Faith

To use religion—or the claimed tenets of a particular version of a particular religion—to argue that all others should adhere to its values and abide by its rules of conduct.

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Mr Steve Jalsevac of the Catholic LifeSiteNews blog who made a shocking and vile attack.

I recently exposed (another) piece of misinformation published by LifeSiteNews, and wrote courteously to them to request withdrawal of the offending article. While I wasn’t hopeful the request would be accepted, I wasn’t prepared for the shocking and vile response I received.

Exposing bull about assisted dying is a key purpose of DyingForChoice.com and it will continue to do so as long as bull is published or publicly spoken, and especially when it makes claims or generates innuendo that is at odds with the readily-available facts, as a smokescreen for fundamentally religious objections.

The specific request to withdraw

In a recent article I factually rebutted the allegation by Mr Brad Mattes that there is suicide contagion (from assisted dying to general suicide) in Belgium, in addition to other statements that were wrong in fact in his opinion piece published by LifeSiteNews. I wrote a courteous letter to the editor of LifeSiteNews to point out the errors and to seek withdrawal of the article. 

My full email to LifeSiteNews

Dear LifeSiteNews,

Clearly we are on different sides of the assisted dying conversation. I’m sure that we can mutually appreciate that different people bring different perspectives and apply some largesse in terms of world views.

However, one must draw the line (as your primary Principle does and upon which I think we agree) at the publication of information, however accidental, on your website that is in places fundamentally misleading and elsewhere quite false.

In this regard may I request that you withdraw the article by Mr Brad Mattes, Assisted suicide no longer just for the terminally ill, that contains multiple errors of evidential fact as well as fundamentally misleading statements, as I point out in this post?

Kind regards
Neil Francis

 

The shocking response

A firm believer in courteous debate even when one disagrees profoundly on important matters, I thought the most likely outcome would be a polite letter declining my request. But I received instead this response from LifeSiteNews Managing Director, Mr Steve Jalsevac.

Full response by Mr Steve Jalsevac of LifeSiteNews

Dear Neil,

I find it somewhat amusing that an advocate for legislation to allow people to kill themselves is demanding that we withdraw an article for supposedly publishing "misleading" or "false" information.

After many years of covering organizations such as yours which, typically cruelly manipulate vulnerable persons, violate or liberally interpret laws, understate their longer term objectives, have an extremely unhealthy and dangerous satisfaction in personally seeing people die before their eyes before their natural time, devastate family members whose loved ones had, unknown to them, been guided to kill themselves, and who have such perverse and wrong views on Christian beliefs and much more, I find it despicable that you would be so concerned about supposed accuracy. You, sir, are a hypocrite of the very worst kind. 

It is our view that you should be behind bars for what you advocate and for your dangerous manipulation of vulnerable persons.

I realize that you will not agree with anything that I write given how blinded your conscience and intellect have become by your death preoccupation. So, I just conclude that your claims, views and interpretations are all rejected because no one should trust anything that you say or do on this subject.

Steve Jalsevac
LifeSite

 

Who is LifeSiteNews, anyway?

LifeSiteNews is an online blog established by the conservative Christian Campaign for Life Coalition. It promotes that it “emphasizes the social worth of traditional Judeo-Christian principles.” Its principles are all very courteously worded and sound ‘respectful” (its principles expressly use that word several times) whilst indicating that it is a pro-life blog.

I’ve read its articles on assisted dying for several years and have not found a single one that is at odds with the position of the Vatican. That’s hardly surprising.

LifeSiteNews publishes a significant proportion of articles about the Catholic Church, as is its right. It is also the sole publisher of Faithful Insight, in its own words “hard-hitting,” “100% faithful” and “fearless Catholic news coverage from the Vatican and beyond.” I argue strongly for the right to publish material of faith. That is not a source of complaint. (Fair disclosure—I’m agnostic.)

faithfulinsightads.jpg
LifeSiteNews' hard-hitting and 100% Catholic-faithful publication.

And, Mr Jalsevac gives a clear indication that he’s at the 'Old School' end of the Catholic spectrum. He admires in multiple blogs the writings of conservative African Catholic Bishop Robert Sarah, noting John Paul II’s teachings as “definitive” and expressing disappointment in the current Pope. And that's entirely his right I again affirm.

Mr Jalsevac’s editor-in-chief, Mr John-Henry Westen has also published a number of articles critical of Pope Francis, also referring to previous Popes as more authoritative.

What do they claim to stand for?

LifeSiteNews’ first principle, in full, is this:

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

Mr Jalsevac's response highlights these claimed priciples in stark relief by comprehensively breaching them.

Additionally, not only have I pointed out multiple falsehoods and inaccuracies in Mattes’ article, but I’ve reported LifeSiteNews previously for implying in a splashy headline that the Council of Europe had determined that “euthanasia must always be prohibited” (it most certainly did not), and publishing false information in multiple articles claiming that as many as 650 babies are or could be euthanized in the Netherlands (no they aren’t).

The ad hominem attack

The statements Mr Jalsevac makes about me are vile. And false. While I’m calling out his blogs’ misinformation for what it is, he’s calling for me personally to be thrown in jail for sins he falsely thinks I’ve committed. That’s squarely known as the ad hominem attack: attacking the person rather than the argument. It conveniently provides him with the excuse to totally ignore solid evidence that contradicts his beliefs.

Interestingly, an article by LifeSiteNews Editor Mr Westen quotes Pope Francis as saying,

We Catholics have some — and not some, many — who believe in the absolute truth and go ahead dirtying the other with calumny, with disinformation…”—Pope Francis.

Quite.

Conclusion

LifeSiteNews is an 'Old School' Catholic blog, and, I argue, has every right to be.

However, it has demonstrated by publishing multiple articles containing serious errors of fact as well as highly misleading statements, and by a gratuitous ad hominem attack on someone pointing this out, that it is not interested in evidence, reason or even civility as it claims. In my view it has unambiguously demonstrated itself to be a biased and unreliable Catholic source on matters of assisted dying.

I will continue to call out misinformation in LifeSiteNews when I see it.


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Yesterday in a prominent opinion piece in The Age newspaper,1 palliative care specialists argued that palliative care is imperfect and in need of an injection of funds. I agree on both counts.

Nurse Peter Hudson, and doctors Mark Boughey and Jennifer Philip of the Centre for Palliative Care argued that instead of assisted dying as recommended by the recent Victorian Parliament committee report, increased funding of palliative care is ‘the answer.’

Key arguments

Here are the highlights of their opinion piece:
  1. They refer to assisted dying, a neutral expression now in common use amongst both lay commentators and scholars, as a euphemism. Instead they laboriously refer to assisted suicide (suicide is universally seen as a pejorative term with all its baggage about mental illness and substance abuse), and euthanasia (consistently omitting the qualifier ‘voluntary’).
  2. Dying at home should not be the gold standard (despite the great majority preferring it); instead, dying in hospital can be ‘preferred.’
  3. In a profound lack of self-reflection or consistent logic, they say that assisted dying ought to remain outlawed because its outcomes are uncertain. Even assuming the premise of the statement, this would be an identical argument to ban palliative care, whose outcomes are at least equally if not considerably more uncertain.
  4. They falsely imply that users of assisted dying not infrequently experience “very unfavourable” reactions to the drugs. This is simply untrue and I challenge them to provide the empirical evidence that they state is so very important.
  5. Tellingly, they describe a peaceful assisted death as “sanitised,” signalling their intrinsic disapproval of other’s choices.
  6. They say that focus should remain on increased resourcing of palliative care, failing to mention that the Parliamentary committee’s report indeed recommended increases in palliative care funding and improvement of evidence-based practice. Overseas evidence also reveals improvements in palliative care in jurisdictions with assisted dying legislation. There’s no false dichotomy between palliative care and assisted dying as the authors try to insinuate.
  7. They assume that medical interventionism (what they have to offer) is the correct and normative response, ignoring the fact that some people simply don’t want more interventions.
 

The filibuster

In a journal article recently published by two of the opinion piece authors,2 and repeated in principle in the Centre’s submission to and appearance before the Parliamentary inquiry,3,4 they say that:

“Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care to benefit many before further consideration is given to allocating resources into legalising EAS to respond to the requests of a few.”

Notice two things about their recommendation—the filibuster.

Maximising what cannot be done

Firstly, they say we must not just ban assisted dying, but that it is dangerous even to talk about it: palliative care must be improved even “before further consideration is given.” The specific purpose of this part of the filibuster is to maximise what cannot be done: to position even mere conversation, let alone actual reform, as ‘unsafe.’

Maximising the delay

Secondly, nowhere in their argument do they provide a single quantitative metric (and which they strongly argue is necessary for the legalisation of assisted dying) by which the palliative care reforms they advocate might be judged: not a single dollar amount nor a single performance benchmark amongst their many recommendations.

How much will reforms cost, how long will they take, and what performance measure improvements would need to be achieved for the expenditure to be judged effective? What performance measures would need to be reached before it was then ‘safe’ to even consider assisted dying? The authors are entirely mute on these critical matters, while making precisely these evidential demands of assisted dying.

So, the opinionists’ argument allows them to indefinitely say that “more improvements are needed in palliative care before we even talk about assisted dying,” because further ‘improvements’ are always possible.

But all that was a ruse anyhow

In any case, the authors say in their submission to the Parliamentary inquiry that there are numerous problems (spurious, I argue) with legalising assisted dying; that they doubt they could be overcome; and then finally “it should not be construed that we would support the legalisation of EAS if efforts were made to address [the problems].”4, page 6 (Curiously, they omit the third, critical statement from their more public opinion piece.)

This truly exposes the classic filibuster… an open-ended call with no metrics, which therefore can be deemed never to have been met. How convenient. But, even if they were met, the authors still wouldn’t support reform. This begs the question:

If the authors are as so firmly evidence-based—as they take pains to emphasise—why would they not support a reform if the evidence endorsed it?

There must be something other than evidence that drives their entrenched opposition to assisted dying: something so important that it renders all their previous arguments null and void. What might that be?

Who are these people, anyway?

It’s informative to answer the question of who these three from the Centre for Palliative Care are. The Centre sounds like a neutral government body. It isn’t. Don’t get me wrong. I have no doubt that these three are skilled and compassionate practitioners and that the Centre delivers good services.

In reality the Center is a section of Melbourne’s St Vincent’s Hospital. That’s an organisation that proudly states “as a Catholic healthcare service we bring God’s love to those in need through the healing ministry of Jesus.”

I believe St V’s to be a high-quality healthcare institution, but too bad if the patient just wants evidence-based medical care and not the ‘healing ministry’ of a religious figure they may not subscribe to.

The reason this is important is this: what the three authors say about assisted dying is entirely consistent with the Vatican’s stance. I have no idea if any of the authors are Catholic, but what would be entirely surprising is if they published anything at odds with the views of the Vatican given their Centre is deeply embedded within the largest Catholic health and aged care service provider in the country.

For clarity and fairness, I once again place on the public record that I am agnostic.

The ‘Catholic card’

Before Messers Paul Russell, Alex Schadenberg and others leap onto their campaigning steeds to megaphone that I’m ‘playing the Catholic card’ (just wait for it!), let me be clear that I specifically am doing precisely that. For sure, The Catholic Church is not the only religious body resolutely opposed to anyone having the choice of assisted dying, but it’s the premier one.

And, Messers Russell et al would be absolutely right to point out that the authors didn’t raise a single religious argument, so let me save them the bother.

Religious opposition dressed up in secular garb

And that’s the point. It’s abundantly clear from multiple sources that religious opponents have actively decided that they will absolutely avoid using religious arguments because they know it will lose them the debate.

Media identity Andrew Denton’s Better Off Dead podcast series makes this avoidance abundantly clear from the Australian perspective. His insights, having attended a global anti-euthanasia conference in Adelaide, are important and revealing. 

From the North American perspective, a study just published by Associate Professor Ari Gandsman of the University of Ottawa in Death Studies5 reports uncanny North American similarities. Assisted dying opponents have actively decided to cease using religious arguments. Instead, their objective is to create an atmosphere of FUD: fear, uncertainty and doubt. It is only this now, they agree amongst themselves, that will keep assisted dying off the statute books. As Gandsman explains (and I paraphrase), religious opponents have moved from ‘it’s a sin’ to ‘but think about all the perceived risks!’

Again, I reiterate that the three opinion piece authors are likely to be fine nurses and doctors (I have never met any of them), but I do say that their incoherent and self-contradictory arguments against assisted dying, remaining opposed even ‘if’ the evidence for it stacks up, is neither their finest work, nor varies one iota from the religious anchor that the Vatican provides to their Centre’s services.

The importance of mutual respect

If a person says to me “I believe assisted dying is wrong,” I respect that view and admire their resolution. For themselves. Including if it is underpinned by religious belief. If you believe that assisted dying, or surrogacy, or other contentious issue is wrong, don’t participate in it. 

But don’t expect that your own view of your own God trumps everyone else’s God—or lack thereof. In Australia for example, the majority of citizens are not Catholic. And most of those who are—three out of four—disagree with the Vatican’s opposition to assisted dying. The Vatican’s view then is not particularly relevant to anyone but its most ardent adherents.

Respect in both directions is warranted but is rather lacking from the more religious end. My argument is not against Catholicism itself. There are very fine Catholics on both sides of the debate, doing their best to live a deliberatively ‘good’ life.

Conclusion

We can do without the incoherent and indefensible nonsense advanced in secular garb by the religiously opposed.

Be clear folks: the FUD campaign is on its last legs. I will be further exposing rubbish arguments posed by those with religious connections but couched in non-religious language.

In the meantime you can see the clumsy, failed attempt at a filibuster by these three opinionists for what it is.

 

References

  1. Hudson, P., Boughey, M. & Philip, J., 2016, Victoria's proposed euthanasia laws are flawed, Melbourne: Fairfax Media, Accessed 21 Jun 2016, http://www.theage.com.au/comment/victorias-proposed-euthanasia-laws-are-flawed-20160620-gpn9p2.html
  2. Hudson, P., Hudson, R., Philip, J., Boughey, M., Kelly, B. & Hertogh, C., 2015, Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications for palliative care, Palliative and Supportive Care, 13(5), 1399-1409.
  3. Hudson, P., 2015, Inquiry into end of life choices: Submission 905 to the Parliament of Victoria, Centre for Palliative Care, St Vincent’s Hospital, Melbourne.
  4. Hudson, P., Boughey, M. and Philip, J., 2016, Witness Appearance Transcript: Inquiry into end-of-life choices - Centre for Palliative Care, Parliament of Victoria, Melbourne, 24 Feb.
  5. Gandsman, A., 2016,“A recipe for elder abuse:” From sin to risk in anti-euthanasia activism. Death Studies, In press.
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Lyle Shelton's bunkum tweet is broadcast on ABC's Q&A program

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

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

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

Mr Shelton's claim is bunkum.

Confused language

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

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

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

ACL staff sing from the same hymn book

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

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

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

What does the evidence actually show?

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

 

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

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

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

ABC news standards

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

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

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

---------------

  1. Onwuteaka-Philipsen, BD, Brinkman-Stoppelenburg, A, Penning, C, de Jong-Krul, GJF, van Delden, JJM & van der Heide, A 2012, 'Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey', The Lancet, vol. 380, no. 9845, pp. 908-915.
  2. Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliative Medicine, vol. 23, no. 3, pp. 198-204.

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One of the articles wrongly claiming 650 Dutch babies euthanized

Opponents of assisted dying have fallen prey to misinformation contagion about the Dutch Groningen Protocol, claiming that 650 babies would be or are euthanized every year. The claim is comprehensively and evidentially false.

Starting in 2013 and increasing in shrillness in 2015, numerous opponents of assisted dying law reform—many of whom are connected to conservative (Christian) sources—published online articles making false claims about the Dutch Groningen Protocol, wrongly claiming that up to 650 babies could be, would be or actually are ‘euthanized,’ ‘killed’ or ‘murdered’ every year under the Protocol’s provisions.

I provide a forensic analysis of the claim, demonstrating it to be comprehensively and evidentially false, in the latest edition of the Journal of Assisted Dying.

 

What is the Groningen Protocol?

  • A national Dutch Regulation (not statute) effective since late 2006 whose current name is so long that it remains convenient to use its old name, ‘Groningen Protocol,’ even though it has changed.
  • Permits, only as a last resort and with a number of strict conditions, the intentional ending of a newborn’s life when the newborn is in current (not merely anticipated) untreatable and unrelievable extremis.
  • Mandatory reporting of intentionally hastened deaths to a national Commission and the Board of Prosecutors General at The Hague.
  • Physician is not cleared until the case is deemed acceptable by the Commission and the Board and the Minister of Security and Justice.
  • The Regulation is entirely separate from and unrelated to the Dutch Euthanasia Act for competent adults.

Where did the '650 babies euthanized' claim come from?

In 2013 the Royal Dutch Medical Association (KNMG) published a media release that launched a major policy paper about end-of-life decisions for neonates. The media release stated that of the approximately 175,000 births in the Netherlands each year, around 650 newborns will die as a result of severe congenital defects.

Some of these babies die soon after birth, in the delivery room. Others die later in neonatal intensive care despite the best interventions attempting to keep them alive. Yet others die after futile treatment is withdrawn and palliative (comfort) care is administered to minimize suffering prior to death.

Only in a tiny minority of cases is there a medical intervention with an explicit intention to hasten the death of the newborn, who is in untreatable and unrelievable extremis.

Despite this clarity, opponents—mostly linked to conservative religious sources—jumped on the misinformation bandwagon and trumpeted that 650 babies either could be or would be or are actually ‘euthanized,’ ‘killed’ or ‘murdered’ every year in the Netherlands.

What's the actual evidence?

  • Neonatal euthanasia occurs around the world regardless of prohibition and is not caused by a protocol or regulation
    • For example, the rate in France, with no regulation, is much higher than the Netherlands.
  • Intentional hastening of neonatal death in the Netherlands is rare
    • Most neonatal deaths occur either quickly with no medical intervention, or intensive treatment proves futile and palliative (comfort) care is administered until death.
  • The (Groningen) Regulation has been further restricted since it was first formulated
    • It has not been 'relaxed' as claimed by some opponents.
  • The Regulation is separate from and completely unrelated to the Netherlands' Euthanasia Act
    • The Euthanasia Act is only for mentally competent adults (and 12-16 year olds with parental agreement).
  • Physicians do not receive black-letter law protection as they do under the Euthanasia Act
    • Reporting, investigation and acceptance requirements are even more rigorous than under the Euthanasia Act.
  • The rate of intention to hasten neonatal death has decreased since the Regulation came into effect
    • In eight years prior to Regulation there were twenty two reported cases, and only two in eight years since Regulation.
    • The rate of medical end-of-life decisions with an explicit intention to hasten death was 8–9% prior to Regulation, dropping to 1% after Regulation.
    • The use of neuromuscular blockers has decreased.
  • Physicians report improved communication with parents
    • Shared decision-making and better opportunities for parents to grieve the loss of their child.
  • There are clear explanations for the decrease in neonatal euthanasia in the Netherlands:
    • Physicians report they are fearful of prosecution under the Regulation, so they now more often administer palliative care not intended to hasten death.
    • A folate supplementation program for pregnant females has resulted in a substantial drop in the rate of spina bifida and related disorders.
    • An antenatal screening program at 20 weeks has resulted in a higher rate of pregnancy terminations for major congenital disorders.

In conclusion

Despite all these facts, in an epidemic of 'confirmation bias' that drove misinformation contagion, many anti-euthanasia commentators have published false claims about '650 babies euthanized' under the Dutch Groningen Protocol. I provide a forensic examination of the issue in the latest edition of the Journal of Assisted Dying.

This is not the first example of how opponents of assisted dying widely circulate information that is untrue (e.g. check out the Council of Europe Declaration 1859 case), and it won't be the last. However, for opponents of assisted dying to avoid egg on face, I'd recommend:

Best not to engage in
misinformation contagion.

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Neonatal deaths under Dutch Groningen Protocol very rare despite misinformation contagion


Author(s)

Neil Francis

Journal

Journal of Assisted Dying, vol. 1, no. 1, pp. 7–19.

Abstract

The Groningen Protocol specifies criteria for the potential termination of life in severely ill newborns in extremis with untreatable and unrelievable conditions. In September 2006 the Netherlands formally adopted a Regulation incorporating the Protocol. Despite the Regulation’s development through extensive professional consultation, endorsement by the Dutch Paediatric Association, empirical data showing a decrease rather than increase in use, and research showing that neonatal euthanasia occurs around the world in the absence of regulation, the Dutch Regulation has sparked controversy. More recently it has been claimed that hundreds of babies a year are killed under its provisions. Forensic analysis reveals the claim to be comprehensively and evidentially false. Wide online dissemination of the claim by mostly religious sources demonstrates confirmation bias and misinformation contagion.

Article keywords

Netherlands, Groningen Protocol, neonatal euthanasia, palliative sedation, neuromuscular blocker, non-treatment decision, confirmation bias, misinformation contagion, religion

Full PDF

Download the full PDF: Download the full article (230Kb)

Citation

Francis, N 2016, 'Neonatal deaths under Dutch Groningen Protocol very rare despite misinformation contagion', Journal of Assisted Dying, vol. 1, no. 1, pp. 7-19.

Download the citation in RIS format: RIS.gif


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On 16th September 2015, the Victorian Director of the Australian Christian Lobby (ACL), Dan Flynn, appeared as a witness to the Victorian Parliament’s end of life choices inquiry being conducted by the Legal and Social Issues Committee. He made a number of mistaken statements, but what was most worrisome was the revelation of the ACL’s real agenda: to wind back patient rights more than a quarter century.

 

Out of touch

In his opening address, Mr Flynn opined that assisted dying was 'not supported' by a 'broad base' of Victorian Christians (not just the ACL). This belief is diametrically at odds with clear and repeated evidence from multiple sources.

In 2012, I reported on a Newspoll study into Australian attitudes towards assisted dying. Not only did a whopping majority of citizens support assisted dying, but so did a great majority of Anglicans, Catholics and other Christians (Francis 2012).

 

Australian attitudes to assisted dying law reform in 2012

Newspoll 2012: Australian attitudes to assisted dying law reform by religion (green=support, red=oppose)

These national results are reflected by a sample of over 60,000 Victorians through the VoteCompass system during the 2014 Victorian election (Stayner 2014). It confirms a substantial majority of Catholics, Protestants, other religious and non-religious Victorians support assisted dying law reform.

 

votecompassvicvereligion2014.jpg

VoteCompass 2014: Victorian attitudes to assisted dying law reform by religion (grey=population average)

Out of date

Mr Flynn then referred to a Tasmanian Parliament’s inquiry into assisted dying which rejected law reform. However, the inquiry to which he refers was held in 1998, when Oregon’s Death With Dignity Act had barely been established, the Northern Territory’s Rights of the Terminally Ill Act had been extinguished within just eight months of coming into operation, and the Dutch, Belgian, Luxembourg, Washington and other legislation and judgements did not yet exist.

So, the Tasmanian Parliament’s rejection came from a position of a then general lack of information. The Oregon law has been in effect since 1997, the Netherlands and Belgium since 2002, Washington since 2008, Luxembourg since 2009, and so on. There is now plenty of evidence that assisted dying law reform doesn’t cause slippery slopes that opponents love to theorise about.

Wrong about ‘United Nations’

Mr Flynn then said that the United Nations had in 2012 expressed concern about a ‘lax attitude’ towards euthanasia in Europe, specifically mentioning the Netherlands and Belgium. This is completely untrue. Because it’s easy to make a simple blooper during a presentation, we’ll put aside the fact that he meant to refer to a completely different organisation: the Council of Europe.

We know this because he read directly from Council of Europe declaration 1859 (Council of Europe Parliamentary Assembly 2012). His ACL submission (Australian Christian Lobby 2015) reports (as he read out) exactly one sentence of the declaration, with his added emphasis, as:

"Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited."

But presented in this manner the statement is quite misleading. As I explain in a forensic analysis of the misinformation campaign about this resolution (Francis 2015), the resolution was utterly clear about its intent: it was not about euthanasia (it explicitly said so), but rather about advance care planning. What the resolution spoke against (in the one sentence conveyed above) is non-voluntary euthanasia, not voluntary euthanasia. Both sides of the assisted dying debate agree that non-voluntary euthanasia (one person deciding for a hastened death on behalf of another) is not acceptable. It is not contentious.

In no way did the Council of Europe's resolution critique voluntary euthanasia or comment on any jurisdiction in which it is legal. And, the United Nations source to which the ACL submission refers was released in 2001, fourteen years ago and at the time of the Netherlands' Euthanasia Act was before the Dutch Parliament. With then limited information about how such laws work in practice, it expressed concern about the upcoming Act.

Wrong about Belgium’s law and practice

Mr Flynn referred vaguely to two cases of euthanasia in Belgium in which persons who requested and received euthanasia were not experiencing intolerable pain, which Mr Flynn asserted was a required safeguard in Belgium’s euthanasia Act. This was another supposed example of transgression of safeguards.  Wrong again.

While the Belgian Euthanasia Act is officially published only in Dutch and French, a robust English translation has been prepared under the supervision of Professor Herman Nys of the Centre for Biomedical Ethics and Law at the Catholic University of Leuven (see Parliament of Belgium 2002). The word ‘pain’ does not appear in the Act… at all. What does the Act have to say about the legislature’s intent on who may qualify? The relevant clause in Section 1 says:

"the patient is in a medically futile condition of constant and unbearable physical or mental suffering that can not be alleviated, resulting from a serious and incurable disorder caused by illness or accident."

It’s abundantly clear: mental suffering from an illness or accident qualifies as much as physical suffering, and the suffering does not need to be ‘pain’ as Mr Flynn mistakenly asserted to the Parliamentary Committee.

Mr Flynn also stated that there are mobile end-of-life units in Belgium. There aren’t. (But there are in the Netherlands, and they must follow precisely all the same requirements as anyone else. They operate to provide choice to patients whose regular or reachable doctors disagree with assisted dying and therefore decline to evaluate whether the patient may qualify under the Act.)

Confused about Advance Care Directives

In further testimony, Mr Flynn opined that the degree to which a doctor should be allowed to override a patient’s Advance Care Directive (ACD) is in part influenced by whether the doctor can speak with the patient.

But if the patient can currently speak and participate in decision-making, the advance care directive doesn’t apply: it is mute and of no effect. An ACD only applies when the patient cannot currently participate in their own decision making. That’s (only) what it’s for.

Winding rights back more than a quarter century

But the most worrying aspect Mr Flynn’s testimony was the revelation of ACL’s opposition to the right to refuse unwanted medical treatment.

The Medical Treatment Act 1998 (Vic) has enshrined for now more than twenty five years a patient’s right to refuse any unwanted medical treatments. In 2003 the Supreme Court of Victoria determined that artificial nutrition and hydration (i.e. via tubes) is medical treatment and can therefore be refused under the Act.

But Mr Flynn repeatedly argued that withholding or withdrawing artificial nutrition and hydration, if the patient’s body could ‘absorb’ them, could amount to physician-assisted suicide, and that doctors must be allowed to override refusals. On the matter of patient autonomy, he said that some autonomy rests "with the patients, but a lot of the autonomy in fact is with the doctor”.

When asked if a Jehovah's Witness who refuses a life-saving and simple blood transfusion ought to be allowed to do so, he conceded that they should be entitled to, but that such a case was a “bit of an outlier”. He didn’t explain on what moral grounds one person could refuse a simple procedure to save their life, but another person mustn’t be allowed to even if the likelihood of saving life was doubtful.              

So, the ACL’s real agenda is revealed: it recommends winding back the legislative clock more than a quarter century so as to force patients to endure some medical interventions that they don’t want and firmly refuse, if the doctor wishes to proceed.

No wonder the Committee repeatedly questioned Mr Flynn to ensure they had heard and understood his testimony correctly. In conclusion, Committee Chair Edward O’Donohue observed that Mr Flynn’s evidence was “quite surprising” and “quite contrary” to wide evidence already given.

And it’s no wonder that Theo Mackaay, General Secretary of the Victorian Council of Churches—a group of 30 member churches representing mainstream Christianity—criticised the ACL as “fundamentally conservative” and expressed “deep concern that media portrayal of statements from an established and narrow focused lobby group is presented as being representative of the entire Christian community” (Uniting Church in Australia 2011).

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References

Australian Christian Lobby 2015, Submission to the Legal and Social Issues Committee on the Inquiry inito End of Life Choices, Parliament of Victoria, Melbourne, pp. 1-17.

Council of Europe Parliamentary Assembly 2012, Resolution 1859 (2012): Protecting human rights and dignity by taking into account previously expressed wishes of patients, Europe, 25 Jan, pp. 2.

Francis, N 2012, Australian public desire for legalisation of assisted dying in restricted circumstances, YourLastRight.com, Melbourne, pp. 11.

Francis, N 2015, Conservatives fudge Council of Europe declaration 1859, DyingForChoice.com, viewed 2 Jun 2015, <http://www.dyingforchoice.com/f-files/conservatives-fudge-council-europe-declaration-1859>.

Parliament of Belgium 2002, 'The Belgian Act on Euthanasia of May 28th 2002 (unofficial English translation)', Ethical Perspectives, vol. 9, no. 2-3, pp. 182-188.

Stayner, G 2014, Victorian election 2014: Electorate overwhelmingly back voluntary euthanasia, Vote Compass reveals, ABC News, viewed 4 Dec 2014, <http://www.abc.net.au/news/2014-11-23/victorians-back-voluntary-euthanasia-vote-compass/5910668>.

Uniting Church in Australia 2011, Australian Christian Lobby does not represent all Australian Christians, nor all Christian viewpoints, 8 Dec, Media Room, viewed 11 Dec 2011, <http://blogs.victas.uca.org.au/mediaroom/?p=971>.


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Bulldust is often advanced by opponents of assisted dying law reform—a reform which most citizens want—to scare or bamboozle us against the reform.

Why is there so much misinformation about? The answer is straightforward: because so far it's worked.

More than academic niceties

This isn't just an academic argument about getting the facts right. It's a fundamental battle between different world views, where misinformation against assisted dying law reform has often held sway. Here are just two real examples:

Examples of real impacts of misinformation

  1. In Australia, in every Parliamentary debate over an assisted dying Bill before them, numbers of opposed politicians have quoted the rhetorical sham "the vulnerable will be at risk" (see why it's a sham here). With the exception of the Northern Territory's Rights of the Terminally Ill Act in 1996, every Bill before Australian Parliaments has been lost or filibustered until the end of the Parliamentary term on this fearmongering. And the Rights of the Terminally Ill Act was annulled by the Federal Parliament in 1997 on the same grounds.
     
  2. In Ireland, the High Court made a determination as to whether Marie Fleming, with advanced multiple sclerosis, was constitutionally allowed to receive assisted dying (Fleming v. Ireland and Ors 2012 10589 P). The court rejected Fleming's claim, saying that the "strikingly high" rates of non-voluntary euthanasia in Switzerland, Netherlands and Belgium "speaks for itself as to the risks involved". But sound research shows that the rates in these countries are similar to rates in other countries without assisted dying laws: evidence of the high degree of 'evidential' bull that was served up to their Honours.

It's time to stop the bull in its tracks

DyingForChoice.com believes it's time for the bull, the misinformation, to stop. It is unacceptable for rational citizens to be denied freedoms on the basis of scaremongering and erroneous information. This is the purpose of the F files. It provides citizens, politicians, policy advisors, healthcare workers, media professionals, researchers and others the evidence, arguments and resources to be properly informed and to avoid misinformation.

 

The F Files

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1
The opinion piece in The Age.

In today’s Fairfax press, Sydney woman Mary Ticinovic advances a number of reasons as to why she believes that assisted dying is not merciful. The by-line identifies her as a “clinical psychologist”. But her arguments are not founded on the basic tenets of psychology. How so?

Read Mary’s opinion piece in The Age

All life is precious

Mary argues that to support assisted dying is to go “against the principle that all life is precious.” She offers no substantive explanation, invoking the notion of ‘human worth’, stating that it exists regardless of the health state or suffering of the person, and complaining that assisted dying promotes the idea that “your life is no longer worth living”.

These are not psychological arguments. We can agree that life is precious. But reluctantly deciding to hasten one’s death in the face of intolerable and unrelievable terminal suffering doesn’t negate that preciousness. Indeed, to some people, choosing assisted dying can evidence the preciousness of one’s very capacities and values as a human.

Whose standards?

Mary further muses over “by whose standards would we judge if life is not worthwhile any more”, as though this is only some vague theoretical argument amongst philosophers or doctors. This is not a psychological argument, either. Under assisted dying law reform, it is only the dying individual’s world-view and circumstances that determine whether he or she feels life is worth living: not anyone else. General philosophical theory doesn’t come into it.

She further argues that assisted dying “promotes a utilitarian view of humanity”. This is not a psychological argument, either. Nor is it valid. Indeed, legalised assisted dying respects the very nature of the diversity of humanity by enabling the world-views many people hold most dear: that of making rational choices consistent with their own beliefs, values and circumstances. Some patients, for example in Oregon, are deeply religious and believe that their God is compassionate and understands and respects their choice to avoid intolerable suffering. That’s not utilitarian at all.

Harm and the Hippocratic Oath

Mary invokes the Hippocratic Oath said by her medical friends to oblige doctors to “do no harm” and that the medical role is “in healing and helping the patient to be restored to health.” This is simplistic nonsense, not a psychological argument.

Firstly, doctors do harm all the time: think of surgical procedures or chemotherapy. Many medical interventions do harm, but we accept the harm because we expect there to be a commensurately greater good as a result.

Secondly, medical practice cannot always “restore the patient to health” as Mary exclusively puts it. What then? The dying patient may judge that the unrelievable suffering they will experience along the path to death is a greater harm than dying a little earlier. And, doctors also have a primary duty to relieve suffering, which Mary doesn’t mention. What is under review is whether a doctor may participate in the relief of intolerable and unrelievable suffering— by hastening death—if the patient believes this is the lesser harm.

Thirdly, the Hippocratic Oath is around 2,300 years old. It requires doctors to swear allegiance to ancient Greek gods. It forbids women from becoming doctors. It requires current doctors to train the next generation free of charge, and it forbids surgery. Contemporary doctors don’t take it, and it’s certainly not “part of training” as Mary mistakenly states.

None of these are psychology arguments.

'Sucker’s choice'

Mary then argues that requiring dying patients to endure until the end promotes—and that assisted dying prevents—“fostering gratitude”, “reconciling hurts or differences with family members or friends” and “showing them strategies or different ways to approach their pain and suffering”.

But, in jurisdictions where assisted dying is legal, for example in Oregon in the USA, these are precisely things that are encouraged under assisted dying. Doctors are required to inform applicants of available medical and palliative interventions. Family gathers on notice of an anticipated death, music and poetry is shared, and expressions of love, devotion and gratitude are exchanged.

If a dying patient has no intention of reconciling with family or reflecting on approaches to dealing with their pain and suffering under an assisted dying law, precisely the same intention applies to the current regime that requires the patient to endure until the end. To assume a difference is a false dichotomy.

Obligatory compassion

Mary also argues that assisted dying ought to remain outlawed because “nursing a sick loved one is a way to give back”. This is yet another specious non-psychology argument. It promotes the ‘right’ of the ‘nurse’ to express love and devotion through ‘caring interventions’ at the expense of the dying patient’s own world view and deeply-held wish for a hastened death. Now who’s being utilitarian?

The upshot

I ran Mary’s opinion piece past an experienced psychologist, who described it as little to do with psychology. Note that neither of us has experience of or is commenting on Mary’s expertise as a clinical psychologist: she may indeed be a very good one.

My associate wondered out loud if Mary’s arguments were based more on underlying religious views than anything else. I agreed: they seemed to me remarkably consistent with the arguments advanced by religious opponents, even though they avoided directly religious words. So I did a little research.

It turns out that Mary is a committed and active Sydney Catholic.* Evidence abounds of her devotion to the Catholic tradition, and I commend her for her conscientious reflective practice and participation in it.

However, I argue that neither the stated psychological qualification nor the unstated religious affiliation make the offered arguments valid.

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* By way of fairness, I place on the record that I am agnostic.


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The F files
 

The public conversation about assisted dying law reform has been influenced by misinformation from opponents for far too long. Often, misinformation is simply given in ignorance, but sometimes not. It is mandatory that a conversation as important as assisted dying for those suffering at the end of life is informed by accurate information and evidential and reasoned views. Arguments that deceive or attempt to shut down the conversation have no place.

Whether misinformation is Fearmongering, Filibuster, Flip-flop, Flapdoodle, Fudge, or Fiction or Faith, the F files identifies misinformation and those who are providing it.

You can help by sending records of misinformation claims to us, and asking claimants to correct the errors.

 

Fundamental forms of misinformation

fearmongering.jpg      

Fearmonger

Represent something as considerably more sinister or dangerous than it is when judged by objective criteria.

filibuster.jpg  

Filibuster

Artificial and overly-lengthy process used in an attempt to stall or block a political outcome.

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Flip-flop

Multiple inconsistent or opposed arguments used to justify a position.

flapdoodle.jpg  

Flapdoodle

An argument that superficially seems intuitively attractive, true or real, but is in fact meaningless or nonsensical.

fudge.jpg  

Fudge

Unscientific analysis (e.g. selective data) used to support an argument that is not supported by proper, full analysis.

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Fiction

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

faith.jpg  

Faith

An argument that all others should adhere to a particular religion's values, tenets and rules.

 

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