Fiction

A thing that is untrue, or invented or feigned by imaginatoin with no sound or verifiable evidence.

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Home of the bible society in Launceston, from where the ACL's latest media release was launched

"Bullshit!"

That was the reaction of Dutch Senator Erik Jurgens when I asked him about a Dutch euthanasia anecdote spread by Mr Paul Russell, then head of the Australian anti-VAD Catholic front organisation "HOPE". In 2011, Mr Russell had been spreading the story:

"I often use the story of the death of a 26 year old ballerina in Holland [sic]. She had contracted a form of arthritis at this young age and her dancing career and dreams were dashed. An American oncologist who spoke later to the killing doctor reported the Dutch medico as saying something like 'One doesn't like doing it, but it was her choice.'" — Paul Russell, "HOPE" [my emphasis]

(Note: "Holland" comprises just the two north-west provinces of the Netherlands. "Holland" and "the Netherlands" are not correctly substitutable terms. The Dutch euthansia Act applies to the whole of the Netherlands, not to just two provinces.)

Checking with authoritative sources

In 2012, I travelled across the Netherlands with camera in tow, interviewing key stakeholders in the nation's assisted dying law about its operation. Nobody had heard of the supposed ballerina case, including long-serving politicians, the Royal Dutch Medical Association, nor even Professor Theo Boer or the Dutch Patient Rights Association who actively oppose the law.

robinbernhoffoncamera.jpgUSA doctor Dr Robin Bernhoft muses about a Dutch ballerina nobody in the Netherlands has heard of

It turns out that the meme was a bit of unverified nonsense put about by USA Catholic radio- and televangelist Dr Robin Bernhoft in an early 1990s polemic anti-VAD video, "False Light", narrated by staunch Catholic actor Joseph Campanella. Dr Bernhoft has castigated believers in evolution as "sexually immoral, abortion supporters, racists and violators of each of the Commandments".

In the video, Dr Bernhoft often gazes nonchalantly into the distance, or at his hands, as he narrates his stories. It's all very third-hand and mysterious, conspicuously devoid of even the faintest whiff of evidence. But Dr Bernhoft doesn't claim to have actually spoken to the doctor, as Mr Russell states. Perhaps the confidently stated direct-contact idea is a signal of confirmation bias.

Those little Dutch cards

Confidence was also common amongst VAD opponents, like Oregon Nurse Donna Howell also featured in "False Light", spreading the nonsense that the Dutch wander around carrying little cards pleading for protection from being killed.

"It's gotten so bad in Holland [sic] that people have in their wallets little cards that say 'Do not euthanise me without my permission'." — Nurse Donna Howell

donnahowelloncamera.jpgUSA Nurse Donna Howell confidently says the Dutch carry little cards saying 'do not euthanise me'

Just like the supposed ballerina, nobody I interviewed across the Netherlands, including the anti-VAD Patient Rights Association which would be the natural source of "little cards" for patients, had ever heard of the little cards, either.
 

Update 13-Oct-2020

A colleague reminds me of an event that's important and very revealing in this context. On 23rd February 2012, the President of the Royal Dutch Medical Association (KNMG) wrote to the President of the American Medical Association in response to "inadequacies" in Republican Presidential candidate Rick Santorum's statements about assisted dying practice and its supposed consequences in the Netherlands.

Mr Santorum, amongst other things, claimed that the Dutch wear bracelets saying "do not euthanise me". Notice how there can be random small, yet conspicuous, mutations in misinformational anecdotes.

The KNMG was unequivocal in its professional advice: "'Do not euthanise me' bracelets do not exist." The KNMG President closed with the observation that:

"Interpretations about the practice of euthanasia in other countries should not be biased by personal opinions whether or not euthanasia is justificed in situations of unbearable suffering without prospect of improvement."

The architect of the Dutch euthanasia law, Dr Els Borst, arguably the most informed stakeholder of the era, responded to the "little cards" claim in plainer language:

"That is an absolute lie." — Els Borst

A diet of evidence-less anecdotes

Anecdotes — devoid of verifiable evidence — about supposed dangers are a favourite diet of VAD opponents, like the nonsense put about by the Vatican, and Catholic Professor Margaret Somerville, that Dutch elderly are streaming into Germany for hospital treatment for fear of being euthanised in the Netherlands; that Els Borst supposedly regretted her law reform; or that there's some kind of slippery slope from VAD to non-voluntary euthanasia — which Rick Santorum handily mutated into involuntary euthanasia.

The anecdote is a favourite snack of opponents for dishing out when they've run out of other confectionery.

Back to now

One's being served up again in Tasmania right now, and it smacks of desperation. In its most recent media release, the Australian Christian Lobby, from the home of the Bible Society in St John Street, Launceston, launched its latest shrill warning with the claim that:

"In a conversation with a member of the British Parliament, one Dutch doctor explained what it was like when euthanasia laws first came to the Netherlands. He said, 'We agonised over our first case of euthanasia all day, but the second case was much easier and the third was a piece of cake.'"

So let's reflect: on some unspecified date ("when euthanasia laws first came to the Netherlands": but that would be the mid 1980s) some unnamed British MP once said that an unnamed Dutch doctor once told him or her… that their third euthanasia case "was a piece of cake".

Who what now?

One only has to glance at readily-available records to see what a load of, um, how shall we put this?... bollocks, the claim is. The Australian Christian Lobby is not referring to a recent, documented, verfied fragment of evidence. Rather, the ACL has jauntily appropriated a statement from May 1998, by Lord McColl of Dulwich in the British parliament. Straight from the Hansard's mouth:

"The Dutch doctors told us: 'We agonised over our first case of euthanasia all day, but the second case was much easier and the third was a piece of cake.'" — Lord McColl

"Dutch doctors": plural. However, the statement is not of the kind that would be said by a broad collective of doctors as Lord McColl story relates.

Indeed, in 2006 his Hansard story mutated to "when a Dutch doctor was asked...". Suddenly from multiple doctors to just one; from direct, personal receipt of the claim, to the claim being made to an unspecified audience, stated in the tell-tale passive voice. If it were really said to you and you wanted to punch home a key point in a spirited on-the-record debate, you wouldn't forget, and you'd make a point that it was said to you, wouldn't you?

Piling up the anecdotes

What else has Lord McColl had to say about the Holland [sic] experience on the Hansard record in 2006? Ah, the "little cards" anecdote, still doing the rounds more than a decade after its invention:

"Many elderly people in Holland [sic] are so fearful of euthanasia that they carry cards around with them saying that they do not want it." — Lord McColl

An anecdotal claim without at least one independent, verifiable source isn't really evidence at all. It's just a myth. A handy but hollow sound bite. It reveals little about the subject... but rather a more about the claimant.

The "piece of cake" anecdote, like those before and since, are just myths conjured up to curry fear, uncertainty and doubt. Piling them up doesn't make them any more true.

Conclusion

As I put one anecdotal claim after another to each of my interviewees across the Netherlands, including VAD opponents, they'd roll their eyes and give courteous replies to the effect that, as one interviewee generously put it, "nobody in the Netherlands takes such commentary seriously."

But I think I prefer Senator Erik Jurgens' parsimony: Bullshit.

And if history is any guide it won't be long before the next re-moistened cowpat is heaved at the political reform fan in the hope that some of it sticks.


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There's a good reason why assisted dying opponents don't mention Switzerland. [Photo by Andrew Bossi]

Supposed Dutch suicide contagion from assisted dying

Recently, Dr Theo Boer, an Assistant Professor at a "black-stocking" (strongly conservative Protestant) theological college in the Netherlands, was at it again — criticising the Dutch euthanasia law to anyone who would listen: "don't follow the Dutch euthanasia law path because it leads to 'suicide contagion'".

I've exposed Prof. Boer's cherry-picked nonsense before. Astonishingly, he even ignores data from the Dutch Euthanasia Commission, despite the fact he used to serve on one of its five Regional Review Committees.

What he doesn't mention is that amongst the five Regions, the Region with by far the highest rate of assisted deaths had the second-lowest rate of general suicide, and the Region with the lowest assisted death rate had by far the highest general suicide rate (Figure 1) in 2014,1 the year Boer left his Committee and began bad-mouthing the Dutch law. Quite the opposite of "suicide contagion".

dutchvadandsuiciderates.gifFigure 1: Dutch assisted death and general suicide rates by region, 2014

From multiple safeguards to just one

The Dutch euthanasia Act has a number of safeguards that stipulate who may qualify to access assisted dying in the Netherlands, and how qualification is assessed, implemented and reported to the authorities.

But there's another country that permits assisted dying with just one provision: Switzerland.

In effect since 1942, an exception in the Criminal Code permits assisted suicide, provided assistance is rendered for non-selfish motives. That's it. There's no legislated (or even government-regulated) requirements for age, illness or condition, decisional capacity, cooling off periods, or anything else.

In the 1980s, two assisted dying associations were formed to make assisted dying generally possible: Exit Deutsche Schweiz for German-speaking Swiss residents, and Exit A.D.M.D. for French-speaking residents.

Since then, several other smaller associations have been formed, including in 1998 Dignitas, which provides assistance to foreigners. (The main societies assist only Swiss residents.) The current membership of the societies, combined, is well in excess of 150,000 people, in a population of just 8.5 million. Assisted dying is often discussed openly in the media.

If "contagion" anywhere, in Switzerland, right?

Given that Switzerland has an abundance of the ingredients that religious opponents of assisted dying claim lead to "suicide contagion", you'd think they'd be shouting about Swiss "suicide contagion" from the rooftops.

But they don't mention Switzerland.

There's a powerful reason why: the data is not only unhelpful to their "contagion" theory, but actively hostile to it.

Latest official government data

I've written about Switzerland before, but, given the ongoing "suicide contagion" misinformation, I thought an update warranted. On request, my contact in the Swiss Federal Statistical Office (FSO) promptly re-supplied all publicly-available statistics of assisted deaths and general suicides, with the data now running up to 2017.

It makes for interesting reading. Figure 2 shows Switzerland's (CH) long-term general (non-assisted) suicide rate, along with the domestic (Swiss resident) and Dignitas (foreigner) assisted death rates. All the official (Australian Bureau of Statistics) longitudinal data I could find for Australia's (AU) general suicide rate is also included.

swissdeathratesto2017.gifFigure 2: Swiss death rates 1969–2017; Australian suicide rates 1990–2017

Immediately obvious is that the Swiss general suicide rate has dropped massively and consistently since the two main assistance societies were formed in the early 1980s. And it's continued to drop even as the rate of assistance, and public discussion, has increased over the most recent three decades.

I also asked the FSO how many cases on record were of minors (persons under the age of majority or 18 years). The answer? None. I double-checked. Zero. Zip. No minors receiving assisted dying in Switzerland. Indeed, cases under the age of 35 years old are uncommon.

Consistent with best practice

Indeed, the data is consistent with suicide prevention. The societies help people get the medical care they need and consider assisted death only when other avenues have failed to provide acceptable relief. Every assisted death is reported as such by the association to the authorities — otherwise the unexpected death would result in a coronial inquiry.

Each association has clearly-defined processes and oversight by ethics specialists. Clients requesting access are assessed carefully by doctors. (In fact, the lethal medication can only be lawfully obtained by medical prescription.) The associations take their responsibilities very seriously.

The data is also consistent with substitution: that what would have been some violent and lonely suicides as a result of unrelievable suffering from intractable conditions, are now peaceful assisted deaths.

And for the record, despite the Swiss law being in effect since 1942 versus Dutch regulation from only 1984; and Swiss law having only one provision versus Dutch regulation/legislation with many; in 2017 the Swiss assisted dying rate, including Dignitas cases, as a percent of all deaths, was less than half that of the Netherlands' rate.

Reasons for requesting an assisted death

Exit Deutsche Schweiz, by far the largest of the Swiss associations, has published statistics of its cases (Figure 3).

exitdsreasons2015.gifFigure 3: Reasons for pursuing assisted dying, Exit Deutsch Schweiz 2015

In 2015, like other jurisdictions, cancer was by far the most common reason (40.8%) for requesting an assisted death. Polymorbidities (22.4%) was next, followed by refractory pain at 8.6%, lung diseases at 5.0% and Parkinsons at 4.3%.

Despite no government-regulated access requirements, assistance for mental illness was very low at 1.7% (Dutch 1.2% in 2015) and cases of dementia at 1.4% (Dutch 2.0%; Belgian combined mental/dementia 3.1% in 2015).

And compared to Australia?

In the 1990s, the Swiss general suicide rate, although falling, was significantly higher than Australia's (Figure 2) until 2010, when the rates were the same. Since 2010, the Swiss suicide rate (with no legislated procedures for its permitted assisted dying) has continued to drop, while Australia's (at that time with no assisted dying law at all), began to rise.

This difference highlights the clear anchoring bias exhibited by religious opponents who cherry-pick their data to try and claim the rise in the Dutch general suicide rate must be the result of "suicide contagion" from assisted dying, when Australia's rate also increased over the same time period, but in the complete absence of an assisted dying law. (Victoria's assisted dying legislation didn't come into effect until mid-2019.)

Further, the Swiss rate has continued to drop even with a significant increase in assisted dying.

Conclusion

Of course, general suicide is a serious issue. It has numerous well-known risk factors (e.g. mental health, substance abuse, unemployment, relationship breakdown, opportunity) and protective factors (e.g. hotlines, funding mental health programs, unemployment benefits, removing opportunity), none of which assisted dying opponents mention while cherry-picking their statistics.

Meanwhile, as legislators contemplate the specific safeguards contained in Bills before their legislatures, it's important to strike an appropriate balance between sufficient safeguards, and inappropriately requiring those considering an assisted death to climb Mount Everest with one hand tied behind their backs.

Switzerland shows that even in a jurisdiction without legislated practices, access to assisted dying is modest, with assistance groups establishing their own stringent ethical and procedural standards.

And it amply demonstrates even under those conditions, an absence of supposed "suicide contagion".

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1 Official Euthanasia Commission data and official Dutch government suicide statistics by region.


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Deep and extensive Catholic connections are behind supposedly secular attacks on VAD.

A friend pointed out to me an opinion piece published this week in MercatorNet that slams Victoria's voluntary assisted dying (VAD) law. Written about an elderly woman with cancer who used the law to die peacefully, it's an angry diatribe written by the woman’s granddaughter-in-law: one Mrs Madeleine Dugdale.

Update 21-Sep-2020

Mrs Madeleine Dugdale's article has been withdrawn from MercatorNet without explanation. Here's a screenshot of the original.

dugdalegranscreenshot620.jpg

And this is Mrs Dougdale's "about" page after the article was withdrawn.

madeleinedugdaleatmercatornet2020_620.jpg

While it's far from my preferred practice to take on someone recently bereaved, Mrs Dugdale has put herself and her family firmly in the public square by publishing an editorial about her grandmother's death (actually her husband’s gran) the very day after she died.

All is not as it seems and a response is required.

Catholic talking points

Let's not beat about the bush: Mrs Dugdale's piece is a grotesque misrepresentation of Victoria's VAD law and relies on gallingly distorted framing. Despite not mentioning faith, religion or Catholicism, her opinion piece ticks most Catholic talking-point boxes I've pointed out previously, such as Mrs Dugdale’s:

  • Headlining that her gran was not in particular pain. We already know from extensive overseas experience that pain is a less common reason behind why people consider VAD.
  • Being sure to emphasise the death was a suicide, and that "suicide is not courageous, it's an horrendous act of desperation and defeat".
  • Linking it to loneliness caused by Covid-19 lockdown.
  • Shabbily inferring that doctors did not discuss and offer all and anything palliative care could bring to bear, when there's a consultation process mandated by law.
  • Suggesting that palliative care could alleviate all intolerable suffering, but which both palliative care peak bodies in Australia concede is not possible.
  • Scandalously implying that medical care workers were forced to participate in her assisted death against their will, when the law protects anyone who wishes to decline.
  • Suggesting her gran's choice was an issue of mental health, implying that she wasn't fit to decide, when in fact doctors must confirm decisional capacity.
  • Describing the process as "obfuscation and secrecy" when a strong chain of documentary evidence is mandated, while no process is mandated for the Catholic church's own accepted patient path to foreseeable death: refusal of life-saving medical treatment.

 

Mrs Dugdale employs no fewer than eight Catholic church talking points in her attack on Victoria's VAD law.

Spurned "help"

Also of note is Mrs Dugdale's description that she and her husband were "silenced" and "quickly shut down" so there was "little my husband and I could do to help." Did the family actually want help of the kind Mrs Dugdale and her husband were determined to dispense?

One wonders what Mrs Dugdale's gran would think if she could see how a granddaughter-in-law had sought to weaponise her choice for VAD, against the law itself.

Update 24-Sep-2020

We now know what gran's immediate family thought of Madelein Dugdale's savage misrepresentation of their mum's death. It's not pretty, and they've asked Madeleine for a written apology. Read the full story at Go Gentle Australia.

Who is Madelaine Dugdale?

So who is Mrs Madelaine Dugdale? Her article bio reports only that she's a former Melbourne high school teacher and now a full-time mum of four with one on the way. Move along, nothing to see here…

Well, it’s worth looking a bit more carefully, elsewhere. Mrs Dugdale graduated from (Catholic) Campion College. And that high school where she worked? St Kevin’s (Catholic) College in Toorak, Melbourne, where she taught… religion.

She's a leading member of Catholic Voices Australia, whose purpose is "putting the Church's case in the public square."

So in summary, this anti-VAD diatribe bristling with Catholic church misinformation was penned by a leading member of Catholic Voices Australia whose remit is "putting the Church's case in the public square", but which failed to identify that religious connection and attempted to give the appearance of secular impartiality.

If there's any remaining doubt about Mrs Dugdale's Catholic devotion, here she is discussing the Pope's amoris laetetia (the joy of love) book with Fr Tony Kerin, an Episcopal Vicar for Life, Marriage and Family in Melbourne.

Hidden religious petticoats indeed.

And who is the publisher?

Mrs Dugdale's anti-VAD tirade is published online by the masthead MercatorNet. It declares itself to be "dignitarian", and reveals that its Editor is a Catholic who believes in God. The masthead is named after Gerardus Mercator, the C16th cradle Catholic cartographer.

MercatorNet's About webpage opines that "religion adds clarity and conviction to the task of defending human dignity" — as if that's an exclusive province or even necessary feature of "religion" — and insists that arguments it publishes are "based on universally accepted moral principles, common sense and evidence, not faith."

Pfft.

Another invitation to "dig here"

Methinks they doth protest too much. It doesn't take much effort to peel back the veneer of neutrality.

MercatorNet is a trading name of the company New Media Foundation Ltd. (For reference, another of its trading names is BioEdge, which has the same Editor as MercatorNet, but we'll get to that later.) It's a company limited by guarantee; a registered charity established in 2005 and based in NSW.

Oddly, its 2019 ACNC records claim 2 full-time and 10 casual employees for a full-time equivalent (FTE) of 5. However, their total payroll expenditure as lodged, "Editor fees", was less than $38k. But If FTE is 5, then that's an average of just $7,600 per full-time annum. A minimum wage of $16/h over a year, without holiday leave, would equate to around $27k per person, times 5 would make a total minimum lawful payroll budget of $135k per annum. Hmmm.

Other major expenses were website maintenance and hosting ($26k), paying contributors ($18k), and insurance ($4k).

The company's bare-bones website mysteriously states only that its mission is "to help people navigate modern complexities in a way that respects the fullness of human dignity."

Of its masthead MercatorNet, the company’s website says only that the outlet is "dignitarian" and "doesn't want to be trapped on one or the other side of the culture wars". Of its BioEdge masthead it says that it's "completely independent".

Double pfft.

Who controls the company?

According to ASIC's records, the four registered Directors of New Media Foundation Ltd are Romano and Francine Pirola, Jude Hennessy and Michael Cook. Romano Pirola is the Chairperson, yet it is Michael Cook and Jude Hennessy who signed off the company's latest financial statements. Who are these people?

Romano Pirola and his wife Mavis were Joint Chairs of the Australian Catholic Marriage and Family Council, which advises the Australian Catholic Bishops Conference. They were appointed by the Pope in 2014 as one of just 14 married couples worldwide to participate in the Extraordinary Synod of Bishops on the Family. They've been awarded the church's honour of Knight and Dame of the order of St Gregory for services to the Church, and in 2016 were awarded honorary doctorates by Australian Catholic University.

Francine Pirola is the wife of Byron Pirola, Romano and Mavis Pirola's son. Francine and Byron were awarded honours by Pope Francis in 2019, are directors of the Catholic Marriage Resource Centre (which, incidentally, acknowledges that Catholic wedding numbers have been falling for 25 years) and were joint Chairs (like Byron's parents before them) of the Australian Catholic Marriage and Family Council. They've even represented the Australian Catholic Bishops at meetings of the Pontifical Council of the Family.

They're also the couple whose investment company loaned anti-marriage-equality lobby group Marriage Alliance $1.67m in support of anti-LGBTI flyers handed out to children on school buses. The Crikey exposé makes further interesting reading.

Jude Hennesy is director of the Confraternity of Christian Doctrine for the Catholic Diocese of Wollongong. It's responsible for "special religious education" in state schools.

Michael Cook is Editor of both MercatorNet and BioEdge. He's been a member of the devout lay Catholic group, Opus Dei for more than four decades. Unlike MercatorNet's About page, BioEdge's own About page doesn't mention religious links of any kind, and says it's "completely independent".

All four directors of MercatorNet's controlling company are very deeply and strongly invested in the Catholic church. One of them, Michael Cook, is its Editor.

MercatorNet's remit

Back in October 2016 I did a keyword breakdown of articles published by MercatorNet. In the then 11 years of its existence, assuming no articles were taken down, it had published more than 2,000 articles containing the word "Catholic". That's a lot for a small outlet: an average of 3.5 "Catholic" articles a week, every week, for 11 years.

In comparison, there were no articles containing the word "Anglican", and just 51 containing the expression "Church of England". There were also 121 mentioning "Hindu", and 868 mentioning "Islam", with many of those negative.

New Media Foundation Ltd's ACNC record indicates its qualifying charitable purpose is "advancing education". But publishing thousands of articles mentioning religion, most of them Catholic, would seem to more fully reflect the qualifying charitable purpose of "advancing religion". But they chose "advancing education" instead — which bypasses any mention of religion.

Tellingly, every visit to and search on the MercatorNet website currently results in a pop-up that invites you to join their "influential community of truth-tellers" to "push back against post-modern relativism". That "relativism" is a pet peeve (and language) of the Catholic church.
 

mercatornetpopup.gif MercatorNet  attacks post-modern relativism: a pet peeve of the Catholic church, to be countered by "truth-tellers".

MercatorNet headlines the Catholic church's pet peeve: post-modern relativism. This is hardly surprising given its controlling company is run by Opus Dei members, Catholic church staff, and church honours recipients.

The founding of New Media Foundation Ltd

When it was founded in 2005, New Media Foundation Ltd's registered address was 296 Drummond Street, Carlton, Victoria. Significant? Decide for yourself.

That's the address of the Drummond Study Centre. And its connection? "Spiritual activities in the centre are entrusted to Opus Dei, a personal prelature of the Catholic Church." Notice how the centre's name doesn't mention "Catholic" or even religion in any way, either. You have to delve through its web pages to find out.

Previous directors

Similarly, the list of former New Media Foundation Ltd company directors adds to its storyline.

One is Mr Richard Vella, who is or was the spokesperson for Opus Dei in Australia. He describes his personal relationship with God as "the greatest love of my life". Another is Fr Phillip Elias, who was ordained into Opus Dei in Rome in 2017.

Another founding director was Fr Amin Abboud, who died in 2013 and was given a full requiem mass funeral at St Mary's Cathedral in Sydney, presided over by church officials including Monsignor Victor Martinez, the then Regional Vicar of Opus Dei for Australia and New Zealand.

Yet another is Carolyn Moynihan, Deputy Editor of MercatorNet and frequent contributor to Crisis Magazine, "a voice for faithful Catholic laity" and a contributor to the Catholic Exchange. She rails repeatedly against the harms of marriage equality.

Get the picture?

New Media Foundation Ltd and its masthead MercatorNet's Catholic underpinnings are deep and strong.

The roots of the garden

But if you think it might simply be a small bunch of enthusiastic individuals, think again. This veritable garden of fertile Catholic plants arose from somewhere.

Where might that be? I've already pointed out seeding strategies for non-clerical commentary promoted by the Catholic Archbishop of Sydney, Anthony Fisher. It's also worth pointing out that, like any other major institution that seeks to influence public policy, the Catholic church in Australia maintains a whole media and communications department.

Further, the Australian Catholic Media Council hosted the triennial Australian Catholic Communications Congress in 2018, which notably for the first time ever was held together with the Australasian Catholic Press Association (ACPA) Conference. ACPA's brief is to "give voice to Catholic perspectives on the issues of our societies". Former Vatican journalist Greg Erlandson delivered the keynote address to the joint conference, and masterclasses were held to "hone particular skills".

Not a recent phenomenon

If you think this just a recent phenomenon you'd be mistaken. Back issues of the Vatican's own newspaper, L'Osservatore Romano, prove most enlightening.

At least as far back as the eighties, through the nineties and the noughties, the Vatican has been vigorous in its promotion of media engagement across Europe, Asia/Pacific and the Americas. For example, in March 1990 Pope John Paul II noted "unprecedented opportunities" to proclaim the word of God via media channels in central and eastern Europe.

In the same year, Archbishop John Foley, then President of the Pontifical Council for Social Communications, told media workers at a Catholic world congress not to "falsely" compartmentalise their lives into private piety versus professional work subjected to commercial pressure, but instead spread Catholic "truth". He also schooled filmmakers amongst the gathering that "great films are 'at least implicitly religious'".

The Vatican and its 'authorities' repeatedly cajole Catholics into "truth-telling", which means evangelising the church's stances.

Ongoing evangelisation focus

Pope John Paul II repeated his firm wish for more mass media coverage in a major address in 1992, and a follow-on note in the same year encouraged USA Catholic journalists to "put their professional skills at the service of the Gospel".
 

massmedianeedscatholicpresence.gifThe Catholic church believes the mass media needs a Catholic presence.

In another example in 1993 Pope John Paul II emphasised how new media — then videotapes and audiocassettes — could serve the "new evangelisation". And in 2002, he again implored Catholics to adopt the latest new media — the Internet — in "proclaiming the Gospel". Two years later MercatorNet was launched online, as were other similar sites.

And if there was any doubt as to what Catholic communications services were for, in October 2012, Pope Benedict XVI delivered a major address confirming that "the church exists to evangelise".

That's just a few of the many.

Media for the faithful

Back in Australia, B. A. Santamaria established the AD2000 journal in the late 1980s. It's an obviously Catholic publication published by the Thomas Moore Centre in Melbourne. A quality journal aimed squarely at and informative to Catholic adherents, it is of limited interest to the general public. What reaches the general public is mainstream media.

But "Houston, we have a problem"...

Mainstream media a "problem"

In a revealing narrative, loyal Catholic Professor Margaret Somerville, now at the (Catholic) University of Notre Dame Australia, laid out the critical importance of the media to the outcome of VAD law reform in her 2001 book Death Talk: The case against euthanasia and physician-assisted suicide (especially see Chapter 19).

In it, she highlights the Catholic communications problem (without mentioning Catholicism), railing against what she claimed even then was the mostly "small-l liberal" mainstream media as resistant to religious messages. She confirmed that religious media are much more accommodating of the "pro-life" world view.

She specifically noted the importance of "framing" the issues to "significantly influence political decisions", complaining that "anti-euthanasia arguments do not make dramatic and compelling television". She then went on to outline a collection of useful anti-VAD "frames", which were wholly consistent with the Vatican's position and language.

Indeed, you'd be forgiven for thinking Professor Somerville wrote the church's framings, because she's given pre-eminent billing over the Vatican itself in the Catholic Archdiocese of Perth's website for bioethics, the LJ Goody Bioethics Centre. Of further relevance is that the Catholic Archbishop of Perth is, along with the Catholic Archbishop of Sydney, the ultimate authority controlling the University of Notre Dame Australia, where Somerville is a Professor.

(Incidentally, the website's home page "What's new" announcement is more than 5½ years out of date, which gives the impression that the Centre was a hasty, event-specific confection whose purpose has long since passed.)
 

ljgoodybioethics2020-09small.jpg Professor Margaret Somerville gets pre-eminent billing on Catholic bioethics, above the Vatican itself.

Don't mention the war religion

Amongst Professor Somerville's numerous writings slamming VAD, some stand out more than others. One that does is a 2008 editorial titled Death talk in a secular age, in which she vigorously encourages religious opponents to "formulate a moral argument against euthanasia without resorting to religion" [my emphasis]. And who published this editorial? Why, it was MercatorNet!

Did the Catholic church take note of Professor Somerville's strategy? As I've pointed out before, Mr Ben Smith, Director of the Life, Marriage and Family Office at the Catholic Archdiocese of Hobart, fails to mention who he really is in at least two purportedly "independent" groups fulminating against Tasmania's current VAD Bill. One of the groups he leads, Live & Die Well, encourages people to write objections to their parliamentarians, but expressly commands "DO NOT use religious arguments."

Professor Somerville was also a keynote speaker at a 2008 conference of media professionals in Toronto, in which she advised journalists and editors how to "frame" the debate against VAD. But these were not just any journalists and editors at large. They were Catholic journalists and editors: members of the Association of Roman Catholic Communicators of Canada, whom she schooled alongside a number of Catholic church officials. The conference's title? "Proclaim it from the rooftops!"

Catholic Professor Margaret Somerville has been central to the Catholic church's hostile "framing" of VAD, and helping media specialists spread that framing through the media.

More religious frustrations

Over the years Professor Somerville continued to build upon the theme, including in her 2015 book, Bird on an Ethics Wire: Battles about values in the culture wars. She escalated her criticism of the "intense tolerance" of "the now ubiquitous moral relativism" as an illustration of how VAD law reform demonstrates what happens "if we take a purely secular approach not balanced by religious views."

A curated garden

You will have noticed by now significant common threads in favour of Catholic "truth"; against "relativism"; calls to evangelise using the media; calls to avoid and actual avoidance of religion in argumentation; avoidance of revealing religious connections in by-lines; and a united portfolio of Church-friendly framings of VAD by a busy theatre of players.

Given the church's perceptions of a hostile mainstream media, is it any wonder that some devout Catholic contributors, and deeply Catholic media outlets, hide their religious petticoats and zucchetti while publishing grave misinformation in the curry of fear, uncertainty and doubt (FUD) against VAD?

This isn't a random jungle.

No, it's a curated garden, tended to by what we might call the 'Catholic communicators guild'.

Failure to mention deep Catholic roots behind purported "secular" attacks on VAD law reform is a strategy of the 'Catholic communicators guild'.

Conclusion

In this review, I've revealed only some of the deep Catholic connections that resulted in a shocking appropriation of the death of an elderly woman with cancer, using misinformation and framing wholly consistent with the Catholic church's evangelisation, but withholding key information about those deep religious underpinnings.

It's clear the Catholic church understands that its religious arguments are unpersuasive to the wider community. It's also important that the public and legislators understand how religious forces attempt to sow fear, uncertainty and doubt about VAD law reform by giving the appearance of secular neutrality to its messages.

Mrs Dugdale’s gran deserved better than to be appropriated for the aggrandisement of an agenda that is clearly at odds with her own beliefs and values… and the values of the overwhelming majority of Australians.

May she rest in peace.


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Multiple "non-religious" anti-VAD campaigns are being run through the Catholic Archdiocese of Hobart

If you're wondering how religious the organised opposition to voluntary assisted dying (VAD) law reform is, current ructions in Tasmania provide a marvellous petri dish of evidence.

Catholic church call to arms

Back in 2011, the now Catholic Archbishop of Sydney, Anthony Fisher, wrote a lengthy, deliberative editorial against VAD, calling on the church to enlist people with no obvious religious connections to help the church fight VAD law reform. He wrote:

“The man or woman in the street … may well be open to persuasion that permissive laws and practices cannot be effectively narrowed to such circumstances”; and
“we need to research and propose new messages and carefully consider who should deliver them, where and how.”

He went on to describe how various doctor, patient, lawyer, indigenous, disability and palliative care specialist groups might be corralled into this public relations campaign. (Nowhere in this musing did he reflect that the church's expectations of VAD calamity themselves might actually be queried or tested.)

Despite this, when promoting anti-VAD messages, he argued, “we do not have to hide our religious petticoats altogether.”

However, this standard of transparency seems to have been abandoned in recent years.

Pop-up group "Live & Die Well"

Take the Tasmanian pop-up group Live & Die Well, for example. Convened just six weeks ago for the sole and express purpose of defeating Tasmanian MLC Michael Gaffney's VAD bill, its website doesn't mention religion… at all. No identified religious connections nor religious arguments of any kind. Meticulously absent.

Indeed, the anti-VAD campaigning pamphlet the group puts about expressly advises folks when writing to their MPs, "DO NOT use religious arguments".

That's quite curious given the religious backing of the group, headed by Mr Ben Smith.

The Catholic church gets busy

Who is Mr Smith? He's the Director of the Life, Marriage and Family Office at the Catholic Archdiocese of Hobart. He reports directly to Archbishop Julian Porteous.

Unsurprisingly, core attributes given in the 2017 job advertisement for which Mr Smith was the successful applicant, require deep knowledge of the Catholic church, unquestioning support for its doctrines, and “highly-developed communication skills” to promote the church's agenda.

And, Messrs Smith and Porteous' arguments are strikingly similar, as I've revealed previously.

Does Mr Smith declare this on the Live & Die Well website? Nope. He's just a "resident of Hobart".

And the other "leaders"?

The other three "team leaders" at Live & Die Well are Mrs Patricia Gartlan, Mrs Karen Dickson, and Mr Daniel Bosveld.

Mrs Gartlan is a recipient of the Catholic church's Knights of the Southern Cross National Award for services to the "sanctity of life". (Recently, her "team leader" entry has been removed from the website.)

Mrs Karen Dickson is Chair of Mothers of Pre-Schoolers (MOPS) Australia, a Christian fellowship group. She's previously campaigned against same-sex adoption, which she opined is against God's will and would result in inevitable "moral decay" and the destruction of "the very foundations upon which society is built". Predictably, she's also actively campaigned against marriage equality, likening it to "dropping a brick on your foot".

Mr Bosveld is a university student (most likely protestant) and President of LifeChoice Tasmania, a tiny student group promoting the "life from conception through [to] natural death" position. His Facebook page "Likes" more than 20 Christian groups, including the Australian Christian Lobby.

Look… over there!

The extent to which Live & Die Well exquisitely attempts to paper over its religious petticoat is exemplified by the inclusion of two articles purporting to strengthen the non-religious case against VAD law reform.

The first is a piece republished from Spectator Australia, in which an atheist says he opposes VAD law reform. Of course there are non-religious people who oppose VAD law reform: but robust survey evidence shows that they're rare, and that in fact strong opposition is strongly correlated with high religiosity. Nor are there teams of atheists actively organising others, as the churches are, to oppose law reform.

The second is an article by Mr Wesley J. Smith which tries to imply that opposition to VAD law reform is more widespread amongst humanists than it is. He's a Senior Fellow at the Discovery Institute. Remember them? They tried and failed to have "Intelligent design" (creationism with lipstick), taught as science in US schools.

I've had words to say about his misinformation and incoherent slippery slope nonsense here, here and here. Oh, and Live & Die Well omits the real publication date of the reproduced op-ed — which is more than a decade ago — presenting it as though it's fresh and contemporary.

Another group

Another group that's been actively and vocally opposing Mr Gaffney's VAD bill is Health Professionals Say No.

A major newspaper ad against the bill was recently taken out in the group's name. It was authorised by a certain Mr Ben Smith. Yes: that's the same Mr Ben Smith who is Director of the Life, Marriage and Family Office at the Catholic Archdiocese of Hobart. And the authorisation address is… the Catholic diocesan centre of Hobart.

One might wonder who actually paid for the ad…

The who's who

The group's website advances the usual slippery slope conjectures, and promotes the video Fatal Flaws, produced by Canadian loyal Catholic, Mr Kevin Dunn. That's the "documentary" that Go Gentle Ausralia's Fatal Fraud film exposes for its extensive religious connections, revealing how it employs emotional manipulation, fear, framing and omission to sow Fear, Uncertainty and Doubt (FUD) in the minds of legislators and the public.

Prominent members of Health Professionals Say No include:

  • Prof. David Kissane, a Knight of Obedience to the (Catholic) Order of Malta.
  • Dr Maria Cogolini, a Catholic bioethicist.
  • Dr Megan Best, a Catholic bioethicist who got her facts fundamentally wrong.
  • Dr Douglas Bridge who has identified his "supreme Christian calling".
  • Prof. John Murtagh who says medicine and Christian ethics are inextricably linked.
  • Prof. Ian Olver, a lay preacher.
  • Dr Peter Coleman who has called for "placing the Christian revelation at the centre of university education."
  • Dr Peter Ravenscroft, past Chairman of the International Christian Medical & Dental Association.
  • Dr Anthony Herbert, former National Secretary of the Australian Christian Medical Fellowship.
     

Too many yet too few

It also includes Victorian, Dr Roger Woodruff. That's significant because one of the group's key claims is that people will feel unduly influenced to use VAD law, i.e. too many people will die from VAD. Yet Dr Woodruff previously published an opinion in the Journal of Palliative Medicine that the most striking feature of the VAD experience in Oregon is “almost total disinterest shown by the terminally ill” due to the small numbers of VAD compared to the number of cancer deaths.

So to sum up that approach: VAD mustn't be legalised because too many people will use it, but it's not worth legalising because too few people use it. Which is it? It can't be both.

Avoiding the ad hominem fallacy

We should be sure not to reject arguments automatically just because they are made by religious people. People of faith have just as much right to be heard in the public square: otherwise one would be arguing special privileges for non-faith Australians. Standards for public discourse are necessary, however.

“Dig here”

The connection being made here is not to reject arguments because of the religion of the informant, but to identify where misinformation almost exclusively comes from. I've been writing about this for years, with exposés on deep religious misinformation like:

  • The Vatican claim that Dutch elderly supposedly go to Germany for medical treatment because they fear being euthanised in Dutch care homes (the claim causing a diplomatic crisis).
  • The Catholic church in Australia spreading grotesque propaganda about Belgium's assisted dying practices, prompting a rare, savage rebuttal from the authors of the scientific study the church misrepresented.
  • The claim that a Council of Europe resolution "banned euthanasia" throughout Europe, when the resolution did no such thing.
  • Spreading the appalling conspiracy theory that 650 babies a year are euthanised in the Netherlands when no such thing happens.
  • Catholic Professor Margaret Somerville's repeated claims, based on cherry-picked data, wrongly claiming suicide contagion from VAD laws, and loftily dismissing extensive evidential rebuttals.
  • A mathematical confection by Catholic bioethicist Dr David Jones and Catholic loyalist and economist Prof. David Paton to attempt to "prove" suicide contagion in Oregon, in which they committed ten deadly sins.
  • The above report being glowingly endorsed by a Catholic psychiatrist, Dr Aaron Kheriaty.
  • Catholic-backed Alex Schadenberg of the "Euthanasia Prevention Coalition" and Catholic "HOPE"'s Branka van der Linden polemicising an article purporting to show 'inhumane deaths' under VAD, but which established no such thing. ("HOPE" was established by the Australian Family Association, a Catholic lobby group founded by Australia's most famous lay Catholic, B. A. Santamaria).
  • Indefensible slippery slope argument from Dr Bernadette Tobin, Catholic ethicist and daughter of B. A. Santamaria.
  • Serious cherry-picking including the negation of cited source meaning, by Victorian Catholic MP, Mr Daniel Mulino, whose report is hosted online by the Catholic Archdiocese of Melbourne.
  • Senior clerics of the Catholic Archdiocese of Melbourne misinforming a parliamentary inquiry.
     

One could go on, but I think the point is amply made.

Conclusion

Public misinformation about VAD law reform and practice arises largely via organised religious commentators who coalesce and focus their efforts against parliamentary law reform bills.

Given how common misinformation about VAD can be from organised religious sources, it's understandable that the public and legislators alike might simply 'switch off' if a commentator reveals a religious background.

It's no surprise then that coordinated religious public relations efforts against VAD law reform try to look as non-religious and as broad-based as possible.

 

-----

With thanks to my friend Chrys Stevenson for contributing research details in this report regarding members of Health Professionals Say No.


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St Mary's Cathedral, Hobart, Tasmania

Hobart Catholic Archbishop Julian Porteous makes a number of incorrect representations about voluntary assisted dying (VAD) in his recent Talking Points article (Hobart Mercury 23rd Aug). And, most of his own flock disagree with his opposed stance.

Let's take a look at the facts, and the Archbishop's 'alternatives'.

NOTE: While The Hobart Mercury published Archbishop Porteous' arguments, they declined to publish this rebuttal.

Key points

  1. Archbishop Porteous wrongly equates VAD with general suicide and insinuates they are lonely deaths when they aren't.
  2. He claims that palliative care can always help, when palliative care peak bodies clearly state that it can't.
  3. He insensitively co-opts Covid-19 victims and their families into his arguments, despite them having nothing to do with VAD.
  4. He doesn't represent his own flock: three quarters (74%) of Australian Catholics support VAD, including near half (48%) who strongly support VAD. A tiny 15% are opposed.
  5. In just twelve years (2007─19), the Australian Catholic church has lost a quarter (26%) of its flock. Of those remaining, an increasing proportion, now half (50%), never or almost never attend services.
  6. Diocese Director of Life, Marriage and Family, Mr Ben Smith, encourages Catholics to write to their politicians using the same talking points as Porteous, and with express instructions "DO NOT use religious arguments".

Assisted deaths completely different from general suicide

One particularly egregious aspect of Archbishop Porteous' rhetoric is the innuendo he employs to equate VAD with general suicide, including liberally sprinkling the word "suicide" through his narrative.

But there are profound differences between general suicide and VAD. Most Australians understand that, and research shows that most Australian doctors agree.

Assisted deaths are not lonely

The Archbishop, with astonishing misjudgement, also co-opts the Covid-19 deceased into his story arc: people whose funeral can't be attended by loved ones because of government-imposed lockdown. He obliquely infers that VAD users are or will be naturally unattended by loved ones — even without imposed lockdown.

He further slathers on observations about family reconciliations during the natural dying process, with the implicit meaning that's the only dying context in which families might reconcile.

His presumptions skirt extensive evidence that one of the most treasured factors amongst both VAD law users and their loved ones is the opportunity to express love and caring, and the ability to gather and say goodbye.

Further, multiple scholarly studies show that loved ones recover from bereavement after an assisted death at least as well as those bereaved from natural death, and in some cases, better.

Contrary to Archbishop Porteous' sinister insinuations, VAD deaths can prompt families to gather, express love, say goodbye, and grieve well.

Palliative care can't always help

Archbishop Porteous also argues that palliative care "is able to manage pain and suffering" such that nobody should experience a bad death. He ought to know better: more than half of all palliative care services in Australia are delivered via Catholic institutions.

Palliative Care Australia has clearly stated that "complete relief of all suffering is not always possible, even with optimal palliative care". Even Catholic Doctor's Association palliative care specialist Dr Odette Spruyt, a past President of the Australian and New Zealand Society of Palliative Medicine, has said "it is simplistic to argue that palliative care can remove all suffering at the end of life."

Both of Australia's peak palliative care bodies acknowledge that even the best care can't relieve all terrible suffering at the end of life.

Less treatment but more treatment

Then there's the incoherence of the Archbishop’s argument acknowledging that people want to avoid more medical intervention, while arguing at the same time that more medical intervention (palliative care) is always the only answer to end-of-life suffering.

What about the devout religious?

He adds an odour of hubris to this unctuous spread by noting with disapproval that "family members of those who have had difficult deaths" are the most vocal supporters of law reform. Indeed. These are real people with real experiences of when even the best palliative care can't help.

For balance, it's worth pointing out that numerous research studies show that it's the most religious who are the most vocal opponents of VAD law reform.

Numerous scholarly studies show that it's the most religious who are the most vocal opponents of VAD law reform.

But don't mention religion

It's curious then that the Archbishop — a senior cleric — invokes not a single religious statement or reference in his narrative. Perhaps he's coordinated well with his diocesan Director of Life, Marriage and Family Office, Mr Ben Smith, who advises in an anti-VAD letter-writing guide handed out at Tasmanian masses last week, "DO NOT use religious arguments".

Unsurpisingly, Mr Smith also recommends other language demonstrated in the Archbishop's opinion piece: imply that people will be vulnerable, say that palliative care is the answer, bring up the Covid-19 pandemic, and refer to assisted suicide rather than assisted dying.

Director of Hobart's Catholic Life, Marriage and Family Office, Mr Ben Smith, urges Catholics to write to their politicians to oppose VAD, but directing them “DO NOT use religious arguments”.

Far from representing the 'everyman'

Rather than use any religious references, Archbishop Porteous carefully crafts his grave implications in 'everyman' language as though the points he makes are naturally agreeable to everyone.

But he doesn't represent the great majority of Australians, four out of five (80%) of whom support VAD, according to the most recent (2019) impeccable national study from Australian National University.

Far from representing Australian Catholics

Nor does Archbishop Porteous represent the views of most Australian Catholics. The ANU study also found that three quarters (74%) of them support VAD, with only a tiny minority (15%) opposed. A staggering near-half (48%) of Australian Catholics now strongly support VAD, up from around a third (36%) just three years earlier in 2016.

Three quarters of Australian Catholics support VAD law reform, almost half of them strongly.

At the same time, the ANU study reveals that the Catholic Church represents fewer and fewer Australians. In just the twelve years between 2007 and 2019, the Catholic Church lost a quarter (26%) of its flock. Australians with no religion (41%) now outnumber Catholics by two to one (21%).

In addition, of the fewer still identifying as Catholic, there's been an increase of more than one in five — now comprising half (50%) — who never, or almost never, attend services.

It's worth emphasising that even amongst those who haven't abandoned the Catholic church altogether — the more entrenched — strong support for VAD law reform has soared.

The Australian Catholic church has lost a quarter of its flock in 12 years, and half of those remaining never or almost never attend services.

Not the best spokesperson

Amid shrinking flocks, withering attendance and a weighty jump in strong Catholic support for VAD, it's curious that the Archbishop continues to vocally push entrenched opposition. Perhaps Sydney's Catholic Archbishop Anthony Fisher was right when he said in 2011, "Bishops, for instance, are not always the best public spokespeople for the Church on such matters." Indeed.

As politicians are only too keenly aware, they're elected by the people, not appointed by religious officials.

Australians unambiguously show a determined and increasing appetite for lawful VAD. It would be a courageous politician indeed who resolved to trudge the road now so obviously on the wrong side of history.


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'HOPE' is pedalling assisted dying misinformation to politicians again.

The Catholic-backed anti-assisted-dying ginger group, HOPE, was represented for years by Paul Russell. He's retired and Branka van der Linden is now at the helm. But its penchant for pedaling egregious misinformation hasn't changed. Van der Linden recently sent an email to all WA members of parliament, containing three points.

Van der Linden's email reads:

 

Dear [MP salutation],

Did you know that the WA majority report that recommended assisted suicide for WA either dismissed or failed to report on the following statistics?

  • In the Netherlands in 2015, 431 people were euthanised without their explicit consent.
  • In Belgium, 8 per cent of all deaths were without explicit consent from the patient.
  • In Oregon in 2017, the ingestion status of 44 (out of 218) patients was ‘unknown’, making it impossible to ascertain if these 44 patients ended their lives voluntarily and without coercion.

Yours faithfully,

Branka van der Linden

Director, HOPE

 

The trouble is, all three claims by van der Linden are either directly false or egregiously misleading. Here are the actual facts:

FACT: Peer-reviewed scientific research shows that the non-voluntary euthanasia rate of both the Netherlands and Belgium has dropped significantly since their assisted dying Acts came into effect in 2002, consistent with more careful end-of-life decision making across the board.

Fiction 1: van der Linden improperly cherry-picked a single year’s statistic for each country (and, incoherently, a raw count for one but a percentage for the other), implying that lawful voluntary euthanasia increases non-voluntary euthanasia, when the opposite is true.

Fiction 2: van der Linden claimed Belgium’s non-voluntary euthanasia rate is 8%. It has never been anywhere near that figure: the most recent figure is 1.7% and it was 3.2% before Belgium’s euthanasia law.

FACT: Oregon’s health department actively matches death certificates with prescriptions issued for assisted dying. At any time some prescriptions have not been taken and the person may still be alive, and for the deceased, death certificates are still being processed. This naturally means that some prescription/death statuses will temporarily be ‘unknown’ to authorities, even though they will be later determined.

Fiction 3: van der Linden comically implies that this proper process is sinister.

It's curious how 'HOPE' likes to repeatedly demonstrate how HOPElessly uninformed it is about the actual facts and that its methods include cherry-picking data which it thinks supports its anti-assisted dying case, but which don't.

Western Australians deserve better than HOPE's silly propaganda campaign.


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A forensic analysis exposes Theo Boer's smoke and mirrors on 'suicide contagion'

In my most recent article in the Journal of Assisted Dying, I forensically analyse Dutch ethicist Professor Theo Boer’s 2017 paper purporting to find suicide contagion from assisted dying in the Netherlands. It doesn’t go well for Professor Boer, to put it mildly. You can find the full article here.

I also find an astonishing coincidence that occurred in 2014, the year Boer went feral against the Dutch euthanasia law.

Multiple fatal flaws

In the ‘analysis’ outlined in his article, Boer commits a number of fatal scientific no-noes, including failing to analyse the variable he actually surmised might cause suicide contagion, cherry-picking data that supported his conclusion while ignoring or offhandedly dismissing data at odds with his conclusion, and wrongly forming a causative conclusion from a simple correlation while failing to control for any confounding variables of which there are many.

A litany of scientific offences

In addition to the fatal flaws, Boer’s article contains numerous other scientific and academic offences. My forensic analysis concludes:

“In summary, Boer’s article contains a litany of scientific and scholarly failures. Its speculations are ill-informed, poorly-assembled, incoherent in places and mostly uncited, the data cherry-picked and invalidly interpreted, and the laissez faire methodology incapable of validly supporting its conclusion.
 

Boer conjures up mere smoke and mirrors to argue suicide contagion from VAD in the Netherlands. The article should be retracted.”

The article also reflects badly on the journal that published this smoke and mirrors: the Journal of Ethics in Mental Health. Neither peer review nor editorial effort identified or attempted to correct any of the nonsense in the article.

What was he thinking?

Professor Boer is an expert in Reformist Protestant theology. As a religious ethicist, it’s astonishing that he considered himself suited to conducting and publishing a ‘causative’ scientific study.

In his article, Boer proposed VAD as the only factor to contribute to changes in the Netherlands’ general suicide rate (and dismissed the Belgian data which contradicted his theory).

In reality, numerous risk and protective factors affect the suicide rate, and in the Netherlands as I’ve established using their official government data, just one factor — unemployment — explains 80% of the variance in the Dutch suicide rate since 1960. Boer casually dismisses this without providing the faintest fume of an empirical analysis himself.

Boer’s article did little but amply demonstrate his underlying anchoring and confirmation bias on the subject, his unfamiliarity with the complexity of suicide, and ignorance of proper scientific principles.

For good measure, he casually threw in a comment about “suicide contagion” or copycat suicides, without understanding that in suicide, copying is the method of causing death. But by definition, general suiciders don’t follow the provisions of the euthanasia Act.

His endeavour made as little sense as me writing a conclusive article about Reformist Protestant theology, about which I know very little.

A copycat analysis?

Coincidentally, the structure of the storyline, the litany of scientific offences committed, and the conclusions reached in Boer’s article were surprisingly similar to those in an ‘analysis’ of Oregon’s suicide rate in another paper by Jones and Paton. Like Boer, Jones and Paton start out by surmising that assisted dying ought to lower the general suicide rate, and conclude the opposite.

Boer approvingly cites the Jones and Paton article, even though a forensic analysis found no fewer than ten major scientific flaws in it and provided multiple sources of empirical evidence at odds with the article’s conclusions.

But Boer manages to cock even the citation up, referring to the article’s authors as Holmes and Paton.

Will the real Theo Boer please stand up?

Boer notes that he’s always been a euthanasia sceptic. Nevertheless, as a Reformist Protestant, he had long accepted assisted dying in “emergency” situations, of which intolerable and otherwise unrelievable suffering is a ‘qualifying’ criterion, and which is the substance of the Dutch euthanasia law (it’s regarded in legal circles as a law of “necessity”). He also opined that the Dutch model was a decent one that other jurisdictions could emulate.

Boer served as the ethicist member of one of the five Dutch euthanasia review commissions, examining every case reported to it between 2005 and 2014.

In 2014 he publicly quit his post on the review committee, slamming the Dutch assisted dying system. He’s been badmouthing it to anyone who will listen, since.

In preparation for this analysis, I asked Boer if his vocal opposition to the Dutch assisted dying model was now based on an in-principle opposition to assisted dying, or only in regard to more recent practice under the Dutch euthanasia Act. Despite a couple of iterations, I didn’t get a specific answer.

The law hasn’t changed

Here’s the point. While Boer repeatedly opines that things changed radically in the Netherlands around 2007, the country’s euthanasia Act hasn’t changed since it was passed in 2001 (and came into effect in 2002). Not. One. Word.

In addition, the Dutch Supreme Court determined in 1994 that individuals with mental (in the absence of concomitant physical) illness could qualify under the then regulatory euthanasia framework, and it was found that cases occurred every year.

And the 2001 Act formalised in statute the regulatory framework that had existed since at least 1984, when the Dutch medical association first published guidelines for euthanasia.

Thus, the Act reflects very long-standing practice, and it hasn’t changed since it was enacted, in contrast to Boer’s claim that things have radically changed.

Flimsy and incoherent ‘ethics’ part 1

This brings us to the first fatal incoherence of Boer’s “ethics”: that he now opposes the law because people with psychiatric illness and other conditions are, in slightly increasing numbers, availing themselves of the euthanasia law. It is these cases against which Boer rails, despite having previously said the Dutch model is a good example for the world, and having actively participated in the system.

Boer’s flip flop is to argue that a law that permits assisted dying under a range of medical conditions (and has done so for decades) is a good law, provided some of those who might qualify (like psychiatric cases) never use it.

Try and explain the ethics behind that position.

Flimsy and incoherent ‘ethics’ part 2

The second fatal incoherence of Boer’s ‘ethics’ is his repeated complaint that until around 2007, the numbers of euthanasia cases was “somewhat steady”, but increased after that. Never mind that the majority of the increase was still in relation to terminal cancer: Boer simply railed at the increased numbers as a major problem.

But, try and explain using ethical principles, why it is appropriate for 2,000 people a year to avail themselves of the euthanasia law, but inappropriate for 4,000 (who all qualify)?

Indeed, the Dutch euthanasia Act makes no mention of numbers: there is no legislated limit on the count of people who might choose to use the law. Rather, it is based on due care criteria, outlining the circumstances of who may qualify, and the process by which they may.

The legislature’s intent remains unchanged and is still being adhered to, though more people, the majority of whom have terminal cancer, are using the law.

It’s astonishing that a Professor of Ethics fails to reflect on the fatal incoherence of his own ‘ethical’ arguments.

What happened?

Boer, who had supported and promoted the Dutch euthanasia model suddenly and incoherently changed his position to vocally opposed in 2014. What happened?

One factor might shed some light. In 2014, Boer was appointed to the endowed professorship of Lindeboom Chair in Ethics in Healthcare at Kampen Theological University.

While Kampen Theological University is a Dutch Reformist Protestant institution and therefore may support assisted dying in “emergency” cases, the Lindeboom Institute, which endows Boer’s eponymous professorship, is less understanding.

The Lindeboom Institute was co-founded by several orthodox Christian institutions and cooperates with the Netherlands Evangelical University which studies science from an creationist Biblical perspective.

The Institute demands “biblically sound medical ethics” along with “Christian norms and values”. You’d be left wondering what that actually means, until you find on its website that the Board’s role is “the protection of people at all stages of life”.

In addition, participating organisations that fund the Lindeboom endowment, like the Dutch Patients Association, Pro Life Health Insurance and the Foundation for Christian Philosophy, are strongly opposed to assisted dying in any form.

It turns out that the authors of that other ‘analysis’ that commits numerous similar scientific offences which generate smoke and mirrors, Jones and Paton, are devout conservative Catholics.

Gosh. What a coincidence.


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Netherlands 'suicide contagion' from assisted dying: Theo Boer's smoke and mirrors


Author(s)

Neil Francis

Journal

Journal of Assisted Dying, vol. 4, no. 1, pp. 1–11.

Abstract

Background: Concerns had been raised about the scientific quality of a 2017 article by ethicist Theo Boer in which he theorised that lawful voluntary assisted dying (VAD) would potentially ‘dampen’ suicide rates, but drew the opposite conclusion: the suggestion that VAD cases have caused higher suicide rates.
Methods: A structured, forensic examination of the article was conducted.
Results: Numerous serious shortcomings were found, including (a) profound unfamiliarity with the complexity of suicide; (b) lack of a clear and specific pre-hoc methodology; (c) numerous unsupported speculations; (d) cherry-picked data and casual dismissal of data at odds with the conclusion; (e) a simple correlation interpreted as causation while failing to control for any confounding factors; (f) incoherent, contradictory and misleading statements; and (g) multiple editorial errors.
Conclusions: Boer’s article is poorly conceived and carelessly assembled, revealing unfamiliarity with both the subject matter and with scientific principles. The conclusions drawn are not supported by the article’s methodology or data. The article offers mere smoke and mirrors to conclude that VAD may increase suicide rates, at odds with wider evidence.

Article keywords

voluntary assisted dying, euthanasia, suicide contagion, Werther effect, Netherlands, methodology

Full PDF

Download the full PDF: Download the full article (5.4Mb)

Citation

Francis, N 2019, 'Netherlands "suicide contagion" from assisted dying: Theo Boer's smoke and mirrors', Journal of Assisted Dying, vol. 4, no. 1, pp. 1-11.

Download the citation in RIS format: RIS.gif


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Margaret Somerville's latest and repeated misinformation deserves censure.

If there’s one thing you have to admire about Margo Somerville, Catholic Professor of Bioethics at the University of Notre Dame Australia, it’s her persistence in the face of being called out for misrepresenting facts about assisted dying. She’s at it again.

Today in the Sydney Morning Herald, Somerville was quoted spruiking her credentials via a recent publication in the peer-reviewed Journal of Palliative Care.1 Since I study the professional literature, I’m aware of said article, which was published several weeks ago. It's a shocker.

The authority bias

Somerville shows herself to again to not care much for the full facts. She seems more comfortable with calling on the ‘authority bias’: advancing her credentials as a “Professor of Bioethics” along with nine “international counterparts” in the authorship of said paper.

I’ll spare you a blow-by-blow analysis of how the JPC article skilfully employs reassuringly professional tones to stake a wholly one-sided and shockingly ill-informed stance against assisted dying law reform.

A very telling example of misinformation

Let’s look at just one very telling example: the statistics that the authors quote about non-voluntary euthanasia (NVE) rates in Belgium and the Netherlands. NVE is a doctor’s act of hastening a patient’s death without a current request from the patient. The authors say that:

“Administration of lethal drugs without patient request occurred in 1.7% of all deaths in the Flanders region of Belgium alone and 0.2% of all deaths in the Netherlands.”

Are these figures correct? Yes indeed they are... as at the date of the cited sources. However, they are just cherry-picked tidbits from a larger and very different smorgasboard of evidence.

A throbbing great falsehood with warts

Do the figures mean what the authors say they mean? In no uncertain terms, absolutely and incontrovertibly not.

The authors don’t just coyly suggest, imply or impute that those NVE rates are caused by the legalisation of assisted dying, they directly claim it. Right in front the statistics, they state categorically that:

“Allowing voluntary euthanasia has led to non-voluntary euthanasia.”

Let’s put this the politest way we can: that’s a throbbing great falsehood with warts on it. The authors would have known this if they’d paid attention to published research facts beyond their own opinions.

Comprehensively ignoring peer-reviewed facts

Had the paper’s authors (and the supposed peer reviewers) actually known much about the subject matter, they wouldn’t have referred to those figures, because they’re massively unhelpful to the case the authors attempt to prosecute. Here are three central published facts about the case:

Fact 1: Before the Netherlands’ euthanasia Act came into effect, the NVE rate was 0.7%. Then in the next research round with the Act in place it had dropped to 0.5%, and the round after that, to 0.2%. The last is the figure the authors quote as evidence that “VE leads to NVE”, despite the fact that the rate had massively dropped, not risen.

Fact 2: Before Belgium’s euthanasia Act came into effect, the NVE rate was 3.2% [typo 3.5% corrected]. Then in the next research round with the Act in place it had dropped to 1.7%, the figure the authors quote. Again, the rate had massively dropped, not risen.

Fact 3: The rate of NVE in the United Kingdom was researched around the same time as the later Dutch figures, and found to be 0.3%.2 The UK has never had an assisted dying law, so the 0.3% NVE rate, which is higher than the Dutch 0.2% rate the authors quote, can't have been caused by one.

So, these three key published facts — known to most of us with an interest in lawful assisted dying — squarely contradict the authors' VE-causing-NVE claim. It's at the very least astonishing and inexcusable that all the numerous authors and peer reviewers of this “scholarly” article either didn’t know, or “overlooked”, them.

Indeed, despite holding one of the world’s largest scholarly libraries on published assisted dying research, I know of no study that establishes a VE-to-NVE link. All the evidence is contrary.

Not the first time

We could perhaps be a little forgiving if the authors just got a statistic wrong. After all, we're all human. But there are ten authors, plus peer reviewers. And there’s the egregious offence the authors committed in making an unequivocal but false claim about the data. Did none of them know what they were talking about or bother to check?

In this case I’m wholly unforgiving. That's because I’ve called Somerville out multiple times before for misrepresenting data, including for misrepresenting Belgian and Dutch NVE data precisely as she does again in this JPC article. We’ve even publicly exchanged words about it via the ABC’s Religion and Ethics portal. It’s not like she simply didn’t know.

I’ve also called Somerville out for wrongly claiming that Dutch Minister of Health Dr Els Borst regretted the euthanasia law; and wrongly claiming the Dutch elderly go to German hospitals and nursing homes for healthcare for fear of being euthanased in the Netherlands, including that NVE actually does occur in German nursing homes, despite, as Somerville notes, “their strict prohibition on euthanasia”.

This rubbish deserves censure and ridicule

While I argue strongly that different views about assisted dying law reform are welcome in a robust democracy, repeatedly spreading such egregious misinformation about assisted dying is an embarrassment to and unworthy of scholarly attribution to professorship. Such rubbish deserves to be rejected, censured and ridiculed.

 

References

  1. Sprung, CL, Somerville, MA, Radbruch, L, Collet, NS, Duttge, G, Piva, JP, Antonelli, M, Sulmasy, DP, Lemmens, W & Ely, EW 2018, 'Physician-assisted suicide and euthanasia: Emerging issues from a global perspective', Journal of Palliative Care.
  2. Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliat Med, 23(3), pp. 198-204.

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Plenty of misinformation will be advanced to oppose Senator David Leyonhjelm's Restoring Territory Rights Bill.

In 1996 the Northern Territory Rights of the Terminally Ill Act (ROTI) came into effect. Just four people had used the Act when seven months later an Act of the Federal Parliament extinguished the NT law, by cancelling the Territories’ authority to enact it.

This week, the Senate [federal parliament] debates the Restoring Territory Rights (Assisted Suicide Legislation) Bill, sponsored by libertarian Senator David Leyonhjelm. If the Bill passes both houses, the Territories will again have the authority to legislate the matter of assisted dying.

Opponents of lawful assisted dying have been sharpening their knives to ensure that Senator Leyonhjelm’s Bill fails and that Territorians remain second-class citizens. In this post I expose one of the desperate and disgraceful pieces of misinformation opponents use to try and curry fear about law reform.

Opponent signals

There are signals from many quarters that assisted dying opponents are dragging out the tired old argument that indigenous Australians are too fearful of assisted dying to allow reinstatement of the Territories’ legislative authority.

The signals are clear, though so far mostly behind the scenes. Nevertheless, they predict a full onslaught of invalid “fear” claims in the parliamentary debate this week.

Populist beginning of the misinformation

Since the NT ROTI Act there have been ongoing claims that indigenous (Aboriginal and Torres Strait Islander) Australians are wholly and deeply fearful of assisted dying law. A chief flag-waver of this proposition is Jesuit Priest Father Frank Brennan. He’s not only argued this line repeatedly in public, but promoted it to at least one parliamentary inquiry.

Fr Brennan likes to frame this argument to suggest that it’s uniquely substantive and persuasive, while other highly relevant information is merely “suggestion”.

“There was a suggestion these fears were whipped up by the churches and other conservative groups.” — Fr Brank Brennan

The “indigenous fears” opinion has been widely disseminated by other Catholics, including now-disgraced Fr John Fleming in a paper on behalf of the Catholic Southern Cross Bioethics Institute, and by Mr Paul Russell, Director of “HOPE”, a ginger group established by the Catholic Australian Family Association.

Classic cherry-picking

I’ve called out Mr Russell and others before for cherry-picking information to suit their arguments. And here we are again. In this blog, Mr Russell correctly reports that indigenous NT parliamentarian Mr Wes Lanhupuy voted in favour of the ROTI Act, but dismisses his vote as the result of “pressure”.

What Mr Russell disgracefully omits from his plug is that Mr Lanhupuy was directly involved in the consultation of indigenous communities, and said this in his parliamentary speech:

“The church has been a major voice. … I heard in the community that some of the churches were telling people that they should not support the bill basically because of their religious beliefs. No information whatsoever was given as a reason for that. No information was given whereby people could determine their own beliefs. That was disappointing.” — NT indigenous parliamentarian Mr Wes Lanhupuy (Hansard)

Disgraceful religious prejudice

But there’s more. At the time the federal parliament was debating its Bill to overturn the ROTI Act in 1997, the Senate Legal and Constitutional Legislation Committee conducted a formal investigation and published a Senate report, Consideration of legislation referred to the Committee: Euthanasia Laws Bill 1996. Its 204 pages make interesting reading.

For example, Mr Creed Lovegrove, a former senior Northern Territory public servant leading the Native Affairs Office, reported to the Senate Committee:

“I express my concern, not at the right of certain ideologists to have their say, but at the misrepresentations some were making to people over whom they have an emotional hold. Where this group happens to be Aboriginal, I believe some of the frightening lies they were told about the subject were a psychological and emotional exploitation of them, as blatant as any that has ever occurred in the Territory.” — p 44

…and reported to him by a group of senior and influential Aboriginals:

“They reckon the government is going to round up all the real sick people and those with V.D. and things like that and finish them off.” — p 45

…and on page 44 of the report, the Northern Territory government noted that at least one Aboriginal community wanted to hear the full story about euthanasia, not just the Church story.

Fake news — avoiding healthcare

There were also widespread claims that indigenous Northern Territorians were avoiding presenting to medical centres for healthcare for fear of being euthanased. However, the Senate report noted (p 52) that the claim was controversial, and that the Northern Territory government had provided statistics to show no significant decrease in presentations for treatment.

In a classic opponent manoeuvre when the data yet again didn’t fit the story, it was then claimed (p 52) that future data could show a decrease in presentations.

Morally bankrupt argument

But that’s a morally bankrupt argument. You don’t deny Jack the right to drive a car because Jill has an ill-informed phobia that Jack’s right is likely to contribute to her own death. Rather, the ethical approach is to provide Jack with his right and to provide Jill with education.

And that’s precisely what the NT government did. In today’s money, it stumped up $500k for education programs, and those programs were beginning to take effect. In testimony to the Committee, Reverend Dr Djiniyini Gondarra (opposed to the legislation) conceded that the education efforts had been somewhat effective in overcoming fears about the ROTI Act (p 52).

Ironic reverse discrimination

Perhaps one of the most ironic aspects of church-led fear of the ROTI Act was the Act’s “reverse discrimination” itself. The Act required, if the doctor and patient did not share the same first language, that a qualified and authorised translator be engaged before the patient might qualify for an assisted death.

Given the rarity of qualified and authorised translators, especially in remote communities, indigenous Northern Territorians would have had significantly less access to use the law than their white, city-based fellow citizens.

Putting it into perspective

Setting aside the dreadfully misinformed fear of assisted dying law and its stoking by churches, the question arises as to the prevalence of indigenous residents in the Territories: both Northern Territory and Australian Capital Territory. I’ve retrieved Australian Bureau of Statistics data from the 2016 census to answer that question (Figure 1).

 

indigenousterritorians.gifFigure 1: Australian Territory indigenous populations
Source: Australian Bureau of Statistics, 2016 census

Indigenous peoples represent a quarter of the population in the NT (25.5%), and a tiny minority (1.6%) in the ACT. Across the two Territories, that’s 10.3% of the population. Even if all the indigenous citizens opposed assisted dying law reform (which is clearly not the case), their impact on overall attitude would be minor.

By way of comparison, most national polls find around 12% of Australians opposed to assisted dying law reform. And, as I’ve factually demonstrated, almost all of that is faith-based. Such ‘fears’ are not a valid reason to prohibit others from pursuing a choice they deeply feel is moral and justified.

Playing the race card

Indeed, if opponents were intent on justifying the denial of a parliament to legislate for assisted dying on the basis of supposed indigenous attitude — playing the race card — then they must also by corollary campaign for the denial of State parliaments to legislate. That's because there are nearly four times as many indigenous Australians in NSW (216,170) and three times as many in Queensland (186,483) as there are in the Northern Territory (58,246) [2016 census data].

To argue one and not the other is to flip-flop.

Contact your Senators now

Church-whipped fear about assisted dying law amongst indigenous Australians is appalling and to be condemned, as is spreading false claims about a supposed reduction in presentations for medical care.

Senators will be inundated with false claims as they contemplate the Leyonhjelm Bill — including that indigenous Territorians are terrified of assisted dying law. (Lyeonhjelm’s Bill doesn’t legalise assisted dying: it only restores Territory parliament rights to consider the reform.)

It’s critical that Senators also hear from supporters of Territory rights — that Territorians not be treated as second-class citizens compared to State-based citizens.

To that end YOU can do something right now! Use the Go Gentle Australia submission page to send a message of support to your State or Territory Senators now. Go Gentle make it so easy, by showing you who your Senators are by merely entering your address.

Don’t delay! Here’s the link again.

 

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Disclaimer: I do not claim, suggest, imply or impute that any individuals named in this article were personally or individually responsible for, or were involved in, any misinformation being provided to indigenous Australians about assisted dying law.


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