Canada’s euthanasia Leviathan

This article was published by Careful a Mercatornet blog on April 26, 2016.

Supporters invoke Thomas Hobbes in a proposal to crush conscientious objection to euthanasia. 

By Michael Cook

Michael Cook

Michael Cook

Canada is soon to have legislation permitting euthanasia and assisted suicide, as decreed by its Supreme Court last year. One question, however, over which some uncertainty hovers is how much wriggle room should be left for doctors who have ethical objections to the new regime.

For one of the country’s most influential bioethicists, Udo Schuklenk, the answer is straightforward: none.

In an article published last weekend, he wrote that “conscientious objection has no place in the practice of medicine”. If doctors feel that they cannot practice euthanasia or refer patients to another doctor for euthanasia, they should find another job.

Dr Schuklenk is worth listening to. He is the co-editor of Bioethics, one of the world’s leading journals in the field, and a professor of philosophy at Queen’s University, in Ontario, Canada. He was one of the authors of an influential white paper commissioned by the Royal Society of Canada for the debate which eventually led to legalisation.

His stand on conscientious objection is not new, but the timing is significant. Bill C-14 was introduced into the Canadian parliament last week implementing the Supreme Court ruling.

Only doctors will be allowed to perform euthanasia, but it is still not clear whether they will have the option of conscientious objection. Dr Schuklenk’s essay in the Journal of Medical Ethics (written with a colleague, Ricardo Smalling, also from Queen’s University), is sure to influence the debate in the weeks before the Supreme Court’s June 6 deadline for passing legislation.

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Another euthanasia scandal behind the euthanasia curtain

Tine Nys (in the centre) with her sisters.

Tine Nys (in the centre) with her sisters.

This article was written by Michael Cook and published today by Careful.

Another euthanasia scandal in Belgium. Two sisters have complained on a television program, Terzake, about the euthanasia of their sister. Tine Nys was 38 at the time and had broken up with her live-in boyfriend. On Christmas Eve 2009 she announced that she was going to be euthanased.

After interviews with doctors, she was given a lethal injection on April 24, 2010, with her mother and father and her two sisters, Lotte and Sophie, at her bedside.

Belgium allows people to request euthanasia if they have unbearable psychological suffering, not just a terminal illness. Tine was obviously a troubled woman and 15 years before she had been seeing a psychiatrist regularly. But she was recovering from a love affair, not suffering unbearable mental anguish.

Three doctors were supposed to concur that she met all requirements: a psychiatrist and two other doctors. This time a psychiatrist casually made a diagnosis of “autism”. The sickness from which euthanasia candidates are suffering is supposed to be incurable. Autism may not be curable, but Tine was functioning adequately. None of the doctors made an effort to treat her – but they were willing to kill her.

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The dark history of eugenics

This article was written by Michael Cook and published by Bioedge on January 23.

By Michael Cook

The dark history of government-sponsored eugenics before World War II has largely been forgotten, although it is well documented. A new book, Illiberal Reformers: Race, Eugenics, and American Economics in the Progressive Era(Princeton UP, 2016), by Thomas C. Leonard, is a painful reminder that some of the best minds in the United States and Britain were in favour of purging the “race” of “defectives”.

The heyday of the eugenics movement was during World War I and the 1920s. Some geneticists distanced themselves from eugenics, but usually because it had been tainted by racism and anti-Semitism.

Eugenics was literally regarded as a religion by leading economists. In 1915 Irving Fisher, one of the greatest of the early 20th century, told a Race Betterment Conference organised by cornflakes inventor and eugenicist John Henry Kellogg, that eugenics was “the foremost plan of human redemption”. Religious opponents (notably the Catholic Church) were a shrinking minority which had also opposed Copernicus, Galileo and Darwin.

It all seemed very scientific. In The Great Gatsby, F. Scott Fitzgerald’s famous novel, the central character complains that civilization is spinning apart and that “ if we don’t look out the white race will be — will be utterly submerged. It’s all scientific stuff; it’s been proved.”

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Under-ground euthanasia in the Netherlands

This article was published on November 28 by Bioedge.

By Michael Cook

The leading Dutch right-to-die society is seeking talks with the Dutch medical association (KNMG) for approval of a “peaceful pill” which will allow its members to kill themselves without the help of a doctor.

As usually happens in the progress of euthanasia, supporters are now telling the media that this already occurs illegally on a vast scale and that legislation is essential to guard against abuses.

People who believe that their lives are “complete”, need a pill, says the Dutch Association for a Voluntary End of Life (NVVE) in a recently-published policy paper. The details have yet to be worked out with the Ministry of Health and the Ministry of Security and Justice and the KNMG. As the NVVE acknowledges, the peaceful pill could be used to murder people, or taken impulsively by otherwise healthy people, or used by young people with mental health issues. Therefore the NVVE would like to run a pilot project so that authorities will have “scientific research” to back up a decision.

NVVE director Robert Schurink told the media

“We see that society wants such a pill, particularly among the babyboomer generation which is not afraid to speak its mind. They want control over the end of their lives.”

For the first time, NVVE and another group, Stiftung De Einder, have acknowledged that they are already promoting a “peaceful pill” outside the existing legal framework. The lethal drugs are ordered from overseas. From China come pills and from Mexico come liquid barbiturates. The packages arrive quickly, sometimes disguised as a birthday card. NRC says that although this arrangement is illegal, there is no chance that the public prosecutor will charge anyone.

About 5300 people are euthanased legally in the Netherlands every year. The NVVE did not disclose how many commit suicide using overseas drugs over and above this figure. De Einder told NRC that it had given advice about its own service to 607 clients last year, although it is unclear how many committed suicide.

One of NVVE’s clients is 75-year-old Jannes Mulder, a doctor who had helped to euthanase several people himself. A feature story in the NRC describes how he contacted China:

Mulder ordered through the mail powder for two people – himself and his wife. Payment was made through Western Union. Two weeks later came a brown envelope with red Chinese postmarks. There was a birthday card for “John”: happy birthday. It is a subterfuge that Chinese suppliers often use. Inside the card was a sachet of powder. Mulder put it in the basement. Those around him know about it -- Jannes H. Mulder is in charge of his own life. He will soon test some of the powder on his goldfish. "I want to make sure it works," he says.

NRC also tells the story of another client, 83-year-old Tom van Manen, who stirred the Chinese powder into his breakfast yoghurt one morning in 2012 with the help of his daughter, Kika Notten. It sounds like a typical “completed life” scenario – except that van Manen was quite demented and may not have understood what he was doing. Ms Notten knew that she was in a grey zone, legally speaking. However, she was careful to inform a local doctor and two police officers. They did nothing.

Belgian prisoners denied euthanasia, for now

This article was published on the Bioedge on November 21.

By Michael Cook

Belgian serial rapist and murderer Frank Van Den Bleeken, who was serving a life sentence, sparked a controversy by asking for euthanasia in 2014. The government at first granted his request and the bureaucratic machine began whirring. However, it quickly backtracked and placed him in a specialised psychiatric unit where he could get better care.

In the wake of his highly-publicised request, 15 other prisoners have asked for euthanasia in Belgium on the grounds that they have unbearable psychological suffering. This week the head of the country’s euthanasia commission declared that they are not eligible. Dr Wim Distelmans told De Morgen that:

The unbearable suffering that these prisoners describe is due in large part to the context (ie, prison) and is not the result of an incurable disease … We have advised the interested parties that they are not within the framework and conditions provided by law.

However, this may not be the end of the story. De Morgen reported that better psychiatric treatment would be made available to some or all of the 15 prisoners at the Sint-Kamillus university psychiatric center in Bierbeek. "If the patients maintain their request for euthanasia, then we'll reconsider," Dr Distelmans said.

After the apparently unstoppable expansion of euthanasia requests, Belgium may be applying the brakes, possibly in response to adverse international publicity. Apart from denying euthanasia to the prisoners, a prominent euthanasia doctor, Dr Mark Van Der Hoey, was recently charged with breaking the law after he was filmed euthanasing a patient in an Australian documentary. It was the first time since euthanasia was legalised in Belgium that a doctor has been charged, let alone convicted.

More information on this story:

How the assisted suicide lobby won in California

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Michael Cook wrote a very insightful article today titled: How the assisted suicide lobby won in California that was published in the online bioethics site Careful. 

Another good analysis of the assisted suicide lobby was titled: Subversive strategies to sell assisted suicide, by Dr Jacqueline Harvey.

Cook bases his analysis on information from the assisted suicide lobby group, Compassion & Choices, formerly the Hemlock society. Cook writes:

According to Barbara Coombs Lee, the head of America’s leading assisted suicide lobby group, Compassion & Choices (C&C), it was Brittany Maynard, the just-married woman who drank a lethal dose of barbiturates on November 1 last year, a few weeks short of her 30th birthday. She died in Oregon because assisted suicide was illegal in her home state of California. 
Brittany, who had an aggressive brain tumour, wanted to use her death to send a message pleading for the legalisation of assisted suicide. A C&C video about her did exactly that. On October 6 last year it was released on YouTube; on October 5 this year, Governor Jerry Brown signed a bill legalising assisted suicide, a measure which had failed six times since 1988.

Defeat in America's biggest state has been a bitter pill for opponents of assisted suicide. But if you're handed a lemon, make lemonade. It’s also an opportunity to learn the lessons in propaganda which are exemplified so brilliantly in Brittany’s video. 

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“Unbearable suffering” questioned in documentary on Belgian euthanasia

This article was published on September 21, by Careful a blog about end-of-life issues.
 

By Michael Cook

This documentary from the Australian SBS network is one of the best on Belgian euthanasia that I have seen. Although short on statistics and background, it gives an insight into its disturbing ethical dilemmas. Journalist Brett Mason interviews two patients about their request for euthanasia and asks a number of doctors and public figures whether the increasing number of cases for unbearable suffering can be justified.

Peter Ketelslegers is a 33-year-old father of two who suffers from cluster headaches. This condition – according to Belgian doctors – is untreatable. The pain is so intense that he can no longer work. He feels that he should die so that he won’t be a burden to his boys and his wife.

Simona de Moor is 85, physically fit and mentally sharp. But five minutes after her beloved daughter died, she decided on euthanasia. Mason films her “mundane and unremarkable” last moments as she drinks a lethal potion brought by her doctor, Marc Van Hoey. A dark family problem overshadows her life; she has another daughter from whom she has been estranged for decades and whom she will not inform about her death.

Dr Van Hoey is an old hand at euthanasia. How many has he killed, Mason asks. “To be frank, I don’t know, maybe hundreds, or over a hundred,” he replies. “A lot of elderly people are not really suffering in the narrow meaning of the word, but one plus one plus one plus one makes a whole,” he says. “That in addition to their age gives them no future, there is nothing left any more, and so quite often they say, I’ve had it with my life.”

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