“Belgian Docs Give Selves OK to Kill ICU Patients”

The Journal of Critical Care Medicine has published a statement by the Belgian Society of Critical Care Medicine giving ICU docs the right to kill patients–even though euthanasia in the country is supposed to only be consensual.

Under the document, futile care impositions of withdrawing or withholding care are up to the medical team–whatever a patient or family may want.

via National Review Online.

“Assisted suicide” is legal in Belgium.

And, despite published statements by doctors who have admitted to breaking the rules, apparently the oversight designed to protect against abuses has not found a single case worthy of prosecution.

So is the next step the part where the patient’s wishes become irrelevant? This blog post seems to think this is exactly what is happening – that the goal this paper is arguing for involves killing patients (even children, and “even in the absence of discomfort”), whether the patients want it or not.

It’s only logical: Once killing is accepted as an answer to human suffering, what constitutes “suffering” expands like an elastic band to include that of society and the hospital having to care for lives defined as meaningless. And it can even include termination when patient suffering isn’t present.

As for choice: What’s that got to do with anything? Efficiency!

You simply cannot trust a doctor if that doctor’s mission is compromised. Either doctors heal or doctors kill people who go over-budget. They can’t do both.

“The Child Killers”

The Belgians are set to allow doctors to persuade children they should die for their own good…

…The law, which follows a 2002 law making euthanasia legal for consenting adults, will allow terminally children of any age to request that their lives be terminated.

via Newsweek

Adult euthanasia – which originally was for terminal illness – has expanded to include a variety of non-terminal transitory life-change conditions, such as fear of blindness or  dissatisfaction with one’s sex change operation.

“We set strict conditions but we do not stick to them, not at all. Why? I think because euthanasia is made banal. It becomes a dignified exit. It becomes more and more normal.”

via National Post [Canada].

The possibility that after a painful transition a situationally depressed person might feel differently istreated as a nonexistent possibility; the assumption appears to be that situational depression doesn’t exist, and chronic depression – like other psychiatric illnesses – are now viewed as valid reasons for requesting death. There is an ideological indifference to questions of informed consent.

There are also concerns about coercion.

Chapter 21 of this book, titled “The Unspoken Argument,” advocates the economic benefits of euthanasia, as follows: “Similar to other social issues, the right-to-die movement has not arisen separate and distinct from other concurrent developments of our time. In attempting to answer the question Why Now?, one must look at the realities of the increasing cost of health care in an aging society, because in the final analysis, economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice.”

Derek Humphry and other right-to-die leaders, time after time, have demonstrated the same willingness to promote this final “solution” to the problems of people with disabilities. Taken together, these words and deeds mark a clear and consistent pattern – one that includes promotion of euthanasia and extermination of people with disabilities.

Nevertheless, leaders of the pro-euthanasia movement still often falsely claim that their concerns are only for those with terminal illness.

via Amazon.com: Michael Muehe’s review of Freedom to Die: People, Politics, and the ….

There are several ways to coerce someone into suicide. One concern is that, at a moment when health care costs are a major concern, euthanasia might be treated as a cost-saving measure.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

“It was horrible,” Wagner told ABCNews.com. “I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won’t give you the medication to live.”

Critics of Oregon’s decade-old Death With Dignity Law — the only one of its kind in the nation — have been up in arms over the indignity of her unsigned rejection letter. Even those who support Oregon’s liberal law were upset…

…But Sellers acknowledged the letter to Wagner was a public relations blunder and something the state is “working on.”

“Now we have to review to ensure sensitivity and clarity,” Sellers told ABCNews.com “Not only is the patient receiving had news, but insensitivity on top of that. This is something that requires the human touch.”

Sellers said that from now on insurance officials will likely “pick up the phone and have a conversation,” he said.

But a 1998 study from Georgetown University’s Center for Clinical Bioethics found a strong link between cost-cutting pressures on physicians and their willingness to prescribe lethal drugs to patients — were it legal to do so.

via ABC News.

There is concern that people could be said to have requested euthanasia when they have not.

Euthanasia or assisted suicide—and sometimes both—have been legalized in a small number of countries and states. In all jurisdictions, laws and safeguards were put in place to prevent abuse and misuse of these practices. Prevention measures have included, among others, explicit consent by the person requesting euthanasia, mandatory reporting of all cases, administration only by physicians (with the exception of Switzerland), and consultation by a second physician.

The present paper provides evidence that these laws and safeguards are regularly ignored and transgressed in all the jurisdictions and that transgressions are not prosecuted. For example, about 900 people annually are administered lethal substances without having given explicit consent, and in one jurisdiction, almost 50% of cases of euthanasia are not reported. Increased tolerance of transgressions in societies with such laws represents a social “slippery slope,” as do changes to the laws and criteria that followed legalization.

via ncbi.nlm.nih.gov

Dr. Van Hoey is remarkably frank about how flexible the euthanasia law is. It requires a written request for euthanasia from a patient, but it can be written on a napkin, he said. The control commission has even approved euthanasia when there was no written request, taking the doctor’s word that an oral request had been made.

via National Post [Canada].

There are concerns that already cases exist where “euthanasia” is really murder – yet the murderer is viewed as justified (so much for ‘voluntary’, eh?)

In the context of a murder trial in Louisiana involving a man who had killed his father with Alzheimer’s disease, Girsh issued a statement on euthanasia and assisted suicide for people with disabilities generally: “Some provision should be made for a situation in which life is not being sustained by artificial means but, in the belief of the patient or his agent, is too burdensome to continue… A judicial determination should be made when it is necessary to hasten the death of an individual whether it be a demented parent, a suffering, severely disabled spouse or a child” [PR Newswire, 12/3/97].

via ALL.org.

Many euthanasia patients are motivated by fear – fear of being a burden, of being alone, of not receiving adequate pain medicine.  That is not “informed consent”. It is duress – a decision made not freely, but made in fear of serious pain (of various kinds).

Guidelines won’t protect us, if the Dutch experience tells us anything. For example, a key guideline is that a person should not be euthanized due to the expense of keeping them alive. In a television documentary, one man said he was only agreeing to be euthanized because he didn’t want to be a financial burden on his family. He was killed.

After the guidelines had been in place for 23 years, doctors were surveyed about people they euthanized. Incidentally, doctors later admitted they had under-reported euthanasia cases, so the following statistics are actually less than what really happened.

In 1990, 130,000 people died in the Netherlands: 2,300 people asked doctors to kill them; 400 asked doctors to provide them with the means to kill themselves; 8,100 died when doctors deliberately gave them an overdose of pain medication to kill them (for which 4,941 patients didn’t consent); 1,040 people died when doctors euthanized them without their knowledge or consent (72 per cent of those never having given any indication they would want their lives terminated).

That’s breathtaking in more than one way.

It’s not so much that nine per cent died at the hands of doctors, which is alarming in and of itself. What should raise our cries of outrage is that 4,941 people (four per cent) did not give their consent to being killed. A doctor who operates on someone without their consent can be successfully sued and made to pay huge dollars for having done so. The same should apply for killing a person without their consent.

via The Province.

Another concern is that abuses simply aren’t investigated.

Belgium’s 16-member Federal Commission of Control and Evaluation is supposed to guard against any abuses, although it only analyzes cases after the patient is dead. It has reviewed more than 8,000 deaths since euthanasia was legalized, and not one has been referred to prosecutors. Critics like Mr. Montero say this is because its membership is heavily stacked with euthanasia advocates who have stretched the acceptable criteria. Wim Distelmans, the country’s leading euthanasia doctor, has been the co-president since its creation….

…Assisted suicide — when the doctor prescribes a patient lethal medication instead of administering it himself – is not legal in Belgium. But Dr. Van Hoey said he has aided the suicides of two of his patients, including one a few years ago who had been refused euthanasia. The 56-year-old businessman was half-paralyzed after a stroke and did not want to live, but he had trouble finding a psychiatrist who would approve euthanasia. Dr. Van Hoey said today he would have gone ahead and performed the euthanasia without the approval of a psychiatrist instead of surreptitiously prescribing lethal drugs. He noted that Belgian law only says a third doctor must be “consulted” if death is not imminent. “It is not said [the doctors] have to agree,” he said.

via National Post [Canada].

Another concern is that we might simply become indifferent to killing – that we become desensitized, viewing people as disposable.

Mr. Montero is troubled by the fact that the deaths of Dr. de Duve and Mr. Claus, neither of whom was terminally ill, were portrayed in Belgium as noble examples. “I am persuaded that there are vulnerable people who think today, ‘I must request euthanasia. I represent a burden for my loved ones. I am contributing nothing to society any more,’ ” he said. “What is presented at first as a right is going to become a kind of obligation.”

via National Post [Canada].

“In only 23 years, Dutch doctors have gone from being permitted to kill the terminally ill who ask for it, to killing the chronically ill who ask for it, to killing newborn babies in their cribs because they have birth defects, even though by definition they cannot ask for it. Dutch doctors also engage in involuntary euthanasia without significant legal consequence, even though such activity is officially prohibited,” writes Wesley J. Smith in Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder.

via LifeNews.com.

Kenneth Chambaere, a postdoctoral fellow at Vrije Universiteit Brussel, said Belgians who oppose euthanasia are a small minority. “In Belgium, the fact that the majority supports euthanasia means that it has actually become part of our culture,” he said. “Ethical paradigms change over time. We’ve seen that throughout history.”

via National Post [Canada].

We need to ask ourselves what this does to a child – and to the overall culture – when our narratives about death make death into an easy out, a painless, harmless means of avoidance.

We should probably also ask ourselves whose suffering the Belgian laws are really aimed at – the patients? Or the caregivers?

In his “Medical Science under Dictatorship”, published in the New England Journal of Medicine, July, 1949, Dr Alexander observed:

“Whatever proportions these crimes finally assumed, it became evident to all who investigated them, that they started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitudes of physicians.

“It started with the acceptance of the attitude, basic to the euthanasia movement, that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick.

“Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted, and finally all non-Germans.”

via The Life Resources Charitable Trust.

“Belgian Senate to vote on child euthanasia next week”

Far from affecting only the terminally ill or the person in extreme suffering, euthanasia has become a free-for-all.

Consider recent cases that have shocked the world. There was a transsexual euthanized after a sex change operation, because he didn’t want to be a monster. Belgian twins were euthanized, not because they were suffering or dying, but because they were going blind. And at least two women suffering from mental illness – anorexia and depression – have been killed as well. These are just the stories that have made international news.

So it shouldn’t be surprising that the Belgian Senate is going to be voting on a bill next week that will allow the euthanasia of children, where it is expected to pass.

via Live Action News.