Garnet Genuis MP: Without amendments, euthanasia Bill C-14 "will protect no one."

Garnett Genuis is the Member of Parliament from Sherwood Park / ­Fort Saskatchewan.

Garnet Genuis   

Garnet Genuis

 

I want to be clear that I do not believe in an all-or-nothing approach. Many of my colleagues and I who have broad philosophical concerns about what is happening here are still willing to vote in favour of legislation that does not re-criminalize euthanasia, if it advances positively in the direction of saving some lives, especially minimizing the risk to vulnerable persons. However, this legislation does not contain meaningful safeguards. Without amendment, it will protect no one.

We know that this law has written exceptions. However, it has exceptions to the exceptions; and may I say it has exceptions to the exceptions that are not at all exceptional?

This legislation has a requirement for the provision of written consent. However, if people cannot provide written consent, someone else can do it on their behalf.

This legislation prescribes a waiting period. However, the waiting period does not apply in the event of possible imminent death or loss of capacity.

There is so much ambiguity here.

The government has said that mental illness is excluded. However, in section 241.2(2) the legislation clearly states that physical or psychological suffering qualifies a person to seek premature death.

The legislation says that death must be “reasonably foreseeable”. May I say that death is reasonably foreseeable for all of us? It is those who think that death is not reasonably foreseeable who probably need the medical attention. Why not put in the word “terminal”? When I was learning to drive, my mother thought that death was “reasonably foreseeable” every time we got into the car. That is no criterion.

There is a requirement that two physicians sign off. However, given the huge ambiguities, obviously doctors are likely to have a wide range of interpretations of the rules. The estimates are that there are 77,000 physicians in this country, and the likely practice of doctor-shopping will ensure that people who think they meet the wooly and ambiguous criteria can somewhere find two physicians.

The member for Victoria said earlier today that this is something doctors do every day. No, it is not. Doctors do not take lives every day. This is fundamentally different from the normal practice of medicine. When we have so many different doctors and opinions to choose from, these are not effective safeguards.

Given these five comically ridiculous exceptions to the exceptions, there is no doubt that detailed provincial legislation or regulation will be required in every case. Therefore, it is not at all clear to me what this law is supposed to accomplish.

Further, there are two key areas where the prevailing rules under this law would leave us demonstrably worse off than the Carter ruling alone.

First, there is a terrifying clause in this bill, which states that if someone kills someone else but can demonstrate, at least beyond a reasonable doubt, that he or she had a reasonable but mistaken belief that the criteria applied then that person cannot be penalized. We can find that at 241(6). Therefore, we can kill someone who did not consent and escape prosecution on the basis of reasonable but mistaken belief. Whatever is done, I implore the government to take this very dangerous section out. This is going even beyond the Belgian model.

Second, this legislation provides no protection for conscience rights, despite the court's clear statement that nothing in this decision required particular health care practitioners to be involved, and despite the clear assurance of the Canadian Medical Association that access does not require taking away section 2 conscience rights.

This legislation constitutes a perfect storm. Ambiguous criteria, no advance legal review, no conscience protection, and allowances for doctor-shopping are not meaningful safeguards at all. The bill leaves patients, seniors, the sick, and the disabled vulnerable to error and systemic abuse. We have seen this in Belgium before. I have quoted the studies during questions and comments. We do not want to go down this road in Canada at all. . . .

This article was published by Choice is an Illusion on May 2, 2016.

Hospice and Hospital will not participate in assisted dying

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The recent report of the federal government's Special Committee on Assisted Dying stated (recommendation 11) that every publicly funded healthcare institution should be required to allow assisted death on its premises.

On March 5, the Windsor Star published an article by Brian Cross concerning Hotel Dieu Grace Hospital and the Hospice of Windsor and Essex County, since both institutions oppose euthanasia and assisted suicide.

Carol Derbyshire the CEO of the Hospice of Windsor stated that their philosophy of ca supports:

“respect for the dignity and sanctity of human life,” and ... that it’s (assisted death) not part of palliative care.

Janice Kaffer, the CEO of Hotel Dieu, that also operate a hospice, stated:

As a faith-based Catholic hospital, it does not believe it should participate in physician-assisted suicide.

Jean Echlin who is the President of the Euthanasia Prevention Coalition and a registered nurse who was instrumental in founding the Hospice of Windsor clinical and volunteer programs and recently co-authored a book titled: It's not that simple told the Windsor Star:

most Canadians don’t understand how dignified death can be when pain and symptoms are well managed. She fears the push for assisted suicide is being driven by a desire to control health costs. Little consideration is given to the “death squads,” the doctors and nurses expected to deliver the deadly drugs,

While Dr Brad Burke, a physical rehabilitation expert told the Windsor star:

“Whether I’m the executioner or I’m made to to refer someone to an executioner, I feel I’m still responsible,”

Burke is concerned that the Ontario College of Physicianswould revoke his medical license if he refuses to kill his patients. The Windsor Star stated:

He worries that if he follows his conscience he may contravene the rules of the Ontario College of Physicians and Surgeons and end up losing his licence.

The Canadian Medical Association recently urged the federal government to respect the conscience rights of healthcare professionals.

Healthcare professionals and institutions must not be forced to participate in killing their patients. If Canada imposes euthanasia upon the nation, there needs to be "safe havens" where people can go and not be pressured to die by lethal injection.

Canadian Medical Association urges respect for conscience rights for medical professionals

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The Canadian Medical Association (CMA) in their response to the report of the Special Joint Committee on Physician-Assisted Dying (the report) were concerned that the report required physicians, who object to killing their patients, to effectivley refer their patients to a physician who will kill. The report also requires all publicly funded healthcare facilities to permit euthanasia and assisted suicide on their premises, including hospices and religiously affiliated healthcare institutions.

The Euthanasia Prevention Coalition published a summary of the report.

The Canadian Press reported in an article written by Sheryl Ubelacker reported that Dr Jeff Blackmer, the CMA Vice-President of Medical Professionalism said:

The CMA, which represents about 80,000 physicians across the country, had argued during hearings to the committee that doctors who oppose assisted dying on grounds of conscience should not be required to refer patients to a colleague willing to provide or administer drugs that would end their lives.
"We were very disappointed to see it not incorporated into the recommendations,"

The CMA is proposing that physicians not be required to refer their patients to a physician who will kill, but rather that a central referral system be created. Blackmer stated:

the CMA had proposed an alternative -- the creation of a central mechanism to facilitate access to medically aided dying, which conscientious objectors could advise patients about.

According to the article, Blackmer also stated that physicians who are refusing to kill their patients have also said that they will leave Canada, if forced to refer.

Link to the full article

Assisted Death: I never thought this day would come

Diane Kelsall

Diane Kelsall

This article was published as a CMAJ blog on Feb 3, 2016 and republished with permission.

By Diane Kelsall, Deputy Editor at CMAJ, and editor of CMAJ Open.

In June 1993 I attended my first international research meeting. WONCA (World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians) was having its annual meeting in The Hague and I had gotten funding from my fellowship program to attend.

It was all very exciting for someone new to the research world to see the hustle and bustle, and feel the energy, that accompanies such a large meeting. Even Queen Beatrix attended.

But that’s not what I remember most about the meeting.

One of the sessions put on by the local organizers focused on euthanasia (that was the term used at the conference). At the time, the Netherlands was the only jurisdiction in the world where this practice was legalized. Many attended out of curiosity—and the collective response was interesting. Numerous attendees filed out of the session in silence, clutching handouts that described euthanasia protocols:

Administer this. If the patient is still breathing, administer that. If the patient’s heart is still beating, do this.

We stood in small groups, hardly able to grasp what we were reading. This was so contrary to everything we had been taught and everything we believed. How could physicians have crossed this line? When did “above all do no harm” turn into an algorithm for death?

When I returned home, I put the protocols away in my desk. Every few years, I would stumble across them—and each time, I felt chilled as I read them.

Link to the full article

Opinion: Doctors should not Kill

There are ethical reasons why physicians are instructed to do no harm to their patients.

This opinion column was published in the Toronto Sun on Jan 23, 2016.

Opinion: Dr Irvin Wolkoff

As a doctor, I have a question about assisted suicide that has not been clearly answered: Who will perform the procedures resulting in someone else’s death?

To look at the news, you would think it will automatically be doctors.

The media refer to this voluntary ending of life as “physician assisted suicide”, or “doctor assisted death” and — this phrase makes me cringe — “medical death”.

The Canadian Medical Association has engaged in the public dialogue about assisted death, but I’m not aware that it, federal or provincial governments, doctors’ licensing and regulating bodies, or anyone else has already decreed the people who will help very sick patients to die will be doctors.

It’s just assumed doctors will do it. Why?

There are practical obstacles to engaging doctors to carry out assisted suicides. For example, where would we find the doctors we’d need?

Canada’s physician population isn’t large enough to care for our growing and aging population as it is and governments are constantly cutting back funding to the facilities, procedures, treatments, medications and working conditions we need to do our jobs properly.

Link to the full article

Alberta Physicians group supports assisted death for minors and forcing doctors to refer patients to death

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The College of Physicians and Surgeons of Alberta approved a advisory document for doctors who participate in assisted death. The new document is based on a consultation document that was circulated in September 2015. 

Dr. Trevor Theman

Dr. Trevor Theman

According to Global News, advisory document approves assisted death for minors and it forces doctors to refer their patients to death.

CPSA Registrar Dr. Trevor Theman said there’s no strict age limit on the requirement for consent, suggesting medical procedures aren’t typically based on age. 
“It’s somebody who would not yet be of adult age, who is fully capable of understanding the options and the choices that are available–and the consequences of each–and is understood to have the capacity to make that decision,” he said. 
Theman said doctors will still be able to opt out of providing assistance to patients who wish to die, but must provide patients with access. 
“If I, as a physician, choose not to assist my patient, I need to make sure my patient has access and is not disadvantaged from gaining access to legally available procedures,” Theman said.

The slope is slippery. Canada has not yet decriminalized assisted dying and the federal government has asked the Supreme Court for a six-month extension to legislate and yet the Provincial College's of Physicians and Surgeons are already expanding the criteria for killing and throwing doctors who oppose killing their patients "under the bus" by requiring them to refer their patients to death. 

The College of Physicians and Surgeons of Alberta is now seeking input concerning standards of consent.

Killing by lethal injection or prescribing lethal concoctions of drugs is not and will never be healthcare.

Beware of Assisted Suicide Bullies

This article was published in the National Post on October 19, 2015.

By Will Johnston

Dr Will Johnston is a family physician in Vancouver and the chair of the Euthanasia Prevention Coalition of BC

Dr Will Johnston

Dr Will Johnston

For at least a few more months, the Canadian medical system will continue to be a safe space, free of assisted suicide and euthanasia. But all that is about to change. In order to ensure our hospitals and palliative care centres remain places where patients feel safe and secure, we must respect doctors’ conscience rights, rather than listen to activists who seek to impose their one-size-fits-all policy on the rest of us.

For instance, the palliative care centres in Quebec that refuse to have anything to do with euthanasia, for reasons of medical judgment and ethics, have apparently angered Jean-Pierre Menard, the lawyer who helped write Quebec’s euthanasia law, Bill 52. The act specifically states that palliative care centres are not required to provide euthanasia service — but maybe to Menard, those were just soothing words to get the bill passed. Now Menard says money should be taken away from palliative services that won’t provide euthanasia on their premises. And the minister of health, Gaetan Barrette, has threatened to revoke the hospital privileges of doctors who won’t comply.

This is wrong. The doctors and nurses who devote themselves to the care of dying people reject euthanasia because it is a tempting substitute for diligence and creativity. People with exceptionally difficult end-of-life illnesses can have reversible palliative sedation, which preserves their life and completely alleviates their symptoms. This makes intentionally killing the patient an unnecessary, dangerous and irreversible intrusion.

Link to the full article