{"id":3864,"date":"2018-11-16T16:07:13","date_gmt":"2018-11-16T16:07:13","guid":{"rendered":"http:\/\/tvndy.ca\/?p=3864"},"modified":"2018-11-27T02:28:39","modified_gmt":"2018-11-27T02:28:39","slug":"webcast-archive-first-euthanasia-prosecution-in-the-netherlands","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-first-euthanasia-prosecution-in-the-netherlands\/","title":{"rendered":"Webcast archive: First euthanasia prosecution in the Netherlands"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/O2yZ53m5iWk?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:<\/p>\n<ul>\n<li>First prosecution under the Netherlands\u2019 euthanasia law<\/li>\n<li>The federal AS\/E monitoring system goes online<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>FIRST PROSECUTION UNDER THE NETHERLANDS\u2019 EUTHANASIA LAW<\/strong><\/p>\n<ul>\n<li>For the first time, a\u00a0<a href=\"https:\/\/www.theguardian.com\/world\/2018\/nov\/09\/doctor-to-face-dutch-prosecution-for-breach-of-euthanasia-law\">Dutch doctor is being prosecuted<\/a>\u00a0under that country\u2019s euthanasia law.\u00a0 The doctor is being charged for \u201cfailing to act carefully\u201d and \u201coverstepping a line\u201d in the euthanasia of a 74-year-old woman with dementia.\u00a0 The woman made an advance directive several years ago that stated she wanted to die \u201cwhenever I think the time is right.\u201d\u00a0 Though she would sometimes say she wanted to die, at other times she\u2019d say\u00a0<a href=\"https:\/\/www.nytimes.com\/aponline\/2018\/11\/09\/health\/ap-eu-med-netherlands-euthanasia.html\">\u201cNot just now, it\u2019s not so bad yet.\u201d<\/a><\/li>\n<li>The doctor interpreted her advance directive, along with the woman\u2019s inconsistent oral statements, as permission to perform euthanasia.\u00a0 In what has become an infamous event, the doctor put a sedative into the woman\u2019s coffee, and the family to held her down as she struggled against the lethal injection.<\/li>\n<li>A public prosecutor in the Hague said the doctor could not have \u201cunambiguously\u201d determined that the woman wanted euthanasia, especially given her conflicting statements about her desire to die. The case will be heard at the district court of the Hague. Two other criminal cases against euthanasia providers have been dropped.<\/li>\n<\/ul>\n<p><strong>THE FEDERAL AS\/E MONITORING SYSTEM GOES ONLINE<\/strong><\/p>\n<ul>\n<li>The federal government\u2019s system for monitoring assisted suicide and euthanasia\u00a0<a href=\"https:\/\/www.canada.ca\/en\/health-canada\/news\/2018\/08\/regulations-for-monitoring-medical-assistance-in-dying-come-into-force.html\">came into effect on the 1st of November<\/a>, but not without a few problems.<\/li>\n<li>The failure of federal and Qu\u00e9bec government officials to agree on a reporting process that would provide both levels of government with the data they want threatened to derail the new system before it even started.\u00a0 On October 31, the\u00a0<strong>Coll\u00e8ge des m\u00e9decins du Qu\u00e9bec<\/strong>\u00a0called on the province\u2019s doctors to ignore the federal reporting requirements while continuing to file reports with the Qu\u00e9bec government.<\/li>\n<li>Qu\u00e9bec&#8217;s Commission on End of Life Care has been recording euthanasia deaths in the province since December of 2015. Because Qu\u00e9bec\u2019s law is slightly different from the federal law, and the provincial government tracks different information, bringing the two reporting systems into line was more difficult than for the provinces that created\u00a0<a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/medical-assistance-dying\/guidance-reporting-summary\/document.html#4.2\">new procedures based on the federal law and regulations<\/a>; Alberta, British Columbia, the Northwest Territories, Nunavut, Ontario and Saskatchewan. Qu\u00e9bec doctors would have had to fill out two reports for each euthanasia.<\/li>\n<\/ul>\n<ul>\n<li>At the last minute, Quebec and Ottawa\u00a0<a href=\"https:\/\/www.ledevoir.com\/societe\/sante\/540457\/aide-medicale\">agreed to harmonize their data collection systems<\/a>, by creating a new form that will provide all the needed information for both levels of government and avoid duplication. The new form is expected to be ready by the end of November.\u00a0 Qu\u00e9bec doctors will continue to use the provincial reporting system until the new form is online.<\/li>\n<\/ul>\n<ul>\n<li>We\u2019ve obtained a copy of the reporting form, so as to see what\u2019s included in all the drop-down menus mentioned on the Health Canada website, and to verify that the federal process complies with all the safeguards.\u00a0 We haven\u2019t had time to do an in-depth analysis but in the meantime the \u201cGuidance for Reporting on Medical Assistance in Dying\u201d provided a few surprises.\n<ul>\n<li>Under \u201cWhat constitutes a written request\u201d the guidance says: \u201cA patient&#8217;s written request may take any form &#8211;\u00a0<strong>it does not have to be in the format required by the Criminal Code as a safeguard when MAID is provided<\/strong>\u00a0(i.e., duly signed, dated and witnessed) to require reporting. It must, however, be an explicit request for MAID and not just an inquiry about MAID or a request for information.\u201d\n<ul>\n<li>There are many sample forms online to request AS\/E, but the ones we found don\u2019t specifically ask about the nature of the physical or psychological suffering.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>The English version of the\u00a0<a href=\"http:\/\/www.osmh.on.ca\/Files\/MOHLTC%20Clinician%20Aid%20A%20-%20Pt%20request%20for%20MAID.pdf\">Ontario form<\/a>\u00a0limits \u201cexternal pressure\u201d to \u201cpressure from others\u201d, while\u00a0<a href=\"https:\/\/www.ehealthsask.ca\/services\/resources\/Resources\/Written%20Request%20Form%20for%20MAID.pdf\">the Saskatchewan form<\/a>\u00a0did not mention suffering, simply referring to the medical condition as \u201cintolerable.\u201d<\/li>\n<li><a href=\"https:\/\/www.canada.ca\/content\/dam\/hc-sc\/documents\/services\/medical-assistance-dying\/guidance-reporting-summary\/document\/MAID%20Guidance%20Document%20October%2015-full.pdf\">The Guidance document<\/a> does nothing to clear up the confusion about the effect of the second opinion.\u00a0 The chart labeled \u201cwhen physicians and nurse practitioners are required to report\u201d includes the contingency that AS\/E was NOT provided because the \u201cpatient [was] ineligible for MAiD.\u201d\u00a0 But later, in the section entitled \u201cExceptions: when is a report not required\u201d, we learn that the practitioner doesn\u2019t have to report when their \u201c\u2026\u00a0involvement is limited to providing a second opinion \u2026 of a patient&#8217;s eligibility.\u201d\u00a0 Does this mean the practitioner giving the second opinion doesn\u2019t have to report only if they agree that the person is eligible?\u00a0 Or does it mean that if the practitioner giving the second opinion says the person is not eligible, their opinion isn\u2019t reported and doesn\u2019t count?<\/li>\n<li>The \u201cPatient\u2019s Description of Suffering\u201d is reduced to a \u201ccheck all that apply\u201d list, with an \u201cother\u201d option.\u00a0 Once we analyze the form, we\u2019ll be able to say whether the list is thorough, or whether there is space to specify what \u201cOther\u201d means.<\/li>\n<\/ul>\n<ul>\n<li>The guide for medical practitioners warns that \u201cHealth Canada or [the] provincial or territorial designated recipient will follow up \u2026 if the information provided is unclear or incomplete, or to find out why [the practitioner has] not reported.\u201d\u00a0 But how will Health Canada know the practitioner hasn\u2019t filed the report?<\/li>\n<li>Health Canada also warns that where practitioners fail \u201cto apply the eligibility requirements or safeguards in the Criminal Code,\u201d or they commit \u201ccontinued or egregious omissions in reports\u201c, practitioners\u00a0<strong>could\u00a0<\/strong>be referred to law enforcement.\u201d \u00a0But will that improve compliance with the law, or just modify what practitioners write on the forms?<\/li>\n<\/ul>\n<ul>\n<li>Though we can\u2019t access the online portal, we did notice a couple of problems on the \u201cwelcome\u201d page.\n<ul>\n<li>Partially-completed reports cannot be saved.\u00a0 If the practitioner doesn\u2019t have everything they need at hand before starting, they can\u2019t save and continue the form later.<\/li>\n<li>On the other hand, the portal website will wait two hours before timing out. \u00a0While this might be helpful for practitioners trying to organize paperwork, it could leave\u00a0 personal information available on an unattended computer.<\/li>\n<\/ul>\n<\/li>\n<li>You might think we\u2019re nit picking here, but this is exactly the kind of backsliding that\u2019s so worrisome. \u00a0Baby steps add up to bigger steps, and the next thing you know, they\u2019re drugging people\u2019s coffee and holding them down for the lethal injection.<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we discuss the first prosecution of a doctor in the Netherlands related to euthanasia.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-first-euthanasia-prosecution-in-the-netherlands\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: First euthanasia prosecution in the Netherlands&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-first-euthanasia-prosecution-in-the-netherlands\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: First euthanasia prosecution in the Netherlands&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[121,127,188,418,53,118],"class_list":["post-3864","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-euthanasia-disability","tag-health-canada","tag-monitoring","tag-netherlands","tag-quebec-en","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3864","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=3864"}],"version-history":[{"count":6,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3864\/revisions"}],"predecessor-version":[{"id":3977,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3864\/revisions\/3977"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=3864"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=3864"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=3864"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}