Non-voluntary euthanasia (NVE)

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Update: Margaret Somerville is now Professor of Ethics at the Catholic University of Notre Dame Australia.

In the previous video a claim by Catholic Professor of Ethics Margaret Somerville was rebutted: that the Dutch and Belgians seek health care in Germany because they fear being killed by their own doctors and without being asked. In this video, she furthers her bizarre claim by referring to Dutch and Belgian non-voluntary euthanasia rates as 'proof' of her border-crossing healthcare thesis.

However, her cherry-picked statistic establishes nothing, whereas her claim is contradicted by robust research, which I discuss in this video.

It's unclear why Professor Somerville seems to be unaware of or ignores readily-available yet contradictory evidence of central importance to her claim.

This 'non-voluntary slippery slope' claim is another one that's popular amongst campaigners against assisted dying.

 

Transcript

Neil Francis: In the last video, we established as false, Professor Margaret Somerville’s absurd claim of the Dutch going to Germany for health care because they feared being killed by their doctors. But she goes on.

Margaret Somerville: In actual fact they’ve got good reason to fear that, uh, there’s a minimum of, a minimum of 500 cases a year, of doctors who administer euthanasia to people in the Netherlands, where it’s legal, and the patient does not know they’re being given euthanasia, and has not consented to it. Some reports put the figure as high as 2000 cases a year.

Neil Francis: And she makes a similar case for Belgium. So let’s look at the empirical evidence.

Neil Francis: What she’s referring to is non-voluntary euthanasia, or NVE. It occurs in every jurisdiction around the world. A study published in 2003 found these rates. You’ll notice that Italy had the lowest and Belgium the highest NVE rates. And at the time of this study, which countries had legalised assisted dying?

Neil Francis: Switzerland had since 1942, and the Netherlands since 1982. But none of the others had. So the Swiss and Dutch NVE rates, with assisted dying laws, were lower than Denmark’s, without one. And the higher Belgian rate wasn’t caused by an assisted dying law, because none existed at the time.

Neil Francis: But did the Belgian and Dutch NVE rates go up when each country legalised assisted dying by statute in 2002? Here’s what happened in Belgium: the rate didn’t go up — it went down, and the drop is highly statistically significant.

Neil Francis: And in the time since Professor Somerville made her misleading claim, it’s remained lower.

Neil Francis: And here’s what happened in the Netherlands. This rate before the Act is around 1,000 cases a year, and this one after the Act is around 500, the rate that Professor Somerville refers to in her claim as “the minimum”. What she failed to mention is that since statutory legalisation of assisted dying, the Dutch NVE rate dropped, not risen, and to a similar level as the UK, the world’s gold standard for palliative care, and which has never had an assisted dying law.

Neil Francis: And since Professor Somerville made her misleading claim, it’s dropped even further.

Neil Francis: If Professor believes that she has verifiable empirical evidence to back up her claims, let her produce it for examination. Until then, her non-voluntary euthanasia “slippery slope ”is nothing more than fear-mongering innuendo.

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Assisted dying rates in Dutch-speaking cultures (orange bars) are much higher than elsewhere.

In this whitepaper, Benelux (Belgium, Netherlands and Luxembourg) primary empirical data on assisted dying is analysed — including with new and advanced approaches — to provide fresh insights into contemporary practices. Investigation reveals that the assisted dying rate in Dutch-speaking cultures appears to be uniquely higher than in other cultures irrespective of the permissiveness of the legislative framework, yet is still practiced conservatively.

Download a full copy of the Whitepaper here: PDF (648Kb).

Summary

This new compilation and unique analysis of primary research data from statutory authorities and the peer-reviewed literature provides fresh insights into assisted dying practice in Benelux, including:

  1. Rates of assisted dying in the Netherlands and Belgium have followed an expected sigmoid curve, now beginning to level out.
  2. Several factors have contributed to the higher increase in the Netherlands rate, including recovery from a suppression of cases immediately following statutory reform, a rise in cancer diagnoses, and an increase in granting of assisted dying through new visiting teams launched in 2012.
  3. Both Netherlands and Belgium doctors demonstrate caution if not conservatism when assessing assisted dying requests.
  4. Despite most assisted dying occurring in cases of cancer, fewer than one in ten cancer deaths in the Netherlands and one in twenty in Belgium is an assisted death.
  5. Other conditions such as degenerative neurological, pulmonary and circulatory illnesses each account for a very small proportion of the increase in cases since legalisation in Benelux.
  6. The assisted dying rate in dementia and other mental illness is very low despite controversy around—and a tiny rise in granting of—such cases.
  7. The hypothesis that females or the elderly would be ‘vulnerable’ to assisted dying law is contradicted by the data.
  8. The rate of non-voluntary euthanasia has decreased significantly in both the Netherlands and Belgium since assisted dying was permitted by statute.
  9. Assisted dying rates in Dutch-speaking cultures are significantly higher than in non-Dutch cultures, seemingly unrelated to the permissiveness of the jurisdiction’s legal framework.

 

beneluxratessmall.gif
Benelux country reported assisted dying rates (as a percentage of all deaths)
as at 2014. The three countries have similar assisted dying laws.
 

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Brad Mattes' blog containing misleading and evidentially false statements.

The latest misinformation employed by assisted dying opponents is to imply that Belgium’s general suicide rate is high as a consequence of its assisted dying law: i.e. to argue the discredited 'suicide contagion' line which has in the past been peddled about the USA state of Oregon. I have demonstrated that it was false in Oregon, and I equally demonstrate here that it's false in Belgium.

Mr Brad Mattes recently published emotional anti-assisted-dying nonsense in LifeSiteNews. (LifeSiteNews is a Canadian blog site that was established by the conservative Christian Campaign for Life Coalition and which has a primary principle of promoting “traditional Judeo-Christian principles”. Mr Mattes is radio host for Ohio’s Life Issues Institute, an anti-abortion lobby group established by conservative American John C. Willke who claimed that women’s bodies were resistant to pregnancy as a result of rape.)

Putting on the misinformation running shoes

In his blog Mr Mattes quickly establishes a practice of communicating misinformation by first claiming that assisted dying laws have “devastating effects” around the world including Japan and Albania—which don’t have such laws.

He then sprints onwards to the ‘650 babies euthanized in the Netherlands’ claim—which I have already comprehensively exposed as fake in the Journal of Assisted Dying—and then onto the bogus claim that the Netherlands has descended into a mire of ‘killing’ without the patient’s ‘consent,’ contrary to empirical evidence I've published that such actions occur around the world regardless of assisted dying laws, and which have decreased significantly in the Netherlands and Belgium since their assisted dying statutes came into effect in 2002.

Let’s add fries to that

Having served up a lot of fat and salt that might appeal to those on a fast-food anti-assisted-dying diet, he then offers the unqualified statement:

By the way, Belgium has the second-highest suicide rate (nonrelated to euthanasia) in Western Europe.” — Brad Mattes

The ‘informational’ consequence is unequivocal: by Mr Mattes failing to contextualise this ‘incidental factoid’ in any way, the reader is destined to deduce that it is Belgium’s euthanasia law that causes Belgium’s suicide rate to be the second-highest in Western Europe. In other words, Mr Mattes is another poorly-informed commentator using the 'suicide contagion' line.

But what are the facts?

Depending on the source and year of data, one can certainly argue that Belgium’s general suicide rate is the second-highest in Western Europe. Setting aside for now the serious question of why it is valid to exclude all of the world’s other countries from the comparison, WorldLifeExpectancy.com reports figures that were published in 2014 (Table 1).

Table 1

Country

Suicides*

Finland

15.11

Belgium

14.64

Iceland

14.06

France

12.84

Austria

11.87

Sweden

11.43

Ireland

11.06

Germany

9.59

Switzerland

9.56

Norway

9.28

Denmark

9.19

Luxembourg

9.14

Netherlands

8.54

Portugal

8.49

Turkey

7.92

UK

6.28

Malta

5.75

Spain

5.23

Italy

4.76

Greece

3.86

* Suicides per 100k population, age-adjusted

The table includes all the countries in the wider definition of “Western Europe”, bar four: no suicide statistics are published for Liechtenstein, Monaco, Andorra or San Marino.

As you can see, Belgium is indeed the second-highest. But this begs the question:

If the reason Belgium is the second-highest is due to its assisted dying law, how come Finland, which Mr Mattes doesn't mention by name and which has no such law, is higher?

It also begs the question:

If assisted dying law were the fundamental cause of a high general suicide rate, how come Switzerland (statute since 1942), Luxembourg (statute since 2009) and the Netherlands (practice since the early 1980s and statute since 2002) have rates that are much lower, all key facts that Mr Mattes also fails to mention?

These are of course indications that the factoid has been included as a cherry-picked morsel of 'proof' because it sounds so compelling as a throw-away sentence amongst the other (false) statements.

But wait, there’s more

We can go further than merely wondering about the country comparisons, by comparing Belgium’s general suicide rate before and after assisted dying law reform. A critical step in establishing causation is to first establish correlation. If there is no correlation, there can be no causation.

Published OECD data shows that in 2013 (the most recent available data), Belgium’s general suicide rate was 16.7 per 100,000 population. What was it before their 2002 law reform? Well in 2000 it was 20.5, in 1990 it was 19.2, … you get the idea.

Has Belgium’s general suicide rate soared (or even increased modestly) since their 2002 assisted dying law came into effect? No. It’s dropped. Indeed, the slight downward trend apparent before the statute came into effect in 2002 has accelerated downward since (Figure 1).

Belgium's suicide rate since 1987Figure 1: The Belgium general suicide rate before and after assisted dying law reform

Even the headline is misleading

Mr Mattes fails to point out in his blog that assisted dying statutes in Benelux countries (Belgium, the Netherlands and Luxembourg) never restricted access to only the 'terminally ill,' that is, those imminently dying. He also fails to point out that USA states whose laws do restrict assisted dying to the terminally ill—most notably Oregon and Washington—have not changed their statutes in this regard since they came into effect.

Therefore, his headling implying that lawful jurisdictions have broadened their laws from 'only the terminally ill' is also wrong.

Conclusion

Mr Mattes makes multiple false and misleading claims and it’s easy to see his opinion for what it is: an emotional dump that fails to engage with and indeed flies in the face of actual evidence. The latest 'suicide contagion' implication, that assisted dying law causes Belgium’s general suicide rate to be the “second-highest in Western Europe” is evidentially false.

I call on LifeSiteNews to withdraw Mr Mattes' article because it breaches their primary principle:

“1. Accuracy in content is given high priority. News and information tips from readers are encouraged and validated. Valid corrections are always welcome. Writing and research is of a professional calibre.” — LifeSiteNews

 

Summary of facts

Belgium's general suicide rate is one of the higher ones in Western Europe. However:

  1. At least one country without an assisted dying law has a higher suicide rate, inconsistent with 'suicide contagion' theory.
  2. Other Western Europe countries with assisted dying laws have suicide rates much lower than Belgium's, also at odds with 'suicide contagion' theory.
  3. But the clincher is that the suicide rate in Belgium has dropped, not risen, since their 2002 assisted dying law came into effect.

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Lyle Shelton's bunkum tweet is broadcast on ABC's Q&A program

The Managing Director of the Australian Christian Lobby, Mr Lyle Shelton, is at it again.

Yesterday, he tweeted ABC's Q&A program as thousands of people do while it is on air. His tweet was broadcast live to air as shown above. What did he say as panelists were discussing assisted dying law reform?

"Sadly voluntary euthanasia quickly became involuntary euthanasia in Holland. #qanda" LyleShelton

Mr Shelton's claim is bunkum.

Confused language

Firstly, he's confused involuntary with non-voluntary euthanasia.

Involuntary euthanasia is the deliberate hastening of the death of an individual in contravention of the express wishes to the contrary of that individual.  Nobody (except the Australian Christian Lobby in its confusion) is seriously suggesting that involuntary euthanasia happens in the Netherlands, even as a 'result' of the country's euthanasia law.

Non-voluntary euthanasia is the deliberate hastening of the death of an individual without an explicit request from that individual. Increased doses of analgesics and sedatives are administered to alleviate intractable symptoms at the end of life, as a result of discussion between doctors and the patient's family (the patient is not currently competent to participate in decisions). The drugs may hasten death and if this happens, life is shortened by hours, or less often, days. Despite claims by some assisted dying opponents that this is unique to the Netherlands, scientific research shows clearly that the practice occurs all over the world and is not 'caused' by voluntary euthanasia laws.

ACL staff sing from the same hymn book

Daniel Flynn, Victorian Director of the Australian Christian Lobby, made a similar claim in a formal submission (#694) to the Victorian Parliament's Inquiry into End Of Life Choices:

"There is sufficient evidence to suggest that involuntary euthanasia is frequent in jurisdictions in which euthanasia has been legalised." [p 4.]

Not a shred—let alone 'sufficient'—evidence was offered to back up this silly myth, though it's hardly surprising given that there isn't any.

What does the evidence actually show?

The scientific evidence is crystal clear and it is the opposite of Lyle Shelton and the Australian Christian Lobby's claim. Since around 1985 the Netherlands had permitted assisted dying by regulation: under agreement amongst relevant authorities. The rate of non-voluntary euthanasia remained relatively unchanged under this arrangement (Figure 1). In 2002 the Netherlands' euthanasia Act came into effect, replacing regulatory arrangements with a comprehensive set of legislative (i.e. statutory) requirements.

 

dutchanduk-nve01.jpg
Figure 1: Netherlands and UK non-voluntary euthanasia rates

Since 2002, the rate of non-voluntary euthanasia in the Netherlands has dropped, not risen.1 The drop is statistically significant. The rate of non-voluntary euthanasia in the Netherlands is now around the same level as in the United Kingdom.2 The UK is generally accepted as the world's gold standard in palliative care practice and it does not have an assisted dying law.

Absolutely contrary to the claim of the Australian Christian Lobby's Lyle Shelton, the rate of non-voluntary euthanasia in the Netherlands has dropped, not risen. It's now similar to the rate in the UK, which has no assisted dying law.

ABC news standards

Since the ABC moved the Q&A program from its entertainment division to its news division there is a heighted obligation on the broadcaster to ensure that the show's content is reason- and evidence-based, and not merely a platform for anyone to promote silly misinformation in support of a perspective.

No doubt the ABC will rise suitably to the occasion of discouraging misinformation and ensuring that any is corrected.

We'll be watching the next episode of ABC Q&A closely to fact check anything Mr Shelton and others say about assisted dying law reform. Give us a bell if you spot anything you know or suspect is untrue.

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  1. 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, vol. 380, no. 9845, pp. 908-915.
  2. Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliative Medicine, vol. 23, no. 3, pp. 198-204.

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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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