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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.gif Figures 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.gif Figure 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.jpg Figure 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, http://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, http://www.theage.com.au/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, http://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, http://www.dyingforchoice.com/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, http://catholicleader.com.au/analysis/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, http://www.sydneycatholic.org/news/latest_news/2017/2017120_1449.shtml.
  15. Catholic Archdiocese of Brisbane 2010, No to euthanasia - yes to genuine care, The Catholic Leader, viewed 25 Feb 2012, http://catholicleader.com.au/analysis/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, http://www.dyingforchoice.com/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.cam.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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The terminally ill are not choosing between life and death, but between two ways of dying, according to their own beliefs and conscience. Photo: Andrew Drummond/AAP

In Monday’s Herald Sun, Victorian Archbishops Philip Freier and Denis Hart, and Bishops Ezekiel, Suriel, Lester Briebbenow, Bosco Puthur and Peter Stasiuk published a half-page advertisement admonishing the Victorian government for its initiative to legalise assisted dying for the terminally ill, an ad similar to the one published by religious figures in 2008.

I have no quarrel with individuals of faith regarding their own private beliefs. However, the bishops’ attempt at public “leadership” through the advertisement is deserving of redress for its multiple fallacies.

The ‘abandonment’ fallacy

The bishops claimed that assisted dying “represents the abandonment of those who are in greatest need of our care and support”. On the contrary: to ignore the deeply-held beliefs and rigorously-tested wishes of people at the end of life is to abandon their values and critical faculties in favour of the bishops’ own religious dogma.

The ‘competition’ fallacy

The bishops demand there should be more funding for healthcare rather than assisted dying, fallaciously pitting one option against the other. The Victorian government is indeed increasing funding for palliative care. It’s also aiming to provide lawful assisted dying for when even the best palliative care can’t help – which Palliative Care Australia has acknowledged – giving lie to the faux competition.

The evidential fallacy

Contrary to the bishops’ false presumption that legalised assisted dying will decrease trust in “the treatment and quality of care” from doctors, scientific studies into attitude change show that more people trust doctors when assisted dying is legal. Patients can then talk openly about options, even if they decide against assisted death. The bishops have abandoned facts in favour of religious assumptions.

The equivalence fallacy

The bishops refer to assisted dying as “government endorsed suicide”. They fallaciously equate a reasoned, tested and accompanied decision for a peaceful assisted death in the face of a terminal illness, with the impulsive, violent, isolated and regrettable suicide of individuals (many of whom have mental health and substance abuse issues) who are failing to cope with problems that can be addressed.

However, while the latter are choosing between life and death, the terminally ill are choosing not between life and death, but between two different ways of dying, according to their own beliefs and conscience. Rigorous 2016 research from Australian National University shows that the vast majority (79%) of Victorians support assisted dying choice for the terminally ill (with just 8% opposed), clearly distinguishing it from general suicide.

Shame on the bishops for disrespectfully equating the two.

The inconsistency fallacy

They also argue that assisted dying ought to remain prohibited because within healthcare, “mistakes happen and the vulnerable are exploited,” and “that in spite of our best efforts, our justice system could never guarantee” no one would die by mistake or false evidence. However, as I’ve pointed out before, an identical hypothetical problem exists under the refusal of life-saving medical treatment, a statutory right that Victorians have enjoyed for nearly 30 years. The statute has only three “safeguard” requirements, yet even those only apply if the refusal is formally documented, but not if it’s verbal.

Further, the United States Conference of Catholic Bishops directs that patients may refuse treatment if it imposes “excessive expense on the family or community,” yet makes no mention of the hypothetical “vulnerability” of the patient to be persuaded so, nor directs any requirements to assess the veracity of the refusal.

In stark contrast, the Victorian proposal for assisted dying legislation contains more than 60 safeguards and oversights.

The bishops are at risk of ridicule for such a gargantuan flip-flop: supporting the refusal of life-saving treatment with little or no oversight, while vocally opposing assisted dying legislation that mandates an armada of protections.

The not-so-hidden agenda

The bishops’ methods are rather unsubtle – hoping that these arguments, erroneous but carefully crafted to avoid any religious connotations, will be accepted as non-religious. Yet religion is writ large across their plea: as signatories to the letter they are all clerics employed directly and centrally in the promotion of their religions.

The authority fallacy

They might also rely on their religious status to convey gravity and authority to their pleas. Yet as people paid to do a job, like anyone else, their titles grant them no special privileges in lecturing Victorians about how they should die in the face of a terminal illness.

According to the 2016 census, just 23% of Victorians identified as Catholic, 9% as Anglican, 0.5% as Lutheran, and the other bishops’ signatory denominations so small as to not appear separately in the government’s statistics. Combined, the bishops’ faiths represent around 33% of the Victorian population, while 32% of Victorians identify with no faith at all. Surely the bishops are not arguing that they’re speaking for these other Victorians, too?

But the bishops don’t represent the views of their own flocks, either. According to the 2016 ANU study, 89% of non-religious Victorians support assisted dying law reform, as do 78% of Victorian Catholics and Anglicans. Indeed, opposition to assisted dying exists mostly among those who attend religious services once a week or more often – that is, those who are frequently exposed institutional religious messages of opposition – yet who comprise just 12% of Australians and 11% of Victorians.

Minding their own flocks

Australians are abandoning religion in droves. For example, when Freier ascended to the top job of Anglican Primate of Australia in 2006, some 19% of Australians identified as Anglican (2006 census). A decade later under his leadership, the 2016 census showed a drop of about a third to just 13%, and in Victoria, his home territory, to just 9%.

Hart’s Catholic church has experienced a drop in affiliation too, and it’s likely to continue and accelerate as Australians react with shock and disgust to the extent of child sexual abuse that the royal commission has exposed from under his organisation’s “pastoral umbrella”.

In conclusion, rather than bishops lecturing the government and Victorians with fallacious and faintly desperate arguments about the choices they shouldn’t have at the end of life, attending to their own flocks may be more useful Christian leadership.

May their God go with them in that endeavour.

 

This article was originally published in The Guardian.


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More Dutch evidence contradicts Margaret Somerville's 'suicide contagion' theory

I’ve previously published an extensive analysis of how Professor Margaret Somerville, of the Catholic Notre Dame University of Australia, cherry-picked her way through select data that seemed to be (but wasn’t) consistent with her ‘contagion’ theory from assisted dying to the general suicide rate. I provided ample evidence from lawful jurisdictions that comprehensively contradicts her claim. I also published the summary in ABC Religion & Ethics.

Yet Somerville still says despite extensive real-world experience to the contrary, that “I believe that my [suicide contagion] statement will prove to be correct.”

She and her Catholic colleagues still hold onto several tenuous threads of information that might — just might — appear consistent with her theory, despite the truckloads of evidence to the contrary.

One of those tenuous threads is that the general suicide rate in the Netherlands has increased from 2008, around the same time that use of the Dutch euthanasia law also increased. (The general suicide rate previously fell as assisted dying rates increased.)

I reported official Dutch government statistics and expert financial reports to show that the unemployment rate explains most (80%) of the variation in the Dutch general suicide rate since 1960, and that the Netherlands was particularly hard-hit by the global financial crisis from 2008 — whereas neighbouring Belgium wasn’t and its suicide rate dropped as assisted dying numbers increased. Unemployment in hard times is a known significant risk factor for suicide.

Now, a detailed and peer-reviewed analysis of Dutch data recently published in the Netherlands Journal of Medicine throws more mud in the face of Somerville’s theory.1

The research looked at the Dutch assisted death and general suicide rates from 2002 through 2014, separately for each of the five Euthanasia Commission reporting regions.

Headline results of the averages for 2002–14 are shown in Figure 1.

netherlandsfiveregionmap.jpgFigure 1: The average assisted death rate (and suicide rate) as a percent of all deaths by region, 2002-14
Source: Koopman & Putter 2016

As you can see, Region 3, which includes Amsterdam, had by far the greatest assisted death rate (3.4%), compared with the other four regions (1.7% – 2.0%). Yet Region 3’s suicide rate at 1.2% was the same as Region 5 which had only half the assisted death rate of Region 3 (1.7% vs 3.4%). (The authors, unusually, expressed suicides as a percentage of all deaths rather than per 100k population.)

The results are the opposite of Somerville’s theory which says that Region 3’s general suicide rate should be much higher than (not the same as) Region 5’s.

Those figures are the average for 2002–14. It’s possible that the picture is a little different for the more recent years in which the assisted dying rate is higher.

To answer that question, I’ve retrieved official Dutch Government data and calculated the assisted dying rates and general suicide rates for 2014 alone, the most recent year for which all the data is available. I’ve also calculated the general suicide rate per 100,000 population, the more usual way of reporting and comparing suicide statistics. The results are shown in Figure 2.

dutchregionsveandsuicide2014.gifFigure 2: The Dutch assisted death rate and general suicide rate by region for 2014
Sources: Euthanasia Commission annual reports, Dutch Government statistics

While region 1 (the far north) has the lowest assisted death rate (3.2% of all deaths), it has by far the highest general suicide rate (13.6 per 100k population).

The latest Dutch regional data shows the opposite of Margaret Somerville’s ‘suicide contagion’ theory, adding to the already extensive evidence against it.Conversely, region 3 (which includes Amsterdam) has by a very large factor the highest assisted dying rate (6.0% of all deaths), yet it has the second-lowest general suicide rate (10.3 per 100k population).

This latest empirical evidence is consistent with other extensive evidence I’ve published showing an inverse — or no — relationship between assisted dying rates and general suicide rates.

The question is whether Margaret Somerville and her Catholic friends will pay the slightest attention, or continue to rely on invalid, cherry-picked morsels of data that they think support their theory, but don’t.

 

References

  1. Koopman, JJE & Putter, H 2016, 'Regional variation in the practice of euthanasia and physician-assisted suicide in the Netherlands', Netherlands Journal of Medicine, 74(9), pp. 387-394.

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Yet more research contradicts Prof. Margaret Somerville's Dutch NVE claim

I’ve criticised Catholic ethicist Professor Margaret Somerville in the past for promoting misinformation about assisted dying. One of her favourite stories is about supposed non-voluntary euthanasia (NVE) ‘contagion’ from voluntary euthanasia laws.

NVE is where a doctor deliberately hastens the death of a patient without a current explicit request from the patient.

Somerville claims that elderly Dutch citizens fear NVE — a slippery slope claim previously promoted by the Vatican. She stated that:

Old Dutch citizens are seeking admission to nursing homes and hospitals in Germany, which has a strict prohibition against euthanasia because of its Nazi past, and they're too frightened to go into nursing homes or hospitals in the Netherlands.”

She made the claim with certainty and without qualification.

She also stated it under the credentials of Professor, yet has offered not a shred of sound, verifiable evidence. That's unscholarly.

Her claim is premised on two false beliefs, that:

  1. The Dutch assisted dying law causes NVE —extrapolated to mean that elderly Dutch are therefore fearful of NVE in the Netherlands; and
  2. Because assisted dying is illegal in Germany, NVE doesn’t happen there — extrapolated to mean that elderly Dutch are confident in German healthcare and seek it in preference to their own.

Belief 1 is soundly contradicted by the evidence. Researchers have found small but significant rates of NVE in every country they’ve studied (though that to date hasn’t included Germany). They’ve also found that the rates of NVE in the Netherlands and Belgium have dropped (not risen) significantly since their assisted dying laws came into effect in 2002.

Now, new research comprehensively knocks Belief 2 off its perch, too.

In a pilot study just published in the German Medical Weekly, a team led by Professor Karl Beine of Witten/Herdecke University in Germany found that around 3.1% of doctors and nurses surveyed were aware of deliberately hastened deaths (which is illegal in Germany) in the past twelve months, and that 2.4% of them administered it themselves.

A new study has found that of German nurses and doctors who had intentionally administered life-ending drugs to patients (which is against the law), 40% of them had not been asked to do so by the patient: non-voluntary euthanasia. Further, of those who administered it themselves, 40% hadn’t been asked for it by the patient. That's NVE.

While previous evidence strongly suggested that NVE would occur in Germany as everywhere else, this study now factually establishes that it does.

The study authors concluded that “illegal intentional life-ending acts were administered by physicians and nurses in all healthcare areas [hospitals and nursing homes] under investigation.”

So much for Somerville’s second premise.

Now both premises of her misinformed NVE story are soundly contradicted by empirical research evidence.


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Patricia Flowers calls Margaret Somerville's arugments 'bullshit' on national television. Photo: ABC

Last week, Mr Xavier Symons published a defence of Professor Margaret Somerville, whose arguments against assisted dying were called ‘bullshit’ by Patricia Flowers on the ABC’s Q&A program. Symons and Somerville are colleagues at the Institute for Ethics and Society at the Catholic Notre Dame University of Australia.

Mr Symons made an important point: that a law about restricted self-choice for assisted dying is in no way comparable to the Nazi Germany euthanasia (or more correctly, eugenics) programme. While Prof. Somerville agrees that such comparisons are invalid, she nevertheless often mentions Nazi Germany as a ‘question’ when debating assisted dying. That’s a bit of a fudge.

And Mr Symons, in his defence of Prof. Somerville, offers some fudges of his own. While Dr Iain Brassington has offered a cool philosophical examination of Mr Symons’ opinion piece in a Journal of Medical Ethics blog, I’ll provide more of an evidential analysis.

Wrong on Dutch law and practice

Mr Symons said that euthanasia was legalised in the Netherlands in 2002. While technically that may be true, it's misleading. Assisted dying was actually made lawful in the Netherlands in 1982, after considerable debate and a number of court cases, when the Board of Procurators-General (the highest prosecutorial authority) formalised a set of conditions under which doctors would not be prosecuted for helping a patient die.

In practice, wider physician participation commenced in 1984 when the Royal Dutch Medical Association (KNMG) issued its own guidelines for clinical practice, based on the Procurators-General ruling, and grew to more than a thousand cases a year by the late 1990s.

It was in 2002 — when the Termination of Life on Request and Assisted Suicide (Review Procedures) Act came into effect — that the Dutch law on assisted dying changed from regulatory to statutory.

Mr Symons also claimed that since 2002, the “Dutch legislation [has] changed several times.” That’s not true: in fact, not one word of the Act has changed since it came into effect.

Nor has there been a “steady rate of increase” in the Dutch assisted death rate since 2002 “even when there was no legislative change” as he claimed. There has been an increase, but far from ‘steady.’ Rather, it’s a sigmoid (stretched-S) curve with very little initial increase, then increasing, and then levelling out again. It’s a pattern typical of human behaviour adoption, and has occurred in both Belgium and the Netherlands.

Selective Euro-evidence

Mr Symons also claimed “significant evidence from Belgium, Netherlands, Luxembourg” for his argued slippery slope. Yet he quotes percentages for only the Netherlands, correctly noting that assisted deaths increased from 1.3% of all deaths in 2002 to 3.7% in 2015.

Mr Symons doesn’t mention that:

  • the Dutch assisted dying rate was lower for a number of years after 2002 than before — as physicians and the public were still getting to grips with the new Act;
  • the Netherlands’ assisted dying rate dropped between 2014 and 2015;
  • the rate in Belgium (1.8% in 2015) is half the Netherlands’;
  • the rate in the Flanders (Dutch) north of Belgium (2.5% in 2015) is higher than in the Wallonia (French) south (0.87%), suggesting that higher rates may be a characteristic of Dutch culture;
  • the rate in Luxembourg, with very similar legislation, is a tiny one twentieth of the Dutch rate — 0.18% in 2014 (the most recent year of available data); or that
  • there is no evidence to date of the rate increasing in Luxembourg.
     

Selective North American evidence

While Mr Symons reports the Dutch rate as a percentage of all deaths, he reports his only other figures (for Oregon) as raw counts: rising from 16 in 1998 (before which assisted dying was entirely illegal) to 132 in 2015. (Actually, the final figure for 2015 was 135 cases.) What he fails to mention is that the Oregon rate in 2015 was 0.38% of all deaths, just one tenth of the Dutch rate. That is, the percentage is far less ‘impressive’ to his thesis and raises questions about ‘inevitable slippery slopes.’

The increase is hardly surprising given that when conduct is made newly lawful, only a few people might pursue it in its first year, with more people pursuing it seventeen years later. Even then, one hundred and thirty-five cases out of nearly thirty-six thousand deaths is hardly a “normalisation,” as Mr Symons argues.

He also argues that Quebec’s initial figures are “alarming,” without reporting the rate as a percentage of all deaths. Data from the first year (2015–16) indicates a rate of 0.74%, slightly lower than French-speaking Wallonia in 2015 (0.87%). (Half-way through the 2015–16 period, Canada’s Federal Parliament also passed an assisted dying law.)

The latest comparative data

The latest data on assisted death rates in Benelux and North America is shown in Figure 1. As I explain in one of the most detailed comparative analyses of lawful assisted dying practice conducted to date, it is likely that the higher rates are associated with Dutch culture.

adrates7jurisdictions.gifFigure 1: Assisted dying in Benelux and North America as a percentage of all deaths

Notes: Dutch cultures appear in orange. Flanders is the northern Dutch, and Wallonia the southern French, ‘half’ of Belgium.
Sources: Government statistics offices and assisted dying authority reports; Quebec, CBC News

The case of Vermont

In the USA state of Vermont (with an Oregon-like Act since 2013), a small number of people (38) have been prescribed lethal medication in the first three years. (Data is not available by year.) Assuming for the sake of argument that all of them took the medication (while Oregon and Washington data indicates that a third or more don’t), that would equate to an assisted dying rate of around 0.27% of all deaths as an annual average for 2013­–15.

Don’t mention Switzerland

Switzerland is perhaps the most ‘inconvenient’ case for slippery slope hypotheses, which might explain why assisted dying opponents usually avoid mentioning it. It has the world’s oldest assisted suicide law, in effect since 1942. It is also the least prescriptive: the only specific statutory requirement is that any assistance rendered must not be for reasons of self-interest. That’s it.

Surely a law in effect for 73 years and devoid of all the complex requirements of others would be the foundation for an out-of-control assisted dying rate, much higher than the Netherlands at 3.7%?

It isn’t. In 2015, the rate for Swiss-resident assisted deaths was 1.4%. The rate including foreigners — in other words, with a global population of potential ‘slippery slope candidates’ — was 1.7%. That’s less than half the Dutch rate.

Conclusion

To summarise, the lawful assisted dying rate varies widely between cultures, currently by a factor of twenty. Yet there’s one thing consistent amongst them all: the most common reason for pursuing an assisted death is advanced cancer.

Ultimately, the only thing Mr Symons’ argument establishes is that he prefers to negatively describe any use of a law of which he disapproves as “normalisation,” regardless of its usage rate. If this were not true it would be incumbent on him to nominate a non-zero assisted dying rate that he thinks acceptable, but not “normalised.”

To be sure, I agree with Mr Symons that it’s important to “review the hard facts” around assisted dying.

And yet, when he promised the reader that his “valid slippery slope” argument would be based on “compelling empirical” evidence, he made incorrect or misleading statements, provided cherry-picked morsels of data, and wrapped it all up in a loaded assumption. I think that Patricia Flowers would call that ‘bullshit.’


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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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The IAHPC website home page.

In response to my previous post about the religious basis of organised opposition to assisted dying, Dr Katherine Pettus, Advocacy and Human Rights Officer at the International Association for Hospice and Palliative Care (IAHPC), tweeted:

Twitter “#Catholic church @Pontifex believes all life is sacred&supports #PalliativeCare and use of strong #pain medicines” — Dr Katherine Pettus

Her just-published IAHPC ‘Concept Note’ railing against assisted dying,1 and summarised on the European Association of Palliative Care’s (EAPC) website,2confirms and amplifies precisely the point I made.

Now you’d think that an organisation with a name like ‘International Association for Hospice and Palliative Care’ would be a neutral organisation representing the world profession irrespective of the faith or personal spiritual beliefs of its members.

But you’d be quite wrong.

Nothing but Catholic doctrine

The IAHPC's musings extensively cite several Popes as the authorities on the subject of — and exclusively against — assisted dying. They expressly use the term "Table of authorities," which includes Popes. And who else?

Precisely nobody: no other faith, and no impartial scientific research, is cited. Just Popes.

She also writes:

IAHPC wishes to encourage our partners to express clear support for faith based teachings on palliative care.”

It is important to clarify this misinformation [about ‘stealth euthanasia’] with the authoritative teachings of the Church.”

Hospice has always been faith based.” [As if ‘the way it’s always been’ is a sound argument for ‘the way it always should be.’ Perhaps we shouldn’t have moved from serfdom to democracy?]

The Catholic Church began the medieval hospice movement, and can lead the modern palliative care movement.” [They curiously neglect to mention that the palliative care (not hospice) movement rose from Anglican roots in the UK, helpfully confirming that this broadcast is primarily about promoting Catholic religion, not palliative care.]
 

Shameless self-promotion

But Dr Pettus and the IAHPC’s Concept Note don’t stop there.

The Word [sic] Day of the Sick (WDS) is a good opportunity to support faith based healthcare organizations.”

Contact your parish to see if you can hold a small event…”

Contact your local Catholic health care provider director to find out about…”

Make an announcement at your local church…”

Gosh, I must have been mistaken. I thought World Day of the Sick was about… the sick!?

But Dr Pettus and the IAHPC commandeer it to shamelessly further the Catholic religious agenda amongst palliative care service providers.

An unexamined conflict of interest

It's deeply disturbing that someone holding the position of “Advocacy and Human Rights Officer” considers the beliefs and values only of the service provider (who she represents) in promoting the world day about sick people (who her organisation serves).

Palliative care organisations repeatedly state that they aim to deliver patient-centred care. But the world palliative care peak body's self-adoration exposes the worst of them: taking the opportunity of a day supposedly for the values and needs of sick patients, and using it to glorify their own particular (Catholic) religious tenets which are to be lauded over those of the patients they serve.

Most of the world is not Catholic, and in Australia at least, most Catholics disagree with Vatican doctrine on assisted dying.

How astonishing then to dictate that Catholic doctrine must prevail over everyone, including Protestants, Hindus, Buddhists, Jews, Muslims, agnostics, atheists and others. Dr Pettus and the IAHPC comprehensively fail to demonstrate any awareness or reflection of potential conflicts of interest in serving people of different faiths and beliefs.

Incomprehensible arrogance

There is little issue with the Catholic Church directing its own willing adherents as to how they might end their days.

But for one religious institution to seek to impose its views on everyone worldwide is incomprehensibly arrogant. I guess it's no surprise then that a Catholic Bishop recently admitted — at a Royal Commission inquiry into the extensive, ongoing and horrific abuse of children under the Church's pastoral care — that the Catholic Church is a "law unto itself".

It would be helpful if the Holy See reflected on the principle: is it legitimate for another faith to force its own views on the Vatican or on Catholic patients?

It would also be helpful if the International Association of Hopsice and Palliative Care reflected on respecting and serving the wider community rather than behaving like a subsidiary of the Holy See.

Conclusion

The IAHPC has provided its own unequivocal proof that it is religious conservatism behind organised opposition to assisted dying, with the Catholic Church at the front of the pack.

You’ll understand why I tweeted in response to Dr Pettus:

Twitter.@kpettus @EAPCOnlus Thanks for confirming @Pontifex arrogance. Not once did you mention PATIENT’S PoV. All about YOU.” — Neil Francis

 

- - -

And furthermore

Parading ignorance

The IAHPC refers repeatedly to the treatment of ‘pain’ in its stand against assisted dying law reform. But pain is not amongst the leading reasons for assisted dying (it is a much less common reason). Key reasons are the inability to participate in any of life’s enjoyable activities, loss of independence and loss of dignity.

I guess the curious focus on ‘pain’ is understandable though, because the Vatican is very fond of the doctrine of double effect (DDE) — which the IAHPC specifically notes in Catholic Catechism 2279 although not by its DDE name, but rather bizarrely as “a special form of disinterested charity.”

The DDE posits that it’s OK for a doctor to administer high doses of analgesics to treat pain, even if an unintended consequence is to hasten the patient’s death. The Catholic Church treats this doctrine as uncontroversial, even though it remains controversial amongst other ethicists and philosophers: the principle says “it’s quite OK for a doctor to kill her patient, as long as she doesn’t really mean to.”

I would commend Dr Pettus and the IAHPC to do some proper research and understand the subject area more competently before pontificating (yes, intended meaning) further.

The smokescreen argument

The IAHPC also states that:

No country or state should consider the legalization of euthanasia or PAS until it ensures universal access to palliative care services.”

That’s purely a smokescreen argument for two reasons. Firstly, the Concept Note also argues that assisted dying:

both violate[s] the bond of trust within the profession of medicine, and undermine[s] the integrity of the profession and the dedication to safeguard human life.”

Setting aside the empirical falsehood of the statement, it furnishes the IAHPC a 'get-out-of-jail-free' card if and when palliative care becomes ‘universally’ available: it’s utterly irrelevant if that goal is reached because there’s a more fundamental objection behind it.

Secondly, it's an established fact that palliative care can’t always help, even when the best services are available. ‘Universal’ access won’t fix all the problems.

All these faux arguments are typical and common from religious opponents of assisted dying.

 

References

  1. International Association for Hospice & Palliative Care 2017, Concept note: Palliative care organisations support World Day of the Sick (WDS), IAHPC, viewed 11 Feb 2017, https://hospicecare.com/uploads/2017/1/concept-note-world-day-of-the-sick-2017.docx.
  2. Pettus, K 2017, Palliative care: A special form of disinterested charity, EAPC, viewed 11 Feb 2017, https://eapcnet.wordpress.com/2017/02/10/palliative-care-a-special-form-of-disinterested-charity/.

 


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antiassisteddyingadtheageheraldsun14jun08.gif

You only have to look to understand who is campaigning against your right to choose an assisted death in the face of intolerable and unrelievable suffering.

A case in point is a massive advertisement published in both of Melbourne’s daily newspapers: News Corp’s The Herald Sun (right-wing) and Fairfax Media’s The Age (left-wing). The ad was published in 2008 when Victorian MLC Colleen Hartland introduced the Medical Treatment (Physician Assisted Dying) Bill into the State legislature.

The Catholic Archbishop of Melbourne, Denis Hart, also sent the advertisement as a letter to all members of the Victorian Parliament.1

So, who are the advertisement’s signatories? I’ve listed them all in Table 1.
 

Table 1: Signatories to the 2008 Victorian anti-assisted-dying advertisement

Rt Rev. Graham Bradbeer
Moderator, Presbyterian Church of Victoria

The Rev. Fr Graeme A. Michell, FSSM
Parish Priest, Anglican Catholic Parish of St Mary the Virgin, Melbourne

Rev. Ross Carter
Uniting Church in Australia

Pastor Graham Nelson
Senior Pastor, Life Ministry Centre

Rev. Dr Max Champion
National Chair of the Assembly of Confessing Congregations within the Uniting Church in Australia

Rev. David Palmer
Convenor Church and Nation Committee, Presbyterian Church of Victoria

Pastor Mark Conner
Senior Minister of CityLife Church

Rev. Greg Pietsch
President, Victorian District, Lutheran Church of Australia

Dr Denise Cooper-Clarke
Adjunct Lecturer, Ridley Melbourne Mission and Ministry College

Marlene Pietsch
[Director of the Lutheran School of Theology]
Lutheran Church of Australia

Rabbi Dr Shimon Cowen
Director Institute for Judaism and Civilization

Very Rev. Dr Michael Protopopov
Dean - Russian Orthodox Church in Australia

Rev. Megan Curlis-Gibson
St Hilary’s Anglican Church, Kew

Marcia Riordan
Respect Life Office, Catholic Archdiocese of Melbourne

Archbishop Dr Philip Freier
Anglican Church of Melbourne

Metropolitan Archbishop Paul Saliba
Primate of Antiochian Orthodox Archdiocese of Australia, New Zealand & the Philippines

Imam Riad Galil
West Heidelburg Mosque
Member of the Victorian Board of Imams

Bishop Peter Stasiuk CSSR DD
Eparchy of Saints Peter and Paul of Melbourne, for Ukrainian Catholics in Australia and New Zealand

Rev. Father James Grant SSC
Chaplains Without Borders,
Melbourne Anglican Diocese

Dale Stephenson
Senior Pastor Crossway Baptist Church

Assoc. Professor Afif Hadj MB BS (Melb) FRACS
Director of Surgery, Director of Medical Training, Maroondah Hospital (A Monash University Teaching Hospital)

Pastor Peter Stevens
Victorian State Officer
Festival of Light Australia

Archbishop Denis Hart
Catholic Archdiocese of Melbourne

Dr Nicholas Tonti-Filippini
Associate Dean, JPII Institute for Marriage and Family Melbourne

Rev. Fr Geoff Harvey
Priest of the Good Shepherd Antiochian Orthodox Mission Parish, based at Monash University

Rob Ward
Victorian State Director Australian Christian Lobby

Assoc. Professor Rosalie Hudson
Aged Care & Palliative Care consultant/educator

Jim Zubic
President of Orthodox Chaplaincy Association

Peter McHugh
Senior Pastor Christian City Church, Whitehorse

Persons in blue: Career is religion

 

Almost all of them are religious by career

To save you a lot of time assessing who these people are, I’ve coloured in blue all the folks whose job it is to espouse religion — at least, their own hierarchy’s view of it.

That’s 27 of the 29 signatories who by career are intensely immersed in their own religious perspective of the world; established and promoted through institutional doctrine.

But what about the other two?

What about the other two signatories, Assoc. Prof. Afif Hadi and Assoc. Prof. Rosalie Hudson (in yellow)?

Notice that Prof. Afif Hadi’s entry lists only his surgery profession. Highly relevant, but not mentioned, is that he was President (previously Vice Chairman) of the Australian and New Zealand Board of Trustees, Antiochian Orthodox Archdiocese of Australia and New Zealand. As head of the Board of the Archdiocese, his religious signature is intimately entwined with another: Metropolitan Archbishop Paul Saliba, the Primate of the Antiochian Orthodox Archdiocese.

Assoc. Prof. Rosalie Hudson’s listing too, mentions only seemingly secular links. What is omitted is that she is or was Chair of the University of Divinity (a multi-faith religious institution) Human Research Ethics Committee, Secretary of the Uniting Church’s committee on bioethics, a member of the Interfaith Committee, and an Academic Associate at Charles Sturt University’s School of Theology.

Thus, both Prof. Hadi and Assoc. Prof. Hudson are also deeply rooted in religious faith. The point is not to make any criticism of their faith or practice, but merely to observe the deeply religious connections to opposing assisted dying law reform. It’s worth mentioning that both Hadi and Hudson do valuable charity work.

So, all of them are deeply religious

A pertinent question to ask is: ‘What proportion of the signatories are neutral, scholarly researchers who have studied the empirical evidence from jurisdictions where assisted dying is already lawful?’ Answer: None of them. Enough said.

And what proportion of the signatories to this anti-assisted dying advertisement are very deeply invested in organised religion? The simple answer is as usual: 100%, all of them.

Disconnected from their flocks

Critically, these career-religious fail to reflect the views of their own flocks. We know from repeated polls, for example, that three out of four Australian Catholics, more than three out of four Uniting Church members, and four out of five Anglicans (Church of England) support assisted dying law reform.

How have the religious hierarchy become so out of touch? Perhaps Mr Ian Wood, co-founder of Christians Supporting Choice for Voluntary Euthanasia might be able to offer his own insights.

This kind of clerical disconnect from the contemporary will of the people is one of the key reasons Australians are deserting religion in droves, as successive censuses show.

Conclusion

The evidence is irrefutable. Those who are actively organised to oppose your right to choose an assisted death are deeply religious, even when they use seemingly secular arguments (more on those later).

They are entitled to their opinions for themselves. But what right do they have to deny the vast majority of Australians, who do not agree with their views, the right to choose?

To phrase it in the personal, why does the Catholic Archbishop of Melbourrne, Denis Hart, think it appropriate to demand that Mr Geoff Drummond, a Buddhist, should have suffered against his will at the end of life for the Archbishop's version of faith, rather than Mr Drummond's own spiritual beliefs? Why does Rabbi Shimon Cowen think it appropriate to demand that Mr Alan Rosendorff, a fellow Jew, should have suffered against his will at the end of life for the Rabbi's version of faith, rather than Mr Rosendorff's own carefully-considered and deeply-held views? And why does Imam Riad Galil think it appropriate to demand that Mr Peter Short, not a Muslim, should have suffered against his will at the end of life for the Imam's beliefs, rather than his own?

Perhaps hubris remains alive and well amongst religious conservatives?

-----

Declaration: In fairness to those mentioned in this article, I openly declare that I am agnostic.

 

References

  1. Bradbeer, G, Rt Rev., Carter, R, Rev., Champion, M, Rev. Dr, Conner, M, Pastor, Cooper-Clarke, D, Dr, Cowen, S, Rabbi Dr, Curlis-Gibson, M, Rev., Freier, P, Archbishop Dr, Galil, R, Imam, Grant SSC, J, Rev. Fr, Hadj, A, Assoc. Prof., Hart, D, Archbishop, Harvey, G, Rev. Fr, Hudson, R, Assoc. Prof., McHugh, P, Michell, GA, Rev. Fr, Nelson, G, Pastor, Palmer, D, Rev., Pietsch, G, Rev., Pietsch, M, Protopopov, M, Very Rev. Dr, Riordan, M, Saliba, P, Metropolitan Archbishop, Stasiuk, P, Bishop, Stephenson, D, Stevens, P, Pastor, Tonti-Filippini, N, Dr, Ward, R & Zubic, J 2008, Reject physician assisted dying - An open letter to Victorian MPs, Catholic Archdiocese of Melbourne, viewed 13 Jun 2008, http://www.cam.org.au/Euthanasia.aspx.

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Notre Dame University welcomes Professor Margaret Somerville via its website.

In two opinion pieces recently published in the ABC’s conservative Religion & Ethics blog,1,2 Margaret Somerville, Professor of Bioethics at Notre Dame University, railed against marriage equality law reform using reasoning that I contend fails not only appropriate standards of ethics argument but indeed her own stated standards. Here’s why.

Railing against careful and reasoned language

In two ABC opinion pieces, Margo (as she refers to herself) railed extensively against the term ‘marriage equality,’ arguing that it ought to be referred to instead as ‘same-sex marriage.’ She volunteers that the real motive for her preferred term is that in her opinion fewer people will support ‘same-sex’ marriage than will support ‘equality’ of marriage.

Margo quite overlooks the fact that some folks deliberatively eschew gender identity or are asexual, yet may wish to honour a loving, life-long relationship through marriage. There’s also the issue of a change of gender identity within marriage, not just when entering into marriage.

The goal of Australian marriage law reform is a single, revised Act which articulates a uniform, equal set of provisions for marriage regardless of sexual orientation or gender identity: not a separate Act which permits a different version of marriage only for same-sex-attracted people.

Therefore, ‘marriage equality’ is indeed an appropriate expression for revised legislation while ‘same-sex marriage’ is less so.

“But what about the children!?”

Margo also railed extensively against marriage equality because, she claims, marriage is primarily about the rights of children, not the married couple.

However, the Marriage Act3 makes no assumptions about the marriage being for the purpose of producing children. Indeed, this would be foolish as it would preclude infertile couples from marrying. Here’s the entire definition of marriage under the Act:

“Marriage means the union of a man and a woman to the exclusion of all others, voluntarily entered into for life.” — Marriage Act 1961 (as amended)

Sure, the Act does have a couple of things to say about children, but in relation to the status of a legally adopted child, and child ‘legitimacy’ (which confers rights to use the family name and inherit titles, for example).

While the Act provides largesse for religious marriage celebrants to include any wording they deem appropriate (and which might cover the subject of procreation) in a marriage service, the minimum required civil celebrant wording is:

“I call upon the persons here present to witness that I, (first and last name), take thee, (first and last name), to be my lawful wedded wife/husband.” — Marriage Act 1961, S45(2) [or words like it]

No mention of children there, either. Section 1A.3 of the Marriage Regulations4 requires a marriage celebrant (religious and civil alike) to recognise “the importance of strong and respectful family relationships.” Notice again the absence of the presumption of producing children.

No necessary connection between children and marriage

Separate State and Territory Acts provide for the recognition of de facto relationships, over which the Commonwealth has no special jurisdiction. While recognised by the state these relationships are legally distinct from marriage.

In terms of unions that Australians willingly establish, Australian Bureau of Statistics data shows that:5

  • Around three quarters of marriages are now conducted by a civil celebrant rather than a religious one; and
  • Around one third of all Australian births are now to non-married partners.

 
It’s obvious that many marriages are now non-religious, that they can be childless, and, conversely, that many children are born in the absence of marriage. There is no necessary relationship in either direction between marriage and children that underpins Margo’s contentions.

No necessary link to assisted reproduction, either

Margo then goes on to rail against assisted human reproduction (surrogacy, gamete donation and IVF), complaining that non-hetero married couples would have to ask for such help to produce children. But, like the child argument itself, this is not unique in any way to marriage. De facto couples and even single women can ask for reproductive assistance, as can infertile hetero couples within marriage. As with children, assisted reproduction and marriage are not uniquely entwined as Margo wrongly argues: they are separate in law and practice even if the link is critical to some couples.

Why the confected 'necessity'?

So why then, does Margo go to such lengths to instil ‘children’ as central to the purpose of marriage? A potential explanation is that her expressed views, while reflecting neither law nor practice, are consistent with her Catholic faith. Catholic tradition is very deeply steeped in the notion that marriage is primarily for the purpose of procreation.

In her 2015 Bird on an Ethics Wire book, Margo invokes the 'would-if-they-could' defence for opposite-sex couples who want to marry but are intfertile (while remaining mute about married couples who expressly don't want children). She fails to articulate any sound reason as to why this is a different 'would-if-they-could' argument from same-gendered or non-gendered partners, except to argue, offensively, that same-sex partners are socially infertile for “lack of an opposite-sex partner.” In her ABC opinion pieces she simply says the hetero version is “symbolic.” Curiously for an ethicist, she fails to reflect on who gets to decide which are valid symbols and whether any symbolism ought to be mandatory for everyone.

Margo asserts that marriage between opposite-sex partners is ‘traditional.’ I say, good on her for personally sticking to a tradition she thinks important: but ‘tradition’ is a poor foundation for continuing to impose historical views on Australians who are not Catholic nor any longer support those views… which is the great majority of us.

The bogeyman argument

Margo then makes vague claims that marriage equality ‘takes away children’s rights’ and causes ‘harms.’ The ‘harm’ she does articulate is the “right to know one’s biological parents.” She speaks of anonymous gamete donation, but fails to note that it occurs equally both inside and outside of — and therefore isn’t conditioned by nor conditions — marriage. Therefore, any “right to know one’s biological parents” is, like children themselves and assisted reproduction in general, entirely independent of the marital status of the parents and is of no special force or relevance in marriage equality debates.

The not-as-good-as-heteros argument

Margo then promotes the importance of the “complementarity in parenting between a mother and father,” with the innuendo that same-sex parents are at least a much lesser standard for raising children, if not unsuitable altogether. Let’s examine this hoary old chestnut, particularly in relation to ‘expert’ evidence Margo proffered in a USA Court case.

Court assessment of Margo’s ‘evidence’

Historically, Iowa’s statute §595.2 restricted marriage to between only a man and a woman. A series of Iowa Court cases overturned that limitation in 2006–9. Margo and two of her colleagues from McGill University’s School of Religious Studies were advanced to the court as ‘expert witnesses’ against the reform, in relation to the ‘perils’ of marriage equality including the ‘harms’ to children. Here’s what the Iowa District Court concluded:6

“Though they may have expertise in certain areas, such expertise is insufficient to qualify Ms Somerville [and her two colleagues from the School of Religious Studies] to answer the particular questions that they are asked. Though these experts desire to make statements regarding gender, results of same-sex marriage on children and the universal definition of marriage, they do not appear to possess expertise in relevant fields such as sociology, child development, psychology or psychiatry. Ms Somerville specifically eschews empirical research and methods of logical reasoning in favour of ‘moral intuition.’ She has no training in empirical research and admits having no knowledge of existing social science research relevant to this case. She concedes that her views do not reflect the mainstream views of other ethicists.”

and

“The views espoused by these individuals appear to be largely personal and not based on observation supported by scientific methodology or based on empirical research in any sense.”

and

“…the Court concludes that these individuals are not qualified to testify as experts regarding the issues in this matter.”

The Court then expressly identified substantive harms that accrue to non-heterosexual partners through denial of marriage.

The case then went to Iowa’s Supreme Court. In a unanimous decision, the Supreme Court upheld the District Court’s determination, noting that:7

“The research appears to strongly support the conclusion that same-sex couples foster the same wholesome environment as opposite-sex couples and suggests that the traditional notion that children need a mother and a father to be raised into healthy, well-adjusted adults is based more on stereotype than anything else.”

and

“Many leading organizations, including the American Academy of Pediatrics, the American Psychiatric Association, the American Psychological Association, the National Association of Social Workers, and the Child Welfare League of America, weighed the available research and supported the conclusion that gay and lesbian parents are as effective as heterosexual parents in raising children.”

and

“For example, the official policy of the American Psychological Association declares, ‘There is no scientific evidence that parenting effectiveness is related to parental sexual orientation: Lesbian and gay parents are as likely as heterosexual parents to provide supportive and healthy environments for children.’”

So much for Margo’s ‘authority’ on the subject of marriage equality.

Those interested in a thorough rebuttal of Margo’s arguments against marriage equality might be interested to read papers by Scoff F. Woodcock of the University of Victoria (BC), an Associate Professor specialising in normative and applied ethics,8 and Timothy F. Murphy of the University of Illinois, Professor of Philosophy in the Biomedical Sciences specialising in professional ethics, assisted reproductive technologies, medicine and sexuality.9 Both these Professors hold earned doctorates in philosophy; whereas Margo, according to her own biography, holds earned academic qualifications in pharmacy and law, but none in philosophy or ethics.

The importance of relevant and persuasive facts

In an important recognition, a highly-published ethicist once wrote that:

“We sometimes overlook the importance of having good facts in dealing with ethical issues. This is a serious mistake. Good facts (including, if necessary, research to establish them) are essential to good ethics, which, in turn, is essential to good law.” and “Good ethical and legal ‘facts’ start with primary sources that are up to date and accurate.” [Italics are original]

That ethicist was… Margo Somerville.10 My view is that Margo has failed to live up to her own standards by getting some fundamental facts expressly wrong and misrepresenting others with innuendo whilst failing to mention readily-available and widely-agreed facts that contradict her thesis.

Also surprising is that she continues to opine against marriage equality law reform in Australia using the same opinions that were publicly and expressly rejected by a USA court; the same opinions that have been insightfully dissembled and rebutted by appropriately-qualified academics via analyses published in professional peer-reviewed journals.

Conclusion

An Iowa Court has determined that Margo Somerville’s views on marriage equality are largely personal and eschew empirical research and methods of logical reasoning in favour of ‘moral intuition.’ (More on ‘moral intuition’ in another blog.) Further, they are at odds with readily available research evidence. Her opinions then are not founded on scholarly verification and fail to reflect the highest standards of thought and deduction.

I firmly believe that Margo is entitled to her opinions. However, it is my view that appeals for her marriage equality opinions to be acclaimed on the basis of the authority bias — as “Professor of Ethics at Notre Dame University” and “a preeminent public intellectual in Bioethics” — are unjustifiable.

And if the ABC chooses to publish any more of Margo’s nonsense about ‘the perils of marriage equality to children,’ I might just ask for a refund of my twelve cents a day.*

-----

Up next: Who is Margo Somerville? Up later: Why is she so comprehensively wrong on assisted dying law reform?

* The ABC (Australian Broadcasting Corporation) is the nation’s public broadcaster and advertises that it provides its services for a mere twelve cents a day from each of the country’ residents.

 

Footnote: yet another fundamental (and simple) fact wrong

You’d think that being an accomplished Commonwealth legal scholar that Margo would understand the fundamental structure of Commonwealth legislatures.

But in her ABC missives against marriage equality, she concluded by remarking that same-sex couples often lament the lack of marriage equality “…such as we saw in the anguish Senator Tim Wilson manifested in his maiden speech in the Senate.” Here’s a photo of Tim Wilson delivering that speech:

Tim Wilson delivers his maiden speech in ParliamentTim Wilson delivers his maiden speech in Parliament. Video still: ABC News

In Commonwealth countries, the upper house (Australia, federal: Senate) is fitted out in red (the colour of royalty and cardinals), while the lower house (Australia, federal: House of Representatives) is green (the colour of ‘common’ fields).

Immediately evident from glancing at his maiden speech for a mere millisecond is that Mr Wilson is not a Senator: all the livery is green. He is MHR for the Victorian Division of Goldstein, not a Senator for the State of Victoria.

Canadian Parliament housesThe Canadian federal Parliament’s green House of Commons and red Senate (Margo has recently returned to Australia from decades in Canada) Photo: Mightydrake

It’s bewildering then that when Margo saw Mr Wilson’s maiden speech she utterly failed to establish which house he was in, nor took the trouble to examine or test her assumptions before publishing her ‘expert’ opinion about it online.

 

References

  1. Somerville, M 2016, 'Marriage equality' or 'same-sex marriage'? Why words matter, ABC Religion & Ethics, viewed 28 Oct 2016, http://www.abc.net.au/religion/articles/2016/10/14/4556874.htm.
  2. Somerville, M 2016, Same-sex marriage: It's about children's rights, not sexual orientation, ABC Religion & Ethics, viewed 28 Oct 2016, http://www.abc.net.au/religion/articles/2016/10/07/4552500.htm.
  3. 1961, Marriage Act (Cth), Australia, pp. 120.
  4. 1963, Marriage Regulations 1963 (Cth), Australia, pp. 85.
  5. Australian Bureau of Statistics 2015, 3310.0 - Marriages and Divorces, Australia, 2014, viewed 28 Oct 2016, http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/3310.0Main%20Features112014?opendocument&tabname=Summary&prodno=3310.0&issue=2014&num=&view=.
  6. Iowa District Court for Polk County 2007, Katherine Varnum et al. v. Timothy J. Brien, CV5965, pp. 63.
  7. Supreme Court of Iowa 2009, Katherine Varnum et al. v. Timothy J. Brien (Polk County), SCC No. 07-1499, Des Moines, pp. 69.
  8. Woodcock, S 2009, 'Five reasons why Margaret Somerville is wrong about same-sex marriage and the rights of children', Dialogue-Canadian Philosophical Review, 48(4), pp. 867-887.
  9. Murphy, TF 2011, 'Same-sex marriage: Not a threat to marriage or children', Journal of Social Philosophy, 42(3), pp. 288-304.
  10. Somerville, MA 2014, Death talk: The case against euthanasia and physician-assisted suicide (2nd Ed.), 2nd Ed. edn, McGill-Queen's University Press, Montreal.

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Wesley Smith and 'intelligent design' at the Discovery Institute

The Discovery Institute's Wesley Smith is at it again. In his latest anti-assisted-dying tirade published by LifeNews.com, he promote lies about the Dutch Groningen Protocol, despite my published detailed analysis — of how that regulation actually works in practice — providing ample evidence to disprove Mr Smith's polemic theories.

Creationism…with lipstick

Wesley Smith is a Senior Fellow at the Discovery Institute (DI). That's the organisation that promotes ‘human exceptionalism’ (the concept that humans are theologically pre-eminent in the universe), opposes the foundations of evolution, and controversially attempted to have ‘intelligent design’ taught as science in Pennsylvania public schools. The Pennsylvania District Court tossed out DI's ‘intelligent-design-as-science’ argument on the basis that:

“Teaching intelligent design in public school biology classes violates the Establishment Clause of the First Amendment to the Constitution of the United States (and Article I, Section 3, of the Pennsylvania State Constitution) because intelligent design is not science and ‘cannot uncouple itself from its creationist, and thus religious, antecedents.’” — Middle District Court of Pennsylvania

Intelligent design is, after all, merely creationism…with lipstick.

Mr Smith is also the fellow I've previously busted for promoting the false ‘suicide contagion’ theory about Oregon, and cherry-picking his way through other ‘evidence’ to fuel another of his polemics.

More nonsense — this time the Groningen Protocol

And now he's at it again. In his latest anti-assisted-dying tirade, he says this:

“Although technically illegal, infanticide happens regularly in Netherlands without legal consequence, and a bureaucratic checklist was published that determines which babies can be killed. Showing the direction of the current, the Groningen Protocol§ (as it is known) was published with all due respect and without criticism, in the New England Journal of Medicine.” — Wesley Smith

Mr Smith does nothing but parade astonishing ignorance and bias with this statement.

The facts

From my extensive and detailed research about the Groningen Protocol published in the Journal of Assisted Dying, Mr Smith ought to know that:

  • Neonatal euthanasia occurs around the world whether it is regulated or not. It occurs, for example, in France, where there is no protocol and no adult assisted dying law, at a rate far higher than the Netherlands.
  • The Groningen Protocol is lawful in the Netherlands and has recently been overhauled and further strengthened.
  • Its provisions are considerably more strict than are those of the Dutch euthanasia Act for decisionally-competent minors and adults.
  • In the nine years since the Protocol came into effect, there have been just two cases of neonatal euthanasia, both for cases of Herlitz type epidermolysis bullosa, a fatal and untreatable illness characterised by extreme internal and external blistering.
  • That compares with twenty two cases, mostly in relation to spina bifida, in the nine years prior to the Protocol coming into effect.
  • The Protocol was subject to considerable criticism from opponents when it was first published in the New England Journal of Medicine (NEJM).

 
Highly relevant too is that the Royal College of Obstetricians and Gynaecology also argued in 2006 (not long after the original Groningen Protocol was published in NEJM) for neonatal euthanasia to be possible in extreme cases in the UK.

Not the only criticism of Mr Smith

Mr Smith has been criticised before by others for selectively using evidence and being:

"prepared to bend the truth to make a point, turn a stomach, and potentially radicalize a reader." — Matthew K. Wynia and Arthur Derse, Medscape

Perhaps Mr Smith doesn't care for the facts getting in the way of a good polemic? While he's entitled to his opinions, by repeatedly bending the truth and making statements contrary to the readily-available evidence, I argue that Mr Smith directly undermines any apparent 'authority' he claims for his musings.

Conclusion

The recurring pattern of resorting to misinformation reveals a lack of any real argument. I challenge Mr Smith to lift his game or retire his quill.

-----
§ Mr Smith links ‘Groningen Protocol’ to a blog published by the Euthanasia Prevention Coalition which is run by Canadian Catholic Alex Schadenberg. That blog is in turn based on a blog published by the Catholic online blog Mercatornet. The Mercatornet blog is itself a reproduction of an article by Dr Felipe Vizcarrondo who was a Clinical Bioethicist at Georgetown University (a Catholic and Jesuit institution), and  which was originally published in Linacre Quarterly, the journal of the USA Catholic Medical Association.


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