Thursday, March 5, 2015

The Carter Decision: Not Safe for Doctors

By Alex Schadenberg,
Executive Director - Euthanasia Prevention Coalition

The Carter decision has been heralded as legalizing “physician-assisted death,” more commonly known as physician-assisted or euthanasia. A closer reading of the decision reveals, however, that these practices are not “legalized” in the sense that they are safe for doctors to do. This will be the case until the expiration of a 12 month suspension and the passage of regulations by Parliament of a regulatory scheme to create safe harbors for practice.

Carter merely provides that the Criminal Code provisions prohibiting physician-assisted death are of no force or effect when three factors are satisfied: patient competency; clear consent; and a “grievous and irremediable medical condition.” (Decision, ¶147). Physicians are not always right regarding such factors.

Consider, the Victorio Noval case, in California, where a hospital reportedly performed a “terminal extubation,” thus causing Noval’s death. After the fact, the hospital learned that his daughters had lied about his condition for the purpose of a quick inheritance and that consent had been required by Noval’s son, which had not been obtained. The hospital and other parties have now been sued. Hospital staff are reportedly refusing to testify in order to avoid incriminating themselves on criminal charges.

If, by contrast, Noval had died under a regulatory scheme such as Washington’s death with dignity act, there would have been no basis for liability as long as the act was used. See: Washington State’s death certificate instructions, requiring that a death be treated as “Natural” as long as the act was “used.”
Without the imposition of a similar regulatory scheme by Parliament, no doctor who assists a suicide, can be assured of his or her safety to do so. Even after the 12 month suspension period, doctors are at risk of homicide charges because, like the hospital in  Mr. Noval’s case, they learn after the fact that they were wrong.

View the Carter decision.

Book Review: Do You Call This A Life? Blurred Boundaries in the Netherlands' Right-to-Die Laws.

Purchase the book or DVD: Do You Call This A Life? Blurred Boundaries in the Netherlands' Right-to-Die Laws for: $20 for the book or $10 for the DVD of van Loenen's talk in Ottawa or (book and the DVD for $25) includes postage from the Euthanasia Prevention Coalition (EPC) by calling: 1-877-439-3348 or email:
Do You Call this a Life? Blurred Boundaries in the Netherlands’ Right-to-Die Laws. By Gerbert van Loenen.
Book Review by Paul Russell;
the director of HOPE Australia and the Vice Chair of EPC-International

What do you want to do when you leave school?” A casual conversation starter I think I’ve probably had with each of my children at some point – even repeatedly. It had an additional context when I raised it with Joseph recently in a quiet moment. 

Joseph, in his fourteen years had had probably more prospective careers than most of us could think of; ranging from a long period when he was convinced he would be a priest to only recently wanting to ‘go into business’ operating a pizzeria out of our kitchen (Mum had other ideas!).

Sometimes this kind of exchange is simply banter; a time filler exploring the thoughts and ideas of a child with ever-expanding horizons as the world opens up before him or her.

“A firefighter, Dad!” “But Joseph, the fire brigade probably won’t accept someone with Down syndrome, mate. It just won’t happen.”

Okay! I know! That sounds like a harsh response, but it’s not. Joseph and I have great conversations about all sorts of things. Anne and I are also as firmly committed to providing him with the very best educational and emotional platform we can. But we’ve done that for all our children, so that’s hardly surprising, even if fleshing that out requires somewhat a different approach from the others.

The question of disability is a consistent theme throughout Gerbert van Loenen’s book: Do You Call this a Life? Blurred Boundaries in the Netherlands’ Right-to-Die Laws. Ostensibly chronicling and analysing the history and progression of the Dutch affair with euthanasia, van Loenen’s crisp prose refers constantly to the changing and challenging of concepts in Dutch academia and politics in relation to the worth of human life. In summary: once human life is valued only in subjective terms of relative merit or worth, there is an inexorable extension of application, in terms of euthanasia laws, from a limited cohort to almost anyone.

Wednesday, March 4, 2015

Paul Russell: A statement we should all fear.

The article was published on the HOPE Australia website on March 4, 2015.

By Paul Russell 
The director of HOPE Australia and Vice Chair - EPC International

The theory and the practice of euthanasia simply don’t match and the rhetoric and reality are miles apart.

Dutch activist Dr Rob Jonquiere, head of the world body pressing for euthanasia, is in New Zealand peddling euthanasia up and down the country.

He has said some outrageous things, some of which I tackle below. But the most outrageous statement, one that we should all fear, he gave recently to the New Zealand media:
"Sometimes the only way to terminate the suffering is to take away the life."
‘What’s so outrageous about that?’ you may ask. Well, perhaps those who are used to hearing pro-euthanasia peddlers talking about people dying in pain might not notice immediately. But Jonquiere is not talking about pain, he’s talking about suffering. There’s a significant difference; one that should ring alarm bells.

Tuesday, March 3, 2015

Great News: Appeal dismissed in BC normal feeding case.

This article was published by Advocate Daily on March 3, 2015.
Hugh Scher

By Hugh Scher, EPC Legal Counsel

The British Columbia Court of Appeal has dismissed a request from the family of an 83-year-old woman that their mother no longer be given nourishment or liquids by staff members at the nursing home where she resides, says Toronto health and human rights lawyer Hugh Scher.

In Bentley v. Maplewood Seniors Care Society 2015 BCCA 91, Justice Mary Newbury agreed with a lower court judge, ruling that the woman, who has advanced Alzheimer’s disease, is exercising her consent when she opens her mouth to accept food and water, despite her family’s position that it was her wish while she was mentally capable that she not be fed in her current condition.

The Euthanasia Prevention Coalition (EPC) and EPC – BC, represented by Scher and Geoff Cowper QC, were intervenors in the case at trial and on appeal.
“I recognize the terribly difficult situation in which Mrs. Bentley’s family find themselves and I appreciate the disappointment they must feel in being unable to comply with what they believe to have been her wishes and what they believe still to be her wishes,” writes Newbury. 
“It is a grave thing, however, to ask or instruct caregivers to stand by and watch a patient starve to death. It should come as no surprise that a court of law will be assiduous in seeking to ascertain and give effect to the wishes of the patient in the ‘here and now’, even in the face of prior directives, whether clear or not," says the decision.
The coalition also advanced its position at the Supreme Court of British Columbia, which previously ruled that oral nutrition should not be considered health care or medical treatment, but rather seen as basic personal care and support. The court found the woman is capable of making the decision to accept oral nutrition and hydration and is “providing her consent through her behaviour when she accepts nourishment and liquids.”

The Supreme Court ruled spoon-feeding is “a form of personal care, not health care,” and “withdrawing oral nutrition and hydration for an adult that is not capable of making that decision would constitute neglect within the meaning of the Adult Guardianship Act.”

The woman had prepared advance directive documents, but the Supreme Court considered them invalid due to lack of clarity and contradictions in the wishes.

The case is one of several examples of end-of-life care issues stirring up heated debates across Canada, says Scher, who appeared at the Supreme Court of Canada on behalf of the  coalition in Carter v. Canada (Attorney General), 2015 SCC 5 in the fall.

Links to more information about the Bentley case:

For more information contact:
Hugh Scher, EPC legal counsel (Toronto): 416-816-6115 or

Oregon debating bill to expand assisted suicide.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

An Oregon, assisted suicide Bill HB 3337 is being debated in the State House to expand the assisted suicide law.

Currently people in Oregon are eligible to die by assisted suicide if they are defined as terminally ill. The assisted suicide act states:
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, [produce] result in death within [six months].
Bill HB 3337 will expand the definition to 12 months.

Jeannette Hall lives in Oregon and was diagnosed as terminally ill with a 6 - 12 month prognosis in 2000. She asked for assisted suicide but is alive today because her physician didn't abandon her by prescribing a lethal dose, but rather provided medical treatment. Hall is happy to be alive today.

The 2014 Oregon assisted suicide report indicates a 44% increase in assisted suicide deaths and a 48% increase in the number of lethal prescriptions. In 2014, at least one person who died by assisted suicide obtained the lethal dose in 2012, (439 days before death) even though the law requires the person to be within 6 months of death.

In 2014, Assisted suicide's in Oregon increased in numbers, conditions and demographics.

  • 105 assisted suicide deaths in 2014 up from 73 in 2013. (44% increase).
  • 155 prescriptions for suicide in 2014 up from 105 in 2013. (48% increase).
In previous years almost 80% of the assisted deaths, were cancer related. In 2014, 68% had cancer with "other illnesses" increasing to 8.6% (9 deaths). Other illnesses included diabetes.

Oregon did not previously attempt to expand the assisted suicide law because the assisted suicide lobby was trying to first expand the number of states that permit assisted suicide.

In Oregon, the doctor who prescribes suicide self-reports the assisted suicide death after the person has died. Since doctors do not self-report abuse of the law and since the doctor is rarely at the death, therefore we have no idea if the assisted suicide death was voluntary and we have no idea if the person who died was mentally competent, depressed or coerced.

The lack of oversight reveals concerns that elders, who are being abused, people with depression or incompetent may be dying by assisted suicide.

Disability advocate: Supreme court is wrong on assisted suicide.

This letter was published in the Hamilton Spectator on March 3, 2015.

By Steven Passmore

As a person living with a disability, I am deeply concerned with the Supreme Court of Canada ruling, which struck down Canada's laws protecting me from assisted suicide. As a non-elected body, the Supreme Court has made a bad decision which will negatively affect all 35 million Canadians.

We are a nation that prides itself on democracy. In April, 2010, Parliament defeated an assisted suicide bill by a vote of 228 to 59. That was a pretty strong consensus. Nine Supreme Court Justices should not be able to overrule 308 members of parliament (MPs).

In Canada, does democracy still rule?

The Supreme Court of Canada has overstepped its mandate; the justices should have upheld the law and not struck down our current law. I would urge Parliament to use the notwithstanding clause to overrule the Supreme Court of Canada's decision on the basis of democracy.

Steven Passmore, Hamilton, Advocate for Persons with Disabilities and Board Member of Euthanasia Prevention Coalition

The case of a BC woman who is being fed normally, to be decided today.

 By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition (EPC) hopes that the BC Court of Appeal will dismiss the case of a BC woman, who is living with dementia and being fed normally. Mrs. Bentley is not being fed by a feeding tube, she is being fed orally and continues to swallow normally. 

On February 3, 2014; Justice Greyall of the BC Supreme Court decided that Normal Feeding is basic personal care and not medical treatment in the Bentley case. The court recognized that there is an obligation to provide basic personal care, whereas medical treatment is optional.

EPC intervened in this case because we agree that normal feeding by spoon and cup to be basic normal care. Mrs. Bentley willing eats and swallows normally. The decision by Justice Greyall was correct. EPC also recognizes that people who require assisted feeding will be negatively affected if Greyall's decision is overturned.

The Bentley family argued that Justice Greyall erred in his decision. They stated that normal feeding by spoon and cup is a form of medical treatment and Mrs Bentley's is being fed against her prior wishes which they define as "assault and battery."

The family wants normal feeding to be discontinued. Mrs Bentley would die from dehydration.

In August 2013, the family of Mrs Bentley launched a lawsuit against Fraser Health and the BC government ordering that feeding by spoon and cup be discontinued. The Bentley family defined normal feeding as medical treatment.

It is interesting that, in August 2013, the Bentley family claimed that Mrs Bentley was living with "end stage" dementia and yet in December 2014 she continues to be fed normally.

For more information contact:
Hugh Scher, EPC legal counsel (Toronto): 416-816-6115 or
Dr Will Johnston, Chair EPC - BC (Vancouver): 604-220-2042 or
Alex Schadenberg, EPC Executive Director (London): 519-851-1434 or

Monday, March 2, 2015

Ontario Physicians want conscience rights protected.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The College of Physicians and Surgeons of Ontario (CPSO) on February 20 ended their consultation on the issue of conscience rights for physicians.

The CPSO has been suggesting that physicians will not be required to assist the death of their patients but that they will be required to refer their patients to a physician who will assist the death.

The CPSO had an online poll asking: Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician's religious or moral beliefs? 

The CPSO published the results of the online poll. Out of 32,912 respondents, 25,230 (77%) agreed that the conscience rights of physician should be protected.

Physicians are demanding that their conscience rights continue to be protected by the CPSO. These physicians consider assisted death to be not part of health care.

Physicians should not be required to lethal inject, assist the suicide, or refer a patient a physician or an agency for the purpose of causing or assisting death.

Connecticut should again reject assisted suicide bill

The following column was written by Paul Choiniere and published on March 1, 2015 in The Day

By Paul Choiniere

You have to give the group Compassion & Choices high marks for persistence. Despite little progress, for the third straight legislative session they are back in Connecticut, asking the General Assembly to pass a law that would allow doctors to prescribe medications that terminally ill patients could use to commit suicide.

I know the group doesn't like that ugly word and you won't find it in any of Compassion & Choices press releases or guest commentaries. Instead there are references to "aid in dying," "death with dignity" and "end-of-life choices."

But what they are talking about is the state sanctioning suicide: "The act of taking one's own life voluntarily and intentionally."

The assisted suicide bills did not get to the floor for a vote in 2013 or 2014, but as I wrote a year ago, the group sees Connecticut as a progressive state that can eventually be persuaded to see the issue as a matter of individual choice - the choice in the organization's words to "have the best death possible."

It is an issue that generates strong and emotional opinions on both sides. Compassion & Choices garnered much media attention last year, and certainly won some converts, with the moving story of 29-year-old Californian Brittany Maynard, who utilized the Oregon law to take her life before her brain cancer became severely debilitating.

This is a movement more imposed on Connecticut than generated from the grassroots. C&C has also launched campaigns in New Jersey, Massachusetts, Colorado and California. Vermont and Washington, as well as Oregon, already allow doctor-assisted suicide in cases of terminal illness.

As proposed in Connecticut, a person with a few months to live, and who is becoming increasingly incapacitated and dependent on others and wants to avoid suffering, can obtain medication to commit suicide at a time of his or her choosing. In the parlance of the movement, they can choose to "die with dignity."

I remain convinced such a law is not needed and would take society down a troubling ethical path.

What message does it send to and about severely disabled people to contend it is undignified to need the assistance of others? When government gives the OK through law that expediting death can be the best option, it can apply subtle pressure on the dying - who may worry they are a financial and emotional burden on family - to "just get it over with."

Sunday, March 1, 2015

Maggie Karner: Assisted Suicide Would Undermine My Cancer Battle

Maggie Karner, who is living with the same medical condition as Brittany Maynard had, wrote an article that was published in the Hartford Courant titled: Suicide Option Would Undermine My Cancer Battle. Karner, who lives in Bristol Connecticut opposes assisted suicide and the assisted suicide bill that is being debated in the Connecticut legislature.
Maggie Karner in Hawaii in 2009

Karner first comments on assisted suicide and her medical condition:
I have been diagnosed with a terminal brain cancer — a glioblastoma. Because of my diagnosis, I would likely be eligible for the state's help to commit suicide under a bill before the General Assembly — and that is terrifying. 
Like many Connecticut residents, I have wondered whether I would want my doctor to offer suicide as a treatment for deadly cancer. The out-of-state proponents of the bill regarding physician-assisted suicide suggest having the ability to end your life legally is comforting. But I can tell you from personal experience that it is nearly as troubling as the cancer itself. 
You see, I get strength and comfort from the knowledge that nobody is going to give up on me — medically, psychologically or holistically. Right now, I have the firm support of the state and my fellow citizens in my desire to live — no matter the cost or burden. If that were to change, the tiny knowledge that I might be straining my family, friends, doctors or community resources unnecessarily would be a heavy burden. The constant "option" for suicide would wear at my resolve and I fear, become an unspoken "duty" for me and others.
Maggie then comments on the Oregon assisted suicide law:
In Oregon, where assisted suicide is legal, the top reasons people give for wanting a deadly prescription are fear of losing autonomy (91.5 percent), fear of being less able to engage in activities (88.7 percent) and fear of loss of dignity (79.3 percent). These are not good enough reasons to upend the medical axiom of "first, do no harm."
Karner then comments on the Connecticut situation:
In 2014, Connecticut legislators enacted a pilot program regarding medical orders at the end of life. These forms, given to medical and hospital personnel, declare in advance the level of intervention a person wants when receiving emergency or end of life care. To build on these efforts and provide laws that will actually help the most people, our legislators should increase awareness and access to hospice and palliative care, double funding for home health care and their aides (more jobs!) and require mandatory training for doctors on pain management techniques. 
These measures would help many more hundreds and thousands of Connecticut people rather than undercutting the care and security of people like me who are fighting for their lives.
Karner concludes her article by arguing for compassionate care and not assisted suicide.