Monthly Archives

September 2014

Euthanasia campaigner Nitschke investigated over more deaths

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The Age 28 September 2014
Embattled euthanasia campaigner Dr Philip Nitschke is being investigated by police in every Australian state over his possible role in nearly 20 deaths in the past three years, all of them apparently suicides.
The latest investigation, by Victoria Police, concerns the death of a 55-year-old Geelong man who allegedly killed himself using a do-it-yourself kit bought though a company affiliated with Exit International, the pro-euthanasia organisation founded by Dr Nitschke.
All of the deaths being investigated involved the use of the two suicide methods promoted by Dr Nitschke, the lethal drug, Nembutal or a nitrogen inhalant device.
A number of coronial inquests are already under way into the deaths.
A Fairfax investigation has found that Victoria Police have obtained a warrant to search the Telstra records of the Geelong man, Ross Currie, prior to his death in the remote Otway National Park on May 25.
Police believe that emails between Mr Currie and Exit International, Dr Nitschke and Mad Dog Brewing, the company which markets the nitrogen inhalent equipment, will provide some insight into Mr Currie’s mental state prior to his death.
It can also be revealed that Dr Nitschke faces expulsion by the Australian Medical Association when its Northern Territory branch Council meets in November, after a move to suspend him last month failed after an error in the paperwork.
Dr Nitschke, who was suspended by the Medical Board of Australia in July, said “attacks” on his character were “coming from everywhere”.

Safeguards will not protect you (Belgium)

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Alex Schadenberg 18 September 2014
Re: Gifford-Jones – Not all lunatics are in the asylum.
In his righteous indignation, Gifford-Jones claims in his article that:
“Nor is there any evidence that the elderly, those with disabilities or those who simply do not want to be part of assisted death, have ever been forced to seek it.”
In 2002 Belgium legalized assisted death giving doctors the right in law to lethally inject patients. Three studies concerning the experience with assisted death in Belgium clearly indicate that Gifford-Jones is wrong.
The first study found that 32% of those who died by assisted death did not request it.
The second study found that 45% of the assisted deaths that nurses were involved with, the person who died didn’t request it.
The third study found that 47.2% of all assisted deaths were not reported.
When analyzing the data, all of the studies found that those who died by an assisted death without request or without reporting it tended to be over the age of 80, incompetent to make decisions for themselves, had an unpredictable end-of-life trajectory and died in a hospital.
There is clear evidence that many elderly and incompetent people in Belgium have been killed by an assisted death without request. The act is a silent crime since the doctor negated to report it.
Don’t be swayed by the propaganda being promoted by Gifford-Jones.
Safeguards will not protect you from physicians who are willing to take your life.
Links to similar articles:
•Disability rights organizations oppose assisted suicide.
•Death with Dignity Act lacks effective safeguards to protect depressed people.
•Most doctors oppose assisted suicide.
•We do not live in a utopia. Assisted suicide is not safe.
•Abuse of older women overlooked and under-reported.

New Zealand’s pro-euthanasia MP fails to re-enter Parliament

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LifeSiteNews 22 September 2014
Staunch euthanasia and assisted suicide advocate, Maryan Street, has failed to make it back into Parliament after New Zealand’s general election on Saturday.
Street, a Labour candidate who has been an MP since 2005, had placed the End of Life Choice Bill into the Member’s Ballot in July 2012.
Late last year, Street came under pressure from her party to remove the Bill as it was deemed too controversial a subject to be debating in an election year.
Street withdrew the Bill from the Ballot, vowing to reintroduce it after the election.  However, once again she failed to win the electorate seat of Nelson.  Her position on Labour’s List should have seen her re-enter Parliament for another term, but their support has deteriorated to its lowest since 1922 and they did not gain enough seats for Street to be selected.
Considered by many to be filled with loopholes, the End of Life Choice Bill, if passed, would have legalized physician assisted suicide for those who were suffering from an “irreversible physical or mental medical condition” who were experiencing “unbearable” pain.
Doctors who object to euthanasia and assisted suicide would have been obliged to refer patients to other practitioners who could carry out their wishes.

Euthanasia clinic reprimanded for death of stroke victim

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Dutch News 27 August 2014
A special clinic set up to help people whose doctors do not support euthanasia has been reprimanded for failings when it helped an elderly woman who did not want to live in a nursing home to die.
The euthanasia monitoring committee said the clinic’s experts had failed to exercise proper care when carrying out their duties. The public prosecution department is now investigating the case.
It is the second time in four months the clinic has been criticised. In April officials said a doctor had not talked enough to an elderly women with psychiatric problems whom it helped to die.
Since it was opened over two years ago, doctors at the clinic have carried out 250 euthanasia requests.
The latest case involves a woman in her 80s who had become partially paralysed since a stroke. Twenty years previously she had written a statement saying she did not want to live permanently in a nursing home. She reconfirmed that position with her doctor 18 months ago.
In order to qualify for euthanasia in the Netherlands, the patient must be ‘suffering unbearably’.
Although this was not the case, the clinic’s doctors decided to perform the euthanasia because this is what the woman wanted. An independent doctor did assess the woman as suffering unbearably, based on gestures and her repeated use of the words ‘kan niet’.
Euthanasia has been legal in the Netherlands since 2002 under strict conditions and with the approval of two doctors.

Belgian Prisoner Serving Life Sentence Granted Request To Die After Years Of Mental Anguish

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Huffington Post 15 September 2014
A Belgian murderer and rapist serving a life sentence is to be allowed to have doctors end his life following a ground-breaking ruling under laws in Belgium permitting people to request euthanasia.
Frank Van Den Bleeken had argued that he had no prospect of release since he could not overcome his violent sexual impulses and so he wanted to exercise his right to medically assisted suicide in order to end years of mental anguish.
“Over recent years, he has been seen by several doctors and psychologists and their conclusion is that he is suffering, and suffering unbearably,” his lawyer, Jos Vander Velpen, told state broadcaster VRT.
The judicial ruling was the first involving a prisoner since the euthanasia law was introduced 12 years ago.
It was not clear when the medical procedure, to be conducted in a hospital, would take place, the lawyer added. Because he was a prisoner, his client’s request had been dependent on the consent of the justice ministry. Belgium, like the rest of the European Union, does not have a death penalty.
Van Den Bleeken, aged about 50 and in prison for nearly 30 years, had complained of a lack of therapy provided for his condition in Belgium and therefore he preferred to die.

The utopian dream of controlling the uncontrollable

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HOPE 9 September 2014
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.
Senator David Leyonhjelm (Assisted Suicide. OnLine Opinion, 8 Sept) poses the classical libertarian view (that: ‘permission from government should not be required’) while The Age writer, Julia Medew records the view of one of the doctors she interviews as seeking legislative control (Don’t-tell doctors supporting secret euthanasia deaths The Age, 7 Sept).
Medew’s premise is the classic shibboleth of ‘it’s happening now, so let’s legalise it’.
That these two views on the same subject are contradictory, one to the other, serves to highlight the need for continued prohibition. Both views are utopian in essence – they cannot be attained no matter how much we might wish it were so.
Both are an appeal to autonomy. Leyonhjelm calls it ‘individual freedom’ and ‘the right to die at the time of our choosing’. That last slogan and its many variations in use by the pro-euthanasia and assisted suicide lobby are modified for public consumption and for the sake of creating some legislative appeal in and through the presentation of limited legislative models. For example, access only for people with a terminal illness.
Leyonhjelm’s libertarian view seems to be consistent with that of Philip Nitschke; that any adult of sound mind should have access to suicide methods. Nitschke’s views (and Leyonhjelm’s by default) are considered by their pro-euthanasia and assisted suicide lobbyist counterparts as ‘unhelpful’ to debate.
And so they are. Limited legislative models are a Trojan horse for a broader application. Whether such limitations are honestly held objectives or simply ‘a foot in the door’ matters little. Whereas proponents of a limited legislative model focus on an emotive case for a limited cohort, Nitschke’s interventions run contrary to that kind of rhetoric. Nitschke and Leyonhjelm point to the ultimate reality, while the limited legislative thrust simply starts us off on the road to get there.
If we’re arguing for a ‘right-to-die’ then the existence of such a ‘right’ creates philosophical and practical implications for any limited public policy that would discriminate against, for example, non-terminally ill people.
Medew’s article offers us three examples of where doctors or relatives may well have crossed the line on assisting in suicide (not euthanasia as the article’s title errantly suggests). Whether these people would have qualified under a limited model cannot be determined; but it would be foolhardy to assume that creating a limited model would stop any doctors from continuing to operate outside any extant framework in circumstances where their patients did not qualify.
If it’s all about ending suffering and about a ‘right-to-die’ then Nitschke and Leyonhjelm are right. Roll on the next wave of revelations about doctors acting outside the law for ‘compassionate’ reasons or look to the inexorable bracket creep of euthanasia in places like Belgium or The Netherlands.
Interestingly, in two of the stories described in The Age article, Medew observes that the concerns of the women in question were not principally about pain at all. The first cited that ‘she did not want to reach a point where she could not look after herself’; the second, ‘feared being unable to remain in her home.’ These are understandable concerns, but not, one would have thought, reason to apply the death sentence. Yet last week in The Netherlands a nursing home came under scrutiny for the euthanasia death of a woman who cited her fear of living in a nursing home as her primary reasoning for asking for someone to kill her. Add that to other examples from the Benelux countries of euthanasia for blindness, anorexia, loneliness and even in the dark throes of clinical depression, and the utopian ideal of a controlled legislative environment or even an absence of any possible maleficence (in a libertarian regimen) are really castles-in-the-air.
That there can be no ‘right-to-die’ seems to have escaped the thinking of all concerned. Nitschke once suggested that, just as there’s a right enshrined in International Human Rights to ‘freedom of religion’ which implies ‘freedom from religion’, that the UN Human Rights Declaration of a ‘right-to-life’ implies a ‘right-to-die’. This is simply nonsense. How can there be a ‘right’ to something that, by our very existence, will come to us all. Regardless of the rhetoric about ‘at a time of our choosing’, it is still predicated upon a right that does not and cannot exist. It is a house of cards.
This reality was most eloquently described last year by the Irish Lords Justice in the Fleming Case: “… the protection of the right to life cannot necessarily or logically entail a right, which the State must also respect and vindicate, to terminate that life or have it terminated… that would be the antithesis of the right rather than the logical consequence of it.”
Should we ever forget that freedom to do certain things also implies a freedom from having certain things done to us; in other words, not to be endangered in any way or to be unjustly deprived of our own rights to freedom and security of person, then we’re staring down the short barrel towards anarchy. The rhetoric of choice and autonomy in regards to deliberate killing or helping people to suicide may seem beguiling enough; but while the classically libertarian ideal of limiting the role of government in our lives is appealing; it also requires that the natural limits of freedom be observed.
I am of course, referring to the clear, bright line drawn in our criminal codes that protects me from killing you and you from being killed by me. It also protects vulnerable people from the risk of being coerced towards suicide or having suicidal thoughts endorsed and supported by others.
Both Leyonhjelm and the euthanasia movement, generally, is dismissive of the risk to vulnerable people; the latter claiming that their ‘safeguards’ will guard against such abuse; the former saying that, ‘this is not about bumping off granny to inherit the house’. The Irish Justices dismissed this idea, confirming that, ‘The medical literature documents specific examples of abuse which, even if exceptional, are nonetheless deeply disturbing.’ The very fact that the pro-euthanasia lobby talks about ‘safeguards’ should be a red flag – we wouldn’t need ‘safeguards’ if there were no risks!
The current prohibition protects us all equally, while crossing the death Rubicon advances risks with each progressive step.
That both of these articles should appear in the media on the eve of World Suicide Prevention Day (10th Sept) is more than a little disturbing; but, then again, there’s an election on the way in Victoria. Leyonhjelm closes his article, ‘If free people own their own lives, they must be free to end them if they wish.’ This is a reckless comment. All suicide is regrettable; all suicides should be abhorred and we should seek to ensure that suicide prevention measures recognise that reality.
If we accept that suicide for the elderly or the ill is appropriate, we send a decidedly mixed message about the value of life. Diminishing the resistance to all forms of suicide by accepting, as Leyonhjelm suggests, that some lives are ‘no longer worth living’ implies that some suicides are good, that some are acceptable. This can never be the case.
The World Health Organisation reporting recently that one suicide occurs every 40 seconds around the world and that, globally, the highest rate of suicide is amongst people aged 70 and over, should provide us with pause for thought. Are we going to discriminate against the aged and infirmed in terms of suicide prevention; are we going to allow the former Nazi slogan of ‘life not worthy of life’ to skew our objectives of reducing the incidents of suicide?
A simpler way to look at it might be to question the inclusion of helplines at the end of articles such as this for those for whom the content might give rise to suicidal thought. Do we need to now include a rider to the ‘phone xxxxxx for assistance’ that says something like: ‘if you think your suicidal thoughts are rational, phone Exit; if your old or sick, ring xxxx for a doctor who will help you end it all.’
The only truly consistent approach to the question of suicide is to seek to prevent it in all its forms. Anything less is a failure; a failure of imagination, commitment and of vulnerable people who deserve the protection of the law and the support of our society.
Paul Russell is director of HOPE: preventing euthanasia & assisted suicide based in Australia.

Belgian Euthanasia Control and Evaluation Commission broadens euthanasia law.

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Alex Schadenberg Blog 9 September 2014
Belgian Euthanasia Increases by 89% in four years.

The Act of 28 May 2002 concerning euthanasia stipulates that the Federal Committee on Oversight and Enforcement, shall biennially report to the legislature. Here is the sixth report, covering the years 2012-2013.
The report comprises firstly a statistical element, which we note here that the number of reported euthanasia has almost doubled in four years (an increase of 89%), from 953 reported in 2010 to 1,807 in 2013 euthanasia. The Commission considers that this increase is due to the “gradual release of information to the public and physicians.” The deaths caused today represent 1.7% of all deaths in Belgium.
More and more people have also asked to be euthanized when their death was not expected in the short term (13% of euthanasia). These figures, however, should probably be revised upward to include some cases of euthanasia practiced, based on early reports of the end of life on irreversibly unconscious people. Indeed, the report ranks arbitrarily all these cases in the category of death in the near future, when the deadline is sometimes indeterminate (“When euthanasia was performed in a patient irreversibly unconscious on the basis of an earlierstatement , the deadline of death was undetermined if it was classified brief.”).
The report then describes the application of the law which highlight the following:
• About the people who were euthanized when they were not at the end of life, the report mentions some cases of early cancers but specifies that some people were euthanized who had non-terminal diseases or conditions. This is particularly true for patients with neuropsychiatric disorders (4%) or people with “multiple conditions” specific to advanced age (5% of cases). In this regard, the Commission notes that the number of euthanasia performed for multiple pathologies is “significantly higher” in 2012-2013 than in 2011 (going from 23 in 2011 to 109 in 2013). The report underlines in this regard that there was a difference of opinion within the Commission as to the justification for euthanasia for these non-terminal disease and “normal” age-related patient.
 2004  2005  2006 2007  2008   2009 2010  2011   2012 2013 
 Neuropsychiatric disorders  6 3  5  4  13  21  25  33  53  67
 “Multiple Pathologies”  9 11 6 10 12 18 16 23 57 109

• Of the patients euthanized, 75% of them were between 60 and 89 years , and there is an increasing proportion of euthanasia in nursing homes and / or care.
• In 4% of cases (73 euthanasia), the report does not indicate the diagnosis justifying euthanasia. While in most cases, the physical pain is present, however, there were 68 cases where the patient did not express (figures 2013).
• The report notes again, as in previous years, the strange disparity between the high number of declarations on euthanasia filled in Dutch-speaking Belgium (1454 2013, or 80% of the acts) next to the smaller number of returns filed in French-speaking Belgium (353 in 2013, representing 20% of total), but no study has yet been taken to account for this discrepancy.
• Regarding the statements of euthanasia, arguing duty to die, the Commission asked for comments or clarification from the reporting physician, “confidentially” in 14% of the cases. But just like the previous 12 years, the Commission has not sent any suspected case to justice, as well as stating that it believes everything is completely under control, at least for the cases that were reported by respondents. “No representation with elements raising doubts about compliance with the essential requirements of the law, no case has been forwarded to the courts.”
• About the forward declaration at the end of life (living will), several members of the Commission have lamented the complexity (writing, recording and renewal) of the process. They said that they would make it “more effective.” About the obstacles and difficulties emerged in some nursing homes and care when there was a request for euthanasia, it seems that “everything has been settled.” The report did not give details.
• The Evaluation Committee considered it within its jurisdiction and its powers to endorse the practice of assisted suicide, arguing that the law “does not impose how the euthanasia should be practiced,” provided it is under medical supervision. This is clearly at odds with the legislative history of the law decriminalizing euthanasia. Parliamentarians, in fact, reserved decriminalizing the act homicide made ​​by the physician, not the patient.
• Concerning the training of doctors, the Commission considers that the curriculum of medical studies should cover the practice of palliative care but also “the proper implementation of euthanasia.” “Likewise, the various postgraduate education and recycling business cycles (for general practitioners) should be encouraged to include such training.”
• In Annex 4 (Brochure for the medical profession), the report insisted the concept of independence in respect of the patient and the attending physician, the consultant called to verify the correct application of the legal requirements for the planned euthanasia. There can be no domestic relationship or hierarchical relationship of subordination between the consultant and the treating physician. However, it is not specified that they can not belong to the same organization or association. So nothing prevents two doctors who belong to the same association – EOL (End of Life) or LEIF (Life End Information Forum), for example, one and the other sponsored by the Association for the Right to Die in dignity – to cooperate, as an attending physician and consulting physician, euthanasia of a patient.
• Reaffirming that only the patient can judge the unbearable and insatiable nature of his suffering, but he has the right to refuse any treatment would alleviate this suffering, the Commission takes the example of the case of this 54 year old man suffering from multiple sclerosis: unrelieved suffering is rooted in the fact that “He does not want to depend on others.” Note also that the patient must remain master of the treatment he receives, it is not a question of imposing palliative care, even though they have precisely the effect of reducing suffering.
• As for products necessary to euthanasia, the Commission recommends to facilitate the availability of public pharmacy. But it was silent about the current lack of control from the same pharmacies.
• Some members of the Commission believe that the last notion of irreversible unconsciousness is interpreted by physicians in a limited way (coma). They argue for a less restrictive interpretation, allowing a wider practice of euthanasia.
Finally, we note that the Belgian Euthanasia Control and Evaluation Commission, established by the legislature to monitor closely the implementation of the law, increasingly assumes the role of an interpreter of the law, broadening its applicability. So much so that one can legitimately ask whether it does not tend to become over the years a promoter of euthanasia.

Palliative care rise strains funding

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Stuff 8 September 2014
Southern hospices are fighting million-dollar funding shortfalls to provide care for patients, as the demand for palliative services increases.
Hospice Southland raised $1.8 million in the past financial year to cover the shortfall left by government funding and is facing a similar deficit this year.
Chief executive Andrew Leys said government funding covered about 50 per cent of the hospice’s operating costs.
The hospice received $1,747,013 of government funding in the past financial year but worked with a net operating deficit of $1,781,402.
This had to be made up by donations, grants, shop sales and bequests through the year, he said.
The biggest cost – about 80 per cent – was staff wages.
The majority of wage costs were to pay for clinical support staff, Leys said.

Euthanasia Report Warns of Elder Abuse & Coercion

By | Media

 killing me softly cover pageA report on the history of the euthanasia debate in New Zealand and an examination of the law and the research evidence overseas warns of the potential for even greater levels of elder abuse if euthanasia were to be decriminalised in NZ. The Report “Killing Me Softly – Should Euthanasia Be Legalised?” by Professor Rex Ahdar of Otago University says that safeguards can only go so far, that coercion is subtle, and that patients will ask themselves why they are not availing themselves of it. He warns that the potential for abuse and flouting of procedural safeguards is also a strong argument against legalisation.
The report was commissioned by family group Family First NZ in response to another promised attempt to change the law by Labour MP Maryan Street after the upcoming general election.
The report warns that in practice, safeguards can only go so far, and that coercion is subtle. The everyday reality is that terminally ill persons and those afflicted with non-terminal but irreversible and unbearable physical or mental conditions are vulnerable to self-imposed pressure. They will come to feel euthanasia would be “the right thing to do”, they have “had a good innings”, and they do not want to be a “burden” to their nearest and dearest. Simply offering the possibility of euthanasia or doctor-assisted suicide shifts the burden of proof, so that patients must ask themselves why they are not availing themselves of it.
A recent study found that 32 percent of all assisted deaths in the Flemish region of Belgium were done without the patient’s explicit request. The requirement to report euthanasia has not been fully complied with in nations that have legalised euthanasia either.
There is some empirical evidence too from these same nations that the availability and application of euthanasia expands to situations initially ruled out as beyond the pale. For example, euthanasia has been extended to enable minors to avail themselves of it with parental consent in the Netherlands and, most recently, Belgium. Labour MP Maryan Street has been reported as saying “Application for children with terminal illness was a bridge too far in my view at this time. That might be something that may happen in the future, but not now.”
The report also notes that the majority of the medical profession and national medical associations around the world have been resolutely against the introduction of voluntary euthanasia or physician-assisted suicide, amidst real concerns that the role of the doctor would be irrevocably changed from healer to, at times, killer; from caring professional who saves lives to one who takes them. Inevitably, patient trust would be eroded.
The report concludes that any decriminalisation of euthanasia will introduce the era of “therapeutic killing”.

Doctors warn on euthanasia

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The West Australian 1 September 2014
WA palliative care specialists are urging Federal MPs to reject the legalisation of euthanasia, warning doctors do not want to be put in the position of having to end patients’ lives.
They have told a parliamentary inquiry looking at the proposed introduction of national right-to-die laws that rather than deliberately ending life, more should be done on improving care for the terminally ill.
Perth Federal Labor MP Alannah MacTiernan and Greens Victorian senator Richard Di Natale are spearheading a push for national euthanasia laws.
Under Senator Di Natale’s “dying with dignity” private member’s Bill, three doctors would need to give their approval before a terminally ill patient could undergo euthanasia. Euthanasia would be limited to adults and Australian residents.
But members of the WA Palliative Medicine Specialists Group, which includes doctors from the State’s major hospitals, worry that legalising euthanasia would change society’s attitude to matters of life and death.
Doug Bridge, former head of Royal Perth Hospital’s palliative care service, said it was “abhorrent” to put doctors in the position of having to end a patient’s life.