Assisted Suicide and Euthanasia
2015-Present
MAiD Muscles In
B.C.’s Delta Hospice Society being evicted, assets expropriated for refusing to allow euthanasia and assisted suicide
- 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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- 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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- 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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- Xavier Symons* | . . .Several well-known commentators on euthanasia argue that, in principle, euthanasia should not be prohibited for people suffering from severe psychiatric disorders. . .
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Why people choose medically assisted death revealed through conversations with nurses
- Barbara Pesut*, Sally Thorne* | . . . Our most recent research involved interviews with 59 nurse practitioners or registered nurses across Canada who accompanied patients and families along the journey of medically assisted dying or who had chosen to conscientiously object. Nurses worked across the spectrum of care in acute, residential and home-care settings. . .
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CMA's "third way" may be a third rail
Responding to Responding to articles by CMA officials (BMJ 2019; 364)
- 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 Medical Association and euthanasia
and assisted suicide in Canada
Critical review of CMA approach to changes in policy and law
- 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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How does assisting with suicide affect physicians?
- Ronald W. Pies*
|When my mother was in her final months, suffering from a heart failure and other problems, she called me to her bedside with a pained expression. She took my hand and asked plaintively,
"How do I get out of this mess?" As a physician, I dreaded the question that might follow: Would I help her end her life by prescribing a lethal drug?
. . .
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Ensuring access to euthanasia by encouraging physician
participation: it's complicated
- 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"
- 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. . .
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Access to euthanasia and assisted suicide:
Letter to Canadian Federal and Provincial Ministers of
Health
- 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
- 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. . .
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Dr. Robert's regrets: Towards death à la carte?
- 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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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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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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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.
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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.
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Euthanasia Statistics: Quebec
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.
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Standing Committee on Justice and Human Rights
House of Commons, Parliament of Canada (May, 2016)
- 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
- 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
- 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. . .
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Special Joint Committee on Physician Assisted Dying
Parliament of Canada (January-February, 2016)
- 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
A bureaucracy of medical deception
Quebec physicians told to falsify euthanasia death certificates
Regulators support coverup of euthanasia of from families
- 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
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. . .
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[Ethics]
2010-2014
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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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.
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The Mary Dilemma - A Case Study on Moral Distress:
Newborn infant starved to death in Toronto hospital
(Toronto, Ontario, Canada. 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.
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Therapeutic homicide in a neonatal unit?
The
Mary Dilemma: Case Study on Moral Distress
(Toronto, Ontario, Canada. 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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Re: Redefining the
Practice of Medicine
Euthanasia in Quebec
An Act Respecting End of Life Care
(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
2005-2009
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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Conscience Situation OK - For Now
(Oregon, USA: 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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2000-2004
Belgium: mandatory referral for euthanasia
(December, 2003)
- 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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Edmonton Hospitals Suspected of Euthanasia
(Edmonton, Alberta, Canada: 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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Assisted Suicide: What Role for Nurses?
(USA: May, 2000)
- Carrie Farella* |
Initially, when [Oregon's assisted suicide law] was designed, the assumption
was that physicians would be the first ones to explore PAS with patients," .
. . "but in reality, nurses are usually the ones in the line of fire.
Patients often feel nurses understand their wishes for good quality of life
and good quality of death, too."
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1995-1999
British Medical Association proposes death by dehydration
(United
Kingdom: 1999)
- Letter | . . .Withdrawal of fluids will cause the patient to
die from dehydration, which is distressing to the
patient, to the carers and to relatives. It is
disingenuous and inhumane to suggest the contrary. .
.
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1990-1994
Chief Justice favours assisted suicide, willing to order assistance
(Canada: 1993)
- When ruling on the case of Sue Rodriguez, who was seeking
legalized assisted suicide, Chief Justice Antonio Lamer of the
Supreme Court of Canada expressed the opinion that assisted
suicide should be available to everyone. Those who object
to euthanasia or assisted suicide have cause for concern that
the also implied that some unspecified actor had a duty to
assist Rodriguez to commit suicide.
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From Abortion to Euthanasia: Nurses on the Spot
(British Columbia,
Canada: 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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