BELGIUM
Euthanasia Statistics: Belgium
The Belgian Commission Fédérale de Contrôle et d'Évaluation de
l'Euthanasie produces reports on the provision of euthanasia every two
years. The first report covers a period of about 15 months
(2002-2003). The Project has compiled the statistics in tables and charts, some of
which are reproduced. A full Excel file with links to original reports
and sources can be downloaded. . .
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Belgium: mandatory referral for euthanasia
Sean Murphy
|. . .The Flemish Palliative Care Federation is silent on the issue of referral,
but the joint statement asserts that an objecting physician must not only
give patients timely notice of his position, but must "organise a smooth
referral." At another point the joint statement insists that an objecting
physician work together with the patient to find a willing colleague. . .
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België: verplichte verwijzing voor euthanasie
Sean Murphy |. . .De Federatie Palliatieve Zorg Vlaanderen heeft zich niet uitgesproken over doorverwijzing, maar in het gemeenschappelijke standpunt wordt beweerd dat een bezwaarde arts patiënten niet alleen tijdig van zijn/haar mening op de hoogte moet brengen, maar ook "samen de patiënt naar een andere behandelende arts moet zoeken". Elders in het gemeenschappelijke standpunt wordt geëist dat een bezwaarde arts 'samenwerkt' met de patiënt om een bereidwillige collega te vinden. . .
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CANADA
MAiD Muscles In
B.C.’s Delta Hospice Society being evicted, assets expropriated for refusing to allow euthanasia and assisted suicide
(January, 2021)
Peter Stockland |
You might think the middle of a global pandemic is less than an ideal time to disrupt the operations of a hospice where palliative care patients receive comfort as they approach death.
If so, you would not share the apparent thinking of the B.C. government or its local Fraser Health Authority, which as of today has forced layoffs of staff at the Irene Thomas Hospice in suburban Vancouver. The dismissals are part of the eviction of the Delta Hospice Society that oversees the facility. . .
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Organ donation and euthanasia make a good team in Ontario
(October, 2019)
Michael Cook |
There is a startling statistic tucked away in Ontario’s September quarter euthanasia statistics. A total of 519 people were euthanised from July 1 to September 30. . . But of the total euthanised, it appears, from government’s sketchy summary, 30 donated organs. . .
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CMA's "third way" may be a third rail
Responding to Responding to articles by CMA officials (BMJ 2019; 364)
(March, 2019)
Sean Murphy |
It is disconcerting to find that the CMA's President-Elect thinks that Canadian law "does not compel any physician to be involved in an act or procedure that would violate their values or faith." The state medical regulator in Canada’s largest province has enacted policies that do just that, requiring physicians who refuse to kill their patients to find a colleague who will. These policies
do have the force of law, and objecting physicians were forced to launch an expensive constitutional challenge to defend themselves. The Protection of Conscience Project and others have intervened in the case to support them; the CMA has not. . .
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Canadian Associate Members at the World Medical Association
General Assembly
(October, 2018)
Sheila Rutledge Harding | We were at the GA
because we wished to contribute to the discussion of a draft resolution
entitled
Proposed WMA Reconsideration of the Statement on Euthanasia and
Physician Assisted Dying which was to be brought forward to the Ethics Committee of the WMA by the Canadian Medical Association (CMA) and the Royal Dutch Medical Association (RDMA). . . .We wished to uphold the WMA opposition to E/PAS and
encourage a life-affirming approach. . .
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Euthanasia in Canada: a Cautionary Tale
(September, 2018
Rene Leiva et al | We are Canadian physicians who are dismayed and concerned by the impact – on patients, on doctors, on medical practice – of the universal implementation, in our country, of euthanasia defined as medical "care" to which all citizens are entitled (subject to the satisfaction of ambiguous and arbitrary qualifying criteria). Many of us feel so strongly about the difficulty of practicing under newly prescribed constraints that we may be forced, for reasons of personal integrity and professional conscience, to emigrate or to withdraw from practice altogether. All of us are deeply worried about the future of medicine in Canada. . .
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Canadian Medical Association and euthanasia
and assisted suicide in Canada
Critical review of CMA approach to changes in policy and law
(September, 2018)
Sean Murphy
| In December, 2013, the Canadian Medical Association (CMA) Board of
Directors decided to shape the debate and law concerning euthanasia and
assisted suicide and revisit CMA policy opposing physician participation in
the procedures. By the summer of 2014 it was clear that the overwhelming
majority of physicians supported the existing policy. However, it appears
that the Board decided the policy should be changed before the Supreme Court
of Canada decided the case of
Carter v. Canada. . .
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Ensuring access to euthanasia by encouraging physician
participation: it's complicated
(October, 2017)
Sean Murphy
| . . . In July, 2017, Canadian euthanasia/assisted suicide (EAS)
practitioners and advocates alleged that patient access to euthanasia
and assisted suicide was in danger because of "barriers" and
"disincentives" to physician participation. . . There
was, in fact, no crisis — only a false perception of crisis
fuelled by unrealistic expectations about levels of
physician participation in euthanasia and assisted suicide. Nonetheless,
it is reasonable for policy makers to respond to their concerns that physicians are discouraged
from participating in euthanasia and assisted suicide. . .
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Canada's Summer of Discontent
Euthanasia practitioners warn of nationwide "crisis": Shortage of euthanasia practitioners "a real
problem"
(October, 2017)
Sean Murphy
| . . . Dr. Jesse Pewarchuk of Victoria, British Columbia, had
provided euthanasia or assisted suicide for more than 20
patients. However, in July, 2017, having concluded there was
"no conceivable way" that providing euthanasia or assisted suicide
("MAID") made "economic sense" for any physician, he made public a
letter announcing that he would no longer provide the services. . . continue reading
Access to euthanasia and assisted suicide:
Letter to Canadian Federal and Provincial Ministers of
Health
(September, 2017)
Protection of Conscience Project | . . .The issue of access to the services is frequently raised
in connection with the exercise of freedom of conscience and
religion by dissenting health care practitioners. This not
infrequently generates heated controversy, and has already
led to a constitutional challenge in Ontario in which the
Project has again jointly intervened. However, informed
public discourse and public policy making requires accurate,
publicly available information about the actual extent of
participation by medical professionals and institutions. . .
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L'accès à l'aide médicale à mourir:
Lettre aux ministres fédéral et provinciaux
de la santé du Canada
(September, 2017)
Protection of Conscience Project | . . .Le problème
de l'accès à ces services est souvent soulevé en lien avec les médecins
qui exercent leur droit de liberté de conscience et de religion, en
refusant de donner ces services. Ceci génère parfois des controverses
sérieuses et a même conduit à une poursuite constitutionnelle en
Ontario, dans laquelle le PCP est à nouveau intervenu conjointement.
Cependant, pour un discours public informé et une législation juste, il
faut que l'information sur la participation réelle des médecins et des
institutions soit disponible. . . continue reading
Standing Committee on Justice and Human Rights
(May, 2016) House of Commons, Parliament of Canada
Framework and Proceedings of Standing Committee on Justice and Human
Rights of the Canadian House of
Commons studying Bill C-14, to implement hysician assisted suicide and physician administered
euthanasia in Canada . . . Standing Committee
What's behind the demolition of conscience rights in Canada?
Autonomy, choice, and tolerance are being used to justify euthanasia but these grand principles don't apply to opponents
(April, 2016)
Margaret Somerville
| I've been puzzling about why Canadian "progressive" values advocates,
particularly those passionately in favour of the legalization of
euthanasia and physician-assisted suicide ("physician-assisted death"
(PAD)), are so adamant in trying to force healthcare professionals and
institutions who have conscience or religious objections to these
procedures to become complicit in them. . .
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Shocking news: Assisted dying means euthanasia and assisted suicide
Ethical, medical and legal perspectives in tension at committee hearing
(February, 2016)
Sean Murphy |
Wayne Kondro protests against the use of the words "euthanasia" and "physician-assisted suicide" during parliamentary hearings conducted by the
Special Joint Committee on Physician Assisted Dying. He refers to the
proceedings as "shock TV." He perhaps has a point. The name of the committee does not indicate that the
hearings are actually about euthanasia and physician-assisted suicide, so
someone watching the proceedings for the first time, might be shocked. . . continue reading
Special Joint Committee on Physician Assisted Dying
(January-February, 2016) Parliament of Canada
Framework and Proceedings of Special Joint Senate and House of
Commons Committee formed to prepare federal statutory framework for
implementation of physician assisted suicide and physician administered
euthanasia in Canada . . . Special Joint
Committee
Canadian Medical Association plans for physician assisted
suicide, euthanasia
Commentary on draft framework
(June/July, 2015)
Sean Murphy
| On 6 February, 2015, the Supreme Court of Canada ordered the
legalization of physician-assisted suicide and euthanasia in Canada,
effective in February, 2016. . . The Canadian Medical Association (CMA)
had been preparing for legalization of physician assisted suicide and
euthanasia since 2014. In the months following the ruling, CMA
officials and the Board of Directors finalized draft guidelines ("draft
framework") on the subject and published them in June. An internal CMA
on-line consulation concerning the draft framework ran from 8 June to 20
July, 2015. . . continue reading
[Ethics]
Promises, promises
Canadian law reformers promise tolerance, freedom of
conscience
Sean Murphy
| With the passage of the Quebec euthanasia law and the pending case of
Carter v. Canada in the Supreme Court of Canada, physicians, medical students, nurses and other health care workers opposed to euthanasia and assisted suicide for reasons of conscience are confronted by the prospect that laws against the procedures will be struck down or changed. They may wonder what the future holds for them if that happens. . . continue reading
The Mary Dilemma - A Case Study on Moral Distress:
Newborn infant starved to death in Toronto hospital
(2012 or
earlier)
Fr. Michael Della Penna, ofm,
Francisca Burg-Feret
| This paper begins with a case study describing the
perspective of a Catholic nurse who experienced moral distress while
observing the tragic death of a newborn infant named Baby Mary. The purpose
of this paper is to raise awareness and educate readers about the concept of
moral distress and promote a greater understanding of the lived experience
of Catholic health care providers who undergo this trauma. It also provides
an analysis and some recommendations for practice that can help health care
professionals make good ethical choices in difficult situations based on
their faith. . . continue reading
Therapeutic homicide in a neonatal unit?
The
Mary Dilemma: Case Study on Moral Distress
(2012 or earlier)
Sean Murphy
| . . .if Baby Mary was being starved to death as
reported by the
Journal article, it was irrelevant that she was
being starved to death by health care professionals wearing white coats
in a neonatal intensive care unit. On the contrary: if she was a "child
in need of protection" - which, according to the
Journal
article, she was - then every one of those professionals was obliged to
immediately report what was happening to the Children’s Aid Society, and
their failure to do so was an offence. . .
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Edmonton Hospitals Suspected of Euthanasia
(May, 2001)
Candis McLean | . . .The Elder Advocate of Alberta . . . says that if the
case does prove to be euthanasia, it will not be the first she has seen
documented. . . Far more common, however, she says, is euthanasia by failure
to feed or hydrate. . .
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Rodriguez v Attorney General of British Columbia et al
Supreme Court of Canada minority would have legalized euthanasia for mental illness in 1993
Sean Murphy | Chief Justice Lamer . . . would have granted exemptions from prosecution for assisted suicide whether or not applicants were near death and suffering from incurable diseases or conditions. The minority would thus have legalized assisted suicide for mental illness in 1993, despite having heard no evidence or argument on the subject, and notwithstanding the global absence of experience and research into legalized physician-assisted suicide and euthanasia for any disorder or illness. . .
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From Abortion to Euthanasia: Nurses on the Spot
(November, 1991)
Transcript | ". . . nurses are employed by
the government. . . I could be weeded out if I don't go along with
euthanasia. I have a contract. I have my nurse's, my RNABC contract as
well. If it becomes a policy under the RNABC, if it becomes a policy
under the hospital hiring policy, I am in contract to kill. It's as
simple as that. . ."
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Quebec
Euthanasia Statistics: Quebec
Quebec health and social services agencies (CISSS and
CIUSSS) are required to send reports to the commission
established by Quebec's euthanasia law to monitor the administration of euthanasia in Quebec
(Commission sur les soins de fin de vie). A full Excel file with
links to original reports and sources can be downloaded. . .
continue readingDr. Robert's regrets: Towards death à la carte?
(May, 2017)
Dr. Yves Robert
| Just over a year after the adoption of the
Act
Respecting End-of-Life Care (hereafter the Act) in
Quebec, the Minister of Health and Social Services recently
announced his plan for a reflection on expanding the scope
of Medical Aid in Dying (MAID). It would seem that we
already want to relax the access criteria. . . If anything
has become apparent over the past year, it is this paradoxical discourse
that calls for safeguards to avoid abuse, while asking the doctor to act
as if there were none. . .
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A bureaucracy of medical deception: Quebec physicians told to falsify euthanasia death certificates
Regulators support coverup of euthanasia of from families (November, 2015)
Sean Murphy
| In
the first week of September, the Canadian Medical Association (CMA) was reported
to be "seeking 'clarity'"about whether or not physicians who perform
euthanasia should misrepresent the medical cause of death, classifying death by
lethal injection or infusion as death by natural causes. The question arose
because the Quebec College of Physicians was
said to be "considering recommending" that Quebec physicians who provide euthanasia
should declare the immediate cause of death to be an underlying medical condition,
not the administration of the drugs that actually kill the patient.
. . .
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Quebec Euthanasia Guidelines
Quebec Bill 52: An Act Respecting End-of-Life Care
Sean Murphy | Original text, text as passed by the Quebec National Assembly in 2014, text as amended in 2023. Arranged in parallel columns to highlight changes made. . .
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Re: Redefining the
Practice of Medicine: Euthanasia in Quebec
(June, 2014)
Sean Murphy
|
Part 1: Overview - An Act Respecting End-of-Life Care ("ARELC")
is intended to legalize euthanasia by physicians in the province of
Quebec. It replaces the original Bill 52, the subject of a previous
commentary by the Project. The
original text of the Bill 52 did not define medical aid in
dying (MAD), but ARELC now makes it clear that Quebec
physicians may provide euthanasia under the MAD protocol.
. .
Part 1
Part 2: ARELC in detail - An
Act Respecting End-of-Life Care ("ARELC")
is intended to legalize euthanasia by physicians in the province of
Quebec. It replaces the original Bill 52, the subject of a previous
commentary by the
Project. ARELC purports to establish a right to euthanasia
for a certain class of patients by including it under the
umbrella of "end-of-life care." . . .
Part 2
Part 3: Evolution or Slippery Slope? - Euthanasia laws frequently include guidelines and safeguards intended
to prevent abuse. Eligibility criteria are the most basic guidelines or
safeguards. In considering their stability, it is important to
consider not only the elasticity of existing statutory provisions, but
recommendations for expansion that might ultimately result in changes to
the law. . .
Part 3
Part 4: The Problem of Killing - The original text of Bill 52 did not define "medical aid dying"
(MAD), but it was understood that, whatever the law actually
said, it was
meant
to authorize physicians to kill patients who met MAD
guidelines. The Minister of Health admitted that it
qualifed as homicide, while others acknowledged that MAD
meant intentionally causing the death of a person, and that
its purpose was death. . .
Part 4
Part 5: An Obligation to Kill -
Statistics from jurisdictions where euthanasia and/or
assisted suicide are legal suggest that the majority of
physicians do not participate directly in the procedures.
Statistics in Oregon and Washington state indicate that the
proportion of licensed physicians directly involved in
assisted suicide is extremely small. . .
Part 5
Part 6: Participation in Killing - It appears that, even where euthanasia or assisted suicide is legal,
the majority of physicians do not actually provide the services. However, by establishing a purported legal "right" to euthanasia, ARELC generates
a demand that physicians kill their patients, despite the high probability that a majority of physicians will
not do so. . .
Part 6
Part 7: Refusing to Kill - It is important identify problems that the
Act poses for those
who object to euthanasia for reasons of conscience, and to consider how objecting health care workers might
avoid or respond to coercion by the government and the state medical and legal establishments . .
.
Part 7
Part 8: Hospitality and Lethal Injection - Under the
Act Respecting End of Life Care (ARELC) palliative
care hospices may permit euthanasia under the MAD protocol on their
premises, but they do not have to do so. Patients must be advised
of their policy before admission. The government included
another section of ARELC to provide the same exemption for La Michel
Sarrazin, a private hospital. The exemptions were provided for
purely pragmatic and political reasons. . .
Part 8
Part 9: Codes of Ethics and Killing - Refusing to participate, even indirectly, in conduct believed to involve
serious ethical violations or wrongdoing is the response expected of
physicians by professional bodies and regulators. It is not clear
that Quebec legislators or professional regulators understand this. .
.
Part 9
Consultations & hearings on Quebec Bill 52
September-October, 2013
NETHERLANDS
Euthanasia Statistics: Netherlands
The Regional Euthanasia Review Committees produce Annual Reports
concerning euthanasia and assisted suicide in the Netherlands. Project has compiled the statistics in tables and charts, some of
which are reproduced. A full Excel file with links to original reports
and sources can be downloaded. . .
continue reading
Researchers cast spotlight on Dutch euthanasia for dementia
(October, 2019)
Xavier Symons | A group of US-based researchers have published a detailed review of Dutch cases of euthanasia for patients with dementia. Their findings show that euthanasia doctors in many cases ‘read in’ what they think an incapacitated patient would say about receiving assistance in dying. . .
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Developments in the Practice of
Physician-Assisted Death Since Its Legalization in the
Netherlands
Jacob J.E. Koopman, MD, PhD | Public prostitution,
freely available marijuana, conventional same-sex marriage—yet the
Netherlands is, perhaps, best known around the world for pioneering
physician-assisted death. Outside of the country, its reputation is
easily misconceived and sometimes blown out of proportion. For example,
in 2012 the Dutch were astonished to hear this assertion of former U.S.
Senator and presidential candidate Rick Santorum . . .
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When is a problem not a problem?
Refusing to dispense drugs to kill patients with psychiatric illness
Levenseinde Kliniek complains about uncooperative Dutch pharmacists
Sean Murphy| In April, 2014, a complaint was made in the
Netherlands that some Dutch pharmacists were refusing to provide euthanasia
drugs. The complaint led members of the Dutch Parliament from the
green party, GroenLinks, to ask for a debate with health minister, and
members of other Dutch political parties let it be known that they were also
concerned. . .
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UNITED STATES
Montana
The Case of the Disappearing Plaintiffs:
Robert Baxter et al vs.
State of Montana
(Montana, USA: 2008-2009)
Sean Murphy
| . . . Janet Murdock lived in Missoula with the four physicians, who,
citing their "professional obligation to relieve suffering," convinced a
judge to legalize assisted suicide in Montana. Where were they in Janet
Murdock's 'hour of need'? . . .
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Oregon
Assisted Suicide Statistics: Oregon
The Oregon Public Health Division produces annual reports concerning
the Oregon
Death with Dignity Act. Project has compiled
the statistics in tables and charts, some of which are reproduced.
A full Excel file with links to original reports and sources can be
downloaded. . .
continue reading
Conscience Situation OK - For Now
(September, 2005)
Ed Langlois | . . .now that more than
200 Oregonians have used the assisted-suicide law to die, doctors and
pharmacists have worked out a system on their own. Physicians writing lethal
prescriptions call ahead to pharmacies to make sure the pharmacist is
willing to comply. . .
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Washington State
Assisted Suicide Statistics: Washington State
The Washington State Dept. of Health produces annual reports
concerning the Washington
Death with Dignity Act. The Project has compiled the statistics in tables and charts, some of which are reproduced. A full Excel file with links to original reports and sources can be downloaded. .
continue reading