Thursday, May 20, 2010

Over 30% of Euthanasia Cases in Belgian Region Did Not Give Consent: Study

Over 30% of Euthanasia Cases in Belgian Region Did Not Give Consent: Study

Most were undergoing medical treatment with the hope of a cure for their illness.

The "Euthanasia Talk"

In one region of Belgium, over 30 percent of reported euthanasia cases were carried out without the consent of the patient, a study has found. At the same time, the overall number of official reported deaths by euthanasia are dramatically increasing in the country since the practice was legalized in 2002, with 40 per cent more cases reported for 2009 than the previous year.

A team of Belgian and Dutch end-of-life researchers circulated a questionnaire to physicians who signed death certificates of patients who died in the Belgian region of Flanders between June and November 2007. The study showed that of the 208 reported Flemish deaths involving the use of "life-ending drugs," 142 were killed with "an explicit patient request," and 66 "were without an explicit request."

The study, published in the Canadian Medical Association Journal this week, showed that in the majority of cases of euthanasia without a patient's consent, the euthanasia "option" was not discussed with them before they were killed, and that most were undergoing medical treatment with the hope of a cure for their illness.

The researchers noted that euthanasia and assisted suicide "mostly involved patients less than 80 years of age, those with cancer and those dying at home." Euthanasia without a "specific request" from the patient was "mostly" carried out on patients over 80 years, "those with a disease other than cancer and those in hospital."

In most cases of patients killed without "an explicit request" (77.9%), "the decision was not discussed with the patient."

Many cases in which patients were killed without requesting euthanasia, the researchers said, "involved patients whose diseases had unpredictable end-of-life trajectories," with death not being an inevitable result.

The Belgian government's statistics show that the number of euthanasia cases is rising dramatically, with 700 cases in 2009 compared to 500 in 2008. It is likely, moreover, that the actual numbers of people being euthanized with or without their consent is likely much higher than the official statistics. Belgian media reports that physicians are "hesitating" to report euthanasia for fear of "judicial problems," with an estimated 1 in 4 actually making formal reports of euthanasia.

In countries, such as the U.S., Canada and the UK, where the possibility of legalizing assisted suicide or euthanasia continues to be debated in legislatures, advocates of the practice routinely cite the "safeguards" that are ostensibly built into the law to protect vulnerable patients. In Belgium, while the law allows euthanasia for people without terminal illnesses and who are suffering from "constant and unbearable physical or psychological pain," it also technically requires a patient's written consent, the opinion of a third physician in cases where an illness is not terminal and a one-month waiting period for patients suffering from depression.

However, a study of cases of euthanasia in patients' homes that was conducted by researchers from the End-of-Life Care Research Group, and Belgian Department of Public Health and found that, "Procedural requirements such as consultation of a second physician were sometimes ignored."

"Euthanasia cases were least often reported when the physician did not regard the decision as euthanasia, when only opioids were used to perform euthanasia, or when no second physician was consulted."

Anti-euthanasia campaigners have long warned that legal "safeguards" in practice do little to guard the safety of vulnerable patients. It has been widely reported, and admitted by euthanasia campaigners, that euthanasia was legalized in the Netherlands after years of physicians killing patients without a law and simply not reporting the cause of death.

Bioethics writer and lawyer Wesley J. Smith, writing on his blog at First Things magazine, said that it is likely that in countries that have legalized euthanasia by this backdoor means physicians are killing patients on their own cognizance without regard to legal restraints.

In reference to the recent study, Smith wrote, "We could say Flemish doctors murdered their patients since explicit request is required under the supposedly 'protective' euthanasia "guidelines."

Smith also points to the next logical step in the euthanasia business, the linking of euthanasia and organ "harvesting."

He cites a letter to the editor of the journal "Transplantation," dated 2008, that recorded a case of a legal euthanasia, and subsequent "harvesting" of organs, of a patient with "locked-in" syndrome, in which she was fully conscious but completely paralyzed, and who requested that she be killed. But before she died, she also decided to donate her organs.

The letter, from the physicians presiding over the case, said, "This case of two separate requests, first euthanasia and second, organ donation after death, demonstrates that organ harvesting after euthanasia may be considered and accepted from ethical, legal and practical viewpoints in countries where euthanasia is legally accepted.

"The ethical and legal possibility of combination of the two separate processes, physician-assisted suicide and after-death organ donation was then considered and agreed by the institutional ethical committee president."

Smith writes, "If this doesn't set off alarm bells about how the sick and disabled are increasingly being looked upon not only as burdens (to themselves, families, and society), but potential objects for exploitation, what will?"

The killing of patients, even with consent, he wrote, validates "the ideas that dead is better than disabled and that living patients can, essentially, be viewed as a natural resource to be killed and mined."

Hilary White
Publish Date: May 19, 2010
Link to this article.
Send this article to a friend.

1 comment:

Ethos said...

For assisted suicide but against voluntary euthanasia !

About the difference between euthanasia and assisted suicide, one must distinguish between the legal, ethical and religious arguments. One cannot just say without qualification that there is no difference between the two : in one case it is the patient himself who take his own life (assisted suicide), whereas in euthanasia it is the physician. One must first specify on what grounds (legal, ethical or religious) he draws is arguments. In the field of ethics, one can reasonably argue that there is no difference between the two. However, in the legal field, there is a difference between euthanasia (so-called first-degree murder with a minimum sentence of life imprisonment) and assisted suicide (which is not a murder or homicide and which the maximum sentence is 14 years of imprisonment). In the case of assisted suicide, the cause of death is the patient's suicide and assisted suicide is somehow a form of complicity (infraction of complicity). But since the attempted suicide was decriminalized in Canada in 1972 (and in 1810 in France), this complicity (infraction of abetting suicide) makes no sense because this infraction should only exist if there is a main offence. But the suicide (or attempted suicide) is no longer a crime since 1972. So, logically, there cannot be any form of complicity in suicide. The offense of assisted suicide is a nonsense. Judge McLachlin said :

« In summary, the law draws a distinction between suicide and assisted suicide. The latter is criminal, the former is not. The effect of the distinction is to prevent people like Sue Rodriguez from exercising the autonomy over their bodies available to other people. The distinction, to borrow the language of the Law Reform Commission of Canada, "is difficult to justify on grounds of logic alone": Working Paper 28, Euthanasia, Aiding Suicide and Cessation of Treatment (1982), at p. 53. In short, it is arbitrary »

In contrast, voluntary euthanasia is considered a first-degree murder. The doctor kills the patient (at his request) by compassion to relieve his pain and suffering. There's a violation of one of the most fundamental ethical and legal principles : the prohibition to kill a human being. Our democratic societies are based on the principle that no one can remove a person's life. The end of the social contract is "the preservation of the contractors" and the protection of life has always founded the social fabric. We've abolished the death penalty in 1976 (and in 1981 in France) in response to the « broader public concerns about the taking of life by the state » (see United States v. Burns, [2001] 1 S.C.R. 283) ! Even if voluntary euthanasia (at the request of the patient) may, under certain circumstances, be justified ethically, we cannot ipso facto concluded that euthanasia should be legalized or decriminalized. The legalization or decriminalization of such an act requires that we take into account the social consequences of the legalization or decriminalization. The undeniable potential of abuse (especially for the weak and vulnerable who are unable to express their will) and the risk of erosion of the social ethos by the recognition of this practice are factors that must be taken into account. The risk of slippery slope from voluntary euthanasia (at the request of the competent patient) to non-voluntary euthanasia (without the consent of the incompetent patient) or involuntary (without regard to or against the consent of the competent patient) are real as confirmed by the Law Reform Commission of Canada which states :

"There is, first of all, a real danger that the procedure developed to allow the death of those who are a burden to themselves may be gradually diverted from its original purpose and eventually used as well to eliminate those who are a burden to others or to society. There is also the constant danger that the subject's consent to euthanasia may not really be a perfectly free and voluntary act ».

Eric Folot