Alex Schadenberg

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Branka van der Linden on the "HOPE" website.

HOPE’s Director, Branka van der Linden, is at it again, foisting more misleading information about voluntary assisted dying (VAD) on unwilling members of Parliament. I expose the rot and provide some background on Mrs van der Linden.

Van der Linden’s latest email to all WA MPs states:

Subject: WA Report relies on troubling Belgian study

 
[MP Salutation] --

Did you know that a study showing that one person in Belgium is euthanised every three days without their explicit consent also found that:

  • in more than 77 per cent of cases, the decision was not discussed with the patient;
  • in more than half of cases, the patient had never expressed a desire for their life to be ended; and
  • in more than half of the cases, the reason given was because killing the patient was the wish of the family?

 
Did you know that the WA majority report cited this study as evidence of assisted suicide and euthanasia reducing the incidence of unlawful activity?

Warm regards,

Branka van der Linden
Director, HOPE

 
Van der Linden’s method is to create an impression of calumny against VAD law reform. She uses a nice PR formula of three bullet points per communication. With repetition. It’s a method I expressly warned the WA Parliament to watch out for in my submission to its inquiry. The growing list of emails is now starting to look like ‘harassment’.

So let’s look at van der Linden’s claims — again. She’s talking about non-voluntary euthanasia (NVE) — again.

In her email to MPs, she complains that the WA majority report on end-of-life choices cited the study as evidence of the NVE rate reducing when VAD is legalised.

Well, the WA majority report formed that correct conclusion because that’s precisely what the cited study reported: drops in the NVE rates in both the Netherlands and Belgium after their euthanasia Acts came into effect in 2002.

While concerns ought to be expressed about the deliberate hastening of death without an explicit request from the patient with a view to improving knowledge and practices, it’s not caused by VAD laws as van der Linden desperately tries to imply.

Here are highly relevant things the cited study’s authors had to say, but van der Linden astonishingly ignores:

“The use of life-ending drugs without explicit patient request are not confined to countries where physician-assisted death is legal.”; and

“[NVE’s] occurrence has not risen since the legalisation of euthanasia in Belgium. On the contrary, the rate dropped from 3.2% in 1998 to 1.8% in 2007. In the Netherlands, the rate dropped slightly after legalization, from 0.7% to 0.4%” [The Belgian rate was 1.7% in a more recent replication of the research.]; and

The NVE cases found in the study “in reality resembles more intensified pain alleviation with a ‘double effect’, and death in many cases was not hastened.”

But let’s not let the facts get in the way of a good story. Van der Linden’s recent emails about VAD to MPs reveal astonishing ignorance and a willingness to overlook critical evidence contrary to her position, contained in the very source she cites.

The superficiality of her cherry-picking is kind of embarrassing: she holds an arts/law degree from Australian National University, so you’d expect more intelligent engagement.

It begs the question: who is Branka van der Linden? The “HOPE” website reveals little if anything.
 

Who is Branka van der Linden?

Branka Van der Linden is the current Director of anti-VAD website “HOPE (Preventing euthanasia and assisted suicide)”. HOPE is an initiative of the Australian Family Association, a Catholic lobby group established by Australia’s most famous lay Catholic, B. A. Santamaria.

HOPE’s founding Director and van der Linden’s predecessor, was Mr Paul Russell, the former Senior Officer for Family and Life at the Catholic Archdiocese of Adelaide.

It turns out that Branka van der Linden (née Seselja) is a sister of Catholic ACT Senator Zed Seselja who voted against David Leyonhjelm's recent Restoring Territory Rights (to legislate on VAD) Bill. But there’s more. Far more.

Branka, who attended Catholic St Clair’s College primary school and Padua Catholic High School, both in the ACT, is a “senior lawyer” at the Truth Justice and Healing Council, which provides services to the Australian Catholic Bishop’s Conference and Catholic Religious Australia in relation to the Catholic Church’s response to the Royal Commission into Institutional Responses to Child Sexual Abuse.

She’s advisory legal counsel for the lay Catholic St Vincent de Paul Society Canberra/Goulburn Territory Council. (And good on her for supporting this philanthropic work.)

She and her husband Shawn represent (or at least represented) the Australian Catholic Marriage and Family Council, and were representatives of the Catholic Archdiocese of Canberra & Goulburn on the National Family Pilgrimage to the (Catholic) World Meeting of Families in Philadelphia in 2015.

Husband Shawn has been described by the church as a “loyal Catholic servant” for nine years of service as the director of CatholicLIFE at the Catholic Archdiocese of Canberra and Goulburn.

And as if this weren’t clear enough, a sample of Branka’s Facebook Likes is equally informative:

A sample of Branka van der Linden’s Facebook Likes

  • Archbishop Anthony Fisher (Catholic)
  • Archbishop Samuel J. Aquila (Catholic)
  • Archbishop Mark Coleridge (Catholic)
  • Bishop Robert Barron (Catholic)
  • Marist College Canberra Faith Formation (Catholic)
  • St Thomas the Apostle Kambah (Catholic)
  • Campion College (Catholic)
  • Teaching Catholic Kids
  • Ascension (Catholic Church)
  • CathFamily
  • St Therese of Lixieux (Catholic)
  • Dominican Sisters of Saint Cecilia in Australia (Catholic)
  • Fusion Youth Group (Catholic)
  • St Clare’s College (Catholic)
  • Marist Canberra Football Club (Catholic)
  • Light To The Nations (Catholic)
  • Catholic Voices USA
  • Centre for Faith Enrichment (Catholic)
  • World Meeting of Families 2015 (Catholic)
  • Quidenham Carmelite Monastery (Catholic)
  • Denver Catholic
  • Catholic Mission – Canberra & Goulburn
  • XT3 (Catholic youth association)
  • Missionaries of God’s Love Darwin (Catholic)
  • Marist College Canberra (Catholic)
  • Life, Marriage & Family Office (Catholic)
  • Infant Jesus Parish, Morley (Catholic)
  • MGL Priests and Brothers (Catholic)
  • Catholic Mission – Sydney, Broken Bay, Parramatta
  • Youth Mission Team Australia (Catholic)
  • Summer School of Evangelisation – Bathurst (Catholic)
  • Missionaries of God’s Live Sisters (Catholic)
  • Sisterhood National Catholic Women’s Movement
  • My Family My Faith (Catholic)
  • Catholic Talk
  • The Catholic Weekly
  • The Catholic Leader
  • Mercatornet (Catholic blog site)
  • BioEdge (Catholic blog site)

It’s clear that Branka van der Linden, like her predecessor Paul Russell, is very deeply invested in Catholic tradition. I will be the first to say I firmly believe that is entirely her right.

Yet how curious it is that while repeatedly advancing (secular) misinformation about VAD, Branka van der Linden doesn’t mention her profound religious convictions. It's surprisingly similar to the approach evidenced by Catholic Professor of Ethics, Margaret Somerville; and Catholic (then) Victorian MP Daniel Mulino; and Catholic Editor of The Australian, Paul Kelly (who warmly quotes Mulino); and Catholic director of the Euthanasia Prevention Coalition, Alex Schadenberg...

You get the idea: perhaps there's a pattern?

One possible source of pattern

What was it that the Catholic Archbishop of Sydney, Anthony Fisher, said at the 2011 Catholic Bioethics Conference in relation to opposing the legalisation of VAD?

"The most effective messengers may also vary: bishops, for instance, are not always the best public spokespeople for the Church on such matters."; and

"...the man or woman in the street ... may well be open to persuasion that permissive laws and practices cannot be effectively narrowed to such circumstances"; and

"We need to research and propose new messages also and carefully consider who should deliver them, where and how."

Nowhere in his address does Fisher propose actually testing whether his calamitous assumptions about VAD are true.

Gosh, another coincidence.

Epilogue

I want to be absolutely clear that I am not using a person’s religious conviction as a reason to dismiss their ideas. That’s called an ad hominem attack: an attack against the person rather than the substance of the argument (even assuming it has any substance to assess).

What I have done here and elsewhere, and I will continue to do, is to expose arguments that are false, misleading, illogical or otherwise unmeritorious on the basis of empirical evidence and reasoning.

It just turns out that organised misinformation against VAD law reform comes from deeply religious circles, and those religious circles often avoid mentioning their religiosity while spreading such nonsense under a ‘veneer of secularism’.

It’s in the public’s interest to understand where most organised misinformation against VAD comes from.


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Victorian MP Daniel Mulino's minority report contains multiple serious errors and misinformation.

Last year, the Victorian Parliament's Legal and Social Issues Committee concluded an extensive investigation into end of life choices, publishing a report of over 400 pages recommending improvements to palliative care and for assisted dying. Catholic-backed Shop, Distributive and Allied Employees' Association (‘shoppies’ union) Labor member of the Victorian Parliament Mr Daniel Mulino furnished his own minority report, opposing the majority recommendation for assisted dying law reform. That’s entirely his right. However, his report contains multiple, serious cases of misinformation. He must withdraw his report.

Daniel Mulino, Labor parliamentary member for the Victorian Region of Eastern Victoria,1 and a member of the Catholic-backed ‘shoppies’ union,2 was a member of the Legal and Social Issues Committee that thoroughly investigated end of life decision making and produced a 400+ page report in 2016 making recommendations for law reform and regulation.

Mr Mulino furnished a “minority report” as an addendum to the main report in order to oppose the Committee’s recommendation that assisted dying be legalised.3

Promoted by Catholics to Catholics

Mr Paul Russell, South Australian publisher of the Catholic anti-euthanasia website ‘HOPE,’§ says this of Mr Mulino’s minority report in the Catholic lawyer association’s blog:4

Daniel Mulino MLC's analysis should be read first, before the Majority Report. It forms not only a sound academic and rigorous approach but also, by implication, is damning of the narrow, outcome focus of the Majority Report.”

How sweet of Mr Russell to so generously plug Mr Mulino’s report. But, in gushing about the ‘sound academic and rigorous approach’ he claims to be in it, shows that he doesn't understand what constitutes proper and sound evidence, and that he's easily impressed by charts and lots of ‘literature’ citations.

Numerous fundamental faults

The reality is very different.

Rather than bore you with a mind-numbing blow-by-blow dissertation on the numerous fundamental faults in Mr Mulino’s report, I’ll demonstrate how the report cherry-picks, misquotes and misunderstands its way through the evidence, via four revealing examples.

Example 1. Cherry-picking ‘helpful’ data

Mr Mulino’s minority report illustrates the rise in number of assisted deaths in the Netherlands and Belgium, and produces some statistics (Figures 1 & 2 are directly from his minority report).

mulinocharts1and2.gifFigures 1 and 2 (of Mr Mulino’s minority report): Assisted deaths in Belgium and the Netherlands

Note that Belgian data is for the years 2003–15, but the Netherlands only for the years 2008–15. That’s odd, because the euthanasia Acts for both countries came into effect in 2002, and so 2003 was the first full year for both.

Mr Mulino doesn’t point out that his report treats the two countries differentially, and provides no explanation as to why. We might notice, however, that the dicrepancy has the consequence of making his claims look 'better.'

Using Mr Mulino’s presentation style, Figure 3 illustrates all the relevant data for the Netherlands.

netherlandsfullfig2.gifFigure 3: The full Netherlands data
Source: Official Euthanasia Commission reports

As you can see, there is a virtual flatline between 2003 and 2007. Indeed, there is even a tiny drop in numbers between 2005–06. This is an inconvenient truth to Mr Mulino’s thesis that there has been a consistent massive rise in numbers. It also substantially reduces the compound annual growth rate he wrongly quotes for just 2008–15.

He’s also cherry-picked only raw data. In fact, the only valid way to compare year to year, and jurisdiction to jurisdiction, is to use the rate for each year: that is, the number of assisted deaths as a proportion of total deaths in the same year and jurisdiction, so that you’re comparing apples with apples. It's necessary because the total deaths count goes down and (mostly) up a bit each year. The official government statistics for total deaths by year for both countries are readily available online, so there’s no excuse for not using them.

When you calculate the rates, you get validly-comparable results, as I illustrate in Figure 4.

dutchbelgianratesto2015.gifFigure 4: Rate of assisted dying as a percent off all deaths in the Netherlands and Belgium 2003–2015
Sources: Official government statistics; Euthanasia Commission reports

As I explain in my detailed research whitepaper on Benelux assisted dying,5 these are sigmoid (stretched-S) shaped curves which are typical of human behaviour change. And there is a drop in the rate in both countries in 2015, which Mr Mulino doesn’t report.

My Benelux whitepaper also reports the data from Luxembourg (Figure 5), which Mr Mulino fails to mention, even though it has legislation, since 2009, almost identical to the Netherlands and Belgium, and the Luxembourg government's data is freely available online.

dutchbelgianluxratesto2015.gifFigure 5: Rate of assisted dying in the three lawful Benelux countries
Sources: Official government statistics; Euthanasia Commission reports

Luxembourg’s data (yellow in Figure 5; no data available yet for 2015), is also an inconvenient truth to the case Mr Mulino attempts to prosecute. There’s no substantial rise.

Example 2. Comparing apples with oranges: mis-matching data

Mr Mulino again fails to compare apples with apples. Take, for example, his vocal claim that the annual total death counts for the Netherlands decreased at the same time as the total counts for assisted dying increased.

When you look at the data he’s used (the citation for the negative total deaths trend he quotes in his Table 2), you find that he’s used total death data for 2000­–10, which is falling, while his assisted dying data is for 2008­–15, which is rising.

This just isn’t on: it’s completely invalid to compare data like this from one period with data from another period to claim or imply a causal relationship. Of what possible relevance is the total death data for 2000–02, while his total deaths data for 2011–15 is missing? I illustrate the full story in Figure 6.

 

mulinomismatcheddata.gifFigure 6: Netherlands total and assisted deaths for different periods
Sources: Official government statistics; Euthanasia Commission reports

The solid blue and orange lines are data Mr Mulino used and reported, and their dotted ends are data that he omitted. It’s easy to see that the total deaths data his report inappropriately relies upon has a negative (downwards) slope (left-hand blue dashes), while the matching total deaths data he should have used has a positive (upwards) slope (right-hand blue dashes). Valid comparison gives lie to his claim.

Example 3. White is the new black: Misquoting the opposite

Mr Mulino’s report also argues that there’s ample evidence that a significant proportion of people with depression are gaining access to assisted dying:

“Ganzini et al, in a broad ranging review of instances of assisted dying in Oregon, found that twenty percent of the patients had symptoms of depression.” [Italics mine]

This assertion is nonchalantly plucked from the review6 without reading it properly, seemingly to support his thesis. In fact, the source does the exact opposite. Figure 7 is an image of the Abstract, where it says in large print, right up front:

Twenty percent of the patients had symptoms of depression; none of these patients received a prescription for a lethal medication.” [Emphasis is mine]

ganziniabstract2000.gifFigure 7: The paper Abstract articulates exactly the opposite of Mr Mulino’s claim
Source: Ganzini et al 20006

Had Mr Mulino bothered to read either the abstract or the methodology of this study properly, he would have realised that the doctor sample was of those eligible to prescribe under Oregon’s Death With Dignity Act, not just those who had, and that none of the study's patients who were assessed with possible depression had accessed an assisted death.

It's not like the information was hard to find — his report cites literally half a sentence to support his claim, when the full sentence says the opposite.

Example 4. Any port in a storm: Cherry-picking, misunderstanding and misrepresenting out-of-date data

In attempting to establish a 'slippery slope' from voluntary, to non-voluntary euthanasia (NVE) — a practice where doctors may hasten death (e.g. by administering increasing doses of opioids) when the patient hasn’t explicitly requested it — Mr Mulino states in his minority report:

“Two countries with the highest rates of this type of end-of-life (Belgium at 1.5% and the Netherlands at 0.60%) allowed the practice of euthanasia and assisted dying.”

Oh dear, Mr Mulino's report cherry-picks again. Just look at his source.7 The study, published in 2003, contains Table 2, with the relevant data in it (Figure 8).

vanderheide2003table2.gifFigure 8: Table 2 from the 2003 study Mr Mulino cites
Source: van der Heide et al 20037

There are no fewer than five major offences Mr Mulino commits here.

Firstly, look at the table. I’ve highlighted the line in yellow from which Mr Mulino draws his figures of 1.5% for Belgium and 0.60% for the Netherlands. You can immediately and easily see that Denmark’s rate of 0.67% is higher than the Netherlands' of 0.60%.

So, Mr Mulino’s statement mentioning only Belgium and the Netherlands with “highest NVE rates” is misleading. He failed to either report or explain why Denmark’s rate is higher than the Netherlands, while Denmark doesn’t have an assisted dying law; the opposite of his thesis.

Secondly, he also fails to mention Switzerland’s NVE rate of 0.42%, or to explain that it’s lower than the Netherlands and Belgium. That’s highly relevant, because Switzerland has the world’s oldest assisted dying law — in effect since 1942 — and its statute contains none of the safeguards in the Belgian and Dutch Acts. This too is at odds with Mr Mulino’s thesis.

Thirdly, if Mr Mulino had read the study properly instead of just cherry-picking convenient figures from it, he would have noticed in the methodology section that the fieldwork (doctors filling in questionnaires) was completed in 2001 and early 2002, that is, before either the Netherlands or Belgian Acts came into effect later in 2002 (the Netherlands in April and Belgium in September).

Thus, the Dutch and Belgian data points Mr Mulino advances as ‘evidence’ of an NVE ‘slippery slope’ from legislated assisted dying have nothing whatever to do with assisted deaths under their Euthanasia Acts, because neither Act existed at the time the study was conducted.

Fourthly, he is resorting here to a single point-in-time study, which has little to no scientific power to establish ‘causation’. To really establish causation, as a minimum you have to assess longitudinal data, which I show in Figure 9. It demonstrates the precise opposite of Mr Mulino's ‘slippery slope’ thesis that voluntary euthanasia causes NVE, which if true would lead to a significant increase in the NVE rate in both countries after statutory legalisation.

dutchbelgianuknverates.gifFigure 9: Longitudinal NVE rates in the Netherlands, Belgium and the UK
Sources: Netherlands8; Belgium9; UK10

Both the Dutch and Belgian NVE rates have dropped with high statistical significance since their euthanasia Acts came into effect. Indeed, the NVE rate in the Netherlands is now similar to the rate in the UK, which is acknowledged as the world’s gold standard in palliative care and which has never had an assisted dying law. This is consistent with assisted dying law reform shining a bright light on all end of life practices.

It’s not like he simply didn’t know

Fifthly, it’s particularly disappointing that Mr Mulino’s report only cherry-picked outdated data in an attempt to ‘prove’ his case when I had already directly furnished the current relevant evidence to his Committee as a properly-researched formal submission: Figure 9 above is Figure 19 in my submission, and I provided the peer-reviewed research citations for the data.11

Not only that, but the official transcript of my appearance as an expert witness before the parliamentary Committee confirms that Mr Mulino specifically quizzed me on that Figure 19 and I pointed out the sources of its data:12

Mr MULINO — Figure 19, for example.

Mr FRANCIS — The reference should be in the text. The last sentence on the previous page gives you the citations for that data.

Mr MULINO — Okay.”

Even further, when fellow-Committee-member and Catholic assisted dying opponent Mrs Inga Peulich asked about the same thing (with Mr Mulino present) — “1,000 of those who have been accidentally euthanased in the Netherlands” — I literally put the chart up on the projection screen and explained it in full to the Committee until they had no more questions. The “1000” figure is the approximate rate prior to the Dutch Euthanasia Act, while the rate has dropped significantly since.

The evidence is irrefutable: it’s not like Mr Mulino was merely blissfully unaware of the relevant data contradicting his NVE ‘slippery slope’ claim. His minority report expressly overlooks this robust evidence and instead refers inapproriately to selective and outdated data that seemed to, but didn’t, support his argument.

Five major offences in a single citation: surely Mr Mulino’s report — far from ‘academic and rigorous’ — sets a new record?

A common religious thread?

The NVE ‘slippery slope’ claim is also popular amongst and spread by the Catholic Archdioceses of Melbourne,13 Sydney14 and Brisbane,15 as well as by other Catholic anti-assisted dying lobbyists such as Alex Schadenberg,16 Paul Russell,17 and Professor of Ethics at the Catholic University of Notre Dame Australia, Margaret Somerville.18

Indeed, Mr Mulino’s minority report appears amongst 11 Catholic responses against assisted dying law reform published by the Catholic Archdiocese of Melbourne (Figure 10).

cam-mulino-report.jpgFigure 10: Daniel Mulino’s minority report appears amongst Catholic responses on the Catholic Archdiocese of Melbourne’s website19

Indeed, Mr Mulino’s linked document doesn’t seem to emanate from his parliamentary office or from wider parliamentary services: the PDF file's metadata reveals that it was authored, electronically at least, by “mmacdonald”.

Calls to both Mr Mulino's electorate office and to the Parliament of Victoria confirm there is no "M Macdonald" at either. I did, however, find online one Matthew Macdonald, researcher and Executive Officer of the Catholic Archdiocese of Melbourne’s (CAM) Office for Life, Marriage and Family — in other words, the same organisation that published the list in Figure 10 containing the link to Mr Mulino’s minority report.

Mr Macdonald is also listed as the CAM's official contact person in its submission (#705) opposing assisted dying to the Victorian Parliament's inquiry into end of life choices.20 Both the CAM and Mulino reports also refer to a journal paper by Catholic doctor José Pereira,21 and neither report mentions the subsequent evidential rebuttal outlining why Pereira's claims were merely "smoke and mirrors".22 Even more curiously, the Pereira paper is included in Mr Merlino's minority report bibliography, though his report doesn't actually cite it as the CAM submission does.

The CAM parliamentary submission was authorised and signed by Episcopal Vicars Anthony Ireland and Anthony Kerin, who also appeared as witnesses before the parliamentary Committee, during which they told, as I've explained, a whopping great falsehood about Oregon.23

Conclusion

Contrary to Paul Russell’s enthusiastic claim that Daniel Mulino’s minority report provides a ‘rigorous’ case against assisted dying law reform, the report merely serves as further evidence of how those implacably opposed to assisted dying can cherry-pick, misunderstand and rather desperately clutch their way through their ‘evidence.’

Mr Russell is not an academic expert and one can understand his limited capacity to judge whether work is ‘scholarly.’ However, Mr Mulino holds a PhD in economics from Yale,* so it’s quite astonishing that he published a ‘researched’ report containing multiple major flaws, including outdated and cherry-picked data contrary to more recent, direct and relevant evidence of which he was specifically aware, actively inquired into and had explained and cited to him in full.

These anomolies beg the question: did Matthew McDonald or someone else at the Catholic Archdiocese of Melbourne write Mr Mulino’s report for him? Mr Mulino needs to explain himself, since regardless of who authoried it, he signed it off in his own name and is therefore ultimately responsible for it.

Given the multiple fundamental errors, the honourable course for Mr Mulino to pursue is to withdraw his minority report.

The question is: will he rise to the occasion?

 

Addendum: A missed opportunity for primary research

Mr Mulino — as well as Mrs Peulich who also wrote a minority report against assisted dying — declined to join other members of the parliamentary Committee on an official overseas fact-finding tour to jurisdictions where assisted dying is lawful. This was a critical opportunity for Committee members to directly quiz proponents, opponents, researchers, regulators, legislators and others with direct experience. It would have given them invaluable opportunities to directly examine and test  assumptions, hypotheses and performance. How curious then that these two non-participataing Committee members each furnished a minority report opposing the majority recommendation to legalise assisted dying in Victoria.

 

---------------

§    The HOPE website is an initiative of the Australian Family Association (AFA), a faith-based organisation founded by Australia’s most famous Catholic, B. A. Santamaria. Mr Russell is a former Vice President of the AFA, and a former Senior Officer for Family and Life at the Catholic Archdiocese of Adelaide.

*    While Mr Mulino holds a PhD and would be entitled to be addressed as “Dr”, his Parliamentary title is “Mr”.

References

  1. Parliament of Victoria 2017, Daniel Mulino, viewed 20 Mar 2017, https://www.parliament.vic.gov.au/members/details/1764-daniel-mulino.
  2. Tomazin, F 2016, Explainer: The push towards a dying-with-dignity policy in Victoria, Fairfax Media, viewed 3 Dec 2016, https://www.theage.com.au/national/victoria/explainer-the-push-towards-a-dyingwithdignity-policy-in-victoria-20161203-gt3bso.html.
  3. Legal and Social Issues Committee 2016, Inquiry into end of life choices. Final report, Parliament of Victoria, Melbourne, pp. 444.
  4. Russell, P 2016, End-of-life choices report: A sugar coated poison pill for Victoria, Melbourne Catholic Lawyers Association, viewed 14 Jun 2016, https://www.catholiclawyers.com.au/latest-news/853-end-of-life-choices-report-a-sugar-coated-poison-pill-for-victoria.
  5. Francis, N 2016, Assisted dying practice in Benelux: Whitepaper 1, DyingForChoice.com, viewed 13 Nov 2016, /resources/fact-files/assisted-dying-benelux-whitepaper-1.
  6. Ganzini, L, Nelson, HD, Schmidt, TA, Kraemer, DF, Delorit, MA & Lee, MA 2000, 'Physicians' experiences with the Oregon Death with Dignity Act', New England Journal of Medicine, 342(8), pp. 557-563.
  7. van der Heide, A, Deliens, L, Faisst, K, Nilstun, T, Norup, M, Paci, E, van der Wal, G & van der Maas, PJ 2003, 'End-of-life decision-making in six European countries: descriptive study', The Lancet, 362(9381), pp. 345-350.
  8. Onwuteaka-Philipsen, BD, Brinkman-Stoppelenburg, A, Penning, C, de Jong-Krul, GJF, van Delden, JJM & van der Heide, A 2012, 'Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey', The Lancet, 380(9845), pp. 908-915.
  9. Bilsen, J, Cohen, J, Chambaere, K, Pousset, G, Onwuteaka-Philipsen, BD, Mortier, F & Deliens, L 2009, 'Medical end-of-life practices under the euthanasia law in Belgium', New England Journal of Medicine, 361(11), pp. 1119-1121.
  10. Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliat Med, 23(3), pp. 198-204.
  11. Francis, N 2015, Submission to the Parliament of Victoria Standing Committee on Legal and Social Issues on the Inquiry into End of Life Choices, DyingForChoice.com, Melbourne, pp. 51.
  12. Parliament of Victoria 2015, Standing Committee on Legal and Social Issues inquiry into end-of-life choices: Witness-Mr Neil Francis, DyingForChoice.com, Melbourne, pp. 10.
  13. The Catholic Leader 2010, No to euthanasia – Yes to genuine care, Catholic Archdiocese of Brisbane, viewed 15 Dec 2010, https://catholicleader.com.au/features/no-to-euthanasia-yes-to-genuine-care_70380/.
  14. Catholic Archdiocese of Sydney 2017, Experts warn against following overseas experience with euthanasia, viewed 12 Mar 2017, https://www.catholicweekly.com.au/2017/2017120_1449.shtml.
  15. Catholic Archdiocese of Brisbane 2010, No to euthanasia - yes to genuine care, The Catholic Leader, viewed 25 Feb 2012, https://catholicleader.com.au/features/no-to-euthanasia-yes-to-genuine-care_70380/.
  16. Schadenberg, A 2013, Exposing vulnerable people to euthanasia and assisted suicide, Ross Lattner, London ON.
  17. Russell, P 2015, Submission 926: Submission to the Victorian Legal and Social Issues Committee inquiry into end of life choices, HOPE, Melbourne, pp. 56.
  18. Francis, N 2017, Margaret Somerville misleading claim - 'Non-voluntary euthanasia slippery slope', DyingForChoice.com, viewed 19 Apr 2017, /resources/videos/margaret-somerville-misleading-claim-non-voluntary-euthanasia-slippery-slope.
  19. Catholic Archdiocese of Melbourne 2017, Why now in Victoria?, viewed 3 Aug 2017, https://www.cam1.org.au/euthanasia/Be-Informed/Why-now-in-Victoria.
  20. Catholic Archdiocese of Melbourne 2015, Submission to the Legal & Social Issues Committee: Inquiry into end of life choices, Submission 705, Melbourne, pp. 16.
  21. Pereira, J 2011, 'Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls', Current Oncology, vol. 18, no. 2, pp. e38-48.
  22. Downie, J, Chambaere, K & Bernheim, JL 2012, 'Pereira's attack on legalizing euthanasia or assisted suicide: smoke and mirrors', Current Oncology, vol. 19, no. 3, Jun, pp. 133-8.
  23. Francis, N 2015, Catholic Church misinforms Parliamentary inquiry, DyingForChoice.com, viewed 25 Nov 2015, http://www.dyingforchoice.com/blogs/catholic-church-misinforms-parliamentary-inquiry.

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Alex Schadenberg's latest shrill and misleading article

Catholic Canadian anti-assisted-dying blogger Alex Schadenberg is at it again. This time he’s parading his ignorance and spreading bull about a potential change in Oregon’s assisted dying legislation.

The Bill

Mr Schadenberg correctly reproduced Section 3 of Oregon Senate Bill 893, which states:

SECTION 3. An expressly identified agent may collect medications dispensed under ORS 127.815 (1)(L)(B)(ii) and administer the medications to the patient in the manner prescribed by the attending physician if:

(1) The patient lawfully executed an advance directive in the manner provided by ORS127.505 to 127.660;

(2) The patient’s advance directive designates the expressly identified agent as the person who is authorized to perform the actions described in this section;

(3) The patient’s advance directive includes an instruction that, if the patient ceases to be capable after medication has been prescribed pursuant to ORS 127.800 to 127.897, the expressly identified agent is authorized to collect and to administer to the patient the prescribed medication;

(4) The medication was prescribed pursuant to ORS 127.800 to 127.897; and

(5) The patient ceases to be capable.

Mr Schadenberg fails to mention Section 2, which states:

SECTION 2. Section 3 of this 2017 Act is added to and made a part of ORS 127.800 to 127.897.

What is the ORS range?

And what precisely isORS 127.800 to 127.897’ (ORS = Oregon Revised Statutes)? Why, it’s the entirety of Oregon’s existing Death With Dignity Act!

In other words, a patient still has to be terminally ill, fully informed, made a formal request, the request assessed as genuine and free, waited the required cooling off period, made another formal request, been assessed as qualifying all the requirements by multiple doctors, has legally appointed an agent expressly for the purpose of administering lethal medication pursuant to the Death With Dignity Act, have their medication prescribed (immediately before which the attending physician must again verify that the patient is making an informed decision) and then the patient ceases to be capable, before the agent may then administer.

Mr Schadenberg exposes that at best he fundamentally doesn’t understand the Bill, nor took much if any effort to do so.

That’s hardly the free-for-all Mr Schadenberg posits in his shrill blog implying that ‘assisted suicide and euthanasia’ was being extended to ‘incompetent people’ without further qualification; falsely insinuating that any incompetent person could then obtain assistance for suicide or euthanasia.

No ‘defence’

If Mr Schadenberg were to claim that he really meant ‘only within the scope of the current Death With Dignity Act,’ and that he’s been taken out of context, that simply won’t wash. Bill 893 makes a provision only for someone else to administer the lethal dose (that is, what Mr Schadenberg refers to as ‘euthanasia’) if the patient ceases to be capable after already qualifying under the existing Act. The Bill does not permit patient self-administration: that is, using Mr Schadenberg’s own language, ‘assisted suicide’—which he expressly refers to in his article.

Parading a non-existent extension of ‘assisted suicide’ clearly exposes that at best he fundamentally doesn’t understand the Bill, nor took much if any effort to do so.

Wrong again…

He also got it completely wrong as to who may administer when the patient ceases to be capable:

“The bill enables the doctor to administer…” — Alex Schadenberg

However, if you read Section 3 of the Bill (above) that Mr Schadenberg himself reproduces, you’ll see clearly that the patient must expressly identify a particular person ('agent') to administer lethal medication should the patient cease to be capable. The patient may appoint his or her doctor, but can appoint in their Advance Care Directive anyone to be the agent; including a trusted and loved family member. The only particular requirement for the agent’s administration is that he or she must “administer in the manner prescribed by the attending physician.”

Conclusion

But let’s not the facts get in the way of a gratuitous reaction trumpeting shrill hyperbole and headline, shall we Mr Schadenberg?

And as usual, Catholic Australian anti-assisted-dying blogger Paul Russel has dutifully reproduced Mr Schadenberg’s farce.


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Back in 2013 the High Court of Ireland rejected a legal bid by multiple sclerosis sufferer Marie Fleming to achieve a lawfully-assisted peaceful death.

The Court naturally relied on expert testimony in reaching its judgement, yet its conclusions included a statement containing significant errors of fact.

The erroneous statement

In its judgement,1 the Court made the following statement:

Above all, the fact that the number of LAWER (“legally assisted deaths without explicit request”) cases remains strikingly high in jurisdictions which have liberalised their law on assisted suicide (Switzerland, Netherlands and Belgium) — ranging from 0.4% to over 1% of all deaths in these jurisdictions according to the latest figures — without any obvious official response speaks for itself as to the risks involved.” [My emphases in bold]

In fact, the Court's judgement is wrong on not one, not two, but three significant matters. But that hasn't stopped opponents of assisted dying law reform from quoting the judgement as though it were factual and persuasive, when it isn't: relying on it because it was made by a High Court—the 'authority bias.'

Consequences

Here are just a few examples of the Court's statement being wielded by assisted dying opponents as though it were conclusive evidence against law reform:

 
These examples illustrate the frequency of quoting the misinformation and how it feeds into and wrongly shapes public policy formation.

Three strikes

So what are the three counts on which the Court's judgement was seriously wrong?

Strike 1: Wrong concept

First, let’s get the concepts right. LAWER is not “legally assisted deaths without explicit request.”

Such nomenclature is an oxymoron. To ‘assist’ is to accommodate, serve or help someone accomplish something. But if there has been no request then one cannot be helping. You can’t ‘assist’ a little old lady across the road if she has expressed no interest in going there: you’d be forcing her across the road. Equally, you can’t ‘assist’ a death if there’s no proper ‘request.’

LAWER in fact stands for “Life-ending Acts Without Explicit Request” (of a competent patient).5 And with the exception of the possible ‘lawfulness’ of the doctrine of double effect, such acts are illegal.

Further, if such acts were legal as the Court’s statement posits, then there would be no need for an “obvious official response” as the Court then concludes. The statement lacks fundamental coherence.

Strike 2: Not ‘strikingly high’

The Court's judgement states unequivocally that LAWER (otherwise known as Non-Voluntary Euthanasia or NVE) rates in Switzerland, the Netherlands and Belgium are ‘strikingly high’, though no comparative yardstick is recorded in the judgement by which one might draw or justify that subjective judgement. Similar 'strikingly high' statements also appear in sections 102 and 104 of the judgement.

There is in fact a scientific study, published in The Lancet in 2003, that provides sound empirical evidence that could have properly informed the Court (Figure 1).6

Non-voluntary euthanasia in seven European countriesFigure 1: The non-voluntary euthanasia (NVE) rates of seven European countries in late 2001/early 2002

As revealed by this study, the NVE rates in Switzerland and the Netherlands were in fact lower than in Denmark, a country which has never had an assisted dying law.

The only country which did appear to have an NVE rate notably higher than the others was Belgium. The research study collected the data for analysis between June 2001 and February 2002. However, Belgium’s Euthanasia Act was not passed by its Parliament until 28th May 2002, well after data collection was complete. Thus, even in describing Belgium’s NVE rate as ‘strikingly high’ compared to a number of other European countries, it cannot be attributed to an assisted dying law because none existed at the time.

In fact, the NVE rate in Belgium had been found to be high back in 1998,7 well before the Bill for the country's Euthanasia Act was even tabled in Parliament.

Further, if assisted dying laws had such effects, it might be expected that the NVE rate would increase the longer that assisted dying laws were in place. In that case the NVE rates in Switzerland (statute since 1942) and the Netherlands (regulation since the early 1980s) would have NVE rates much higher than Belgium’s (statute since 2002). But the exact opposite is true.

Indeed, Rietjens and colleagues8 further concluded in their review of NVE in the Netherlands, Belgium, Denmark and Switzerland that “the use of drugs with the intention to hasten death without an explicit request of the patient is part of medical end-of-life practice in the studied countries, regardless of their legal framework, and it occurs in similar fashion.” The study, published in 2007, would also have been important evidence before the Court.

Strike 3: Not ‘remaining’ high

The Court's judgement states unequivocally that the LAWER (NVE) rate of the three countries ‘remains’ strikingly high. No specific evidence was supplied in the judgement to support this statement. Indeed, the judgement notes:

  • In section 28 that Dutch NVE had been “consistently declining.”
  • In section 91 that “the number of LAWER deaths has significantly declined in both [Dutch and Belgian] jurisdictions.”
  • In section 94 that “the trend in [Dutch] LAWER cases are declining in numbers (from 1,000 in 1990 to 550 in 2005)” and that in Belgium “the number of LAWER cases has declined since legalisation of assisted death.”
  • In section 101 that the NVE rates of both the Netherlands and Belgium had dropped.

 
Despite this clear and repeated evidence, the Court summarises in section 96 that the evidence cannot be “regarded as encouraging or satisfactory.”

But what does empirical research tell us about the NVE trends? In both the Netherlands and Belgium, since assisted dying was enshrined in statute and became effective in 2002, the rate of NVE has decreased significantly (Figure 2).7,9-11 In fact, the rate in the Netherlands is now similar to that in the UK, a country which has never had an assisted dying law and which provides the world’s gold standard in palliative care practice.

Non-voluntary euthanasia rates have decreased in the Netherlands and BelgiumFigure 2: Empirical trends in NVE rates before and after legalisation of assisted dying

These are critical yardsticks by which to judge practice in jurisdictions that have assisted dying laws with jurisdictions that don't. The UK study was published in 2009 and was readily available prior to the High Court’s hearings, yet appears not to have been presented in evidence.

The final (2010) Dutch NVE statistic in Figure 2 may or may not have been available to the Court: it was published in 2012 around the time the Court was taking evidence. The final (2013) Belgian statistic would not have been available to the Court as it was published in 2015.

Conclusion

While the High Court worked diligently within the scope of evidence brought before it:

  • The Court’s definition of LAWER is incorrect and incoherent;
  • Its statement that the NVE rates of the Netherlands and Switzerland are ‘strikingly high’ are evidentially wrong when compared with other countries without assisted dying laws;
  • Its implication that the higher NVE rate in Belgium was caused by assisted dying law reform is evidentially wrong; and
  • Its statement that the rates remain high is evidentially wrong.

 
The High Court's judgement does not provide defensible evidence or argument against assisted dying law reform.

Many lobbyists have repeated these incorrect statements, significantly misleading media, policy makers and legislators.

Now that the facts are readily available it’s appropriate to avoid repeating evidentially wrong statements, regardless of the apparent 'authority' of their source.
 

Summary of facts

  1. LAWER stands for "Life-ending Acts Without Explicit Request". Its practice is similar in countries with and without assisted dying laws.
  2. The NVE rates in the Netherlands and Switzerland are lower than the rate in Denmark, a country which has never had an assisted dying law.
  3. The NVE rate in Belgium appears higher, but was so long before assisted dying law reform and so cannot have been caused by such a law.
  4. The NVE rates of the Netherlands and Belgium have both decreased significantly since their assisted dying statutes came into effect in 2002.

References

  1. High Court of Ireland 2013, Fleming v Ireland & Ors - Determination, [2013] IEHC 2, Dublin.
  2. Boudreau, JD, Somerville, MA & Biller-Andorno, N 2013, 'Physician-assisted suicide: should not be permitted/should be permitted', New England Journal of Medicine, 368(15), pp. 1450-1452.
  3. Somerville, M 2016, 'Killing as kindness: The problem of dealing with suffering and death in a secular society', The Newman Rambler, 12(1), pp. 1-26.
  4. Keown, J 2014, 'A right to voluntary euthanasia? Confusion in Canada in Carter', Notre Dame Journal of Law, Ethics & Public Policy, 28(1), pp. 1-45.
  5. Pijnenborg, L, van der Maas, PJ, van Delden, JJM & Looman, CW 1993, 'Life-terminating acts without explicit request of patient', Lancet, 341(8854), pp. 1196-1199.
  6. van der Heide, A, Deliens, L, Faisst, K, Nilstun, T, Norup, M, Paci, E, van der Wal, G & van der Maas, PJ 2003, 'End-of-life decision-making in six European countries: descriptive study', The Lancet, 362(9381), pp. 345-350.
  7. Bilsen, J, Cohen, J, Chambaere, K, Pousset, G, Onwuteaka-Philipsen, BD, Mortier, F & Deliens, L 2009, 'Medical end-of-life practices under the euthanasia law in Belgium', New England Journal of Medicine, 361(11), pp. 1119-1121.
  8. Rietjens, JA, Bilsen, J, Fischer, S, Van Der Heide, A, Van Der Maas, PJ, Miccinessi, G, Norup, M, Onwuteaka-Philipsen, BD, Vrakking, AM & Van Der Wal, G 2007, 'Using drugs to end life without an explicit request of the patient', Death Studies, 31(3), Mar, pp. 205-21.
  9. Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliat Med, 23(3), pp. 198-204.
  10. Onwuteaka-Philipsen, BD, Brinkman-Stoppelenburg, A, Penning, C, de Jong-Krul, GJF, van Delden, JJM & van der Heide, A 2012, 'Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey', The Lancet, 380(9845), pp. 908-915.
  11. Chambaere, K, Vander Stichele, R, Mortier, F, Cohen, J & Deliens, L 2015, 'Recent trends in euthanasia and other end-of-life practices in Belgium', N Engl J Med, 372(12), pp. 1179-1181.
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Schadenberg and Russell falsely call the Oregon Medical Association the "assisted suicide lobby" in contradiction of the facts.

Last week, Alex Schadenberg wrote—and Paul Russell republished—another nonsense article, this time about medical associations going neutral on assisted dying. They opine that there is no such thing as neutrality. And start out by getting their facts wrong... again.

Got the facts wrong yet again, lads

Messers Schadenberg and Russell claim that the Oregon Medical association is an "assisted suicide lobby" group. Had they bothered to check the rudimentary facts before sounding off, they would have known that the Oregon Medical Association remains neutral toward assisted dying. It reconfirmed its neutral stance as recently as early this month. It does not hold a 'supportive' stance.

How did Schadenberg and Russell come to their conclusion?

American Medical Association AGM

They refer to a motion that the Oregon Medical Association put to the recent annual general meeting of the American Medical Association. The motion sought to establish a process by which the American Medical Association would consult in order to re-evaluate its opposed stance to assisted dying, given that assisted dying is legal in a number of USA States and there are already many doctors who in good conscience provide assistance to die to qualifying patients.

Heavy-handed partisanship

In their usual style of heavy-handed partisanship, Schadenberg and Russell describe the Oregon motion as the "assisted suicide lobby" applying "pressure" to the American Medical Association.

They fail to level the same criticism at another group, the Louisiana Medical Society who put another motion to the meeting. The Louisiana motion sought to expressly confirm and entrench the American Medical Association's currently opposed stance. Schadenberg and Russell fail to criticize the Louisiana motion as "pressure," despite the fact that Oregon's motion was for open consultation, while Louisiana's was for a closed position.

Good sense prevails

In fact, they don't mention the Louisiana motion at all. Why? Because wiser heads prevailed at the national conference. The Louisiana motion was defeated and the Oregon motion was passed as I reported last week.

Desperate hyperbole

Schadenberg and Russell then desperately argue that you can only support or oppose assisted dying. There is no neutral, they say.

In the language of 'influence' we call this rhetoric "the sucker's choice." You put up just two options and demand folks pick one or the other.

"You're either for us or agin us!"

No other options, no nuances, no consideration of different options for different folks. Hardly the kind of stuff that would pass even a junior high school debate.

Back to the real world

Of course it's possible to be neutral.

Individually, a doctor may be personally opposed to assisted dying, but appreciate that another doctor, having equally examined their conscience, may support choice. Thus, the first doctor opposes for themselves but remains neutral to the position of other doctors. Indeed, an individual doctor may neither support nor oppose choice.

Collectively, it makes sense for a professional medical body to hold a neutral stance. How can it justify respecting the deeply-held beliefs and values of some of its members at the same time as explicitly disrespecting other members' views that are as closely examined and deeply held?

Conclusion

The best that opponents running the global charge against assisted dying can do is to first get their facts wrong (again), develop their false assumptions into shrill hyperbole, and then try to press the false dichotomy of a "suckers choice" into doing some heavy lifting: an exercise that falls flat on its face.

The evidence is crystal clear: they provide no real argument at all.


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The Council of Europe chamber in session.

On the 25th January 2012, the Council of Europe passed declaration 1859 on advance care planning. Immediately, lobbyists opposed to assisted dying loudly proclaimed that the resolution banned euthanasia across Europe, when it did nothing of the sort. What actually happened?

Declaration 1859 on advance care planning

The Strasbourg-based Council of Europe passed declaration 1859 on 25th January 2012. The declaration was about advance care planning, which allows patients to inform others about what treatments they would or wouldn't want if they become unable to participate in treatment decision-making.

The declaration made the explicit point that it was about advance care planning and not about euthanasia or assisted suicide.  It made the point that non-voluntary euthanasia is unacceptable—that is, that others should not make death-hastening decisions about a person for their 'alleged benefit'. This is an important point on which both sides of the assisted dying debate can agree.

Council of Europe resolutions are informative to members, but are not binding.

Misstatements by opponents of assisted dying

Despite this simplicity and clarity, the very next day after the vote, a host of conservative religious organisations and commentators began trumpeting that "the Council of Europe banned euthanasia across Europe." It started with the Catholic Church (through its online service Zenit) and sprinted right around the world in a matter of days—even appearing eventually in a professional journal paper two and a half years later.

What really happened: the evidence

But no matter how often and how loudly lobbyists try to claim that the Council of Europe banned euthanasia across europe, it did nothing of the sort.

Read the forensic analysis of the misinformation trail in the F files, here.


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The Council of Europe chamber in session.

Here’s a clear example of mistaken information (misinformation) — more commonly known as ‘bull’ — published by conservative opponents of assisted dying law reform. In this case, lobbyists and commentators misreport by fudge: by cherry-picking and repositioning a declaration of the Council of Europe, asserting that it ‘banned euthanasia' throughout Europe.

It did nothing of the sort.  So what actually happened?

The Council of Europe

The Strasbourg-based Council of Europe (not to be confused with the Brussels-based European Union or its strategic advisory body the European Council or representative body Council of the European Union) commissions careful studies into various subjects of importance to its member states.

In 2011, the Council’s  Social, Health and Family Affairs Committee conducted a study called “Protecting human rights and dignity by taking into account previously expressed wishes of patients.” Its purpose was to make recommendations about advance care directives, and enduring powers of attorney—also known in some jurisdictions as guardianship.  These are preferences, documented in advance by a person, which help ensure his or her healthcare wishes are respected and honoured at times when the person can’t currently decide and speak for him or herself. The Committee’s report was handed down as Document 12804.

Wednesday January 25th 2012

On January 25th 2012, declaration 1859 regarding the Committee’s report came before the Parliamentary Assembly of the Council of Europe (PACE) for consideration and a vote.

After most delegates had left the very lengthy session, some remaining delegates moved an amendment to the declaration. While it was procedurally their right to do so, they made the attempt only when some five sixths (268 of 318) of their Council colleagues were absent.  

David Pollock of the European Humanist Federation describes the delegates pushing the amendment as:

“an unlikely alliance of the Catholic Church and evangelicals like Pat Robertson who is behind the European Centre for Law and Justice.”

As a result, a statement mentioning euthanasia was added to the original declaration and was passed by (a tiny) vote.

You can read the entire declaration here.  It’s less than two pages.

Now, what the declaration has to say about ‘euthanasia’ appears exclusively in Clause 5, and Clause 5 says in its entirety:

“5.   This resolution is not intended to deal with the issues of euthanasia or assisted suicide. Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited. This resolution thus limits itself to the question of advance directives, living wills and continuing powers of attorney.”

Notice that the clause contains exactly and only three short sentences.

  1. The first sentence is explicit and unambiguous: the declaration is not about euthanasia or assisted suicide.
  2. The second sentence makes it abundantly clear that hastened-dying decisions made by persons other than the patient themselves but alleged to be (i.e. by others) for a ‘dependent’ patient’s ‘benefit’ are unacceptable. Declaring against such non-voluntary euthanasia is a fundamental principle on which both sides of the assisted dying debate can agree. The resolution does not speak against voluntary euthanasia: that is, when a competent patient chooses assisted dying for themselves.
  3. The third sentence reiterates clearly that the declaration deals only with advance directives ('living wills') and continuing powers of attorney (persons granted the legal power to make decisions consistent with the advance directive). Note that the declaration wording does not even speak against assisted dying options within advance directives where permissible by law (e.g. as in the Netherlands), because these are made voluntarily by a competent patient on their own behalf and not by someone else for some 'alleged benefit’.

So, the declaration is not in conflict in any way with the laws of member states which already have assisted dying laws. Nor does it preclude other member states from introducing assisted dying laws.

Indeed, the declaration is not in conflict because the adoption of declarations by each member state is voluntary. It is incorrect to represent in any way that a Council of Europe declaration is a ‘determination,’ ‘ruling,’ ‘ban,’ ‘prohibition’ or other form of obligation upon its members.

But don’t just take my word for it.

Dr Stephen Latham, Director of the Interdisciplinary Centre for Bioethics at Yale University, states unequivocally in his blog on bioethics:

“… it’s a mistake to report it [the declaration] as a condemnation of assisted suicide, or to anticipate that it will have strong effect on pending cases involving assisted suicide.”

Dr Latham rightly points directly to the explicit declaration statement that it “is not intended to deal with the issues of euthanasia or assisted suicide." He further affirms that the European Court for Human Rights (a court of the Council of Europe) has held that Article 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms protects the individual’s choice to avoid a painful and undignified death.

So, despite the clarity of the declaration, how long did it take for opponents of assisted dying to publish mistaken information about it?

Thursday January 26th 2012

Within mere hours of the vote, cherry-picked bull began charging around the globe.

Bolting energetically out of the paddock was the Catholic online newspaper promoting Vatican opinion, Zenit. Proclaiming jubilantly, “Anti-euthanasia ruling hailed as major victory”, Zenit stumbled at the first hurdle of truthfulness —the declaration was not, in any sense, a ‘ruling,’ nor called for a blanket “prohibition of euthanasia” as its lead paragraph states.[1]

Off to a similarly agile start was Dr Grégor Puppinck, Director General of the conservative Christian lobby group the European Center of Law & Justice — who you will remember David Pollock described above as in an alliance with the Catholic Church and others.  Published on the Catholic Family-backed Turtle Bay and Beyond blog, this article was wrongly titled “Major victory for life in Europe: euthanasia must always be prohibited.”[2]

For good measure, Dr Puppinck’s opinion piece, complete with alternate headline “Victory: Council of Europe adopts resolution against euthanasia”, was published the same day on the USA Christian/Catholic pro-life website LifeNews.com.[3]

Similarly, Christian/Catholic pro-life website LifeSiteNews.com's John Westen published a piece the same day titled "Major victory for life in Europe: ‘Euthanasia must always be prohibited'".[4]

Also on the same day, the conservative European think tank European Dignity Watch’s headline likewise cherry-picked words from the declaration: “Council of Europe bans euthanasia”.[5]

Wasting no time, the Swedish Christian “Yes To Life” group trumpeted the mistruth “Council of Europe prevents euthanasia in Europe!”  (The Council of Europe would be very talented indeed if it could actually “prevent euthanasia across Europe".)[6]

Canadian Alex Schadenberg’s Euthanasia Prevention Coalition also repeated the same cherry-picked nonsense with the headline “Council of Europe states that: ‘Euthanasia must always be prohibited.’”[7]

Friday January 27th 2012

Well-known UK Catholic journalist Simon Caldwell was only a shade slower out of the blocks just one day later.  His article’s headline in UK’s Daily Mail rates a comprehensive fail for saying “Euthanasia ‘must always be prohibited’, rules Council of Europe.”[8]

Saturday 28th January 2012

Another day later and the UK Telegraph republished the story, misstating “Assisted suicide should be illegal through Europe, human rights body rules.”[9] (While this article had no by-line, its copy was remarkably identical to Simon Caldwell’s pieces in the Daily Mail [above] and UK Catholic Herald [below]. Caldwell is a known writer for the Telegraph.)

Monday 30th January 2012

Simon Caldwell followed up with the same article in the UK Catholic Herald, again with a false headline “Euthanasia should be banned across Europe, rules Council.”[10]

Also on 30th January, Catholic-founded Australian Family Association's Paul Russel uncritically republished Alex Schadenberg’s opinion piece on their anti-voluntary euthanasia campaign site “HOPE”.[11]

Tuesday 31st January 2012

Not to be outdone, the next day the Patients Rights Council (formerly the International Task Force on Euthanasia and Assisted Suicide), an anti-euthanasia lobby group consisting essentially of two people (Rita Marker and Wesley Smith), uncritically summarised Simon Caldwell’s Daily Mail opinion piece.[12]

Wednesday February 1st 2012

On February 1st the polemic was republished in CathNews in Australia, with false headline “Council of Europe says ban euthanasia.”[13]

The Catholic Archdiocese of Sydney republished on its youth engagement website xt3, with the headline “Euthanasia should be banned across Europe, rules Council.”[14]

Friday February 3rd 2012

By February 3rd, the Church of England Newspaper had jumped on the bandwagon, misstating “Council of Europe assemby [sic] calls for ban on euthanasia.”[15]

So did the Scottish Catholic Observer with an extra dose of hyperbole: “European human rights body rules that euthanasia and assisted suicide should be banned in every country on the continent.”[16]

The misinformation was repeated on the Irish Catholic web portal CiNews, the blog site of conservative USA Christian organisations the Population Research Institute and The Moral Liberal, the Catholic parish for Wymouth Our Lady Star of the Sea, in an opinion piece by Catholic British Peer David Alton, the Perth Catholic Archdiocese LJ Goody Bioethics Centre, the Australian blog site of Catholic News Jesus Caritas Est, … I think you get the idea.

No wonder Yale University’s Dr Latham mused dryly in his blog:

“… a number of different publications are mistakenly alleging that PACE has called for a permanent ban on assisted suicide.”

September 19th 2012

Later in the year I was kindly invited to speak at a Brisbane public forum on the legalisation of voluntary euthanasia hosted by the Queensland Council for Civil Liberties. Mr Yuri Koszarycz, then recently retired lecturer in bioethics, ethics and church history from Australian Catholic University, spoke for the opposing position. Given the audience were paying to listen to our respective pearls of wisdom, it was paramount that our material be properly researched and backed by good evidence.

Yet Mr Koszarycz dropped the “R” bomb (amongst others) in his presentation: yes, he asserted that the Council of Europe had ‘ruled’ against euthanasia, when it clearly had not.

July 17th 2014

Dr Grégor Puppinck (remember, he’s Director General of the European Center of Law & Justice) makes another appearance, this time as the lead author of a paper published in the International Journal of Human Rights[17]. In it, he rails against his perception that when reviewing cases of assisted suicide, the European Court of Human Rights ‘ignores’ Council of Europe declaration 1859. To support his argument, he quotes the single sentence “Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited” (p 746).

The paper’s discussion quite omits the two crucial, framing sentences, so a reader unfamiliar with the declaration’s original text would not know that it said it is “not intended to deal with the issues of  euthanasia or assisted suicide” and that it is about “living wills and continuing powers of attorney”. No wonder the European Court of Human Rights doesn’t believe that declaration 1859 is crucial when considering cases of assisted suicide: declaration 1859 is about advance care planning!

Indeed, a reader of the journal article could be forgiven for wrongly deducing, on the basis of the only sentence quoted by authors Puppinck and de la Hougue, that the Council had ‘banned euthanasia’.  It most certainly had not.

Conclusion

So let’s recap what happened. The primary facts are:

  1. The Council of Europe passed a declaration (#1859) about advance care planning—not about euthanasia or assisted suicide (it explicitly said it wasn't).
  2. The declaration spoke only against non-voluntary euthanasia (NVE)—not against voluntary euthanasia (VE) about which it contained no statement of any kind.
  3. Council declarations are in no way 'rulings', 'bans' or 'prohibitions' on its members because member adoption is entirely voluntary.

Yet despite the clarity of the declaration, quite a number of anti-euthanasia lobby groups and commentators, commencing the very next day and starting with the Catholic Church (through Zenit) and the European Centre for Law and Justice, published editorials mistakenly stating that the Council of Europe had ‘banned euthanasia': in other words, spreading bull.

A question that could be asked is this: how did it happen that so many anti-euthanasia individuals and groups published misstatements so closely together in both interpretation and in time?


[17]  Puppinck, G & de La Hougue, C 2014, 'The right to assisted suicide in the case law of the European Court of Human Rights', International Journal of Human Rights, vol. 18, no. 7-8, pp. 735-755.

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