Bedside gatherings at Canadian euthanasia deaths are normally an adults-only affair. Of course we’re not privy to most of them, but occasionally a journalist describes the last moments of an elderly man or woman in a magazine feature. Sometimes there’s a party, glasses of champagne, hilarity — until the doctor arrives. The friends and relatives gather around the bed while the doctor administers a lethal injection.
In fact, most of these deaths are of people well over 65. Very few are of an age to be leaving youngsters behind. It is their children or grown grandchildren who are with them in their last moments.
What about people with young children? One experienced MAiD doctor suggests that young children will benefit from becoming involved.
In a blog entry at a University of British Columbia site, Dr Susan Woolhouse, who has been involved in some 70 “assisted deaths”, says “instinct told me that involving children in the MAID process of their loved one was possibly one of the most important and therapeutic experiences for a child. My past experiences during my palliative care rotations reassured me that children could benefit from bearing witness to a loved one’s death. Why would MAID be any different?”
She gives some tips about how to explain the process of dying to young children:
Assuming that children are given honest, compassionate and non-judgmental information about MAID, there is no reason to think that witnessing a medically assisted death cannot be integrate as a normal part of the end of life journey for their loved one. If the adults surrounding them normalize MAID, so will the children.
“These conversations can easily be had with children as young as 4,” she says.
Dr Woolhouse estimates that between 6 and 7 percent of MAiD deaths are of people under 55. As the numbers grow, “this will result in more children being impacted by the assisted death of a loved one.”
This is how she would explain euthanasia to a child:
“In Canada, when someone has an illness that will cause their body to die, they can wait for this to happen or they can ask a doctor help. The doctor or nurse uses a medication that stops the body from working and causes the body to die. This is done in a way that isn’t painful …
“I am going to give your [loved one] medication over a period of about ten minutes. This medication will make her very look very tired and then she will very quickly go into a coma. This means that she will no longer be able to hear, see or feel any pain. You might hear strange breathing sounds, however these do not cause her any pain. Her skin will get colder and maybe even change colour. She will stop moving her body. Her heart will eventually stop beating and this means that her body has died. When a body dies, it can no longer see, feel pain, or hear. It can’t ever be fixed.”
I wonder if a child will find this explanation convincing. The doctor will not be around to answer her questions as she becomes a teenager, a young adult, and a parent. One researcher found that, years afterwards, some children still described the death of a pet as “the worst day of their lives.” How much worse will it feel to remember the day that your mother or father was put down?
Dr Woolhouse’s brief essay leaves some questions up in the air. The obvious question is “where is Dad now?” She can’t offer the child the comfort of an afterlife. Dad isn’t anywhere anymore; he’s just dead.
In her description of her hypothetical patient’s last hours, it’s clear that he is not suffering unbearably, at least at that moment. Why, the child is bound to ask, did Dad want to leave me? Why did he choose to die and leave me an orphan?
But Dr Woolhouse is right about one thing: if you want to normalise euthanasia, what better marketing device could there be than photos of little kids watching her give a lethal injection?
This article by Michael Cook was originally published on MercatorNet under a Creative Commons licence. The original article can be found here. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines.
The New Zealand Parliament legalised euthanasia this week by 69 votes to 51, pending the outcome of a referendum next year. On paper, The End of Life Choice Act 2017 looks restrictive. Its architect, libertarian MP David Seymour, claims it permits “one of the most conservative assisted dying regimes in the world.”
Opponents say it is full of loopholes, which would make it like every other piece of euthanasia legislation in the world. Indications are that, once such a law is in place, nobody much cares about how it is working.
As National MP Chris Penk said at the final debate: “The question is not whether some people will die in the way the bill allows, but whether many people could die in a way that the law does not allow.” That is what has happened in the Netherlands and Belgium.
Hospices won’t be exempt
The Act allows assisted suicide by a lethal dose of drugs, either self-administered or administered by a doctor or a nurse practitioner. This option would be available to New Zealand citizens or permanent residents aged 18 and over who have been diagnosed as terminally ill and having less than six months to live.
Originally, the Act also covered people with “grievous and irremediable” conditions, which could apply to depressed and disabled persons, but this was dropped by Seymour to garner more support from MPs.
Conscience protection for doctors and nurses was added. They are not obliged to participate in any part of the assisted dying process or suffer any penalties for opting out. However, an attending practitioner with a conscientious objection must tell a patient that they have a right to ask the group administering the scheme for the name and contact details of a replacement doctor or nurse.
An amendment drafted in consultation with Hospice New Zealand that would allow organisations to opt out without risking losing public funding was voted down.
Other efforts to address weak provisions concerning safeguards and accountability were shut down in successive debates by members impatient to get the bill passed.
The beautiful-young-woman-with-a-tumour factor
In the end, Seymour got 69 of the 120-member Parliament on his side. However, to get the eight votes of the New Zealand First Party members (led by Deputy Prime Minister Winston Peters) he and supporting MPs had to accept the party’s demand that the Act go to a referendum. It will be one of at least two proposals the public can vote on alongside next year’s general election, the other being the legalisation of recreational cannabis.
It has taken four attempts, starting in 1995, to get euthanasia across the line in the New Zealand Parliament. Its success this time is in keeping with social trends such as secularisation, but also owes a lot to the advocacy of Wellington lawyer Lecretia Seales, who died of brain cancer in 2015. As an attractive, clever 42-year-old tragically facing death, she has done for euthanasia in this country what another beautiful young woman with a brain tumour, Brittany Maynard, did for the cause in California.
Ms Seales, who had worked for the liberal-minded Law Commission, applied to the New Zealand High Court for a declaration that she had a “right” to assisted suicide under the NZ Bill of Rights Act. She failed at court, but succeeded in the public domain where the support of her husband and family and influential figures such as former Law Commission chief Sir Geoffrey Palmer – not to mention massive and sympathetic media attention – emboldened politicians to have another go at legalising euthanasia. Seales died peacefully of natural causes in June 2015 and in October Seymour lodged his member’s bill. In December that year the New Zealand Herald declared Lecretia Seales “New Zealander of the Year”.
Tens of thousands of opposing public submissions binned
The Seymour bill was drawn from the ballot in June 2017 and had its first reading in December. It then went to a select committee of MPs for study and to receive public submissions. More than 39,000 submissions were received, 90 percent opposing it. Over four months touring the country the committee heard over 2000 oral submissions, of which 85 percent were opposed. These included the majority of medical associations and individual doctors and nurses who addressed the committee.
In addition, a grassroots effort saw published a number of excellent video testimonies from people who had faced a terminal diagnosis or lived with a severe disability, as well as professional commentary on the issue. One of the people appearing in these videos, Clare Freeman, who became tetraplegic at 17 and attempted suicide, addressed hundreds of opponents in front of Parliament on Wednesday as MPs prepared for the final vote. She recounted how a psychiatrist suggested that she could get help to end her life overseas.
All of this has counted for very little with the majority of our political representatives. The public opinion they fear is the referendum looming at the election next year and the debate that will precede it. As NZ Herald writer Claire Trevett commented today: “Few MPs will want to take the lead in that debate – for few will want to be defined by it and have it overshadow their campaign.” That is probably truer of those supporting the legislation than those against it.
The “misinformation” spectre
Supporters have already raised the spectre of “misinformation” to ward off inconvenient publicity about euthanasia and the End of Life Choice Act itself. In fact, Minister of Justice Andrew Little (a supporter) is so concerned that the public may be misinformed and misled that he has talked about setting up a unit in the Ministry of Truth – sorry, Justice – to monitor advertising campaigns. This applies also to the cannabis referendum.
Following an interview with Little, however, the NZ Herald reports, “Teams in the Justice Ministry will prepare neutral, factual information for each referendum and make that publicly available, but they will not be tasked with calling out misinformation.” The Minister expects things to get “ugly” and expects the worst of social media, but has indicated that complaints to the Advertising Standards Authority are the way to go for disgruntled members of the public. He will simply do what he can to “call out misinformation.”
It would be foolish to think that the public is already well informed (and could only be misled by further debate), although politicians and the media regularly invoke opinion polls that show a level of public support for euthanasia of around 70 percent. If the public is generally ignorant, what is the value of a poll that asks a superficial question such as, “Parliament is considering passing a euthanasia law that would allow terminally ill patients to die with the help and approval of their doctors. Would you support it?”
Of course people should be allowed to die. Of course doctors should do what they can to ease their symptoms and reassure them as they die. Aren’t they, don’t they already? Yes. But the euthanasia movement fosters the deceitful idea that people are being kept alive against their will by extraordinary means.
Three-quarters of Kiwis don’t know what ‘choices’ the Act allows
A poll commissioned by Euthanasia-Free NZ and released early this week showed that, despite the legislation being around for four years, the great majority of the public do not know what “choices” the End of Life Choice Act would legalise.
70% thought it would make it legal for people to choose to not be resuscitated, when people can already ask for such a request to be added to their medical file.
75% thought that the Bill made euthanasia available to terminally ill people only as a last resort, after all treatments have been tried to control their pain.
“However, the Bill does not require an eligible person to have tried any pain relief or palliative care before requesting a lethal dose, or to have a consultation with a palliative care or pain specialist to find out what options are available to them,” says Euthanasia-Free NZ.
Like the Act’s supporters. this group is concerned about the referendum. “We doubt that another year would be long enough to allow the public to become adequately informed about the Bill’s content, amid contentious debates on cannabis and the general election,” says its executive officer Renee Joubert. “We are concerned that a referendum result may not reflect the public’s true sentiments.”
There seems, indeed, a real possibility that the cannabis referendum, being a more grass-roots issue (so to speak) and therefore given more media time, will eclipse that of euthanasia. The best we can hope for in any case is a change of government.
World Medical Association reaffirms its opposition
Jurisdictions which permit assisted suicide or euthanasia suck all the oxygen out of media coverage of this topic. To put the issue in perspective, assisted suicide or euthanasia is only legal in Canada, Belgium, the Netherlands, Switzerland and a handful of American states. Nearly everywhere else, doctors have repudiated it.
As a reminder of this, the World Medical Association has reaffirmed its long-standing policy of opposition to euthanasia and physician-assisted suicide. At its annual Assembly in Tbilisi, Georgia, the WMA adopted a revised Declaration on Euthanasia and Physician-Assisted Suicide. It states:
“The WMA reiterates its strong commitment to the principles of medical ethics and that utmost respect has to be maintained for human life. Therefore, the WMA is firmly opposed to euthanasia and physician-assisted suicide.”
Furthermore, the WMA strongly supports conscientious objection. Its statement says: “No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end.”
On the other hand, the WMA also supports the right to refuse burdensome treatment. “The physician who respects the basic right of the patient to decline medical treatment does not act unethically in forgoing or withholding unwanted care, even if respecting such a wish results in the death of the patient,” it states.
WMA Chair Frank Ulrich Montgomery, a German physician, summed up the feeling of the medical profession on a global level: ‘Having held consultative conferences involving every continent in the world, we believe that this revised wording is in accord with the views of most physicians worldwide.’
End-of-life care has been at the centre of heated debates within the WMA. Last year the Canadian and Dutch delegations to the WMA’s assembly failed in a bid to change the organisation’s stand to neutrality, rather than opposition. As a result, the Canadians pulled out of the WMA. There is sure to be on-going pressure for the WMA to change its position.
So it’s significant that earlier this year, the WMA’s official journal published a strong rebuttal of arguments for neutrality. It stressed that the proportion of doctors who back the Canadian approach was minuscule:
“Only a small minority of physicians support E&PAS. The vast majority of doctors around the world wish only to foster the will to live and to cope with illness and suffering, not to facilitate acts of suicide or to create ambiguity around what constitutes a medical treatment. We must remember that the four regional WMA symposia demonstrated that most doctors would never be willing to participate in euthanasia.”
The WMA statement coincided with another statement, this time from a religious angle. Representatives of the three Abrahamic religions – Christians, Jews, Muslims – signed a declaration in the Vatican repudiating euthanasia and assisted suicide. It is an extraordinary demonstration of ethical unity on a deeply controversial topic by theologically separate groups. Their declaration says:
We oppose any form of euthanasia – that is the direct, deliberate and intentional act of taking life – as well as physician assisted suicide – that is the direct, deliberate and intentional support of committing suicide – because they fundamentally contradict the inalienable value of human life, and therefore are inherently and consequentially morally and religiously wrong, and should be forbidden without exceptions.
The statement also stresses the importance of palliative care and of trying to ensure that patients do not feel useless at the end of their lives.
The signatories included Vatican officials, Avraham Steinberg, co-chair of Israel’s National Council of Bioethics, Samsul Anwar, chairman of the Central Committee of the Indonesian Muhammadiyah and Orthodox clergy.
Michael Cook is editor of MercatorNet
This article by Michael Cook was originally published on MercatorNet under a Creative Commons licence. The original article can be found here.
New Zealand groups opposing euthanasia have come together in a movement to fight legislation in parliament that could soon legalise assisted suicide. #DefendNZ launched on March 10 with a website and video trailer introducing Kiwis who could be eligible for assisted suicide under a bill that could be passed in the current parliamentary session.
#DefendNZhas excellent background resources for the case against all forms of euthanasia.
Not satisfied with our mounting suicide rate – at a 10-year high in the year to June 2018 – the right-to-die lobby want to encourage the terminally ill and seriously disabled to think along those lines. It’s only about “the right to choose,” they say, but that is not how many of those living with disabilities and illness see it.
Over the next few weeks #DefendNZ will feature some of them in five mini-documentaries exploring the impact the End of Life Choice Bill would have on their relationships with their doctors and caregivers, on how society views and values their lives, on the way they feel about themselves, and on their safety. Former MP, Hon. Dame Tariana Turia DNZM will also share her perspectives in these documentaries.
The bill is a project of Act Party MP David Seymour. Mr Seymour, the sole representative of his party in parliament, is a libertarian who has taken up the cause of right-to-die advocates The cause received a major boost from the 2015 case of Lecretia Seales, a lawyer with terminal brain cancer who appealed to the High Court claiming a right to assisted suicide under the New Zealand Bill of Rights Act.
The Court’s finding, that there was no such right in the law, led to a petition to parliament to change the law, and a commission of inquiry attracting over 21,000 submissions – 80 percent of which were opposed to any form of euthanasia.
Another public consultation on Seymour’s bill brought a record 37,000 submissions last year and a large number of people wanting to be heard in person. The Justice Select Committee is due to report back to parliament by the end of this month. A huge majority of submitters – 92 percent — again oppose the bill.
Of particular concern is a clause permitting assisted suicide for a person with “terminal illness or grievous and irremediable condition.” A “grievous and irremediable condition” is defined as “degenerative, unable to be successfully treated, and very severe,” which has raised fears among people with disabilities about how their lives may be viewed in future.
In response, Seymour has proposed eliminating this provision from his bill, to the dismay of the euthanasia lobby. However, it will help keep the Greens, who are concerned about voters suffering disabilty, on board. Other changes include eliminating advance directives.
He has also “made explicit” that mental health conditions and disability alone do not allow a person to have a doctor kill them. To get the support of the New Zealand First MPs he says the issue should be the subject of a binding referendum at the next election.
The country has a proud record of ignoring referenda results, but to keep its coalition partner NZ First happy, Labour might go along with this one. It has already committed itself to a binding referendum on personal cannabis use at the 2020 election.
Seymour also proposes incorporating an Access to Palliative Care Bill sponsored by National MP Maggie Barry, and an amendment to protect the conscience rights of pharmacists, nurses and medical practitioners.
With these changes he hopes to get enough support in parliament – and, with any luck, the voting populace — to get the principle of a right to assisted suicide enshrined in law – after several failed attempts over the last few decades.
Whether that would do anything for the government’s promised wellbeing budget outcomes remains to be seen.
This article by Carolyn Moynihan was originally published on MercatorNet under a Creative Commons licence. The original article can be found here.
The other country where euthanasia for children is legal—Colombia
The long process of legalisation began in 1997
Colombia is not a nation that one associates with end-of-life debates, but it is one of the few which has legalised euthanasia – even for children over 6 years old. Perhaps the issue has flown under the radar because many Colombians are Catholics or Evangelicals for whom euthanasia is anathema.
The process began in 1997 when Colombia’s Constitutional Court ruled that ending lives in certain circumstances was not illegal. In Sentencia C-239/97 it stated: “Nothing is more cruel than to force a person to survive in the midst of shameful suffering, in the name of other people’s beliefs.”However, this still left the legal status of assisted suicide and euthanasia in a legal limbo. Activists could not be sure that they would not be prosecuted.
And then, in 2017 (Sentencia T-544) the Court ordered the Department of Health and Social Protection to issue regulations which would “guarantee the right to death worthy of children and adolescents”. So on March 9, 2018, the Department of Health and Social Protection issued Resolution 825 which allowed euthanasia for children over 6. The Department explained that before that age children cannot grasp the idea of their own death. However, children between the ages of 7 and 12 are allowed access euthanasia with the approval of their parents. Children between 12 and 14 can access it even if one parent disagrees. After 14, no parental involvement is needed, provided that all the requirements for euthanasia are fulfilled.
Like adults, the child must have an incurable condition, have unmanageable pain and the mental capacity to consent. “Doing this for children is a whole new world,” Ricardo Luque Nunez, a doctor and bioethicist who is an adviser to the Colombian Ministry of Health and oversees this issue, told the Globe and Mail.
According to official records only 40 people have taken advantage of Colombia’s euthanasia regulations. Unofficially, there may be many more. As in other countries, activist doctors who are impatient with red tape take the law into their own hands. One doctor claims that he has “provided euthanasia” to almost 400 people, including more than 30 children.
Colombian voters have had no say in this momentous legal change. “We have not had a big national debate about this, and I’m not very happy about it,” says a former Colombian health minister. “We need a public debate: We are not Belgium or Holland – this is at odds with people’s beliefs and mode of thought.”
This website provides links to a number of international articles and documents pertaining to euthanasia, assisted suicide advance directives, disability rights, pain control and more.
This article by Michael Cook was originally published on MercatorNet under a Creative Commons licence. The original article can be found here.
Euthanasia: False Light
International Task Force on Euthanasia and Assisted Suicide (2009) This video looks at euthanasia and assisted suicide through the eyes of five people — three patients, a doctor, and a hospice nurse, all of whom speak from their hearts, not from a script.
The only person that I trusted was my doctor. And to have my doctor walk into the room and say, “I’m going to give you the choice to just end all this right now.”
And it’s a lot easier to push people out of the picture then to actually get involved with them and suffer with them. Which, by the way, is what the word compassion means. It means it means to suffer with. If you kill somebody, there is no ‘with’. You’re not compassionate if somebody’s dead.