Quebec euthanasia rate almost doubled in last half of 2016

Quebec euthanasia rate after one year passes Belgian rate at five year mark

Sean Murphy*

Since 10 December, 2015, euthanasia has provided by physicians in Quebec under the terms of An Act Respecting End of Life Care (ARELC).  Health and social services agencies established by the government throughout the province are state agencies responsible for the delivery and coordination of health care in the province administrative regions. These are called Centres intégrés de santé et de services sociaux (CISSS) and Centres intégrés universitaires de santé et de services sociaux [CIUSSS).  Some administrative regions (like Montreal and the Quebec City region) have more than one CISSS or CIUSSS.

These agencies are responsible for the delivery of euthanasia and are required to make reports to a commission established by the law (the Commission sur les soins de fin de vie) to monitor the administration of euthanasia.  According to the Commission, they are also required to post these reports on their websites.

As of 6 March, 2016, one of these agencies (Outaouais) had not posted the reports on its website.  Two (Outaouais and Abitibi-Temiscamingue) had neither posted the most recent report nor sent the report to the Commission, and did not respond to a request for it.

The Project has compiled the statistics provided by the other agencies in tables and charts.  Note that, in some cases, the number of patients lethally infused is higher than the number of requests because euthanasia was provided in response to a request made in the previous reporting period.

Quebec’s euthanasia rate almost doubled in the last half of 2016.  One year after legalization, Quebec has passed the euthanasia rate reached by Belgium after five years.  If Quebec’s rate continues without escalation throughout 2017, it will exceed that achieved by Belgium after nine years.

Euthanasia Requests
Response to Euthanasia Requests
Euthanasia Provided
Reasons Euthanasia Not Provided
Frequency of Euthanasia Requests
Frequency of Euthanasia
Quebec Mortality Rates
Quebec, Belgium and Netherlands
Projected Quebec Euthanasia Deaths in 2017

 

Dr. Coelho’s ‘crazy’ battle for conscience rights

The Catholic Register

Michael Swan

It’s not surprising patients fall in love with Dr. Ramona Coelho. Not just because she’s a young, pretty doctor who smiles easily, laughs frequently and focuses her attention completely on whoever is talking to her.

Her patients in London, Ont., know that she’s a doctor who is in it for something more than the status, money or security attached to most medical practices.

“I love my work,” Coelho confesses. “I love being a doctor. I love helping people and being with them — trying to find solutions for them.”

Her practice is heavily slanted to marginalized patients. Her waiting room is full of refugees, ex-cons, the poor. Many of her patients are on permanent disability.

All that is at risk as the College of Physicians and Surgeons of Ontario mounts an ever more prickly defense of its “Professional Obligations and Human Rights Policy.” The policy is currently before the courts. It would force Ontario doctors to refer for abortions and for assisted suicide.  . . [Full text]

Conscience protection still at risk with assisted death legislation

News Release
For Immediate Distribution

Coalition for HealthCARE and Conscience

OTTAWA, ONT. (April 14, 2016) – The Coalition for HealthCARE and Conscience recognizes that federal legislation tabled today on physician-assisted death has rejected disturbing recommendations from the parliamentary joint committee regarding access to assisted suicide.

However, the coalition, which represents more than 100 healthcare facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across Canada, is concerned that the bill doesn’t protect the conscience rights of health care workers or facilities that morally object to performing or referring for what is being referred to as “medically assisted death.”

By making no reference to conscience rights in the legislation, it appears that the federal government intends to leave it up to individual provincial and territorial governments to determine whether to protect health care workers and institutions and how to do so.

“No other foreign jurisdiction in the world that has legalized euthanasia/assisted suicide forces health care workers, hospitals, nursing homes or hospices to act against their conscience or mission and values,” says Larry Worthen, Coalition member and Executive Director of the Christian Medical and Dental Society of Canada. “These conscience rights must be preserved. As we review this legislation, we will continue to advocate for the vulnerable and for conscience protection, which is provided in the Canadian Charter of Rights and Freedoms.”

A strong majority of Canadians are on side with the coalition’s beliefs on conscience protection. A recent Nanos Research poll found that 75% of Canadians agreed that doctors “should be able to opt out of offering assisted dying,” compared with 21% who disagreed.

Members of the coalition fully support the right people clearly have to accept, to refuse and/ or discontinue the use of life-sustaining treatment and to allow death to occur.  They also hold strong moral convictions that it is never justified for a physician to help take a patient’s life, under any circumstances.

“Our health care workers journey with those who are sick and suffering each day. We will continue to do this in a caring and compassionate way,” Worthen says. “We help patients at the end of life, what we object to is ending their life.”

The coalition contends Canada can significantly reduce the number of people who see death as the only possible option to end their suffering by improving medical and social services.

“Our worth as a society is measured by the support we give to the vulnerable,” said says Worthen. “We need increased access to palliative care, chronic disease and mental health services to help individuals who are suffering across the country.”

The coalition continues to urge Canadians with concerns about assisted suicide legislation to visit CanadiansforConscience.ca where they can communicate directly with their elected members of provincial or federal parliament.

The coalition represents several like-minded organizations committed to protecting conscience rights for health practitioners and institutions. Members of the coalition include the Catholic Archdiocese of Toronto, the Christian Medical and Dental Society of Canada, the Catholic Organization for Life and Family, the Canadian Federation of Catholic Physicians’ Societies, the Canadian Catholic Bioethics Institute, Canadian Physicians for Life and the Catholic Health Alliance of Canada.

For more information, please contact:
Jeff Blay
Media Relations, Coalition for HealthCARE and Conscience
jblay@enterprisecanada.com
289-241-5114


About The Coalition for HealthCARE and Conscience:

The Coalition for HealthCARE and Conscience represents a group of like-minded organizations, including representing more than 110 healthcare facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across Canada , that are committed to protecting conscience rights for faith-based health practitioners and facilities. We were brought together by a common mission to respect the sanctity of human life, to protect the vulnerable and to promote the ability of individuals and institutions to provide health care without having to compromise their moral convictions.

To learn more, visit CanadiansforConscience.ca

Emerging assault on freedom of conscience

Canadian Family Physician

Stephen J. Genuis

genius-stephenDiscussion on physician autonomy at the 2014 and 2015 Canadian Medical Association (CMA) annual meetings highlighted an emerging issue of enormous importance: the contentious matter of freedom of conscience (FOC) within clinical practice. In 2014, a motion was passed by delegates to CMA’s General Council,and affirmed by the Board of Directors, supporting the right of all physicians, within the bounds of existing legislation, to follow their conscience with regard to providing medical aid in dying. The overwhelming sentiment among those in attendance was that physicians should retain the right to choose when it comes to matters of conscience related to end-of-life intervention. Support for doctors refusing to engage in care that clashes with their beliefs was reaffirmed in 2015. However, a registrar from a provincial college of physicians and surgeons is reported to have a differing perspective, stating “Patient rights trump our rights. Patient needs trump our needs.1

So, do the personal wishes of doctors hold much sway in Canadian society, where physicians are increasingly perceived as publicly funded service providers? Should the colleges of physicians and surgeons have the power to remove competent physicians who refuse to violate their own conscience?

And what about FOC in a range of other thorny medical situations unrelated to physician-assisted dying?

Genuis SJ. Emerging assault on freedom of conscience.  Canadian Family Physician April 2016 vol. 62 no. 4 293-296  [Full text]

 

Pope Francis: modernity’s suppression of freedom of conscience is diabolically inspired “polite persecution”

Sean Murphy*

In the course of a morning homily discussing the martyrdom of St. Stephen in Jerusalem,1 Pope Francis linked the “cruel persecutions” of early Christians with the Easter Sunday mass murder of Pakistani Christians three weeks ago by Taliban killers.

However, the Pope also identified “another kind of persecution that is not often spoken about.”   In addition to the “clear, explicit type of persecution” like the slaughter of Christians who profess their belief in Jesus Christ, there is a second kind, he said, one ““disguised as culture, disguised as modernity, disguised as progress.”

“It is a kind of — I would say somewhat ironically — polite persecution.”

This “polite persecution” is not against those who merely profess Christian beliefs, he explained, but against those  who want “to demonstrate the values of the Son of God.”  This “polite persecution” does not use bombs or guns, but the force of law.

“We see every day,” said the Pope, “that the powerful make laws that force people to take this path, and a nation that does not follow this modern collection of laws, or at least that does not want to have them in its legislation, is accused, is politely persecuted.”

This denial of freedom includes the legal suppression of conscientious objection, now notably advocated by powerful interests and some politicians in Canada who want to force participation of even objecting health care workers and institutions in euthanasia and assisted suicide.

“God made us free, but this kind of persecution takes away freedom!”

Canadian health care workers who refuse to provide or facilitate homicide or suicide now face the kind of threats described by Pope Francis,2 who explained how “polite persecution” works.

“[I]f you don’t do this, you will be punished: you’ll lose your job and many things or you’ll be set aside.”

Calling this “the persecution of the world,” the Pope warned that its leader is the one identified by Jesus Christ as “the prince of this world” (i.e., Satan).

“The prince of this world” can be recognized, warned Pope Francis, “when the powerful want to impose attitudes, laws against the dignity of the children of God, persecute them and oppose God the Creator: it is the great apostasy.”

The Christian’s path, he concluded, is always beset by these two kinds of persecution  that bring “much suffering,” so Christians must be confident in the presence of Jesus “with the consolation of the Holy Spirit.”


Notes

1. “Pope’s Morning Homily: Denial of Conscientious Objection Is Persecution.  At Casa Santa Marta, says devil is behind the persecution brought by culture and modernity.”  Zenit, 12 April, 2016

2.  See, for example, Attaran A. “Doctors can’t refuse to help a patient die – no matter what they say.” iPolitics, 13 November, 2015 (Accessed 2015-11-24).  In response, see Murphy S., “Amir Attaran and the Elves.” Protection of Conscience Project, 15 November, 2015;

Everybody’s a winner when euthanasia combines with organ donation, say doctors

BioEdge

Michael Cook

Several Dutch and Belgian doctors have proposed legal reforms to increase the popularity of combining euthanasia and organ donation in the Netherlands and Belgium.

Writing in the Journal of Medical Ethics, they report valuable unpublished information about the prevalence of the procedure. So far, it has been performed only about 40 times in the two countries. However, there is “a persisting discrepancy between the number of organ donors and the number of patients on the waiting lists for transplantation” – which euthanasia patients could help to balance.

The authors stress that euthanasia is not a cure-all for the organ shortage. Most euthanasia patients suffer from cancer, which is a contraindication for organ transplantation. However, 25 to 30% of them do not, so there is obviously a real possibility of expanding the supply.

Furthermore, the authors say, public perception of this formerly abhorrent practice is increasingly positive:

. . . transplant coordinators in Belgium and the Netherlands notice a contemporary trend towards an increasing willingness and motivation to undergo euthanasia and to subsequently donate organs as well, supported by the increasing number of publications in popular media on this topic.

Ethically, the procedure is basically uncontroversial as long as the patient is not pressured to donate, they contend.

In the context of organ donation after euthanasia, the right of self-determination is a paramount ethical and legal aspect. It is the patient’s wish and right to die in a dignified way, and likewise his wish to donate his organs is expressed. Organ donation after euthanasia enables those who do not wish to remain alive to prolong the lives of those who do, and also—compared with ‘classical’ donation after circulatory death—allows many more people to fulfil their wish to donate organs after death.

However, there are some legal hitches in both countries. In the Netherlands, unlike Belgium, euthanasia is regarded as an “unnatural death” which has to be reported to the public prosecutor. This could delay donations. If the law were changed to allow the cause of death to be reported as the underlying condition, the procedure would be more expeditious. And “In Belgium, the current policy of determination of death by three independent physicians could be abandoned, facilitating a more lean procedure with only one physician.”

Public perceptions need to be managed as well. At the moment, it is necessary to maintain a strict separation between the request for euthanasia and the need for the organ. Partly this is needed to ensure that the donor is not being pressured. But the public also needs to have confidence that physicians will give objective advice.

Finally, there is the tradition of the dead donor rule “that donation should not cause or hasten death”. The authors imply that this could be scrapped for euthanasia volunteers:

Since a patient undergoing euthanasia has chosen to die, it is worth arguing that the no-touch time (depending on the protocol) could be skipped, limiting the warm ischaemia time and contributing to the quality of the transplanted organs. It is even possible to extend this argument to a ‘heart-beating organ donation euthanasia’ where a patient is sedated, after which his organs are being removed, causing death.

The article’s proposals were not received with great enthusiasm in the UK where there is a simmering debate on assisted dying. Tory MP Fiona Bruce told the Daily Mail: “The paper confirms the worst fears expressed by Parliament when the House of Commons conclusively voted to stop the legalisation of assisted suicide in this country. The possibility of euthanasia achieved through live organ donation, such as by removing a patient’s beating heart, as posited in this paper is shocking and chilling.”

And Lord Carlile of Berriew, a Liberal Democrat peer who is a leading lawyer, said: “I have extreme concerns about the ghoulish nature of the combined euthanasia and organ donation systems in the Netherlands and Belgium. Both can result in unbearable and irresistible pressure on an individual to die, and on a doctor to encourage death.”


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UN Special Rapporteur Favours of a Right to Conscientious Objection

News Release 

European Centre for Law and Justice

On the occasion of a conference organized by the ECLJ at UN headquarters in Geneva, Professor Heiner Bielefeldt, the UN Special Rapporteur on Freedom of Religion or Belief, spoke in favor of the right of medical staff to refuse to participate in performing an abortion or euthanasia. He mentioned the case of a midwife who was harshly sentenced in Sweden for having refused to participate in an abortion and was forced into “professional exile.”

He considers that this right, based on freedom of conscience, should extend to the medical staff directly involved in the matter, as long as their objection is well-founded on a strong and deep conviction. . . [Full text]

 

Don’t trample other folks’ rights with euthanasia

The Province

Gordon Clark

It’s not often that an issue comes along where I struggle to figure out where I stand, especially after considering various points of view. But like many people I’ve spoken with recently, I sure find myself conflicted about euthanasia which, thanks to last year’s Supreme Court of Canada ruling, is rapidly becoming transmogrified from murder into a publicly funded health-care service not much different than an emergency appendectomy.

The court has given the federal government until June 6 to draft the rules by which doctors will be permitted to end the lives of suffering people who consent to be killed. . . [Full Text]

Cardinal Collins Presses for Protection of Conscience and the Vulnerable as Euthanasia/Assisted Suicide Legislation Prepared

Canadians coast to coast encouraged to take action

News Release

Archdiocese of Toronto

TORONTO (March 2, 2016) As legislation is prepared to legalize euthanasia/assisted suicide in Canada, the Archbishop of Toronto is calling on the federal government to protect the vulnerable and those who care for them. In a statement released Wednesday, Cardinal Thomas Collins expressed shock at federal joint committee recommendations that would force health care workers and institutions to offer or refer assisted death:

“Physicians across our country who have devoted their lives to healing patients will soon be asked to do the exact opposite. They will not be asked to ease their suffering by providing them with treatment and loving care, but by putting them to death.”

The archbishop highlighted other committee recommendations that would profoundly impact the vulnerable, including:

• A desire to allow, in three years from now, access to euthanasia/assisted suicide for minors (those under 18).

• The ability for those suffering from conditions like dementia to pre-schedule the date of their death.

• Insistence that those with psychiatric conditions be eligible for euthanasia/assisted suicide.

Cardinal Collins stated: “Once we make people’s worthiness to live dependent on how well they function, our society has crossed the boundary into dangerous territory in which people are treated as objects that can be discarded as useless.”

The archbishop has invited all those who share his concerns to visit CanadiansforConscience.ca and join the Coalition for HealthCARE and Conscience. The coalition includes more than 5,000 Canadian doctors with a common mission to respect the sanctity of human life.

CanadiansforConscience.ca portal provides numerous resources, including an opportunity for people to easily share their concerns directly with their local member of parliament.

Cardinal Collins’ statement will be read or shown by video this weekend in more than 200 Catholic churches across the Archdiocese of Toronto. –

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On Sunday, March 6, 2016, Cardinal Collins will deliver his statement at St. Paul’s Basilica at the 11 a.m. Mass. He will meet with the media following Mass.

Media Contacts:

Neil MacCarthy, Director, Public Relations & Communications,
Archdiocese of Toronto (416) 934-3400 x 552, neilm@archtoronto.org
(416) 879-2846 (cell) www.archtoronto.org

Bill Steinburg, Communications Manager
(416) 934-3400 x 558,
bills@archtoronto.org
(416) 708-9655 (cell)

MDs group disappointed by recommendation to require referrals for assisted death

Canadian Press

Sheryl Ubelacker

TORONTO — A parliamentary committee’s recommendation that doctors who object to assisted dying be required to at least refer patients to a willing colleague is not only disappointing, but has also led some physicians to consider leaving their practices, says the Canadian Medical Association.

The all-party committee, which released a set of recommendations Thursday aimed at helping the federal government draft legislation governing medically aided death, said Ottawa should work with the provinces and territories to establish a process that respects a doctor’s freedom of conscience, while respecting the needs of patients.

“At a minimum, the objecting practitioner must provide an effective referral for the patient,” the committee said. . . [Full text]