Thursday, July 28, 2016

Study uncovers concerns with the practice of euthanasia and assisted suicide.

Alex Schadenberg
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A recent research article concerning euthanasia and assisted suicide was published July 5 in the Journal of the American Medical Association (JAMA) titled: Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada and Europe; uncovers significant concerns.

The media mainly reported on this research article by once again promoting the legalization of euthanasia and assisted suicide. The media reports essentially reported that:
Euthanasia and physician-assisted suicide are increasingly being legalized, remain relatively rare, and existing data does not indicate widespread abuse of these practices.
The media reports often ignored the concerns identified within the conclusion:
Problems and complications with the performance of euthanasia or PAS occur, but the available data make it difficult to determine the precise rates.
The researchers uncovered several concerns with the practice of euthanasia while sadly ignoring a couple of significant concerns. For instance the article states that:
The most recent death certificate studies in those countries, which incorporate unreported cases, found a prevalence of 2.9% of all deaths in the Netherlands (2010) and 4.6% in Belgium (2013) from euthanasia and PAS.
The Netherlands death certificate study, referred to in the article was based on data from 2010 and published July 11, 2012 in the Lancet. The Lancet study found that 2.9% of all deaths were from euthanasia or assisted suicide in 2010. The Lancet study also found that:
  • the number of euthanasia deaths had increased significantly (4051 in 2010, 2425 in 2005). Since 2010, the number of reported euthanasia deaths has increased by more than 77%. 
  • the under reported euthanasia deaths in the Netherlands increased (23% in 2010, 20% in 2005). The Lancet study indicated that there were 3859 euthanasia deaths 192 assisted suicide deaths. There were 3136 official reported euthanasia deaths in the Netherlands. The remaining 723 euthanasia deaths were not reported. 
  • hastening of deaths without explicit request continued (310 in 2010, 550 in 2005).
Since 2010, people with psychiatric conditions and/or dementia are now dying by lethal injection in the Netherlands. In 2015 there were 109 people who died by euthanasia based on dementia and there were 56 people died by euthanasia for psychiatric reasons.

The Belgian death certificate study that was referred to in the article was published in the NEJM on March 19, 2015 was based on deaths in the first 6 months of 2013 in the Flanders region of Belgium. The Belgian study found that:
Similar to the Netherlands people with psychiatric conditions and/or dementia are dying by euthanasia in Belgium. The co-chair of the Belgian euthanasia commission commented in March 2015 that the number of psychiatric euthanasia deaths:
"It is a small group, 50 to 60 patients. But it is not a negligible number:. 2 to 3 percent of the 1,924 people who were euthanized last year."
The research article made some key conclusions. One conclusion relates to the data on euthanasia and assisted suicide, the article stated:
Data about the practices of assisted dying are limited. Therefore, collecting reliable data to evaluate end-of-life practices should be prioritized in all countries, and not only in countries legalizing euthanasia or PAS.
The Netherlands and Belgium have conducted death certificate studies examining every death. These studies uncovered abuses and under-reporting of the law.

Since Oregon and Washington States have not conducted death certificate studies, as in Belgium and the Netherlands and since the death certificate studies uncovered mis-use and under reporting of assisted death, therefore comments suggesting that assisted death laws in Oregon and Washington State have not been abused is only conjecture.


Legalizing euthanasia and/or assisted suicide gives medical professionals the right in law to directly and intentionally cause the death, or be involved with causing the death of their patients. It is never safe or ethical to enable one group of people to cause the death of another group of people. 

Society needs to focus on how it cares for its citizens, not how it kills its citizens.

Hate Crime: A killing rampage targets disabled people

This article was published on July 27 on the Not Dead Yet website.


Diane Coleman - President: Not Dead Yet

Like so many in the disability community who have heard this news, we were horrified to begin the July 26th anniversary of the Americans with Disabilities Act by reading of the murder of 19 people with disabilities in a residential institution in Japan. Japan Today reported the following details of the “stabbing rampage”:
The man arrested over a stabbing rampage in which 19 people were killed Tuesday at a residential care facility near Tokyo has told police that he wanted to “save” those with multiple disabilities and feels “no remorse” for what he did, investigative sources said Wednesday. 
The sources have also found that Satoshi Uematsu, a 26-year-old former employee of the facility in Sagamihara, Kanagawa Prefecture, sought to buy time by constraining at least two facility workers with binding bands before launching the attack, which also left 26 people injured. 
As a result, it took more than 40 minutes for workers at Tsukui Yamayuri En (Tsukui Lily Garden) to make an emergency call to the police after Uematsu entered the facility by breaking a window at around 2 a.m. Tuesday. 
Uematsu told investigators that he “tied up” facility staff and made them hand over the keys to the residential areas. The 19 victims—nine men and 10 women ranging in age from 19 to 70—were all found in the residential areas, which are divided into eight sectors, each having self-locking doors. 
Most of the victims were stabbed in their necks, with some stab wounds as deep as 10 centimeters. Other wounds were also found on their chests and throats. They were apparently attacked when they were asleep.
Los Angeles Times reports also stated that Uematsu attempted to deliver a three-page letter to Japan Parliament Lower House Speaker Tadamori Oshima’s residence, revealing his views on euthanasia and his murderous plans:
The hand-written letter, which was obtained and released by the Mainichi newspaper, begins abruptly, with the writer saying he “is able to kill 470 disabled people” and a disclaimer that he realizes his threats defy common sense. Uematsu said he reached the conclusion that his plan to kill the disabled should be put “into action” and that “looking at the exhausted faces of the caretakers and the lifeless eyes of the employees of the caretaking facilities makes me feel for Japan and the world.”

The disabled, he wrote, “live as animals, not humans and many must succumb to a wheelchair for life while often being shunned from their own families.” 
He said his goal was a world “where the severely disabled who cannot manage life at home or be an active member of the society can make the choice of being euthanized with the consent of their guardians. The disabled are only capable of creating unhappiness.”

Japan care home murders probed as euthanasia hate crimes against people with disabilities.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Japan Times News has reported that the recent masacre of 19 residents at the Tsukui Yamayuri En care home for people with disabilities is being investigated as a mercy killing.

According to the Japan Times News Satoshi Uematsu, a 26-year-old former employee of the facility told police he was trying to “save” people with multiple disabilities and had “no remorse” for what he did. The Japan Times News reported:

Despite declaring no remorse for his actions, Uematsu appeared to express one regret: “I wanted to apologize from the bottom of my heart to the bereaved families as I made them suddenly part with” the victims, the investigative sources quoted him saying.
Uematsu earlier told investigators that “it would be better if the disabled disappeared.” He also said he stabbed “people who could not communicate well.” 
Police believe Uematsu intended to commit murder. The attack was likely premeditated, taking advantage of his more than three years of working experience at the facility.

According to the Japan Times News article, the police did not released the names of the 10 women and 9 men murder victims because their relatives do not want them identified based on their disabilities. The article expressed concerns that these murders may lead to further attacks upon people with disabilities.
“People with disabilities who are most vulnerable should not be victimized like this,” said Toshiyuki Hokage, 29, who came to lay yellow flowers at the entrance. “I am worried that discrimination toward people with disabilities might spread after this incident.”
Disability rights group, Not Dead Yet, decried this murderous rampage as a hate crime that targeted people with disabilities.

Tuesday, July 26, 2016

Euthanasia: The conversation has become too quiet.

By Charles Lewis

Perhaps it is just me who has noticed but the conversation around euthanasia has become far too quiet. In my own case, as someone who spent a few years speaking out against euthanasia, as well as writing anti-euthanasia essays, I could count on someone from time to time to comment about the issue and usually commiserate over our mutual opposition.

A few weeks ago, while waiting for mass to begin, a priest offered his condolences. At first I did not get what he meant. But I soon realized it was over the final legalization of euthanasia in Canada.

I really did not react. Was not sure what to say. No one can spend every waking moment thinking and talking about euthanasia. It takes too much out of you.

I am sure the priest meant well. But what he should have said is something like this: 
“What a shame they have made this legal. We are really going to have to redouble our efforts to make sure our friends do not avail themselves of this evil.”
My abiding concern is that the vast majority of people have lost interest. They are going to be fooled because the final legislation was not as odious as what the special committee recommended and nor what the Supreme Court laid out in Carter decision.

To me this is a trap. It is like in the old Westerns when the sheriff says, “I don’t like it. It’s too darn quiet.”
But this is not over. I have said the before and I will risk repeating myself: Legalized euthanasia is a travesty and no one need avail himself or herself of it. It is a law to be spit on.

We can still do what we can to educate people and continue to lobby for greatly improve palliative care – which is sorely lacking in Canada. At the moment only 30 per cent of Canadians who need that care can get it.

We can also personally care for others and help people live when they are feeling drawn to end their lives. We can also support the Compassionate Community Care Service that is being promoted by the Euthanasia Prevention Coalition.

Monday, July 25, 2016

California assisted suicide law is unconstitutional... Killling is never medical care.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr Philip Dreisbach is one of six physicians who joined with the American Academy of Medical Ethics to legally challenge the California assisted suicide law has written an important article that was published in the Wall Street on July 24, 2016 titled: Why are they trying to make us kill our patients.

Dreisbach explains why the California assisted suicide law is unconstitutional:
I am an oncologist/hematologist who has been practicing in California, primarily at Eisenhower Medical Center in Rancho Mirage, for 39 years. It has been my privilege to have treated and cared for more than 16,000 patients with cancer or blood diseases and to have provided pain relief and comfort for the dying. 
... Our state’s physician-assisted suicide law instantly removes penal-code protections from a vulnerable segment of the population deemed “terminally ill.” The law allows anyone labeled as terminally ill to request assisted suicide—but it also accepts heirs and the owners of caregiving facilities to formally witness such requests, even though the probate code does not even accept “interested” parties as witnesses to a will. 
The law does not require an attending physician to refer the patient for psychological assessment. It thus does not allow for screening for possible coercion, or for underlying mental conditions that could be behind the suicide request—unless the patient has signs of mental problems, which may not be visible to a suicide-specialist doctor they may not even know. In these and other ways, the law devastates elder-abuse law and mental-health legal protections, and it deprives those labeled as terminally ill of equal-protection rights that all other Americans enjoy. 
All of us in the practice of cancer care have seen patients, diagnosed with so-called terminal illness, who have experienced a marvelous remission of disease. Very little is absolute—except death itself.
D
Dr Philip Dreisbach
reisbach explaines why doctors should not assist in killing of their patients:
Killing is never medical care. There is no circumstance when any compassionate, competent physician would prescribe a deadly drug to any patient. If “medical practice” has any meaning, it definitely does not include using drugs to willfully kill a patient or for a physician and pharmacist to supply a lethal drug so that a patient can kill himself. 
The American Medical Association has spoken for all physicians by stating: “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.” 
The irony here is that the medical community has strongly objected to facilitating the death of felons on death row, but that same medical community is now expected to help kill the innocent.
Dreisbach comments on the experience of Dr William Toffler, from Oregon, where assisted suicide has been legal since 1998:
... Dr. William Toffler, a distinguished professor of family medicine at Oregon Health & Science University in Portland, Ore., testified before Congress in 2015 about abuses of the law and about the state health department’s negligence. “There is a shroud of secrecy enveloping the practice,” he said. “Doctors engaging in this practice are required by state law to fabricate the cause of death stating that the cause is ‘natural’ rather than suicide.” 
As the law took effect, Dr. Toffler noted, “the Oregon legislature implemented a system of two different death certificates—one that is public with no medical information and a separate one that is never made public. Thus, review and tracking of physician-assisted suicide deaths by anyone outside of the Oregon Health Division is impossible.”
Dreisbach concludes his article by confirming why the California assisted suicide law is unconstitutional:
Equal protection is not a mindless bumper-sticker slogan. It is a pillar of state and federal constitutions and must not be corrupted. Under the law, equal protection must apply not only to the healthy and able but to the most vulnerable—the unhealthy, the disabled, the elderly—and all who might fall victim to those peddling physician-assisted killing.
Several weeks ago the California assisted suicide law was also denounced by the Disability Rights Education and Defense Fund (DREDF).

Wednesday, July 20, 2016

Court case filed to protect Vermont physicians and patients from coercion in assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.


The Alliance Defending Freedom (ADF) has filed a lawsuit to protect the conscience rights of healthcare professionals in Vermont and prevent physicians and patients from being coerced into assisted suicide.

According to the ADF media release the case was filed on July 19 in federal court on behalf of health care professionals in Vermont who refuse to refer their patients for death by assisted suicide and against the officials in the Vermont Board of Medical Practice and the Office of Professional Regulation.

The ADF Senior Counsel Steven H. Aden states in the media release:

“The government shouldn’t be telling health care professionals that they must violate their medical ethics in order to practice medicine,” 
“... The state has no authority to order them to act contrary to that sincere and time-honored conviction.”

The Vermont assisted suicide law requires physicians to inform patients about all palliative care options. The ADF states that the Vermont Department of Health expanded the definition of palliative care to include assisted suicide. The ADF release quotes a Vermont Department of Health document that states:
“Do doctors have to tell patients about this option? Under Act 39 and the Patient’s Bill of Rights, a patient has the right to be informed of all options for care and treatment in order to make a fully-informed choice. If a doctor is unwilling to inform a patient, he or she must make a referral or otherwise arrange for the patient to receive all relevant information.”
The complaint filed as Vermont Alliance for Ethical Healthcare v. Hoser states:
This is nothing but the redefinition of ‘palliative care’ to mean providing assisted suicide, an intolerable position for Plaintiffs and other conscientious physicians and healthcare professionals." 
“Plaintiffs, state and national associations of conscientious healthcare professionals whose personal and professional ethics oppose the practice of assisted suicide, bring this action on behalf of their members against the operation of Act 39 to force them to counsel and/or refer for the practice.”
A similar case was filed in Canada by physicians in Ontario who are being coerced by the Ontario College of Physicians and Surgeons to refer patients to die by euthanasia or assisted suicide, even if the physician morally or ethically opposes killing patients.

Tuesday, July 19, 2016

Malta rejects euthanasia and proposes living wills.

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Last week, a Maltese political party rejected euthanasia and decided instead to codify "living wills." 

The Malta Independent news published a statement from government Chairperson, Professor Arnold Cassola.
"A 'biological will' would allow a person, when still in full possession of one's intellectual faculties, to declare what kind of treatment to accept and whether to prolong or not in an artificial way - through the use of machines or other artificial systems - a life that would otherwise have naturally come to an end. The standards of palliative care should also be looked into to guarantee dignified end-of-life care for everyone." 
“Whilst AD does not agree with the termination of life through euthanasia, it is in favour of the drawing up of 'living wills' or 'biological wills.’”
It is good that the Maltese political parties are debating the issue of euthanasia and recognizing that euthanasia constitutes the termination of a human life.

Accidental dog euthanasia, Illegal euthanasia at animal service, should humans be concerned?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Everyday I receive euthansia news updates from a google alert. Usually there are stories about euthanasia of animals as part of the alert. Most of the animal euthanasia stories concern a change of rules for euthanasia or an announcement that an animal shelter is lessening or eliminating euthanasia.

Recently there have been several interesting stories about animal euthanasia that made me think. Could this also happen to humans?

The first story concerns a dog that was accidentally euthanized after staff at the Contra Costa Animal Services failed to follow protocols.

According to the article in the East Bay Times Barbie was accidentally euthanized based on a communication error. Animal Services Director Beth Ward stated:
...her agency had agreed to perform surgery on Barbie before transferring her. When a staff member went looking for Barbie to prep for surgery, it was discovered that the dog had been put down. 
Barbie was getting picked up to get a biopsy done on a mammary gland mass, when it was discovered she was mistakenly euthanized, said Melissa Farley Law, the dog adoption coordinator at Petaluma Pet Pals, which had found a foster family to care for Barbie. 
She still wants to know whether staff who made the mistakes are being held accountable.
Pietro D'Amico
In April 2013, Pietro D'Amico died at a Swiss assisted suicide clinic, after receiving a wrong diagnosis. An article published in Switzerland's english news service, The Local, stated:
... his family's lawyer Michele Roccisano told Italian newspaper Corriere della Sera. 
An autopsy carried out by the University of Basel’s Institute of Forensic Medicine found that D’Amico was not suffering from a life-threatening illness at the time of his death. 
Roccisano has called on the Italian and Swiss authorities to examine D’Amico’s medical records to determine what went wrong.
Did the D'Amico family ever find out what went wrong?

The next article concerned the resignation of the Louisville Metro Animal Services Director, Jessica Montgomery, who had illegally euthanized a dog. According to the Insider Louisville news Montgomery was not certified to do euthanasia.

A study published published in the NEJM in March 2015 on the experience with euthanasia in the Flanders region of Belgium indicates that approximately 1000 Belgian deaths were hastened without explicit request in 2013. A similar study that was published in the CMAJ in May 2010 found a nearly identical percentage of Belgian deaths that were hastened without explicit request in 2007.

The final article concerned grieving that many people experience after the euthanasia death of a pet. According to the Long Beach Post:
The loss of a pet is sometimes not appreciated by those who have had no similar experiences or can’t relate to a pet as a loved one. When a loss happens, there are steps to deal with the pain. The first thing to realize is that your feelings of grief and sadness are real.
Tom Mortier's depressed mother died by euthanasia in April 2012. Mortier was completely shocked and traumatized by her euthanasia death.

Society has long understood that there are abuses of euthanasia related to animals. Should humans not also be concerned?

Wednesday, July 13, 2016

Utah's assisted suicide bill encourages people with years to live to throw away their lives


CHOICE IS AN ILLUSION, A NONPROFIT CORPORATION
1001 4th Avenue, Suite 4400
Seattle WA 98154

Wednesday, July 13, 2016

FOR IMMEDIATE RELEASE

Dore: "Utah’s assisted suicide bill, if enacted, will allow the perfect crime. The law will encourage people with years to live to throw away their lives."
Contact: Margaret Dore (206) 697-1217

Salt Lake City, UT -- Attorney Margaret Dore, president of Choice is an Illusion, which has fought assisted suicide legalization efforts in many states, and now Utah, made the following statement in connection with a bill pending before the Utah Legislature. (HB 264).

“The bill has an application process to obtain the lethal dose,” said Dore. “The process includes a written lethal dose request form with two required witnesses. One of the witnesses is allowed to be the patient’s heir who will financially benefit from the patient’s death.”

"A central problem with the bill is that a person assisting a suicide can have his or her own agenda," Dore said. "For example, if the person will financially benefit from the patient's death due to an inheritance, he or she will have a potential motivation to be sure that the death goes through. This may or may not be consistent with the patient's choice."

"This central problem is exacerbated by bill provisions that strip away existing patient rights. Dore explained, "Under current Utah law, patients have a right to informed consent regarding treatment alternatives. Under the proposed bill, patients instead have the right to an 'informed decision,’ which limits their right to information. More to the point, they have no right to be told about alternatives for cure or to extend life."

Dore said, "Another problem is that the bills allow someone else to speak for the patient during the lethal dose request process." Dore elaborated, "There is no requirement that speaking person be the patient's designated agent, for example, through a power of attorney. The person is merely required to be 'familiar with the patient's manner of communicating,' for example, that the patient communicates with a stutter. This is obviously not a sufficient standard for a life and death decision."

“After the lethal dose is issued by the pharmacy, there is no oversight,” Dore said. “No doctor, not even a witness, is required to be present at the death. This creates the opportunity for someone else to administer the lethal dose to the patient without his or her consent. If the patient objected or even struggled, who would know? The bill allows the perfect crime."

"The bill seeks to legalize assisted suicide for people who are 'terminal,' which is defined as a doctor's prediction of less than six months to live," Dore said. "In real life, such persons can have years, even decades, to live. This is due to actual mistakes: The doctor evaluated another patient's test results. More typically, doctors are wrong because predicting life expectancy is not an exact science."

Dore concluded, "Utah’s assisted suicide bill, if enacted, will allow the perfect crime. The law will encourage people with years to live to throw away their lives."

-00-

For more information:

1. Legal/policy analysis of HB 264, which can be viewed at these links:
https://choiceisanillusion.files.wordpress.com/2016/07/utah-memo-only-hb-264-07-12-16.pdf https://choiceisanillusion.files.wordpress.com/2016/07/utah-attachments-only.pdf

2. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
3. Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide-once they’ve determined that the patient has only six months to live. But what if they’re wrong?" Seattle Weekly, 01/14/09, available at: https://choiceisanillusion.files.wordpress.com/2015/08/terminal-uncertainty-w-o-ad.pdf

www.margaretdore.com
www.choiceillusion.org

Choice Is An Illusion is a human rights organization, working to keep assisted suicide and euthanasia out of your state, and out of your life

Tuesday, July 12, 2016

Assisted Dying: What can we learn from places where it is legal.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Baroness Ilora Finlay
Professor Ilora Finlay wrote an excellent article that was published in the Guardian today titled: Assisted Dying: What can the UK learn from places where it is legal.

Last year the British parliament overwhelmingly defeated an assisted suicide bill. Finlay responded to the push to legalize assisted suicide with this article. 

Finlay first analyzes the Oregon experience with assisted suicide. She writes:
In 1997 the US state of Oregon licensed doctors to supply lethal drugs to terminally-ill patients who met certain conditions – that they had less than six months to live, had mental capacity and were acting voluntarily. 
Up to 2013 there was a steady overall upward trend in the numbers of such assisted suicide deaths. But from 2013 there has been a marked upturn. The two years 2014 and 2015 saw an 80% increase in deaths of this nature: there are now more than eight times the number than when the law came into force. 
There are other concerns too. There is “doctor shopping”, whereby people whose doctors won’t participate in assisted dying (and two out of three won’t) seek lethal drugs from other doctors who are willing but have never met them before and know nothing about them beyond case notes. One such doctor issued no less than 27 prescriptions for lethal drugs in 2015 alone. 
Prognosis of terminal illness is fraught with difficulty. The reports from Oregon illustrate this. They show that some people who had been supplied with lethal drugs on the basis of a prognosis of six months or less lived for up to three years before taking them. How long they might otherwise have lived is anybody’s guess.
Baroness Finlay then looks at the experience with assisted dying in the Netherlands.
What of the Netherlands? Their 2002 legislation also permits physician-administered euthanasia – where a doctor injects lethal drugs (coma-inducing drugs plus, often, a paralysing agent to cause death by asphyxia). The Netherlands’ assisted death rate also rose modestly at first before turning sharply upwards. Last year euthanasia or assisted dying accounted for one in 26 of all deaths in the Netherlands: that’s the equivalent of over 20,000 deaths annually in the UK. 
The Dutch official reports also reveal legislative drift. Increasing numbers of people were euthanised last year because of psychiatric illness (56 cases) or dementia (109 cases). In 2015 euthanasia was administered to a young woman suffering from post-traumatic stress disorder and anorexia nervosa who had been sexually abused as a child. Dutch campaigners want to make suicide drugs available to people who aren’t ill at all, just tired of life.

Dutch legislators simply didn’t envisage this in 2001 when they enacted the Termination of Life on Request and Assisted Suicide Act – a title that is at least upfront and honest and avoids the sugar-coated euphemisms (like assisted dying) that are used here to cloak the realities.
Professor Finlay finishes by stating:
... Campaigners in the UK claim they only want Oregon-style physician-assisted dying for the terminally ill. But such criteria are purely arbitrary and contain within themselves the seeds of their own expansion. ... The limited criteria we are seeing look more like an unpacking of assisted dying in an attempt to get it through the door of a skeptical parliament. If we are wise, we will learn from the experience of others rather than from our own mistakes.

Ilora Finlay is professor of palliative medicine at Cardiff University and has taught end-of-life care internationally. She is a crossbench Peer in the House of Lords; her private member’s Access to Palliative Care Bill is before parliament. She co-chairs the independent think-tank Living and Dying Well.