Thursday, February 22, 2018

Not Dead Yet: The Opioid Crisis the News Isn’t Talking About

Response to RFI – Opioid Public Health Emergency[1] 
February 20, 2018
We are members of Not Dead Yet, a national grassroots disability rights organization, and some of us are living with chronic pain ourselves. Based on our knowledge of the disability community through personal experience and through our work, we have not seen disabled people with chronic pain experiencing opioid use disorder. What we are seeing is many disabled people who are suffering due to the lack of access to opioid medication[2]  previously available as part of comprehensive strategies and approaches to address chronic pain. They are experiencing an increase in chronic pain and other symptoms associated with that pain. Disabled people and others with chronic pain are rarely the ones who are abusing opioids,[3] but they are the ones who are having to deal with chronic pain symptoms without access to medications that made this pain more tolerable.

That is not to say that some disabled people will not have opioid use disorder. However, from our observation, chronic pain is not a causal factor[4] in who has abused opioids. Instead, opioids are a mitigating factor in how independent those with chronic pain are able to be. Having to deal with chronic pain with no relief, when opioid medication prevented such pain, can greatly affect the quality of life[5] disabled people with chronic pain have. It can affect their ability to perform activities of daily living. It can affect their ability to sleep. It can affect their mood. It can affect their productivity. Those with chronic pain that is untreated or mistreated are more likely to be depressed,[6] and depression itself can also be linked[7] to physical pain. Being depressed and in pain can also make disabled people more susceptible to suicidal ideation,[8] especially when there is seemingly no relief to the long-term pain they experience.

For some disabled people, opioids are the only medication or treatment that can help their pain. Now, those who have chronic pain are treated with suspicion,[9] as though they are abusing opioids, especially by medical personnel at doctors’ offices and hospitals when they seek out this medication. Doctors are increasingly afraid and unwilling[10] to prescribe opioids, so instead of continuing effective treatment for those who have seen great benefits from using these medications, too often doctors are essentially abandoning those who truly need access to opioids.

Opioid abuse is a problem, but it is not a problem for the overwhelming majority[11] of the disability community or others with chronic pain. It’s a problem for those who have already been abusing these medications. Those are typically not people who need these medications to handle long-term chronic pain.

Yet, as sometimes misguided approaches to addressing the opioid crisis are hastily undertaken across the country, the very individuals, who benefit greatly in terms of health and productivity from continued opioid use as part of a comprehensive pain management strategy, are the people who face the most scrutiny and harm by not having access to medically necessary and appropriate medication.

HHS/ACL must recognize the harmful effects of a misguided crackdown on the legitimate use of opioids for chronic pain, educate state governments and providers about research on this issue, and discourage federal, state and local programs that do more harm than good in addressing the opioid crisis.

[2] Andrew Rosenblum, et al., Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions (2008)
[3] Maia Szalavitz, Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause (Scientific American, May 10, 2016)
[4] Michael A, Yokell, et al., Presentation of Prescription and Nonprescription Opioid Overdoses to US Emergency Departments (Jama Intern Med, Dec 2014)
[5] McCarberg BH, et al., The impact of pain on quality of life and the unmet needs of pain management: results from pain sufferers and physicians participating in an Internet survey (Am J Ther 2008)
[6] Bair MJ, et al., Depression and pain comorbidity: a literature review, (Arch Intern Med, Nov 2003)
[7] Madhukar H. Trivedi, M.D., The Link Between Depression and Physical Symptoms (Prim Care Companion J Clin Psychiatry, 2004)
[8] Beverly Kleiber, et al., Depression and Pain (Psychiatry, May 2005)
[9] Chronic pain patients say opioid crackdown is hurting them (Chicago Tribune, June 5, 2017)
[10] Kelly K. Daneen, et al., Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction? (Am J Law Med 2016)

[11] Nobel M, et al., Opioids for long-term treatment of noncancer pain (Cochrane, Jan 2010)

Wednesday, February 21, 2018

Expanding Assisted Suicide: Legal Safeguards and Burdensome Obstacles

This is part of the article written by Nancy Valko and published on her blog on February 21, 2018.

Nancy Valko
By Nancy Valko

Already there are impatient calls to expand medically assisted suicide and euthanasia.

Thaddeus Pope, JD, PhD, the influential Director of the Health Law Institute and Professor of Law at the Mitchell Hamline School of Law in Saint Paul, Minnesota and writer of the Medical Futility Blog, wrote an article last December titled “Medical Aid in Dying: When Legal Safeguards Become Burdensome Obstacles” for the American Society of Clinical Oncology Post. (According to ASCO, it “has taken no official position on medical aid in dying”.)

Mr. Pope notes the “uniformity and similarity” of the six current medically assisted suicide statutes but brings up four so-called “safeguards” affecting the “next-generation issues: the justifiability of prevailing eligibility criteria and procedural requirements” that will allegedly need to be addressed. (Emphasis added)

The first is “Expanding From Adults to Mature Minors” which Mr. Pope characterizes as “unduly restrictive” in part because “Many states already allow terminally ill mature minors to withhold or withdraw life-sustaining treatment”. (Emphasis added)

Mr. Pope’s second issue is “Expanding From Contemporaneous Capacity to Advance Directives”, stating that “All six statutes require that the patient concurrently have both a terminal illness and decision-making capacity. But this dual mandate excludes many patients who have no other exit options” such as those with “advanced dementia”. (Emphasis added)

The third issue he cites is “Expanding From Terminal Illness to ‘Reasonably Predictable’” because:

“(T)his rigid time frame excludes patients with grievous and irremediable conditions that cause suffering intolerable to the individual. Some medical conditions may cause individuals to irreversibly decline and suffer for a long period before dying. Instead of demanding a strict temporal relationship between a medical condition and death, these statutes might be more flexible and instead require that death be ‘reasonably predictable’.” (Emphasis added)
Mr. Pope’s final issue is “Expanding From Self-Ingestion to Physician Administration”:
“First, it excludes patients who lose the ability to self-administer before they otherwise become eligible. Second, self-ingestion is associated with complications. For example, around 3% of these patients had difficulty ingesting or regurgitated the medication. Other patients regained consciousness after ingestion.” (Emphasis added)
And, as in most of the previous issues, Mr. Pope approvingly cites the rapidly expanding assisted suicide situation in Canada:
“Canadian patients avoid all these problems (with self-ingestion), because physicians usually administer the medication. As a result, only 5 of more than 2,000 Canadian patients who used medical aid in dying self-ingested the lethal medication.” (Emphasis added)
Ironically, there is one so-called “safeguard” that Mr. Pope would like to see tightened:
“that the prescribing or consulting physician refer the patient “for a mental health specialist assessment” if “there are -indications of a mental disorder.” Yet prescribing and consulting physicians have referred only 5% of medical aid in patients who are dying. Leading experts argue that this rate is probably too low relative to the expected rate of impaired judgment. Others are “surprised by how rarely the prescribing or consulting physicians refer patients for a psychiatric consultation.” (Emphasis added)
This discrimination in suicide assessment is not acceptable for any suicidal person-except now, of course, for a person requesting medically assisted suicide.


Without a strong resistance movement, these proposals are only just the next step in the death agenda. So far, much of the public, government officials and medical professionals have been shielded from the real truth by euphemisms and false reassurances from assisted suicide supporters, a mostly sympathetic mainstream media and often spineless professional and health care organizations. We all must educate ourselves to speak out before it is too late.

Tuesday, February 20, 2018

Moral Disengagement – Mechanisms Propelling the Euthanasia/PAS Movement

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Fabian Stahle
Fabian Stahle, the Swedish researcher who recently uncovered hidden problems with the Oregon assisted suicide model, now explains the mechanism of the euthanasia lobby to change the concept of killing through the mechanism known as Moral Disengagement.

The Journal of Medical Ethics in Mental Health published (January 30, 2018) Stahle's research article: Moral Disengagement – Mechanisms Propelling the Euthanasia/PAS Movement.

It is difficult to write a summary of Stahle's substantial article. I encourage you to read it.

Stahle examines Albert Bandura's theory of Moral Disengagement to explain, based on social cognitive theory, how a social justification for acts that are otherwise considered inhumane become accepted over time.

The abstract to Stahle's article clearly explains the importance of the article:

The international movement that promotes the legalisation of euthanasia/physician-assisted suicide (PAS) is propelled by highly potent psychological mechanisms to overcome the resistance to its agenda. It is all about cognitive restructuring to justify inhumane actions. These are always in use when normal, well-socialised persons are coerced into accepting and participating in the killing of fellow human beings. Various scientific studies, pioneered by Albert Bandura, have shown that participators are able to endure their deeds by activating these powerful mechanisms of moral disengagement.

However, those who make use of such mechanisms pay a high price. These mechanisms have a personality-changing power that dehumanizes the perpetrators. For the society that has allowed itself to be manipulated by such mechanisms for the purpose of systematizing “death on demand”, there are also serious consequences. These consequences can be described in terms of dehumanization and brutalization of that society as a whole.
Fabian Stahle explains:
Osofsky et al.: “Operating at the behavior locus are three separate disengagement mechanisms that convert the construal of injurious conduct into righteous conduct. In moral justification, worthy ends are used to vindicate injurious means … Second, by the use of sanitizing euphemistic language, injurious conduct is rendered benign … Exonerative comparison with even more flagrant inhumanities is a third mechanism for cloaking injurious behavior in an aura of benevolence.

The second set of disengagement mechanisms operates at the agency locus by obscuring or minimizing the perpetrator’s agentic role in an injurious activity. Under displacement of responsibility, people view their actions as stemming from the dictates of authorities rather than being personally responsible for them … Because they do not perceive themselves to be the main causal agent of their actions, they are spared self-condemning reactions. The exercise of moral control is also weakened when personal agency is obscured by diffusing responsibility for injurious conduct…

The weakening moral control at the outcome locus is achieved by minimizing or disregarding the harmful consequences of one’s action. As long as the injurious outcomes are ignored, minimized, or disbelieved there is little reason for moral self-regulation to be activated.

The final set of disengagement mechanisms operates at the locus of the recipients or objects of detrimental acts through dehumanization and attribution of blame. Self-censure for injurious conduct can be disengaged or blunted by divesting people of human qualities, or by attributing demonic and bestial qualities to them ... Blaming the recipients of injurious treatment for bringing suffering on themselves also serves self-exonerating purposes.”
Stahle also comments on the social effect of medicalizing euthanasia and assisted suicide.
For the euthanasia movement, this medicalization is a crucial disengaging maneuver in moving forward. But just this maneuver is especially harmful, by reason of the fact that it is aimed at the care-giving sector of our communities, which makes it a devastating stab wound in the very heart of a humane society.
The use of language is just as important for opposing assisted suicide. When our opposing to euthanasia and assisted suicide also leads to a medicalization, then we are in fact helping the euthanasia lobby.

Stahle ends his article by writing:
Albert Bandura's theory of moral disengagement has been applied for a long time in in-depth analyses of various harmful activities. Nevertheless, the theory has not received much attention in the study of the euthanasia movement's activities. This theory has great significance in explaining the euthanasia/PAS phenomenon, and might have the potential to publicly de-mask the euthanasia movement. 
This can be done by conducting an in-depth scientific analysis of the disengagement mechanisms in the euthanasia movement’s various activities. Such an analysis would provide much clarity and depth of insight into an activity that is shrouded in deep obscurity and could be a contributing factor in exposing the actual driving forces behind its progress. A more thorough study should also be undertaken concerning the dehumanizing effect on the functionaries in the practice of euthanasia/PAS. 
The results of the studies then need to be popularized so that they become digestible for mass media, politicians, authorities, and the general public.
But first and foremost, the medical profession should be informed about the implications of Bandura's theory on the entire euthanasia/PAS movement and of the harmful effect their participation will have on their personal and professional integrity.
Fabian Stahle first informed us of the uncovered hidden problems with the Oregon assisted suicide model, now Stahle explains the mechanism that the euthanasia lobby has employed to change the concept of killing through a mechanism known as Moral Disengagement.

I am taking Stahle's research seriously and the Euthanasia Prevention Coalition is responding to the respect, equality and integrity of the human person through the lens of Moral Disengagement theory.

Journal of Medical Ethics in Mental Health (January 30, 2018): Moral Disengagement – Mechanisms Propelling the Euthanasia/PAS Movement.

Friday, February 16, 2018

Belgian euthanasia dispute erupts over the killing of a person with severe dementia

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Ludo Vanopdenbosch
A dispute has erupted in Belgium after a person with dementia was killed by euthanasia even though the person did not request death by lethal injection and was incapable of consenting.

The division has grown since Dr Ludo Vanopdenbosch, a palliative care specialist, resigned from the Belgian euthanasia commission. 

Maria Cheng wrote in an article published by the Associated Press that Vanopdenbosch explained in his resignation letter that:
The most striking example took place at a meeting in early September, ... when the group discussed the case of a patient with severe dementia, who also had Parkinson's disease. To demonstrate the patient's lack of competence, a video was played showing what Vanopdenbosch characterized as "a deeply demented patient." 
The patient, whose identity was not disclosed, was euthanized at the family's request... There was no record of any prior request for euthanasia from the patient.
According to Cheng, the dispute questions whether the hastened death was euthanasia:
Some experts say the case as documented in the letter amounts to murder; the patient lacked the mental capacity to ask for euthanasia and the request for the bedridden patient to be killed came from family members. The co-chairs of the commission say the doctor mistakenly reported the death as euthanasia.

Believe it or not, Dr. An Haekens, psychiatric director at the Alexianen Psychiatric Hospital in Tienen said:
"It's not euthanasia because the patient didn't ask, so it's the voluntary taking of a life,"
This appalling case of euthanasia without request is not the first dispute. Cheng wrote that:
The AP revealed a rift last year between Dr. Willem Distelmans, co-chair of the euthanasia commission, and Dr. Lieve Thienpont, an advocate of euthanasia for the mentally ill. Distelmans suggested some of Thienpont's patients might have been killed without meeting all the legal requirements. Prompted by the AP's reporting, more than 360 doctors, academics and others have signed a petition calling for tighter controls on euthanasia for psychiatric patients.
The euthanasia dispute among Belgian doctors is long overdue. A Belgium government sponsored study examining deaths in the Flanders region of Belgium (2013) concluded that 4.6% of all deaths were hastened without request. The data indicates more than 1000 people died by hastened death without request in 2013 in the Flanders region of Belgium.

Recent reports indicate that palliative care professionals in Belgium have resigned due to pressure to participate in euthanasia. 

Legalizing euthanasia gives physicians, the right in law, to end the lives of their patient.

The dispute relates to the fact that the Belgian euthanasia law gives doctors the power to decide, the power to act and the requirement to self-report their acts. The commission is only analyzing deaths that have already occurred.

By the way, the same system exists in Canada, the Netherlands, Oregon, Washington State, etc. All of these laws are designed to be abused.

Thursday, February 15, 2018

Non - voluntary euthanasia/organ harvesting - Coming soon to the Netherlands.

This article was published by National Review online on February 15, 2018

Wesley Smith
By Wesley Smith

It is legal in the Netherlands for doctors and psychiatrists to lethally inject the sick, disabled, elderly, and mentally ill who ask to die. 

It is not legal for them to kill patients who have not repeatedly asked to die. 

But that happens anyway, and not rarely. Various studies come up with different numbers, but it seems safe to say that hundreds of patients–431 in 2015–are killed each year non-voluntarily, which in Dutch euthanasia-speak is called ”termination without request or consent.” 

Technically, that’s murder under Dutch law, but so what? I know of no case in which any meaningful sanction was imposed on a doctor who killed a patient without consent. 

And now, in 2020 the Dutch are going to institute a “presumed consent” law, meaning that everyone is legally an organ “donor” unless they explicitly opt out. From the story
The Dutch senate on Tuesday narrowly voted in favour of a new law to change the Dutch organ donation system to a ‘yes unless’ register. The new system will apply to everyone over the age of 18 and registered as resident in the Netherlands with their local authority, including foreign nationals. 
The government plans to send letters to people with options they want regarding donation. Silence will be considered consent. 

So, that means a patient could very conceivably be both killed and harvested without having requested it. 

Oh Wesley! You alarmist! You slippery slope hysteric! That will never happen. 

Right. That’s what my critic also said when I predicted in 1993 that legalizing euthanasia/assisted suicide would eventually lead to conjoined killing and harvesting “as a plum to society.” 

For those with eyes to see, let them see.

Wednesday, February 14, 2018

British Columbia (BC) Health Authority orders hospice to do euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sign the Petition: Killing Conscience Rights in BC Hospitals and Hospices.

 The recent edict by the Fraser Health Authority in British Columbia ordering (non-religious) healthcare facilities to participate in euthanasia (MAiD) including hospices is an infringement on the conscience rights of the medical staff. I believe that:
Institutional conscience rights are about the rights of the workers within an institution to not participate in acts that they consider wrong.
Delta Hospice
The edict by Fraser Health directly effects institutions such as the Delta Hospice that is opposed to participating in euthanasia. 
Janice Strukoff, an administrative leader with the Delta hospice stated:
“Hospice palliative care is not about hastening death and we object to the bullying currently taking place in B.C.,”
Nancy Macey, the founder and executive director of the Delta hospice stated:
MAiD can be a traumatizing experience for staff, patients, and volunteers, and all groups might not want to stay or work there if the principals of palliative care are compromised. Hospices are already grappling with a shortage of health professionals so compelling the society to provide MAiD could exacerbate the problem.
Dr Neil Hilliard
In response to the order by the health authority, Delta hospice rejected the order and Dr Neil Hilliard, the medical director of the Fraser Health Palliative Care stated in his resignation letter:

Providing euthanasia or physician-assisted suicide is not in accordance with palliative care (which) “affirms life and regards dying as a normal process …”
Last weekend a meeting in Langley BC concerning the forcing of euthanasia upon medical facilities against the staff decision to not participate in MAiD. 

Sign the Petition: Killing Conscience Rights in BC Hospitals and Hospices.

The meeting attracted 300 people and featured federal MP Mark Warawa and provincial MLA Mary Polak, along with representatives from the Fraser Health Authority. At the meeting Warawa commented that the battle to protect conscience rights: "is not over. It's just begun." Warawa also stated:
“That (permitting MAiD) will destroy palliative care as it has developed,”
Mary Polak
Mary Polak was forthright in her comments by stating:

“To say that you are going to place medical assistance in dying — or let’s call it what it is, killing people. Sorry, but that is what it is — (and decide that) you’re going to put that into a hospice palliative circumstance, is to completely contradict what palliative care is to begin with,”
The decision of the Fraser Health Authority also affects plans to build a new hospice in Langley. Kathy Derksen, the executive director of the Langley hospice stated:
When MAiD was first law, Fraser Health consulted with stakeholders and agreed it would not be imposed on hospice and palliative care facilities.
Healthcare workers conscience rights have become a national issue in Canada. Recently, an Ontario Court decided that doctors who oppose euthanasia must participate by doing an "effective referral" for euthanasia.

Dr Will Johnston eloquently explained the pressures that are faced by medical professionals in his article: The alarming trend of forcing hospitals and hospices into doing assisted suicide.

Monday, February 12, 2018

Kevin Yuill - Assisted Dying: A failure of Psychiatry.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill
Kevin Yuill, who is an academic who has written extensively about euthanasia and assisted suicide wrote an interesting article that was published by Spiked titled: Assisted Dying: A failure of Psychiatry.

In his article, Yuill comments on the death of Aurelia Brouwers, the 29-year-old Dutch woman who died by euthanasia for psychiatric reasons and the research by Fabian Stahle, from Sweden, uncovering hidden problems with the Oregon assisted suicide law.

Yuill comments on Brouwer's death:

Brouwers had carefully planned her death – in her pyjamas, listening to Hugh Laurie, with her beloved pink T-Rex cuddly toy, Dido – ‘[he] has been my support since I was four-years-old’, as Aurelia put it. She asked her parents to care for Dido, who is to get ‘a spot on the coffin’ at her funeral. 
Brouwers told an interviewer: ‘I think that after such a rotten life I am entitled to a dignified death – people who have a serious illness get a chance for a worthy ending, so why is it so difficult for people who are psychologically ill?’
Yuill asks the question: at what stage do psychiatric professionals admit defeat and sanction the death of a patient? Yuill states
In the Netherlands as it stands, nine per cent of requests for euthanasia due to ‘unbearable’ and ‘hopeless’ psychological suffering are granted, although it is rare that the patients are as young as Brouwers. Brouwers had decided long ago that her treatment was not working and that her suffering was too great to bear. And her doctors eventually gave her the green light. But when is psychological suffering deemed ‘unbearable’? When is it adjudged ‘hopeless’? These seem to be incredibly subjective criteria.
Yuill challenges the UK assisted dying group Dignity in Dying who have stated that Brouwers would not qualify for assisted death based on the proposed UK legislation.
In the UK, Dignity in Dying and other campaigners for assisted dying insist that cases like Brouwers’ could never happen under their proposed legislation. Citing assisted-dying legislation in Oregon, they claim that similarly ‘robust safeguards’ would be implemented in the UK, preventing cases similar to Brouwers’. 
But, if assisted dying is legalised, is it realistic to expect ‘autonomy’ and ‘compassion’ to be reserved only for those who suffer from life-shortening physical diseases? Although Dignity in Dying denies it, assisted-dying laws are always extended beyond their original justifications. Indeed, in every nation where euthanasia has been legalised, the parameters in which assisted dying is permitted eventually always stretch beyond those with ‘less than six months to live’.
Yuill comments on the recent research by Fabian Stahle, into the Oregon assisted suicide law based on the proposed safeguards in the UK as being similar to the Oregon assisted suicide law:

Stahle had asked the Oregon Health Authority whether a diabetic person who was only dying because they refused treatment would qualify for an assisted death. The OHA’s answer was a straight ‘yes’, and it admitted that this had always been the case. 
Indeed, Oregon oncologist Dr Charles Blanke noted a difficult case regarding a young woman with Hodgkin’s lymphoma who had a 90 per cent chance of survival with treatment but refused it. Blanke acceded to her demand for an assisted death, despite the fact she was likely to lose potentially ‘seven decades’ of life. Opportunities for self-induced terminal illness are numerous. Anyone with anorexia nervosa, for example, can bring themselves to a terminal condition, thus qualifying for an assisted death in Oregon. 
... In Oregon, for example, pain does not figure in the top five reasons why citizens choose assisted death. Instead, it is fear that dominates the reasoning of those seeking to end their lives: fear of not being able to participate in enjoyable activities; fear of loss of autonomy; fear of loss of physical capabilities; fear of loss of dignity; and fear of being a burden. Fear, however, is curable, even if the underlying physical condition is not.

Yuill ends his article by recognizing how legalizing assisted suicide corrupts society:
... But when society legalises assisted dying, it surely corrupts the fundamental belief in the value of life that underlies all medical treatment. Compassion in the past meant doing what we felt was best for a patient. It meant disagreeing with a suicidal patient who felt her life was worthless. Today, compassion seems to mean respecting someone’s requests, even when we don’t feel that those requests are in his or her best interests. As Brouwers declared in her blog in January: ‘Respect that I will die Friday.’ 
Brouwers’ sad case is a grim reminder that a society that sanctions suicide is a society that has given up on certain people. It is a society that has lost its moral bearings. An individual may lose all hope and may feel that life is no longer worth living. She may even take her own life, and there is little we can do to prevent that. But, surely, if a fellow human being expresses the wish to die, we must be loyal to her life, not her wishes.
Kevin Yuill teaches American studies at the University of Sunderland. His book, Assisted Suicide: The Liberal, Humanist Case Against Legalisation, is published by Palgrave Macmillan.

2018 Conference of the Physician's Alliance Against Euthanasia

Physicians' Alliance Against Euthanasia

When: March 24th, 2018 9:00 am  to 5:00 pm
Location: Holiday Inn 999 Saint Urbain Street, Montréal, Québec H2Z 0B4 Canada
Event Fees: Physicans $200, Others $100, Students $25

With legal euthanasia and assisted suicide now a reality in Canada, we turn our attention to helping doctors and other health professionals improve their skills so as to better care for patients at risk of requesting death. This conference is an opportunity to learn from experts in palliative care and psychiatry, as well as to meet colleagues from across the country who share your concerns about the direction medicine is taking under these new laws.

The learning objectives for the conference are as follows:
  • Improve knowledge and skills related to analgesia at the end of life
  • Recognize existential distress in terminally ill patients
  • Knowledge of the indications and method for prescribing palliative sedation
  • Recognize and treat treatment-resistant depression in terminally ill patients
  • Recognize and address the biological, psychological and social factors underlying a patient's desire for hastened death
  • Understand the barriers to the development of palliative care at the societal level

Please note: If you would like to attend the French sessions, click here to register.

Veuillez noter: Ceci est la page d'inscription pour les sessions en anglais. Si vous souhaitez assister aux sessions en français, veuillez cliquer ici pour vous inscrire.

Click here to download a PDF document of the poster to share.

If you would like to register by mail, please download and fill out the registration form by clicking hereCheques may be sent to the address in the form.

Sunday, February 11, 2018

Wisconsin bill AB216 forces doctors to participate in assisting a suicide.

Wisconsin AB216 sponsors want to put doctors out of business who will not Assist Suicide.

Nancy Elliott
By Nancy Elliott
Chair - Euthanasia Prevention Coalition - USA

Wisconsin's assisted suicide bill AB216 will implement Assisted Suicide, and it will also revoke the licenses of doctors who are unwilling to participate in causing the death of their patients. 

AB 216 Section 156.21(a) states:
failure of an attending physician to fulfill a request for medication constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication.
Therefore a physician could be found liable for unprofessional conduct if he/she refuses to prescribe lethal drugs or refer the patient to a willing physician. Referring your patient to another doctor, who you know will complete the death is the same as writing a prescription for that patient. Both are a dereliction of the physicians duty to do no harm.

The sponsors want to punish doctors who will not be a party to ending their patients lives and they want to force all doctors to have their hands dirty. 

Surprisingly the bill grants immunity to those who participate. In the same section it states no health care facility or health care provider may be charged with a crime, held civilly liable, or charged with unprofessional conduct for fulfilling the act and prescribing poison to end the life of their patient. The bill states that next of kin is not required to be notified, so you can find out that a family member took their life by a suicide drug prescribed by their doctor without input from family members and there is no legal recourse, not criminally nor civilly.

Not only do the sponsors harm innocent doctors and deny families input or justice, this bill takes away the choice of citizens who do not want to be treated by a doctor that kills their patients. 

As ethical doctors lose their licenses or flee the state, there will be only one type practicing. 

Wisconsin is not the first state to attempt to force doctors to refer for assisted suicide. Vermont also forced doctors to refer for assisted suicide but in May 2017, a Vermont court decision upheld physicians conscience rights.

Saturday, February 10, 2018

2017 Oregon assisted suicide report. The number of deaths increase again.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The 2017 Oregon annual assisted suicide report is similar to prior years. The report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

According to the 2017 Oregon assisted suicide report.

  • There were 143 reported assisted suicide deaths up from 138 in 2016. 
  • 129 of 130 people who reportedly ingested lethal drugs in 2017, died from it, 
  • one person survived and died of natural causes.
  • 14 of the deaths, the drugs were prescribed in previous years.
  • There were 218 lethal prescriptions obtained, up from 204 in 2016.
There may be more assisted suicide deaths.

According to the 2017 Oregon report, the ingestion status was unknown in 23 deaths. 

When the ingestion status is unknown the authorities do not know if the person died by assisted suicide. It is possible that some or all of the 23 unknown deaths were assisted suicide deaths. These deaths may represent unreported assisted suicide deaths.

Researcher uncovers hidden problems with the Oregon assisted suicide act.

In December, Fabian Stahle, a Swede who is concerned about assisted suicide, communicated by email with a representative of the Oregon Health Authority.
Stahle confirmed that the definition of terminal illness, used by the Oregon Health Authority includes people who may become terminally ill if they refuse effective medical treatment.
The responses to Stahle from the Oregon Health Authority also confirmed that their is no effective oversight of the Oregon assisted suicide law. 
The yearly Oregon DWD reports are based on data from the physicians who approved the assisted suicide death and the data is not independently verified. Therefore, we don't know if the information from these reports is accurate or if abuse of the law has occured.