France approves terminal sedation legislation


By Alex Schadenberg, International Chair - Euthanasia Prevention Coalition

Politicians in France have been debated the legalization of euthanasia for many years. 

In January 2011, the French Senate rejected a euthanasia bill by 170 - 142. During the 2012 election President François Hollande promised to legalize euthanasia but since then Hollande has faced strong opposition to his plan. In June 2015, France's Senate rejected a bill that permitted euthanasia by dehydration and in October 2015, a French court decided that Vincent Lambert should continue to receive food and fluids.

The Associated Press has now reporting that French lawmakers approved a bill that allows "terminal sedation" but not euthanasia. 

According to the media report the French government approved a bill that allows doctors to sedate a person, upon request, who is nearing death, and withdraw life-sustaining treatments including nutrition and hydration (food and water). According to the article:

The new law will allow patients to request "deep, continuous sedation altering consciousness until death" but only when their condition is likely to lead to a quick death. Doctors will be allowed to stop life-sustaining treatments, including artificial hydration and nutrition. Sedation and painkillers will be allowed "even if they may shorten the person's life." 
The bill will also apply to patients who are unable to express their will, following a process that includes consultation with family members. 
The methods can involve medicating patients until they die naturally of their illness or until they starve. Some doctors, however, say it may be more human to euthanize.

I have not read the bill, but if the bill allows doctors to intentionally cause the death of a person by dehydration, when the person is not otherwise dying, then the act is "slow euthanasia" or euthanasia by dehydration. If the bill clearly limits sedation and dehydration to people who are actually nearing death, then the act is closer to palliative sedation.

Link to the full article

A 4-year-old girl in coma recovers

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The story of Gemma Botelho, a 4-year-old girl who is recovering after being in coma, is a story of hope and a story of caution.

According to an article in CNN:

Shortly after arriving at the emergency room on December 17, Gemma went into cardiac arrest. For 45 minutes doctors and nurses performed CPR, but her heart wouldn't start. Doctors and nurses filled the room, asking her parents to wait outside the door. 
"We heard beeping, and then no beeping," said her mother, Lejla Szabo, a model in Miami. "She was just flatlining. We really felt that we had lost her." 
Her husband, Alexander Botelho, who works in the hospitality industry, turned to her. "He told me we just had to look back and appreciate those 4½ years we had with her," she remembered. 
On Friday (Dec 18) ... Gemma flew to All Children's Hospital Johns Hopkins Medicine, 250 miles away in St. Petersburg. 
Friday and Saturday Gemma's heart quivered uselessly. Doctors prepared to put her on a list for a new heart but there were no guarantees it would arrive in time to save Gemma's life. 
On the Sunday before Christmas, as their daughter lay in intensive care, Szabo, who is from Hungary, and Botelho, who's from Brazil, organized friends to say prayers for Gemma at Catholic Masses in their home countries as well as in Argentina, Italy, Miami and Boston. 
That night, Szabo and Botelho finally heard good news: Gemma's heart was beginning to beat again. 
Two days later, her heart was working well enough that her pediatric heart surgeon, Dr. Jeffrey Jacobs, and his team at All Children's Hospital removed her from life support. 
The heart surgeon said he can't explain what caused her heart to start again. 
"Sometimes we don't understand everything that happens in medicine," said Jacobs, director of the Johns Hopkins All Children's Heart Institute.

According to the article, Gemma was given a 1% chance of recovery.

Often families and medical professionals will give up on a person who is in coma too quickly and agree to withdraw all treatment and care, including food and water causing death by dehydration rather than a natural death caused by the medical condition.

South Korea has not legalized euthanasia or assisted suicide

By Alex Schadenberg, International Chair - Euthanasia Prevention Coalition

The Korean Times reported that the National Assembly Health and Welfare Committee voted in favor of a "death with dignity" bill.

In the western world "death with dignity" is a euphemism for euthanasia or assisted suicide.

Korea has not legalized euthanasia or assisted suicide but rather Korea is passing a law outlining the rules for withholding or withdrawing of medical treatment. The Korean Times reported:

The bill addresses the needs of dying patients. Life-sustaining treatment, such as CPR, artificial respiration and cancer-fighting drugs, will be withheld from such patients. 
Such treatments could be stopped if a patient expresses the clear intention of not being willing to receive them while still being sentient. The patients can write orders for their physicians about life-sustaining treatments (POLST) or advanced directives (AD). 
If the patients become unconscious, doctors can check their POLST and stop treatment. Or at least two members of a family can testify that a patient prefers death with dignity and at least two doctors should confirm it. 
When it is impossible to figure out what the patient thinks about life-sustaining treatment, it requires parental consent in the case of minors, and consent from all family members when adults are the patients. 
If a patient is without family, the bill said the hospital's bioethics committee could make the decision.

The article refers to the withholding or withdrawing of medical treatment as passive euthanasia. This is an unfortunate use of a false and confusing term.

The withholding and withdrawing of medical treatment has been debated in Korea for many years.

To withhold or withdraw medical treatment from a person who is dying is not euthanasia or assisted suicide. When treatment is withheld or withdrawn, the patient may or may not die, but if the patient dies they die of their medical condition, which is a natural death. 

Important: The withholding or withdrawing of medical treatment must be differentiated from the withholding and withdrawing of basic care from a person who is incompetent and not otherwise dying. To intentionally deny basic care to a person who is not otherwise dying (such as food and water) is ethically the same as euthanasia. The person dies from intentional dehydration rather than dying from their medical condition.

French court decides to allow Vincent Lambert to receive food and water

Vincent Lambert

Vincent Lambert

By Alex Schadenberg, International Chair - Euthanasia Prevention Coalition

A French court decided, yesterday, that Vincent Lambert could continue to live. The court decision supported the position of Lambert's parents, was that Lambert would continue to receive food and water. Lambert's wife wanted feeding to cease which would cause him to die by dehydration.

On June 5, 2015; the European Court of Human Rights decided that Vincent Lambert, a cognitively disabled man, could have his food and water withdrawn causing his death by dehydration. Lambert's parent's appealed the ruling of the European Court of Human Rights.

Lambert has been living with a significant cognitive disability since his motorcyle accident in 2008.

According to the RFI news, the judges said:

Lambert's doctors were within their rights, based on their "professional and moral independence," to suspend an earlier court decision that would have seen them cut the intravenous food and water keeping him alive. 
...the decision to stop intravenous feeding can be undertaken "solely by the doctor in charge of care." The hospital may not oppose it. 
The judges also ruled that the previous medical decision could not be imposed on a new doctor. 
This judgement throws the burden of responsibility back on to the doctor, 

To intentionally withdraw fluids from a person who is not otherwise dying is a form of euthanasia by omission because the person directly and intentionally dies from dehydration and not from a medical condition.

Texas bill is model legislation to prevent Death by Dehydration

By Dr Jacqueline Harvey

Dr Jacqueline Harvey and Rep. Drew Springer

Dr Jacqueline Harvey and Rep. Drew Springer

On Friday, June 12, 2015, Texas Governor Greg Abbott overturned 16 years of legal forced dehydration and starvation in Texas by signing House Bill 3074. The Euthanasia Prevention Coalition (EPC) was present for the historic moment and presented a commendation to Representative Drew Springer on his skillful passage of this landmark legislation, and EPC briefly explained the significance of this bi-partisan, unanimously-supported, model disability rights bill. HB 3074 is a critical first step in EPC’s national and worldwide efforts to restore the rights of persons with disabilities to receive nutrition and hydration (ANH). Therefore this vital win in Texas is anticipated to save lives not just within the Lone Star State but throughout the United States and even globally as EPC prepares to explore this issue with standing at the United Nations.

Under Representative Springer’s leadership, HB 3074 moved Texas from the one state to allow healthcare providers to remove food and water in any circumstance to joining five other states that explicitly protect patients in need of ANH. The Texas law was an anomaly in that it allowed the medical community authority to remove ANH in any circumstance. In contrast, five states have passed laws to ensure that food and water is not forcibly withheld by a healthcare provider to kill a patient. Now that HB 3074 is signed into law, Texas no longer ranks as the worst state for patients in need of ANH but ranks among the best. 

EPC believes that HB 3074 is model legislation. Representative Springer brokered an unprecedented compromise that cleared a 12-year stalemate on this issue. HB 3074 began in committee with opposition, but Springer was able to find language agreeable to all parties and foster unity to enable the bill to be passed in all committees and chambers of both House and Senate with no opposition. 

The universal agreement on the wording in HB 3074 across various stakeholder groups and unanimous passage from the Texas House of Representatives as well and the Texas Senate indicates broad, bi-partisan support that EPC expects to cultivate nationwide. Furthermore, EPC hopes to employ the language from HB 3074 to reform Connecticut law, the only other state that grants healthcare providers authority to starve and dehydrate patients in some circumstances (terminal illness and permanent unconsciousness). Moreover, the broad bi-partisan support and unanimous passage of HB 3074 through both chambers of the Texas Legislature indicates that this model legislation has significant promise of passage in a variety of political environments, red states and blue states alike. 

Link to the full article

Wesley Smith: France debates slow euthanasia

This article was published on Wesley Smith's blog on June 16, 2015.

By Wesley Smith

Wesley Smith

Wesley Smith

Sigh. If the euthanasia pushers can’t get people dead one way, they try another.

The French Senate is debating legalizing terminal sedation for the terminally ill who want it. From the Yahoo story:

France’s debate over end-of-life care goes to the Senate, with a bill that would allow doctors to keep terminally ill patients sedated until death comes, but stops short of legalizing euthanasia and assisted suicide. 
Euthanasia is currently legal in the Netherlands, Belgium and Luxembourg, and recent polls show a large majority of French people favor legalization. But French lawmakers haven’t been willing to go quite that far, in a debate that is arising at the same time as the wrenching family dispute surrounding Vincent Lambert, a Frenchman in a coma since a car accident seven years ago.

But terminal sedation is “that far,” just via a slower process than lethal injection, as this part of the story makes clear:

The new bill would give people “the right to deep, continuous sedation until death.” Some doctors say it can mean patients are sedated for weeks, and that euthanasia may be more humane.

That’s killing by slow motion because it involves putting a patient into a coma and depriving them of food and fluids so they dehydrate to death.

Link to the full article

European Court of Human Rights orders France to dehydrate Vincent Lambert to death

Vincent Lambert's mother

Vincent Lambert's mother

By Alex Schadenberg, International Chair - Euthanasia Prevention Coalition

The European court of Human Rights ordered France to withdraw fluids from Vincent Lambert, a 38 year-old man with cognitive disabilities.

The case came about when Lambert's wife wanted her husband to have his fluids withdrawn to cause his death while his parents wanted to continue caring for him.

The Telegraph newspaper reported that Lambert's wife stated after the Strasbourg court decision that withdrawing fluids will fulfill her husbands wishes while Lambert's mother, Viviane stated:

“It’s scandalous. They are condemning my son. We will remain by Vincent’s side and will continue to fight,"

This decision should concern people who believe in the equality of every human being. Lambert was not dying, but has a cognitive disability. This decision means that people with cognitive disabilities, who are incapable of speaking for themselves, may be intentionally dehydrated to death.

The decision of the European court of Human Rights is considered a precedent case in all of the 47 European states.