Category: Procedures & Services

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.

Italy Needs Abortion Doctors

The Daily Beast

Barbie Latza Nadeau

ROME — If a woman wants to end her pregnancy in Italy, she has the legal right to do so under the public health system within the first 90 days, or first trimester, of the gestation. The law, known in Italy as Law 194, has been on the books for nearly 40 years, but it has one major flaw, say pro-choice advocates: It allows for doctors, nurses, anesthetists, and other assistants to an abortion procedure to be conscientious objectors. Boiled down, that means that many administrators of hospitals and clinics who do not support the pro-choice law simply hire abortion doctors who object to performing abortions.

The practice of hiring conscientious objectors is all-too-common across Italy. The national estimate of conscientious objectors hired as public health gynecologists mandated to perform abortions is around 70 percent, meaning seven out of 10 doctors can, but won’t, do the procedure. . . [Full text]

 

Italy’s legal loophole saw woman denied abortion by 23 different hospitals

Mirage News

An Italian woman has revealed she was turned away from 23 hospitals in north-west Italy when she was seeking abortion services, highlighting the disconnect between the country’s abortion laws and its Catholic influence.

The anonymous 41-year-old mother of two came forward to share her story in Il Gazzettino after she became pregnant when her contraceptive failed. She was refused an abortion by her gynecologist and her local hospital, and then began contacting other hospitals which also refused to carry out the procedure.

The hospitals said they didn’t have an opening within the 12-week timeframe, or that they didn’t have doctors who were willing to do the procedure. . . [Full text]

No case to answer in UK’s odd female genital mutilation imbroglio

BioEdge

Michael Cook

An unusual criminal investigation in London of high-profile doctors for female genital mutilation (FGM) has collapsed. FGM is usually carried out in secret amongst communities from the Middle East and Africa. However, this procedure was described in a medical journal and involved leading British physicians.

In 2011 a surgeon, Professor Joe Daniels, and a psychiatrist, Professor David Veale, published an article in The Archives of Sexual Behaviour about a clitoris removal operation on a 33-year-old Western patient. She had already had labia reduction surgery but still thought her genitals were “ugly” and “hated the look of them”. So Veale gave his approval as a psychiatrist and Daniels did the operation.

Upon reading the article, another academic, Professor Susan Bewley, was outraged and urged the Crown Prosecution Service to investigate because it appeared to breach the UK’s law banning FGM. However, surgery of this kind is permitted for medical or psychological reasons and eventually the police declared that there was no case to answer.

Professor Veale told the Evening Standard that he was utterly opposed to FGM.

“FGM and cosmetic surgery are completely different. To me it’s completely clear. FGM is an abhorrent practice conducted on girls against their consent motivated by a desire to control female sexuality, but [cosmetic genital surgery] is provided for adult women with capacity to consent and motivated by a desire to improve their appearance and sexuality. It’s no different to any other cosmetic surgery…

“I don’t like the procedure. But the bottom line for me is freedom of choice. You have a freedom of choice if you have capacity for consent to do what you wish with your own body.”

Professor Bewley was disappointed, fearing that it might be impossible to prosecute over FGM:

“It makes a mockery of the law. It’s extraordinary. Despite the police having spent three years investigating, it’s puzzling that the CPS has decided against pressing charges. Does this mean all female cosmetic genital surgery, maybe even on minors, is exempt? The CPS decision-making looks inconsistent. Inevitably doctors are left confused and patient safety is unclear.”

 

No case to answer in UK's odd female genital mutilation imbroglioThis article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees.

Is it ethical to refuse a patient surgery for body art?

BioEdge

Michael Cook

The “bioartist” Stelarc has an ear surgically implanted on his forearm. Like him, a number of other people have hacked their own bodies with implants and prostheses. With growing interest in transhumanism, more and more people are likely to request enhancements to turn them into cyborgs.

Many doctors are unwilling to modify bodies for artistic, political or whimsical reasons. Stelarc complains that it took him ten years to find a willing surgeon. Is it ethical for a doctor to refuse? This is the question tackled by Francesca Minerva in the Journal of Medical Ethics. . . . [Full Text]