What could help me to die? Doctors clash over euthanasia

Associated Press

Maria Cheng

GHENT, Belgium (AP) — After struggling with mental illness for years, Cornelia Geerts was so desperate to die that she asked her psychiatrist to kill her.

Her sister worried that her judgment was compromised. The 59-year-old was taking more than 20 pills every day, including antidepressants, an opioid, a tranquilizer, and two medicines often used to treat bipolar disorder and schizophrenia.

About a year later, on October 7, 2014, her doctor administered a lethal dose of drugs. It was all legal procedure in Belgium, which has among the world’s most permissive euthanasia laws.

“I know it was Cornelia’s wish, but I said to the psychiatrist that it was a shame that someone in treatment for years could just be brought to the other side with a simple injection,” said her sister, Adriana Geerts. . . .[Full text]

 

Ensuring access to euthanasia by encouraging physician participation: it’s complicated

Sean Murphy*

In July, 2017, Canadian euthanasia/assisted suicide (EAS) practitioners and advocates alleged that patient access to euthanasia and assisted suicide was in danger because of “barriers” and “disincentives” to physician participation. Dr. Stefanie Green, president of their professional association, described the situation as “a crisis.”1 There was, in fact, no crisis — only a false perception of crisis fuelled by unrealistic expectations about levels of physician participation in euthanasia and assisted suicide.2

Nonetheless, it is reasonable for policy makers to respond to their concerns that physicians are discouraged from participating in euthanasia and assisted suicide. Indeed, objecting physicians are less likely to experience disadvantage and coercion if policy-makers seriously consider suggestions by EAS practitioners and advocates about how to encourage physician participation in euthanasia.

Removing barriers and disincentives to physician participation

Minimizing procedural and administrative requirements
Returning to the complaints and concerns of Canadian euthanasia practitioners (see Canada’s Summer of Discontent2), reducing or streamlining procedural requirements and minimizing burdensome paperwork might encourage more physicians to participate. However, this raises a question that may prove difficult to answer. Is a procedural requirement a “barrier” — or a necessary safeguard? A “disincentive” — or an essential ethical prerequisite? The difficulty is illustrated by developments in Belgium. . . .[Full text]

Belgian Catholic psychiatric hospitals ‘adjust’ their view of euthanasia

BioEdge

Michael Cook*

One of the last substantial barriers to increasing the number of euthanasia cases for non-terminally-ill psychiatric patients in Belgium seems to have crumbled.  A religious order in the Catholic Church, the Brothers of Charity, is responsible for a large proportion of beds for psychiatric patients in Belgium – about 5,000 of them. The international head of the order, Brother René Stockman, is a Belgian who has been one of the leading opponents of euthanasia in recent years.  Nonetheless, in a surprise move this week, the board controlling the institutions of the Brothers of Charity announced that from now on, it will allow euthanasia to take place in their psychiatric hospitals. . . . Full Text

Belgian euthanatist notes some reluctance among physicians, advocates more euthanasia

Dr. Wim Distelmans is a Belgian physician who is a leading practitioner and advocate of euthanasia.  He has provided euthanasia in high-profile cases, like that of the woman who was dissatisfied with the results of sex change surgery, and of deaf twins who did not want to continue to live because they were going blind.  He acknowledges having provided euthanasia in “a lot more borderline cases,” but declines to discuss them because of the publicity might have adverse effects on legalization of the procedure elsewhere.  He is also co-chairman of the federal commission that reviews reports of euthanasia.  In an interview with a National Post reporter, he said that Belgium had “a good law on euthanasia,” but indicated that many physicians, hospitals and nursing homes  are reluctant to provide the service.  He described them as “still very prudent,” adding, “There are still a lot of people suffering unbearably because they ask for euthanasia and they don’t get it.”

It is not clear to what extent the “prudence” Dr. Distelmans attributes to his reluctant colleagues reflects conscientious objection; it could be simply the result of a more cautious interpretation of the law.  In any case, Dr. Distelmans wants the law expanded to permit euthanasia for those suffering from dementia who have made advance directives to that effect before becoming incompetent.  He also wants the law extended to allow euthanasia for minors.

Dr. Distelmans implies that a physician has “a medical responsibility” to provide euthanasia in appropriate cases. [National Post]