At a press conference, Prof. Dr. Etienne Montero, Dean of the Faculty of Law, University of Namur, Belgium, gave an overview of 11 years of euthanasia in Belgium. The proponents of euthanasia in Belgium recognize that most requests for euthanasia are not rooted in physical pain, which can be controlled, but in psychological suffering.
Examples include loss of meaning, loneliness, weariness of life, and need to master one’s death. In situations of suffering, a euthanasia request is understandable, but courts cannot give the right to euthanasia without endangering the lives and security of its citizens. All citizens are at risk of excesses and abuse.
The Belgian experience of euthanasia teaches us that it is an illusion to believe that we can have the right to euthanasia as a well-defined and well-controlled practice.
Once euthanasia is permitted, it becomes very difficult to maintain a strict interpretation of legal requirements. Quickly, restrictions fall away, one after the other, and boundaries become wider and larger. Such an expansion is inevitable due to the intrinsic dynamics of law. Indeed, law is part of a legal system that has its own dynamics, driven by higher principles such as equality and non-discrimination. First, euthanasia, initially reserved for adults, will open to minors. Second, the law initially requires a serious and incurable disease with physical or mental suffering. Applying these same principles, how can a person be denied euthanasia with only psychological suffering, without a serious and incurable disease?
The Belgian experience illustrates the difficulty of adhering to original statements and intentions of the legislator and of ensuring compliance to the original strict legal requirements. It was originally stated that psychiatric, demented or depressed patients would not be targeted by the Belgian law. However, the Belgian Control Commission (BCC) approves euthanasia in such cases today.
Conditions of severe and incurable disease and suffering are also interpreted very loosely. The BCC approves euthanasia at the request of people who suffer from various diseases related to old age, none of which, taken alone, is severe (arthritis or decreasing sight and hearing). It also recognizes the possibility of future anticipated suffering as a condition for euthanasia.
Moreover, how can anyone make sure that the patient is given free and informed consent, without external pressure? How can anyone ensure that the prognostic information (predicting chances of survival) and therapeutic options are correct as well as sufficiently explained and given in an empathetic manner? How reliable is the verification process a posteriori (after the fact) based on a document completed and submitted by the same doctor who euthanized a person (self-reporting)?
Today, the emphasis is on patient autonomy. However, there is a real danger that vulnerable people, faced with declining health, will feel pressured and compelled to be euthanized so as not to be a burden to family or society. There is also a risk that people will be euthanized due to incompetence (i.e. inadequate pain control). Finally, society may be more willing to offer euthanasia as a solution to suffering than to alleviate the suffering.
If Quebec decides to partially open the door to euthanasia, be warned that the door will automatically open wider and wider regardless of initial intentions. This is not pure conjecture, but reality based on the Belgian experience.
2 days prior to « a vote in principal » of Bill 52 at the Quebec National Assembly, the Coalition of Physicians for Social Justice invited an Oregon physician, Dr Kenneth Stevens, who described how Oregon’s physician assisted suicide law had caused hundreds of physician assisted suicides over the past fifteen years. He also described how if the current Bill 52 on euthanasia is passed in Quebec, hundreds of Quebecers will die annually at the hands of doctors.
Dr Kenneth Stevens is a leading cancer specialist with more than 40 years’ experience. He is also a Professor Emeritus and a former Chair of the Department of Radiation Oncology, Oregon Health & Sciences University, and Portland, Oregon. He has treated thousands of patients with cancer.
According to Oregon law, patients must be considered to have less than 6 months to live. Dr Stevens stated that the ability to diagnose and predict the survival of people at the « end of life » with months to years to live is inaccurate. Many patients who are considered « terminal » or « end of life » are not necessarily dying.
Dr Stevens described one patient in his 40’s who was diagnosed in 2004 with advanced cancer with 13 tumors in his liver and more than 70 tumors throughout his lung. The original biopsy showed « adenocarcinoma of the liver. » He was told that he would probably be dead in 6 weeks. After the bad news, he sold off many of his assets and bought his burial plot. When he realized that he was feeling well he sought second opinions. After consulting other pathologists he was finally told that the condition was « epithelioid hemangioendothelioma » which can be chronic and not fatal. Now 9 years later he is doing well and happy to be alive without any cancer treatments.
Dr Stevens described how hundreds of so-called « hopeless cases » with treatment can go on to survive many profitable years or be cured. Hospital administrators and doctors would have abandoned and not treated these people. Four other of his patients were discussed. One was a 30 year old woman with liver cancer which had metastasized to her chest and was told « she did not have long to live. » With combined radiation/chemotherapy she lived over 20 years with quality life. An 18 year old college man with glioblastoma multiforme (the most malignant brain cancer) was treated. He graduated from college, law school, passed the Oregon bar exam, married had 2 children, was elected to city council and survived over 20 years. Another 50 year old woman with advanced lymphoma, was bedridden and not able to stand or walk. She received radiation treatments with total resolution of her disease. All these patients were treated despite « poor prognosis » and other physicians questioning the reasonability of such « aggressive and futile treatment » for these very severe conditions.
According to Dr Stevens; other people are encouraged to give up on care because of the existence of the assisted suicide law. The message of the proponents of assisted suicide is that « doctors can do a better job of killing you than caring for you. »
Present at the conference and giving her testimony was a patient of Dr Stevens, Jeanette Hall. She was diagnosed in 2000 with lower bowel cancer and told that she had six months to a year to live. She considered chemotherapy and radiation therapy futile. She asked for assisted suicide as provided by the state of Oregon. Dr Stevens disagreed with her decision for assisted suicide and was able to convince her to undergo radiation and chemotherapy. She is now thrilled to be alive 13 years after undergoing cancer therapy and not killing herself with a lethal dose of barbiturates.
Dr. Stevens believes that people who are not dying are being lured into assisted suicide. They are misguided to believe that their medical condition is irreversible and discouraged to undergo any treatment that is « overaggressive and futile. » Dr Steven’s states that « overaggressive and futile therapy » is a relative term—and can only be defined in hindsight. If a patient undergoes therapy for a very severe condition and survives—such therapy is not overaggressive and futile because it was successful. People are being denied therapies that could prolong and save their lives. Dr Stevens also talked about how financial incentives in Oregon’s government health plan steers patients to suicide. In Oregon, the government insurance sets limits on cancer care. Dr. Stevens warned that if assisted suicide or euthanasia is legalized in Quebec, then the Quebec government health program could follow a similar pattern—that is limit coverage for cancer care and thus encourage euthanasia.
Dr. Paul Saba, a family physician and co-president of the Coalition of Physicians for Social Justice explained how Québec’s proposed euthanasia law would encourage people, including young adults 18 and over with treatable conditions such as depression, chronic lung and heart disease, diabetes, rheumatoid arthritis and fibromyalgia to agree to euthanasia and end their lives.
The Coalition’s position against euthanasia is supported by the World Medical Association representing nine million physicians.
Date: October 25, 2013
Time: 10:30 am
Location: Auberge Bonaparte
447, rue Saint-François-Xavier
Montréal, QC H2Y 2T1
(Beside the Centaur Theatre)
The Coalition of Physicians for Social Justice presents a doctor and his patient from Oregon where assisted suicide is legal.
Dr Kenneth Stevens is a practicing cancer doctor with more than 40 years’ experience. He is also a Professor Emeritus and a former Chair of the Department of Radiation Oncology, Oregon Health & Sciences University, Portland, Oregon. He has treated thousands of patients with cancer.
Jeanette Hall, Dr. Stevens’ patient, is thrilled to be alive 13 years after he talked her out of “doing” Oregon’s law, i.e., killing herself with a lethal dose of barbiturates.
In 2000, Jeanette was diagnosed with cancer by another doctor and told that she had six months to a year to live. This was without treatment. The other doctor had referred her to Dr. Stevens for radiation and chemotherapy. Jeanette, however, had voted for Oregon’s law. She had made a firm decision to go forward with Oregon’s law instead.
Dr. Stevens did not believe in assisted suicide. He also believed that Jeanette’s prospects for treatment were good. He convinced her to be treated instead of doing Oregon’s law.
Dr. Stevens will talk about how the mere existence of legal assisted suicide steered Jeanette Hall to suicide. He will also talk about how financial incentives in Oregon’s government health plan also steer patients to suicide. Dr. Stevens warns how if assisted suicide or euthanasia is legalized in Quebec, then the Quebec government health program could follow a similar pattern—that is, to pay for people to die, but not to live.
Dr. Paul Saba, a family physician and co-president of the Coalition of Physicians for Social Justice will demonstrate how Québec’s proposed euthanasia law will encourage people, including young adults with treatable conditions, to agree to euthanasia and throw away their lives.
The Coalition’s position against euthanasia is supported by the World Medical Association representing nine million physicians.
In 2008, Barbara Wagner wanted to continue fighting for her life and continuing cancer treatment. Her doctor recommended a treatment that could help extend her life, but the government sent her a letter declining coverage for the drug, but offering to pay for comfort care including physician aid in dying…
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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La triste histoire de la mort de la mère (64 ans) d’un professeur belge, permise par l’application de la loi sur l’euthanasie de Belgique, découlant de sa dépression. « À la mémoire de mon père et de ma mère »
Depuis 2002, la Belgique permet l’euthanasie aux citoyens qui souffrent de douleurs insupportables et intraitables
Nombre de cas déclarés d’euthanasie en Belgique
2003 235 2008 704
2004 349 2009 822
2005 393 2010 953
2006 429 2011 1133
2007 495 2012 1432
98% des cas déclarés d’euthanasie ont été demandés par un patient conscient alors que dans 2 % des cas, la procédure a été complétée chez des patients qui n’étaient pas conscients mais qui avaient dicté leur volonté antérieurement