To use unscientific analysis methods or inappropriately selective data to support an argument or conclusion, where valid scientific analysis methods or use of available full data would support different conclusions.
Blog by Neil FrancisPosted on Saturday 11th August 2018 at 11:33pm
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-disgracedFr 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).
Figure 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 Australiasubmission 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.
Disclaimer: I do notclaim, 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.
Blog by Neil FrancisPosted on Monday 13th November 2017 at 6:28pm
The deeply-flawed Jones & Paton, and Kheriaty articles purporting to show suicide contagion.
In the ongoing political campaign against assisted dying law reform, opponents have spread one piece of egregious misinformation after another. One of the most common is supposed “suicide contagion” from assisted dying laws to general suicide, a theory popularised by Catholic Prof. Margaret Somerville. Despite the nonsense of her claim being comprehensively exposed, she still believes that her opinion “will prove to be correct.” Two journal papers published in 2015 purported to, but didn't, establish suicide contagion in Oregon and Washington states.
Assisted dying law reform opponents are still relying on a 2015 paper by Catholics David Jones and David Paton, bolstered by a glowing editorial of it written by Catholic psychiatrist Aaron Kheriaty, published in the Southern Medical Journal, as continued ‘proof’ of suicide contagion theory, at least in respect of USA states Oregon and Washington (since data from other lawful jurisdictions contradicts the theory).
Jones & Paton’s article reported the use of econometric modelling to test for ‘suicide contagion’ from Oregon and Washington’s Death With Dignity Act (DWDA) laws. But, in an exposé to be published this week, no fewer than ten ‘deadly sins’ of the study are peeled back to reveal the rot within.
The very deep flaws and biases of the original articles include:
Cherry-picking information from cited sources to argue their case, while omitting information from the same sources that contradicted their case;
Including test and control subjects whose consequence was likely to maximise the likelihood of finding a positive association;
Demonstrating a poor understanding of suicide and its risk and protective factors and failing to control for most confounding effects in their econometric model ‘pudding’;
Overegging the “causative suicide contagion” interpretation when no correlation between assisted dying and general suicide rates was found; and
Failing to use direct, robust and readily-available evidence that showed their study couldn’t possibly have hoped to return scientifically valid “contagion” proof.
The USA’s National Violent Death Reporting System (NVDRS), of which Oregon is a founding member, shows that even if “assisted dying suicide contagion theory” were true, fewer than 2 of 855 Oregon “total suicides” in 2014 could have been attributed to “contagion” from DWDAs.
Further, both Oregon and Washington state rankings for suicide rates have improved, not deteriorated, since their DWDAs came into effect, while the suicide ranking for a relevant control state — Oklahoma — has deteriorated substantially over the same time.
Ultimately, through numerous and deep methodological flaws, the Jones, Paton and Kheriaty articles reveal a bias to promote “assisted dying suicide contagion theory” while ignoring the robust evidence from multiple lawful jurisdictions, including in their own ‘study,’ that contradict it.
The exposé, titled “The ten deadly sins of Jones, Paton and Kheriaty on ‘suicide contagion’,” will be published by DyingForChoice.com later in the week.
Blog by Neil FrancisPosted on Wednesday 18th October 2017 at 9:41pm
The Victorian parliament is debating the Government's Voluntary Assisted Dying Bill
Former Australian Prime Minister Paul Keating once famously branded the Senate “unrepresentative swill” for obstructing his legislative agenda. Today, the question of how representative our political masters are remains moot.
Major community support for VAD
Take voluntary assisted dying (VAD) for example. Poll after poll demonstrates that the overwhelming majority of Australians want this additional choice for people in extremis at the end of life. The impeccable Australian Election Survey (AES) conducted by Australian National University scholars last year confirmed that 77% of Australians want VAD reform, with 13% undecided and just 10% opposed.
Strong support (43%) is ten times greater than strong opposition (4%), and support is high across the political spectrum: amongst minor/independent (69%), Coalition (77%), Labor (80%) and Greens (87%) voters. Public support has been in the majority for more than four decades.
Political support missing in action
But since the Northern Territory Rights of the Terminally Ill Act in 1996, none of the many VAD Bills before various state parliaments has passed. And the Northern Territory’s Act was torn down by the federal parliament just eight months after coming into effect.
A 2008 university study of federal MP voting opportunities found 100% of Greens, 55% of Labor, and a paltry 17% of Coalition MPs voting in favour of VAD.
New analysis
Now, a new analysis of the ten state VAD Bills since 2000 where final divisions were called, offers further insights. It found 100% of Greens MP voting opportunities were in favour, along with 51% of Labor, 29% of minor party and independent, and a similarly paltry 17% of Coalition MPs. Excluding South Australia, whose parliament has debated the greatest number of VAD Bills, the Coalition support rate was just 9%.
Overall, while state Labor MP votes fell 29% short of Labor voter attitudes, Coalition MP votes fell an astonishing 60% short of Coalition voter attitudes. At the state level, Coalition MPs had the most voting opportunities — nearly half (48%). No wonder passing VAD Bills is challenging.
It begs the question, how is it that our legislative representatives fail to reflect clear public majority views on matters of conscience for so long?
Hidden reasons behind MP opposition
Obviously, lobbying on both sides of the conversation in part informs MPs’ views, but there are several more persuasive factors.
For a start, there’s a “truism” held by many MPs that their vote in favour of a VAD Bill would lose them more votes at a general election than would a vote against the Bill. However, the opposite has been demonstrated in multiplestudies.
Further, I’ve shown before that opposition to VAD is largely religious. A university study has also found that those who are more religious and who are politically engaged tend to hold very conservative views. So while there are religious MPs on both sides of politics, Coalition MPs are naturally more inclined to hold much more conservative views.
But that doesn’t fully explain the massive 60% representation gap on the Coalition side, either.
In good conscience?
A key factor lies in the seemingly reassuring principle of the “conscience vote.” The major parties have announced that their members are accorded a conscience vote (also known as a “free vote”) on the VAD Bill. That simply means that there’s no official published party policy on the matter and party members may vote freely on the basis of their own conscience.
There are two significant issues with this state of affairs.
The first is that the member may refer exclusively to their own conscience. But what if the MP’s conscience is at odds with the electorate’s? For my home state of Victoria, the 2016 AES study found 79% of the community in favour of VAD. There are 88 members of the Victorian parliament lower house, and just 40 members in the upper house. Therefore, it’s possible for as few as just 20 Victorian MPs to vote “no” in order to extinguish the will of 3.2 million Victorians (79% of 4.05 million Victorian voters).
If that weren’t enough, the second issue is that the right to ‘conscience’ is granted only in respect of the Bill itself, not on procedural matters about the Bill. It can make a huge difference.
How the parry works
Here’s what happened in 2008 when Victorian Greens MP Colleen Hartland’s VAD Bill was before the Legislative Council. MPs were afforded a conscience vote, and many of them had said they were supportive of VAD in general, but couldn’t support Hartland’s Bill in its current form. (That’s also a common ruse of MPs who in reality oppose the reform in principle but wish to appear ‘open minded’.)
When the final vote on Hartland’s Bill was lost, then Greens MP Greg Barber immediately moved a motion to refer the Bill to a parliamentary committee so that it could be improved to MPs’ satisfaction. Neither Labor nor Coalition parties afforded their members a conscience vote on this procedural matter, instead directing MPs to vote against such motions. The referral, which may have resulted in Victorians having wider end-of-life choices years ago, was cynically buried.
Most voters remain unaware of the shenanigans played in the corridors of power to achieve such results.
Australia’s special political conservatism
They’re not the only shenanigans, though. Another university study comparing federal MP conscience voting patterns in the UK, New Zealand and Australia found Australia to be different, accounting for why the UK and NZ have legalised marriage equality, while Australia hasn’t.
Firstly, the centre-left in Australia has a larger proportion of Catholic members than in the UK and NZ, accounting for some of the shortfall in Labor representation of progressive views.
Secondly, those amongst Coalition ranks, but with more liberal social consciences, had been lashed by Coalition party whips to vote against progressive reform. So while there was a public display of fairness and neutrality, the reality was quite different.
Borne out in state parliaments
These findings are replicated in Australian state parliament votes too, with Coalition MPs rarely if ever voting in favour of progressive social reform. Coalition MP votes on VAD including and since Hartland’s legislative attempt in 2008 are telling: in Victoria 2008 10:5 against, in Tasmania 2009 6:0 against; in Western Australia 2010 19:1 against; in NSW 2013 10:0 against; in South Australia 2016 14:7 against and in Tasmania 2017 13:1 against.
Rather than reflect 77% Coalition voter support for VAD, Coalition MP voting patterns reflect the highly negative stance of party leaders, whipped through the parliamentary party membership. For example, then WA Premier Mr Colin Barnett made it clear he thought assisted dying was “government-sanctioned killing”. Tasmanian coalition leader Mr Will Hodgman said that “protection for [vulnerable] people cannot be guaranteed.” Then-NSW Premier Mr Barry O’Farrell declared himself “strongly opposed”.
Back to Victoria’s Bill under debate
The situation in Victoria is looking somewhat more positive, with Premier Mr Daniel Andrews and many in his Cabinet publicly supporting reform. A lengthy, detailed, professional and well-resourced process has informed the crafting of the Bill.
However, opposition leader and would-be Premier Mr Matthew Guy has stated his resolute opposition to it and that he intends to vote “no”. That would mean he is quite comfortable for his own personal view to extinguish the contrary views also held in good conscience by 34,626 of the 43,831 voters in his own electorate of Bulleen, and 3.20 million of Victoria’s 4.05 million voters. (Electorate numbers as at 10 October 2017.)
An obvious solution
There’s an obvious solution for MPs whose own consciences disallow them from reflecting the overwhelming majority conscience of the electorate.
They could consider abstaining — simply absenting themselves from the chamber during the division. That would keep their own consciences intact while allowing the electorate’s conscience to be reflected.
I’m a constituent of Mr Guy’s. Over a period of months I made six robust attempts to meet with him to discuss these matters, especially the covert whip arrangements and the consideration of abstention. I can be persuasive in obtaining appointments, but my best efforts proved wholly unfruitful.
As I said to Mr Guy’s private assistant after the last failed attempt, voters could be forgiven for believing he’s more interested in meeting allegedly shady characters in fancy Brighton restaurants, than meeting with his own constituents.
Victorians are watching the parliamentary VAD debate. We’re taking notes that will inform our votes at the state election late next year.
Indications are at present there’s a good chance that Victorian MPs won’t be “unrepresentative swill”.
Blog by Neil FrancisPosted on Thursday 12th October 2017 at 1:50am
The latest religious right 'think tank' lobby group, the Institute for Civil Society.
I challenge the latest religious right commentators opposing Victoria’s Voluntary Assisted Dying Bill to skip the flip-flopping and engage constructively.
They’re at it again. This time it’s the religious right’s latest ‘think tank’ front group, the impressively-named Institute for Civil Society. Sounds grand, doesn’t it?
But if you look into their lot in life, it’s to protect ‘religious freedoms.’ By that, they mean the right to lawfully discriminate against others of whom they disapprove, while at the same time arguing that they not be discriminated against.
Mark Sneddon and Sharon Rodrick of the ‘Institute’ published an opinion piece in Fairfax Media today.
In it, they slam the Victorian Government’s Voluntary Assisted Dying Bill, which was introduced into the Parliament recently.
They level several criticisms at the Bill to say it's not 'safe'. But they could have advanced any criticism of the Bill to claim, as they do, that “the vulnerable will be at risk” — a logical fallacy as I’ve pointed out before. The "vulnerable will be at risk", by circular definition, if the Bill is printed in black ink (as it is) instead of purple, but they didn't complain about the colour of the ink.
The flip-flop
The point is, they flip-flop because they’re remarkably inconsistent in their position. At the same time as pointing out supposed flaws in the Voluntary Assisted Dying Bill, demanding a much higher standard of proof about a number of things, they completely fail in their opinion piece to even mention — let alone demand the same level of safeguards for — an already-legal and equivalent hypothetical risk for the “vulnerable.”
Equivalent hypothetical risk in operation for nearly 30 years
In Victoria, patients have an inalienable right to refuse any and all medical treatment. No reason need be given, even if the treatment is life-saving. The Medical Treatment Act 1998, currently in force, has several safeguards to protect against coercion or undue influence. In Section 5(1), one doctor and “another person” (who can be anybody) must be satisfied that:
“the patient has clearly expressed or indicated a decision”; and
“the patient’s decision is made voluntarily and without inducement or compulsion”; and
“the patient has been informed” about their condition and “has appeared to understand that information”; and
“the patient is of sound mind and has attained the age of 18 years.”
They’re all the legislated safeguards for the refusal of life-saving medical treatment.
And how many cases of undue influence have been prosecuted in Victoria over the nearly 30 years the Medical Treatment Act 1998 has been in effect? Precisely none. Not one.
So much for Messrs Sneddon and Rodrick’s avaricious relatives lurking at every bedside.
A new, equivalent hypothetical risk
The Medical Treatment Planning and Decisions Act 2016, which will come into force in March next year and which extinguishes the Medical Treatment Act 1998 at that time, also contains several similar safeguards for the refusal of life-saving medical treatment.
In witnessing an Advance Care Directive (Section 17), the two signatories, only one of whom must be a medical doctor, must certify that:
the person “appeared to have decision-making capacity” in relation to the documented decisions; and
the person “appeared to understand the nature and effect of each statement”; and
“the person appeared to freely and voluntarily sign the document”; and
“the person signed the document in the presence of the two witnesses”; and
“the witness is not an appointed medical treatment decision maker for the person.”*
In Section 52 of the Act, a health practitioner is forbidden to administer medical treatment if they are aware the patient has refused it, however (lawfully) refused.
This Act was passed in the term of the current Parliament: that is, by the same State MPs who are now considering the Voluntary Assisted Dying Bill.
There was no great fracas over the sensible safeguards spelled out in the new Medical Treatment Planning and Decisions Act. There was no onslaught of “crisis!” op-ed screeds published in newspapers. There were no countless hours of talking heads tut-tutting and painting doomsday scenarios.
It was passed by the Parliament and accepted by the people as striking the right balance.
No safeguards at all in many cases
And that’s it: the sum-total of safeguards to refuse life-saving medical treatment in Victoria. However, if the patient refuses medical treatment verbally, there are no mandated safeguards at all in either old or new Act, because the statutory safeguards apply only to refusal given in writing.
Yet despite all this, Messrs Sneddon and Rodrick rail against safeguards against coercion and elder abuse only in regard to the Voluntary Assisted Dying Bill, in which the safeguards are of a significantly higher calibre, with, for example, mandatory multiple doctor opinions, documentation trail, multiple requests, no go-ahead until approval by an external authority, notifications of numerous kinds, oversight by a specially-established panel, and so on.
It’s obvious what a flip-flop Messrs Sneddon and Rodrick’s demands are in respect of decisions that will foreseably result in death.
Another embarrassing flip-flop
Messrs Sneddon and Rodrick particularly also complain at length at the supposedly ‘lax’ definition of decision-making capacity in the Voluntary Assisted Dying Bill.
That’s a major and embarrassing flip-flop. Here’s why.
The section of the Voluntary Assisted Dying Bill that stipulates those requirements (Section 4) is the same section number 4 that governs the right to refuse of life-saving medical treatment in the Medical Treatment Planning and Decisions Act 2016. Only a few words have been changed to alter the context from refusal of treatment to consideration of assisted dying. Otherwise, the Sections are identical.
Messrs Sneddon and Rodrick don't point this out in their opinion piece. Indeed, I was unable to find online any evidence that they had published any complaint about the provisions when the Medical TreatmentPlanning and Decisions Act was in debate, nor since. If they have, I’d be happy for them to point it out.
Is it all a strategic ruse, anyhow?
It’s pertinent to ask if the objections are a ruse anyhow, because, as Andrew Denton has rightly pointed out, a key opponent strategy is not to give an outright “no” to assisted dying Bills, but to say only “not this Bill” and create an atmosphere of FUD (fear, uncertainty and doubt) so that it is defeated.
A typical ruse example
By way of example, I’ve published an account of how Victorian MP Daniel Mulino published outrageous misinformation about assisted dying. As a result, we had an extended conversation, during which he acknowledged that he had indeed published misinformation. At the end of the conversation I asked if he could support the Government’s Voluntary Assisted Dying Bill. (He’s a member of said Government.)
No, it’s too liberal, he said, pointing to Oregon’s Death With Dignity Act, now in force for nearly 20 years, as a more conservative approach. So I asked him if he would support a Bill like Oregon’s.
No, he said, there were still concerns about it.
By now you’ve spotted the merely incremental withdrawal of supposed possible support. So I asked him outright if there was any form of assisted dying Bill he could support.
The relevant word within a long discourse: No.
And there’s the answer that belies the political strategy. It doesn’t matter one whit what provisions are included in an assisted dying Bill, just criticize a bunch of provisions and create FUD to defeat it.
A direct challenge to Messrs Sneddon and Rodrick
If “doubters of this Bill” are genuine about permitting assisted dying in some defined circumstances, the duty is on them to define those circumstances and recommend wording to enact it.
And that’s the challenge I throw down directly to Messrs Sneddon and Rodrick. Don’t just bitch and gripe: define precisely what provisions and wording you think would be acceptable.
If you fail to stipulate what you deem acceptable, then your opposition to “this flawed Bill” is, like the supposedly ‘soft’ opposition of other campaigners in the negative, merely a ruse.
And that’s rather suggested by your deliberate use of the term “killing” for what most Australians believe to be an understandable and welcome release. But let’s give you the benefit of the doubt… for now.
Will you rise to the constructive challenge, or lurk in the shadows merely making snide remarks and flip-flopping?
----
* Section 62 of the Act also requires a doctor to notify the Public Advocate if “significant treatment” is refused — but only if it is refused by a substitute decision maker on behalf of the patient: not by the patient herself. And “significant treatment” is defined as treatments (not non-treatments) which are likely to have a serious impact on the patient (bodily intrusion, risk to life, side effects or distress). “Significant treatment” in the Act does not mean treatment whose refusal may result in death.
Blog by Neil FrancisPosted on Tuesday 10th October 2017 at 7:58am
The Parliament of Victoria is currently debating an assisted dying Bill.
As the Parliament of Victoria prepares to debate an assisted dying Bill, South Australian Catholic anti-assisted-dying lobbyist Mr Paul Russell is at it again. This time he's sent a missive to Victorian politicians shouting about, amongst other things, a crisis of assisted dying numbers in Washington state. He’s conveniently cherry-picked his arguments again.
Mr Russell wrote that in Washington state:
“deaths from lethal drugs prescribed under the Act have nearly quadrupled (376%) from 51 in 2010 to 192 in 2016.”
His latest claim extends his misinformation crown title.
Don’t get me wrong. He cites the correct raw data figures for Washington. But he packages them up handily with FUD (Fear, Uncertainty and Doubt) wrapping, all tied up with the most sinister bow he can muster.
I’ve criticised the use of uncontextualized raw data before, and I do so again.
The relevant facts
Washington state legalised assisted dying by ballot in 2008. The following year the law was put into practice, and 2010 was the first full year of its operation.
Here’s the rate of assisted deaths as a proportion of all deaths in Washington state for all the years on record. As you can see, the rate hasn’t even reached one half of one percent of all deaths in 2016.
2009
2010
2011
2012
2013
2014
2015
2016
0.07%
0.11%
0.14%
0.17%
0.23%
0.24%
0.30%
0.35%
Never ones to miss out on an opportunity to spread FUD, if it were just one case last year and two this year, assisted dying opponents would be shouting from the rooftops: “Crisis!! 100% increase!!”. But in reality, only a small minority use the law, yet thousands of patients and their families are given comfort by the option being avaialble even if they don't use it. That message was made loud and clear by Oregon Senator Ginny Burdick. Washington's Death With Dignity Act is modelled on Oregon's, and Oregon's Act has been in effect for twenty years.
A Catholic trifecta
Of course in his missive, Mr Russell, like his fellow Catholic whom I’ve also called out for misinformation, Prof. Margaret Somerville, avoids referring to Swiss data. And their fellow Catholic Mr Daniel Mulino, who furnished a minority report to the Victorian Parliament’s recommendations on end of life choices, a report I’ve also called out for stunning misinformation, fudges his numbers about Switzerland, referring to data from 1998 without further context.
Why do these lobbyists avoid or selectively refer to the Swiss situation? Because the actual data is an inconvenient truth to their FUD story-telling.
An inconvenient truth
Switzerland’s assisted dying law came into effect seventy-four years ago, in 1942. If just one person had used the law in 1942, using Mr Mulino’s favourite annual increase figure of 17.5%, that would equate to 110,338 people pursuing an assisted death in Switzerland in 2014.
I say 2014 because that’s the most recent year for which official Swiss Government assisted dying figures are available. And what was the actual figure in 2014? There were 742 cases of assisted dying amongst Swiss residents, and Dignitas reports that it assisted 198 foreign nationals. That’s a total of 940 assisted deaths.
Let’s add another 60 foreign-national assisted death cases from the much smaller Swiss society that provides accompaniment for foreigners. That makes around 1,000 cases in 2014, including all those who came from all over the world. And it’s less than one hundredth of the minimum rate the doomsayers predict by cherry-picking one statistic that suits their argument.
Swiss law has the fewest safeguards
The Swiss assisted dying law has none of the safeguards of the Washington law. By Mr Russell and Co’s reckoning, you’d think that the Swiss (and those who visit) would be dropping off like flies.
By way of further comparison, the doomsayer number of assisted deaths for 2014 (a minimum of 110,338 cases) is substantially greater than the total number of deaths in Switzerland that year: 63,938. It’s an obvious impossibility.
In 2014, the Swiss rate of assisted deaths including all the foreign nationals who came to use its law, was 1.5% of all deaths; and 1.2% for resident-only cases.
And the rate of assisted deaths in Luxembourg in 2014 (legalised in 2009), whose laws are much more liberal than Washington’s though stricter than Switzerland’s, was 0.17% of all deaths. It’s odd how the doomsayers don’t report Luxembourg data, either.
And what are these cases?
These are cases of people in extremis with no realistic prospect of relief or improvement, choosing a peaceful assisted death as a better option than being forced to prolong their torture, according to their own deeply-held beliefs, values and examined consciences.
Mr Russell believes they should be required to endure their torture. There is a point to it, he says: because it joins them “in some mysterious way to the sufferings of Christ”... whether others believe in Christ, or at least Mr Russell’s version of him, or not.
You won't find this degree of candour on his anti-assisted dying website, but you can find it at NewsWeekly, which is run by the National Civic Council (NCC), itself established by Australia's most famous and conservative lay Catholic, B. A. Santamaria. Mr Russell has been President of the NCC South Australian chapter.
It’s not the numbers, it’s the circumstances
To be clear, in no jurisdiction has its legislature enacted access to assisted dying on the basis of a numeric ceiling. They’ve enacted access on the basis of intolerable and unrelievable suffering. And to this day, those are the folks who may be granted access to an assisted death.
Conclusion
Again, Mr Russell (and colleagues) do themselves no favours by conspicuously cherry-picking the data they want to use, and wrapping it up in threatening garb to create FUD amongst politicians.
Blog by Neil FrancisPosted on Tuesday 19th September 2017 at 10:30pm
The Age reports on the three AMA dcotors' appearance at Spring Street
As reported in The Age, on Tuesday this week three AMA doctors fronted the Victorian Parliament to spread the word about their perceived horrors of an assisted dying law. Their arguments don’t hold water and politicians should see them for what they are: utter nonsense.
Doctors Stephen Parnis, Mukesh Haikerwal and Mark Yates say they will continue to lobby politicians.
With what?
Here is the ‘substance’ of their arguments — a sticky blomonge of the same old confected and discredited claims.
The vulnerable will be at risk
Dr Parnis said that such a law “puts the most frail and vulnerable in our community — the dying — at profound risk,” pointing to coercion, and patients not getting the medical care they need.
As I’ve explained before, the claim is flapdoodle — circular nonsense.
It’s a circular argument (a logical fallacy) because “the vulnerable” are by definition those “at risk” and vice versa. While the circularity makes the claim about assisted dying risks seem true, it's a false imputation.
By way of comparison, we could equally say that “the vulnerable will be at risk if we wear yellow socks on Wednesdays,” so we should outlaw that as well. Or anything else of which we disapprove and make our argument seem valid by attaching it to “the vulnerable being at risk.”
Let’s not talk about it
Dr Yates argued that the Parliament should not be pursing “divisive legislation.” That’s also a false argument because it's merely an appeal to emotion: avoiding legislating anything upon which there is any disagreement and discomfort. The consequence of this argument is to not legislate at all.
Patient trust in doctors
They also argued that assisted dying legislation would “change the doctor-patient relationship” — by which they mean “damage the relationship,” or they wouldn’t have mentioned it.
Again, as I have shown before, the empirical evidence from around the world is consistent with improved, not damaged, patient trust in doctors where assisted dying is legal.
The massive AMA flip-flop
But, as I’ve also pointed out before, the real telltale of the AMA doctors’ farcical representation to the Victorian Parliament is this: while opposing assisted dying legislation because patients might be pressured, subtly or otherwise, to choose death, the AMA officially endorses the right to refuse medical treatment, which includes life-saving treatment.
The hypothetical risk of patients being encouraged to refuse life-saving medical treatment is identical in kind to that of assisted dying. Yet in Victoria, the right to refuse is protected by just three statutory safeguards, while the assisted dying legislation is founded on no fewer than 68 safeguards.
So the AMA incoherently promotes one hypothetical pressure-to-die pathway with only three protections, while cruelly opposing a parallel path with an armada of protections. Let's award 10 out of 10 for the impressive flip-flop manoeuvre.
Conclusion
The AMA doctors’ claims are without merit and advancing them does no favours to their professional credibility.
Blog by Neil FrancisPosted on Thursday 14th September 2017 at 10:20pm
Another Catholic 'academic' spreads more misinformation. Photo: donaldytong
It’s very disappointing that Catholic theologian Dr Joel Hodge’s recent editorial in Fairfax media about assisted dying law reform contained misinformation: the same old tired and discredited story trotted out as though it's true. Dr Hodge also repeated an old and curiously one-sided (Catholic) examination of the hypothetical slippery slope.
Unhappily, the kind of misinformation that Dr Hodge advances muddies the waters and cruelly stands in the way of legislative action, which most Australians want.
An impeccable national survey conducted by scholars at Australian National University last year found 77% of Australians in favour of assisted dying law reform. Strong support (43%) outweighed strong opposition (4%) by more than ten to one. In the two states whose Parliaments are currently considering reform, NSW and Victoria, support stands at 75% and 79% respectively.
Non-religious support is 91%, and it’s high amongst Catholics (74%) and Anglicans (79%) as well. Bishops are jarringly out of step with the views of their flocks. And across the political spectrum, 87% of Greens, 80% of Labor, 77% of Coalition and 69% of minor party voters also want reform.
The electorate’s desires couldn’t be clearer. But politicians — who have little time to fact-check what they’re told — are fed the kind of misinformation Dr Hodge advances.
The false 'non-voluntary euthanasia slippery slope' argument
He quotes details from a medical journal article by Dr José Pereira, a Canadian Catholic physician. Like others who cite this article, Dr Hodge fails to mention that it was thoroughly debunked in a surgical deconstruction by expert scholars. They found Pereira’s claims variously unsupported by any evidence, unsupported by the sources he cited, or false, concluding that the article was “smoke and mirrors.”
Like other Catholics, Dr Hodge relies heavily on a thoroughly debunked journal article by Catholic Canadian doctor, José Pereira.A significant source of smoke, which Dr Hodge fans from this debunked article, is the claim regarding “900 Dutch deaths hastened without explicit request”: that is, non-voluntary euthanasia or NVE. Such figures are cited as ‘proof’ of the hypothetical slippery slope from legalised voluntary euthanasia to NVE.
Other opponents of assisted dying variously put the figure at 500 or 1,000. For the sake of argument, let’s say the 900 figure is equivalent to 1,000. Both the 500 and 1,000 figures, also repeatedly promoted by Catholic ethicist Professor Margaret Somerville and others, have been true. But here’s the thing.
What they don’t mention is that the 1,000 rate is from the 1990s when Dutch assisted dying was conducted under a general regulatory framework. In 2002 the Dutch euthanasia Act came into effect. Amongst the Act's many details was the establishment of a Commission which examines every reported case of assistance.
Since then, the Dutch NVE rate has dropped to 500, and even further. It has stayed low and is now similar to the NVE rate in the United Kingdom, the world’s gold standard for palliative care, and where assisted dying remains illegal.
There was a significant drop in the NVE rate in Belgium, too, after its euthanasia Act came into effect, also in 2002.
It is absolutely unconscionable that yet another Catholic commentator has trotted out the same old lie as though it's true. Dr Hodge is an academic and it is incumbent on him to check the facts before sounding off.By cherry-picking a single figure, opponents argue the opposite of the facts, implying or even directly claiming that NVE rates are caused by or have risen as a result of legalised assisted dying. I’ve comprehensively exposed this nonsense before, yet it comes up repeatedly.
It’s similar to other lines of Catholic argument against assisted dying, like the claim that Dutch elderly supposedly travel to Germany for healthcare because they fear being euthanised by their Dutch doctors — an outrageous falsehood. There’s also the faintly desperate claim that Dr Els Borst, the architect of the Dutch euthanasia Act, later regretted her reform — a fake claim she’s firmly corrected.
Consider too a Catholic bishop’s claim, without reservation and in formal evidence before an official Parliamentary inquiry, that Oregon’s general suicide rate was very low prior to its assisted dying Act but very high afterwards — contrary to the facts. Or a report cherry-picking just half a sentence from a journal paper to claim that a significant proportion of assisted-death patients in Oregon had symptoms of depression, when the other half of the verysame sentence clearly stated that none of them had.
As Professors Griffiths, Weyers and Adams wrote in 2008, “imprecision, exaggeration, suggestion and innuendo, misinterpretation and misrepresentation [and worse] took the place of careful analysis.” Sadly, the same still seems true today.
Major Catholic flip-flop on choosing death
Now let’s turn our attention to the core of Dr Hodge’s thesis. His plea for “the vulnerable” leads his argument and is heavily egged throughout the polemical pudding.
A comparison is moot: Australians have the right to refuse any unwanted medical treatment, even if it’s life-saving.
In my home state of Victoria, this right to refuse is enshrined in statute. The statute contains just three ‘safeguards’ for checking a refusal, and those only apply if the refusal is formally documented in writing but not if it’s only oral.
As I’ve explained in detail before, the consequence is that a person can refuse life-saving medical treatment with few if any checks and balances. In theory, just as Dr Hodge argues in regard to assisted dying, the person might feel pressured by greedy relatives, resource-poor doctors or others, to so refuse.
In this case, where is the Catholic call for protections? Where is the moral outrage on behalf of ‘vulnerable patients’? There is none. In fact, the Catholic Church’s call is quite the opposite. In a directive to all Catholic healthcare institutions in the USA, the Conference of Catholic Bishops make the Church’s position abundantly clear. They direct that there is no obligation for patients to use “disproportionate means of preserving life.”
The Catholic church's rhetoric against assisted dying is a major flip-flop when compared to its cosy attitude towards refusal of life-saving medical treatment: both might result in hypothetical pressure to choose death, yet only assisted dying has adequate safeguards.They define disproportionate means as “…those that in the patient’s judgement do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.”
So, under two identical hypothetical possibilities of inappropriate persuasion to choose death, Dr Hodge’s argument bristles against an assisted dying reform containing — as he acknowledges — no fewer than 68 safeguards, while his Church argues that patients may refuse life-saving medical treatment if the patient feels it’s “hopeless,” entails “excessive burden” or imposes “excessive expense” on others, with hardly any, or no statutory safeguards at all.
The incoherence, and repetition of misinformation, is indefensible. Civil debate on such an important matter deserves better.
Blog by Neil FrancisPosted on Sunday 6th August 2017 at 3:36am
Victorian MP Daniel Mulino's minority report contains multiple serious errors and misinformation.
Last year, the Victorian Parliament's Legal and Social Issues Committee concluded an extensive investigation into end of life choices, publishing a report of over 400 pages recommending improvements to palliative care and for assisted dying. Catholic-backed Shop, Distributive and Allied Employees' Association (‘shoppies’ union) Labor member of the Victorian Parliament Mr Daniel Mulino furnished his own minority report, opposing the majority recommendation for assisted dying law reform. That’s entirely his right. However, his report contains multiple, serious cases of misinformation. He must withdraw his report.
Daniel Mulino, Labor parliamentary member for the Victorian Region of Eastern Victoria,1 and a member of the Catholic-backed ‘shoppies’ union,2 was a member of the Legal and Social Issues Committee that thoroughly investigated end of life decision making and produced a 400+ page report in 2016 making recommendations for law reform and regulation.
Mr Mulino furnished a “minority report” as an addendum to the main report in order to oppose the Committee’s recommendation that assisted dying be legalised.3
Promoted by Catholics to Catholics
Mr Paul Russell, South Australian publisher of the Catholic anti-euthanasia website ‘HOPE,’§ says this of Mr Mulino’s minority report in the Catholic lawyer association’s blog:4
“Daniel Mulino MLC's analysis should be read first, before the Majority Report. It forms not only a sound academic and rigorous approach but also, by implication, is damning of the narrow, outcome focus of the Majority Report.”
How sweet of Mr Russell to so generously plug Mr Mulino’s report. But, in gushing about the ‘sound academic and rigorous approach’ he claims to be in it, shows that he doesn't understand what constitutes proper and sound evidence, and that he's easily impressed by charts and lots of ‘literature’ citations.
Numerous fundamental faults
The reality is very different.
Rather than bore you with a mind-numbing blow-by-blow dissertation on the numerous fundamental faults in Mr Mulino’s report, I’ll demonstrate how the report cherry-picks, misquotes and misunderstands its way through the evidence, via four revealing examples.
Example 1. Cherry-picking ‘helpful’ data
Mr Mulino’s minority report illustrates the rise in number of assisted deaths in the Netherlands and Belgium, and produces some statistics (Figures 1 & 2 are directly from his minority report).
Figures 1 and 2 (of Mr Mulino’s minority report): Assisted deaths in Belgium and the Netherlands
Note that Belgian data is for the years 2003–15, but the Netherlands only for the years 2008–15. That’s odd, because the euthanasia Acts for both countries came into effect in 2002, and so 2003 was the first full year for both.
Mr Mulino doesn’t point out that his report treats the two countries differentially, and provides no explanation as to why. We might notice, however, that the dicrepancy has the consequence of making his claims look 'better.'
Using Mr Mulino’s presentation style, Figure 3 illustrates all the relevant data for the Netherlands.
Figure 3: The full Netherlands data Source: Official Euthanasia Commission reports
As you can see, there is a virtual flatline between 2003 and 2007. Indeed, there is even a tiny drop in numbers between 2005–06. This is an inconvenient truth to Mr Mulino’s thesis that there has been a consistent massive rise in numbers. It also substantially reduces the compound annual growth rate he wrongly quotes for just 2008–15.
He’s also cherry-picked only raw data. In fact, the only valid way to compare year to year, and jurisdiction to jurisdiction, is to use the rate for each year: that is, the number of assisted deaths as a proportion of total deaths in the same year and jurisdiction, so that you’re comparing apples with apples. It's necessary because the total deaths count goes down and (mostly) up a bit each year. The official government statistics for total deaths by year for both countries are readily available online, so there’s no excuse for not using them.
When you calculate the rates, you get validly-comparable results, as I illustrate in Figure 4.
Figure 4: Rate of assisted dying as a percent off all deaths in the Netherlands and Belgium 2003–2015 Sources: Official government statistics; Euthanasia Commission reports
As I explain in my detailed research whitepaper on Benelux assisted dying,5 these are sigmoid (stretched-S) shaped curves which are typical of human behaviour change. And there is a drop in the rate in both countries in 2015, which Mr Mulino doesn’t report.
My Benelux whitepaper also reports the data from Luxembourg (Figure 5), which Mr Mulino fails to mention, even though it has legislation, since 2009, almost identical to the Netherlands and Belgium, and the Luxembourg government's data is freely available online.
Figure 5: Rate of assisted dying in the three lawful Benelux countries Sources: Official government statistics; Euthanasia Commission reports
Luxembourg’s data (yellow in Figure 5; no data available yet for 2015), is also an inconvenient truth to the case Mr Mulino attempts to prosecute. There’s no substantial rise.
Example 2. Comparing apples with oranges: mis-matching data
Mr Mulino again fails to compare apples with apples. Take, for example, his vocal claim that the annual total death counts for the Netherlands decreased at the same time as the total counts for assisted dying increased.
When you look at the data he’s used (the citation for the negative total deaths trend he quotes in his Table 2), you find that he’s used total death data for 2000–10, which is falling, while his assisted dying data is for 2008–15, which is rising.
This just isn’t on: it’s completely invalid to compare data like this from one period with data from another period to claim or imply a causal relationship. Of what possible relevance is the total death data for 2000–02, while his total deaths data for 2011–15 is missing? I illustrate the full story in Figure 6.
Figure 6: Netherlands total and assisted deaths for different periods Sources: Official government statistics; Euthanasia Commission reports
The solid blue and orange lines are data Mr Mulino used and reported, and their dotted ends are data that he omitted. It’s easy to see that the total deaths data his report inappropriately relies upon has a negative (downwards) slope (left-hand blue dashes), while the matching total deaths data he should have used has a positive (upwards) slope (right-hand blue dashes). Valid comparison gives lie to his claim.
Example 3. White is the new black: Misquoting the opposite
Mr Mulino’s report also argues that there’s ample evidence that a significant proportion of people with depression are gaining access to assisted dying:
“Ganzini et al, in a broad ranging review of instances of assisted dying in Oregon, found that twenty percent of the patients had symptoms of depression.” [Italics mine]
This assertion is nonchalantly plucked from the review6 without reading it properly, seemingly to support his thesis. In fact, the source does the exact opposite. Figure 7 is an image of the Abstract, where it says in large print, right up front:
“Twenty percent of the patients had symptoms of depression; none of these patients received a prescription for a lethal medication.” [Emphasis is mine]
Figure 7: The paper Abstract articulates exactly the opposite of Mr Mulino’s claim Source: Ganzini et al 20006
Had Mr Mulino bothered to read either the abstract or the methodology of this study properly, he would have realised that the doctor sample was of those eligible to prescribe under Oregon’s Death With Dignity Act, not just those who had, and that none of the study's patients who were assessed with possible depression had accessed an assisted death.
It's not like the information was hard to find — his report cites literally half a sentence to support his claim, when the full sentence says the opposite.
Example 4. Any port in a storm: Cherry-picking, misunderstanding and misrepresenting out-of-date data
In attempting to establish a 'slippery slope' from voluntary, to non-voluntary euthanasia (NVE) — a practice where doctors may hasten death (e.g. by administering increasing doses of opioids) when the patient hasn’t explicitly requested it — Mr Mulino states in his minority report:
“Two countries with the highest rates of this type of end-of-life (Belgium at 1.5% and the Netherlands at 0.60%) allowed the practice of euthanasia and assisted dying.”
Oh dear, Mr Mulino's report cherry-picks again. Just look at his source.7 The study, published in 2003, contains Table 2, with the relevant data in it (Figure 8).
Figure 8: Table 2 from the 2003 study Mr Mulino cites Source: van der Heide et al 20037
There are no fewer than five major offences Mr Mulino commits here.
Firstly, look at the table. I’ve highlighted the line in yellow from which Mr Mulino draws his figures of 1.5% for Belgium and 0.60% for the Netherlands. You can immediately and easily see that Denmark’s rate of 0.67% is higher than the Netherlands' of 0.60%.
So, Mr Mulino’s statement mentioning only Belgium and the Netherlands with “highest NVE rates” is misleading. He failed to either report or explain why Denmark’s rate is higher than the Netherlands, while Denmark doesn’t have an assisted dying law; the opposite of his thesis.
Secondly, he also fails to mention Switzerland’s NVE rate of 0.42%, or to explain that it’s lower than the Netherlands and Belgium. That’s highly relevant, because Switzerland has the world’s oldest assisted dying law — in effect since 1942 — and its statute contains none of the safeguards in the Belgian and Dutch Acts. This too is at odds with Mr Mulino’s thesis.
Thirdly, if Mr Mulino had read the study properly instead of just cherry-picking convenient figures from it, he would have noticed in the methodology section that the fieldwork (doctors filling in questionnaires) was completed in 2001 and early 2002, that is, before either the Netherlands or Belgian Acts came into effect later in 2002 (the Netherlands in April and Belgium in September).
Thus, the Dutch and Belgian data points Mr Mulino advances as ‘evidence’ of an NVE ‘slippery slope’ from legislated assisted dying have nothing whatever to do with assisted deaths under their Euthanasia Acts, because neither Act existed at the time the study was conducted.
Fourthly, he is resorting here to a single point-in-time study, which has little to no scientific power to establish ‘causation’. To really establish causation, as a minimum you have to assess longitudinal data, which I show in Figure 9. It demonstrates the precise opposite of Mr Mulino's ‘slippery slope’ thesis that voluntary euthanasia causes NVE, which if true would lead to a significant increase in the NVE rate in both countries after statutory legalisation.
Figure 9: Longitudinal NVE rates in the Netherlands, Belgium and the UK Sources: Netherlands8; Belgium9; UK10
Both the Dutch and Belgian NVE rates have dropped with high statistical significance since their euthanasia Acts came into effect. Indeed, the NVE rate in the Netherlands is now similar to the rate in the UK, which is acknowledged as the world’s gold standard in palliative care and which hasnever had an assisted dying law. This is consistent with assisted dying law reform shining a bright light on all end of life practices.
It’s not like he simply didn’t know
Fifthly, it’s particularly disappointing that Mr Mulino’s report only cherry-picked outdated data in an attempt to ‘prove’ his case when I had already directly furnished the current relevant evidence to his Committee as a properly-researched formal submission: Figure 9 above is Figure 19 in my submission, and I provided the peer-reviewed research citations for the data.11
Not only that, but the official transcript of my appearance as an expert witness before the parliamentary Committee confirms that Mr Mulino specifically quizzed me on that Figure 19 and I pointed out the sources of its data:12
“Mr MULINO — Figure 19, for example.
Mr FRANCIS — The reference should be in the text. The last sentence on the previous page gives you the citations for that data.
Mr MULINO — Okay.”
Even further, when fellow-Committee-member and Catholic assisted dying opponent Mrs Inga Peulich asked about the same thing (with Mr Mulino present) — “1,000 of those who have been accidentally euthanased in the Netherlands” — I literally put the chart up on the projection screen and explained it in full to the Committee until they had no more questions. The “1000” figure is the approximate rate prior to the Dutch Euthanasia Act, while the rate has dropped significantly since.
The evidence is irrefutable: it’s not like Mr Mulino was merely blissfully unaware of the relevant data contradicting his NVE ‘slippery slope’ claim. His minority report expressly overlooks this robust evidence and instead refers inapproriately to selective and outdated data that seemed to, but didn’t, support his argument.
Five major offences in a single citation: surely Mr Mulino’s report — far from ‘academic and rigorous’ — sets a new record?
A common religious thread?
The NVE ‘slippery slope’ claim is also popular amongst and spread by the Catholic Archdioceses of Melbourne,13 Sydney14 and Brisbane,15 as well as by other Catholic anti-assisted dying lobbyists such as Alex Schadenberg,16 Paul Russell,17 and Professor of Ethics at the Catholic University of Notre Dame Australia, Margaret Somerville.18
Indeed, Mr Mulino’s minority report appears amongst 11 Catholic responses against assisted dying law reform published by the Catholic Archdiocese of Melbourne (Figure 10).
Figure 10: Daniel Mulino’s minority report appears amongst Catholic responses on the Catholic Archdiocese of Melbourne’s website19
Indeed, Mr Mulino’s linked document doesn’t seem to emanate from his parliamentary office or from wider parliamentary services: the PDF file's metadata reveals that it was authored, electronically at least, by “mmacdonald”.
Calls to both Mr Mulino's electorate office and to the Parliament of Victoria confirm there is no "M Macdonald" at either. I did, however, find online one Matthew Macdonald, researcher and Executive Officer of the Catholic Archdiocese of Melbourne’s (CAM) Office for Life, Marriage and Family — in other words, the same organisation that published the list in Figure 10 containing the link to Mr Mulino’s minority report.
Mr Macdonald is also listed as the CAM's official contact person in its submission (#705) opposing assisted dying to the Victorian Parliament's inquiry into end of life choices.20 Both the CAM and Mulino reports also refer to a journal paper by Catholic doctor José Pereira,21 and neither report mentions the subsequent evidential rebuttal outlining why Pereira's claims were merely "smoke and mirrors".22 Even more curiously, the Pereira paper is included in Mr Merlino's minority report bibliography, though his report doesn't actually cite it as the CAM submission does.
The CAM parliamentary submission was authorised and signed by Episcopal Vicars Anthony Ireland and Anthony Kerin, who also appeared as witnesses before the parliamentary Committee, during which they told, as I've explained, a whopping great falsehood about Oregon.23
Conclusion
Contrary to Paul Russell’s enthusiastic claim that Daniel Mulino’s minority report provides a ‘rigorous’ case against assisted dying law reform, the report merely serves as further evidence of how those implacably opposed to assisted dying can cherry-pick, misunderstand and rather desperately clutch their way through their ‘evidence.’
Mr Russell is not an academic expert and one can understand his limited capacity to judge whether work is ‘scholarly.’ However, Mr Mulino holds a PhD in economics from Yale,* so it’s quite astonishing that he published a ‘researched’ report containing multiple major flaws, including outdated and cherry-picked data contrary to more recent, direct and relevant evidence of which he was specifically aware, actively inquired into and had explained and cited to him in full.
These anomolies beg the question: did Matthew McDonald or someone else at the Catholic Archdiocese of Melbourne write Mr Mulino’s report for him? Mr Mulino needs to explain himself, since regardless of who authoried it, he signed it off in his own name and is therefore ultimately responsible for it.
Given the multiple fundamental errors, the honourable course for Mr Mulino to pursue is to withdraw his minority report.
The question is: will he rise to the occasion?
Addendum: A missed opportunity for primary research
Mr Mulino — as well as Mrs Peulich who also wrote a minority report against assisted dying — declined to join other members of the parliamentary Committee on an official overseas fact-finding tour to jurisdictions where assisted dying is lawful. This was a critical opportunity for Committee members to directly quiz proponents, opponents, researchers, regulators, legislators and others with direct experience. It would have given them invaluable opportunities to directly examine and test assumptions, hypotheses and performance. How curious then that these two non-participataing Committee members each furnished a minority report opposing the majority recommendation to legalise assisted dying in Victoria.
---------------
§ The HOPE website is an initiative of the Australian Family Association (AFA), a faith-based organisation founded by Australia’s most famous Catholic, B. A. Santamaria. Mr Russell is a former Vice President of the AFA, and a former Senior Officer for Family and Life at the Catholic Archdiocese of Adelaide.
* While Mr Mulino holds a PhD and would be entitled to be addressed as “Dr”, his Parliamentary title is “Mr”.
Ganzini, L, Nelson, HD, Schmidt, TA, Kraemer, DF, Delorit, MA & Lee, MA 2000, 'Physicians' experiences with the Oregon Death with Dignity Act', New England Journal of Medicine, 342(8), pp. 557-563.
van der Heide, A, Deliens, L, Faisst, K, Nilstun, T, Norup, M, Paci, E, van der Wal, G & van der Maas, PJ 2003, 'End-of-life decision-making in six European countries: descriptive study', The Lancet, 362(9381), pp. 345-350.
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, 380(9845), pp. 908-915.
Bilsen, J, Cohen, J, Chambaere, K, Pousset, G, Onwuteaka-Philipsen, BD, Mortier, F & Deliens, L 2009, 'Medical end-of-life practices under the euthanasia law in Belgium', New England Journal of Medicine, 361(11), pp. 1119-1121.
Seale, C 2009, 'End-of-life decisions in the UK involving medical practitioners', Palliat Med, 23(3), pp. 198-204.
Francis, N 2015, Submission to the Parliament of Victoria Standing Committee on Legal and Social Issues on the Inquiry into End of Life Choices, DyingForChoice.com, Melbourne, pp. 51.
Parliament of Victoria 2015, Standing Committee on Legal and Social Issues inquiry into end-of-life choices: Witness-Mr Neil Francis, DyingForChoice.com, Melbourne, pp. 10.
Schadenberg, A 2013, Exposing vulnerable people to euthanasia and assisted suicide, Ross Lattner, London ON.
Russell, P 2015, Submission 926: Submission to the Victorian Legal and Social Issues Committee inquiry into end of life choices, HOPE, Melbourne, pp. 56.
Catholic Archdiocese of Melbourne 2015, Submission to the Legal & Social Issues Committee: Inquiry into end of life choices, Submission 705, Melbourne, pp. 16.
Pereira, J 2011, 'Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls', Current Oncology, vol. 18, no. 2, pp. e38-48.
Downie, J, Chambaere, K & Bernheim, JL 2012, 'Pereira's attack on legalizing euthanasia or assisted suicide: smoke and mirrors', Current Oncology, vol. 19, no. 3, Jun, pp. 133-8.
Blog by Neil FrancisPosted on Sunday 6th August 2017 at 2:31am
The terminally ill are not choosing between life and death, but between two ways of dying, according to their own beliefs and conscience. Photo: Andrew Drummond/AAP
In Monday’s Herald Sun, Victorian Archbishops Philip Freier and Denis Hart, and Bishops Ezekiel, Suriel, Lester Briebbenow, Bosco Puthur and Peter Stasiuk published a half-page advertisement admonishing the Victorian government for its initiative to legalise assisted dying for the terminally ill, an ad similar to the one published by religious figures in 2008.
I have no quarrel with individuals of faith regarding their own private beliefs. However, the bishops’ attempt at public “leadership” through the advertisement is deserving of redress for its multiple fallacies.
The ‘abandonment’ fallacy
The bishops claimed that assisted dying “represents the abandonment of those who are in greatest need of our care and support”. On the contrary: to ignore the deeply-held beliefs and rigorously-tested wishes of people at the end of life is to abandon their values and critical faculties in favour of the bishops’ own religious dogma.
The ‘competition’ fallacy
The bishops demand there should be more funding for healthcare rather than assisted dying, fallaciously pitting one option against the other. The Victorian government is indeed increasing funding for palliative care. It’s also aiming to provide lawful assisted dying for when even the best palliative care can’t help – which Palliative Care Australia has acknowledged – giving lie to the faux competition.
The evidential fallacy
Contrary to the bishops’ false presumption that legalised assisted dying will decrease trust in “the treatment and quality of care” from doctors, scientific studies into attitude change show that more people trust doctors when assisted dying is legal. Patients can then talk openly about options, even if they decide against assisted death. The bishops have abandoned facts in favour of religious assumptions.
The equivalence fallacy
The bishops refer to assisted dying as “government endorsed suicide”. They fallaciously equate a reasoned, tested and accompanied decision for a peaceful assisted death in the face of a terminal illness, with the impulsive, violent, isolated and regrettable suicide of individuals (many of whom have mental health and substance abuse issues) who are failing to cope with problems that can be addressed.
However, while the latter are choosing between life and death, the terminally ill are choosing not between life and death, but between two different ways of dying, according to their own beliefs and conscience. Rigorous 2016 research from Australian National University shows that the vast majority (79%) of Victorians support assisted dying choice for the terminally ill (with just 8% opposed), clearly distinguishing it from general suicide.
Shame on the bishops for disrespectfully equating the two.
The inconsistency fallacy
They also argue that assisted dying ought to remain prohibited because within healthcare, “mistakes happen and the vulnerable are exploited,” and “that in spite of our best efforts, our justice system could never guarantee” no one would die by mistake or false evidence. However, as I’ve pointed out before, an identical hypothetical problem exists under the refusal of life-saving medical treatment, a statutory right that Victorians have enjoyed for nearly 30 years. The statute has only three “safeguard” requirements, yet even those only apply if the refusal is formally documented, but not if it’s verbal.
Further, the United States Conference of Catholic Bishops directs that patients may refuse treatment if it imposes “excessive expense on the family or community,” yet makes no mention of the hypothetical “vulnerability” of the patient to be persuaded so, nor directs any requirements to assess the veracity of the refusal.
In stark contrast, the Victorian proposal for assisted dying legislation contains more than 60 safeguards and oversights.
The bishops are at risk of ridicule for such a gargantuan flip-flop: supporting the refusal of life-saving treatment with little or no oversight, while vocally opposing assisted dying legislation that mandates an armada of protections.
The not-so-hidden agenda
The bishops’ methods are rather unsubtle – hoping that these arguments, erroneous but carefully crafted to avoid any religious connotations, will be accepted as non-religious. Yet religion is writ large across their plea: as signatories to the letter they are all clerics employed directly and centrally in the promotion of their religions.
The authority fallacy
They might also rely on their religious status to convey gravity and authority to their pleas. Yet as people paid to do a job, like anyone else, their titles grant them no special privileges in lecturing Victorians about how they should die in the face of a terminal illness.
According to the 2016 census, just 23% of Victorians identified as Catholic, 9% as Anglican, 0.5% as Lutheran, and the other bishops’ signatory denominations so small as to not appear separately in the government’s statistics. Combined, the bishops’ faiths represent around 33% of the Victorian population, while 32% of Victorians identify with no faith at all. Surely the bishops are not arguing that they’re speaking for these other Victorians, too?
But the bishops don’t represent the views of their own flocks, either. According to the 2016 ANU study, 89% of non-religious Victorians support assisted dying law reform, as do 78% of Victorian Catholics and Anglicans. Indeed, opposition to assisted dying exists mostly among those who attend religious services once a week or more often – that is, those who are frequently exposed institutional religious messages of opposition – yet who comprise just 12% of Australians and 11% of Victorians.
Minding their own flocks
Australians are abandoning religion in droves. For example, when Freier ascended to the top job of Anglican Primate of Australia in 2006, some 19% of Australians identified as Anglican (2006 census). A decade later under his leadership, the 2016 census showed a drop of about a third to just 13%, and in Victoria, his home territory, to just 9%.
Hart’s Catholic church has experienced a drop in affiliation too, and it’s likely to continue and accelerate as Australians react with shock and disgust to the extent of child sexual abuse that the royal commission has exposed from under his organisation’s “pastoral umbrella”.
In conclusion, rather than bishops lecturing the government and Victorians with fallacious and faintly desperate arguments about the choices they shouldn’t have at the end of life, attending to their own flocks may be more useful Christian leadership.
May their God go with them in that endeavour.
This article was originally published in The Guardian.
Blog by Neil FrancisPosted on Thursday 27th July 2017 at 11:52pm
Research results must be judged in relation to the study's methodology.
In his latest blog, titled “Who are you going to trust?”, anti-assisted dying lobbyist Mr Paul Russell says:
“Polling noted today in the Australian shows a significant level of distrust in our political classes to get the issue of euthanasia and assisted dying right.”
He then goes on to quote some select statistics from said poll. In his blog, he mentions nothing about the sponsorship or conduct of the poll. After some searching, I found no other reference to said poll on his ‘HOPE’ website.
This is rather curious, because The Australian article he quotes, points out that the ‘poll’ was commissioned by him (his website is called ‘HOPE’).
Thus, Mr Russell tries to add credibility to his ‘poll results’ in his blog by citing only that it has been reported in a national newspaper. This ‘quote-someone-else-so-it-must-be-authoritative’ rhetorical strategy has been used before by opponents of assisted dying (see Box at end).
But as Mr Russell has himself promoted — happily republishing the opinion of the CEO of Christian Medical Fellowship (UK) — “opinion polls add up to very little.” That’s quite true… when they’re poorly designed and run, including the big no-no, ‘push-polling’, in which the researcher attempts to get the answer they want by crafting questions more likely to get it.
I searched hard for any reference to the methodology of said ‘poll’, but was unable to identify any despite a diligent search. Therefore, we don’t know what approach Mr Russell took: robust or otherwise.
Let’s assume for the sake of argument (and the absence of public evidence) that a poll of some kind was actually conducted. If it were a truly legitimate poll, you’d think that Mr Russell would be shouting about the study from his own rooftop (the ‘HOPE’ website). But so far, he hasn’t.
Mr Russell, while quoting statistics, has said absolutely nothing about the methodology — that I can find via a quite diligent search.
Results can only be interpreted in light of how the research was actually conducted, so quoting a 'study' while failing to publish its methodology in full is an absolute no-no. It only invites derision.
Rebecca Urban, for The Australian, quotes a number of ‘statistics’ from the ‘poll’ seemingly without question. But she’s hardly to blame: she’s skilled at journalism, not primary research.
So, for the benefit of Paul Russell, Rebecca Urban and all journalists reporting claimed statistics, here’s your minimum standard of conduct if the public are not to guffaw at the claims. All reported results must be in relation to properly disclosed methodology:
Who commissioned the research? (✔ Ms Urban reports who)
Who conducted — actually carried out — the research (e.g. a reputable research company)?
What precise population were respondents drawn from, how were they recruited, and screened in or out? What were the counts and percentage participation (approached/participated)?
What were the dates of the fieldwork?
What procedures were used to establish and maintain the authenticity of who was sampled (e.g. if an online poll, could people from anywhere technically participate in this Victorian poll)?
How was the questionnaire administered (e.g. paper self-complete, online, CATI)?
What was the script of stimuli administered to respondents? In other words, what prompts were given and what questions were asked: exact order and wording?
What results were obtained for each question (i.e. full rather than selective crosstabs)?
Until Mr Russell publishes in full how his ‘poll’ was conducted, the only honourable course of action for him to pursue is to withdraw the claimed results.
Until then, we can only see them as untrustworthy and a bit of a joke.
Rhetorical tactic — “Not” quoting yourself
This rhetorical tactic is also used by Mr Russell’s fellow Catholic, Prof. Margaret Somerville. For example, in her 2015 book Bird on an Ethics Wire, in relation to the supposed (but fanciful) fear of being euthanized in the Netherlands if adequate pain management is accepted, Somerville says in Chapter 4:
“It has been alleged that Dutch physicians have interpreted patients’ consent to pain management as consent to euthanasia.38”
If you’re like most people, you’d assume, given the effort of a citation (38), that an independent source had made the statement based on some evidence. Indeed, if you look at reference 38 you’ll see that the author is Lauren Vogel, and the source article is in the Canadian Medical Association Journal. All sounds like solid, legit stuff, doesn’t it?
However, Ms Vogel is a journalist, not a Dutch medic or a researcher, and what she reports in relation to Somerville’s claim is merely a quote of what someone said. And who is that someone? Why, it’s Margaret Somerville — what a coincidence!
Somerville could have just said “I’ve argued this before…”, but instead gives a seemingly robust reference to a source that has the appearance of independence and scholarship. Yet obviously she knows that the source is merely herself saying so.
Let’s be clear: something is not true just because someone alleges it. Even if they allege it twice or more. And happen cite themselves via someone else in the process.
Figure 1: Australian Territory indigenous populations
Figures 1 and 2 (of Mr Mulino’s minority report): Assisted deaths in Belgium and the Netherlands
Figure 3: The full Netherlands data
Figure 4: Rate of assisted dying as a percent off all deaths in the Netherlands and Belgium 2003–2015
Figure 5: Rate of assisted dying in the three lawful Benelux countries
Figure 6: Netherlands total and assisted deaths for different periods
Figure 7: The paper Abstract articulates exactly the opposite of Mr Mulino’s claim
Figure 8: Table 2 from the 2003 study Mr Mulino cites
Figure 9: Longitudinal NVE rates in the Netherlands, Belgium and the UK
Figure 10: Daniel Mulino’s minority report appears amongst Catholic responses on the Catholic Archdiocese of Melbourne’s website19
