Dans l’article de La Presse le 5 octobre 2013, le Dr Gaétan Barrette s’interroge sur les risques de dérapage si la loi 52 sur l’aide médicale à mourir franchit avec succès sa dernière étape. Oublions les hypothèses au sujet du bien-fondé de l’euthanasie et discutons des faits suscitant une vigoureuse remise en question de cette procédure.
1- Neuf millions de médecins de L’Association Médicale Mondiale (AMM) à travers 100 pays condamnent l’euthanasie. Pourquoi ?
2- L’euthanasie autorisée légalement en Belgique montre de sérieux dérapages en étant utilisée chez des sujets non en « fin de vie ». Dans ce pays, des gens sont euthanasiés à cause de l’épuisement de vivre ou d’un état dépressif, sans préavis à la famille. Un patient Nathan Verhelst (« Nancy ») de 44 ans qui n’était pas heureux avec la chirurgie pour changer son sexe fut euthanasié le 30 septembre, 2013. En 2003, toujours en Belgique, l’adoption d’une loi autorisant l’euthanasie entraîna 235 décès prématurés. En 2012, ce nombre s’éleva à 1,432 décès. Actuellement, le sénat belge discute de la possibilité d’élargir l’accès à l’euthanasie aux mineurs souffrants et affectés par une maladie sévère. Au Pays-Bas, cette loi permet déjà l’euthanasie pour des nouveaux nés et des jeunes enfants.
3- Les balises mises en place en Belgique n’assurent pas une protection complète. Le tiers des patients euthanasiés en Belgique n’aurait pas été en mesure de donner un consentement libre et informé. Toujours en Belgique, presque 50% des cas d’euthanasie n’ont pas été rapportés aux autorités.
4- Il n’existe pas de modèle fiable pour déterminer avec précision la durée de vie des patients avant leur décès. Les modèles de calcul sophistiqués utilisés pour prédire la fin de vie dans les prochains six mois chez les patients porteurs de maladies chroniques montrent une précision de 50%.
5- L’euthanasie est discriminatoire pour les patients souffrant de problèmes de santé mentale. Ces patients ne sont pas en stade de vie terminale et à cause de leur maladie, ils ne sont pas en mesure de prendre une décision libre et éclairée. Le droit d’accéder à l’euthanasie crée des risques non négligeables tels que les décès prématurés chez ceux qui souffrent de conditions potentiellement réversibles.
6- La tentation est grande de réaliser des millions de dollars d’économie par le biais de l’euthanasie. L’euthanasie est une approche très efficace pour épargner des sommes importantes et les soins palliatifs exigent des ressources financières beaucoup plus lourdes. Au Québec, 20% seulement des patients ayant besoin de soins palliatifs ont accès à ces services. En Oregon, le traitement pour un cancer doit obtenir un taux de réussite de plus de 50% pendant 24 mois—même pour les personnes à jeune âge, pour que le gouvernement accepte de supporter le coût des soins médicaux.
7- En légalisant l’euthanasie, les citoyens du Québec prennent l’allure de citoyens de seconde zone en comparaison avec les criminels.
En effet, nous avons aboli la peine capitale pour éviter la mort d’innocents suite à des erreurs judiciaires et les gouvernements investissent des sommes astronomiques pour les services de réclusion.
Les sept points apportés sont des faits clairement établis. La légalisation de l’euthanasie a bien du mal à justifier sa présence dans une société qui a choisi de défendre les droits individuels et qui prône le respect de la vie.
On the last day of public hearings on » end of life care , » the Coalition of Physicians for Social Justice invited Dr. Georges Casteur , former medical director of a neurological rehabilitation center in Ostend , Belgium(1976 to 2012) to present results of 10 years of euthanasia in his country. According to Dr. Casteur, safeguards and controls in Belgium do not provide complete protection. According to studies, one-third of patients “euthanized” were not able to give free and informed consent. Almost 50% of “euthanasia cases” were not reported to authorities. He described the steep slippery slope and “the culture of death” that is now installed in Belgium. He gave several examples of people “exhausted of life, or depressed » who were given lethal injections without prior notification to their family members. Recently a 44 year old patient named Nathan Verhelst ( » Nancy « ) unhappy with a sex-change surgery was euthanized on Sept. 30, 2013. In contrast, several of Dr. Casteur’s patients have changed their decisions to end their lives after talking with him or his colleagues. Last year one of his patients with severe quadriplegia, following an accident, was referred to a Brussels hospital for three weeks of rehabilitation after euthanasia was already programmed. After a chance conversation with a physician at the clinic, he changed his mind and is now enjoying life. He also described how pressures such as financial problems, family members, heirs, health care providers and administrators lacking hospital beds, can prevent people from making “free and unbiased decisions.” Also there is a lack of independence of the second consulting physician who is often a member of the same team with a goal of promoting euthanasia. He showed the similarities of the Belgian and proposed Quebec law. He argued that the same tragic consequences will happen if euthanasia is legalized in Quebec. Furthermore Dr Casteur is astonished that the word euthanasia is not used in the Bill 52. However there is one major difference: Belgian law is a federal law unlike the proposed Quebec law which is a provincial.
Also present were a couple from Lachine, Quebec, Jacques Ro:y and his wife Diane Bergevin, whose life has been challenged since 2011 by two tumors, one behind the left eye and another in her lung. Despite the severity of the diagnosis, they are both relieved by the good response to treatment. Mr. Roy discussed the potential dangers of a poor prognosis given by some doctors and a variety of external pressures that may endanger the health and survival of patients. He is concerned that the new law will « encourage people to look for the easiest and the fastest fix- the deadly needle. Administrators, government and some doctors will benefit. It is clear that it is more expensive to treat diseases. So even though there may be a chance to survive or live longer, some doctors will quickly ship patients off to funeral homes. »
Dr. Paul Saba who is a family physician and co-chair of the Coalition of Physicians for Social Justice explained the fatal consequences of euthanasia and the loss of individual autonomy if Bill 52 is passed. Euthanasia also creates significant risks such as premature deaths in those with potentially reversible conditions. In Oregon, before the government agrees to pay the cost of medical care even for young people, cancer treatment must obtain a success rate of over 50% for 24 months. People who could potentially live a long time or even get cured from a cancer diagnosis must pay out of pocket or accept the free lethal cocktail.
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Announcement of a Press Conference – The Coalition of Physicians for Social Justice: A Belgian doctor condemns euthanasia in his country and the deadly risks for Quebecers
Date: October 10, 2013
Location : Édifice André-Laurendeau
1050, rue des Parlementaires
Québec QC: On the last day of public hearings on « end of life care » Dr. Georges Casteur , a Belgian family physician and former director of IMBO (a neurological rehabilitation center at Ostend from 1976 to 2012 ) will present 10 years of euthanasia and the slippery slope of this practice in his country.
Also present will be a Quebec couple Jacques Roy and his wife Diane Bergevin , who has struggled with two life threatening tumors-one behind the left eye and the other in the lung that are under treatment since 2011. Despite a serious illness, the couple is optimistic about the future. Mr. Roy will discuss the dangers of physicians giving a poor prognosis and « external pressures « that may endanger the health and survival of patients.
Dr. Paul Saba, a family physician and co- president of the Coalition of Physicians for Social Justice will discuss the inherent dangers to patients and the loss of individual autonomy if Bill 52(euthanasia) is passed.
MONTREAL, Sept. 24, 2013 /CNW Telbec/ – At the end-of- life public hearings in Quebec City on September 24, 2013, the Coalition of Physicians for Social Justice criticizes the very foundations of Bill 52, which aims to promote an illegal and criminal medical procedure that contravenes medical ethics. In support of this assertion, Dr. Paul Saba, co-chair of the Coalition of Physicians for Social Justice, fiercely criticizes the lack of ethics of the law, which deviates from the basic principle which guarantees the safety and life of each person. « We must remember that 9, 000,000 doctors, who are part of the World Medical Association in 100 countries, reject euthanasia as a medical practice. » The risks are real and apparent in four countries allowing euthanasia or assisted suicide (Netherlands, Belgium, Luxembourg, and Switzerland) and in two American states (Washington, Oregon). We must not forget that there are 192 countries where euthanasia is illegal and not allowed.
The slippery slope is real. Dr. Saba cited the increase of euthanasia in Belgium where death by injection has increased substantially from 235 in 2003, rising to 1,432 in 2012. During a visit to Montreal, Professor Tom Mortier severely criticized the death of his mother by euthanasia at the age of 64 years on April 19, 2012. His mother suffered from depression. Without prior notification to the family Mrs. DeTroyer was euthanized, leaving two adult children and three grandchildren in grief and in shock. According to Dr. Mortier, « In Belgium, we are ten years ahead of Quebec. Originally, the criteria and restrictions for the euthanasia were similar to those of Bill 52. What is happening currently in Belgium offers a perspective of what can happen in Quebec in ten years if Bill 52 is adopted. «
Currently, the Belgian Senate is discussing the possibility of extending access to euthanasia for minors suffering and affected by severe disease. In the Netherlands, the Groningen Protocol was passed into law in 2005 allowing euthanasia for newborns and young children who are « without hope of a good life. » (35 BMJ, 2006).
International studies clearly demonstrate that safeguards and controls don’t work. 32% of patients euthanized in Belgium did not give free and informed consent (J Medical Association Canada, 15 June 2010). Also in Belgium, almost 50% of euthanasia cases were not reported to the authorities (British Medical Journal, October 5, 2010). In the Netherlands, many patients were not evaluated by a second doctor (BMJ, 24 September 2005). In Oregon, 20% of depressed patients do not have access to a psychiatrist or psychological evaluation before being euthanized (BMJ, 2 August 2008).
After analyzing 57 reports and studies in Current Oncology in 2011, Dr. Jose Pereira, director of palliative care at the University of Ottawa Hospital, concluded that safeguards and controls for euthanasia are an illusion.
The risks to euthanatized patients are real because of the inaccuracy in terms of « prognosis « . Under Bill 52, the patients with severe and incurable disease associated with significant and irreversible deterioration in their medical condition are candidates for euthanasia. For those patients with severe and chronic diseases, the prediction of life expectancy for the next six months is about 50 %, which corresponds to a coin toss. Even for patients with cancer, the prediction rate of death is not always that accurate. A case in point; Dr. Kenneth Stevens, radiation oncologist at Oregon Health and Science University in Portland, Oregon, presented an affidavit to Superior Court in Trois Rivieres, Quebec (2012). One of his patients, Jeannette Hall, then in her fifties, asked to die by assisted suicide 13 years ago because of a newly diagnosed cancer rather than undergoing cancer treatment Fortunately for her, Dr. Stevens refused the request, and Mrs. Hall agreed to treat her cancer. Today, Ms. Hall is still alive and happy.
In 2002, euthanasia was legalized in the Netherlands. Initially it was reserved for people with cancer and other physical illnesses. However, in the case of one Dutch woman, she convinced her doctors to take her life just because she was deeply depressed after a divorce. In another case, a young anorexic woman insisted on dying, and the committee of doctors decided that it was acceptable under the new law.
In such cases, it must be concluded that these two women lost their lives mainly on the ground that they could not find effective solutions to their problems in their health care system.
In Quebec, treatments in many cases are not sufficient or timely enough due to a lack of financial resources.
Dr. Farquhar describes in his analysis, how the system is discriminatory to patients suffering from mental health problems and is concerned that Bill 52 will impact negatively on psychiatric patients. As a psychiatrist he is concerned that people with mental illness could choose euthanasia because they lack medical and psychiatric care.
In his legal brief, Mr. Dominic Talarico is concerned that the proposed law disregards the intrinsic value of human life of its citizens both from a legal and medical perspective. The right of access to euthanasia creates significant risks, such as death in those who suffer from potentially reversible conditions.
In his advocacy for patients’ rights, he claims that the proposed Bill 52 presents a high risk of causing human tragedies and it should not be passed.
Hélène Beaudin related how she lost her father in 2010 through chronic illness and is now accompanying her mother diagnosed with terminal cancer in a palliative care unit. She clearly does not want euthanasia for her mother or others,
Active euthanasia, framed in the present legislation, may appear as a choice in a society open to bold and new changes in its orientations and policies. In fact, the proposed law 52 illustrates the lack of coherency on the part of the government and reflects a disregard for human life. A question must be raised. Is the government in a conflict of interest by benefiting from millions of dollars saved by reducing health services and promoting euthanasia at the same time?
Finally, Dr. Saba asks doctors not to perform euthanasia or refer anyone for euthanasia because euthanasia contravenes legal and ethical practice of modern medicine. Despite this, the government wants to force doctors to do what is illegal and unethical.
SOURCE: Coalition of Physicians for Social Justice