Will Johnston: The case against physician-assisted dying

This article was published by the CanadianHealthcareNetwork.ca on June 1, 2016

Discussed: The 'wedge' cases, the language of the debate, the moral culpability of the doctor, and the question of pure autonomy
Dr Will Johnston

Dr Will Johnston

By Tristan Bronca.

The Euthanasia Prevention Coalition was officially founded in 1998 in response to rising public support for physician-assisted dying. It’s made up of about 2,000 donors—both members and organizations—who began to come together in about 1993 during the Sue Rodriguez case. One of those members is Dr. Will Johnston.

Now the chair of the B.C. chapter of the coalition, the family physician took a strong stance against euthanasia about 22 years ago, when he began writing about it and speaking to high school students and church groups. He also testified opposite euthanasia advocates in the Carter case, which led to the legalization of medically assisted death in Canada. Dr. Johnston spoke with the Medical Post about his concerns with the legislation recently passed through the house of commons, the laws around the world, and why he feels Canada is about to make a dangerous mistake.

Q: Explain the impetus for a coalition of bodies who are opposed to physician-assisted dying.

The bodies that are involved in the Euthanasia Prevention Coalition might not agree on any other issue but they share in common a sense of the huge societal mistake that is being made in euthanasia and assisted suicide. We realize that there is some strength in numbers. Obviously not enough strength to stop the freight train that ended with the Supreme Court being unanimous in its decision—which I think is a troubling sign of the shallowness of the Supreme Court’s reasoning—but nonetheless more power than we would have as individual activists.

Q: Which elements of the proposed federal legislation do you personally find most troubling?

The legislation doesn’t yet allow the euthanasia of children, psychiatric patients, or mentally incapable patients long after they consent, but the preamble to the legislation promises to explore those areas further, which is deeply troubling.

Link to the full article

Rushing toward death - Euthanasia in the Netherlands

Theo Boer

Theo Boer

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

In July 2014, Professor Theo Boer, who was member, for nine years, of a euthanasia regional review committee in the Netherlands, wrote an article that was published in the Daily Mail urging the British parliament to reject the legalization of assisted suicide. Boer then gave the Euthanasia Prevention Coalition permission to publish the full text of his article entitled "Assisted Suicide: Don't go there."

Today Professor Boer published a significant critique of the Netherlands Euthanasia Law under the title: Rushing toward death?

Boer begins by explaining how euthanasia became legal, and how the law works in the Netherlands. He wrote:

In 1994 the Netherlands became the first country to legalize assisted dying. The Dutch added a clause to the Burial and Cremation Act allowing doctors to help a person die as long as the patient made an informed request and faced unbearable suffering with no prospect of improvement; a second doctor concurred in the decision; and medically advised methods were used. The clause was further codified by the Assisted Dying Act in 2001. Belgium followed suit with similar legislation in 2002. 
In the Netherlands, five regional review committees, each consisting of a lawyer, a physician, and an ethicist, were charged with keeping an eye on the practice and assessing (after the fact) whether a case of assisted dying complied with the law. 
Two forms of assisted dying are legally practiced: euthanasia, in which the action of the physician causes death, and physician-assisted suicide, in which a physician provides the patient with a lethal drink administered by the patient. The overwhelming majority of patients who make use of the law (95 percent) choose euthanasia.

Boer then explains why he originally supported the Netherlands euthanasia law.

Link to the full article

Margaret Somerville - What the top court left out in assisted suicide decision

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Margaret Somerville

Margaret Somerville

Margaret Somerville, the founding director of the Centre for Medicine, Ethics and Law at McGill University, wrote an insightful article titled - What the top court left out in judgement on assisted suicide - that was published in the Globe and Mail on October 27.

In her article, Somerville comments on the Supreme Court of Canada assisted suicide decision:

A central question in legalizing physician-assisted suicide is where the balance between respecting individual rights to autonomy and protection of the “common good” (protection of others and society, including its important values) should be struck. In this case, there was almost no such balancing. 
Rather, both the trial court and the Supreme Court focused almost exclusively on the rights of individual persons, so that the factual findings and legal reasoning were intensely individualistically based. 
Both courts adopted a narrow definition of Parliament’s purpose in prohibiting assisted suicide (namely, that it was to protect a vulnerable person in moments of weakness from acting on suicidal ideation) and concluded that an absolute prohibition was not needed to achieve this. Indeed, the courts accepted the evidence of plaintiff Gloria Taylor, who suffered from Lou Gehrig’s disease, that she did not need this protection as showing that she and people like her did not – that is, they were “not vulnerable.”

Then Somerville asks - But was the court correct in its assessment of vulnerability? She explains:
 

Prof. Henk ten Have, a physician-ethicist at Duquesne University in Pittsburgh, recently published a paper proposing that vulnerability is an innate human characteristic that we all experience throughout our lives, because it “comes from the social dimension of human existence.” In short, we are not free-floating autonomous atoms.

Somerville explains:

Vulnerability is linked to dependence on others. We are all interdependent, which means we are all vulnerable. This is not necessarily bad, as we might at first assume when we hear the word “vulnerable.” 

Somerville then concludes that Supreme Court missed the common good or the importance of people caring for one another.

Link to the full article

Physician-Assisted Suicide: Improving the Debate

By John Keown

John Keown

John Keown

The Washington Post reported on Valentine’s day that since the death of her husband, Diane Rehm, the NPR talk show host, is emerging as a “key force” in the “right to die” debate. The Post relates that she is addressing fundraising dinners for “Compassion and Choices,” a pro-PAS pressure-group. The Post quotes her as saying:

As strongly as I feel, I don’t want to use the program to proselytize my feelings … But I do want to have more and more discussion about it because I feel it’s so important.

She is right. It is important. And it is worthy of more discussion, not least because more discussion, if fair and balanced, allows opponents of PAS to refute the superficially attractive arguments of pressure-groups like “Compassion and Choices”—arguments that have, with very few exceptions, been rejected by legislatures, expert committees, courts, professional healthcare associations, and disability groups around the world.

What are the main arguments for changing the law to allow doctors, at the patient’s request, to write a lethal prescription (PAS) or to administer a lethal injection (voluntary, active euthanasia, or VAE)? In Debating Euthanasia, a book in which I debate a leading advocate of PAS and VAE, I considered ten arguments for relaxing the law. To illustrate their weakness, let us consider just three of the most popular arguments.

Link to the full article.

Without true north, the Supreme Court of Canada’s compass is pointless

By Don Hutchinson

We have a compass on the dashboard of our Jeep. It’s a good old-fashioned oil filled ball compass. I stuck it there shortly after we moved from Toronto to Ottawa because my “personal positioning system” occasionally got confused with the transition from decades in a water-to-the-south city to driving in a water-to-the-north city.

We have since acquired a GPS unit; but the compass stays. Why? It’s my experience that when the compass and the GPS are in disagreement, the compass is right. GPS units are notorious for being more disoriented than even I can be. But a compass is continuously reliable once it is fixed to true north. Without true north, the compass is pointless.

[February 6’s] decision of the Supreme Court of Canada in the Carter assisted suicide case gives every indication that the Court is practising orienteering based on a “personal autonomy positioning system.” Abandoning constitutional true north, the role of its decision as a legal compass is unpredictable. The guidance provided in this case resembles dire true stories of GPS units gone awry.

Link to the article

Physician Hastened Death: Awaiting a Verdict

Harvey Chochinov

Harvey Chochinov

By: Prof Harvey Max Chochinov, OC OM MD PhD FRCP(C), is Canada Research Chair in Palliative Care; Director, Manitoba Palliative Care Research Unit; Chair, Canadian Virtual Hospice; and Distinguished Professor in the Department of Psychiatry, University of Manitoba.


Prof Balfour M. Mount, OC QC MD FRCP(C), is Eric M. Flanders Professor Emeritus of Palliative Medicine, McGill University.

Balfour Mount

Balfour Mount

On October 15th, the Supreme Court of Canada will hear an appeal by the BC Civil Liberties Association that could grant terminally ill Canadians the right to assisted suicide. Given that impending ruling, the recent passing of Bill 52 in Quebec (legalizing euthanasia or what is euphemistically being called Medical Aid in Dying [MAD]) and rumblings from parliament of yet another private members bill on assisted suicide, Canada is clearly at a crossroads on this issue. The Court faces a daunting task. Where rhetoric ends, the war of what the data say begins; with each side invoking elements of empirical evidence that happen to support their particular argument. Add fear of death, dread of the process of dying—and our societal aversion to discuss these issues—and one begins to appreciate what the court is up against.

Link to the full article

 

The utopian dream of controlling the uncontrollable

This article was originally published on Sept 9, 2014 on the Hope Australia Website.

Paul Russell

Paul Russell

By Paul Russell 
The Director of Hope Australia

Two recent articles on euthanasia and assisted suicide in the Australian press serve to highlight the dilemma of the form of any legislation that might be proposed as well as the reality of what crossing the Rubicon of the prohibition on killing or assisting in suicide will mean for a society like ours.

Read More: http://noeuthanasia.org.au/blog/2103-the-utopian-dream-of-controlling-the-uncontrollable.html