Category: Assisted suicide

Six questions about physician-assisted death, from a conscientious objector

National Post

Ewan C. Goligher

Canadian policy makers have recently proposed to require all doctors to provide an effective referral for physician-assisted death (PAD) upon the patient’s request. Forcing doctors to knowingly send their patient to another doctor willing to cause the patient’s death will seriously compromise the moral integrity of conscientiously objecting doctors and risks undermining the quality of patient care. To understand the position of conscientiously objecting doctors, consider the following questions.

1. Should doctors provide physician-assisted death merely because it is legal?

2. Must all doctors accept the assumptions underpinning the claim that physician-assisted death is good medical care?

3. If physician-assisted death remained illegal, would doctors be legally liable for making an effective referral?

4. Does the Charter right of Freedom of Conscience apply to doctors?

5. How does respect for conscientious objection affect patient care?

6. Will respect for conscientious objection obstruct access to physician-assisted death?

(For the author’s answers, see the full text)

Pope Francis: modernity’s suppression of freedom of conscience is diabolically inspired “polite persecution”

Sean Murphy*

In the course of a morning homily discussing the martyrdom of St. Stephen in Jerusalem,1 Pope Francis linked the “cruel persecutions” of early Christians with the Easter Sunday mass murder of Pakistani Christians three weeks ago by Taliban killers.

However, the Pope also identified “another kind of persecution that is not often spoken about.”   In addition to the “clear, explicit type of persecution” like the slaughter of Christians who profess their belief in Jesus Christ, there is a second kind, he said, one ““disguised as culture, disguised as modernity, disguised as progress.”

“It is a kind of — I would say somewhat ironically — polite persecution.”

This “polite persecution” is not against those who merely profess Christian beliefs, he explained, but against those  who want “to demonstrate the values of the Son of God.”  This “polite persecution” does not use bombs or guns, but the force of law.

“We see every day,” said the Pope, “that the powerful make laws that force people to take this path, and a nation that does not follow this modern collection of laws, or at least that does not want to have them in its legislation, is accused, is politely persecuted.”

This denial of freedom includes the legal suppression of conscientious objection, now notably advocated by powerful interests and some politicians in Canada who want to force participation of even objecting health care workers and institutions in euthanasia and assisted suicide.

“God made us free, but this kind of persecution takes away freedom!”

Canadian health care workers who refuse to provide or facilitate homicide or suicide now face the kind of threats described by Pope Francis,2 who explained how “polite persecution” works.

“[I]f you don’t do this, you will be punished: you’ll lose your job and many things or you’ll be set aside.”

Calling this “the persecution of the world,” the Pope warned that its leader is the one identified by Jesus Christ as “the prince of this world” (i.e., Satan).

“The prince of this world” can be recognized, warned Pope Francis, “when the powerful want to impose attitudes, laws against the dignity of the children of God, persecute them and oppose God the Creator: it is the great apostasy.”

The Christian’s path, he concluded, is always beset by these two kinds of persecution  that bring “much suffering,” so Christians must be confident in the presence of Jesus “with the consolation of the Holy Spirit.”

Notes

1. “Pope’s Morning Homily: Denial of Conscientious Objection Is Persecution.  At Casa Santa Marta, says devil is behind the persecution brought by culture and modernity.”  Zenit, 12 April, 2016

2.  See, for example, Attaran A. “Doctors can’t refuse to help a patient die – no matter what they say.” iPolitics, 13 November, 2015 (Accessed 2015-11-24).  In response, see Murphy S., “Amir Attaran and the Elves.” Protection of Conscience Project, 15 November, 2015;

What’s behind the demolition of conscience rights in Canada?

Mercatornet

Margaret Somerville*

I’ve been puzzling about why Canadian “progressive” values advocates, particularly those passionately in favour of the legalization of euthanasia and physician-assisted suicide (“physician-assisted death” (PAD)), are so adamant in trying to force healthcare professionals and institutions who have conscience or religious objections to these procedures to become complicit in them.

Complicity would occur if objecting individual physicians were forced to provide “effective referrals” or objecting institutions were forced to allow PAD in their facilities. An “effective referral” is defined by the Ontario College of Physicians and Surgeons as “a referral made in good faith, to a non-objecting, available, and accessible physician or other health-care provider.”

In general, progressive values advocates claim to give priority to rights to individual autonomy, choice, control over what happens to oneself, and tolerance for those who believe differently. Yet in relation to respect for the freedom of conscience and, where relevant, religious belief, of physicians or institutions who oppose PAD, none of these principles seem to be applied. Why? [Full text]

The intersection of freedom of conscience and assisted dying

One MP’s views on balancing the needs of patients and doctors who have personal issues providing assisted dying

Macleans

Garnett Genuis

Garnett Genuis, the Conservative MP for Sherwood Park—Fort Saskatchewan in Alberta, has served on the Physician-Assisted Dying Committee.

Parliament will imminently be dealing again with the issue of physician-assisted suicide / euthanasia. If government legislation follows the direction given in the report of the Liberal-dominated joint committee, we are in for (among other things) a significant change in the way Canadian law treats freedom of conscience.

The court was clear in Carter that nothing in their decision would require anyone to be involved in euthanasia or assisted suicide if they did not wish to be. In this respect, I think the court got it right. Freedom of conscience is protected by the Charter itself. Euthanasia and assisted suicide were considered murder until just this year; it’s understandable that many healthcare providers remain uncomfortable with it. . . [Full text]

 

Everybody’s a winner when euthanasia combines with organ donation, say doctors

BioEdge

Michael Cook

Several Dutch and Belgian doctors have proposed legal reforms to increase the popularity of combining euthanasia and organ donation in the Netherlands and Belgium.

Writing in the Journal of Medical Ethics, they report valuable unpublished information about the prevalence of the procedure. So far, it has been performed only about 40 times in the two countries. However, there is “a persisting discrepancy between the number of organ donors and the number of patients on the waiting lists for transplantation” – which euthanasia patients could help to balance.

The authors stress that euthanasia is not a cure-all for the organ shortage. Most euthanasia patients suffer from cancer, which is a contraindication for organ transplantation. However, 25 to 30% of them do not, so there is obviously a real possibility of expanding the supply.

Furthermore, the authors say, public perception of this formerly abhorrent practice is increasingly positive:

. . . transplant coordinators in Belgium and the Netherlands notice a contemporary trend towards an increasing willingness and motivation to undergo euthanasia and to subsequently donate organs as well, supported by the increasing number of publications in popular media on this topic.

Ethically, the procedure is basically uncontroversial as long as the patient is not pressured to donate, they contend.

In the context of organ donation after euthanasia, the right of self-determination is a paramount ethical and legal aspect. It is the patient’s wish and right to die in a dignified way, and likewise his wish to donate his organs is expressed. Organ donation after euthanasia enables those who do not wish to remain alive to prolong the lives of those who do, and also—compared with ‘classical’ donation after circulatory death—allows many more people to fulfil their wish to donate organs after death.

However, there are some legal hitches in both countries. In the Netherlands, unlike Belgium, euthanasia is regarded as an “unnatural death” which has to be reported to the public prosecutor. This could delay donations. If the law were changed to allow the cause of death to be reported as the underlying condition, the procedure would be more expeditious. And “In Belgium, the current policy of determination of death by three independent physicians could be abandoned, facilitating a more lean procedure with only one physician.”

Public perceptions need to be managed as well. At the moment, it is necessary to maintain a strict separation between the request for euthanasia and the need for the organ. Partly this is needed to ensure that the donor is not being pressured. But the public also needs to have confidence that physicians will give objective advice.

Finally, there is the tradition of the dead donor rule “that donation should not cause or hasten death”. The authors imply that this could be scrapped for euthanasia volunteers:

Since a patient undergoing euthanasia has chosen to die, it is worth arguing that the no-touch time (depending on the protocol) could be skipped, limiting the warm ischaemia time and contributing to the quality of the transplanted organs. It is even possible to extend this argument to a ‘heart-beating organ donation euthanasia’ where a patient is sedated, after which his organs are being removed, causing death.

The article’s proposals were not received with great enthusiasm in the UK where there is a simmering debate on assisted dying. Tory MP Fiona Bruce told the Daily Mail: “The paper confirms the worst fears expressed by Parliament when the House of Commons conclusively voted to stop the legalisation of assisted suicide in this country. The possibility of euthanasia achieved through live organ donation, such as by removing a patient’s beating heart, as posited in this paper is shocking and chilling.”

And Lord Carlile of Berriew, a Liberal Democrat peer who is a leading lawyer, said: “I have extreme concerns about the ghoulish nature of the combined euthanasia and organ donation systems in the Netherlands and Belgium. Both can result in unbearable and irresistible pressure on an individual to die, and on a doctor to encourage death.”

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