Friday, December 2, 2016

Italian doctor and nurse may have killed dozens.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition


Dr Leonardo Cassaniga
An Italian doctor and nurse were arrested yesterday for allegedly causing the deaths of 10 people between 2011 - 2014 and are being investigated in connection to 50 suspicious deaths at the hospital in Saronno Italy.

Yahoo news reported that:

Emergency room anaesthetist Leonardo Cazzaniga, 60, and nurse Laura Taroni, 40, were held on Tuesday over the deaths of at least five patients but prosecutors are now examining the medical files of more than 50. 
The couple is also suspected of killing Cazzaniga's father, as well as Taroni's mother and Taroni's 45-year-old husband, who the couple reportedly tricked into believing he was diabetic. 
Taroni's spouse died on June 30, 2013 after regularly taking medicine that was "absolutely incongruous with his actual health conditions, weakening and eventually killing him," according to a police report.

Based on the Yahoo news report, Cazzaniga and Taroni may have had an obsession with killing:
Wiretapped conversations allegedly in the possession of investigators recorded the couple talking about killing other relatives, as well as Taroni discussing the "perfect murder" with her 11-year-old son. 
In one of the most disturbing calls, Taroni told Cazzaniga she was also prepared to kill her son and her eight-year-old daughter, wiretaps allegedly reveal. 
"If you want, I'll kill the children," she told Cazzaniga, who replied: "No, not the children." 
There is no evidence that Cazzaniga and Taroni were practising unauthorised euthanasia or that they were motivated by compassion. 
"Every now again I have this urge to kill someone - I need to," Taroni allegedly told Cazzaniga in an intercepted conversation. 
According to one of Cazzaniga's colleagues, the anaesthetist frequently referred to himself as an "angel of death".
Legalizing euthanasia provides a perfect cover for medical killings. Yahoo news reported that the Saronno hospital is also being investigated for either covering up the suspicious deaths or simply not investigating.
Prosecutors are also probing 14 people, including the top management of Saronno hospital, for failing to investigate the suspicious deaths. Regional health authorities have pledged to set up a committee of enquiry over the issue. 
One of the people under investigation, a female doctor, is allegedly suspected of blackmailing the hospital into hiring her in exchange for keeping quiet about the murders and of helping Taroni falsify blood tests results to convince her husband he had diabetes.

A 2103 study found that 1.7% of all deaths in the Flanders region of Belgium were hastened without request. It is likely that other cases of medical killings would be found if an indepth investigation were done.

Considering the cases of medical killing and how the medical system rarely uncovers these acts, we cannot expect that effective oversight will be provided, where euthanasia is legal.

Wednesday, November 30, 2016

Assisted suicide: Vulnerable to abuse

The following letter by John Kelly was published in the Cape Cod Times on November 28.
To the Editor: 
John Kelly
Proponents of legalization like Elias Lieberman (My View, 11/16) present assisted suicide as a fairytale in which doctors can predict the future and everyone wants the best for you.
 
In the real world, legalized assisted suicide inevitably leads to the tragic deaths of innocent people, through mistakes and abuse. 
Every year nationally, thousands of people prove doctors wrong by outliving their mistaken terminal diagnosis. Every year in Oregon and Washington, doctors prescribe suicide for people who are not terminally ill. You may have months, years, or decades of life left, but with assisted suicide it takes just one mistaken doctor and their colleague to put you in the ground. 
One out of every 10 older adults is abused every year, mostly by adult children and caregivers. Someone in line to inherit your estate can help sign you up, pick up the prescription, and then take action against you. No witness is required at the death, so who would know? 
Insurers always cover assisted suicide because it’s the cheapest “treatment.” Meanwhile, they routinely deny seriously-ill people medical treatment prescribed by their doctors. 
Let’s protect innocent people like ourselves from a law that could send us to our early deaths. 
John B. KellyDirectorSecond Thoughts MA: Disability Rights Advocates against Assisted Suicide
Link to previous articles by John B Kelly.

Tuesday, November 29, 2016

Elder Abuse, Power of Attorney/Substitute Decision making.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

After speaking this morning to a caring daughter I felt compelled to write about the abuse of power by people who are designated as the power of attorney/substitute decision maker.

We often receive calls or emails from friends or family members of a competent person who is being pressured or controlled by the power of attorney/substitute decision maker.

This morning I spoke to a caring daughter who told me her brother, who is the power of attorney, is preventing her from visiting her mother and refused to release money, from her mother's bank account, to pay for her mother's prescription glasses. The mother is elderly but she remains competent to make decisions for herself.

The daughter said that her mother is afraid of her son. This is a serious problem and a form of elder abuse.

I received a call, a few weeks ago, from a daughter, whose mother was living with ALS. Her mother wanted a life-preserving medical intervention, but the hospital was refusing. The hospital abused her mother's rights by pressuring the "power of attorney" to refuse treatment, even though the mother was competent.

It must be stated that this type of abuse has also been expressed by disability advocates.


Family, friends, medical institutions, nursing homes, etc., should know that it is a form of elder abuse to ignore the rights of people who are elderly or living with a disability.  Just because someone has difficulty communicating doesn't mean that they are incompetent.

Elder and disability abuse is a scourge on the culture. 

Now that euthanasia and assisted suicide have become legal in Canada, the attorney for personal care may assume the "right to decide" if the person lives or dies. 

Order the Life Protecting Power of Attorney for Personal Care for $10 by contacting the EPC office at: 1-877-439-3348 or info@epcc.ca.

What do you need to know:
  • The person who you designate as your power of attorney or substitute decision maker only has the right to make decisions,  on your behalf, when you are deemed incompetent.
  • When you are competent, you can sign a new representation agreement (power of attorney) at any time, so long you sign it and have it witnessed by unrelated persons.
  • You are considered competent until you have been declared incompetent.
  • The Euthanasia Prevention Coalition distributes the Life Protecting Power of Attorney for Personal Care for $10. This legal document will protect you.
Order the Life Protecting Power of Attorney for Personal Care for $10 by contacting the EPC office at: 1-877-439-3348 or info@epcc.ca.

Monday, November 28, 2016

Caring not Killing pamphlet

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition has published new Caring Not Killing pamphlet.

The Caring Not Killing pamphlet explains:
  • Why people ask for euthanasia or assisted suicide,
  • Why euthanasia or assisted suicide are not necessary,
  • Why we oppose euthanasia and assisted suicide,
  • What is proper palliative/hospice care, and
  • How you can make a difference.
Order the Caring Not Killing pamphlet by calling: 1-877-439-3348 or email: info@epcc.ca.

The Caring Not Killing pamphlet is designed to be distributed in your community as a bulletin insert (Church) or to provide information at schools, etc. 

We need groups and individuals to order the Caring Not Killing pamphlet to distribute through Churches or mail boxes.

  • $25 for 100 pamphlets + (shipping and taxes)
  • $100 for 500 pamphlets + (shipping and taxes)
Order the Caring Not Killing pamphlet by calling: 1-877-439-3348 or email: info@epcc.ca.

EPC is working to build a culture of caring, not killing.

Sunday, November 27, 2016

Iowa newspaper uncovers abuse of assisted suicide laws and pressure to extend it to lethal injection (euthanasia).

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Des Moines Register newspaper published an in-depth examination of the practice of assisted suicide in Oregon and Washington States and uncovered significant problems. They learned that the data is incomplete, that there missing reports (under-reporting) and that the laws are not designed to be effectively monitored.

They found that the assisted suicide lobby wants to extend assisted suicide laws to permit euthanasia or lethal injection.

Des Moines Register columnist, Kyle Munson, and investigative reporter, Jason Clayworth examine the practice of assisted suicide in America by analyzing the data and interviewing leaders from both sides of the assisted suicide debate. Their report was published on November 25, 2016.

The report states that Betsy Davis, who died by assisted suicide in California, received assistance in administering the lethal dose bringing into question the meaning of the term "self-administer." According to the report:
So when it came time to end her life under a new California law for the terminally ill, her caregivers propped her up and held the cup as she drank a fatal mix of prescription drugs. 
But physical assistance in taking the toxic medications is illegal, multiple experts contend. The report then examines the meaning of "self-administer." 
Kelly and Okray, Betsy's caregiver, were left with a lingering question: Is there an easier way to do this? 
Kelly said she also was troubled by the legal gray area: Had they violated the "self-administer" clause of California's law? 
The law defines “self-administer" as the “physical act of administering and ingesting the aid-in-dying drug to bring about his or her own death.”

"That doesn't mean they couldn't hold a cup that a person is drinking out of," said Matt Whitaker, state director in California of the organization, which supports assisted-suicide laws. "That would be fine."
Jennifer Holm
Jennifer Holm, who lobbies for assisted suicide in Iowa, stated that concerns with the definition of "self-administer" would be solved by legalizing euthanasia (lethal injection). According to the report:

Holm has been one of Iowa’s most outspoken advocates for assisted suicide. She says the data tell her that doctors should be allowed not only to prescribe the lethal drugs but to administer them as well, to help avoid complications.
The report not only uncovers problems with the definition of "self-administer" it also uncovers problems with the practice of assisted suicide laws. The report states:
Marilyn Golden (disability leader)
“Assisted suicide is nearly untraceable. There is minimal reporting and tracking,” said Marilyn Golden, a senior policy analyst for the Disability Rights Education & Defense Fund in California. “It almost appears as if the practice of assisted suicide has deliberately been made secretive, all with the claim of patient confidentiality.” 
Among the 1,642 documented assisted suicides in Oregon and Washington since the states began reporting statistics in 1998 and 2009, respectively, the Register found: 
  • COMPLICATIONS: At least 38 people (about 2.5 percent) experienced complications as they were dying, including regurgitation of the fatal medicine, seizures or waking up after taking the medication. 
  • INCOMPLETE RECORDS: At least 478 deaths occurred without record of key details, such as whether complications occurred. At least 203 people have died without a record of whether the deaths were from ingesting medication or from natural causes. 
  • PROLONGED DEATHS: In 2009, a person in Oregon took more than four days to die after taking the medication. Of the two states, Washington had the most complete data. For deaths where time was recorded, 17 percent took 91 or more minutes. In Oregon, the median time before death in 2015 was 25 minutes.
  • NO DATA: Two of the states where assisted suicide is an option — Vermont and Montana — do not track deaths at all. Data from California and Colorado, the most recent states to legalize assisted suicide, is not yet available.
The Des Moines Register report uncovers similar abuses and problems with assisted suicide in Oregon and Washington State as reported by the Euthanasia Prevention Coalition.

Friday, November 25, 2016

Netherlands: Euthanasia for alcoholism.

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition.

Marcel Langedijk's brother - Mark
Michael Cook, the editor of BioEdge, reported that Dutch journalist, Marcel Langedijk, is writing a book about the euthanasia death of his brother Mark, who was an alcoholic. Cook reported:
The ever-expanding circle of eligibility for euthanasia now includes alcoholism. Writing in the Magazine Linda, journalist Marcel Langedijk describes the life and death of his brother Mark, an alcoholic. 
After eight years and 21 stints in hospital or rehab, Mark decided that he had enough. He had two children but his marriage had collapsed; his parents cared for him and he had plenty of family support, but he was unable to dry out.  
Finally he asked for euthanasia. Physically he was quite ill and psychologically he was suffering badly. 
A woman doctor in a black dress and sneakers arrived to give him his lethal injection. She confirmed his decision and then gave him three doses.
Mr Langedijk is writing a book about his younger brother’s disease and his death through euthanasia which will be published next year.
Recently the Dutch government announced that they will be amending the euthanasia law to include people who are not sick or dying but who simply believe that they have lived a "completed life" - whatever that means.

The Netherlands permits euthanasia for psychological suffering. The term - psychological suffering - has expanded over time. 
 

Thursday, November 24, 2016

Australian Medical Association re-affirms opposition to euthanasia and assisted suicide

This article was written by Paul Russell, the director of HOPE Australia, and published on the HOPE Australia website on November 24.

Paul Russell
Today (24th November 2016) the Australian Medical Association released its new policy on euthanasia and assisted suicide.

The policy review is a five-yearly process that involved significant consultation and surveying of members ahead of the development of the final document released today.

The two page document changes the focus somewhat by opening with various affirmations about the AMA's commitment to making quality end-of-life care available to all Australians:

1.4 All dying patients have the right to receive relief from pain and suffering, even where this may shorten their life. 
1.5 Access to timely, good quality end of life and palliative care can vary throughout Australia. As a society, we must ensure that no individual requests euthanasia or physician assisted suicide simply because they are unable to access this care.
The AMA rightly calls for action by all Australian governments:
1.6 As a matter of the highest priority, governments should strive to improve end of life care for all Australians through: the adequate resourcing of palliative care services and advance care planning; the development of clear and nationally consistent legislation protecting doctors in providing good end of life care; and increased development of, and adequate resourcing of, enhanced palliative care services, supporting general practitioners, other specialists, nursing staff and carers in providing end of life care to patients across Australia.
The statement includes a clear direction to doctors on their responsibility should a patient ever ask for euthanasia or assisted suicide:
2.1. A patient’s request to deliberately hasten their death by providing either euthanasia or physician assisted suicide should be fully explored by their doctor. Such a request may be associated with conditions such as depression or other mental disorders, dementia, reduced decision-making capacity and/or poorly controlled clinical symptoms. Understanding and addressing the reasons for such a request will allow the doctor to adjust the patient’s clinical management accordingly or seek specialist assistance.

The key paragraph that retains the AMA's opposition:
3.1 The AMA believes that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life. This does not include the discontinuation of treatments that are of no medical benefit to a dying patient.
The statement acknowledges that there are divergent views in the medical fraternity just as there is in Australian society. They acknowledge, correctly, that law and public policy in this area is the preserve of our parliaments and they insist on being consulted and included in any debate on the matter.

This last observation, though a general principle no doubt, could just as easily be a reflection on the lack of consultation with the AMA and other medical bodies evident in the recent South Australian debate.

The AMA was clearly intent upon using the release of this new policy as an opportunity to educate the public. From the press release:

"Dr Gannon said the AMA recognises that good quality end of life care can alleviate pain and other causes of suffering for most people, but there are some instances where it is difficult to achieve satisfactory relief of suffering. 
“There is already a lot that doctors can ethically and legally do to care for dying patients experiencing pain or other causes of suffering,” Dr Gannon said.

“This includes giving treatment with the intention of stopping pain and suffering, but which may have the secondary effect of hastening death. This is known as the principle of double effect,” Dr Gannon said.
While the statement is exceptionally clear, the media reporting has been very shabby.

The Australian ran with the headline: Most doctors would help terminally ill die: AMA. The Fairfax Press: Four in 10 doctors want voluntary euthanasia, Australian Medical Association survey shows.

The Fairfax headline is at least accurate. Indeed, as the story states 38% of the doctors who completed the AMA survey said that doctors should be involved in euthanasia or physician assisted suicide. But, according to Fairfax, 50% said that doctors should not be involved.

The survey, according to AMA President Dr Michael Gannon, will not be made public until the membership has seen the results. It would seem that some of the references in the articles may well be to slightly different questions.

For example, The Australian says that 55% of doctors were in favour of retaining the existing policy; that's not the same result and probably not the same question referred to above. The Australian calls the results on the policy question 'relatively close' at 55-45. Not so. Only 30% of doctors, according to the same article were in favour of a policy change to 'neutral' on euthanasia while 15% were undecided.

The Australian's headline: Most doctors would help terminally ill die, is misleading. The article explains:

"Crucially, an even clearer majority of AMA members said if voluntary euthanasia were made legal at the state and territory level, doctors should be involved in helping terminally ill people die rather than dig in on principle and boycott the process."
That's a far more nuanced position than the headline suggests.

It tells us that while doctors don't want a change to the law, that if it is changed they think they have a role. This may be because they see no problem with patient killing but it may also indicate, for those not ethically or morally opposed, that better that doctors do it rather than cowboy operators. It suggests, as Dr Gannon confirms, that doctors see that they have a role in protecting their patients.

This is also borne out by the fact that the variation in results to the two questions on retaining opposition to euthanasia and assisted suicide and whether a doctor should be involved suggests that some doctors who opposed any change in policy still thought that doctors had a role. This, it seems, reflects the understanding of the second question that it is not about doctors who are keen and willing to kill, but something much more than that. As Dr Gannon summarised:

“What did surprise me is that our members have made it very clear that if society moves, they want doctors involved in euthanasia. A conservative view might be that this is not medicine, that ending patients’ lives is not what doctors do and that role should go to another group in society, maybe a new professional group.”
I could go on about The Australian's new-found enthusiasm for euthanasia. That's annoying enough but sloppy journalism really gets me going. Here's a classic example (The Australian):
"The replacement policy states that a failure by doctors to initiate or continue life-prolonging measures for a dying patient does not constitute euthanasia."
Failure? That implies negligence; the doctor 'failed' to do his or her job. What rot! The policy says nothing of the sort:
2.2 If a doctor acts in accordance with good medical practice, the following forms of management at the end of life do not constitute euthanasia or physician assisted suicide: not initiating life-prolonging measures; not continuing life-prolonging measures; or the administration of treatment or other action intended to relieve symptoms which may have a secondary consequence of hastening death.
Doesn't sound like 'failure' to me.

In closing, we welcome the AMA's policy statement and its affirmation that 'doctors should not be involved in interventions that have as their primary intention the ending of a person’s life.' We also welcome the educational initiatives and the call for better access to quality care for all Australians.

The survey recorded something like 4000 responses from a membership of some 30,000 doctors Australia wide.

Saturday, November 19, 2016

Two Winnipeg hospitals will not offer euthanasia or assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Concordia Hospital Winnipeg
CBC News Manitoba reported yesterday that two Winnipeg hospitals will not be offering assisted death, Laura Glowacki reported on November 18 that Concordia and St Boniface Hospitals have informed the public that they will not offer assisted death to their patients. According to the CBC News report:
A spokesperson for St. Boniface Hospital said while the institution is not participating in MAID, it will work with patients to facilitate a transfer. 
Concordia Hospital said it will treat patients requesting MAID with "compassion" and connect them with the provincial medical assistance in dying clinical team. 
The WRHA told CBC it has accommodations for patients who live at or are being treated in a faith-based facility to receive MAID at another facility. 
"This ensures people from across the province can access the service, while respecting our commitment to the faith-based facilities," said a WHRA spokesperson. 
In Canada there are two legal forms of medically assisted death: the first involves a health practitioner injecting a drug, called voluntary euthanasia. In the second, a health practitioner provides or prescribes a drug that is self-administered to cause death, known as medically assisted suicide.
In other words, both institutions will not offer euthanasia or assisted suicide on their premises but they will not stop their patients from having their death arranged through another facility. Conscience rights for health care professionals and institutions protects people who oppose medical killing from being pressured into death by lethal injection.

Assisted suicide - doctors should have conscience rights too.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Politicians, Harold Albrecht MP and Michael Harris MPP held a round table discussion on conscience rights in Kitchener yesterday. Luisa D'Amato, wrote an excellent report 
for the Kitchener-Waterloo Record on the event. D'Amato begins by writing:
Physicians are supposed to save lives, not hasten death. 
So it's not surprising that some doctors are having problems seeing how they fit into Canada's new law that legalizes physician-assisted suicide for some patients. 
It turns out that conscientious objectors like Sandra Brickell, a physician who works in Kitchener hospitals, are not protected. 
"When somebody wants to end their life, it goes against what we've been trained to do," she said at a meeting Friday with several other doctors, Kitchener-Conestoga MP Harold Albrecht and Kitchener-Conestoga MPP Michael Harris. 
"I cannot truthfully say there is no life worth living," Brickell said.
D'Amato then explains that in Ontario conscience rights are not legally protected:
Last summer, Parliament passed the law allowing those with a "grievous and irremediable medical condition" to die with the assistance of health-care professionals. 
But in Ontario, there is no provincial law protecting doctors who cannot perform assisted dying because it is against their religious or ethical beliefs. 
The absence of a law leaves physicians in the hands of the College of Physicians and Surgeons, which regulates doctors. The college says doctors don't have to do the procedure themselves, but they are required to refer the patient to a physician who will. It's called an "effective referral." 
Brickell says this still compels her to participate, indirectly.
Amato then reports her concerns about how the assisted suicide law works:
She has profound concerns about how assisted suicide — which was mandated for Canadians by a Supreme Court decision last year — would work. 
What if the patient feels like too much of a burden on family members? What if an underfunded, overworked health-care system feels the pressure to move the patient along? What if the wish for suicide was something that could be treated with the right mental-health medications? 
Brickell understands that the new law gives patients the right to die with assistance. But she wants her rights, too. And that's the right to step away. 
In Alberta, patients whose doctors decline to participate in euthanasia can have their care transferred to another doctor if they're in hospital. If they're at home, they can call a number that provides access to a wide range of services, including physician-assisted suicide. Either way, the patient can access the service without the participation of his or her doctor. 
But in Ontario, there is no such solution. Doctors must either provide the service or refer the patient to another doctor who will. Disobey, and you could lose your licence.
Bioethicist, Udo Schuklenk disagrees. He wants students who oppose euthanasia to be denied access to medical school:
There could be other repercussions down the road. One bioethicist at Queen's University, Udo Schuklenk, has suggested that students who couldn't set aside their moral values shouldn't be admitted into medical schools.
Harris and Albrecht support conscience rights:
Harris and Albrecht, who pushed in Parliament for respect for conscientious objectors, listened carefully to Brickell and the others on Friday. 
Harris, an opposition MPP, said he will now make the case to the Ontario ministry of health and the attorney general to create legislation that better protects these conscientious objectors. 
I hope the Ontario government listens and agrees.
Conscience rights for medical professionals are essential. It is one thing to give doctors the right in law to lethally inject their patients, it is another thing to force doctors to participate.

Previous articles on conscience rights for medical professionals.

Wednesday, November 16, 2016

Remarkable turnabout in the middle of the night. Euthanasia bill defeated in South Australia.

B
Paul Russell
y Paul Russell
Director of HOPE Australia

The second bill this year, the Death with Dignity Bill 2016, came closely on the heels of an abandoned recent attempt in the same South Australian Parliament to enact a ‘Belgium style’ bill. That bill was deemed to be a bridge too far for the parliament. The substitute new bill was seen by many to be more moderate – a ‘good-cop-bad-cop’ scenario.

The bill provided for assisted suicide as a preference but with euthanasia for people who, for whatever reason, cannot take the lethal drug themselves. Once the death is approved, there are no further checks or safeguards, including that further consent (in the case of euthanasia in particular) is not required.

No authorized person need be present at an assisted suicide, placing people in their homes at particular risk.

For the first time in the history of the Lower House of the Parliament, the bill passed the first hurdle (called the second reading) by a margin of 27 votes to 19. As recently as 12 hours before the debate, the numbers were thought to be slightly in favor of the NO vote. Such has been the volatile nature of these debates over the last six weeks that change and uncertainty has become the norm.

South Australian Parliament
A small number of MPs who supported the vote spoke of concerns with the bill but were willing to see the debate continue. This reflects the culture drift where fewer people seem to hold moral or ethical objections that would provide them with a sense of certainty about such matters. Instead, we see an increasing number who see no problems with patient killing or helping people to suicide in philosophical terms, swayed singularly by such matters as safeguards only.

The debate moved on to the committee stage where clauses are debated and questions can be asked of the mover of the bill. Running late into the night–in fact, all night–those opposed to the bill and others exposed many of the shortcomings.

The bill’s mover, Dr. Duncan McFetridge, seemed unable at times to answer questions about his own bill. This is perhaps unsurprising considering that the bill was introduced in an unseemly hurry and was drafted by a third party on McFetridge’s behalf.

When pressed on the question of “doctor shopping,” for example, it took considerable time for McFetridge to acknowledge that a person could, indeed, shop around for the answer that they want.

That a small number of MPs held reservations gave some hope that the situation at the second reading might be redeemable. That would require four MPs to reverse their vote.

That was a tall order in a chamber of 47 persons.

The final vote was taken at 4:02 am. The house divided 23 votes to 23. The bill was defeated on the casting vote of the Speaker.

There is no precedent for what took place in the early hours of this morning. History made at the second reading and then made over in the defeat of the bill at the last hurdle!

Printfriendly