Taquisha McKitty was declared brain dead after suffering cardiac arrest relating to drug overdose. Ontario Superior Court Justice Lucille Shaw ordered that McKitty‘s life support be withdrawn in a month but the family appealed the decision, challenging the brain death designation. According to the family’s lawyer, Hugh Scher, Justice Shaw erred by applying a legal definition of death that fails to conform to a biological definition of death. The court also erred by not allowing independent experts to assess McKitty’s movements, which differs in nature, quality and duration from spinal cord reflexes. Scher and the McKitty family say that beyond breathing and having a heartbeat, Taquisha shows other signs of life like moving her legs - which proves she's still biologically alive. The McKitty case questions whether a person who has been declared brain dead is actually dead.
Robert Latimer is seeking a federal pardon for murdering his 12 year old daughter Tracy who was born with cerebral palsy. He killed her by carbon monoxide poisoning in October 1993 and was convicted of second-degree murder. The conviction was upheld by the Supreme Court of Canada in 2001. The larger issue at stake is that Latimer and Vancouver lawyer Jason Gratl are seeking to employ Canada’s two-year old medical assistance in dying legislation as part of their plea. Currently the legislation does not apply to minors nor does it justify euthanizing Canadians simply because they are in some measure disabled. Latimer is trying to get federal Justice Minister Jody Wilson-Raybould to pardon him based on this argument.
Designated Federal Health Minister, Jens Spahn has requested that the Bonn Federal Institute for Drugs and Medical Devices refuse applications for euthanasia drugs, contradicting a March 2017 decision by the German Federal Court. In view of "fundamental and far-reaching questions, particularly constitutional questions … It cannot be the task of the state to actively support suicidal acts through the official, administrative approval of the acquisition of the specific suicide agent," deputy health minister Lutz Stroppe wrote in a letter. "This is not compatible with the purpose of the Narcotics Act to ensure the necessary medical care of the population. A suicide cannot be considered therapy.”
Ten Quebec doctors have denounced a health care system that is forcing patients and doctors to accept “medical aid in dying” as medical care. Reasons for the rapid acceptance for euthanasia can be attributed to patients having difficulty in accessing palliative care services. Access to palliative care is regarded as a fundamental human right by the World Health Organization (WHO) and palliative care is the ethical responsibility of health system providers, with the ethical duty of health care professionals to alleviate pain and suffering irrespective of whether the disease or condition can be cured. WHO members are urged to develop and implement palliative care policies to strengthen health systems and to ensure domestic funding and allocation of human resources. The Quebec College of Physicians informed the Health Minister that there are difficulties with accessibility to palliative care in Canadian health care systems.
Several influential doctors and ethicists have co-published a commentary in the Journal of Palliative Care opposing any policy change and summarizing what they take to be the five strongest reasons to oppose euthanasia. Among the authors of the article entitled “Physician-Assisted Suicide and Euthanasia: Emerging Issues From a Global Perspective” are Georgetown University’s Daniel Sulmas, who served on President Obama’s Commission for the Study of Bioethical Issues, Margaret Somerville, a legal scholar and one of the most vocal opponents of the legalisation of euthanasia in Canada, and influential palliative care specialist Lukas Radbruch. The 5 reasons are: 1) “Slippery slopes”: Allowing voluntary euthanasia has led to non-voluntary euthanasia”. 2) “Lack of self-determination”: many expressions of a desire for death do not mean that a patient wants euthanasia or assisted suicide. 3) “Inadequate palliative care”: the most urgent ethical obligation of jurisdictions worldwide rather than legalizing PAS-E. 4) “Medical professionalism”: doctors assisting in PAS-E threaten the moral integrity of the medical profession. 5) “Differences between means and ends”: Confusing the problem of suffering with the life of the person: “we must kill the pain and suffering, not the person with the pain and suffering”.
The Centers for Disease Control is concerned about a steep increase in suicides in the US over the past two decades. Suicide is now the tenth leading cause of death for Americans. Suicide, Alzheimer’s disease and overdoses are the only causes of death which are increasing. Among people aged 15 to 34, suicide is the second leading cause of death. “At what point is it a crisis?” Nadine Kaslow, a past president of the American Psychological Association asks. “Suicide is a public health crisis when you look at the numbers and they keep going up. It’s up everywhere. And we know that the rates are actually higher than what’s reported. But homicides still get more attention.”
Ludwig Minelli, founder of the Dignitas assisted suicide clinic has been charged for profiteering in the deaths of his clients. Accusations that Minelli charges inappropriate fees at the Dignitas clinic have circulated for years. Several years ago Soraya Wernli, a former Dignitas employee, told the Daily Mail that Minelli was selling the personal effects of his dead clients at pawn shops and charging some clients exorbitant fees. Providing assisted suicide in Switzerland is not illegal but it is illegal to do so for profit, under the threat of a maximum five year prison sentence. Prosecutors are seeking a fine of 7,000 Swiss francs (£5,200) and a further suspended fine of 65,000 francs (£48,000).
The Portuguese General Assembly voted down four government legislative proposals to legalize euthanasia in Portugal. The Socialist Party proposed law was defeated with 115 votes against 110 in favor and four abstentions. The head of the Portuguese Catholic Doctors Association, Pedro Afonso, congratulated parliamentarians and declared the vote to be a “victory for medicine and for life.” At the same time he criticized the proposals as “a subterfuge by those claiming to eliminate suffering who instead eliminate the sufferer”. Another opponent from the medical profession repeated a well-known fact that approximately 80% of gravely ill Portuguese people have no access to palliative care and the government should focus on this rather than assisting death.
Laws regarding medical staff participation in euthanasia are geared at forcing medical doctors and medical staff to violate medical ethics and practice - for example, lying on death certificates. Several state laws legalizing assisted suicide force MD’s who assist suicides to falsify death certificates on public documents needed for the accrual of vital statistics stating that the cause of death was the underlying disease and not a self-administered drug overdose. Minnesota legalization proposal SF1572 states that unless otherwise prohibited by law the attending physician may sign the qualified patient’s death certificate. The qualified patient’s underlying terminal illness shall be listed as the cause of death. No report of a public agency may refer to the practice of obtaining and self-administering life-ending medication to end a qualified patient’s life as suicide or assisted suicide, and shall refer to the practice as medical aid in dying, making sure that the term “assisted suicide” is banned from use in public communications, documents and announcement.
The American medical Association (AMA) was asked by legalization activists to revisit its decades-long opposition to legalizing assisted suicide, specifically, to distinguish between suicide and the euthanasia movement’s favorite euphemism, “aid in dying.” The Ethics Committee however reiterated its opposition to legalization in full because the AMA rejects the nonsense that assisted suicide somehow isn’t suicide. Taken from the “Report of the Council on Ethical and Judicial Affairs (CEJS),” Report 5-A-18, the council recognizes that choosing one term of art over others can carry multiple, and not always the intended messages. However, in the absence of a perfect option, CEJA believes ethical deliberation and debate is best served by using plainly descriptive language in the issue of physician assisted suicide and euthanasia. The CEJS therefore recommends that the Code of Medical Ethics not be amended.
Dr Dawid Goodall, 104 years old and a distinguished ecologist was not terminally ill - just tired of living. He had a press conference declaring that "Everyone over middle age should have the right unquestioned to end their lives as and when they choose”, and the next day he was dead. So, as a long-time member of Philip Nitschke’s Exit International organisation, Dr Goodall was turned into a poster boy for legalising suicide on demand, or so-called “rational suicide”. There are a few lessons to be learned from this sad episode. 1. Pro-euthanasia organisations are eager to exploit the loneliness and isolation of the elderly. 2. The lonely and socially isolated are vulnerable. 3. Pro-euthanasia organisations are willing to take short-cuts. 4. The goal of pro-euthanasia organisations is a universal right to suicide. 5. "Rational suicide" is the ultimate act of selfishness.
A 3D-printed suicide machine designed to aid euthanasia is planned to be made public for the first time at the Amsterdam Funeral Fair. Dubbed the Sacro, the device was created by Dr. Philip Nitschke, a euthanasia activist who's also known as "Dr. Death". It has been reported that event attendees could actually try the device using virtual reality technology. Plans to demonstrate the euthanasia machine has sparked outrage. According to critics, Nitschke's creation is "gruesome" and it also glamorizes suicide.
Only about 15% of euthanasia cases in the semi-autonomous region of Flanders in Belgium are being reported, according to the latest research by physicians. It has long been known that euthanasia is underreported on official forms but that there are about 550% more cases of euthanasia than are currently in government statistics seems to have astonished even researchers. Research lists several reasons; physicians consciously or unintentionally not recognizing their cases of euthanasia as such, because they believe that they have not complied with the legal due care criteria (e.g. not reported euthanasia to the evaluation committee as is required by law), because they have privacy concerns for themselves as reporting attaches their name to the euthanasia case and the patient, and because they do not consider it necessary to report it on the death certificate. The lack of clear guidelines is probably also a reason for the low number of euthanasia cases indicated on death certificates.
It has long been known that euthanasia is underreported on official forms but that there are about 550% more cases of euthanasia than are currently making their way into the government statistics, seems to have astonished even researchers. In a letter to the European Journal of Epidemiology, researchers from the End-of-Life Care Research Group at the Free University of Brussels admit that “death certificates substantially underestimate the frequency of euthanasia as a cause of death in Belgium and are therefore an unreliable tool for monitoring its practice. The authors of a BMJ article noted that "societal control over the euthanasia practice is an important prerequisite for effective euthanasia legislation". If that is the goal, Belgium's experiment with euthanasia has failed.
Medical conscience is the new battlefront in right to life issues. The Trump administration announced rules that place emphasis on enforcing federal laws protecting medical conscience. Supporters of “medical conscience” argue that forcing doctors to participate in interventions they find morally abhorrent is involuntary medical servitude. Pro-euthanasia lobbies are strategically dismantling laws which protect medical practice in the United States and Canada. Some bioethicists are lobbying to enact laws that would give dementia patients the right to sign an advance directive requiring nursing homes to starve them to death once they reach a specified level of cognitive decline and increasing calls to do away with the dead-donor rule in transplant medicine so that patients can be organ-harvested while still alive. Assisted-suicide advocates are pushing an “aggressive advance directive” that would force nursing homes to starve dementia patients, even if they willingly eat, when they reach a specified stage of cognitive decline.
Nearly a year after the District of Columbia enacted a law (2016) allowing terminally ill patients to end their lives, disregarding the objections of congressional Republicans, religious groups and advocates for those with disabilities, not a single patient has used it. Just two of the approximately 11,000 physicians licensed to practice in the District have registered to help patients exercise their rights under the law and only one hospital has cleared doctors to participate. Mary Klein, a D.C. resident in the final stages of cancer who became the public face of the pro-euthanasia movement, says she hasn’t been able to find a willing doctor. The physician community was not out there advocating for it, according to Pia Duryea, spokeswoman for the Medical Society of the District of Columbia. No local practicing physician testified in favor of the measure and several opposed it, during debate before the D.C. Council. The bill allows patients with less than six months to live to receive a fatal dose of drugs after making two requests at least 15 days apart. Two witnesses must attest that the requesting patient was of sound mind, and patients must take the medication without assistance.
Hawaii has become the seventh American jurisdiction where assisted-suicide is legal, by a vote of 23-2. Governor David Inge signed the bill. “It is time for terminally ill, mentally competent Hawaii residents who are suffering to make their own end-of-life choices with dignity, grace and peace,” he said. The legislatures of Hawaii, Oregon, Washington State, California, Colorado, Vermont, Montana and the District of Columbia are all permitting assisted suicide now. In the same time ten states have passed laws explicitly banning assisted suicide. The latest was Utah, where the criminal code was clarified to include assisted suicide. It was prompted by a gruesome case in which 18-year-old Tyerell Przybycien helped 16-year-old Jchandra Brown to hang herself and filmed her last moments.
The Pediatrics medical journal asked Dutch and American bioethicists whether they would support repealing all age limits for euthanasia in the Netherlands as Belgium has. Euthanasia in the Netherlands is legal, starting at age 12. Indeed, the infanticide-allowing Groningen Protocol isn’t technically legal but is virtually never punished and specifically does not require that the baby killed be otherwise dying. Under the Groningen Protocol, serious disabilities justify infanticide. In the Netherlands research has shown that medical practice has changed dramatically since the legalization of Euthanasia. Since 2017 euthanasia deaths have increased to 8%from 2016 with 6091 reported deaths, a 10% increase. Use of potentially life-shortening medication and continuous deep sedation to relieve end-of-life suffering is common practice in the Netherlands. The frequency of physician assistance in dying is similar to the rate that was recently reported in Belgium, one of the few countries in which physician assistance in dying are also allowed. About half of all requests for physician assistance in dying were granted in 2015. It’s a very big deal that a respected Dutch medical journal such as Pediatrics hosted a debate on the ethical propriety of child euthanasia without international criticism. This means that among the medical intelligentsia, child euthanasia has become a respectable proposition.
An article by Swedish researcher Fabian Stahle, in the Journal of Medical Ethics in Mental Health explains the mechanism of the euthanasia lobby to change the concept of killing through the mechanism known as Moral Disengagement. By examining Albert Bandura’s theory of Moral Disengagement based on social cognitive theory to justify acts that are otherwise considered inhumane to become acceptable, the pro-euthanasia movement uses highly potent psychological mechanisms to propel its agenda and coerce well-socialized persons into participating and accepting the killing of fellow human-beings. Operating at the behavior locus are three separate disengagement mechanisms that convert the construal of injurious conduct into righteous conduct. Moral justification is used to vindicate injurious means. Second, by the use of sanitizing euphemistic language, injurious conduct is rendered benign. Exonerative comparison with even more flagrant inhumanities is a third mechanism for cloaking injurious behavior in an aura of benevolence.
Even though the legalisation of euthanasia has been gathering momentum around the world, the World Medical Association (WMA) has refused to support it. Dr John Lee, the president of Fédération Internationale des Associations de Médecins Catholiques (FIAMC) has issued a stark warning about impending changes in WMA policy. The WMA has plans to introduce two policy measures to facilitate worldwide abortion and euthanasia by curtailing doctors’ conscientious objection. By saying that the WMA does not condemn physicians who perform euthanasia where it is legal, the WMA is saying that euthanasia can be ethical if it is legal.
Bill SB 490 was defeated by 12 votes to 10 which would have opened a “gateway” for legalizing physician assisted suicide. Assisted suicide has become a cost cutting measure that puts a dollar sign between the patient and caregiver. Palliative, rehabilitative and psychological care will always be more expensive than a lethal dose of a drug. Neutrality on assisted suicide is never acceptable policy. Honest discussion of end-of-life issues in New Hampshire has to begin with calling assisted suicide by its right name. The New Hampshire Senate, by a narrow margin, refused to be neutral.
A joint committee hearing scheduled for February 2018 will discuss the legislation of physician assisted suicide in the state of Hawaii. House Bill 2739 which is modeled after California’s law entitled ‘Our Care, Our Choice’ would institute a process where adult residents in Hawaii with a medically confirmed terminal illness, and less than six months to live, could request a prescription for medication that would end their life.
In early 2002 Wesley Smith was invited to offer an opening keynote speech against euthanasia at a South African bioethics conference. All of these years later, I am pleased to report that, The World Medical Association (WMA) African region has called for strengthening of palliative care for patients with terminally ill ailments across Africa. The president said the African region rejected physicians assisted suicide and euthanasia, describing them as contrary to the physician’s oath. It is good to know that African doctors have not forgotten the profession’s venerable stand against the active killing of patients. Contemporary doctors in the West could learn from their African colleagues.
Dr Ludo Vanopdenbosch, a neurologist, resigned as a member in of the Federal Commission for Euthanasia Control and Evaluation due to gross negligence in Belgium’s euthanasia regulatory body. Legislation regarding physician assisted suicide in Belgium provides euthanasia “rights” for patients regardless of mental capabilities. Recently, a patient who suffered dementia was euthanized at the request of her family in spite of the fact that the patient did not reveal any request for euthanasia. Divisions within the medical establishment regarding euthanasia for psychiatric reasons and issues of transparency in health care systems even one as liberal as Belgium, has been brought to the surface despite efforts to make more information available.
A healthy elderly couple has asked the Indian President, Ram Nath Kovind, to grant them joint euthanasia because their lives are of no use. Narayan Lavate 88 and his wife Iravati 78, have no children or siblings. The couple view themselves as having “no use for society.” They argue that keeping them alive against their wishes is nothing less than imprisonment and a waste of the country’s scarce resources as well as theirs. The influence of humanist philosophy prevails in the couple’s utilitarian appeal to society. If their desire is granted the couple would consent to donating their bodies after death and whatever wealth they have to the state treasury.
The Swiss Supreme Court has declared a constitutional right to assisted suicide for the mentally ill. However, Switzerland’s enshrining of “plant dignity” into law, its outlawing the boiling of lobsters and the flushing of goldfish, but abandoning the despaired, disabled and mentally ill to go into extinction in suicide clinics, are symptomatic of our fast-eroding ability in the West to think critically, and to distinguish serious from lesser ethical concerns.
Berna van Baarsen, a medical ethicist has said she could not support “a major shift” in the interpretation of her country’s euthanasia law to endorse lethal injections for increasing numbers of dementia patients. Miss van Baarsen is the second regulator to quit in just three years following Professor Theo Boer who stepped down in 2014. The latest case of euthanasia involving a healthy 29- year old Dutch woman (Aurelia) who was granted euthanasia on the grounds of suffering from psychiatric reasons revealed the “slippery slope” pitfall that exist in euthanasia safeguard models. Miss van Baarsen said it was very difficult to assess if patients with dementia were suffering unbearably – one of the criteria that has to be met before an act of euthanasia is legally permissible. Professor Theo Boer also stated in an article that euthanasia in the context of psychiatry raises complex ethical and legal problems.
Aurelia Brouwers died at home after her request for assisted suicide for "unbearable and hopeless psychological suffering”. She wrote on her blog: "I am Aurelia, 29 years and I have Borderline Personality Disorder, chronic and complex PTSD, addiction, anxiety disorders and many more mental issues. I also spend my time fighting for euthanasia for mentally ill patients and euthanasia around the world. This state sanctioned killing of a physically healthy young woman will likely raise more concerns about the expansion of euthanasia in the Netherlands - where a woman with dementia is held down and lethally injected, alcoholics meet the criteria for assisted suicide, and there are plans to introduce it for those who have "completed life."
Quebec’s College of Physicians has issued an ethics bulletin which says that last year, “in some Quebec hospitals, some people who had attempted to end their lives through poisoning were not resuscitated when, in the opinion of certain experts, a treatment spread out over a few days could have saved them with no, or almost no, after-effects.” Bernard Mathieu, president of Association of Quebec Emergency Physicians said, “It’s possible it has confused doctors a little bit,” he said. Wesley J. Smith commented, “How many of those people would have been glad their lives were saved, as sometimes happens when suicides fail? We’ll never know because they are dead.”
Dr Ellen Wiebe has been reported to the College of Physicians and Surgeons in British Columbia, Canada, by CEO David Kesselman, director of the Louis Brier Nursing Home, Vancouver, for euthanizing a patient residing in the home at the time, without consulting his nursing staff. Dr Wiebe snuck into the old age home after hours to perform the procedure. Dr Wiebe will face a disciplinary hearing with the College of Physicians and Surgeons which regulates the practice of medicine in British Columbia. David Kesselman states that Dr Wiebe’s action was totally unethical as she was made aware of the nursing home’s policy regarding Medical Assistance in Dying.
The UK Supreme court will be ruling on the 29 January 2018 on whether doctors can remove food and fluids from brain-damaged patients without going to court.
Articles by Wesley J. Smith expose weaknesses in safeguarding measures in the USA Oregon Death with Dignity Act Model. The Oregon Health Authority revealed that its own interpretation of the law is permissive. The law does not compel patients to have exhausted all treatment options first, or to continue with their current treatment.
Euthanasia is becoming so popular in the Netherlands that the country’s only dedicated death clinic cannot keep up with the demand. Steven Pleiter, director of the Levenseindekliniek in Amsterdam said ‘If there was any taboo, it has gone’. Professor Theo Boer, who served on the Dutch euthanasia review committee between 2005 and 2014, has become a prominent critic of euthanasia, “There is no dispute about the good intentions of the people at the end of life clinic. [But] they may have become too used to doing euthanasia. Yes, they have expertise but they are too experienced. You should never get used to helping someone die.”
Australia’s best-known euthanasia activist, Dr Philip Nitschke, is back in the news with another machine for committing suicide. The machine will allow anyone who has the access key to end their life by simply pressing a button. Developed in the Netherlands by Nitschke and an engineer, the machine can be 3D printed and assembled in any location. Access to the Sarco capsule will be by an online mental questionnaire which will provide a four-digit access code. Design criteria for the Sarco will be free, made open-source and placed on the internet.
The rates of assisted suicide in Switzerland increased by 30% in 2015, bringing it close to eclipsing suicide as a cause of death. 965 Swiss residents (426 male and 539 female) died by assisted suicide in Switzerland in 2015, up from 742 deaths (320 male and 422 female) in 2014. Of the 965 deaths by assisted suicide, 822 were of individuals 65 years or older. Importantly the statistics do not include those who have travelled from another country to end their life in Switzerland.
Disclaimer: the views and opinions expressed in these articles do not necessarily reflect those of Doctors for Life International