Trudeau Curtails Harper's Anti-Choice Activist End-of-Life Panel Activities

This is brilliant. Former PM Stephen Harper appointed in the dying weeks of his government a smallish panel of anti-choice activists to advise his government on how to implement the Supreme Court of Canada's ruling on assisted dying. The CBC reports today that PM Trudeau's government has moved to curtail this panel's scope of activities. It doesn't want advice from the panel on possible legislation any longer, the federal government simply asks the panel members to summarise the results of its consultation. I'm pretty sure the results of this panel's activities will be filed away right after that. Game over for these anti-choice activists. Here is some more background information on two of them. Note that both of them were expert witnesses on behalf of the Harper government fighting the case against assisted dying in our courts. Their expertise sank without a trace when the Supreme Court decided unanimously that depriving us of access to assisted dying violates our Charter rights. Mind boggling the amount of tax monies that were wasted on their activities.

Is it that difficult to get your questions right, Globe and Mail?

The Globe and Mail newspaper has done a pretty sterling job covering the ongoing proceedings on end-of-life matters in Canada. Reporting has been well-informed and its editorialising has been supportive of the decriminalisation of assisted dying in the country.

Yesterday though, the paper flunked it. It tried to have yet another for-and-against on the subject matter. I don't blame the paper, the issue is currently heard by the Supreme Court of Canada, it's a big issue (right next to that non-issue, Ebola scare in Belleville). The for and against asked Margaret Somerville (mysteriously introduced as one of Canada's best-known experts on the subject) and Arthur Schafer to address the question of whether doctors should be permitted to accede to patient requests for assisted dying. Not unexpectedly, the two contenders had nothing new to say, but nonetheless their comments were the starting point for a lively debate among Globe and Mail readers.

What I found shocking is that the paper didn't manage to phrase the question correctly. It asked: 'Should patients be allowed to request suicide?' Well, obviously, this isn't the question at all.

Canadians are legally permitted to ask this question of anyone at any time. Nobody is questioning Canadians' right to request assisted dying (it's about assisted suicide/voluntary euthanasia, btw, not about suicide, dear Globe and Mail). The real issue is whether health care professionals should be permitted to accede to such requests. That the paper didn't quite get to asking its 'best-known experts'. Bit disappointing.

Royal Society Report on End-of-Life Issues makes it into Oxford UP textbook

How delightful little surprises such as this can be :). Talking about the wonders of social networking. So here it goes. Samantha Brennan and Charles Weijer (two friends and colleagues at Western University) posted a link on Facebook, advertising their new bioethics textbook. It's called Bioethics in Canada and found no less a publisher than Oxford University Press. The author list certainly reads like a list of the Who is Who in Bioethics internationally and in Canada. Imagine my delight when I discovered - by chance! - that our Royal Society of Canada Report on End-of-Life Decision-Making was reprinted in part in said textbook. Thank you!

Margaret Somerville engages in anti-choice agitprop - again...

Margaret Somerville, a tireless campaigner for Catholic values the world all over, and a member of the law faculty at Canada's McGill university, has penned a truly embarrassing attack on the Royal Society of Canada's Expert Panel on End-of-Life Decision-Making Report in the Montreal Gazette. Without hesitation she repeats arguments that I have demonstrated in the blog entry below to be false and clearly deliberately misleading. My good colleague Daniel Weinstock, a Montreal based member of the expert panel, penned this in reply to Somerville's agitprop. Well worth reading and well worth disseminating. Ms Somerville, for far too long has got away with this kind of mischief making.

Anti-choice AgitProp

I have just penned an editorial for BIOETHICS on the fall-out resulting from the Report on End-of-Life Decision-Making in Canada that I had a hand in producing. The gist of it is that I wondered whether there's much point debating this issue with anti-choice activists (you know, for hire 'anti euthanasia', 'pro-life' agitprop types). I gave two examples, in said editorial, of encounters I had in the aftermath of the release of said Report where I confronted anti-choicers with incontrovertible evidence that their arguments are flawed. They were, in fact, unable to counter the arguments I put forward, yet that did not stop them, within 24 hours, from repeating arguments they knew at that stage to be faulty. So, why pretend that you have a genuine counter-part in a public debate, when arguably the real motives of your opponents are not out in the open to begin with and when their arguments, peppered with heart wrenching abuse stories, serve their propaganda objectives only. 


I began, half tongue-in-cheek, about a week ago a competition, encouraging readers of this blog to send me mistake they found in two such newspaper pieces of agitprop. To my delight, people actually took the time to dissect these two pieces. So, trying to be a good sport here, I am reproducing some of the mistakes people have identified in said agitprop. For reference, the Report is here or here. The agitprop articles  were published in a National Post blog entry penned by Barbara Kay, as well as in a piece published by Licia Corbella in the Calgary Herald.


Here we go: Both articles (the incriminating 'evidence' was self-reportedly 'googled' by Ms Corbella, it seems) report at great length and to much fanfare incidences of non-voluntary euthanasia in jurisdictions that have decriminalized assisted dying in some form or shape. Both authors take this as evidence that a slippery slope exists, whereby people's lives are being terminated in these jurisdictions variously against their wishes or without having requested this as a result of decriminalization. Ms Corbella bitterly complains that we have missed this evidence that is so very easily available to anyone with access to google (Ms Corbella's favourite research tool, presumably right next to wikipedia and the Anti-Euthanasia Coalition's website). Well, it turns out that we have mentioned non-voluntary euthanasia cases in our Report. Was Ms Corbella too busy copy-pasting her evidence from fellow anti-choice activists websites to actually read the Report we produced?  Be that as it may, we also pointed out that non-voluntary euthanasia takes place in societies that have not decriminalized assisted dying, hence the existence of non-voluntary euthanasia in societies that have decriminalized demonstrates nothing at all. This point has been made very eloquently in this article in the Ottawa Citizen. In fact, we provided empirical evidence in our Report that following decriminalization non-voluntary euthanasia has actually decreased in some jurisdictions (not as sexy as Ms Corbella's anecdotes, I know).  Ms Corbella was called on her obvious mistake by commentators on the Calgary Herald's on-line site, but has chosen not to reply, which brings me back to my theme: These agitprop type activists are not seriously engaged in debate, and we should not pretend otherwise. 


Barbara Kay makes a similarly obvious mistake, uncritically citing Margaret Somerville, a conservative Christian activist employed at McGill University who campaigns traditionally on any topic the Catholic Church has a strong view on (among her favourites are: gay marriage, and end-of-life issues). Kay quickly declares Somerville a bio-ethicist even though Somerville doesn't seem to have any formal degree type education at all in ethics. Be that as it may, Somerville is cited in Ms Kay's commentary, claiming that a survey shows that Canadians are in favor of improving palliative care rather than decriminalizing assisted dying. Our Report is duly blamed for not having taken this survey into account in our report. Not quite, and here we have another example of misleading use of empirical evidence. The poll in question was actually published after we completed our empirical survey chapter. More than that, the poll in question is not actually at variance with the findings of the polls we cite. The poll cited in the newspaper blog was commissioned by Life Canada (an anti-choice organization). [p 3 of on-line poll] Most of the questions in this poll are, given the nature of its partisan funder, suitably leading. However, on the evidence cited in this report 57% of respondents were in favor of the decriminalization of assisted dying. Surveys commissioned by organisations less in agitprop mode than Life Canada found significantly higher percentages of Canadians in support of a more permissive regime when it comes to assisted dying. We have cited some of those in our Report. Reportedly Life Canada has since dropped the decriminalization question altogether. Ms Somerville, in fact, used one bit of the Life Canada poll that suited her anti-choice agenda, and happily ignored what the actual evidence shows. She created the misleading impression that the survey results demonstrate preferences when they highlight priorities. The question posed was basically (pretending misleadingly that a society could have only one or the other) whether respondents were in favor of improving palliative care or in favor of decriminalizing assisted dying. [p 4 of on-line poll] I strongly encourage the interested reader to both read the newspaper blog as well as the actual survey in order to evaluate the evidence for the claims I am making in this paragraph. Kay and Somerville's misleading use of the data in Life Canada's poll brings us back to me theme for this entry: What's the point of having a serious debate with activists who are clearly not seriously interested in a genuine exchange of arguments? 


Ms Kay also mistakenly claims that access to euthanasia in the  Netherlands initially required evidence of a terminal illness. The fact is that terminal illness was never a necessary condition for access to euthanasia in that country, rather the relevant criteria were autonomous choice and individual suffering. Unlike in Ms Kay's reality, the Netherlands actually decriminalized euthanasia in 2002 and not in 1984 as she claims in her National Post piece. The problem with getting her facts right also bedevils Ms Corbella's commentary/article. She excitedly waves her hands about a 1995 report indicating that some 950 people's lives were terminated in the Netherlands without their request. Euthanasia, as already mentioned, was only decriminalized in the Netherlands in 2002.  Ms Kay must be equally desperate, why else would she have chosen to also resort to a 1995 piece to comment on the reality of euthanasia in the Netherlands today? I suspect that our two campaigners both used the same journal article, happily ignoring empirical evidence that has since 1995 been published in peer reviewed international medical journals - as referenced and discussed in our Report -  simply because it suited their ideological agenda. The author of the 1995 paper has not responded to the more recent evidence as it has accumulated.  It is worth mentioning that the incidence of non-voluntary euthanasia is higher in some countries with prohibitive regimes than in the Netherlands and Belgium.  There is no evidence that legalization of voluntary euthanasia results in non-voluntary euthanasia.  Rather, if anything, it reduces non-voluntary euthanasia.


What bothers me about agitprop such as that served up by Corbella, Kay and Somerville is that they must know that their arguments are not sustainable. They're not sustainable in the sense that it should be obvious to these authors that they are misleading the public with their intellectual content.  It seems pointless then to pretend that there is a serious intellectual debate taking place here. All that can reasonably be achieved is to debunk flawed and misleading arguments when they pop up. Because, trust me, you will see the same arguments popping up again in up-coming anti-euthanasia agitprop, probably within less than 24 hours after I post this blog entry. Such is life on the anti-choice campaign trail. 


Thanks to everyone who participated in the impromptu competition. The book price goes to a Canadian entrant, Mr. A. M. He found no less than 18 false or misleading statements across the articles/comments by Kay and Corbella. Well done Sir! 

Competition on End-of-Life AgitProp

As you might have noticed, last week the Royal Society of Canada released (to much media interest in Canada and internationally) a Report drafted by an international expert panel on End-of-Life Decision-Making in the country. I chaired the panel. It was comprised of well-known figures in bioethics and health law, namely Jocelyn Downie, Hans van Delden, SheilaMcLean, Ross Upshur and Daniel Weinstock. Check the report out here or here.

As is inevitable with such a report, some of its recommendations are taken to be controversial by some people. It was no surprise to me that many of our recommendations on the provision of palliative care in the country, advance planning and other such pressing matters were ignored by the media, and instead the focus was on our recommendations on the decriminalization of certain kinds of assisted dying. The usual suspects came out of their woodwork in no time, the expected condemnations of church affiliated academics, and activist groups were so quick that it is unlikely the people in question actually had the time to read our document. My favourite was a medical school professor who condemned the report in its entirety, even though we actually cited his work approvingly. It seems it is not just philosophers shooting from the hip, as James Rachels worried in his classic article on this issue, but medical school professors, too.

So much has been said in the media, most of which was in fact positive and supportive of our conclusions, that it is impossible for me to respond to everything. However, I am determined to respond to two vile pieces of agitprop that were published in a National Post blog entry penned by Barbara Kay, as well as in a piece published by Licia Corbella in the Calgary Herald.

I intend to write a detailed response to these two pieces some time this coming week, but in the meantime, here's my Competition idea: I invite readers of this blog to analyse these two pieces of what might mistakenly be described as journalism by some and point out their mistakes and misleading arguments. Whoever finds the most mistakes and misleading arguments will receive a free hard cover copy of '50 Voices of Disbelief - Why We Are Atheists', signed by me or 'clean', whatever you prefer. The deadline for submissions will be Wednesday November 30, 2011, 5pm EST. Feel free to send your comments to me at udo schuklenk.

Good success!

Globe and Mail on End-of-Life Issues

Marina Jimenez of the Canadian national paper Globe and Mail initiated a meeting between three members of their Editorial Board and myself for a brief interview on end-of-life issues in Canada. The result is this Editorial and this interview. Check it out. Reading the spoken words now I realize how way more sophisticated written content is when compared to an interview transcript, let alone how typing errors like 'Advanced Directive' can sneak in (that can easily occur when one is not that familiar with the terminology). Interesting experience. I like the gist of the editorial, but be warned, do not assume that the views I express in the interview reflect necessarily the content of the Royal Society expert panel report that will be out later this year.

Lives not worth living and voluntary euthanasia

Most of the voluntary euthanasia crowd argue that we should permit competent folks who are suffering from a terminal illness, and who consider their lives not worth living access to death with dignity if they so wish. Death with dignity here is meant to include access to voluntary euthanasia and/or physician assisted suicide. The main reasons have both to do with the idea that we should respect competent people's choices particularly when it comes to how they wish to end their lives, and also with the view that there is little point in sticking around when you suffer from a terminal illness, and there is no prospect that you'd be able to enjoy your life sufficiently again that you yourself consider it worth living. So, it's not about a Nazi declaring your life not worth living, but that you yourself say that you wish to die, because you yourself do not consider your life worth living any longer.

I find this argument by and large persuasive, but it strikes me as mostly strategically motivated. Opponents of voluntary euthanasia have long been arguing that accepting this argument, and translating it into policy would lead us down a slippery slope to non-voluntary euthanasia (say folks get killed a) against their express wishes [there doesn't seem to be any evidence whatsoever to support this claim, at least with regard to countries that have since legalised voluntary euthanasia], and b] that incompetent folks get killed). The latter point is quite dicey obviously. If you've someone who meets the other criteria (terminal illness, overwhelming impact on that patient's quality of life), and you know that competent people under such circumstances often (but not always!) demand voluntary euthanasia or physician assisted suicide, how are you to go about someone unable to express an autonomous choice?

Anyway, my main question today is somewhat different, but also somewhat related to the incompetent patient. As you may or may not know, very many people suffer from clinical depressions. It's truly a debilitating disease that renders the quality of life not worth living for many of those affected. Some of the anti-depressants that are on the market work for some of those affected, but for many patients these drugs do not work, or do not work reliably over time, or do not work sufficiently well to permit them to enjoy their lives again. It goes without saying that depressive people have suicidal thoughts that are usually caused by their depression.

But, here is the question: If a given depressive patient has tried and tested the available anti- depressants over reasonable periods of time, and they fail to do the trick for her, would it be unethical if a doctor complied with her request for an overdose of some drug cocktail or other that would permit her to end her life? If the legitimacy of decisions on voluntary euthanasia or physician assisted suicide rests on a patient's evaluation of her experienced quality of life over time, who are we to say that a depressed patient 'because she is depressed' should not be respected in her wish to end her life?

My view would be that we should acknowledge that depression might be the major factor triggering her demand to die with dignity, but equally that unless we're able to do something successfully (in her judgment, not our's) about her depressions, we should respect her choice. At the end of the day, whether or not we consider our lives worth living should be the decisive factor with regard to society respecting patients' end-of-life decision making. The question surely is not whether their condition is terminal but whether there is a reasonable likelihood that the condition that renders their life not worth living (in their judgment!) can be fixed in the foreseeable future. If the answer to this question is 'no', or 'most likely not', it does not matter whether the condition we are concerned about is of a terminal nature. It does not help a great deal to go on about depressed people being not competent to evaluate exactly how they feel about their lives. The fact of the matter is that they know perfectly well how it is to live with depressions, they understand that it is their depression that stuffs up their lives, but also that nothing that they tried worked to bring their lives back to reasonably livable normality. To use that experience to declare them incompetent to make choices about ending their lives seems absurd to me.

Am I missing something?