Euthanasia-on-demand could be legalised in Canada and Germany, while Spain and Portugal debate legalising assisted suicide

Assisted suicide advocates are seeking to legalise the practice in Spain and Portugal while expanding the availability in Canada and Germany.

Euthanasia-on-demand could become available in Canada and Germany for the majority of the general population, showcasing how, once introduced in law, assisted suicide regimes often expand significantly either through the courts or parliament.

Canada

The Canadian Government has tabled a bill that, if approved, would expand the country’s assisted suicide regime to include people without a terminal illness.

The legislation comes after the Quebec Superior Court ruled last year that a safeguard requiring patients to prove their natural death was “reasonably foreseeable” was unconstitutional.

According to Reuters, the bill will now “remove the requirement for a person’s natural death to be reasonably foreseeable in order to be eligible for medical assistance in dying,” opening up assisted suicide to those who aren’t terminally ill.

Disability advocates, including the Council of Canadians with Disabilities, have said the court’s decision sent the message that “having a disability is a fate worse than death”.

A recent report by the Special Rapporteur on the rights of persons with disabilities in Canada highlighted very troubling concerns about the impact Canada’s assisted suicide laws are having on people with disabilities.

According to the report, “The Special Rapporteur is extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. She has learned that there is no protocol in place to demonstrate that persons with disabilities deemed eligible for assistive dying have been provided with viable alternatives.”

The report goes on to say: “moreover, she [the special rapporteur] has received worrisome information about persons with disabilities in institutions being pressurised to seek medical assistance in dying and of practitioners not formally reporting cases involving persons with disabilities.”

During her visit, the Special Rapporteur said people with disabilities told her “they are being offered the ‘choice’ between a nursing home and medical assistance in dying”.

More than 13,000 Canadians have been given a medically-assisted suicide since it was legalised in September 2016, according to the data from the justice department.

Ethical concerns were raised earlier this year when it was revealed the legalisation of assisted suicide in the country had resulted in a surge of organ donations and the open solicitation of those considering medically assisted death.

In Ontario, a hospital has faced criticism for advertising euthanasia in an urgent care waiting room.

An alarming study has found that the legalisation of assisted suicide could save the Canadian health care system up to $138 million per year.

According to the Alzheimer’s Society of Canada, over 500,000 Canadians live with dementia, with 25,000 new cases diagnosed each year.  It currently costs more than $10 billion per year to care for those in Canada’s health system.  

Germany

A five-year-old law banning professional assisted suicide in Germany has been declared unconstitutional by the country’s top court.

In 2015, Germany’s parliament voted to amend paragraph 217 of the country’s criminal code to add in safeguards preventing groups or individuals creating a form of business that profited from assisted suicide.

However, in its ruling on Wednesday, the Federal Constitutional Court declared Germany’s constitution includes a right to a self-determined death which encompasses the freedom to take one’s own life and use assistance provided voluntarily by third parties.

The Government must now draw up new laws to reflect the legality of assisted suicide in the country.

The German Medical Association opposed any relaxing of Paragraph 217, warning it could open the door to euthanasia, where doctors take an active role in helping a patient die – for example through lethal injection.

The head of Germany’s Palliative Medicine Society, Heiner Melching, said that overturning the ban on professional assisted suicide could also open the door to “self-styled euthanasia assistants”.

The court stressed however that legislators still had “a broad spectrum” of options to regulate assisted suicide, for instance through mandatory waiting periods or through introducing other safeguards in law.

Portugal

Last week, Portugal’s parliament moved closer to legalising assisted suicide and euthanasia after voting in favour of five “right-to-die” bills. 

The details of the bill will now be discussed in detail and amended by the parliament’s constitutional affairs committee, after which it will be subject to a final vote.

President Marcelo Rebelo de Sousa can veto any new law passed by the Government, but the country’s parliament can override his veto by voting a second time for approval.

Francisco Guimaraes, a 21-year-old protestor, told Reuters that he believes “life is an inviolable asset, human life has an inviolable value, consecrated by our Portuguese constitution.”

“We must care for life until it comes to its natural end,” he added.

Spain

The lower chamber of Spain’s parliament, the Congress of Deputies, has voted in favour of considering a bill that would legalise assisted suicide and euthanasia in cases of “clearly debilitating diseases without a cure, without a solution and which cause significant suffering.”

The bill will now go to the upper chamber of Spain’s parliament, the Senate, for a final vote with assisted suicide activists hoping it will be approved by June.

Rocio Monasterio, the leader of the Madrid branch of the Spanish political party Vox, told Reuters her party would mount “fierce” resistance to the bill, which she said would allow people whose life was no longer considered useful to be “eliminated”.

A spokesperson for Right To Life UK, Catherine Robinson said:

“You can learn a lot from paying close attention to countries and other places where assisted suicide and euthanasia has been legalised. What we often see is that death soon starts to appear as an all-too-acceptable solution to all sorts of conditions and, alarmingly, emotional situations.

“Every year there is a significant increase in the number of people being euthanised or helped to commit suicide by their doctors. This is compounded by the fact that once assisted suicide has been legalised for one category of people, it is often only a matter of time before it is extended to others, whether it is imposed through the courts or Government.

“In Belgium and the Netherlands doctors now routinely end the lives of patients suffering from psychiatric illness, with no underlying physical illness. 

“Recently, The Telegraph and the Daily Mail reported that a Dutch family held down their mother as she fought against being euthanized by her doctor.

“Cases like these aren’t one off rarities but are becoming commonplace and have even prompted Theo Boer, a medical ethicist at the University of Groningen, to issue a warning to countries considering legalising assisted suicide and euthanasia.

“‘Look closely at the Netherlands because this is where your country may be 20 years from now,’ he said.

“Furthermore, evidence from Canada demonstrates how a so-called ‘right to die’ can become a ‘duty to die’. Feelings of being a burden were cited in 55% of Oregon and 56% of Washington assisted-suicide requests in 2017.

“This is especially the case when families and health budgets are under financial pressure, which makes the Canadian study which found that the legalisation of assisted suicide could save the health care system more than $138 million per year so alarming.

“Legalising assisted suicide would likely lead to pressure on vulnerable people to choose the quicker, cheaper option of death over palliative care.”

Ethical concerns raised over surge in organ donations in Canada after legalisation of assisted suicide

The legalisation of assisted suicide in Canada has led to a surge in organ donations and the open solicitation of those considering medically assisted death, raising ethical concerns.

During the first 11 months of 2019, Trillium Gift of Life Network, which oversees organ and tissue donation in Ontario, revealed that 18 organs and 95 tissues were donated by people who had ended their life through assisted suicide in the Canadian province. Even without the inclusion of organs and tissues donated in December’s data, the number of donations is up 14% from 2018 and 109% higher than it was in 2017.

“Medical assistance in dying,” as it is legally referred to in the country, has been legal in Canada since 2016, under certain conditions. Since then, organs and tissues donated from those who ended their life through assisted suicide have risen significantly each year.

The 113 assisted suicide related donations in 2019 accounted for 5 percent of overall donations in Ontario, a share that has also been increasing. In 2018, assisted suicide related donations made up 3.6 percent of the province’s total donations, and in 2017 just 2.1 percent.

This new source of organs and tissues is significant as Ontario’s waiting list for organs remains typically static around 1,600.

Countries such as Belgium and the Netherlands require assisted suicide recipients to initiate organ donation, while others, like Switzerland and several US states, prohibit them from donating organs altogether.

In Canada, however, provincial law requires medical professionals to notify the Trillium Gift of Life Network of any potential assisted suicide recipients when a death is imminent. Trillium is then free to approach these individuals and solicit organ donations, leading politicians and medical professionals to question its ethical implications.

Conservative MP Michael Cooper told CNA that the practice raises questions regarding consent and opens up the possibility of coercion.

“The concern that I have is that it muddies the waters in terms of the patient making a decision freely, without any degree of coercion or influence from anyone,” said Cooper.

He added that with the current setup of physician-assisted death in Canada, there is a chance that it is administered to a patient who is not able to properly consent or who may not want to die.

Dr Moira McQueen, executive director of the Canadian Catholic Bioethics Institute, said such practices appear “rather horrifying.”

Given that a person who is approved for euthanasia may not be terminally ill, McQueen she added it is not out of the realm of possibility that a primary physician “might well suggest organ donation as, if not an incentive, a kind of ‘consolation’ for the person’s own loss of life.”

Despite ethical concerns, the policy of allowing medical groups to solicit those considering assisted suicide for organ donations is being adopted by more Canadian provinces and could be a templated for other countries that introduce medical assisted death.

Quebec recently approved Transplant Quebec to raise the possibility of organ donation with patients after their request to die by euthanasia is approved by doctors.

Parliamentary report calling for child euthanasia to be available for children under 12 tabled in Netherlands

Assisted suicide advocates in three different countries that have already legalised euthanasia have this week sought to expand the regime.

Children under the age of twelve, dementia patients and those who have a “fulfilled life” are all targeted by those who wish to expand the so-called ‘right to die’.  

The Netherlands

The Netherlands was the first country in the world to legalise euthanasia when its Termination of Life on Request and Assisted Suicide (Review Procedures) Act came into effect in 2002. 

Under the country’s current law, euthanasia for children aged between 1 and 12 years old is prohibited. However, non-voluntary euthanasia is available for Dutch babies up to 12 months. Children between 12 and 16 can be euthanised with the approval of their parents.

A coalition of three Dutch teaching hospitals has undertaken a survey of 38 doctors which they claim shows 84% of paediatricians in the country want euthanasia for children between 1 and 12 years old. A report on the survey was recently tabled in the lower house of the Dutch parliament by the country’s Minister for Health, Welfare and Sports.

Recently, The Telegraph and the Daily Mail reported that a Dutch family held down their mother, as she fought against being euthanized by her doctor.

The vulnerable patient, who suffered from dementia, had allegedly expressed a wish to be euthanised but also indicated that she wanted to determine the right time.

In the days leading up to the killing, the patient stated her desire to live, saying “I don’t want to die” several times. Despite this, the doctor slipped a sedative into her coffee to relax her before administering the lethal injection. However, the patient awoke and resisted the doctor, causing the physician to ask the family for help in holding down the patient down while he finished the procedure.

The doctor has since been acquitted of any wrongdoing by a Dutch court that ruled “all requirements of the euthanasia legislation” had been met.

In 2018 the number of official euthanasia cases in the Netherlands was 6,126 which was 4 percent of total deaths in the Netherlands. 144 cases of people in the early stages of dementia.

The Netherlands was the first country in the world to legalise euthanasia for patients experiencing “unbearable suffering with no prospect of improvement”, in 2002. Since then, euthanasia and assisted suicide, in which one individual facilitates the suicide of another, have been introduced by Belgium and Canada.

Canada

In Canada, where euthanasia has only been legal for three years, there is continued pressure to expand its scope to remove what has been identified as an important safeguard for people: consent at the time the drugs are administered.

Canada’s euthanasia regime involves a doctor administering the drugs, and at this point, a patient must give consent directly before the procedure.

However, assisted suicide advocates are hoping that the law will change to allow dementia patients to provide an advanced request for euthanasia “perhaps even years prior to death.” 

They argue that if you are deemed to lack the capacity to choose a prior request should be sufficient to administer euthanasia. This is even in circumstances where the patients have since changed their mind and don’t want to end their life.

The Fourth Interim Report on Medical Assistance in Dying revealed there have been at least 6,749 medically assisted deaths since Canada legalised euthanasia, in June 2016.

In September, a Québec court struck down a safeguard in Canada’s euthanasia law requiring that a person be terminally ill to qualify for death by lethal injection.

In Ontario, a hospital has faced criticism for advertising euthanasia in an urgent care waiting room.

An alarming study has found that the legalisation of assisted suicide could save the Canadian health care system more than $138 million per year.

According  to the Alzheimer’s Society of Canada, over 500,000 Canadians live  with  dementia, with 25,000 new cases diagnosed each year.  It currently costs more than $10 billion per year to care for those in Canada’s health system.  

Belgium

Belgium legalised euthanasia in 2002, and since then the practise has even been extended to children. The current law allows euthanasia if the patient is in a state of constant physical or psychological pain.

There is now a renewed push for euthanasia to be available for those who are healthy but have decided they have a “fulfilled life”

The President of Belgium’s Liberal Party, Gwendolyn Rutten, told the Brussels Times: “We must be able to choose the right to die not only when we are suffering in an intolerable way but also when our lives are fulfilled and we request to do it explicitly, freely, independently and firmly.”

In 2018 there was a total of 2,357 reported assisted suicides, up from 2,309 in the previous year. Since 2010, there has been a 247% increase in just 8 years.

The country is currently considering euthanising a physically healthy 23-year-old over her mental health problem. Three Belgium doctors are facing trial for certifying that a heartbroken woman was autistic, so she could be euthanised.

Right To Life UK spokesperson Catherine Robinson said:

“You can learn a lot from paying close attention to countries and other places where assisted suicide and euthanasia has been legalised. What we see is that there is a significant increase year-on-year in the number of people being euthanised or helped to commit suicide by their doctors. This is compounded by the fact that once assisted suicide has been legalised for one category of people, it is often only a matter of time before it is extended to others.

“In 2002, euthanasia was legalised for adults in Belgium who met certain criteria, the main one being that they must be in constant and unbearable physical or psychological pain. Only 24 people were euthanised that year. Now, it is legal to euthanise those with mental illnesses and children of any age, if they are terminally ill.

“The evidence from other jurisdictions demonstrates that the so-called ‘right to die’ may become the ‘duty to die’. Feelings of being a burden were cited in 55% of Oregon and 56% of Washington assisted-suicide requests in 2017.

“This is especially the case when families and health budgets are under financial pressure, which makes the Canadian study which found that the legalisation of assisted suicide could save the health care system more than $138 million per year so alarming.

“Legalising assisted suicide would inevitably lead to pressure on vulnerable people to choose the quicker, cheaper option of death over palliative care.”

The UK has rejected numerous attempts to legalise assisted suicide. The most recent assisted suicide bill, in 2015, was defeated by 330 votes to 118, a majority of 212 votes.

Canada: 26 organisations denied funding for being pro-life

The Canadian Government has denied youth summer jobs to 26 organisations because officials felt they were attempting to weaken or limit access to abortion. The 26 organisations, a number of which were crisis pregnancy centres, found themselves denied funding because they are pro-life.

In 2018, Justin Trudeau’s Liberal Party introduced controversial changes to the Canada Summer Jobs program (a Canadian employment and skills initiative), which required that applicants attest that neither the job nor the core mandate of the organization to which they applied opposed abortion. In Canada abortion is available through all nine months of pregnancy for any reason.

Employment and Social Development Canada said 403 applicants for the Canada Summer Jobs program this year were deemed ineligible for the funding under new rules that say the money cannot be used to undermine abortion.

At the time, many organizations complained, arguing that it forced them to choose between their beliefs and money that helped them to run summer camps and other programs that had nothing to do with abortion.

The Liberal government responded to the outcry by changing the wording, requiring applicants to declare instead that the organization does not actively work to limit access to abortion.

Newly released documents reveal the federal government in Canada worked vociferously in at least some instances to ensure that pro-lifers did not receive any funding.

After their initial application, some organisations were pressed to be more specific in this regard and received a follow-up letter saying:

“Please provide additional information or clarification on the services your organization provides to women seeking access to sexual and reproductive health services.”

“The Government of Canada defines sexual and reproductive health services as including comprehensive sexuality education, family planning, prevention and response to sexual and gender-based violence, safe and legal abortion, and post-abortion care,” said the letter.

The Canadian Press obtained the letter through the Access to Information Act.

This ideological discrimination against pro-lifers has been lauded by the Abortion Rights Coalition of Canada, which is said to have played a role in pushing the Liberal government to take this into account when deciding which groups receive funding.

Spokesperson for Right To Life UK Catherine Robinson said:

“Trudeau’s Government are engaging in ideological discrimination against pro-lifers. Their actions marginalise pro-lifers for the sole reason that they are pro-life.”

“Having lost the argument a long time ago, they are doing everything they can to disadvantage pro-lifers, to limit their spread and engagement with each other and mothers in need.”

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