All citizens at risk of excesses and abuse – #Bill52 #Quebec

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.law is part of a legal system that has its own dynamics, driven by higher principles such as equality and non-discrimination

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.

Euthanasia – dangerous for patients not at the end of life, illegal for doctors and a conflict of interest for the government

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. « 

http://www.youtube.com/watch?feature=player_embedded&v=TwCLxV9L6v0

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

 

For further information:

 

Dr. Paul Saba 514-886-3447 or 514-249-8541
pauljsaba@gmail.com
Web: Coalitionmd.org

L’euthanasie légale a changé la Belgique – Dr. Sc. Tom Mortier, PhD

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

Source – The fifth report (2010‐2011) to the legislative chambers dawn up by the Federal Commission for Control and Assessment of Euthanasia & http://www.ieb-eib.org/en/pdf/20121208-dossier-euthanasia-in-belgium-10-years.pdf