Saturday, October 31, 2009

Switzerland considers implementing restrictions to assisted suicide - possibly banning suicide tourism.

There have been many articles in the mainstream media showing how the Swiss law that allows assisted suicide is out-of-control and causing a concern for the Swiss government.

On October 28, Reuters reported that the Swiss government is looking to change the assisted suicide law to make sure that it is only used as a “last resort” for terminally ill people and that they would like to limit “suicide tourism”.

The issue of “Suicide Tourism” has become embarrassing for the Swiss due to the large number of high-profile suicide tourists from the UK, some of whom are not terminally ill, but simply tired of living and some cases were people who appear to be depressed.

The recent Canadian case of the couple from British Columbia who were seeking permission to die together at the Dignitas clinic in Switzerland was particularly distressing. The husband had a chronic health condition and his wife was perfectly healthy.

The Swiss Justice Minister stated at a news conference in Berne:
“We have no interest, as a country, in being attractive for suicide tourism,”
A heated debate on the issue of suicide tourism has erupted in Switzerland due to the rise of suicide tourism and due to a study last year that indicated that many of the people who go to Switzerland for assisted suicide are not terminally ill.

The Swiss cabinet is divided on the issue. In response to their concerns they have made two proposals for a consultation that will continue until March 1, 2010. The first proposal is to tighten regulations and the second proposal is an outright ban on suicide tourism.

The Swiss Justice Ministry stated that the government did not want to change the law but assisted suicide groups have increasingly tested the boundaries of the law creating an urgent need for guidelines.

Assisted suicide groups Dignitas and Exit have opposed the government proposals and have stated that they will seek a referendum on the topic if the law is tightened or if “suicide tourism” is banned.

The proposal to ban suicide tourism is based on the concerns of the Justice Ministry that:
“... individuals working in assisted suicide organisations are never actually motivated by purely altruistic reasons, and may develop a close relationship with the suicidal person.” they added “Suicide must only be a last resort. The government believes that the protection of human life must be uppermost.”

The government has stated that:
“Assisted suicide should be restricted to terminally ill and not be available to chronically or mentally ill individuals.” The government stated that they: “wanted to promote palliative care and suicide prevention.”

The Euthanasia Prevention Coalition is hopeful that the Swiss government will restrict assisted suicide. Some media reports have indicated that the Swiss government might severely restrict assisted suicide, but the actual quotes from the Swiss government indicate that they want to eliminate “suicide tourism” and restrict assisted suicide to people who are terminally ill. Nonetheless, this is a step forward.

Join Steve Passmore's on Nov. 16 as he protests Bill C-384

Bill C-384 was introduced by Bloc MP Francine Lalonde on May 13, 2009 to legalize euthanasia and assisted suicide in Canada. This was her third attempt to legalize euthanasia and assisted suicide with her previous two attempts dying on the order paper, without going to a vote, after elections were called.

On October 2, C-384 received its first hour of debate. C-384 is tentatively scheduled to receive its second hour of debate on Nov 16and it is tentatively scheduled to be voted-on at second reading on Nov 18.

Steve Passmore, a disability rights advocate who was born with cerebral palsy, will be protesting C-384 near the steops on parliament hill while it is being debated in the house on Monday November 16. His protest will go from 10:30 am to 12:30 (noon).

Passmore protested the first hour of debate of on October 2nd and is hoping that many people with disabilities and others will join his protest of C-384.

We expect that C-384 will be defeated by a significant margin. We are not resting. We need to continue putting pressure on MP’s in order to ensure that we strongly defeat C-384.

Mom charged with first-degree murder in the death of her autistic son.

The Toronto Sun reported on October 26 that a Mississauga woman was charged with the killing of her 15-year-old autistic son.

The report stated that the body of Tony Khor was found after Peel police were called to the Homewood Suites Hotel on Edwards Blvd., in the Hurontario St.-Hwy. 401 area, around 11 a.m. yesterday.

Const. J.P. Valade refused to say who called police, but sources confirmed the woman called authorities, saying the boy was dead.

Valade said the suspect and her husband had a domestic argument Saturday night. While she wasn't physically hurt, she apparently felt that she needed to leave the home and she booked a room at the hotel for her and her son, he said.

"Sometime between (Saturday) evening and (Sunday) morning," the teen was killed, Valade said.

Police said there were signs of trauma on the boy's body, but didn't release any details. Results from an autopsy have not been released.

Homicide detectives allege the boy's murder was premeditated and charged the boys mother with first-degree murder.

Police didn't reveal the severity of Khor's autism. The family is not known to police and Khor is the couple's only child, Valade said.

A similar incident happened more than a decade ago in Montreal where Charles Blais, an autistic boy, was killed by his mother. Blais's mom was charged but when prosecuted she was given a suspended sentence.

Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition commented that these cases are particularly distressing because the autistic son will normally completely and totally trust and depend on his mother.

"My fourteen year-old son is autistic and I feel particularly connected to cases where a parent of an autistic child injures or kills there child, said Schadenberg. I understand the challenges in raising an autistic child and I do not claim to be a perfect parent but the thought of killing an autistic child is abhorent."

We cannot make a judgement on this case without further information. It is possible that Khor's mother was experiencing a total mental breakdown, but even if that were true the court should not consider autism as a mitigating factor but rather society needs to extend special legal protection to people with disabilities because of their vulnerable nature.

http://www.torontosun.com/news/torontoandgta/2009/10/25/11522176.html

Wednesday, October 21, 2009

Media Release from the Canadian Hospice Palliative Care Association and the Alzheimer Society

Let's Talk about the Right to Hospice Palliative Care Instead

(October 19, 2009 - Winnipeg, Manitoba) After a five year battle with cancer, Robert was told he had three months to live. He and his wife were unsure what to expect, and their 23 year-old child had not yet accepted his father's impending death. They asked for advice from a neighbour who worked in hospice palliative care. Her first question was "What do you want your last month of life to look like?" No one had ever asked Robert that question so he found it hard to answer.

What would he want or need at the end of life? Would he suffer pain and need medication to manage his symptoms? Would he and his wife need help at home? What did he want to do with those days? What decisions would he have to make?

Like Robert, many Canadians are unsure what to expect at the end-of-life. This uncertainty often leads people to question how they want to die, and whether they should have more control over their dying. In our society, it can lead to a focus on controversial issues, such as euthanasia and physician assisted suicide.

The Canadian Hospice Palliative Care Association (CHPCA), the Canadian Society of Palliative Care Physicians and the Alzheimer Society of Canada believes it's time to refocus the debate on the right to have high quality hospice palliative care for all Canadians at the end of life.

What is high quality hospice palliative care? It is care that aims to relieve suffering and improve the quality of living and dying. It strives to help patients and families meet all their physical, psychological, social, spiritual and practical needs at the end of life, and cope with loss and grief. High quality hospice palliative care includes treatment for conditions that can be treated, care to prevent people from developing other health problems, and opportunities for meaning and spiritual growth.

High quality hospice palliative care can give people a greater sense of meaning and control over their lives. It helps people plan for end of life, and gives them choices about when and for how long they want treatment, medications, food or ventilator support. It recognizes that people have the right to refuse treatment and that loss of appetite is a normal stage in dying. Hospice palliative care also offers many ways to control and manage pain and other symptoms. It provides psychological and spiritual support to address the suffering of patients and their families.

The Quality End-of-Life Care Coalition of Canada (QELCCC) believes that all Canadians have a right to die with dignity, free of pain, surrounded by their loved ones, in the setting of their choice.

We also believe that every health care provider should have basic competency in providing end-of-life care and that every health care institution should ensure quality at the end of life for all of those who will die in institutions. We believe that the option of staying at home as long as is possible, and perhaps dying at home as most Canadians wish, needs to be supported with increased resources and specialized hospice palliative care resources.

Each year, more that 259,000 Canadians die[2] and, with our aging population, that number will grow. By 2026, 330,000 will die each year. By 2036, more than 425,000 will die.

Will all those Canadians receive high quality hospice palliative care? Right now, only 16% of Canadians who die have access to or receive hospice palliative, and quality end-of-life care services. Too many Canadians die with suffering that could be addressed in a more effective manner.

The CHPCA believes it is time to shift the focus to the right to high quality hospice palliative care at the end of life before we enter into the debate around the contentious issue of euthanasia and physician assisted suicide.

Please refer to the attached list of definitions should you wish clarification on various terms.

Join us for a discussion of hospice palliative care as a human right -- nationally and internationally -- at the closing plenary during the 2009 Canadian Hospice Palliative Care Conference, to be held in Winnipeg, Manitoba, October 18-21 2009.
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For further information, please contact:

Jennifer Kavanagh Joan Lawless
Communications Officer Development Coordinator
jkavanagh@bruyere.org jlawless@manitobahospice.mb.ca
Phone: (613) 882-5365

_____________________________________

Lexicon of Commonly Used Terms

Advance Care Plan - Advance care planning is a process of reflection and communication in which a person who is capable, makes decisions about future health and personal care in the event that they become incapable of giving informed consent. It involves:
- Thinking about what gives life meaning
- Talking to health care providers, family and friends about future health care wishes
- Thinking about who a person would like to speak for them, when they cannot speak for themselves
- Recording goals and wishes

Advance Directive - a verbal or written statement of the person's future desires in the event that he or she should be unable to communicate his or her intentions in the future.

Allow Natural Death (AND) - "refers to decisions that can be made NOT to have any treatment or procedure that will only delay the moment of death and applies only where death is about to happen from natural causes"[1]

Caregiver - Anyone who provides care.[2]

Formal caregivers are members of an organization and accountable to defined norms of conduct and practice. They may be professionals, support workers, or volunteers. They are sometimes called "providers."

Informal caregivers are not members of an organization. They have no formal training, and are not accountable to standards of conduct or practice. They may be family members or friends.

Do Not Resuscitate (DNR) - an order given by a patient or family, directing medical staff not to start CPR if a person's heart stops beating. It does not mean "do not treat." Until the point when the heart stops beating, aggressive medical interventions may still be used. This also is not a form of assisted dying; the definition is included here only for reference.

Family - Those closest to the patient in knowledge, care and affection. May include:
- the biological family
- the family of acquisition (related by marriage/contract)
- the family of choice and friends (including pets)

Health - "a state of complete physical, mental, and social well-being and note merely the absence of disease or infirmity."[3]

Hospice Palliative Care - Hospice Palliative careaims to relieve suffering and improve the quality of living and dying.[4]
Hospice palliative carestrives to help patients and families:
address physical, psychological, social, spiritual and practical issues, and their associated expectations, needs, hopes and fears prepare for and manage self-determined life closure and the dying process. Cope with loss and grief during the illness and bereavement.
Hospice palliative care aims to: treat all active issues prevent new issues from occurring promote opportunities for meaningful and valuable experiences, personal and spiritual growth, and self-actualization.

Pain - An individual, subjective, unpleasant sensory and emotional experience that is primarily associated with tissue damage or described in terms of tissue damage, or both (Adapted from the International Association for the Study of Pain - see http://www.iasp-pain.org/dict.html#RTFToC25).[5]

Proxy - A person or agency of substitute recognized by law to act for, and in the best interest of the patient.

Quality of Life - "meaningful and valuable experiences" and "the capacity to have such experiences."[6]

Suffering - A state of distress associated with events that threaten the intactness of a person. It may be accompanied by a perceived lack of options for coping.[7]

Total pain - Suffering related to, and the result of, the person's physical, psychological, social, spiritual, and practical state.[8]

[1] http://www.fraserhealth.ca/Services/HomeandCommunityCare/AdvanceCarePlanning/Pages/Definitions.aspx
[2] Ferris FD, Balfour HM, Bowen K, Farley J, Hardwick M, Lamontagne C, Lundy M, Syme A, West P. A Model to Guide Hospice Palliative Care. Ottawa, ON: Canadian Hospice Palliative Care Association, 2002.
[3]World Health Organization (WHO) Definition of Health, http://www.who.int/aboutwho/en/definition.html.
[4]Ferris FD, Balfour HM, Bowen K, Farley J, Hardwick M, Lamontagne C, Lundy M, Syme A, West P. A Model to Guide Hospice Palliative Care. Ottawa, ON: Canadian Hospice Palliative Care Association, 2002.
[5] Ibid.
[6] Ibid.
[7] Ibid.
[8] Ibid.


Parlons plutôt du droit aux soins palliatifs

(Le 19 octobre, 2009 - Winnipeg, Manitoba) Après avoir lutté contre le cancer pendant cinq ans, Robert a appris qu'il lui restait trois mois de vie. Lui et sa femme n'étaient pas certains de ce qu'ils devraient prévoir, et leur fils de 23 ans n'avait pas encore accepté la mort imminente de son père. Ils ont demandé conseil à une voisine qui travaille dans le domaine des soins palliatifs. Sa première question était : « Comment voulez-vous que se passe votre dernier mois de vie? » Personne n'avait jamais posé cette question à Robert, il a donc trouvé qu'il était difficile d'y répondre.

Que voudrait-il ou de quoi aurait-il besoin à la fin de sa vie? Est-ce qu'il souffrirait de la douleur et aurait-il besoin de médicaments pour gérer ses symptômes? Lui et sa femme auraient-ils besoins d'aide à la maison? Que voulait-il faire de ses journées? Quelles décisions devraient être prises?

Comme Robert, beaucoup de Canadiens ne sont pas certains de ce qu'ils devraient prévoir à la fin de la vie. Cette incertitude mène souvent les gens à s'interroger sur la façon dont ils veulent mourir et à se demander s'ils devraient avoir davantage de contrôle sur leur mort. Dans notre société, cela peut mener à s'orienter sur des questions controversées, comme l'euthanasie et le suicide médicalement assisté.

L'Association canadienne de soins palliatifs (ACSP), la Société canadienne des médecins de soins palliatifs et la Société Alzheimer du Canadacroient qu'il est temps de réorienter le débat sur le droit qu'ont tous les Canadiens de recevoir des soins palliatifs de grande qualité à la fin de la vie.

Qu'est-ce que des soins palliatifs de qualité? Ce sont des soins qui visent à soulager la souffrance et à améliorer la qualité de la vie et de la mort.[1] Ils ont pour but d'aider les patients et les familles à répondre à tous leurs besoins physiques, psychologiques, sociaux, spirituels et pratiques à la fin de la vie. De plus, les soins palliatifs les aident à composer avec la perte, le chagrin et le deuil. Les soins palliatifs de grande qualité comprennent les traitements pour les maladies qui peuvent se soigner, les soins qui permettent d'empêcher aux gens de développer d'autres problèmes de santé et les occasions de trouver un sens et de s'épanouir sur le plan spirituel.

Les soins palliatifs de grande qualité peuvent donner un sens à la vie des gens ainsi qu'un plus grand sentiment de contrôle sur leur vie. Ils permettent d'aider à planifier la fin de la vie et donnent des choix sur le moment et la durée pendant laquelle les gens veulent recevoir des traitements, des médicaments, de la nourriture ou le soutien par ventilateur. Ils reconnaissent le droit qu'ont les gens de refuser un traitement et le fait que la perte d'appétit est un stade normal du cheminement vers la mort. Les soins palliatifs offrent aussi plusieurs façons de contrôler et de gérer la douleur et les autres symptômes. Ils fournissent un soutien psychologique et spirituel en vue de répondre à la souffrance des patients et des familles.

La Coalition pour des soins de fin de vie de qualité du Canada (CSFVQ) croit que tous les Canadiens ont le droit de mourir avec dignité, sans douleur, entourés de leurs proches et dans le milieu de leur choix.

Nous croyons aussi que chaque fournisseur de soins de santé devrait avoir des compétences de base en matière de prestation de soins de fin de vie, et que chaque établissement de soins de santé devrait s'assurer de la qualité de la fin de la vie de toutes les personnes qui mourront dans ces établissements. Nous croyons que l'option de rester à la maison aussi longtemps que possible, et peut-être de mourir à la maison comme le souhaitent la plupart des Canadiens, doit être soutenue à l'aide d'une augmentation des ressources et en offrant des ressources spécialisées en soins palliatifs.

Chaque année, plus de 259 000 Canadiens meurent et, compte tenu du vieillissement de notre population, ce nombre va s'accroître. D'ici 2026, 330 000 personnes mourront chaque année. D'ici 2036, plus de 425 000 personnes mourront chaque année.

Est-ce que tous ces Canadiens recevront des soins palliatifs de grande qualité? À l'heure actuelle, seulement 16 % des Canadiens qui meurent ont accès ou reçoivent des soins palliatifs et des soins de fin de vie de qualité. Trop de Canadiens meurent dans une souffrance qui pourrait être soulagée de manière plus efficace.

L'ACSP croit qu'il est temps de mettre l'accent sur le droit de recevoir des soins palliatifs de grande qualité à la fin de la vie, avant de lancer le débat sur la question litigieuse de l'euthanasie et du suicide médicalement assisté.

Veuillez consulter la liste ci-jointe des définitions si vous souhaitez obtenir une clarification sur différents termes.

Joignez-vous à nous pour une discussion sur les soins palliatifs en tant que droit humain - à l'échelle nationale et internationale - lors de la séance plénière de clôture du Congrès canadien de soins palliatifs 2009, qui se tiendra à Winnipeg, au Manitoba, du 18 au 21 octobre 2009.

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Pour obtenir plus d'informations, veuillez communiquer avec :

Jennifer Kavanagh Joan Lawless
Agente des communications Coordonnatrice du développement
jkavanagh@bruyere.org jlawless@manitobahospice.mb.ca
Téléphone : (613) 882-5365
__________________________________

Lexique des expressions et termes courants

Directive préalable - Une déclaration verbale ou écrite des futurs désirs de la personne dans le cas où elle serait incapable de communiquer ses intentions à l'avenir.

Permettre la mort naturelle - « Fait référence aux décisions qui peuvent être prises pour NE PAS recevoir de traitement ou subir de procédure qui retarderont le moment de la mort, et cela s'applique seulement quand la mort est sur le point de survenir en raison de causes naturelles. »[1]

Ne pas réanimer - Une ordonnance donnée par le patient ou la famille, indiquant au personnel médical de ne pas commencer la réanimation cardio-respiratoire (RCR) si le cœur de la personne s'arrête. Cela ne signifie pas « ne pas traiter ». Les interventions médicales agressives peuvent encore être utilisées jusqu'au moment où le cœur s'arrête. Ce n'est pas une forme d'aide à la mort; la définition est incluse ici seulement à titre de référence.

Douleur - Expérience sensorielle et émotionnelle désagréable liée à une lésion tissulaire existante ou potentielle, ou décrite en termes d'une telle lésion. (D'après l'Association internationale de l'étude sur la douleur. http://www.iasp-pain.org/dict.html#RTFToC25).[2]

Mandataire, tuteur ou curateur - Personne ou organisme substituts, légalement habilités à agir au nom du patient pour défendre au mieux ses intérêts.

Planification préalable des soins- La planification préalable des soins est une démarche de réflexion et de communication qu'entreprend une personne dite apte, afin de prendre des décisions concernant les soins de santé et soins personnels qu'elle pourrait nécessiter plus tard, dans l'éventualité où elle ne serait plus en mesure de donner un consentement éclairé. Cette démarche procure aux gens l'occasion de:
- réfléchir à ce qui donne du sens à leur vie;
- discuter avec des professionnels de la santé et leurs proches de leurs volontés en matière de soins de santé;
- réfléchir à qui pourrait parler en leur nom s'ils en deviennent incapables;
- consigner leurs objectifs et leurs volontés.

Proche - Les personnes ayant un lien significatif selon le patient.[3]

Elles comprennent :
- la famille biologique
- la famille par alliance (liée par le mariage / par contrat et conjoint de fait)
- la famille choisie, des amis, des animaux familiers
Le patient désigne qui est associé à ses soins et peut rester à son chevet.

Qualité de vie - État de bien-être défini par chaque individu. Concerne les expériences importantes et valorisantes pour l'individu, et sa capacité de vivre ces expériences.[4]

La santé - "« un état de complet bien-être physique, mental et social, et [elle] ne consiste pas seulement en une absence de maladie ou d'infirmité »"[5]

Soignant : Toute personne qui fournit des soins ou services.[6]

Soignant naturel : Toute personne qui ne fait pas partie d'un établissement ou d'un organisme. Elle n'a pas de formation structurée et n'est pas tenues de respecter un code de déontologie ou des normes de pratique. Elle peut être un membre de la famille ou avoir des liens d'amitié.[7]

Les soins palliatifs : Ils visent à soulager la souffrance, à améliorer la qualité de vie et à accompagner vers le décès.[8]

Les soins palliatifs sont prodigués pour aider les patients et leurs proches à : faire face aux problèmes physiques, psychologiques, sociales, spirituels et pratiques de la maladie, ainsi qu'aux attentes, besoins, espoirs et craintes qui y sont associés; se préparer à accomplir les tâches de fin de vie définies par le patient et à affronter l'étape de la mort; surmonter les pertes et la peine pendant la maladie et le deuil.

Les soins palliatifs visent à : traiter tous les problèmes qui surviennent; prévenir l'apparition de nouveaux problèmes; promouvoir les occasions d'expériences enrichissantes, de croissance personnelle et spirituelle, et d'accomplissement individuel.

Souffrance - État de détresse associé à des événements qui menacent l'intégrité d'une personne et qui sont accompagnés par la perception qu'on n'a pas de choix pour s'adapter.[9]

Souffrance globale - Souffrance multidimensionnelle en rapport avec l'état physique, psychologique, social, spirituel et pratique de la personne, ou qui résulte de cet état.[10]


[1] http://www.fraserhealth.ca/Services/HomeandCommunityCare/AdvanceCarePlanning/Pages/Definitions.aspx
[2]Ferris FD, Balfour HM, Bowen K, Farley J, Hardwick M, Lamontagne C, Lundy M, Syme A, West P. Modèle de guide des soins palliatifs. Ottawa (Ontario). L'Association canadienne de soins palliatifs, 2002.
[3] Ibid.
[4] Ferris FD, Balfour HM, Bowen K, Farley J, Hardwick M, Lamontagne C, Lundy M, Syme A, West P. Modèle de guide des soins palliatifs. Ottawa (Ontario). L'Association canadienne de soins palliatifs, 2002.
[5] Définition de la santé de l'Organisation mondiale de la santé (OMS) http://www.who.int/.
[6]Ferris FD, Balfour HM, Bowen K, Farley J, Hardwick M, Lamontagne C, Lundy M, Syme A, West P. Modèle de guide des soins palliatifs. Ottawa (Ontario). L'Association canadienne de soins palliatifs, 2002.
[7] Ibid.
[8] Ibid.
[9] Ibid.
[10] Ibid.

Wednesday, October 14, 2009

Internet Suicide Predator loses nursing license

An article published in the Pioneer Press in Minnesota updates the case of William Melchert-Dinkel who admits to being involved with at least 5 cases where he acted as a predator via the internet to convince someone to commit suicide.

Link to the article: http://www.twincities.com/topstories/ci_13555747?nclick_check=1

Melchert-Dinkel
The article explains that Melchert-Dinkel has lost his license as a practical nurse.

The article also states that he went to a hospital emergency room the day (January 7) he was questioned by police and he told medical professionals that he was addicted to suicide chat rooms.

As part of the revocation order, the nursing board stated that Melchert-Dinkel "aided suicide ... by encouraging and advising individuals to commit suicide." in violation of Minnesota law.

Nadia Kajouji
The article explains that an 18-year-old Canadian woman (Nadia Kajouji) took her life after communicating online with Melchert-dinkel. The article also connects him to the death of a 32-year-old person from the UK.

The article explains that the investigation into his crimes continues, even though no charges have been layed.

The nursing board documents also cited several other serious problems with Melchert-Dinkel over the past 15 years.

Celia Blay, who was featured in the CBC television program - Fifth Estate - on this issue stated that she counted a minimum of eight suicides that are connected to Melchert-Dinkel and she further stated that she would be surprised if it wasn't double figures.

In Canada Harold Albrecht MP (Kitchener - Connestoga) has introduced Motion 388 to clarify the criminal code concerning internet suicide predators. Motion 388 had its first hour of debate on September 30, 2009 and will receive its second hour of debate on November 5, 2009. We expect Motion 388 will receive a huge majority of the vote in parliament.

The Euthanasia Prevention Coalition asks the question: Why has William Melchert-Dinkel not been charged in Canada under Section 241 of the Criminal Code - assisted suicide? Under Canadian law Melchert-Dinkel should be extradited to Canada to face trial.

Tuesday, October 13, 2009

Federation des medecins specialistes du Quebec - Survey on Euthanasia

The Federation of medical specialists of Quebec have released a survey of their members that indicates that a large majority of medical specialists in Quebec appear to support euthanasia.

When reading the survey I am absolutely convinced that a large number of physicians in Quebec are unsure of what euthanasia is or is not.

For instance, the survey showed that 48% of the respondents thought that palliative sedation can be likened to a form of euthanasia. The fact is that palliative sedation is not euthanasia.

Euthanasia is the direct and intentional cause of death, whereas palliative sedation is the sedation of a person in order to eliminate their suffering. The proper use of palliative sedation does not cause death, but rather it eliminates suffering.

The confusion surrounding the use of large doses of analgesics is similar to the problem with the statement by the Quebec College of Physicians in July that confused the use of large doses of analgesics with euthanasia. The proper use of large doses of analgesics is not euthanasia unless the physician has clearly done so outside of the accepted guidelines with the intention of causing death.

Read my comments on the Quebec College of Physicians statement from July: http://alexschadenberg.blogspot.com/search/label/Quebec%20College%20of%20Physicians

Clearly we are concerned that such a large number of medical specialists in Quebec support euthanasia.

Physicians in Quebec are clearly moving in the wrong direction. The Quebec College of Physicians and other physicians groups in Quebec should be focusing on improving end-of-life care rather than considering the legalization of euthanasia. When so many Quebecers are not receiving effective pain and symptom management then really are the Quebec physicians actually offering their patients a choice?

Secondly, the survey suggests that physicians support euthanasia within a clearly defined legal framework. The fact is that with negative attitudes towards people with disabilities, and the incidence of elder abuse continues to significantly rise in our culture, the question is: can their ever be adequate safeguards to protect the vulnerable.

Finally, the legalization of euthanasia and assisted suicide does not give a person - the right to die but rather to legalize euthanasia gives the physician the right to directly and intentionally cause the death of a person. Legalizing euthanasia confers new rights to the physician and enables a physician to cover-up intentional acts that cause death.

When we consider the vulnerable nature of people who are being considered for euthanasia, the answer is to Care and not to Kill.

For more information contact:
Euthanasia Prevention Coalition - 1-877-439-3348
or website: www.euthanasiaprevention.on.ca or email: euthanasiaprevention@on.aibn.com

Wilberforce Weekend - Session on Euthanasia and Assisted Suicide

The Wilberforce Weekend (November 13, 14 at the University of Ottawa) is one of the most important events that have ever been co-organized by the Euthanasia Prevention Coalition. The Wilberforce Weekend is being organized with the Manning Centre for Building Democracy along with several other groups who helping to make this weekend a tremendous success.

The Wilberforce Weekend is a national seminar to explore and enhance transformative cultural and public policy advocacy supporting people with disabilities, those who are chronically ill, dying, or otherwise medically at risk.

The Wilberforce Weekend will examine the culturally transformative campaign by William Wilberforce in England to outlaw slavery. The culturally effective methods that were developed by Wilberforce would then be examined within the framework of changing our cultural attitudes in relation to euthanasia and assisted suicide. This weekend will bring together people from different perspectives

The cost for attending is $99 per person or $49 for students or people with disabilities. To register go to: http://www.manningcentre.ca/en/activity_description/57

Hotel accommodations can be arranged directly at the Novotel Ottawa, 33 Nicholas Street, Ottawa, ON, K1N 9M7, 613-230-3033, www.novotelottawa.com. The group reservation name is Wilberforce Weekend Ottawa, Booking code: 15981. The special rate cut-off date is October 21. The special rate is $119 per night.

We have had 3 people contact us needing sponsorship to attend. They are young people who are involved with ministry in the Ottawa area, but not students. Please consider donating $99 to the Euthanasia Prevention Coalition to make this possible.

Alex Schadenberg
Euthanasia Prevention Coalition
Box 25033, London ON N6C 6A8
Toll free: 1-877-439-3348
website: www.euthanasiaprevention.on.ca
email: euthanasiaprevention@on.aibn.com

Saturday, October 10, 2009

Kajouji featured on Fifth Estate TV program


The suicide death of Nadia Kajouji was featured on the Fifth Estate tonight. Link to the web: http://www.cbc.ca/canada/ottawa/story/2009/10/09/ottawa-kajouji-fifth-estate-diary-suicide.html

Kajouji died by suicide after being pressured by an internet suicide predator named William Melchert Dinkel from Minnesota.

No arrest has been made but Harold Albrecht MP introduced Motion 388 into the parliament of Canada to clarify whether Section 241 - assisted suicide law - applies to Internet Suicide Predators such as Melchert Dinkel.

Thursday, October 8, 2009

Motion 388 receives its first hour of debate

Are Internet Suicide Predators protected by the language of the law?

Nadia Kajouji
Harold Albrecht MP introduced Motion 388 to encourage the government to clarify Section 241 of the Criminal Code in order to ensure that the law applies to Internet suicide predators.

In March 2008, Nadia Kajouji killed herself after being encouraged and counseled by William Melchert-Dinkel, a licensed practical nurse in Minnesota.

In response to a plea by Kajouji's mother, Albrecht introduced M388 to clarify the assisted suicide law and to address the crime of online suicide counseling, which has led to Nadia and other young people committing suicide after being urged by predators via the Internet.

In his speech at the House of Commons, Albrecht presented several key points.

Nadia's mother
His first point was concerning the role of Section 241 of the Criminal Code. He stated, "Our society has long recognized that vulnerable people require the protection of the law. That is the purpose behind Section 241 of the Criminal Code which makes it illegal to counsel someone to commit suicide."

He then spoke about the concerns related to depression and the vulnerable person. He stated, "Each of us in this chamber has gone through periods of discouragement and perhaps depression, or at least we have family members and friends who struggle with depression and mental health issues. For some people these downtimes might be a fleeting emotion that lasts only for a few hours or days. For others, it may drag on for weeks, months or even years. In these times of feeling overwhelmed, discouraged or depressed, many have had the thought of ending it all in order to avoid the ongoing pain."

Harold Albrecht
Albrecht then explained Nadia's story. "In March 2008 in Ottawa, Nadia, a Carleton University student, was going through a period of depression when an Internet predator encouraged her to take her life. … The online friend turned out to be a 46-year-old licensed practical male nurse from Minnesota who allegedly lurked as a predator in online chat rooms. He also admitted to Minnesota police that he coaxed at least five different people to commit suicide using the Internet."

Albrecht then quoted Nadia's mother who stated, "One thing that has now been brought to light is that this predator is not alone. There are many more just like him out there. And when things go wrong in our lives, or in the lives of the people we love, they'll be out there hunting, hunting for the opportune moment."

Albrecht quoted Nadia's mother further by stating, "Stories like this make it necessary to clarify our laws. In our Internet age, we need to make it clear that the use of technology where one might presume to hide behind the anonymity of the Internet is not a defense against prosecution for very serious criminal offenses."

Albrecht concluded his speech by saying, "My concern is for vulnerable Canadians. The changes called for in M388 are needed in order to provide greater protection to those who are at a very vulnerable point in their lives. Predators must be stopped before they repeat their crime. Their destructive deeds will not be tolerated and predators who choose to ignore the deterrent message need to know that they will face severe consequences."

Serge Menard
Serge Ménard (BQ) spoke next, stating that the Bloc supports M388. But he questioned the need for the motion, noting that Section 241 is written in a broad manner.

Albrecht responded by stating that Melchert-Dinkel has not been charged by Canadian authorities and that it is important to give a clear message as a deterrent to those who counsel suicide over the Internet.

Ménard then continued by stating that suicide is the second leading cause of death in Quebec. He then stated, "We believe that it is important to ensure that counselling or aiding and abetting suicide is an offence, no matter the means used - including telecommunications, the Internet or a computer system."

Alex's Note: This comment is especially interesting considering the fact that the Bloc Québecois supports Bill C-384 that would essentially eliminate the protections in Section 241 of the Criminal Code.

Rod Bruinooge
Rod Bruinooge (CPC) spoke in favour of M388 and asked if the motion would act as a push-back to groups attempting to normalize suicide.

Albrecht responded that M388 is only concerned with suicide predators who are taking advantage of vulnerable people, especially youth.

Alan Tonks (Lib) spoke in favour of M388 and expressed his concerns related to the rate of suicide and attempted suicide among youth in Canada.

Joe Comartin
Joe Comartin (NDP) was next to speak in favour of M388. Comartin was clear in his support by stating, "It is quite appropriate and very timely that this motion is before the House. I believe the government, the Department of Justice in particular, needs to be looking into this area and seeing if there are ways that we can tighten up either under the Criminal Code or in other areas to, as much as possible, prevent this type of predatory activity."

Chris Warkentin (CPC) spoke in favour of M388, but emphasized the importance of maintaining a broad interpretation of Section 241 of the Criminal Code.

Motion 388 is tentatively scheduled to receive its second hour of debate on November 5, 2009. To circulate a petition in support of Motion 388, contact Harold Albrechts office at: AlbreH@parl.gc.ca

Monday, October 5, 2009

The first parliamentary debate reveals significant opposition to Bill C-384.

On Friday, October 2, 2009, Bill C-384 -- the private member's bill introduced by Francine Lalonde (BQ) to legalize euthanasia and assisted suicide in Canada -- received its first hour of debate in the House of Commons.

Parliamentary procedure states that a private member's bill receives two hours of debate before being voted on at second reading. C-384 is tentatively scheduled to receive its second hour of debate on November 16, 2009.

Eight Members of Parliament spoke on C-384. Two spoke in favour - Francine Lalonde (BQ), Serge Cardin - (BQ); six opposed the bill - David Anderson (CPC), Hon John McKay (Lib), Jacques Gourde (CPC), Hon Marlene Jennings (Lib), Joe Comartin (NDP), Paul Szabo (Lib).

Francine Lalonde

Francine Lalonde (BQ) led off the debate, explaining how C-384 would work.

"… it amends the Criminal code so that a medical practitioner does not commit homicide just by helping a person to die with dignity if ... the person is at least 18 years of age, continues to experience severe physical or mental pain without any prospect of relief or suffers from a terminal illness. The person must have provided a medical practitioner with two written requests more than ten days apart expressly stating the person's free and informed consent to opt to die."

Lalonde then spoke about the experience of legalizing euthanasia and/or assisted suicide in other jurisdictions including the Netherlands, Belgium and Oregon.

Lalonde continued by focusing on the attitude of the Quebec College of Physicians that appears to be considering a change in their position on the issue. She also spoke about recent polls in Quebec that appear to indicate that the majority of Quebecers support her bill.

She then spoke about palliative care and she emphasized that there are cases when palliative care does not adequately relieve a person's suffering. She quoted a palliative care doctor who appears to support euthanasia.

She then challenged the recent article from a group of 100 physicians in Quebec who oppose C-384 and who oppose the possible change in position by the Quebec College of Physicians concerning euthanasia.

David Anderson

David Anderson (CPC) spoke against C-384, making three main points.

His first point was, "… we need to understand that allowing people to die is a far cry from causing their death."

His second point was, "She talked about the fact that choice exists in other countries. While that is true, many of those countries (Switzerland) have developed death tourism, so that people go there to die. That is not in line with what we want either the heritage or the future of this country to be about."

Anderson's final point was, "It is ironic that she claims that an association for palliative care champions euthanasia. Is this not a complete twisting of the commitment that so many palliative care providers across this country believe in? They believe they are doing good work. They do not believe in euthanasia."

Lalonde responded, "It is about determining whether or not we should, by changing the Criminal Code, allow doctors who so wish -- only those who wish to do so -- to medically end the life of someone who wants to die, who has made that choice, who is at the end of life and who is suffering. That is the only question."

Editor's Note: Lalonde admits that the change to the Criminal Code would allow doctors to end the life of someone. The Euthanasia Prevention Coalition has argued that C-384 is not about a person dying with dignity but rather giving the right to physicians to end a patient's life.

John McKay

John McKay (Lib) made two points.

The first was, "The essential core of this legislation is that it would engage society in the ending of a life. It would engage the doctor and it would engage us as a society."

His second point related to capital punishment. He spoke about how the justice system can make mistakes.

"I would request that the hon. member (Lalonde) respond to the inevitable, the absolute certainty that errors will be made and that therefore she and I and all the rest of us will bear that guilt."

Lalonde responded by speaking about the recent report from Belgium that stated that only people who have requested it and who are suffering are dying by euthanasia.

Jacques Gourde

Jacques Gourde (CPC) spoke against C-384. He was representing the government in his opposition to the bill. He said, "Bill C-384 is too broad in terms of its scope. Bill C-384 proposes to amend the Criminal Code to provide an exemption not only to the offence of assisted suicide, but also to the offence of murder. These amendments would represent a substantial change to the current state of the law on a matter that touches on life and death."

His second point was, "The proposed legalization of medical euthanasia and assisted suicide would not only apply to terminally-ill patients, but also to persons who suffer from severe physical or mental pain without any prospect of relief. Therefore, under this bill, persons who suffer from depression could request that a doctor help them to commit suicide. They could also request that the doctor carry out the act itself that would cause their death."

His third point was concerning the lack of safeguards. "In this respect, Bill C-384 contains a number of vague and undefined terms that could lead to interpretation problems and, therefore, potentially to misunderstandings or abuses."

"For example, terms such as 'while appearing to be lucid', 'appropriate treatment', 'severe physical or mental pain', 'without any prospect of relief' have the potential to be interpreted very subjectively.'

"Under Bill C-384, the doctor who would assist in a suicide or terminate someone's life would only have to provide a copy of the diagnosis to the coroner after the fact. This bill would give a doctor the authority to terminate life on the apparent consent of the patient."

Gourde's next point was, "I know that other countries have struggled with this difficult issue over the years, both in their legislatures and in the courts. While some countries have amended their laws to permit physician-assisted suicide and/or euthanasia, others have not supported such changes. In any event, regardless of what other countries have done, we have to consider what is right for our society."

He concluded by stating, "I would like to reiterate that I do not support this bill. … It raises a number of significant legal and policy concerns and, in my view, would not adequately protect human life. Bill C-384 would also have a major impact on current medical ethics and practice. Such substantial changes to the law should not be considered without extensive advance consultations."

Marlene Jennings

Marlene Jennings (Lib) spoke against the bill by first reading the letter from the Canadian Medical Association opposing C-384. She then argued that the government and previous governments have not followed through on the research studies that need to be done before Canada consider legalizing euthanasia or assisted suicide.

Joe Comartin

Joe Comartin, the NDP Justice Critic, was the next speaker to oppose C-384. His first argument was in relation to palliative care. He stated, "I want to quote from a statement made by Dr. Balfour Mount, whose name I think everybody in the country would recognize as being a leader in palliative care in Canada."

"Mount said he is profoundly against euthanasia because it is simply not needed …."

"What he was saying is that it is not needed in the kind of care he is able to provide and that he has provided for the better part of 30 years, as is the case in my community."

"We need to look at our system right now. … At this point, approximately 20% of our population is covered by meaningful palliative care, hospice and a home care system. That is all we have in the country. Then there is another 15% or maybe 17% who are covered by partial assistance at the end of life."

"However, that is what it is about. It is about providing that system, and we are not doing it."

Comartin then spoke against the very concept of legalizing euthanasia and assisted suicide. "I know there are disputes over this, but it is the analysis that I have brought to bear, and I think it is an accurate one. In spite of how we build that system, and I say that about the legislation my colleague has brought here, that is not what actually happens. Should we make the mistake of passing this kind of legislation, we are in effect giving our approval to doctors who are willing to do this, to family members who want it and to those individuals who are still capable of making a decision. They will simply figure out ways of working around the legislation."

He concluded by saying, "I think we do need a fuller debate on this, but not in this context. It has to be in the context of people living out their natural lives, and what we, as a society and legislators, have to do to ensure that can happen."

Editor's Note: In other words, Comartin says that we need to discuss how people live out their natural life before we discuss how they die.

Serge Cardin

The next speaker was Serge Cardin BQ who supported C-384. He spoke about suffering and the death of his father. He then challenged people who oppose euthanasia based on a faith perspective, by stating, "I can say that in ancient times, the Greeks and the Romans were able to bring the issue of suicide out into the open and ensure that it was part of public discourse and debate. That was in ancient times. They decided to discuss it honestly and openly, to debate the matter. Intolerance of suicide began to take root in the 2nd and 3rd centuries and was heightened under the influence of Christianity. Naturally we do not wish to go against people's beliefs."

Cardin warned the Members of Parliament that if they didn't deal with the issue, more cases would go before the courts, leading to a judicial decision.

He concluded by stating, "I am not trying to convince the members to say yes so that this bill becomes law tomorrow morning. What I am trying to do is convince them to consider, discuss, debate, and improve this bill. In the end, it is not up to us to choose. It is up to the person to say lucidly that, in the event something should happen, they want to have control over their life and, ideally, their death as well.

Editor's Note: Cardin's concluding remarks follow the same point of view of the euthanasia lobby in Canada who have been asking Members of Parliament to vote in favour of C-384 in order to allow it to receive a national debate.

Paul Szabo

The final speech on C-384 was by Paul Szabo (Lib) who spoke against the bill, making two key points.

His first point was related to the nine years he served on the board of the Mississauga hospital. "The issues of informed consent and mental competency, whether the person had all the medical information, or were aware of all the options or if there was coercion by family members or friends, are important issues to take into consideration."

His second point was about what euthanasia actually is. "The bill goes under the moniker of right to die with dignity, but the amendment to the Criminal Code would give a person the right to terminate a life before natural death. It would not give the right to die with dignity to someone. It would give the right of someone to take a life. That is a subtle difference."

He concluded by saying, "I hope as many members as possible will get an opportunity to address this. Palliative care workers are concerned about this. Organizations and hospices are doing their very best to give the best possible care in terrible situations. Disabled in our society are obviously concerned about whether their lives are at risk because someone decides they do not live in dignity."

Editor's Note: The first hour of debate for C-384 went very well. For us to strongly defeat the bill we will need more supporters to write letters, send post-cards, or meet with their MP. Please continue the work.

Saturday, October 3, 2009

People with disabilities protest Bill C-384

Mark Warawa MP with
Steve Passmore
By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On Friday October 2, 2009; Steve Passmore, a man who was born with Cerebral Palsy arrived at Parliament Hill at 12:30 pm to protest Bill C-384. Passmore was innundated by the media, including the CBC and many other reporters representing newspapers and news outlets in Canada. Mark Warawa MP came over to greet Passmore and to assure him that he will be voting against Bill C-384 because the bill threatens the lives of people with disabilities.

Even though the media interviewed Steve Passmore -  why did they completely black-out covering the Bill C-384 debate and the protest by Steve Passmore, a man with a life-long disability?

I am convinced that since the debate in parliament didn't go well for Bloc MP Francine Lalonde and since Steve Passmore understands the issue very well and has experience speaking about euthanasia. The media probably ignored Steve Passmore's message because they would rather report on a  person with a sad and emotionally moving story who supports euthanasia so they can make that story the issue.

The story line concerning the lack of support for Lalonde's third attempt to legalize euthanasia and assisted suicide and the effective comments by Passmore doesn't fit within the framework that the media wants for Canadians.

I wish the media would honestly present the news rather than attempting to create news, and that is why I think that Passmore and Lalonde experienced a media blackout.

The following is the media release from Thursday October 1, 2009.

LONDON, ON, Oct. 1 /CNW/ - Steve Passmore, a person with a disability, will voice his opposition to Bill C-384 - the bill that would legalize euthanasia and assisted suicide - and that represents a threat to persons with disabilities.

Mr. Passmore will be available for media interviews near the front steps of Parliament hill, Ottawa, from 12:30 - 3 pm on Friday, October 2.

His protest is based on the fact that Bill C-384 directly threatens his life and the lives of people with disabilities.

The Euthanasia Prevention Coalition is a broadly based network of groups and individuals working to create an effective social barrier to euthanasia and assisted suicide.

The Euthanasia Prevention Coalition and the Council of Canadians with Disabilities recognize that Bill C-384 directly threatens the lives of people with disabilities.

Thursday, October 1, 2009

Doctors and people with disabilities oppose Bill C-384

The CBC has reported on the press conference that was held at the parliamentary press gallery this morning by Dr. Jose Pereira and Dr. Jean Bartkowiak.

is particularly unique because of his experience as a palliative care professional in Switzerland where he came into personal contact with legal assisted suicide.

The CBC article is fairly good but it doesn't cover enough of the information that Pereira shared with the media about his personal experience but it does present his opposition to Bill C-384 in a very effective manner.

The article also mentions that Steve Passmore will be protesting Bill C-384 on parliament hill tomorrow while it is being debated in the house. Passmore, a man who was born with disabilities, rightly views Bill C-384 as threatening his life and the lives of other people with disabilities.

Link to the article: http://www.cbc.ca/canada/ottawa/story/2009/10/01/ottawa-euthanasia-bill-doctors-pereira.html

The Canadian Medical Association sent a letter to Members of Parliament today explaining why they oppose Bill C-384, the bill that would legalize euthanasia and assisted suicide in Canada. The message was straight forward and written for a general opposition to euthanasia and assisted suicide.

The following is the policy of the Canadian Medical Association on Euthanasia and Assisted Suicide.
http://policybase.cma.ca/dbtw-wpd/Policypdf/PD07-01.pdf