Associate professor and geriatrician Mark Yates has warned that elderly Victorians now face the additional burden of choosing to continue with life or to have it terminated. He warns that the legalisation of assisted suicide and euthanasia in Victoria from 19 June 2019 now puts the elderly - 10 to 15 per cent of whom already experience abuse - at an additional risk of being coerced or persuaded to request or ingest a deadly poison under the new law.
The American Medical Association has decisively reaffirmed its position that:
Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.
At the annual meeting of its House of Delegates delegates voted 392-162 (that is 70% for; 30% against) to retain the policy unchanged.
In a landmark study of decision making capacity of persons with terminal cancer and a prognosis of less than six months to live – that is a cohort that would be eligible for assisted suicide under the schemes in Oregon and other US States as well as in Victoria, Australia – 90% were found to be impaired in regard to at least one of the four elements of decision making – Choice (15% impaired), Understanding (44%), Appreciation (49%) and Reasoning (85%).
Under Victoria’s Voluntary Assisted Dying Act 2017, for example, “a person is presumed to have decision-making capacity unless there is evidence to the contrary” (Section 4(2)).
This study suggests that, at least in the case of persons with cancer and a prognosis of less than six months to live, it would be more prudent to start from the presumption that they are likely to have impaired decision making capacity unless it is demonstrated to the contrary.
It has been widely reported that a 17 year old girl was euthanased on Sunday 2 June 2019 at her home in Arnhem, the Netherlands, on the grounds of her suffering as a victim of rape. However, later reports indicate she died from starvation/dehydration after refusing to eat with the intention of ending her life.
Noa Pothoven had been the victim of rape on three separate occasions between the ages of 11 and 14 years.
On 15 May 2019 three judges on the Court of Appeal of Ontario dismissed an appeal by four individual doctors and three medical associations, including Canadian Physicians for Life, against a lower court ruling upholding the constitutionality of a policy issued by the College of Physicians and Surgeons of Ontario requiring doctors who have a conscientious objection to certain procedures - including euthanasia - to provide any patient requesting such a procedure with an "effective referral" to "a non-objecting, available, and accessible physician, other health-care professional, or agency".
The Court [at 184] cited favourably "evidence" that doctors who conscientiously objected not just to killing their patients but to "effectively referring" them to another doctor who would do so could easily "change the scope of their practice" to a specialty or sub-specialty where they "are unlikely to encounter requests for referrals for" euthanasia such as "hair restoration" or "obesity medicine".
Speaking at the Voluntary Assisted Dying Implementation Conference held in Melbourne from 9-10 May 2018, Dr James Downar, a leading Canadian proponent of legalising euthanasia and the first doctor to carry out euthanasia in Ontario, made it crystal clear that euthanasia was primarily carried out for what he called "existential suffering" and not because palliative care could not adequately treat pain and other physical symptoms.
Dr Downar, who on his own admission has intentionally ended the lives of over 40 people by administering a lethal injection, describes the typical case of euthanasia as involving a "captain of industry, self-willed, a giver not a taker" - or at least, he adds, seeing himself that way - who simply wants to exercise control over the timing and manner of his exit rather than to die in an (ordinary) haphazard manner.
He also stressed that the eligibility criteria for access to euthanasia were all subjective and that "there are no absolute gold standards for identifying coercion."