowed a child breathing on her own, not on life support and not diagnosed with any terminal illness, to be killed by the medical system.

Euthanasia of people with disabilities is an extremely dangerous and wholly inappropriate solution to inadequate pain management. In cases where painkillers are insufficient, a number of alternatives for pain management exist. A policy of euthanasia targets vulnerable people, particularly when it is applied to children. People with disabilities who experience chronic pain should have same access as others to life-sustaining medical treatment.

When parents and physicians have the ability to authorize the killing of disabled children, we see serious abuses. Recently, ASAN and twelve other disability rights groups filed an amicus brief in a case challenging the University of Wisconsin Hospital’s practice of counseling parents to withhold care from children with disabilities for treatable but life-threatening medical conditions. In one such instance, a child with developmental disabilities died after a hospital doctor advised his parents that they could withdraw his feeding tube – which provided fluids and nutrition – based on his supposedly low “quality of life.” The medical condition supposedly justifying this measure was treatable pneumonia. The child died the next day, after administration of morphine. Such actions demonstrate the results of a policy that allows families and clinicians to discriminate on the basis of disability in the application of life-sustaining treatment.

ASAN furthermore was “concerned that the voices of people with disabilities with similar support needs were not heard in this discussion.”

ASAN hits the nail on the head, and especially so by calling out the media coverage of this story, which has been overwhelmingly positive.

Read it all here.

Related reading: Bioethicists and Death Control; First Child Euthanized in Belgium

Bioethicists and Death Control

"Thousands of medical ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptionable."—Richard John Neuhaus

Wesley J. Smith

If you want to see what is likely to go awry in medical ethics and public healthcare policy, pay attention to the advocacy of bioethicists—at least of those who don’t identify themselves as “conservative” or “Catholic.” In their many journal articles and presentations at academic symposia, they unabashedly advocate for discarding the sanctity- and equality-of-life ethic as our moral cornerstone. Instead, most favor invidious and systemic medical discrimination predicated on a patient’s “quality of life,” which would endow the young, healthy, and able-bodied with the highest moral value—and, hence, with the greatest claim to medical resources.

Thanks to the work of bioethics, life-taking policies that a few decades ago were “unthinkable” now are unremarkable. Withholding tube-supplied food and water from the cognitively disabled until they die—Terri Schiavo’s fate—is now legal and popularly accepted, much like abortion. The legalization of assisted suicide is a constant threat. Even where lethal prescriptions or injections cannot be legally provided, some of our most notable bioethicists urge that doctors be permitted to help the elderly and others commit suicide by self-starvation—a process known in euthanasia advocacy circles as VSED (Voluntary Stopping of Eating and Drinking).

Promoters of the culture of death never rest on their laurels. Listed below are a few of the more dangerous “advances” being promoted in bioethics.

Read it all here.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council. His new book, Culture of Death: The Age of “Do Harm” Medicine, was just published by Encounter Books.

Canada Grants Right to Active Euthanasia

Canada’s Senate passed Bill C-14, the euthanasia and assisted suicide bill.

The Senate first passed Bill C-14 a few days ago with seven amendments from the original bill that was passed in the House of Commons on May 31.
Yesterday, the House of Commons removed a controversial amendment and a protective amendment in the Senate version of the bill and then sent it back to the Senate for approval.

This morning the Senate considered an amendment that would have referred the terminal illness provision in the bill (natural death is reasonably foreseeable) to the Supreme Court of Canada, but that amendment was defeated.

The controversial issue was the requirement that a medical or nurse practitioner could approve a lethal injection if the person’s “natural death is reasonably foreseeable.” Parliament insisted that this requirement remain in the bill while the Senate argued that the Supreme Court did not state that a person must be “terminally ill.”

The final bill maintains that “natural death must be reasonably foreseeable.”

I was disappointed that House of Commons withdrew the amendment that prohibited a beneficiary from participating in a persons assisted death or signing the person’s request for assisted death. This was an amendment that protected people from a greedy beneficiary or an unscrupulous family member.

The final bill allows a beneficiary to participate in the act, even to lethally inject.
The Senate then passed Bill C-14 by a vote of 44 to 28. The response from parliament was to declare a summer recess.

The bill that determines how Canadians will kill Canadians was passed on the last day of the parliamentary schedule in time for the summer recess.

Bill C-14 now goes to the Governor General to be signed.

No attempts were made to amend the most grievous parts of Bill C-14.

1. Bill C-14 provides medical practitioners or nurse practitioners legal immunity for decisions or acts that contravene the law.

•Section 241.3 states: Before a medical practitioner or nurse practitioner provides a person with medical assistance in dying, the medical or nurse practitioner must: (a) be of the opinion that the person meets all of the criteria set out in subsection (1);

• Section 227(3) states: For greater certainty, the exemption set out in subsection (1) or (2) applies even if the person invoking it has a reasonable but mistaken belief about any fact that is an element of the exemption.

These sections of the law ensure that a medical or nurse practitioner will never be prosecuted for decisions or acts that contravene Bill C-14.

2. Bill C-14 allows anyone to cause death by euthanasia or assisted suicide.


• Bill C-14 – Section 227(2) states: No person is a party to culpable homicide if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2.


• Bill C-14 – Section 241(3) states: No person is a party to an offence under paragraph (1)(b) if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2.


• Bill C-14 – Section 241(5) states: No person commits an offence under paragraph (1)‍(b) if they do anything, at another person’s explicit request, for the purpose of aiding that other person to self-administer a substance that has been prescribed for that other person as part of the provision of medical assistance in dying in accordance with section 241.‍2.

No jurisdiction in the world offers legal immunity to anyone who does anything for the purposes of assisting death. Bill C-14 is the most wide-open bill in the world. It is even worse than the Belgian law. Recent studies from Belgium indicate that more than 1000 assisted deaths occur without request each year.

Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition, writes, "I cannot understand why people remain so blind about the implications of the language of Bill C-14. The Euthanasia Prevention Coalition will resist the cultural acceptance of euthanasia and assisted suicide." You can read his blog here.

Belgium's Big Business: Organ Harvesting

Belgium is plagued by a culture of death and has been for many decades. By a vote of 50 to 17, the Belgian Senate approved euthanasia for children in December 2013. In a case that attracted world attention, Belgian doctors killed 45-year-old deaf identical twins who were going blind in 2013. Since before 2011, Belgium doctors have been harvesting the organs of euthanised patients. It is a big business there.

In the latest news from Belgium, a 24-year-old woman who is suffering from depression but is otherwise healthy will be euthanised.

She qualifies for "the right to die" under the Belgian law, even though she does not have a terminal or life-threatening illness.

The 24-year-old woman, known simply as Laura, has been given the go-ahead by health professionals in Belgium to receive a lethal injection after spending both her childhood and adult life suffering from "suicidal thoughts", she told local Belgian media.

Laura has been a patient of a psychiatric institution since the age of 21 and says she has previously tried to kill herself on several occasions. She told journalists: "Death feels to me not as a choice. If I had a choice, I would choose a bearable life, but I have done everything and that was unsuccessful." The date of Laura's death is yet to be decided.

Read more here.

Related reading: Belgium Approves Euthanasia for Terminal Children; Insane Conversations in Belgium; Organ Harvesting in Belgium

Belgium Approves Euthanasia for Terminal Children

The outcome was expected, but overseas observers were astonished at the margin of victory. By a vote of 50 to 17, the Belgian Senate has approved euthanasia for children. When the bill finally passes - which now seems quite certain - there will be no age limit for choosing to die at the hands of Belgian doctor. The next step is a vote in the lower house, which will probably take place in May.

The conditions for euthanasia are vague. Children who are under 18 but who are of sound mind can request death if their situation is "medically hopeless" and if they are experiencing "unbearable physical suffering that within the foreseeable future will result in death."

Supporters of the bill have argued that there will only be about 10 or 15 cases each year. They contend that terminally-ill children are already being euthanased and it is better for the practice to be regulated. How will the doctor know if the child is of sound mind? He or she must be examined by a psychiatrist or psychologist. The parents or the legal guardian must also consent.

The debate raises the issue of something that is often taken for granted: is there really an ethical difference between a child and an adult?

In November 16 paediatricians urged lawmakers to approve the legislation in an open letter in the press. "Why deprive minors of this last possibility? Experience shows us that in cases of serious illness and imminent death, minors develop very quickly a great maturity, to the point where they are often better able to reflect and express themselves on life than healthy people."

This seems to be a consistent theme in the Belgian debate. One senator, Louis Ide, a Catholic and a conservative, explained why he voted for the bill in his blog, Gezondheidszorg. He argues that assessing mental competence by calendar age is an archaic standard. "Children" can drive, or can give testimony in divorce cases. The only relevant standard is a capacity to make sound decisions.

However, British barrister and medical ethicist Charles Foster has been especially critical about the issue of informed consent.

"Death, so far as we know, is terribly final. And if you're opting for death, you need to be sure that you've got it right. This demands an understanding of many complex facts (such as prognosis - how your disease or condition is going to pan out - and your therapeutic and palliative options), and an evaluation of their significance. It's hard for anyone; it's likely to be impossible for children.

"There's lots of evidence to show that when we find ourselves in the situations we have most feared (for instance severe disability), we find that those situations are nothing like as unbearable as we anticipated. When we are stripped of much, we value all the more what is left. Try explaining that to a child."

Source: BioEdge

Related reading: Insane Conversations: Talking to children about euthanasia

Secular Quebec is Poised to Euthanize

QUEBEC CITY — Quebec is North America’s most European jurisdiction, but this doesn’t appear to be an asset in terms of valuing human life, economic health or the preservation of its Catholic heritage.

The predominantly French-speaking Canadian province has this continent’s lowest birth rate, at 1.5 children per woman, the highest debt-to-GDP ratio at 94%, the lowest weekly church attendance at 6% of residents — and soon, if its separatist Parti Quebecois government has its way, it will add euthanasia to the list of dubious similarities.

However, the term “euthanasia” doesn’t appear anywhere in the Quebec government’s Bill 52, “An Act Respecting End-of-Life Care.” While it offers doctor-applied fatal injections to those wishing to escape painful, terminal illnesses, it calls this “palliative care … including terminal palliative sedation and medical aid in dying.”

Read it all here.

Palliative Care Undermined by Euthanasia

Palliative care is undermined by euthanasia and assisted suicide, according to many palliative care organisations. In Australia, where end-of-life issues are hotly debated, the peak palliative care body has joined the chorus of opposition.

The Australia and New Zealand Society for Palliative Medicine (ANZSPM) has released a new position statement on the practices, arguing that they are not a solution to patient suffering, and that legalising the procedures would take attention away from the real issue - a lack of access to palliative care.

In the document the ANZSPM emphasises, "There is a clear distinction between good care for the dying and active interventions instituted in order to deliberately end the life of a patient." Instead of providing VE or PAS, doctors should try to alleviate symptoms: "When requests for euthanasia or assisted suicide arise, particular attention should be given to gaining good symptom control, especially of those symptoms that research has highlighted may commonly be associated with a serious and sustained 'desire for death' (e.g. depressive disorders and poorly controlled pain)."

Out of a the ten point policy statement, three points stressed "the significant deficits in the provision of palliative care in Australia and New Zealand". ANZSPM called for new government "health reform programs", as well as increased carer support for respite care, so as "decrease the sense of burden for many patients at the end of life."

Source: BioEdge

Montana Man Survives Wrong Diagnosis

A Montana man brain cancer diagnosis shows how difficult it is to determine whether or not a person has a "terminal illness". Mark Templin was awarded US$59,000 for expenses and emotional stress after his doctor wrongly told him in 2009 that he had only six months to live. "It is difficult to put a price tag on the anguish of a man wrongly convinced of his impending death," said the judge. "Mr. Templin lived for 148 days ... under the mistaken impression that he was dying of metastatic brain cancer."

One of Templin's daughters asked the doctor how her father would die and "he explained one of the tumors would grow 'like cauliflower' and Templin would die from a brain bleed."

After that disturbing diagnosis, Mr Templin sold his truck and quit his job. He put his affairs in order and displayed a large sign in his home saying "Do Not Resuscitate". His family held a "last birthday" dinner for him and he paid for a funeral service. His son-in-law made a wooden box for his ashes. He entered a hospice for dying patients.

He even considered shooting himself to spare himself and his family the pain of a terminal illness.

However, Mr Templin began to get better, not worse. He booked himself out of the hospice and had more tests. These revealed that he had had a stroke and that he did not have a brain tumor.

Good thing he didn't live in a state like Oregon or Vermont that pushes euthanasia!

Identical Twins Killed by Belgium Doctors

In a case which has attracted world attention, Belgian doctors have announced that a fortnight before Christmas they killed 45-year-old deaf identical twins who were going blind and thought that they had nothing to live for.

I wonder if their otherwise healthy organs were harvested, and if so, how much did the family receive in payment?

Marc and Eddy Verbessem were born deaf. They never married and lived together, working as cobblers. When they discovered that they had another congenital disorder, a form of glaucoma, they asked for euthanasia. According to their local doctor, David Dufour, they had other medical problems as well. "All that together made life unbearable," he told the London Telegraph. "I have been very surprised but there is so much interest and debate about this".

Under Belgian law euthanasia is allowed if "the patient is in a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident".

Critics point out that the Verbessem brothers were not terminally ill nor suffering physical pain. In fact, it took the men two years to find doctors who would agree to help them. A doctor at their local hospital said, "I do not think this was what the legislation meant by 'unbearable suffering'".

Professor Wim Distelmans, a right-to-die activist who was the other doctor involved in the decision to euthanase the men, based his own assessment on their psychological suffering.

"It's the first time in the world that a 'double euthanasia' has been performed on brothers. There was certainly unbearable psychological suffering for them. Though there is of course it always possible to stretch the interpretation of that. One doctor will evaluate differently than the other."

The media learned of the deaths a few days ago but they had actually occurred on December 14 at Brussels University Hospital. A few days later the government announced that it would amend the law to allow minors and people with dementia to be euthanased as well.

In an email interview, Jacqueline Herremans, president of Belgium's Association for the Right to Die with Dignity, defended the decision and told BioEdge that this was not a case of the "slippery slope".

"When we opened the debate almost 15 years ago, the first thought was for people suffering from incurable cancers. And it is still the cancer which is at the origin of almost 80% of the cases of euthanasia. But we must admit that suffering may exist in other circumstances. MS, ALS, Parkinson's are obvious. But what about psychiatric disorders without any possibility of cure? What about ageing persons with several medical affections losing their autonomy and seeing no more sense to their life, knowing that tomorrow is going to be worse than today? What about Alzheimer's patients? ... The decision to ask for euthanasia is not easy. And the decision for the doctor to answer to this request is far from an banal and usual act."

A report published late last year by the Brussels-based European Institute of Bioethics took a very different point of view. It claimed that euthanasia was being "trivialized" and that the law was being monitored by a toothless watchdog. After 10 years of legalised euthanasia and about 5,500 cases, not one case had ever been referred to the police.

Professor Chris Gastmans, of the Catholic University of Leuven, criticised the deaths as an impoverished response to disability. "Is this the only humane response that we can offer in such situations? I feel uncomfortable here as ethicist. Today it seems that euthanasia is the only right way to end life. And I think that's not a good thing. In a society as wealthy as ours, we must find another, caring way to deal with human frailty."

Related reading: Organ Harvesting in Belgium

France to Consider Euthanasia Legislation

The French government has announced that it will introduce legislation allowing assisted suicide and some forms of euthanasia. A report by the former head of the national bioethics commission, Didier Sicard, was given to President François Hollande. Legislation could be presented to the National Assembly as early as June.

"The existing legislation does not meet the legitimate concerns expressed by people who are gravely and incurably ill," Hollande told the media this week.

Sicard professes to be a foe of legalised euthanasia. However, his three main proposals do involve ending life without consent. He says that death should be "accelerated" if patients ask for it or if they have made an advance directive. In a second scenario, doctors could withdraw nutrition and hydration at the request of relatives of an unconscious person. And third, doctors could withdraw nutrition and hydration from persons in a permanent vegetative state.

Euthanasia Coming to Quebec?

A report from a legislative committee in Quebec reads like a pro-euthanasia manifesto, not an unbiased study. That's the opinion of  Margaret Somerville, the founding director of the Centre for Medicine, Ethics and Law at McGill University.  Here is what she has to say:

Will Quebec Legalize Euthanasia?

By Margaret Somerville

Before society responds affirmatively to the call for legalized euthanasia, we will need to provide the public with a more full and open explanation of the case against it. The recent Quebec National Assembly committee report Dying with Dignity fails to do that.

Like the previous report of the expert panel of the Royal Society of Canada on this same subject, the Quebec report is not balanced and reads rather like a pro-euthanasia manifesto. The fact that it strongly recommends palliative care does not negate that characterization. The Quebec report takes a purely utilitarian approach to the euthanasia question. In the committee’s estimation, legalizing euthanasia will do more good than harm -- and that justifies allowing it.

It upholds respect for individuals’ rights to autonomy and self-determination as the overriding value, citing, among other examples, the current approach to abortion as showing this value predominates in contemporary Quebec society.

The committee concludes that legalizing euthanasia will not harm the value of respect for life, because euthanasia will only be used in exceptional circumstances and there will be very few cases. And in any case, “La valeur du caractère sacré de la vie a subi une transformation notable” ("The value of the sanctity of life has undergone a significant transformation") relative to other values, which means that now respect for life itself doesn’t necessarily take priority.

The committee argues that allowing euthanasia is merely an incremental change --- we all agree with palliative care and, it says, “aide medicale a mourir” (euthanasia) needs to be seen as just another “palliative-care option.”

How should we respond to these arguments?

First, many people who oppose legalizing euthanasia do so because they believe it’s inherently wrong to kill another person, except when that is the only way in which to protect innocent human life. Euthanasia does not fall within this exception and, therefore, for them, can never be ethically justified.

The clash of values involved in the euthanasia debate is between, on the one hand, respect for life, both individual human life and human life in general; and, on the other hand, individuals’ rights to autonomy and self-determination. People who reject euthanasia give priority to respect for life; people who support euthanasia give priority to autonomy and self-determination.

“Respect for life” must be upheld at two levels: respect for each individual human life and respect for human life, in general. The latter requirement is the reason that the consent of an individual to being euthanized is not sufficient to avoid damaging the value of respect for life. Authorizing doctors to kill their patients necessarily contravenes respect for human life, in general.

And, even if the committee’s  reassurance that cases of euthanasia will be exceptional and, therefore, not damage the value of respect for life, indeed, even if there were only one case, legalizing euthanasia still involves crossing the line established by the fundamental rule that we must not intentionally kill each other.
In short, it would unavoidably harm the value of respect for life, which means that legalizing euthanasia involves a radical change in our society’s values.

Pro-euthanasia advocates often argue that seeing life as “sacred” is a religious value and, because of that, should not be taken into account in the public square. Whatever one’s views are in that regard, respect for life is not just a religious value; it’s a foundational value of all societies in which reasonable people would want to live.

Concern about the consequences of legalizing euthanasia raises the question of whether a utilitarian case against euthanasia can be made. Exploring that question shows that the utilitarian case for euthanasia is not nearly as strong as the committee argues it is. Many seriously harmful consequences from legalizing euthanasia could far outweigh any benefits it might have.

Apart from its harmful impact on the societal value of respect for life, it would harm the institutions of law and medicine, and the healthcare professions. Can we even imagine teaching medical students how to kill their patients?

The committee recognizes the serious danger of the abuse of euthanasia must be taken into account and proposes safeguards. However, contrary to what the committee states, experience with euthanasia in the Netherlands and Belgium is not strongly reassuring that such safeguards are effective.

The committee adopts the strategy used by advocates of legalizing euthanasia of confusing it with interventions that are not euthanasia and are ethically and legally acceptable. For instance, it tells us that in accepting, as we do in some cases, the withdrawal of life-support treatment to allow a person to die, we are already practicing euthanasia; therefore, legalizing euthanasia is just a small step forward. These are false and misleading analogies and a false and misleading line of argument. There is a radical difference between killing a person and allowing them to die of natural causes.

In proposing to replace the word euthanasia with the term “aide médicale à mourir,” the committee introduces a euphemism that both trivializes and is likely to conceal the moral and ethical issues. Terminology matters because our emotional responses and moral intuitions play an important role in helping us to decide what is ethical and what is not and the language we use affects these responses: compare “physician assisted death” with “doctors killing their patients”.

If we are to have a discussion about euthanasia, it must be an unbiased one. It’s hard for me to conclude from its report that the National Assembly committee undertook such an unbiased reflection, especially in view of the fact that two-thirds of the submissions it received argued against legalizing euthanasia.



Related reading:  More Euthanasia, Assisted-Suicide Propaganda; Utilitarian Euthanasia and the Question of Dignity

Dutch Prince Would be allowed to Die in His Homeland

Dutch Prince Johan Friso, brain-damaged after being buried by an avalanche in Austria last month, has been transferred to Wellington Hospital, in London. Doctors believe that the 43-year-old is unlikely to recover consciousness, although will be weeks before they have a clear idea of his prospects.

Prince Frisco  with his family

Prince Friso is the second son of Queen Beatrix but is not in line to the throne because of his marriage to a controversial commoner. He has been working in London as the financial director of a company producing enriched uranium.

The Netherlands does not have specialised centres for treating brain-damaged patients over 25, so the royal family has been forced to seek treatment abroad. It appears that the standard for care in the Netherlands is different than in neighbouring Germany, for instance. German doctors use biological life as the standard, while Dutch doctors use "brain death". If Dutch patients are permanently neurologically unresponsive, they are allowed to die. In Germany, on the other hand, there are between 3,000 and 5,000 patients living in a permanent vegetative state. In the Netherlands there are very few. 

The Dutch and German media have broached the topic of euthanasia and organ donation. However, there has been no comment whatsoever from the Prince's family. Opposition to euthanasia, even though it is legal under some circumstances in the Netherlands, is still strong, especially among Evangelicals. Media experts on the Dutch royalty feel that this option is not really possible.

"The fact that a few days after the accident, the question of euthanasia for Prince Friso is discussed publicly is appalling," says Eugen Brysch, head of the German Hospice Foundation. ~ Der Hamburger Abendblatt, Mar 3; Radio Netherlands, Mar 3

Guidelines for British doctors asked to assist suicides

The British body for regulating doctors, the General Medical Council, has announced that it is working on guidelines for telling doctors what they should do if a patient asks for help in committing suicide. There is an increasing number of Britons seeking to go to Switzerland to seek death at suicide clinics. There will be a public consultation early next year. Niall Dickson, the Chief Executive of the General Medical Council, said:


"The issue of assisted suicide is complex and sensitive. We already have clear guidance for doctors that they must always act within the law and assisting or encouraging suicide remains a criminal offence. This guidance will not in any way change the legal position for doctors. It is not our role to take a position on whether or not the law should be changed; that is a matter for the relevant legislature.

"We recognise however that there are a range of actions which could be considered as assisting in a suicide, such as providing information to a patient about suicide or providing practical assistance for someone to travel to a clinic such as Dignitas. Some of these actions may not lead to criminal charges but may still lead to complaints to us about a doctor's fitness to practise."

The guidance considers factors that might be relevant in determining the seriousness of each case, in the context of the different actions doctors may take in assisting patients who wish to end their lives. The new guidance will not cover euthanasia (in which a doctor's actions have directly led to a patient's death), as standards on this are clear.

The legal position of assisted suicide in England and Wales is unclear. It is clearly illegal, but there are doubts about whether charges would be brought against a doctor who assisted someone in a suicide. In 2010 Keir Starmer, the public prosecutor, issued liberalised guidelines which focused on the intention of the person assisting. There is a case currently in the courts which could raise the issue of whether doctors could help with impunity. ~ GMC, Dec 14, Guardian, Dec 15
 

More Euthanasia, Assisted-Suicide Propaganda

Margaret Somerville (Reprinted from here.)

The Royal Society of Canada Expert Panel on End-of-Life Decision Making recently released its Report to much media attention. The parts of that report we can all agree on, for instance, the need for much better access to palliative care and pain management for terminally ill patients, was not the media’s focus. The panel’s recommendation that euthanasia and physician-assisted suicide (PAS) should be legalized was.

It has generated many calls for a national debate in Canada on these latter issues – mainly, I would guess, if not entirely, from people advocating the legalization of euthanasia. In entering such a debate and deciding whether they agree with this recommendation, it’s important for Canadians to understand the weaknesses of the Report.

The Panel’s mandate included the following direction: “The public would… benefit greatly from having a careful, balanced review of various pros and cons of decriminalization of physician-assisted death from well-reasoned ethical and legal standpoints.” The Report comes nowhere near fulfilling this mandate. It’s a pro-euthanasia manifesto – to paraphrase an advocate for disabled people speaking in another context, it’s “thinly veiled euthanasia and assisted suicide propaganda disguised as an expert report”.

This is not surprising in view of who the authors are. Many are well-known pro-euthanasia advocates and, as the Report is unanimous, one can assume all agree with this stance. The people I know whom the Panel lists as consulting to them are, likewise, pro-euthanasia -- three of them world-leading advocates.
 
It’s important to understand this is not a Report of the Royal Society of Canada, as many have mistakenly assumed, as that gives it an unmerited credibility. It’s a Report of an expert panel (only one member of which is a fellow of the Royal Society) set up by the Royal Society. The fairness and wisdom of the Royal Society’s choice of panel members must, however, be questioned.

The Report is very far from being a “balanced review” or adequately comprehensive. The arguments against the legalization of euthanasia and PAS are almost entirely absent. Issues are considered almost entirely at the level of the individual. There is almost no discussion of the impact of legalizing euthanasia and PAS at the institutional level -- in particular, the impact on healthcare institutions and professions, and the law – or at the societal level, in particular, on important shared values, such as respect for life. In fact, this value is not discussed, an extraordinary omission considering the topic of the report.


Discussion of abuses is deficient and selective

The discussion of the practices in jurisdictions that have legalized or allow euthanasia and assisted-suicide are seriously deficient and very selective so as to minimize the Report’s coverage of abuses, expansions of justifications for the practices, and other problems or controversies.

For example, the Report indicates there has been one case of the use of euthanasia on disabled babies in the Netherlands. This is probably correct in the short time since the Groningen protocol allowing such euthanasia was formally accepted. But, prior to that, an article in the New England Journal of Medicine documents 22 cases of babies with spina bifida being euthanized, which is not mentioned. Such “pro-euthanasia presentations” of the facts are concerning and misleading. Likewise, the availability in the Netherlands of euthanasia for children is not mentioned. The combination of euthanasia and donation of organs for transplant in Belgium and the recent case in Flanders of “joint euthanasia” of a terminally ill man and his healthy wife are ignored. And a survey of Belgian physicians who had carried out euthanasia, published in the Canadian Medical Association Journal, which showed 32 percent of those physicians had carried out euthanasia without the patient’s request or consent is never mentioned.

The system set up under the Oregon Death with Dignity Act is presented as largely problem-free. The literature describing problems, for instance, articles and book chapters by renowned pain specialist and head of palliative care at Memorial Sloane Kettering, Dr Kathleen Foley, and Dr Herbert Hendin, a New York psychiatrist specializing in suicide prevention, is likewise totally ignored.

And although Canadian psychiatrist Dr Harvey Max Chochinov’s research is referenced, his ground-breaking work in the psychiatry of dying people, what helps them and what they want, is not discussed.



Through the lens of individual autonomy

The authors make an assumption that individual autonomy, implemented through “informed choice”, is always the prevailing value and construct their case for euthanasia and PAS from there. They do not consider that for many people some other value might prevail – for example, respect for human life which requires that we don’t kill each other, except when unavoidable to save life -- and what line of argument and decision outcomes that would result in.

In short, the authors have adopted a basic assumption, from which, as they state, everything else they accept and recommend flows, without adequately justifying doing so and not even mentioning the possible alternatives.

The essential difference between the pro and anti euthanasia positions is that the former gives priority to individual autonomy over respect for life, the latter does the opposite. We should keep in mind, here, that we are not just talking about the value of respect for each individual human life, important as that is, but also, respect for human life in general. The authors refer to the Charter as the primary source of our shared values: Apart from any other claims on behalf of the value of respect for life, it is one of the values enshrined in the Charter.

There is a strong emphasis in the Report on the burden and healthcare costs of an aging population and the Report gives the impression that euthanasia and PAS will help to resolve this “problem”. The authors note that euthanizing people “in advanced stages of dementia” will be an issue to be addressed in the future. In other words, they don’t reject the possibility that this might be acceptable.

The Report doesn’t mention survey results, such as those from an Environics poll, which last year (2010) asked over 2000 Canadians what the government priority should be - legalizing euthanasia or improving end-of-life care, or both. Seventy-one percent said improving end-of-life care and 19 percent said legalizing euthanasia, and 5 percent said both (the remainder were Did not know/Neither).



What about elder abuse?

Because the Report seems to have a special focus on aging, I note that the Environics polls also showed Canadians are very concerned about elder abuse if euthanasia or PAS is legalized. The 2011 poll expressly asked about "elder abuse" and 76 percent of respondents said they were concerned about it, if euthanasia were legalized. The 2010 poll did not expressly ask about "elder abuse", but did ask a question where 78 percent of respondents said they were concerned that elderly persons (disabled and sick persons too) would be euthanized without consent. To another 2010 question, 63 percent said they were concerned elderly persons could be pressured to accept euthanasia in order to reduce health care costs.

The authors recognize their position involves an inconsistency in that they champion individual autonomy as the prevailing value, but clearly will place limits on its exercise and not recognize the validity of the choice to die of all autonomous, competent adults.

But, if individual autonomy trumps all other considerations, then why is there a need for any other justification for euthanasia? Simply wanting to be dead and consenting to it should be sufficient: “Over 70 and tired of life”, as proposed in The Netherlands, would suffice. And why, even, does the person need to be “over 70”? What about the broken hearted 18-year-old whose first love has abandoned her; why can’t she exercise her autonomy to have assistance committing suicide?

And if there’s a right to commit suicide, then there is a duty not to interfere with people exercising that right. How then can we justify treating people brought to an emergency room who have attempted suicide?

The usual “confusions” used to promote the case for euthanasia are all present in the Report: equating all acts and omissions; arguing there is no difference between killing and allowing to die; conflating intention and motive in relation to desired and unwanted consequences of pain relief treatment; and so on. The opposite arguments are not presented. And the fact that courts and others rely on these distinctions daily in making legal and ethical decisions is ignored.

The section on dignity, which the authors recognize is a prominent concept in the euthanasia debate, is especially biased to the pro-euthanasia arguments and inadequate. In particular, a 2008 major and very comprehensive research report on the concept by the US President’s Commission on Bioethics is not even mentioned.

The above criticisms are not comprehensive, many more could be articulated. Fortunately, in my view, there is a wealth of grounds on which the Report can be easily dismissed.


Margaret Somerville is founding director of the Centre for Medicine, Ethics and Law at McGill University.

Dutch Crazy about Euthanasia

Straight from the “just when you thought it couldn’t possibly get any worse” files come reports that the Dutch Health Minister admitted in their parliament recently that her department is “considering” setting up mobile euthanasia death squads.

Minister Edith Schippers is quoted in the UK Telegraph as saying that mobile units "for patients who meet the criteria for euthanasia but whose doctors are unwilling to carry it out" was worthy of consideration.

Instantly, many will be reminded of the SS Einsatzgruppen death squads that moved through towns on the Eastern Front following the Nazi invasion of Russia in 1941. I hesitate to draw any further comparison with this dark and sinister period in European history, but this recent development is disturbing on a number of levels.

The suggestion that these mobile units would euthanase people where the local doctor was not willing to do the killing could constitute a serious breach of medical ethics. What if the doctor would not kill for sound medical reasons such as untreated depression or evidence of coercive pressure? Will his or her advice be sought and will his opinion and treatment plan prevail? It doesn’t seem that likely.

Already we have seen Dutch patients with Alzheimer’s being euthanased. But Dutch pro-euthanasia groups are known to want to expand the eligibility for euthanasia further; the UK Daily Mail reports the lobby as saying “that 80 per cent of people with dementia or mental illnesses were being ‘missed' by the country’s euthanasia laws’.” Missed? Is there a door-to-door search? Quick, hide Grandma in the cupboard!

Would the patient’s doctor even be told that the death squad was about to visit his patient? For the frail, elderly or those with depression or mental illness, the doctor may well also be the patient’s only advocate. Doctor shopping for a preferred diagnosis is one thing, but this is death as a door-to-door salesman!

A salesman it is. In Washington State, where assisted suicide is legal, advocates like the euphemistically titled “Compassion and Choices” provide advice to those seeking death in how to approach their doctor and what to do if he or she tries to talk the patient out of it or tries to defer the conversation. Their advice suggests that any answer other than supporting the provision of assisted suicide under their Dignity With Dying Act is unacceptable. But again, is it not a legitimate role of the doctor to avoid a direct answer on such a question with the aim of taking the time to conduct a proper medical and mental health assessment and the best outcome for the patient?

Of course, if you don’t get what you want, there’s always help at the other end of the phone: “... call Compassion; Choices of Washington and request a Client Support Volunteer who can help you achieve a peaceful, humane death.” One can easily imagine a similar line being adopted in Holland: “Your doctor said no. How terrible! Here, call the mobile hotline now!

Paul Russell is the Director of HOPE: Preventing Euthanasia & Assisted Suicide and is based in South Auustralia. He is also Vice Chair, International Euthanasia Prevention Coalition.
www.noeuthanasia.org.au

Hungary: Suspicious Hospital Deaths

Hungarian police have launched an investigation into 70 suspicious deaths at a Budapest hospital following claims that patients were given lethal drug overdoses.

Police have interviewed doctors and nurses at the Uzsoki Hospital over deaths which took place between 2005 and 2007. They came to light after a former doctor at the hospital wrote an article for a medical journal in which he alleged that cancer patients had died from overdoses of morphine. The hospital has declined to comment.

According to a report in the London Telegraph, it is possible that patients were euthanased by giving them overdoses of morphine. Murder could be difficult to prove, as morphine may have been needed to control severe pain, rather than less potent drugs.

Euthanasia in Hungary is illegal. Istvan Eger, president of the Hungarian Hospital Association, said that any proven "misuse of drugs or euthanasia clearly constitutes a violation of ethics, and is a matter with criminal consequences". ~ London Telegraph, Nov 25
 

Suspicions of Royal Euthanasia

Queen Maud

One of the sensational claims made in a new book about Norway's monarchs during World War II, King Haakon VII and Queen Maud is that the Queen may have been involuntarily euthanased. Norwegian author Tor Bomann-Larsen writes in his book "Æresordet" (Word of Honour) that "Queen Maud had left home strong and healthy and would return in a coffin, without Norwegian doctors having had any connections to what happened."

The evidence for this startling claim is largely circumstantial. Maud was English, a granddaughter of Queen Victoria. It was reported that she died of heart failure in 1938 in England, under the care of the most eminent and respected physician of the day, Lord Bertrand Dawson.

However Bormann-Larsen has unearthed documents which suggest that the real cause of death had been cancer. Dawson wrote to his Norwegian counterpart: "When reading this account, you will agree that the Queen's sudden death was a relief and which saved her from these last painful stages of the disease both you and I know only too well."

In the light of Dawson's personal history, these words take on a sinister, if ultimately unverifiable, significance. For he was not only a strong advocate of euthanasia, but two years before he had euthanased the King of England.

This only came to light 50 years later when Dawson's personal papers were opened. On the day of the death of George V he wrote in his diary: "I therefore decided to determine the end and injected (myself) morphia gr.3/4 and shortly afterwards cocaine gr. 1 into the distended jugular vein."

Why? It appears that the King's death was imminent. However, if he had lingered on for a few more hours, the news would have appeared first in London's sleazy tabloids. Dawson felt that it was more fitting that the death of a sovereign be announced in The Times, the British paper of record. An early death also enabled him to return to his busy practice in London. "There is no reason to think that King George V was the only patient he treated in this way," wrote J.H.R. Ramsay in the BMJ. Why not Norway's queen?

Neither Buckingham Palace nor the Royal Court in Oslo has commented on the allegations. ~ The Foreigner, Nov 4; Dagbladet, Oct 31

Euthanasia Safeguards for Doctors, not Patients

The criminal law in Australia holds that the intentional taking of human life is a major criminal offence. This accords with the United Nations' Universal Declaration of Human Rights, to which Australia is a signatory, which declares that the right to the integrity of every person's life is equal, inherent, inviolable, inalienable and should be protected by law.

Since the intentional taking of human life is the specific aim of every euthanasia law, such a law would be unique in the following critically important ways:

• it would intend to subvert the existing law,
• it would fail to respect the principle that all are equal before the law,
• it would fail to respect the principle that all human lives have equal value and
• it would attempt to gain legal recognition for the concept of life not worth living.

This would present an impossible task, if honesty were to prevail. It would have to rely on such things as asserted but non-existent human rights, shades of deceit, inexact definitions and words or clauses allowing loose interpretations, rather than objectivity and specificity.

The push for legalised medically assisted death in Australia has now increased to the point where bills are before several State parliaments and another is before the Australian parliament to reverse the previous overturning of the Northern Territory Act. I have analysed most of the previous failed bills and noted their weaknesses. Rather than debate the pros and cons of the social role of euthanasia, I believe that members of Parliament, who have sole responsibility for making safe laws, should direct their attention to ensuring that draft euthanasia bills cannot imperil the lives of innocent people who do not wish to die.


The trouble with safeguards

It is evident that the authors of those bills have not read any of the extensive literature on this subject because they invariably include, as so-called safeguards, provisions which are known not to work in practice. A common feature of those who advocate euthanasia bills is their touching reliance on the fact that certain things will happen, just because the draft prescribes it. If that were true, no crime would ever be committed because all crime is currently forbidden by some law.

In 1958, Yale Kamisar, a renowned American professor of law in this field, wrote a seminal paper in which he listed these basic difficulties: ensuring that the person's choice was free and adequately informed; physician error or abuse; difficult relationships between patients and their families and between doctors and their patients; difficulty in quarantining voluntary euthanasia from non-voluntary, and risks resulting from this overt breach of the traditional universal law protecting all innocent human life.

All these problems still exist and others have been added, such as the critical role of depression in decision-making and the evolution in the moral basis for requesting death from the relief of severe suffering in the terminally-ill to reliance on respect for personal autonomy. Some of these will be discussed below.

Read it all here.
 

Bulgaria Rejects Euthanasia Bill

The Bulgarian Parliament has rejected a euthanasia bill by a vote of 59 to 13, with 29 abstentions.

Socialist MP Lyuben Kornezov had proposed a bill which would have allowed euthanasia if a patient made a notarised request. A spouse, adult children or parents could also make a request if a patient was not competent. A panel of three doctors and lawyers would review requests.

According to the Sofia Echo, Mr Kornezov said that euthanasia already had been legalised in some European countries, Japan, Oregon, Albania, Australia, Uruguay and Japan. (Mr Kornezov misinformed his parliament. Only in the Netherlands, Belgium and Luxembourg is euthanasia permitted. A few jurisdictions, like Oregon, allow assisted suicide.)

"With gritted teeth and a heavy heart, I say 'yes' to euthanasia because for me it is the highest form of humanitarianism," said Mr Kornezov. If suffering is unbearable, a person must be able to choose between life and death.

Bulgarian news agency BTA reported that other MPs were critical of the proposed law. GERB ruling party MP Daniela Daridkova said that the proposal was against Bulgaria's constitution, laws and the physicians' Hippocratic Oath. Vanyo Sharkov of the Blue Coalition said that it was doubtful that doctor would perform euthanasia. And Ataka's Pavel Shopov said that it was possible to have choices, but not about matters that were the subject of Divine commandments. He quoted the sixth of the ten commandments, "you shall not kill". ~ Sophia Echo, Sept 1