California state assembly passes right-to-die bill

September 12, 2015 • 11:45 am

One of the signs of increasing secularism, and of advancing morality as well, is the recognition that people who are terminally ill and wish to end their lives to avoid a horrible “natural” death should be allowed to do so.  Three U.S. states—Oregon, Washington, and Vermont—already have such laws, and the California assembly just passed a similar bill, the “End of Life Option Act “. (The bill squeaked through the Senate, the other part of the legislature, a few months ago.) Most of the opposition to these bills comes from religion, especially Catholics and, in the UK and Canada, Anglicans.

The California Act stipulates that physicians can prescribe a life-ending dose of drugs (presumably barbiturates) after patients go through a three-part procedure: presenting two oral requests (15 days apart) to an attending physician, as well as one written request, which has to be signed in front of witnesses who declare the patient compos mentis. The act has been called the Brittany Maynard Bill, after the young woman who died of cancer in November of last year at age 29. As the Los Angeles Times reports:

. . . the proposal gained momentum after Californian Brittany Maynard, 29, moved to Oregon last year so she could end her life with drugs to avoid the debilitating effects of brain cancer. Her case was covered nationwide, and in a videotaped appeal before her death Maynard urged California lawmakers to pass the assisted-death legislation.

“I am heartbroken that I had to leave behind my home, my community and my friends in California, but I am dying and refuse to lose my dignity,” Maynard says in the video. “I refuse to subject myself and my family to purposeless prolonged pain and suffering at the hands of an incurable disease.”

The bill has been strenuously opposed by the Catholic Church, of course, who see end-of-life suffering as a good because, like the odious Mother Teresa, they think it’s what God wants. “Euthanasia,” as the Vatican calls it, is considered a grave sin by the Church—for both the patient and the doctors who assist the dying. How anybody can presume to pass such judgment on another person’s rational decision is beyond me. This is one of the ways that the tenets of religion violate standards of common decency.

The California Senate, which narrowly passed the bill, must revisit it, but I suspect it will go through, and then move to to governor Jerry Brown’s desk. Brown has, I believe, refused to say whether he’ll sign the bill, which is reprehensible. If he vetoes it, there won’t be enough votes to override his veto. If he vetoes this bill I will have lost every iota of respect I ever had for the man.

Brittany Maynard

And this just in from reader David, who called my attention to a tw**t emitted by Ricky Gervais three days ago. Can anyone imagine a more screwed-up attitude than that evinced on the poster?

Screen Shot 2015-09-12 at 12.26.39 PM

Here’s an anecdote about Mother Teresa—told by the Mother herself at the U.S. National Prayer Breakfast:

One day I met a lady who was dying of cancer in a most terrible condition. And I told her, I say, “You know, this terrible pain is only the kiss of Jesus–a sign that you have come so close to Jesus on the cross that he can kiss you.” And she joined her hands together and said, “Mother Teresa, please tell Jesus to stop kissing me.”

Did she not see the irony?

More Catholic insanity: organ donation = euthanasia

August 3, 2015 • 11:14 am

Reader Pliny the in Between sent me a link to this article, which I thought worth mentioning because of its unusual stance—a stance that, I realized, comes directly from Catholic Church’s uniform opposition to assisted dying. The upshot of the article, which comes from the “Pro-Life Healthcare Alliance“, is that we should not donate organs after we are declared brain-dead.

As you can see from the list of committee members at the bottom (and from my further investigations), the members are largely, if not wholly, Catholic.  This makes me fairly certain that the “no organ donation” slant comes from the religious view that such donations, which of course cause the “death” of the rest of the body when the brain is already dead, are a prohibited form of euthanasia.  Reader Pliny added this note with the link:

In your copious spare time, this article is worth skimming as an example of lying for Jesus.  The author’s horror stories reveal a deep lack of knowledge regarding the legal definitions of brain death.  None of the pseudo-patients she describes would have satisfied brain death criteria.  I’m thinking about writing something up about this topic.

I’ll have a say here as well. The article in question is called “Organ donation refusal, Q&A” by Julie Grimstad, the Executive Director of “Life Is Worth Living, Inc.”, a Catholic pro-life organization which opposes not only abortion, but assisted dying, which they call “euthanasia.” Her piece makes the following four points. I emphasize, though, that I am not a doctor, and though I’ve done my best to educate myself and pass that along, I may have made some errors. Readers are invited to correct any that they find.

1. There are dangers in donating an organ, like a kidney, to help a relative or a stranger.  Here’s how they scare you out of that:

Single kidney donation is the most frequent “living donor” procedure. Other organs that may be taken are one of the two lobes of the liver, a lung or part of a lung, part of the pancreas, or part of the intestines. The donor faces the risk of an unnecessary major surgical procedure and recovery. Sometimes there are adverse psychological outcomes or other consequences such as reduced function, disability, or problems getting medical insurance coverage at the same level and rate as previously. A small percentage of “living donors” die as a result of donation. All of these risks must be weighed along with the benefit the donated organ may be (no guarantee here either) to the organ recipient.

Note that the altruistic aspect of this procedure is not mentioned at all—only the risks to the donor (which are usually minimal).

2. “Brain death,” the usual criterion for determining death, and how death is declared, doesn’t mean that the patient is really “dead.” This depends on redefining death as the cessation of all physiological functions, even if the patient stands no chance of recovering, much less regaining consciousness. Their take:

Are organ donors certainly dead before their organs are removed?

The simple answer is “no.” Before organ transplantation was possible, physicians cautiously determined death, based on irreversible cessation of both cardiac and respiratory functions, in order not to treat the living as dead. Today, “brain death” is declared while a patient still has a beating heart and is breathing (albeit with the aid of a ventilator) because removal of vital organs must be done before they begin to deteriorate due to loss of blood circulation. Vital organs are useless if physicians wait to remove them until they are certain the patient is dead.

Tissues (such as bone, skin, tendons, cartilage, connective tissue, corneas, and heart valves) do not require continuous circulation of blood to remain useful for purposes of transplantation. Therefore, tissues may be taken up to several hours after death is certain.

I discussed these issues with my own doctor, Alex Lickerman, who told me several things about brain death. What that means is death of the brainstem, usually caused by head trauma. When the brainstem is destroyed, the underlying process has also usually destroyed the brain tissue above it, usually due to massive head trauma or vascular occlusion.

A defunct brainstem destroys the nerves that keep the heart beating and the lungs breathing (there is occasionally some endogenous heart rhythm caused by the heart’s own pacemaker). In such cases, patients are kept alive with a ventilator. (The definition of brain death varies among U.S. states.)

Because of the near-impossibility of someone recovering whose brainstem is dead, but also the ability of doctors to keep circulation and respiration going with ventilators and other means, the organs can still remain viable, and so can be used for donation. Waiting until all the organs die, which could take weeks, will make them useless for donation. (Donated organs include corneas, hearts, livers, pancreases, kidneys, and lungs.) Donors are typically young people with healthy organs who have suffered brainstem death due to head trauma (motorcycle accidents are a typical cause).

Doctors have several ways to test for brainstem death. Here are some common ones. (For these and others, see the Massachusetts General Hospital Guide to declaring brainstem death, or the American Academy of Neurology’s (AAN) guidelines, both of which show how seriously doctors take this issue.)

a. Lack of oculocephalic reflex. With the patient’s eyes held open, the head is turned rapidly to the side. If the brainstem is functional, the eyes will not turn with the head, but remain looking forward. The failure to see this, so that the eyes turn with the head, is a good indication of brainstem death, and doesn’t depend on consciousness.  Also, pupils will not respond to a bright light shined in the eye if the brainstem is dead.

b. Touch a Q-tip to the cornea.  The patient will not blink if the brainstem is dead. This is a reflex, not a conscious act.

c. Apnea testing. Turn off the ventilator. If the patient stops breathing without mechanical aid, the brainstem is dead.

d. EEG shows no electrical activity in the brain as a whole. 

There are other criteria as well. Although there may be very rare cases of patients recovering if they fail these tests, Alex doesn’t know of any, and I deeply suspect the two cases cited in the article.

It is NOT the case, despite what the article implies, that doctors are eager to declare patients dead so their organs can be harvested. ER doctors have no incentive to rush the patient to transplant surgeons. Rather, their mission is to help the patient and to deal with the family and with the patient’s or medical guardian’s wishes—should those be recorded.

Notice that the article redefines “death” not as “brainstem death” but as “organ death.” This means, of course, that no organs can be harvested under this definition:

The vast majority of organs for transplant are taken from patients who have been declared dead. A declaration of death does not always mean that the patient is certainly dead. Morally, organs and tissues may be taken from Patient A only after death is certain. (This “dead donor rule” is one of the basic ethical principles guiding organ donation.)

The article also misleadingly cites a report from a Committee at Harvard Medical School:

The insurmountable moral and legal problem is that stripping living patients of their organs is murder.

Yes, and doctors agree with that in general, but with the caveat that “living patients” are those with living brainstems. One exception is the existence of “persistent vegetative states,” in which there are signs of “arousal,” like the eyes being open but no sign of consciousness. Doctors can remove organs in such a state, but ONLY if the patient or the patient’s medical guardian has declared in advance that the patient does not want to be kept alive in such a condition.

4. Finally, the article claims that some patients declared dead have apparently recovered. Two cases are cited.

The first is that of Zack Dunlap, a 21 year old man who suffered brain trauma when his off-road bike rolled over. In this case, the patient was declared dead not using the criteria above, but via a PET scan, which measures metabolic activity in the brain via glucose uptake. As Steve Novella wrote on the Neurologica Blog, this is not a normal nor accurately calibrated way of determining brainstem death, and there is no case in which a PET scan has been independently tested to show that its results correlate highly with brainstem death. Novella argues that the declaration of brain death here could have also been subject to errors:

To summarize – in this case the clinical determination of brain death was made too early to be definitive. The only confirmatory test that was mentioned, the PET scan, is subject to technical errors that could have erroneously resulted in the absence of any signal. In this type of case (especially considering the age of the person) my personal recommendation would have been to either wait a couple of days after the edema mostly resolved, or to do more definitive confirmatory tests, like an angiogram for cerebral blood flow. I suspect that the patient was not thoroughly examined because the doctors were relying upon the PET scan, which was very likely in error. (Relying upon a false test always causes problems.)

The second case was that of 17-year-old Steven Thorpe, a British boy who suffered head injuries in a car accident. He was declared brain dead by four doctors, but another detected faint brain activity, and he eventually recovered. I can’t find much information about how brain death was determined, except that the doctors relied on CT scans, which aren’t designated by either the Massachusetts General or AAN’s guidelines as ways to determine brain death. We must remember, however, that those checklists may not be 100% infallible, though Alex Lickerman was unaware of anyone declared brain dead by conventional procedures having recovered. Very rare exceptions might occur.

The upshot of the article is given at its end:

Should I refuse to be an organ donor?

Yes, for the reasons stated above and because the Uniform Anatomical Gift Act (UAGA), as revised in 2006 and since adopted by most states, allows for patients who have never consented to be organ donors to be considered “prospective” donors unless they explicitly refuse. This means, if you have not explicitly refused to be an organ donor, you may be subjected to potentially harmful measures done solely to preserve your organs for transplant or to determine if you are “brain dead.” These things can be done without your family’s knowledge or permission. Your family may be left “in the dark” until asked for your organs.

The PHA suggests you carry an Organ Donor Refusal card at all times.

This, however, misrepresents the UAGA, at least if Wikipedia is correct, which describes who must make the decision to donate a patient’s organs:

UAGA governs organ donations for the purpose of transplantation, and it also governs the making of anatomical gifts of one’s cadaver to be dissected in the study of medicine. The law prescribes the forms by which such gifts can be made. It also provides that in the absence of such a document, a surviving spouse, or if there is no spouse, a list of specific relatives in order of preference, can make the gift. It also seeks to limit the liability of health care providers who act on good faith representations that a deceased patient meant to make an anatomical gift. The act also prohibits trafficking and trafficking in human organs for profit from donations for transplant or therapy.

In other words, the patient’s wishes (in a living will or on a driver’s license), or the expression of a medical guardian who has discussed the patient’s wishes (and those wishes are met in a given case), can lead to organ donation.

What should you do?

The article by Julie Grimstad is a pastiche of misrepresentations, all motivated by the religious notion that donating organs is a form of assisted suicide.  It neglects the fact that living donors save lives, often with minimal risk to themselves, and especially that families may feel that a patient who cannot recover can help save other people’s lives by donating organs—something that has been very comforting to many families.

If you wish to participate in organ donation, it’s important to have a “living will” that specifies what measures should be taken to preserve your life if you’re brainstem dead or in a persistent vegetative state, and to specify in both that document and on your driver’s license that you want to donate organs in such a condition. You should also have discussed your wishes with a medical guardian (you can specify this in your will), who can act on your behalf when you no longer can. I have done all this, and would be happy to donate my organs to save other people’s lives.

The only people who don’t are those religionists who see organ donation as a form of murder, which is unconscionable given the numerous safeguards used by doctors to determine who can be a donor. And, of course, there are those who think that if you donate organs, you’ll show up in Heaven minus a kidney or lungs.


To finish, here’s the “about” statement of the Pro-Life Healthcare Alliance and and list of their committee members. Pro-Life Healthcare alliance:

The Pro-life Healthcare Alliance was formed in the summer of 2012 as a non-denominational, faith-based program of Human Life Alliance.

All of our efforts are directed toward renewing reverence for life within healthcare.

The Pro-life Healthcare Alliance (PHA) actively shares faith-inspired principles that guide the care, support, and protection of the life and dignity of all human beings, including those who are preborn. The PHA provides reliable pro-life information about medical decision making and the challenges facing pro-life healthcare providers and patients. Our speakers are willing to go anywhere they are invited.

We are in the process of establishing a support network of healthcare providers and organizations who subscribe to the pro-life healthcare philosophy. We seek to work together to pool our resources and courageously oppose imposed death, help vulnerable patients and their families, and renew reverence for life within healthcare and society.

PHA is led by a committee of pro-life leaders from all spheres of the pro-life movement. We invite you to join us in a mutually-supportive mission that honors the Creator of all life and renews the culture of life in healthcare.

Working Committee Members

Ralph Capone, MD, Internist, Hospice Medical Director, palliative care consultant and co-founder of the Saint Gianna Sodality for the Sanctity of Human Life, Our Lady of Grace Parish, Greensburg, PA, USA

Rey Flores, Director of Outreach, American Life League

Julie Grimstad, Exec. Dir., Life is Worth Living, Inc.

Mary Kellett, Exec. Dir., Prenatal Partners for Life

Brian J. Kopp, DPM, Podiatrist in Johnstown PA, and Faith Community Laison for Catholic Hospice of Greensburg, PA

Cristen Krebs, DNP, Dir., Catholic Hospice of Pittsburgh

Ann Olson, Education Dir., Human Life Alliance

Alex Schadenberg, Exec. Dir., Euthanasia Prevention Coalition

Jo Tolck, Exec. Dir., Human Life Alliance

NPR sort-of disses euthanasia

May 21, 2015 • 9:30 am

The National Public Radio (NPR) “Health” site has a sad article about a young mother in California terminally ill with scleroderma, and near the end of her life.  It’s going to be a pretty grim death as her lungs first give out, and then her heart.  But the mother, Stephanie Packer, is religious, and has decided against assisted dying because only God has the right to end someone’s life. As the article notes,

 She and husband Brian, 36, are devout Catholics. They agree with their church that doctors should never hasten death.

“We’re a faith-based family,” he says. “God put us here on earth and only God can take us away. And he has a master plan for us, and if suffering is part of that plan, which it seems to be, then so be it.”

That is her choice, though if you’re an unbeliever you’re relieved of the burden of “letting God decide,” and can die when you so choose. But Packer goes further, criticizing a new California bill that allows terminal patients to receive “end of life” medications.

They also believe if California legislation called SB 128 passes, it would create the potential for abuse. Pressure to end one’s life, they fear, could become a dangerous norm, especially in a world defined by high-cost medical care.

Instead of fatal medication, Stephanie says she hopes other terminally ill people consider existing palliative medicine and hospice care.

“Death can be beautiful and peaceful,” she says. “It’s a natural process that should be allowed to happen on its own.” Even, she says, when it poses uncomfortable challenges.

Sadly, as any doctor knows, death isn’t always “beautiful and peaceful” (ALS is one example) and a fair number of people would prefer to take a fatal dose of morphine (often given anyway by concerned doctors) or barbiturates rather than suffer needlessly.  Of course Packer has the right to give her opinion about the bill, but trying to prevent its passage is a way of forcing one’s religious beliefs on those who don’t share them. Not all of us believe in God, and even some believers don’t feel that they have to wait for God to take them.  Further, the “slippery-slope” argument simply hasn’t panned out in states and countries that allow assisted dying.

It’s interesting to compare this story with NPR’s treatment of Brittany Maynard, a 29-year-old woman with incurable brain cancer who moved from California to Oregon so she could end her life when she wanted. (She passed away on November 1 of last year.) After Brittany explained her reasons in the article, NPR decided to give the arguments against assisted dying:

But this is a complicated topic. As The Washington Post reports, just as [Maynard] had support for her decision, there were others who tried to persuade her to live:

“Ira Byock, chief medical officer of the Institute for Human Caring of Providence Health and Services, spoke loudly against the practice.

“‘When doctor-induced death becomes an accepted response to the suffering of dying people, logical extensions grease the slippery slope,’ he wrote in a New York Times op-ed. He cited statistics in Holland, where the practice is permitted, that claim more than 40 people sought and received doctor-assisted death for depression and other mental disorders. ‘Even the psychiatrist who began this practice in the 90′s recently declared the situation had gone “off the rails.”

“‘Moral outrage is appropriate and needed to fix the sorry state of dying in America. Legalizing assisted suicide fixes nothing. The principle that doctors must not kill patients stands.'”

Note that both sides are presented in the article about Brittany Maynard, but only one side, against assisted-dying, in the piece on Stephanie Packer (and the paragraphs right above are basically the end of the piece).

Is this more coddling of faith by NPR? I don’t know, but the journalistic treatment of the two cases is hardly comparable.

h/t: Cindy

The Missing Links: On assisted dying, a great atheist book reprinted, and some justice in the case of First Nation children murdered by faith

February 24, 2015 • 10:25 am

I basically got nothing today: it’s one of those days when I come to work with a few lame ideas that I can’t work up enthusiasm to write about. Fortunately, Ceiling Cat usually saves me by the intervention of kindly readers, who send me items that are more interesting. I have three today, which I’ll combine in a single post.


First, my physician Alex Lickerman (see my posts about him here), a secular Buddhist who has a Psychology Today website called “Happiness in this World,” has published a moving piece about assisted dying. The topic of death has been much on his mind since his father recently passed away (see the poignant pieces about it here and here), and he decided to give the issue a wider airing in Slate, in an article called “Achieving a good death.” It tells the story of Michael, a man struck down by ALS, and how Alex helped him with his final exit. An except:

Which is why I told Michael that though I couldn’t prevent him from dying, I could give him the power to choose how and when his death would occur. (Though physician-assisted suicide remains illegal in most states, withdrawal of care is permitted in terminal cases if death will occur as a result of the underlying disease process and not as a result of direct physician intervention.) And in the thanks he expressed—painstakingly, over 20 minutes on his cardboard tablet—about being given back that control, I found the reason my interactions with dying patients have been among the most gratifying of my career. For when a patient’s death becomes impossible to prevent, I’ve never believed that there’s nothing I can do. On the contrary, I find I’m needed to offer what are arguably the three most important things a doctor can: a willingness to discuss the subject of mortality, guidance regarding end-of-life care, and a promise to do everything I can to limit suffering and preserve patient autonomy.

You can read the piece to find out how a good physician helps limit suffering and preserve autonomy at death.


You may remember the several posts I put up about the First Nations girls afflicted with leukemia who were refused protection by the Canadian government when their parents decided to give them “alternative medicine” rather than chemotherapy. Cowed by the thought of violating ethnic traditions, the government allowed both girls, in lieu of chemotherapy (which is highly effective for their disease) to be treated at the Hippocrates Health Institute in Florida, a quack operation where cancer patients are given special vegetarian diets and “cold laser treatment.” None of the Hippocrates treatments are of any value in curing leukemia. And those kind of treatments are hardly a “tradition”: for any First Nations tribes!

Well, one girl, Makayla Sault, has already died, and the other, “J. J.”, is in the process of dying. The Canadian government’s refusal to act to protect these children was and remains reprehensible. But there’s at least one piece of good news, although it’s not great news. Reader Diana MacPherson informs me, through a link on the CBC News, that Brian Clement, director of the Hippocrates Health Institute, has been ordered by the state of Florida to stop representing himself as a doctor and to cease practicing medicine without a license. This action is apparently a result of news about his treatment of Makayla and J. J.:

In documents obtained by CBC News, Florida’s Department of Health say they have probable cause to believe the director of the Hippocrates Health Institute treated two children battling leukemia “with unproven and possibly dangerous therapies.”

. . . Makayla died last month, after suffering a relapse of leukemia. Her death is currently being investigated by Ontario’s coroner’s office.

J.J.  is another 11-year-old girl with leukemia who left chemotherapy to attend the Hippocrates institute last August. Her identity can’t be revealed because of a publication ban.

Her mother told CBC News that she was convinced her daughter should abandon chemotherapy after speaking with Clement.

“By him saying, ‘Oh yes, no problem we can help her,’ that’s the day I stopped the chemo.”

Clement denies having said this to the girl’s mother.

Clement is also being sued by former employees who were fired for criticizing his pretense of giving medical treatment, and he may face felony charges for practicing medicine without a license. The CBC also notes that his “degrees” are either lame or bogus:

Clement claims to have a doctorate of naturopathic medicine and a PhD in nutrition from the University of Science Arts and Technology (USAT), based in Montserrat.

However, USAT president Orien Tulp said, “Brian Clement, he is not anaturopathic doctor from USAT. I can guarantee that. He shouldn’t be making false claims for one. If he is, I’ll withdraw his degree.”

George Gollin, a professor at the University of Illinois who has investigated USAT, calls it a diploma mill.

“It’s horrible,” Gollin says. “I could have printed him a degree on a laser printer and it would be … just as indicative of training and skills. What I think is terrible is that he’s using this, as I understand it, to treat patients who are desperately sick children.”

Clement’s treatment is what the Canadian government considered valid alternative treatment to chemotherapy. Will they rethink their policy of non-intevention now that this quack has killed two children? I doubt it.

(From the CBC)L Brian and Anna Maria Clement are co-directors of the Hippocrates Health Institute in Florida. (Hippocrates Health Institute)


Finally, a quick note about a good book. Philosopher Walter Kaufmann wrote two excellent critiques of religion:  Critique of Religion and Philosophy and The Faith of a Heretic. I’ve read and liked both and give quotations from then in The Albatross. The former is more academic and philosophical, the latter more personal and readable; but both are superb. Reader Christopher now informs me that The Faith of a Heretic, long out of print, will be available on Kindle on June 8. (Twelve of the thirteen reader reviews give it the full five stars.) You can order it here. It’s a Professor Ceiling Cat Book Club Recommendation, though I don’t have the reach of Oprah.

Canada’s Supreme Court rules in favor of assisted suicide

February 6, 2015 • 12:12 pm

Amid a morass of bad news, there’s also some excellent news today. According to many Canadian sources, including the Globe and Mail and the CBC, the Supreme Court of Canada ruled unanimously this morning that terminally ill adults cannot be prosecuted for having a doctor help them end their lives. Assisted suicide had previously been a criminal violation. The ruling won’t take effect for a year, but that’s only to allow the provinces to develop regulations about the procedure. Quebec already has such a law, which was in some limbo as it violated Canada’s criminal code, but now it looks kosher.

Doctors do not have to comply with these requests, either, but I suspect that many compassionate ones will. How could they not—unless they were religious? The terminally ill people.

According to the CBC, the court ruled on a suit initiated by two women who were terminally ill, but the ruling came too late for both:

The case was brought by the B.C. Civil Liberties Association on behalf of two women, Kay Carter and Gloria Taylor, both of whom have died since the legal battle began. Both women had degenerative diseases and wanted the right to have a doctor help them die.

A lawyer on behalf of Carter and Taylor argued that they were being discriminated against because their physical disabilities didn’t allow them to kill themselves the way able-bodied people could.

Carter went to Switzerland with her daughter, Lee, to die. Taylor died of amyotrophic lateral sclerosis (ALS) in 2012.

There are those who object to this ruling, of course. I suspect the Anglican and Catholic churches will raise a fuss—after all, it was the Anglican Church’s refusal to give any credence to priest Eric MacDonald’s wish to help his M.S.-afflicted wife die with dignity that eventually made Eric (who used to comment here), leave the Church. And according to the Globe and Mail, an organization of Canadians with disabilities have also objected:

Critics of the ruling said it puts disabled people at risk. In a joint statement, the Council of Canadians with Disabilities and the Canadian Association for Community Living said they are “profoundly disappointed” with the ruling.

“As we each near the end of our lives, at the time when we are likely to be most vulnerable to despair and fear, we have now lost the protection of the Criminal Code,”the groups said. “Where shall we now find that protection? CCD and CACL caution that our collective response to this question must go far beyond the technical exercise of so-called ‘safeguards.’ ”

The protection, of course, will come with stringently written laws that require psychological evaluation, a terminal illness, and absolutely verified consent of the patient. It’s not as if anybody is going to pass laws allowing people to be killed willy-nilly! As far as I’m aware, places that allow assisted suicide have not had any cases of abuse, or even questions about abuse. One thing that I’ve learned from reading about assisted dying is that people who are given prescriptions that will end their lives painlessly—barbiturates—feel a great sense of relief that they have some control about how and when they die. And some don’t even use the prescriptions.

This ruling is very good news—another move upwards on the moral arc—and I hope that the U.S. courts will take notice of this, for assisted suicide is legal in only a few places in the U.S. Wikipedia lists them:

OR, WA, VT have legalized assisted suicide through the legislature or popular referendum; assisted suicide is de facto legal in Bernalillo County, NM and MT through court decisions; New Jersey’s House has passed legislation legalizing assisted suicide; bills in CT and CA are under review in the state legislatures.


That is not a lot of territory.

You can find the Canadian Supreme Court’s full decision here; I present just a few excerpts of how they nullified existing law:

Section 241 (b) of the Criminal Code  says that everyone who aids or abets a person in committing suicide commits an indictable offence, and s. 14  says that no person may consent to death being inflicted on them. Together, these provisions prohibit the provision of assistance in dying in Canada.

The trial judge found that the prohibition against physician‑assisted dying violates the s. 7 rights of competent adults who are suffering intolerably as a result of a grievous and irremediable medical condition and concluded that this infringement is not justified under s. 1  of the Charter . She declared the prohibition unconstitutional, granted a one‑year suspension of invalidity and provided T with a constitutional exemption.

. . . The appeal is allowed.  We would issue the following declaration, which is suspended for 12 months:

Section 241 (b) and s. 14  of the Criminal Code  unjustifiably infringe s. 7  of theCharter  and are of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

h/t: Norm

The American Medical Association’s misguided position on euthanasia

December 3, 2014 • 1:02 pm

From their website:

Screen Shot 2014-12-03 at 1.45.46 PM

This is simply wrong, and something that could have been written by the Catholic church (except there’s no talk of “souls” or “empathy with Jesus’s suffering”). For a patient who is terminal, and suffering horribly, the role of the physician as “healer” is no longer attainable. And of course many physicians, as I’ve been told by doctors, actually perform euthanasia by giving overdoses of pain medication to terminal patients, perfectly aware that it will cause their deaths. Why is this not euthanasia? After all, AMA policy also says this:

Screen Shot 2014-12-03 at 2.06.38 PM

Isn’t “withdrawing life-sustaining medical treatment” really equivalent to “helping people die”? It surely is. Here we have a medical version of the trolley problem, where people feel it’s okay to take a passive role that will kill someone (to save more people) but not an active one. You can turn off the feeding tube, but not give an overdose of morphine (which doctors already do anyway) or barbiturates. But the borders are less clear for assisted suicide than for the runaway trolley .

Finally, the canard that euthanasia is “difficult or impossible to control,” poses “serious societal risks,” and “could be readily extended to incompetent or vulnerable patients and other vulnerable populations” can and has been taken care of in those places where assisted dying is legal, as in Switzerland, Holland, and the few states in the U.S. that allow it.

It’s time for the AMA to catch up to the rest of society. When a doctor can no longer heal, and the patients want his or her torment to end, there is nothing wrong with a doctor helping. In fact, with their medical knowledge, doctors are the best people to do so.

Of course I do agree with the AMA’s stand to not assist with legal executions in the judicial system, because I’m opposed to capital punishment. But there’s a world of difference between assisted suicide and involuntary execution of criminals.


The Vatican calls Brittany Maynard’s decision to end her life “reprehensible”

November 5, 2014 • 8:29 am

Gad, the Catholic Church is dreadful: the most immoral and perfidious religion on Earth besides Islam. It just can’t stop sticking its nose into people’s private lives, and visiting oppression on gays, women, and the many children who have been the victim of the church’s sexual predators. My only consolation is that some day the Church will dwindle to a useless remnant like the human appendix. And it makes me happy that the Vatican knows this, and is desperate to stop its slide into irrelevance.

Yet the off-putting nonsense that spews from the Vatican continues to amaze me. The latest is their pronouncement on—or rather condemnation of—the assisted dying of Brittany Maynard.

Two days ago I wrote about the heartbreaking but courageous decision of Maynard, a 29-year-old American with terminal brain cancer, to end her life by taking barbiturates. She did this to forestall the inevitable but gruesome death that comes from glioblastoma. She was bright, eloquent, and had everything to live for had not an errant tumor invaded her brain. In the end, she had as good a death as one might expect from her illness. Brittany was a role model for everyone in an end-of-life situation

Except, of course, for the Catholic Church.

As The Independent reports, the Vatican is carping about Maynard’s decision. The church, after all, regards suicide, whatever the situation, as sinful, equivalent to murder. Here’s an excerpt from its Declaration on Euthanasia:

Intentionally causing one’s own death, or suicide, is therefore equally as wrong as murder; such an action on the part of a person is to be considered as a rejection of God’s sovereignty and loving plan.

And a 1995 statement by John Paul II declared that those who assist in “euthanasia” can also be guilty of murder. In other words, Maynard and her doctor will go to hell (even though she, at least, wasn’t a Catholic):

I confirm that euthanasia is a grave violation of the law of God, since it is the deliberate and morally unacceptable killing of a human person. This doctrine is based upon the natural law and upon the written word of God, is transmitted by the Church’s Tradition and taught by the ordinary and universal Magisterium. . . Depending on the circumstances, this practice involves the malice proper to suicide or murder.

The Declaration on Euthanasia explains the twisted logic behind the conviction that God wants you to suffer right up to the end:

. . . According to Christian teaching, however, suffering, especially suffering during the last moments of life, has a special place in God’s saving plan; it is in fact a sharing in Christ’s passion and a union with the redeeming sacrifice which He offered in obedience to the Father’s will.

What hogwash: a doctrine, based on a fairy tale, that has caused innumerable people to suffer needlessly. Mother Teresa was the instantiation of this “suffering-is-holy” paradigm.

So, of course, here’s the Church’s reaction to Maynard’s sensible decision (from the Independent). The stupidity is embodied in the quote I’ve bolded:

The Vatican has condemned cancer patient Brittany Maynard’s decision to end her life, describing assisted suicide as an “absurdity”.

. . . the Vatican’s bioethics chief told the ANSA news agency that “dignity is something other than putting an end to one’s own life” and branded assisted suicide “reprehensible”.

Monsignor Ignacio Carrasco de Paula, head of the Pontifical Academy for Life, said: “This woman (took her own life) thinking she would die with dignity, but this is the error.

“Suicide is not a good thing, it is a bad thing because it is saying no to life and to everything it means with respect to our mission in the world and towards those around us.”

Father Carrasco de Paula cautioned that he was not judging individuals “but the gesture in and of itself should be condemned”.

In the case of Brittany Maynard, it was indeed saying “no” not to life, but life with intractable suffering—an existence no longer worth living.  And what, exactly, would have been her “mission” in the last few weeks of intractable pain? To re-enact the sufferings of Jesus? That, in fact, is the Vatican’s ridiculous answer.

There aren’t yet many readers’ comments, but most of them are supportive, like this one:

Screen Shot 2014-11-05 at 7.43.36 AM

But of course we also have the benighted, who can’t take the trouble to find out the facts without adding their two cents’ worth:

Screen Shot 2014-11-05 at 7.43.26 AM

h/t: Grania