Alex Schadenberg at U of T

Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, delivered a lecture at the University of Toronto last week, so we’ve been focusing on the topics he covered in our series on euthanasia and assisted suicide.

We’ve uploaded video from Alex Schadenberg’s talk at U of T to our new YouTube channel. I can’t embed the playlist here, so I’ll just embed all 10 parts (though, if you use the playlist, it should play them one after another automatically). I’ve also included some rough point form notes that I took, in case you’re looking to skim rather than watch the whole thing.

What struck me as one of the most important themes in his talk was to clear up confusion over what euthanasia is and what it isn’t. Euthanasia is about the direct and intentional cause of death, about killing people. It’s not euthanasia to kill pain. That is, an unintentional overdose of a pain killer is similar to death on a surgeon’s table; assuming that the proper precautions are being taken, death is an unintended accident of trying to provide care for the patient. That’s not euthanasia.

Also, every patient has a right to refuse treatment. That’s not euthanasia either. (Though, a right to refuse treatment doesn’t mean that it’s okay for medical practitioners to remove basic care, like food and water.) Many people don’t understand what euthanasia is and mistake it for the refusal of treatment. We need to be clear that patients have a right to refuse treatment, but that euthanasia is about giving medical practitioners the power to directly and intentionally cause the death of another person by means of something like a lethal injection.

Anyways, you can hear the whole talk (and the Q&A) in Alex’s own words.

My notes:

• So many people confuse the refusal of treatment with euthanasia
• definitions are everything, so much ambiguity
• there’s a difference between withholding treatment and care
• it’s not about the unintentional overdose (too much pain killers), it’s similar to death on a surgeon’s table — it’s about direct and intentional cause of death
  • it’s not euthanasia to kill pain
  • abuse of pain management is a serious issue however, but euthanasia proponents are trying to create confusion
    • are they saying that the abuse is okay?
• Euthanasia by omission: withdrawal of basic medical care with the direct and intentional cause of death of a person who is not otherwise dying
  • this is different than accepting the limits of life and withdrawing hydration and nutrition from a person who is dying and nearing death / actively dying
• Jocelyn Downie says that there’s no difference between killing and letting die
• It’s not about “choice;” it’s about the rules a physician needs to follow to bring about the death of a patient
• Bill C-384: it’s not about choice or autonomy
  • amends section 222 and section 241 of the criminal code, about euthanasia and assisted suicide
    • the homicide provision
    • do we really want to create exceptions to homicide?
  • Schadenberg calls the clauses “ink on paper” — just trying to pretend that there are safeguards
    • “you must have either tried or expressly refused appropriate treatments”
    • “or terminally ill”
      • insulin dependent diabetic who may be depressed
    • “appears to be lucid”
      • she included people undergoing mental pain…
  • doesn’t define terminal illness
    • Schadenberg died over 2 years after he was told he had 6 months to live
    • he would have been eligible for euthanasia at the point of shock when he was first diagnosed
  • does not require a witness at the time of death
  • does not restrict death tourism
  • what does any of this have to do with autonomy or choice?
    • it’s about giving the power to medical practitioners to be directly and intentionally causing the death of another person by lethal injection
  • it’s a threat to the lives of people with disabilities or other vulnerable people
• Tracy Latimer
  • people only heard about her inabilities, not her abilities
  • she went to school everyday by bus, her educational assistant said that she was a happy child who was not suffering
  • she had a radio attached to her wheelchair that she turned on and off on her own
  • yet, she had such a low quality of life that she was better off dead
  • the perception about disability means that to be disabled means that you’re always suffering
• Groningen Protocol for the euthanasia of severely ill newborns in the Netherlands
  • infant must have a certain diagnosis and prognosis
    • BUT spina bifida is a condition that is very treatable, and for the most part people have a good prognosis
  • infant must have a hopeless and unbearable suffering
    • well, if you’re not going to give them pain management or palliative care as you kill them…
  • must have second doctor
    • when did physicians become the moral arbiters of our culture?
  • must be carried out in accordance with the accepted medical standard
    • since when was infanticide accepted medical practice?
  • after the fact reporting
    • and the doctor who euthanized the patient writes the report
    • not a safeguard
  • how can you say at birth that a child’s life will be “wretched in the extreme
  • Schadenberg thinks the protocol exists to end the lives of infants with disabilities because the cost to society and to the parents is deemed too great to allow their lives to continue
• Van der Lee (pro-euthanasia): clinical impression was that requests for euthanasia were base don well-considered decisions… but she finds the opposite was true!
• also, Linda Ganzini’s study found that 15 of 58 people who’d requested assisted suicide were depressed, and none of the 49 people who died by assisted suicide in 2007 were offered a psychological assessment
  • Van der lee was asked to comment on the article, said that it matched her findings, but her response was… who cares? (Schadenberg: I guess they appear to be lucid)
• Nadia, 18 year old student at Carlton, met someone online who convinced her to commit suicide
  • William Melchert-Dinkel setup a suicide pact with her… he wanted her to hang herself in front of the webcam… he had no intention of committing suicide himself
  • He’s now been tied to at least 5 suicides
  • If Bill C-384 passes, could you protect someone from someone like Melchert-Dinkel?
  • The law isn’t designed to restrict you, but to protect vulnerable people (the assisted suicide law)
• Need clear themes
  • not medical treatment
  • lethal injection
• need to work in coalitions
• messages
  • choice is a lie
  • euthanasia and assisted suicide have nothing to do with autonomy
  • euthanasia and assisted suicide are the direct and intentional killing of people
  • we need narratives, personal stories
    • turning the tide http://www.saltandlighttv.org/prog_special_ttt.html

morphine is not a good killer, so intent makes a big difference (dose for pain would be quite different from dose to kill)

letting die versus killing
– still has ethical questions, but it wouldn’t be euthanasia

Previous posts in this series:

• Canadian Physicians for Life Educates Pro-Life Medical Students
• Euthanasia Bill Shut Down In South Australia
• Man trapped in 23-year “coma” misdiagnosed
• Euthanasia and Assisted Suicide: Why Not?
• Euthanasia is not appropriate care