Friday, April 29, 2011

Euthanasia Prevention Coalition to intervene in BC court case that threatens to legalize euthanasia and assisted suicide in Canada.

The BC Civil Liberties Association (BCCLA) has launched a court challenge (the Carter case) to overturn Canada's prohibition of assisted suicide and euthanasia. The Euthanasia Prevention Coalition (EPC) will intervene, when appropriate, in the case. EPC believes that the case should not be given standing by the court; however, if the case proceeds EPC will seek intervention status.

The case is based on Kay Carter, who was diagnosed with spinal Stenosis in 2008. Kay was a member of the euthanasia lobby for many years, and was brought to Switzerland in January 2010, by her daughter Lee Carter and son-in-law Hollis Johnson. She died by assisted suicide at the Dignitas suicide clinic in Zurich. Lee and Hollis claim that they technically broke the law. The case also includes Dr. William Shoichet, a physician in Victoria BC who claims that he is willing assist the suicides of his patients, if the law were changed or struck down by the court.

The BCCLA is attempting to overturn the Criminal code provisions prohibiting euthanasia and assisted suicide by asserting that the law is unconstitutional. The BCCLA hope to bring the case to the Supreme Court with the expectation that the Court will reverse the Rodriguez decision (1993) and strike down the assisted suicide act. They also want to strike down the provisions in the Criminal Code that prohibit euthanasia.

EPC challenges BCCLA’s assertion that the Assisted Suicide Act is unconstitutional. The very basis of their case is incorrect, for several reasons. The Criminal Code does not infringe individual autonomy but rather it protects vulnerable persons. Canada has an interest in protecting its citizens from having death or harm imposed on them. The government must protect elders and people with disabilities from abuse and undue influence.

The BCCLA states in its “Notice of Claim” that the provisions in the Criminal Code that are unconstitutional, in relation to this case are: Sections 14, 21, 22, 222, and 241.

Section 14 states:
no person is entitled to consent to have death inflicted on him, and such consent does not affect the criminal responsibility of any person that inflicts on the person who consents.

Section 21 states:
(1) Every one is a party to an offence who: (a) actually commits it; (b) does or omits to do anything for the purpose of aiding any person to commit it; (c) abets any person in committing it.
(2) Renders two or more persons carry out an unlawful intention to carry out an unlawful purpose and to assist each other to carrying out the common purpose, commits an offence, each of them who knew or ought to have known that the offence would be a probable consequence.
Section 22 states:
(1) and (2) Renders a person who counsels another person to be party to an offense, where the person counselled is thereafter a party to an offence, also a party to the offence.

Section 222 is the homicide provision of the Criminal Code. Euthanasia is defined as a form of homicide.

Section 241 is the assisted suicide provision in the Criminal Code. Section 241 prohibits, aiding, abetting (encouraging) and counselling suicide.

The BCCLA asserts that the Criminal Code prevents people from having control over personal choices. In fact the Criminal Code does not prevent personal choice, but rather it prevents another person from causing death or being involved with causing the death of another person. The Criminal Code prohibits a person from aiding, encouraging or counselling a person to commit suicide and it prohibits a person from directly and intentionally causing the death of another person.

The BCCLA also falsely asserts that withholding medical treatment or care that may result in the death of the person is that same as actively causing the death of a person. The courts have correctly recognized that there is a difference between causing a person’s death and letting them die.

EPC holds that the Criminal Code, when effectively applied, is designed to protect vulnerable people from another person influencing, encouraging, counselling or physically assisting the suicide of a person or directly causing that persons death. The Criminal Code protects people with disabilities from others who may consider their lives as not worth living and it protects seniors and other vulnerable people from the ultimate form of elder abuse, an intended death.

Disability activist, Mark Pickup, from Alberta stated to EPC:
"the newspaper described Kay Carter (89) as a Right to die proponent. She developed spinal stenosis in 2008 which causes "pain, lack of coordination, numbness, loss of bladder and bowel control and paralysis." That was enough reason to overturn laws against assisted suicide? I disagree. I've had those very same symptoms (and many others) throughout my 27 year journey with multiple sclerosis. I want our laws prohibiting assisted suicide to stay in effect and enforced, in case I despair and happen to meet someone like Kay's daughter and son-in-law who agrees with killing me."
Based on negative social attitudes toward people with disabilities and the growing awareness of the social scourge of elder abuse, society must not remove the protections in law that exist to prevent assisted suicide or euthanasia, but rather society needs to uphold and maintain these laws while enhancing the care and protection that is provided for people with disabilities, people with chronic conditions, the frail elderly and those who are nearing death.

Tuesday, April 26, 2011

Pope comments on man in PVS

Pope Benedict, recently had a rare televised interview, where he commented on the difficult case of a man in PVS since April 2009.

He reportedly told the mother of an Italian man who has been in PVS since Easter Sunday 2009 that her son's soul was still in his body and that he could feel the presence of love.

"The situation, perhaps, is like that of a guitar whose strings have been broken and therefore can no longer play," the pope told Maria Teresa.

Benedict, who frequently reminds the faithful that according to Catholic teachings euthanasia is wrong, then told her that spending hours a day by her son's side was an act of faith in God and of "respect for human life, even in the saddest of situations."

The Pope was emphasizing the humanity of the person, even while in PVS. The fact is that this man remains a human person deserving of love, care and respect.

Friday, April 22, 2011

Baby Joseph is home and breathing on his own

Now that baby Joseph is home, having had a tracheotomy and breathing on his own without a ventilator, it is important to once again consider why this legal battle occurred and why the Ontario government needs to change the Health Care Consent Act. The fact that Joseph is breathing on his own, without a ventilator, proves that the request that a Tracheotomy be done was appropriate and was not extra-ordinary, excessive or burdensome. It would be good to find out why the hospital actually refused to do a Tracheotomy when their proposed plan of treatment was to cause him to die of asphyxiation?

The Euthanasia Prevention Coalition (EPC) became involved in the baby Joseph case because of the way that the Consent and Capacity board and the Ontario Superior court decided to withdraw the ventilator from baby Joseph without the consent of his parents. The error in judgment by these legal bodies affects us all.

The meaning and value of life cannot be assessed by medical tribunals and the court and it is not measured in years, months, or days. It is measured in the giving and receiving of love. Love is the greatest quality of life that there is. This is the lesson that the Ontario/Canadian medical system needs to learn. This is what they are blind to.

Who has the right to decide.
The baby Joseph case was about who has the right to make medical treatment decisions and what is in the best interest of baby Joseph. The Children's hospital in London Ontario wanted to withdraw the ventilator from Joseph, which would likely have resulted in him dying, grasping for air. The family wanted to bring Joseph home to care for him in the same way that they cared for their first child who died of a similar condition 9 years ago. The family asked that a tracheotomy be done to allow Joseph to breathe on his own, so they could bring him home.

The Baby Joseph case was not about futile care.
The baby Joseph case was different than previous cases because the family was not requesting treatment or care that was futile, excessive, extra-ordinary or burdensome. The family simply wanted to bring Joseph home, which required that a Tracheotomy be done to enable Joseph to breath.

Not about euthanasia.
Some people have suggested that withdrawing the ventilator from baby Joseph would constitute an act of euthanasia. Euthanasia is an action or omission of an act that directly and intentionally causes the death of another person with the intention of relieving suffering. Euthanasia is a form of homicide. If the ventilator had been withdrawn from baby Joseph, he was likely to die, but he might have survived. If he died, his death would have been caused by his medical condition and therefore it is not euthanasia.

The legal system in Ontario is unfair.
A significant problem in Ontario is that the legal system is loaded against families. When a family and the doctor/hospital disagree about the treatment plan for a person, these cases are sent to the Consent and Capacity board for a decision. This is where the inequality begins. The doctor/hospital have nearly unlimited financial resources to hire a top lawyer who has experience in this area of law. The family often has limited resources and sometimes hires a legal aid lawyer who lacks experience in this area of law. When the Consent and Capacity board sides with the doctor/hospital, often the family will give up, but sometimes they appeal the decision to the Superior Court. It is prohibitively expensive for the family to bring a case to the Superior Court and yet the doctor/hospital has no fear of the cost because the health care institution has significant legal resources provided by the taxpayer. Because of the inequity in the legal defense, case after case has resulted in decisions by the Consent and Capacity board or the Superior court supporting the doctor/hospital. The law's inequality has resulted in a growing body of precedent-setting cases that have increased the power of the doctor/hospital to make medical decisions against the wishes of the family. The Ontario government must change the Health Care Consent Act.

It is unreasonable that families are required to spend an incredible amount of money in order to defend their rights. If doctors/hospitals have access to huge legal budgets that are from the taxpayer, that is spent to fight families (taxpayers) who are simply attempting to make medical care decisions on behalf of family members, then the system should also pay the cost for the family. Ontario citizens should recognize that the great majority of precedent-setting legal cases have given more power to the doctors/hospital. The rights of each citizen in Ontario to make medical treatment decisions have been eroded. We hope that the energy that has been created around baby Joseph can be used to help other people by changing our health care statutes.

The Rasouli case
This is why EPC sought and become an intervenor in the Rasouli case. The Rasouli case will determine if doctors are required to obtain consent before withdrawing life support. This means that the Rasouli case will determine that a doctor is required to obtain consent to withdraw a respirator, or even fluids and food. It is euthanasia to cause a persons death by withdrawing fluids and food when that person is not otherwise dying. Death is then caused by dehydration.

You also need to protect yourself. You can protect yourself by contacting EPC and ordering the Life-Protecting Power of Attorney for Personal care. The cost for this legal document is only $25.00.

Vermont Assisted Suicide bad idea, bad bill

Grace Weber wrote a good article about the bill to legalize assisted suicide in Vermont that was published in the Burlington Free Press yesterday. Weber comments about the language of the bill and the outcome of legalizing assisted suicide.

If there is nothing wrong with assisted suicide, then why do they need to lie about it.

The article is republished in full.

Grace Weber

When we discard the euphemism "death with dignity" and replace it with plain English, we see that the Vermont Legislature proposes to endorse and enable suicide for qualifying citizens. The idea is bad, and the bill is bad.

Certainly, terminal illness is a wrenching problem. But there are others. Loss of good name, heartbreak and financial ruin are among the other reasons for which competent persons commit suicide. Does anyone doubt that mental anguish can be as great as physical pain?

We can be sure that every person who ever took his own life felt that his reason for doing so was truly compelling. It is not the province of government to evaluate the motives for suicide, and to legislate the timing and circumstances in which a person may take his own life. Where is the justice or the compassion in providing clean, easy suicide to one person, while someone else, in equal anguish, has to do it the hard way? This is why right-thinking societies do not start granting exceptions to the no-suicide rule.

The bill, H. 274, is dishonest in its statement, "Action taken in accordance with this chapter shall not be construed for any purpose to constitute suicide (or) assisted suicide." So someone will ingest a lethal substance for the sole and express purpose of ending his life, but we won't call it suicide. If the bill's drafters must misrepresent what they're proposing, they shouldn't propose it. Even where a terminal illness is present, someone who anticipates his natural death by committing suicide does not die from the disease, he dies by suicide.

Another flaw in any such bill is that safeguards against undue influence are impossible. How can we know that a patient is not being pressured when pressuring commonly operates under the gentle mask of support and concern? A cruelly ironic provision of this bill is its helpful promise that doctors who are unwilling to prescribe suicide for their patients will not be charged with abandonment of the patient! One would think it abandonment, even malpractice, for a doctor to abet his patient's suicide.

It has been pointed out, and correctly, that doctor-enabled suicide is elder abuse waiting to happen. Let's be aware that it also poses a great danger to young people by muddying the waters. We tend to think that if something is legal, then it's all right. With what moral authority will mental health counselors try to convince despairing teens that suicide is not the answer, once the state has legitimized suicide by creating even a conditioned right to it?

This misguided bill will create worse problems than the one it purports to solve -- and that's a good definition of bad law. I urge its defeat.

Grace Weber lives in Weybridge.

Wednesday, April 20, 2011

UK high school kids taught about assisted suicide



This is a reprint of an article written by Paul Russell, the founder of HOPE Australia, and published on mercator.net on April 17. It is absolutely insane that students will be taught "how to" kill themselves by Dr. Death within the school system. The article is printed below.

By Paul Russell, the founder of HOPE Australia

Revelations this week that a UK company that produces educational videos for school children has included in its production vision of Philip Nitschke’s ‘death machine’, explanations on how it works and footage from his workshops explaining his other suicide methods has shocked even pro-euthanasia advocates in the UK.

The Daily Mail report suggests that children as young as 14 years of age have seen the video sparking angry responses from groups that oppose assisted suicide who described the video as an ‘invitation to commit suicide’.

At the same time the BBC is scheduling a program by euthanasia advocate Terry Pratchett that features the death of a UK man in the Dignitas clinic in Switzerland.

Claims by the education video producers that the issue is treated in a balanced way simply don’t add up. Including contrary messages from anti-euthanasia campaigners can never balance the chilling imagery of suicide described in graphic detail. Producer and Director, Thomasina Gibson’s comments to the effect that she is simply giving both sides of the argument and treating teenagers as ‘young adults’ is utter nonsense.

None of the media coverage has suggested that Nitschke was aware of the age level of the audience for the video production. But given his comments to the effect that young people should have access to his suicide methods and other comments advocating that such products should be on the supermarket shelves, complicity would come as no surprise.

Australians know all too well that suicide amongst our young people is a significant problem. That’s why our broadcast codes of practice explicitly reject such depictions of suicide. Yet give the poison a sugar coated veneer such as ‘educational’ or ‘balanced view’ and the Brits, it seems have swallowed the pill without prescription and without thought of the side effects.

When the ‘side effects’ are as devastating as the loss of a young life with known far reaching consequences such as copy cat suicides and a cluster of devastated families in its wake, we can only wonder at whether the Brits really are barmy or whether, like Pratchett, there are euthanasia & suicide activists in the education ranks who either don’t care about the consequences or are so blinded by their cause as not to even notice.

And it’s not that such issues should not be broached with teenagers. I have personally spoken to many classes of students about the issues, but it needs to be done with care – and certainly without visuals. Anyone who has seen the Gruen Transfer show on ABC television knows the power of the image; it is beyond and sometimes entirely contra to the spoken word.

A friend suggested to me recently that, in terms of the negative effect that Nitschke has on pro-euthanasia legislation whenever he chooses to enter the fray that he’s very much ‘the gift that keeps on giving’. But in terms of protection for the vulnerable of any age, particularly the young, he and those he chooses to associate with are extremely dangerous.

Anyone listening at the AMA?

Tuesday, April 19, 2011

Idaho Governor signs bill to assure that seniors and other vulnerable people are protected from assisted suicide

Bill SB 1070, the bill that makes assisted suicide a felony in Idaho, was signed by Governor Butch Otter almost two weeks ago.

Last year, Kathryn Tucker, the legal director for Compassion & Choices, formerly the Hemlock Society, organized a campaign to legalize assisted suicide in Idaho.

In response to the campaign by Compassion & Choices, on February 4, Senator Russ Fulcher introduced Senate Bill SB 1070 to clean-up the criminal code making assisted suicide a felony in Idaho.

On March 11, the Idaho Senate passed the bill by a vote of 31 to 2 and on March 27, the Idaho House passed the bill by a vote of 61 to 8.

This is a significant victory that was supported by the Idaho Medical Association. This amendment will ensure that Idaho citizens and elders are protected from assisted suicide.

We thank the group Idaho Chooses Life for supporting the bill.

Elder Abuse case shows how little protection exists for elders.

An article written by Ron Winter and printed by CT Watchdog on March 30, 2011 examines the issue of elder abuse from the personal experience of a family. The CT watchdog reported in their article: Granny Snatching, Narcotic Poisoning - A Bitter Prescription.

The article states:

Police in Saanich, British Columbia, are investigating a narcotic poisoning incident involving an 88-year-old resident of an elder care facility that may provide a classic example of how the elderly in Canada and the United States often have little protection by legislation or organizations that are charged with their safety.

Records show that Kathleen Palamarek, a resident of The Lodge At Broadmead in Greater Victoria, British Columbia was removed from her room by ambulance attendants on the morning of February, 24, 2011 and taken to a local emergency room after a 911 call from her daughter Lois Sampson. Mrs. Palamarek was diagnosed as suffering from narcotic poisoning after being prescribed a morphine opiate. People familiar with her case say she is fortunate to have survived.

So what happened? The article states:

The emergency room diagnosis revealed that Mrs. Palamarek was prescribed hydromorphone, a powerful morphine derivative supposedly because she was deemed “palliative.” Palliative care is defined as providing medical or comfort care for people with intractable pain due to incurable diseases. Those familiar with Mrs. Palamarek say she does not have any terminal illness, nor does she have intractable pain.

You may be asking what this has to do with elder care issues in the United States in general or Connecticut in particular. I’ll get to that in a bit, but first I’ll give you a rundown on the case in British Columbia.

According to case records, the Sampsons have waged a costly and frustrating three-year legal battle to win the release of Mrs. Palamarek from Broadmead Lodge into their care. The records and interviews with principals in the case show that Mrs. Palamarek originally entered the facility in 2007 after she was hospitalized for an internal hemorrhage caused by the improper prescribing of two drugs.

In 2008 Mrs. Palamarek met with a lawyer, who assessed her to be capable of legal instruction. After several meetings, she appointed her daughter Lois Sampson as her legal representative so she could move out of Broadmead. She moved in with her daughter briefly, but was forced by Canadian authorities to return to Broadmead.

That “involuntary apprehension” occurred on the afternoon of October 31, 2008, as Lois, Gil, Mrs. Palamarek and a family friend who also is a registered nurse and advocate for the elderly, waited in Lois’s home for other family members to arrive for a scheduled visit. However, a knock at the door revealed instead a squad of police and ambulance attendants who seized Mrs. Palamarek, hustled her into a waiting ambulance, and returned her to forced confinement.

The B. C. Mental Health Act allows medical personnel and police officers to apprehend, detain and treat a person against their will if they believe the individual’s physical or mental condition “may” deteriorate – based solely on their own observations or on “information received” from any other person. No evidence or substantiation is required.

This forms the basis for my concerns about the laws in Canada. Even though the US does not have uniform laws to protect the elderly, groups in both countries are working to “harmonize” existing laws so they would be the same in Canada and the US. Considering how the Canadian authorities terrorized an elderly widow and her family, we should all be concerned about efforts to duplicate those laws here.

Unfortunately, cases similar to Mrs. Palamarek’s are not rare in Canada or the US.

The story continues:

The drugs originally prescribed for Mrs. Palamarek included Fentanyl patches, another powerful opiate that is reserved for patients who are in intractable pain that cannot be managed by regular analgesics such as Tylenol or codeine. Tisdell’s analysis stated that sometimes the patches were defective or leaking, and at other times, although the medication was prescribed it wasn’t administered or went missing.

“I found it appalling that Mrs. Palamarek was not in pain, yet she was prescribed Fentanyl patches,” he said. Nonetheless, it was barely a week after the trial concluded that Mrs. Palamarek was again administered powerful narcotic medications.

The family continues to fight for justice:

The Sampsons and the registered nurse who was present when the paramedics were called reported the poisoning incident to the Saanich Police Department. Asked for an update on the case, department Public Information Officer Dean Jantzen, wrote, “I have spoken to Kathleen Murphy (the detective assigned to the case.) This is an active investigation that she is currently working on. At this point it would be premature to speak about this until she concludes her inquiries.”

A letter expressing grave concerns regarding Mrs. Palamarek’s safety was also sent to the health authority but no response has been received thus far.

Concerns about Mrs. Palamarek’s medication have been raised since before she was forcibly returned to Broadmead. In July 2008 the Sampsons filed a formal request with the Public Guardian and Trustee (PGT), the state agency that oversees the guardianship of British Columbia’s elderly, seeking an independent medical assessment of her health and drug regimen. That request was denied outright.

Canada’s actual treatment of some of its elderly citizens does not appear to jibe with the international view of that country as a benign human-friendly sanctuary. Reviewing the case of Kathleen Palamarek and others reported in the media shows that in Canada, growing old may result in facing unexpected and potentially lethal issues.

It is said that the wheels of justice grind slow, but in the case of Kathleen Palamarek there is a legitimate question of whether they are moving at all. The police are investigating, but a decision on the court case has been pending for more than a month.

The Sampsons have had further issues with Mrs. Palamarek’s treatment in Broadmead since the Feb. 24 narcotic poisoning incident, and meanwhile Kathleen Palamarek spends much of her time in her room, reading books, and waiting ….

Who will judge whose lives are worth living?

The UK media has been fussing and promoting assisted suicide and trips to Switzerland. Recently Terry Pratchett, a famous writer, has paid to establish a "government committee" to promote assisted suicide that is comprised of members of the suicide lobby.

An article on Sunday April 17, in the Sunday Observer by columnist Barbara Ellen challenges the media promotion of assisted suicide.

Ellen responds to the showing of an assisted suicide death on TV in this way:

The filming of the death seems secondary – for me, it has the opportunistic whiff of a medicalised snuff movie, but that's just my opinion. No one is forced to watch, just as no one is forced to watch all the births on television these days.

There are bigger issues at stake, not least the arrogance of the pro-euthanasia able bodied towards the profoundly ill – the unseemly rush to pronounce the lives of others "not worth living". A recent study discovered that some sufferers of locked-in syndrome – as many as three out of four of the main sample – were happy and did not want to die. Such studies are flawed (some sufferers are unable to articulate either way), but it should still give us pause for thought before blasting off about "lives not worth living".

Likewise the knee-jerk: "They wouldn't have wanted to end up like this." Of course not – who would? – but that might not be the end of the story. How individuals feel when they are fit may change considerably when their health fails. Like those with locked-in syndrome, they may adjust to a life that is very different, often difficult, but just as precious. Who are we to judge?
Ellen responds the religious critics of euthanasia in this way:

Personally, if I ever get something nasty, I'd rather be with a God-botherer than somebody who decides I'm looking peaky, books a Swiss flight and whisks me off to the ghouls at Dignitas.
Ellen challenges the euthanasia lobby directly by stating:

One reason we don't have the death penalty is that there is no guarantee that mistakes would not be made. Who could guarantee that mistakes wouldn't be made with euthanasia? Not all seriously ill people can communicate their current wishes (not necessarily the same as when they first became ill). And no one else should be deciding for them, in worst-case scenarios "putting them down" against their will.
Barbara Ellen is a breath of fresh air who is willing to ask the difficult questions with realistic answers.

Actor Patrick Stewart is simply another in a line of actors pushing suicide

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Some of the media in the UK have become the cheerleaders for the legalization of assisted suicide and the suicide lobby. The article in the UK Sunday Times and reprinted world-wide.

It is interesting that the media considers an actor commenting on assisted suicide to be newsworthy. I guess selling newspapers is more important than finding an objective and educated response.

The reports fail to present the issue accurately. Legalizing euthanasia and/or assisted suicide creates a right to be killed or allow a physician to actually cause or be involved with causing your death, it is not about a right to die.

There is another issue with the complicity of the media in promoting euthanasia and assisted suicide cases. The reality of the copy cat suicide effect is well known and that is why the World Health Organization established a set of guidelines for the media to help prevent suicide.

People, like Patrick Stewart, do raise legitimate concerns about the care of people who are dying. These concerns are properly dealt with by a society that improves the care of the dying, improves the care and attitude towards people with disabilities, maintains an effective suicide prevention strategy and understands the need to prevent the scourge of elder abuse.

The sad reality is that the media does not consider a position of opposing euthanasia to be newsworthy because it promotes the "status quo."

I challenge the media to focus on people and organizations that care for others and help them live comfortably and with dignity rather than killing them.

Cheerleading BBC Pushes Suicide by Violating WHO Prevention Reporting Guidelines

The following blog comment is a complete reprint from Wesley Smith's blog comment from last Friday. This comment is particularly important because it uncovers the role of the media in promoting or discouraging suicide. It also shows how important team-work in our euthanasia prevention work is by the fact that Wesley Smith and Margaret Dore teamed up to create this excellent report.

From Wesley Smith's blog - Second Hand Smoke - April 15, 2011

The BBC will soon play a video of an assisted suicide–narrated by a famous euthanasia advocate–that took place in one of the Swiss suicide clinics. This isn’t the first time such a thing has been done in the UK. And of course, in the USA ,the pro euthanasia advocate Mike Wallace allowed Jack Kevorkian to narrate a video he took of himself murdering Thomas Youk with a lethal injection. The result was nearly 10 (too short) years in the hoosegow for Kevorkian–but not to worry, you K fans–the amnesiac media has turned him into a harmless Muppet and Al Pacino played him in a fictional hagiography. The anti assisted suicide lawyer Margaret Dore notes that by playing such videos, the media endanger other suicidal people, and thereby, promote suicide. That’s not just her opinion, but comes directly from the World Health Organization’s Preventing Suicide: A Resource for Media Professionals. From the resource.

One of the earliest known associations between the media and suicide arose from Goethe’s novel Die Leiden des jungen Werther (The Sorrows of Young Werther), published in 1774. In that work the hero shoots himself after an ill-fated love, and shortly after its publication there were many reports of young men using the same method to commit suicide. This resulted in a ban of the book in several places (1). Hence the term “Werther effect”, used in the technical literature to designate imitation (or copycat) suicides.

Other studies of the media’s role in suicide include a review going back to the last century in the United States (2). Another famous and recent case concerns the book Final Exit written by Derek Humphry: after the publication of this book, there was an increase in suicides in New York using the methods described (3). The publication of Suicide, mode d’emploi in France also led to an increase in the number of suicides (4). According to Philips and colleagues (5), the degree of publicity given to a suicide story is directly correlated with the number of subsequent suicides. Cases of suicide involving celebrities have had a particularly strong impact (6). Television also influences suicidal behaviour. Philips (7) showed an increase in suicide up to 10 days after television news reports of cases of suicide. As in the printed media, highly publicized stories that appear in multiple programmes on multiple channels seem to carry the greatest impact – all the more so if they involve celebrities.

To prevent one suicide from leading to others, the WHO suggests:

WHAT NOT TO DO
• Don’t publish photographs or suicide notes.
• Don’t report specific details of the method used.
• Don’t give simplistic reasons.
• Don’t glorify or sensationalize suicide.
• Don’t use religious or cultural stereotypes.
• Don’t apportion blame.

By playing the suicide, and allowing a pro assisted suicide advocate to tell the story of the suicide, the BBC did what it isn’t supposed to, and failed to do what it should to prevent more suicides. Indeed, I don’t think there is much doubt that media sensationalism in the UK, have pushed suicide tourism to Switzerland. And this, my friends, is how the media too often are cheer leaders for suicide.

Wednesday, April 13, 2011

Euthanasia Prevention Coalition is granted intervener status in the precedent setting Rasouli case

The Euthanasia Prevention Coalition (EPC) has been granted intervener status in the Rasouli case which will be heard before the Superior Court on May 18. The Rasouli case is a precedent-setting case of national importance. that will decide whether doctors must obtain consent before withdrawing life-sustaining medical treatment. EPC has retained lawyers Hugh Scher and Mark Handelman to represent us. We will require at least $20,000 in donations to pay for the intervention. Donate toward the cost of the Rasouli intervention.

There have been many previous cases whereby a doctor has withdrawn life support against the previously expressed wishes of a person or without the consent of the substitute decision-maker. Many of these decisions were made based on futile care theory, cost containment, and “quality of life” evaluations by doctors. Some of these decisions result in a death by “slow euthanasia” (dehydration of a person who is not otherwise dying) and many are based on negative attitudes toward people with disabilities or other vulnerable people.

The Rasouli case will determine whether doctors are required to obtain the consent of the patient, the patient’s guardian, or the Consent and Capacity board before withdrawing life support. This decision will apply to all life-sustaining interventions, including the withdrawal of hydration and nutrition.

The Rasouli case

In October 2010, Hassan Rasouli had surgery at the Sunnybrook Health Sciences Centre (the Hospital) in Toronto to remove a benign tumour in his head. Following the procedure, Mr. Rasouli developed bacterial meningitis and ventriculitis. The infection caused a severe and widespread brain injury as well as damage to the brainstem and the spinal cord. He has been in coma since October 16, 2010 and is on a ventilator and being fed through a tube inserted in his stomach.

Mr. Rasouli was examined on five occasions, before his doctors, Dr. Brian Cuthbertson and Dr. Gordon Rubenfeld, decided that he is in a Persistent Vegetative State (PVS) and that they would withdraw all treatments, including ventilation.

Parichehr Salasel, Mr. Rasouli’s wife, a doctor who was a doctor in Iran and who is his substitute decision-maker, met with the physicians and discussed their proposed treatment plan (non-treatment). She refused to consent to their treatment plan.

In response, the doctors attempted without success to have Mr. Rasouli transferred to another hospital in Toronto.

Ms. Salasel applied to the court for an injunction to prevent the doctors and the hospital from withdrawing life-sustaining treatment from her husband. She believes that Mr. Rasouli is not PVS. She stated that he is moving and he has some awareness of his surroundings. She will not provide consent to withdraw the ventilator from her husband because the action is not consistent with their religious views. As Shia Muslim's, they believe that life must be respected and upheld until all signs of life are gone.

The doctors state that they are not required to continue providing treatment which they believe lacks benefit. They stated that they are obliged to refrain from continuing such treatment even if the patient or substitute decision-maker does not consent to the withdrawal. In other words, they believe that they have the right to withdraw life-sustaining medical treatment or care without consent.

Justice J. Himel heard the case on February 25, 28 and March 3, 2011 and her judgement was published on March 9. This decision is a precedent setting case concerning the question of who has the right to decide to withdraw life-sustaining medical treatment.

The Rasouli Decision.

The first question Justice Himel asked was: Should the physicians have brought the proposed plan to withdraw treatment to the Consent and Capacity Board or is the Superior Court of Justice the appropriate forum to determine the case?

The doctors argued that they were not required to ask the Consent and Capacity Board for consent to withdraw treatment. They were only required to seek consent for treatment.

Justice Himel concluded that the doctors should have brought the case to the Consent and Capacity Board for a decision. She stated that:
“Treatment” under the Health Care Consent Act includes the withdrawal of life support. Therefore doctors require consent when withdrawing life support in Ontario."
The second question was: Does the Canadian Charter of Rights and Freedoms apply to this case?

The lawyers for Mr Rasouli and his wife argued that since the Charter applies to hospitals, because they are a publicly funded institution, that the Charter also applies to the doctors, who work in the hospitals and are paid through public funds. They argued that Mr. Rasouli’s Charter rights were breached under Section 7 - rights to “life, liberty and security of the person”

Justice Himel concluded that the Charter does not apply in this case. She stated:
“I am of the view that the Canadian Charter of Rights and Freedoms does not apply to the proposed decision of the Physicians to withdraw mechanical ventilation.”
The Third question was: Is injunction relief appropriate in this case?

The lawyers for Mr. Rasouli and his wife argued that an injunction was necessary in order to prevent the doctors from withdrawing the ventilator without consent.

The lawyers for the doctors argued that consent was not required for the doctors to withdraw the ventilator and that no injunction could prevent them from withdrawing the ventilator.

Justice Himel concluded that an injunction was not necessary because the doctors were required to obtain consent before withdrawing the ventilator. If they are not given consent from the substitute decision maker, then they are obligated to seek consent through the Consent and Capacity Board. She stated:
“I have concluded that the doctors do need consent of the substitute decision-maker under the statutory scheme of the Health Care Consent Act to remove Mr. Rasouli from life support. Accordingly, no injunction need be granted.”
The doctors have appealed the decision of Justice Himel to the Superior Court. The doctors continue to believe that they are not required to obtain consent before withdrawing life support.

What is at stake?

If the doctors win the appeal at the Superior Court, then doctors will not be required to obtain consent before withdrawing life support. The definition for life support includes providing Hydration and Nutrition (fluids and food). Therefore, doctors will be able to withdraw fluids and food without consent from a person who is, for example, diagnosed as PVS, but who is not otherwise dying. Families of people with cognitive or other disabilities and people experiencing life threatening conditions will be unable to prevent a doctor from withdrawing life-support, if the doctor decides that the life-support is futile (futile care theory).

Many doctors are experiencing increased pressure to contain the cost of health care. There is an increasing tendency to make decisions based on a “quality of life” ideology and futile care theory. Considering these trends, it is essential that the Himel decision be upheld by the Superior Court.

This Rasouli case will determine if doctors are required to obtain consent before withdrawing a ventilator, antibiotics, or even fluids and food. If we win this case, your doctor will be required to obtain consent before withdrawing life support or basic care. It is euthanasia to withhold or withdraw fluids and food from a person who is not otherwise dying.

The cost to intervene in the Rasouli case is estimated at $20,000. EPC needs many generous donations to make the intervention possible. If we win, the Rasouli decision may be appealed to the Supreme Court of Canada. We have consulted other organizations who share our concerns.

Donate toward the cost of the Rasouli intervention.

Tuesday, April 12, 2011

Farewell Foundation seeks to Challenge Canada's assisted suicide Act

A group of suicide activists, is attempting to establish a non-profit corporation in British Columbia to assist the suicides of its members and to overturn Section 241b of the criminal code, the assisted suicide Act in Canada, through the court. On March 17, 2011 the British Columbia Registrar of Companies refused to register the Farewell Foundation because the aims of the organization contravene the criminal code. The leader of the Farewell Foundation appears to be Russel Ogden, a criminologist who has been involved in the euthanasia lobby for many years. His euthanasia work has included being involved with Nu-Tech. Ogden has always claimed that he was a researcher but in fact he has always been an activist in the euthanasia lobby. In an article written by Tiffany Crawford and published in the Vancouver Sun on April 8, 2011; Crawford quotes the statement by Jason Gratl, the lawyer for the Farewell Foundation who stated:
The foundation proposes a similar model based on organizations in that country (Switzerland) such as Exit, which has 70,000 members.
This means that the Farewell Foundation intends to establish an assisted suicide killing centre/organization that will provide lethal drugs, information and devices and directly assist their deaths. The Farewell Foundation is appealing the decision of the Registrar of Companies and it is also attempting to bring its case further by challenging the assisted suicide Act itself. The Euthanasia Prevention Coalition is watching this case closely and will intervene in the case, if necessary, at the appropriate time.

Tuesday, April 5, 2011

The Euthanasia Prevention Coalition seeks intervener status in court case about who has the right to decide when to stop life support.

The Euthanasia Prevention Coalition (EPC) is seeking intervener status in the Rasouli case, which will be heard before the Superior Court in May. The Rasouli case is a precedent-setting case of national importance. This precedent-setting case will decide whether doctors must obtain consent before withhold or withdraw life-sustaining medical treatment. EPC has retained lawyers Hugh Scher and Mark Handelman to represent us. EPC will require significant financial support to pay for the intervention. Donation link.

There have been many previous cases whereby a doctor has withdrawn life support against the previously expressed wishes of a person or without the consent of the substitute decision-maker. Many of these decisions are made based on futile care theory, cost containment, and “quality of life” evaluations by doctors. Some of these decisions result in a death by “slow euthanasia” (dehydration of a person who is not otherwise dying) and many are based on negative attitudes toward people with disabilities or other vulnerable people.

The Rasouli case will determine whether doctors in Ontario are required to obtain the consent of the patient, the patient’s guardian, or the Consent and Capacity board before withdrawing life support. This decision will apply to all life-sustaining interventions, including the withdrawal of hydration and nutrition.

The Rasouli case

In October 2010, Hassan Rasouli underwent surgery at the Sunnybrook Health Sciences Centre (the Hospital) in Toronto to remove a benign tumour in his head. Following the procedure, Mr. Rasouli developed bacterial meningitis and ventriculitis. The infection caused a severe and widespread brain injury as well as damage to the brainstem and the spinal cord. He has been in coma since October 16, 2010 and is on a ventilator and being fed through a tube inserted in his stomach.

Mr. Rasouli was examined on five occasions. His doctors, Dr. Brian Cuthbertson and Dr. Gordon Rubenfeld, are convinced that he is in a Persistent Vegetative State (PVS) and they decided to withdraw all treatments, including mechanical ventilation.

Parichehr Salasel, Mr. Rasouli’s wife, a doctor who practiced medicine in Iran and his substitute decision-maker, met with the physicians and discussed their proposed treatment plan (non-treatment). She refused to consent to their treatment plan.

In response, the doctors attempted without success to have Mr. Rasouli transferred to another hospital in Toronto.

Ms. Salasel applied to the court for an injunction to prevent the doctors and the hospital from withdrawing life-sustaining treatment from her husband.

Ms. Salesel will not provide consent to withdraw the ventilator from her husband because the action is not consistent with their religious views. As a Shia Muslim, they believe that life must be respected and upheld until all signs of life are gone.

The family also believes that Mr. Rasouli is not PVS and that he may improve. They stated that he is moving and he has some awareness of his surroundings.

The doctors state that they are not required to continue providing treatment which they believe to be of no benefit. They stated that they are obliged to refrain from continuing such treatment even if the patient or substitute decision-maker does not consent to the treatment plan. In other words, they believe that they have the right to decide when to withdraw life-sustaining medical treatment or care.

Justice J. Himel heard the case on February 25, 28 and March 3, 2011. Her judgement was published on March 9, 2011. This decision is a precedent setting case concerning the question of who has the right to decide to withdraw life-sustaining medical treatment.

The Rasouli Decision.

The first question Justice Himel asked was: Should the physicians have brought the proposed plan to withdraw treatment to the Consent and Capacity Board or is the Superior Court of Justice the appropriate forum to determine the case?

The doctors argued that they were not required to ask the Consent and Capacity Board for consent to withdraw treatment. They were only required to seek consent for treatment.

Justice Himel concluded that the doctors should have brought the case to the Consent and Capacity Board for a decision. She stated that:
“Treatment” under the Health Care Consent Act includes the withdrawal of life support. Therefore doctors require consent when withdrawing life support in Ontario."
The second question was: Does the Canadian Charter of Rights and Freedoms apply to this case?

The lawyers for Mr Rasouli and his wife argued that since the Charter applies to hospitals, because they are a publicly funded institution, that the Charter also applies to the doctors, who work in the hospitals and are paid through public funds. They argued that Mr. Rasouli’s Charter rights were breached under Section 7 - rights to “life, liberty and security of the person”

Justice Himel concluded that the Charter does not apply in this case. She stated:
“I am of the view that the Canadian Charter of Rights and Freedoms does not apply to the proposed decision of the Physicians to withdraw mechanical ventilation.”
The Third question was: Is injunction relief appropriate in this case?

The lawyers for Mr. Rasouli and his wife argued that an injunction was necessary in order to prevent the doctors from withdrawing the ventilator from Mr. Rasouli without consent.

The lawyers for the doctors argued that consent was not required for the doctors to withdraw the ventilator and that no injunction could prevent them from withdrawing the ventilator.

Justice Himel concluded that an injunction was not necessary because the doctors were required to obtain consent before withdrawing the ventilator. Without consent they were obligated to seek consent through the Consent and Capacity Board. She stated:
“I have concluded that the doctors do need consent of the substitute decision-maker under the statutory scheme of the Health Care Consent Act to remove Mr. Rasouli from life support. Accordingly, no injunction need be granted.”
The doctors have appealed the decision of Justice Himel to the Superior Court. The doctors continue to believe that they are not required to obtain consent before withdrawing life support.

What is at stake?

If the doctors win the appeal at the Superior Court, then doctors will not be required to obtain consent before withdrawing life support. The definition for life support includes providing Hydration and Nutrition (fluids and food). Therefore, doctors will be able to withdraw fluids and food without consent from a person who is, for example, diagnosed as PVS, but is not otherwise dying. Families of people with cognitive or other disabilities and people experiencing life threatening conditions will be unable to prevent a doctor from withdrawing life-support, if the doctor decides that the life-support is futile (futile care theory).

Many doctors are experiencing increased pressure to contain the cost of health care. There is an increasing tendency to make decisions based on a “quality of life” ideology. Considering these trends, it is essential that the Himel decision be upheld by the Superior Court.

This Rasouli case will determine if doctors need consent to withdraw a ventilator, antibiotics, or even fluids and food. If we win this case, your doctor will be required to obtain consent before withdrawing life support or basic care.

It is euthanasia to withhold or withdraw fluids and food from a person who is not otherwise dying.

The cost to intervene in the Rasouli case is estimated at $20,000. EPC needs many generous donations to make the intervention possible. If we win, the Rasouli decision may be appealed to the Supreme Court of Canada. We have consulted other organizations who share our concerns. Donation link.

Monday, April 4, 2011

Third - International Symposium on Euthanasia and Assisted Suicide Vancouver BC - June 3 - 4, 2011.


Celebrating our successes; preparing for new challenges.

Highlights:
Friday Night Banquet, featuring: Senator Helen Polley of the Australian Parliament representing Tasmania. http://aph.gov.au/Senate/senators/homepages/senators.asp?id=e5x

International Speakers representing Canada, Quebec, the US, Australia, England and Scotland.
For more information, see event brochure: http://www.euthanasiaprevention.on.ca/symposium.pdf
Where:
Vancouver Airport Marriott Hotel. Call 1-877-323-8888 for special room rates: $139 for a room; $159 for a suite (let them know that you are attending the Euthanasia Symposium). For more information about the hotel, go here: http://www.marriott.com/hotels/hotel-information/travel/yvrsa-vancouver-airport-marriott-hotel/

When:
Start: Friday, June 3, 2011 at 9am.
Finish: Saturday, June 4, 2001 at 5pm

Fees
The registration fee is: $199 regular and $149 for a student or a person with a disability (does not include banquet fee).
The Friday night banquet is $50.00.
When booking your flight from anywhere, with Air Canada at www.aircanada.ca use promotion code: FNKB4F91.

How to Register and/or donate

Use this form: http://www.euthanasiaprevention.on.ca/symposium.pdf

Donations Appreciated!

Consider donating $199 to enable a student or a person with a disability to attend the Symposium at no cost.
How to donate: http://www.euthanasiaprevention.on.ca/Donations.htm

Looking forward to meeting you!

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
Chair, Euthanasia Prevention Coalition International

A Disability Perspective on Euthanasia

Erik Leipoldt sent me the following statement from Australia:

Australia is facing a tsunami of euthanasia Bills. The first to come up is the Criminal Law Consolidation (Medical - Defences) - End Of Life Arrangements Bill 2011 in South Australia.

A comprehensive Disability Position Statement On Euthanasia and Physician-Assisted Suicide was developed by a group of people who have direct experience of living with disability or chronic illness in their lives.

Please read and support the statement by leaving a comment. 
See the Statement here (I have reprinted the statement in full): http://proliving.blogspot.com/2011/03/disability-position-statement-on.html.

Disability Position Statement on 
Euthanasia and Physician-assisted suicide in Australia - March, 2011

• We are Australians who live with a disability (1) or chronic illness, directly, and/or by our close involvement with people with disabilities/chronic illness, as family, friend or ally.

• We are concerned that euthanasia and physician-assisted suicide (PAS) (2) legislation may be introduced in this country that allows the intentional shortening of life, including on grounds that life with disability is not worth living.

• We oppose the introduction of euthanasia and physician assisted suicide legislation because it is inherently wrong to end a life in answer to suffering (3). This is especially so in absence of the many things we, as a rich society, can do to alleviate suffering.

• We believe that much ‘suffering’ is not primarily caused by a person’s disability or medical condition. It often arises from inadequate care and support, contributing to requests for euthanasia or PAS.

• We believe that state-sanctioned euthanasia and physician-assisted suicide poses great risks to life and well-being of people with disabilities, in particular to highly vulnerable (4) disabled people. It would undermine any social climate of support and life-giving values that they need to live good lives.

• It is a matter of social justice for the status of people with disabilities in our society to be duly considered in this matter (5).

Yes to good quality care and support
No to euthanasia and physician assisted suicide.

Pro-Living calls for…

A halt to introduction of euthanasia and physician-assisted suicide Bills and the development of social policy that:

• Meaningfully supports people with disabilities and those who assist them, to live good lives (6) in the community, where good quality community, health and palliative care service is widely available;

• Affirms disability as a normal part of life in all its diversity;

• Affirms the human worth of people with disabilities as equal to all other human beings;

• Recognises their real needs, takes responsibility for meeting them, does so competently, and in participation with the focal person with a disability, to the fullest extent.

Pro-Living Endorses…

• The Palliative Care Australia Position Statement on Euthanasia and Physician-assisted Suicide (7) with the proviso that acquiring any disability does not of itself indicate “an approaching end of life”.

• The Australian Disability Strategy’s (2011) stated intent of full inclusion of people with disabilities into society, based on the UN Convention on the Rights of Persons with Disabilities. However, ProLiving believes that the acknowledgement of people with disabilities as interdependent should be a guiding principle, rather than regard pursuit of independence as primary.

Pro-Living Believes…

The role of quality disability support is critical
Much community interest in voluntary euthanasia involves fear of pain and suffering, especially that of “loss of dignity” through increased dependence on others, sometimes through the most basic of assistance, such as with toileting, showering and dressing. Where good quality support is provided, many people with disabilities live well with those realities on a daily basis (8). We are not claiming that therefore everyone should do likewise. We merely point to the fact that good quality care is a potent remedy against suffering and fears of suffering and preserves dignity. It contributes to a civil society where those who embody fears about aspects of life, such as fragility, loss of personal control and dependence, are treated as inherently worthy.

Fear of disability may lead to euthanasia
Because of the existence of such fears in our community, and the generally low social worth accorded to people with disabilities, life with disability is easily conflated with that of meaningless, and unbearable suffering. A low ‘quality of life’ is often assigned to living with a disability. This perception makes them vulnerable to being viewed as eligible for euthanasia and physician-assisted suicide, rather than call for good care and support.

Fear of inadequate care and support underlies some euthanasia requests
Fears of a presently inadequate care and support environment, for example ‘ending up in a nursing home’, or ‘stuck on a tube’, also underlie community support for laws that allow the intentional ending of life under such circumstances. The causes of these realistic fears are human-made. They must be addressed at that level by attention to the development of widely available, quality care and support.

About access to quality care and support
We acknowledge that in an imperfect world there may never be enough care and support to address all suffering. At the same time we assert that our wealthy country can and ought to do much more in offering quality care and support than it presently does. By this we do not primarily mean providing more money. We aim for the development, in genuine participation with disabled people and their supporters, of the best possible quality approaches to meeting their needs. Without such quality, and available support in place, it is irresponsible to legislate for euthanasia and PAS as we presently do not attend to all the reasons for people requesting euthanasia. "Unrelievable suffering?"

There are no effective safeguards against abuse of legalized euthanasia and PAS
Long accepted and legal euthanasia practice in the Netherlands (9) and in Oregon (10), as well as more recently in Belgium (11), give no reason for confidence in believing that euthanasia and physician assisted suicide can be properly regulated. To the contrary, they show the inevitability of a widening of eligibility criteria for assisted death beyond terminal illness, beyond ‘pain’, and beyond the person’s own autonomous request. Assisted by expert advice, parliamentary inquiries in the UK, Canada and US have all concluded that effective safeguards are not possible (12).

So-called ‘narrow’ euthanasia Bills, focused on terminal illness and pain, are no safeguard. They are merely a foot in the door to wider criteria, prompted by inevitable calls for additional ‘suffering’ to be treated with ending of life, as the many attempts for such widely constructed Bills show (13).

Illegal euthanasia is no rationale for legalization
Undoubtedly illegal intentional ending of life where life is considered not worth living in our healthcare institutions is happening today (14). We believe that the answer to this situation is to pay attention to better quality and safeguards in care, and safeguards against abuse, not to sanction medically assisted suicide by legalising it.

Changing the doctor-patient relationship
If choosing to have medical assistance to end one's life becomes a legal option it will have to presented as an option to people with chronic illness or disability who meet the requirements, as their right. Such an offer from health professionals would dramatically change the doctor-patient relationship and our dependence on their medical support in living our lives in good health. Many people with disabilities also depend on doctors for many social benefits, allowances and subsidies, where doctors are gatekeepers. Given research, showing a high level of negative attitudes towards disability, the roles of healer, gatekeeper and life terminator provide such tensions and conflicts of interest that the doctor-patient relationship is severely eroded by it. This further adds to a high vulnerability of people with disabilities.

Putting us out of our misery
Under a requirement of being offered euthanasia, as a legal option, our lives as disabled people would be contingent on our will to keep living in the face of the possibility that carers and family members may be thinking that we should take the option available, and our fear that we should put ourselves out of their misery in having to cope with us.

Euthanasia undermines civil society
Huge and unprecedented social, environmental and economic changes are upon us, in the form of the effects of climate change. In a society under pressure, where the response to suffering is sanctioned as killing the sufferer, presently highly vulnerable people are increasingly at risk of being treated as cumbersome, unproductive burdens, beginning with a reduction in their entitlements from the public purse, and ending with an obligation to remove themselves from the planet. On the other hand, a truly caring society, with an eye for the realities of dependence, fragility, and limitations in life, will be inclusive and socially sustainable.

Equal human worth
All people with disabilities are equally worthy to any other human being, possessing a meaningful and purposeful life by virtue of their own potential to grow as a human being, whether or not the nature and rate of that growth or its potential can be readily discerned. They should be treated accordingly, in the best spirit of care.

Disability is a normal part of life
Disability is inherent in the diverse experience of the human condition. Anyone of us appear on a scale from dependent to ‘independent’, rational to non-rational, able to less-able at any one time in our lives. A pro-living disability perspective on euthanasia is therefore relevant, and of value to all.

Autonomy, choice and independence
Much of the euthanasia debate revolves around rights to exercising personal choice. While it is true that people with disabilities are trying to rise up from very low levels of personal autonomy and choice, it is quite another thing to let respect for these principles decide in favour of euthanasia. Especially when they are being denied autonomy and life choices in a range of important areas. Many people with disabilities need better and real choices about needs like health, accommodation and work: a better life balance in other words. Independent living in disability means living in an ordinary home, with support, in a community: enjoying relationships, not being isolated. Many people with disabilities are limited in their capacity to be an autonomous human being because of cognitive impairments or mental illness. This renders autonomy a principle of limited value in euthanasia. It also means that such people with disabilities, who are thus impaired in judgment, are vulnerable to involuntary or nonvoluntary euthanasia by those who want to address suffering through euthanasia in a broad sense. Autonomy, like independence, is actually an illusion in the lives of many people with disabilities (15).

Engagement, not polls
Currently the debate is driven by polls that ask quick, simplistic questions on complex issues, involving end of life support. Disability, as is death, dying and responses to them, are mostly poorly understood by the community (16). A variety of ways of engaging with those realities must be explored, in the interests of a meaningful debate and ongoing safeguard to human wellbeing. No legislation should be passed on uninformed, uneducated assumptions.

Some context
While some progress has been made, a broadly socially devalued status for people with disabilities in Australia exists. This has resulted in their exclusion from many pursuits that are regarded as normal in our country. These include activities that people in the community typically do, for example, work, attend school and university, participate in social activities, maintain familial relationships, live in regular housing, and use public transport. Those whose impairments raise the greatest challenges to participating in these ways, such as some with significant mental illness, cognitive impairment and dementia, are among those with the highest vulnerability to abuse and covert life-ending now. Under any euthanasia law they would be more so, sooner or later.

Aside from vulnerability through their exclusion, people with disabilities are among groups in Australian society that are highly vulnerable to isolation, neglect and abuse. Negative assumptions about (people with) disability are endemic. Hate crimes against them continue (17). Their voice is rarely heard and good disability advocacy is under-supported. Many lack the adequate care and support needed for them to live good lives and reflect their human worth as equal to anyone else. The Commonwealth Government’s Shut Out report (2010) (18) for example found 56% of its respondents revealed disability support services themselves presented “barriers” in their lives. Many are still excluded from work, often cannot get good support and live in poverty.

More than half the submissions received (56 per cent) identified exclusion and negative social attitudes as critical issues. People with disabilities and their families, friends and carers reported daily instances of being segregated, excluded, marginalised and ignored. At best they reported being treated as different. At worst they reported experiencing exclusion and abuse, and being the subject of fear, ignorance and prejudice.
(Shut Out report (2010), p.7)

Proponents of euthanasia and physician-assisted suicide often characterise disability experience as unbearable suffering and a burden that should by extension be eligible for treatment by euthanasia (19). Where people with disabilities do suffer, this is often the result of their social exclusion and inadequate care and support. Their suffering is not primarily, or inherently found in the nature of their impairments, as it is often misrepresented. Such realities make people with disabilities highly vulnerable to effects of legalized euthanasia (20).

Impairment is a normal part of the human condition. Currently some one in five Australians has some sort of disability. This means not only that anyone is prone to acquire a disability at any time but that those factors that are part of disability experience are equally valid for any of us.

Until Australians are assured of the best palliative care, community services and advocacy, we will not truly know the extent to which suffering can be relieved.

...the lives of many people with disabilities are awful. (...) Only when we improve the quality of the lives of those people will we be able to ascertain whether they want euthanasia because they think life with a disability is worthless or because they think it is awful (Parsons & Newell, 1996, p. 54 , reporting Ann McDonald’s view on euthanasia. Anne lived in appalling institutionalised conditions as a child with disability).

We have reason to fear that a medical view of disability still persists (21), while that same medical, and allied, professions are often gatekeepers to disability entitlements and play a central role in euthanasia. At the same time there is evidence of substantial emotional and psychological damage to doctors themselves when participating in euthanasia (22). This is not a sign of a socially ‘good’ practice.

A growing application of market-economics to community services reduces the notion of heightened vulnerability of many people with disabilities, as arising in significant part from effects of negative attitudes, to one of ‘market failure’. This concept results in values-free financial and managerial remedies to such failure, letting those in charge off the hook in addressing attitudinal causes and quality in service. A business-like focus on effectiveness and efficiency in meeting ‘demand’, results in cost-benefit analysis of service where genuine needs are not necessarily met.

A joining of a medical view of disability and a market view of life are serious threats to the lives and wellbeing of people with disabilities, when they not meet a medical benchmark of ‘quality of life’, or the primarily valued status of contributor to the economy.

An ageing population, increase in disability, and over population are developing as significant problems. So are the emerging social, environmental and economic effects of climate change. We have reason to fear that in a culture that accepts euthanasia and PAS as legitimate responses to suffering, such developments will put further pressures on good care, support and rights to life of such people as ‘unproductive burdens.’ (23)

Our society is at a crossroads in deciding whether to emphasize our culture as one that cares, or kills.

Reference Points

Making statements about end of life issues carries responsibility. ProLiving therefore makes every effort to support its arguments with evidence - something too often lacking in the high emotions involved in this debate. While the issues are seldom black and white and involve personal values, empirical and anecdotal information does help. The reference points provided here are not intended as exhaustive.

1 We understand ‘disability’ as created from the interactions of impairments (physical, cognitive, mental, sensory), social and personal values and attitudes and environmental barriers. This understanding is compatible with view of disability taken in the UN Convention on the Rights of Persons With Disabilities (UNCRPD).

Furthermore we not orthodox on a particular ‘correct’ term describing people who are disabled in the above described interactions. We use “people with disabilities”, “disabled people” and “people with disability” interchangeably in this position paper. They are not pejorative and everyone knows what they mean.

2 “Euthanasia” and “physician assisted suicide” can be treated as having distinct meanings but can also be used interchangeably. Either can be done or facilitated by a medical doctor, allied health professionals, like nurses, or family members. Furthermore one could describe sub categories of active or inactive, voluntary, involuntary or non-voluntary euthanasia, where it usually, but not necessarily carried out by a physician, whether one terminally ill or not. The term “mercy killing” is also used.

In this position paper, euthanasia and physician assisted suicide are both covered by this definition:

An intervention or non-intervention by one person, to end the life of another person, who is terminally ill, for the purpose of relieving suffering, with the intent of causing the death of the other person, except where the primary intent is either to provide treatment necessary for the relief of pain or other symptoms of serious physical distress, or non-provision or withdrawal of treatment is justified, in particular, because there is a valid refusal of treatment or the treatment is futile. Somerville, M.A. (1993). The song of death: The lyrics of euthanasia. Reprinted from The Journal of Contemporary Health, Law and Policy, 9, 10–76.

3 Euthanasia is usually proposed as an act to address suffering. Such suffering can be identified as pain, futile medical interventions, fear of loss of dignity, existential pain or even being ‘tired of life.’ Whereas euthanasia proponents may use disability experience as suffering which warrants a right to euthanasia, the vast majority of people with disabilities see their experience as just a part of the variety of life. That experience does not call for euthanasia but for good support.

4 All human beings are vulnerable. A bus could hit, illness could strike. One might be sacked. People with disability are often much more vulnerable to ill effects on their health, personal safety, employment, housing, through combined effects of impairment, social attitudes and environmental barriers. This follows from adopting the above-described definition of disability. A large body of research exists, describing their grossly disproportionate collective experience of exclusion, abuse, neglect, poverty, ill-health and incarceration. Whereas “dependent” or “vulnerable” is at times used as a pejorative label, heightened vulnerability for disabled people is a fact of life and should be understood for its causes. Any pejorative use should be addressed at the level of those using it in this way.


States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others.

6 A ‘good life’ for people with disabilities means having opportunities in being supported towards achieving one’s individual potential to be the best one can be and to minimize harm to the person. This includes being part of a community or communities, involving a sense of belonging and contribution, living, working and playing - being fully welcomed - alongside everyone else. A good life is not a segregated and congregated life.


8 Gill,G. (2001). Divided understandings: The social experience of disability. In Albrecht,G,L.,Seelman,K,D., & Bury, (Eds.). Handbook of disability studies. Thousand Oaks, CA: Sage Publications.

See also Rapley,M. (2003). Quality of life research: a critical introduction. Sage Publications. London.

9 See comments expressing concern of The United Nations Covenant on Civil and Political Rights Concluding observations of the Human Rights Committee : Netherlands. (2001). Inter alia, about inability to regulate euthanasia, euthanasia for newborns and children.

Furthermore, Dutch regulations have gradually widened to include people who are mentally ill, have beginning dementia, are newborn babies with disabilities and extended a right to euthanasia from age 12. Now a large citizens initiative around a right to euthanasia when ‘tired of life’ from age 70, is pushing the boundaries even further.

See Jochemsen,H. (2007). Recent developments in the euthanasia debate in the Netherlands. ;Ms Els Borst, the Minister responsible for euthanasia supports a ‘tired of life’ rationale: Dutch Minister favours suicide pill

Jochemsen,H.; Keown,J. (1999). Voluntary euthanasia under control? Further empirical evidence from The Netherlands. Journal of Medical Ethics, 25,1, 16-21. This study concluded that voluntary euthanasia in the Netherlands remains beyond effective control.

Around 1,000 cases of nonvoluntary euthanasia, through not being competent to consent, were reported in the first two government reports on euthanasia in 1991 and 1995. The government’s third report made it clear that it was the patient’s responsibility to make an advance direction NOT to have euthanasia, in the event of suffering and being incompetent. See The Linacre Centre for Healthcare Ethics (2004). Submission to the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill.

Buiting,H., van Delden,J., Onwuteaka-Philpsen,B., Rietjens,J., Rurup,M, van Tol,D., Gevers,J., van der Maas,P, & van der Heide,A. (2009). Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study. BMC Medical Ethics 2009, 10:18.

This 2009 study concluded that “The information [Dutch doctors performing euthanasia] provide is in most cases sufficient to enable adequate review.” It also reports:

63% physicians mentioned 'other aspects'; these included increased dependency (28%), deterioration (15%) and more rare aspects (16%), such as loneliness, being a burden to relatives and being mentally exhausted. Physicians most often based the 'hopelessness' of the suffering upon the "absence of treatment alternatives" (32%), "absence of curative treatment alternatives" (28%), or "absence of treatment alternatives to relieve the patient's symptoms", or combinations of these (14%).

10 Hendin,H; Foley, K. (2008). Physician-assisted suicide in Oregon: A medical perspective. Michigan Law Review, 106,8. This study found that legally mandated safeguards were being circumvented, causing harm to patients.

Eleven years of assisted suicide in Oregon. Patients Rights Council. A comprehensive analysis of implementation of Oregon’s Death With Dignity Act (1997), showing many flaws.

11 Cohen-Almagor,R. (2009). Law, ethics and medicine Belgian euthanasia law: a critical analysis. J Med Ethics 2009;35:436-439 Found concerns with the Belgian euthanasia law itself and about potential abuse.
Inghelbrecht, E, Bilsen,J., Mortier, F., Deliens, L.(2010). The role of nurses in physician-assisted deaths in Belgium. Canadian Medical association Journal, 182,9. This study highlight the role of nurses in administering life-ending drugs and warns of the nursing profession’s illegal practice in going beyond the boundaries of the profession, including through direct involvement in euthanasia without an explicit request from the patient, and in which close to half of all nurses in this study involving 1678 Belgium nurses.

Until death do us part... not. Presented as "taboo-breaking", Belgium couples are having euthanasia together. Reported on March 30, 2011, an 84-year old terminally ill man and his 78-year old non-terminally ill wife (she had arthritis), met all the Belgium euthanasia criteria and had euthanasia done together. The wife simply did not want to to on without her spouse. See video here. It was the first time that such joint euthanasia had been openly acknowledged in funeral notices but joint euthanasia by Belgium couples is reportedly not uncommon. Like Dutch provisions, three doctors had assessed the joint request and judged it as within the law, which, also like Dutch law, does not require terminal illness as a criterion.
12 The UK House of Lords Select Committee, which stated in 1993, in the context of the Bland case:

We do not think it is possible to set secure limits on voluntary euthanasia. It would be impossible to frame safeguards against non-voluntary euthanasia if voluntary euthanasia were to be legalised. It would be next to impossible to ensure that all acts of euthanasia were truly voluntary, and that any liberalisation of the law was not abused. Moreover, to create an exception to the general prohibition of intentional killing would inevitably open the way to its further erosion, whether by design, by inadvertence, or by the human tendency to test the limits of any regulation. These dangers are such that we believe that any decriminalisation of voluntary euthanasia would give rise to more and more grave problems than those it sought to address.

The Senate of Canada established a Special Committee to study the issues of euthanasia and assisted suicide and reached similar conclusions in 1994 on the same grounds and so did the New York State Task Force on Life and the Law.

13 For example the so-called “Parnell” Bill introduced in the South Australian Parliament in 2010, expressly allowed euthanasia for persons “suffering” from a disability. Leipoldt, 2010. Euthanasia in Australia: Raising a disability voice. Australian Policy Online.

Like wise the “Rights Of The Terminally Ill Act” (1998) had inadequate safeguards. (Keown, J. (2002). Euthanasia , ethics and public policy: An argument against legalization. Cambridge University Press.)

14 Magnussen (2002). Angels of death: Exploring the euthanasia underground. Yale University Press.


16 Kopp,S.W. (2009). The influence of death attitudes and knowledge of end of life options on attitudes towards physician-assisted suicide. Omega (Westport). 58(4)299-311.

Aranda.S, O,Connor.M (1995). Euthanasia, nursing and care of the dying: rethinking Kuhse and Singer. Australian nursing Journal,3,18-121.

Webster, J., & Kristjanson, L. (2002). But isn‘t it depressing: The vitality of palliative care. Journal of Palliative Care,18(1), 144-150.

17 Sherry, M. (2000.). Hate crimes against people with disabilities. School of social work. University of Queensland. Accessed Oct 25, 2010.

18 Shut Out: The Experience of People with Disabilities and their Families in Australia, 2010. National Disability Strategy Consultation Report prepared by the National People with Disabilities and Carer Council. FAHCSIA10307.0908.

19 Leipoldt, 2010. Euthanasia in Australia: Raising a disability voice. Australian Policy Online.


21 Hubbard,S.(2004). Disability studies and health care curriculum: The great divide. Journal of Allied Health, 33(3),184-8.

Byron,M., Cockshott,Z., Brownett,H.& Ramkalawan,T. (2005). What does ‘disability’ mean for medical students? An exploration of the words medical students associated with the term ‘disability.’ Medical education 39:176-183.

Dixon,D.P. (2008). Informed consent or institutionalized eugenics? How the medical
profession encourages Abortion of fetuses with Down Syndrome. Issues in Law &
Medicine.24.

22 Stevens, Jr, Kenneth, R. (2006). Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia on Participating Physicians. Issues in Law & Medicine, 3, 187-200.p

23 Herman Daly is a professor of economics and past World Bank economist. John Cobb is a professor of philosophy and theology. As one strategy to reduce excess of births over deaths in answer to the overpopulation problem, they proposed a right to die for older people. Of course, the incidence of disability is high in old age, and like in disability, a sense of meaning in old age has been eroded. When meaning in the lives of vulnerable people is questioned, a perceived suffering from old age or disability, can lead to the concept of their lives as worthless and disposable. We should also ask, is a ‘right to die’ here a front for the greater good of society? They wrote:

Older people should have the right to die on their own terms. A major dread of the elderly is that they will be kept alive at great expense to society and with much trouble to their children long after their lives have ceased to have any meaning for themselves and for others. This is, on any large scale, a problem brought about by the triumphs of modern medicine. The proper response cannot be found in ancient religious texts that came out of a very different social and demographic situation. Society is beginning to take a few tentative steps toward releasing doctors from the need to take extreme measures in preserving the life of one who wants to die we hope that with due caution it will go considerably further. Quite apart from any general demographic considerations, a proper respect for human freedom and the needs of the elderly should grant them the right to die and aid them in implementing their decision. In a world where population presses upon ecological limits, there are additional reasons to take these humane steps. (p.250). Daly, H.E., Cobb, J,B. (1989). For the common good. Redirecting the economy toward community, the environment and a sustainable future. Beacon Press. Boston.

Another warning on a slippery slope from Pieter Admiraal, a former Dutch anesthetist, who became one of Holland's leading campaigners for euthanasia. He said:
In 50 years time, you will see euthanasia accepted all over the world. It will be used with patients suffering from Alzheimer's who are otherwise kept alive for five or ten years. The time will come when we say that this costs money, and if you are demented for one year, we will kill you. I see it not as the answer to the growing elderly population but as the exercise of the right of self-determination.
Reported in an excellent article by Ruth Limkin (2008). Living with Dignity. Eureka Street