Webcast archive: Citizens with Disabilities Ontario presentation

This week, we present a “rehearsal” of our presentation on assisted suicide.

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray give a presentation about their work with TVNDY.

Please note that this text is only a script and that our webcast contains additional commentary.

REHEARSAL FOR PRESENTATION

  • On Sunday, April 26, at 3 p.m. ET Citizens with Disabilities Ontario is sponsoring an online workshop to discuss assisted suicide. You can find a link on our facebook page to sign up.
  • Today we offer a preview of that presentation, by way of a dress rehearsal.

Definitions

  • Palliative care / palliative sedation
  • Refusal / withdrawal of treatment
  • “Do not resuscitate” orders
  • Assisted suicide
  • Euthanasia

Euphemisms – designed to make it more acceptable

  • “Medical aid in dying”
  • “Death with dignity”
  • Merger / evolution of group names

Hemlock society + Compassion in Dying = Compassion & Choices

History of disability opposition to AS/E In the U.S.

  • 1983, Elizabeth Bouvia
  • Give me liberty or give me death cases –
    • Quads in nursing homes, D. Rivlin, L. McAfee, K. Bergstadt
    • Won the right to refuse treatment, have comfort care
    • McAfee got out, changed his mind.
  • Kevorkian trials, NDY is born

Reasons people give for asking for AS/E …

  • Loss of autonomy
  • No longer able to do things they enjoy
  • Perceived loss of dignity
  • Feeling like a burden
  • Pain or fear of pain

The Disability Rights Arguments

  • Assisted suicide is discriminatory: non-disabled people get suicide prevention, PWDs are helped to kill themselves.
    • Social devaluation – better dead than disabled
    • Suicide is a rational choice.
  • Choice is an illusion: There can be no free choice to die while people with disabilities have no choice in where and how they live.
  • It’s unnecessary: Anyone can commit suicide or refuse medical treatment and have palliative sedation.
  • Safeguards don’t work: Safeguards do not prevent non-eligible people from being killed.
    • Evidence appears to conflict
      • Studies of doctors reports show no problem
      • Laws designed to hide information
      • Retrospective examination of deaths shows problems.
    • “It won’t happen here”
  • The needs of a few to plan their death v. the risk to many more of coercion to accept AS/E.
  • We don’t need to die to have dignity!
  • We need help to live, not to die!
  • Suicide prevention for all!
  • Disability is not a fate worse than death.

Meanwhile, north of the border…

  • Nancy B – Established the right to refuse treatment (1992)
  • Rodriguez – was the gold standard (1993)
  • Legislation & Commissions –
    • 12 bills in parliament,
    • Latest, bill C-384 defeated 226-59 in 2010
  • Québec process & statute
    • 2009 Québec commission – Dying with dignity
    • Living with Dignity – 59% people don’t want AS/E.
    • March, 2012 Commission recommends
      • palliative care
      • “Medical aid in dying” = euthanasia
    • January 2013, legal panel says “if you call it medical care, it’s OK”
    • June 2013 Bill 52 introduced – would allow euthanasia.
    • June 2014 Bill 52 is adopted by QC National Assembly

Carter case

  • BC Supreme Court – Justice Smith
    • 400-page decision
    • Protect “hypothetical patients from hypothetical harm”
  • Appeals Court
    • Lower court didn’t have the right to revisit the Rodriguez decision; stare decisis
  • Supreme Court
    • “physician assisted death”
    • Irremediable medical condition (illness or disability)
    • Enduring suffering
    • Intolerable to the person
  • Takes effect a year from the decision; parliament must act, or not.
  • Reasoning based on inability to commit suicide, but eligibility not so limited.
  • Cites European evidence when it agrees, discounts European evidence when it disagrees.

Safeguards

  • NCD (1997, 2005) and Endicott report (2003)
  • “effective safeguards are unworkable”
  • AS/E are, by definition, discriminatory.
  • Experience of BeNeLux countries show practical slippery slope.

Strategies for avoiding the worst damage

  • Reduce requests by removing the causes
  • Narrow eligibility requirements
  • Create a formal, detailed process
    • More detailed evaluation
    • Must go before a court for eligibility and approval
  • Take the doctors and interested parties out of the process

NEWS BRIEFS

  • Bills allowing assisted suicide in Nevada and Connecticut were defeated. In Connecticut, the bill didn’t have the support for a vote in the judiciary committee.  In a similar vein, the chair of the Health and social services committee in Nevada decided not to look at the assisted suicide bill that was filed this year. But a bill to legalize assisted suicide was filed in North Carolina this week.
  • Black-market baths – This week, we learned of a common practice in long term care facilities in Québec where residents pay attendants under the table for a second bath each week. According to articles, the minister of health and social services was warned about the practice in 2011, but they did nothing. Following the revelation, Health Minister Gaetan Barrette forbade the practice, saying “personal hygiene doesn’t require that each person have a bath every day.”  However he did not address the actual problem; that the demand for two baths per week expresses the will of the residents.