To represent a thing or situation as considerably more sinister or dangerous than it is when assessed objectively using evidence and balanced evaluation.
Blog by Neil FrancisPosted on Sunday 30th August 2020 at 9:13pm
St Mary's Cathedral, Hobart, Tasmania
Hobart Catholic Archbishop Julian Porteous makes a number of incorrect representations about voluntary assisted dying (VAD) in his recent Talking Points article (Hobart Mercury 23rd Aug). And, most of his own flock disagree with his opposed stance.
Let's take a look at the facts, and the Archbishop's 'alternatives'.
NOTE: While The Hobart Mercury published Archbishop Porteous' arguments, they declined to publish this rebuttal.
Key points
Archbishop Porteous wrongly equates VAD with general suicide and insinuates they are lonely deaths when they aren't.
He claims that palliative care can always help, when palliative care peak bodies clearly state that it can't.
He insensitively co-opts Covid-19 victims and their families into his arguments, despite them having nothing to do with VAD.
He doesn't represent his own flock: three quarters (74%) of Australian Catholics support VAD, including near half (48%) who strongly support VAD. A tiny 15% are opposed.
In just twelve years (2007─19), the Australian Catholic church has lost a quarter (26%) of its flock. Of those remaining, an increasing proportion, now half (50%), never or almost never attend services.
Diocese Director of Life, Marriage and Family, Mr Ben Smith, encourages Catholics to write to their politicians using the same talking points as Porteous, and with express instructions "DO NOT use religious arguments".
Assisted deaths completely different from general suicide
One particularly egregious aspect of Archbishop Porteous' rhetoric is the innuendo he employs to equate VAD with general suicide, including liberally sprinkling the word "suicide" through his narrative.
But there are profound differences between general suicide and VAD. Most Australians understand that, and research shows that most Australian doctors agree.
Assisted deaths are not lonely
The Archbishop, with astonishing misjudgement, also co-opts the Covid-19 deceased into his story arc: people whose funeral can't be attended by loved ones because of government-imposed lockdown. He obliquely infers that VAD users are or will be naturally unattended by loved ones — even without imposed lockdown.
He further slathers on observations about family reconciliations during the natural dying process, with the implicit meaning that's the only dying context in which families might reconcile.
His presumptions skirt extensive evidence that one of the most treasured factors amongst both VAD law users and their loved ones is the opportunity to express love and caring, and the ability to gather and say goodbye.
Further, multiple scholarly studies show that loved ones recover from bereavement after an assisted death at least as well as those bereaved from natural death, and in some cases, better.
Contrary to Archbishop Porteous' sinister insinuations, VAD deaths can prompt families to gather, express love, say goodbye, and grieve well.
Palliative care can't always help
Archbishop Porteous also argues that palliative care "is able to manage pain and suffering" such that nobody should experience a bad death. He ought to know better: more than half of all palliative care services in Australia are delivered via Catholic institutions.
Palliative Care Australia has clearly stated that "complete relief of all suffering is not always possible, even with optimal palliative care". Even Catholic Doctor's Association palliative care specialist Dr Odette Spruyt, a past President of the Australian and New Zealand Society of Palliative Medicine, has said "it is simplistic to argue that palliative care can remove all suffering at the end of life."
Both of Australia's peak palliative care bodies acknowledge that even the best care can't relieve all terrible suffering at the end of life.
Less treatment but more treatment
Then there's the incoherence of the Archbishop’s argument acknowledging that people want to avoid more medical intervention, while arguing at the same time that more medical intervention (palliative care) is always the only answer to end-of-life suffering.
What about the devout religious?
He adds an odour of hubris to this unctuous spread by noting with disapproval that "family members of those who have had difficult deaths" are the most vocal supporters of law reform. Indeed. These are real people with real experiences of when even the best palliative care can't help.
For balance, it's worth pointing out that numerous research studies show that it's the most religious who are the most vocal opponents of VAD law reform.
Numerous scholarly studies show that it's the most religious who are the most vocal opponents of VAD law reform.
But don't mention religion
It's curious then that the Archbishop — a senior cleric — invokes not a single religious statement or reference in his narrative. Perhaps he's coordinated well with his diocesan Director of Life, Marriage and Family Office, Mr Ben Smith, who advises in an anti-VAD letter-writing guide handed out at Tasmanian masses last week, "DO NOT use religious arguments".
Unsurpisingly, Mr Smith also recommends other language demonstrated in the Archbishop's opinion piece: imply that people will be vulnerable, say that palliative care is the answer, bring up the Covid-19 pandemic, and refer to assisted suicide rather than assisted dying.
Director of Hobart's Catholic Life, Marriage and Family Office, Mr Ben Smith, urges Catholics to write to their politicians to oppose VAD, but directing them “DO NOT use religious arguments”.
Far from representing the 'everyman'
Rather than use any religious references, Archbishop Porteous carefully crafts his grave implications in 'everyman' language as though the points he makes are naturally agreeable to everyone.
But he doesn't represent the great majority of Australians, four out of five (80%) of whom support VAD, according to the most recent (2019) impeccable national study from Australian National University.
Far from representing Australian Catholics
Nor does Archbishop Porteous represent the views of most Australian Catholics. The ANU study also found that three quarters (74%) of them support VAD, with only a tiny minority (15%) opposed. A staggering near-half (48%) of Australian Catholics now strongly support VAD, up from around a third (36%) just three years earlier in 2016.
Three quarters of Australian Catholics support VAD law reform, almost half of them strongly.
At the same time, the ANU study reveals that the Catholic Church represents fewer and fewer Australians. In just the twelve years between 2007 and 2019, the Catholic Church lost a quarter (26%) of its flock. Australians with no religion (41%) now outnumber Catholics by two to one (21%).
In addition, of the fewer still identifying as Catholic, there's been an increase of more than one in five — now comprising half (50%) — who never, or almost never, attend services.
It's worth emphasising that even amongst those who haven't abandoned the Catholic church altogether — the more entrenched — strong support for VAD law reform has soared.
The Australian Catholic church has lost a quarter of its flock in 12 years, and half of those remaining never or almost never attend services.
Not the best spokesperson
Amid shrinking flocks, withering attendance and a weighty jump in strong Catholic support for VAD, it's curious that the Archbishop continues to vocally push entrenched opposition. Perhaps Sydney's Catholic Archbishop Anthony Fisher was right when he said in 2011, "Bishops, for instance, are not always the best public spokespeople for the Church on such matters." Indeed.
As politicians are only too keenly aware, they're elected by the people, not appointed by religious officials.
Australians unambiguously show a determined and increasing appetite for lawful VAD. It would be a courageous politician indeed who resolved to trudge the road now so obviously on the wrong side of history.
Blog by Neil FrancisPosted on Friday 21st June 2019 at 10:00pm
The Catholic Church's video which blatantlly misrepresents Belgium
The Catholic Archdiocese of Sydney has released a video which blatantly misrepresents scholarly research about non-voluntary euthanasia practices in Belgium. The lead author of the peer-reviewed research has slammed the video as "cherry-picked", "scaremongering" and "appalling". His full statement about the video appears below.
Back in 1998, non-voluntary euthanasia — or NVE — was carefully studied by Belgian scholars. It’s a problematic practice, even though often the medication doctors administered didn’t actually hasten death. They found it occured in 3.2% of all deaths.
In 2002, the Belgium parliament legalised voluntary assisted dying — or VAD.
In 2007, the Belgian scholars repeated their study and found that NVE had dropped by nearly HALF, to 1.8% of all deaths. Again in 2013, it was found to remain at a lower level, 1.7% (Figure 1).
Figure 1: Belgium's NVE rate has dropped dramatically since VAD was legalised
Thus, the State shining a bright light on end-of-life practices, including VAD, has resulted in improvements.
NVE has also been found to occur in every jurisdiction that’s been studied, VAD law or not, including Australia and New Zealand (Figure 2).
Figure 2: NVE has been found in every jurisdiction that's been studied
But the Catholic church would have you believe otherwise.
In a recent video, the Catholic Archdiocese of Sydney grotesquely misrepresented a single statistic from the Belgian studies. Using cold colours and the sound of a flatlining heartbeat, the Catholic video claims Belgium’s VAD law has caused its NVE. It’s a chilling confection of innuendo that thumbs its nose at the facts.
The Belgian study the church relies on expressly points out the significant NVE drop, so it’s not like they wouldn’t know.
Figure 3: The study expressly points out the significant drop
It's no wonder that lead scholar of the Belgian research, Assistant Professor Kenneth Chambaere, called the Church’s video “cherry-picked", “a blatant misrepresentation”, “scaremongering” and “appalling”. Professor Chambaere's full response appears below.
Despite the unambiguous evidence, multiple Catholic lobbyists have used cherry-picked NVE rates in a similar way, like:
I’ve directly corrected their misleading claims before. Yet here we go again with the same unconscionable nonsense.
Interestingly, at a 2011 Catholic conference, Archbishop Anthony Fisher said:
“the man or woman in the street … may well be open to persuasion that permissive laws … cannot be effectively narrowed to such practices”
and
“we need to research and propose new messages”
Note that the Archbishop proposed... new messages. In his address he didn't propose to examine if his assumed calamities were valid or not.
The Church is entitled to opinions, but promoting misinformation doesn’t seem to be very Christian. The Church should withdraw its grotesque propaganda and apologise.
In conclusion, repeating fake news doesn’t make it true. The fact remains that Belgium’s NVE practice was considerably higher before it legalised VAD, and dropped significantly after.
Prof. Kenneth Chambaere's response in full
On viewing the Catholic Archdiocese of Sydney's video on Belgian NVE, which cites Prof. Chambaere's 2007 study, Prof. Chambaere made the following statement:
13th July 2019
Recently, a Vimeo video of the Archdiocese of Sydney on 'Debate on Euthanasia Laws' was brought to my attention: https://vimeo.com/339920133.
As lead author of the cited research, I was appalled at the video's blatant misrepresentation of the robust and honest research that we have been conducting in Belgium. It is quite frankly an insult to us as researchers who day in day out work to generate reliable and trustworthy insights into end-of-life practice in Belgium.
It is clear to me that the video has cherry-picked results from our studies to the effect of scaremongering among the public. As researchers, we fully grasp the emotional, ethical and societal gravity of the euthanasia practice and therefore also euthanasia research, and we never take it lightly. We believe we are always as objective and impartial as possible, as is to be expected of independent and free research. This only adds to my duty as a scientist to respond to the video in question and correct its mistakes. The general public and politicians must have access to reliable and correct evidence.
First of all, the figures shown in the video do not concern euthanasia practices at all. Euthanasia is by definition always at the explicit request of the patient. What the figures do refer to are physician acts to hasten a dying patient's death without their explicit request, a separate type of end-of-life practice altogether (see further).
Secondly, yes, this problematic practice does exist in Belgium. But so does it exist in every other country where anyone has had the audacity to conduct research into it, euthanasia law or no euthanasia law.
Thirdly, the incidence of such practices has halved since the euthanasia law was enacted in Belgium.
Conclusion: acts of hastening death without explicit request are not a by-product of euthanasia legislation, and if anything, euthanasia legislation seems to decrease the occurrence of these practices. This conclusion features prominently in the paper cited in the video.
This practice even exist in Australia, and in significant numbers, according to one (potentially outdated) study. While this study was not identical to ours in Belgium, it still provides clear evidence of its occurrence in Australian end-of-life practice. The authors of the video ask whether Victoria will become like Belgium? If it means diminishing rates of these questionable practices, then surely becoming more like Belgium is a good thing!
Lastly, a 2014 detailed analysis in CMAJ Open clarified much about what these cases of hastening death without explicit request entail. I quote our conclusion here: "Most of the cases we studied did not fit the label of "nonvoluntary life-ending" for at least one of the following reasons: the drugs were administered with a focus on symptom control; a hastened death was highly unlikely; or the act was taken in accordance with the patient's previously expressed wishes. Thus, we recommend a more nuanced view of life-ending acts without explicit patient request in the debate on physician-assisted dying."
This is not to condone or excuse physicians who engage in such practices, but it is important to know and be clear about what we are focusing our societal discussions on.
The question then is, why did the authors of the video overlook these clear conclusions during their extensive review of the evidence? It is very difficult to see how our research could be misrepresented in the way it has been in the video. The research is very clear and it does not support the claims made in the video. I urge anyone relying on the large body of peer-reviewed evidence to analyse it carefully, and if necessary consult with the authors, before communicating to the general public.
Assistant Professor Kenneth Chambaere
End of Life Care Research Group
Vrije Universiteit Brussel
Belgium
The Catholic Archdiocese of Sydney has released a grotesque and appalling video that blatantly misrepresents Belgium's non-voluntary euthanasia practices as being 'caused' by their voluntary assisted dying law. They're not.
“Belgian scholars have researched the country's non-voluntary euthanasia rate (or NVE) over a number of years.
Their findings unambiguously show that Belgium's NVE rate was much higher BEFORE it legalised voluntary assisted dying (or VAD), and dropped significantly afterwards.
Yet the Catholic Archdiocese of Sydney has released a grotesque video which cherry-picks just the 2007 figure to claim that Belgium's VAD law has caused its NVE practices.
But the NVE drop is no secret: it's expressly stated in the very research the Church cites.
It's no wonder that lead researcher, Assistant Professor Kenneth Chambaere, called the Church’s video “cherry-picked", “a blatant misrepresentation”, “scaremongering” and “appalling”.
The video casts serious doubts over the Church's competence in assessing scholarly evidence, and calls into question its desire to avoid misinformation.
To conclude, Belgium's NVE rate dropped dramatically, and has remained lower, after it legalised voluntary assisted dying.”
Blog by Neil FrancisPosted on Thursday 23rd May 2019 at 2:39am
Palliative care specialist advances incoherent reasons to oppose VAD.
Director of Palliative Care at Cabrini Health, Associate Professor Natasha Michael, yesterday published an opinion piece in The Age newspaper. In it, she rails against Victoria’s voluntary assisted dying (VAD) Act which comes into effect on 19th June. Instead she articulates an arrogant and prescriptive view of what Australians should and shouldn’t be allowed, consistent with Catholic dogma, as I uncover.
Michael, along with fellow devout Catholic Dr Stephen Parnis, ‘tirelessly’ opposed the introduction of Victoria’s VAD law. They continue to actively oppose it, and her opinion piece reveals her spurious ‘reasoning’.
The Catholic Healthcare brick wall
More than half of all palliative care services in Australia are delivered through Catholic institutions, of which Cabrini Health is one arm. These institutions have determined that VAD will not be available in any of their facilities or via any of their services, even if the individual patient and doctor are supportive.
This arbitrarily limits access to lawful choice by citizens.
Confected ‘institutional conscience’
I say ‘arbitrarily’ because ‘institutional conscience’ is a confection: it doesn’t really exist. Only real persons have conscience. The fabricated dictates of any institution — presented as ‘moral rules’ — extinguish the actual real conscience of those who exist within it: at least, those whose conscience differs.
The upshot is that a specific cohort of religious, celibate men in Rome dictate whether Australian citizens can or can’t obtain lawful healthcare services from half the service providers.
So let’s examine what the institutional ‘conscience’ has to say.
Disgraceful framing in headline
“We can’t let voluntary assisted dying negate our commitment to the ill”, Michael’s article headline screams.
Firstly, VAD is not available to the “ill”. It’s available only to those with terminal illness and intolerable suffering, according to 68 criteria.
Secondly, Michael invokes a false dichotomy of “negating a commitment”. VAD does not “negate a commitment”. Indeed, to fail to hear and respect a persistent, fully informed and tested request for VAD that meets all the criteria is to negate palliative care’s commitment to honour the patient’s deeply held values, beliefs and decisions.
Medical-coloured glasses
“The introduction of voluntary assisted dying legislation in Victoria on June 19 will remind us of the occasional failure of medicine,” Michael says.
That’s it. The patient’s death is a failure of medicine, as though a person’s death is a medical event rather than a deeply human and private one of personhood.
It also flags the common but immature medical assumption that “death = failure”. Death is inevitable, not a “failure”. The key question about death for people with terminal illness is “how”, and Michael presumes to prescribe the “how”: being receptacles for interventions that she and her colleagues provide.
Let’s be clear. Many people are helped enormously by palliative care. That’s a great credit to the discipline’s specialists.
However, as Palliative Care Australia acknowledges, even the best palliative care can’t relieve all excruciating, debilitating and humiliating refractory symptoms.
Michael’s answer to this sometimes “failure” of medical interventions? Deliver more interventions, whether the patient considers them consistent with his own values, beliefs and circumstances or not.
They’re very heavily medical-coloured glasses indeed.
Three faux ‘threats’
Michael then invokes three faux ‘threats’ supposedly caused by lawful VAD in Victoria.
Faux threat 1: “Validating suicide as an acceptable choice”.
Michael exposes her own bias here: that all self-hastening of deaths are the same — that there is no meaningful difference between a dying person who is fully informed and whose rational choice for a peaceful assisted death has been extensively tested, with the violent and impulsive action of a person suffering a temporary, resolvable personal crisis, be it mental illness, substance abuse, intimate relationship breakdown or other circumstance.
Michael is pretty much on her own here. Most Australian doctors make a clear distinction between these very different contexts.
Faux threat 2: “accepting substandard medical care by supporting the lack of rigour in defining [VAD] eligibility”.
Michael overlooks that there is a major lack of rigour in existing, lawful end-of-life choices.
There are no statutory requirements for a patient to refuse medical treatment, even if the treatment would be life-saving.
There are no statutory requirements for the voluntary refusal of food and fluids in order to die, either.
More critically, despite terminal sedation being a common end-of-life medical practice but ethically problematic (including that it may hasten death and may not alleviate intractable symptoms), not only is there no statutory requirement for its practice, but neither the Australian Medical Association nor Palliative Care Australia have official guidelines on its practice.
Thus, in railing against the staggering 68 standards of practice prescribed in Victoria’s VAD law — vastly more than any other in the world — as a “lack of rigour”, Michael makes no mention of three other major life-end choices that have no such standards, including her own discipline’s terminal sedation.
Doctor, heal thyself (and thine own systems).
Faux threat 3: “introducing into the healthcare curriculum the intentional ending of life as acceptable medical treatment”
Michael creates a misleading impression here. By referring to ‘curriculum’ you might think that all medical students would have to undergo training on how to end lives, or be ‘indoctrinated’ to accept VAD. That is not true.
To be able to prescribe lethal medication under Victoria’s legislation, the doctor must undergo additional training in relation to that procedure. Doctors will only receive the training if they self-nominate for it: it’s not compulsory.
If, by ‘curriculum’ Michael means only “VAD might be discussed” in medical school, then she would have to articulate why termination of pregnancy (to which the Catholic church objects) should not be discussed, either. Nor the transfusion of blood, since many Jehovah’s Witnesses object to the procedure.
Own failure in palliative care principles
Nowhere in her opinion piece does Michael acknowledge that the patient may deeply hold values and beliefs that validly favour VAD. Thus, Michael offends the first principle of palliative care which is to make the patient the centre of care and to honour as much as possible the patient’s values, beliefs, attitudes and wishes.
Indeed, in her conclusion, Michael states that palliative care “remains committed to the ongoing accompaniment of our patients. Not abandoning them” and which is “the only plausible method of compassion and care.”
This surely is the most egregious and arrogant self-interest of all: patients must subject themselves to being accompanied by palliative care staff and their ‘interventions’ whether they want more or not.
On the contrary, to fail to hear and respect a genuine, informed and persistent request for a peaceful hastened death from a dying patient for whom this accords most firmly with his deeply held values and beliefs, is to abandon the patient.
Conclusion
Michael is of course entitled to her personal stance, and I celebrate her right to hold her views: for herself.
However, her ‘requirement’ that all Victorians be denied access to an option that four out of five believe to be moral — and instead subject themselves to interventions administered by Michael and her colleagues — reveals an unattractive arrogance.
It’s a shame that Catholic bioethics doesn’t teach more about reflection, especially as to whether one’s own beliefs ought to dictate and limit the choices of others with equally firmly held, though different, values.
In the meantime, Victorians are pawns to the tyranny of the Vatican as to whether there is a local healthcare facility that will hear and examine their request for a peaceful, assisted death in the face of terminal illness.
Blog by Neil FrancisPosted on Wednesday 10th April 2019 at 8:39pm
Branka van der Linden on the "HOPE" website.
HOPE’s Director, Branka van der Linden, is at it again, foisting more misleading information about voluntary assisted dying (VAD) on unwilling members of Parliament. I expose the rot and provide some background on Mrs van der Linden.
Van der Linden’s latest email to all WA MPs states:
Subject: WA Report relies on troubling Belgian study
[MP Salutation] --
Did you know that a study showing that one person in Belgium is euthanised every three days without their explicit consent also found that:
in more than 77 per cent of cases, the decision was not discussed with the patient;
in more than half of cases, the patient had never expressed a desire for their life to be ended; and
in more than half of the cases, the reason given was because killing the patient was the wish of the family?
Did you know that the WA majority report cited this study as evidence of assisted suicide and euthanasia reducing the incidence of unlawful activity?
Warm regards,
Branka van der Linden
Director, HOPE
Van der Linden’s method is to create an impression of calumny against VAD law reform. She uses a nice PR formula of three bullet points per communication. With repetition. It’s a method I expressly warned the WA Parliament to watch out for in my submission to its inquiry. The growing list of emails is now starting to look like ‘harassment’.
So let’s look at van der Linden’s claims — again. She’s talking about non-voluntary euthanasia (NVE) — again.
In her email to MPs, she complains that the WA majority report on end-of-life choices cited the study as evidence of the NVE rate reducing when VAD is legalised.
Well, the WA majority report formed that correct conclusion because that’s precisely what the cited study reported: drops in the NVE rates in both the Netherlands and Belgium after their euthanasia Acts came into effect in 2002.
While concerns ought to be expressed about the deliberate hastening of death without an explicit request from the patient with a view to improving knowledge and practices, it’s not caused by VAD laws as van der Linden desperately tries to imply.
Here are highly relevant things the cited study’s authors had to say, but van der Linden astonishingly ignores:
“The use of life-ending drugs without explicit patient request are not confined to countries where physician-assisted death is legal.”; and
“[NVE’s] occurrence has not risen since the legalisation of euthanasia in Belgium. On the contrary, the rate dropped from 3.2% in 1998 to 1.8% in 2007. In the Netherlands, the rate dropped slightly after legalization, from 0.7% to 0.4%” [The Belgian rate was 1.7% in a more recent replication of the research.]; and
The NVE cases found in the study “in reality resembles more intensified pain alleviation with a ‘double effect’, and death in many cases was not hastened.”
But let’s not let the facts get in the way of a good story. Van der Linden’s recent emails about VAD to MPs reveal astonishing ignorance and a willingness to overlook critical evidence contrary to her position, contained in the very source she cites.
The superficiality of her cherry-picking is kind of embarrassing: she holds an arts/law degree from Australian National University, so you’d expect more intelligent engagement.
It begs the question: who is Branka van der Linden? The “HOPE” website reveals little if anything.
Who is Branka van der Linden?
Branka Van der Linden is the current Director of anti-VAD website “HOPE (Preventing euthanasia and assisted suicide)”. HOPE is an initiative of the Australian Family Association, a Catholic lobby group established by Australia’s most famous lay Catholic, B. A. Santamaria.
HOPE’s founding Director and van der Linden’s predecessor, was Mr Paul Russell, the former Senior Officer for Family and Life at the Catholic Archdiocese of Adelaide.
It turns out that Branka van der Linden (née Seselja) is a sister of Catholic ACT Senator Zed Seselja who voted against David Leyonhjelm's recent Restoring Territory Rights (to legislate on VAD) Bill. But there’s more. Far more.
Branka, who attended Catholic St Clair’s College primary school and Padua Catholic High School, both in the ACT, is a “senior lawyer” at the Truth Justice and Healing Council, which provides services to the Australian Catholic Bishop’s Conference and Catholic Religious Australia in relation to the Catholic Church’s response to the Royal Commission into Institutional Responses to Child Sexual Abuse.
She’s advisory legal counsel for the lay Catholic St Vincent de Paul Society Canberra/Goulburn Territory Council. (And good on her for supporting this philanthropic work.)
She and her husband Shawn represent (or at least represented) the Australian Catholic Marriage and Family Council, and were representatives of the Catholic Archdiocese of Canberra & Goulburn on the National Family Pilgrimage to the (Catholic) World Meeting of Families in Philadelphia in 2015.
Husband Shawn has been described by the church as a “loyal Catholic servant” for nine years of service as the director of CatholicLIFE at the Catholic Archdiocese of Canberra and Goulburn.
And as if this weren’t clear enough, a sample of Branka’s Facebook Likes is equally informative:
A sample of Branka van der Linden’s Facebook Likes
Archbishop Anthony Fisher (Catholic)
Archbishop Samuel J. Aquila (Catholic)
Archbishop Mark Coleridge (Catholic)
Bishop Robert Barron (Catholic)
Marist College Canberra Faith Formation (Catholic)
St Thomas the Apostle Kambah (Catholic)
Campion College (Catholic)
Teaching Catholic Kids
Ascension (Catholic Church)
CathFamily
St Therese of Lixieux (Catholic)
Dominican Sisters of Saint Cecilia in Australia (Catholic)
Fusion Youth Group (Catholic)
St Clare’s College (Catholic)
Marist Canberra Football Club (Catholic)
Light To The Nations (Catholic)
Catholic Voices USA
Centre for Faith Enrichment (Catholic)
World Meeting of Families 2015 (Catholic)
Quidenham Carmelite Monastery (Catholic)
Denver Catholic
Catholic Mission – Canberra & Goulburn
XT3 (Catholic youth association)
Missionaries of God’s Love Darwin (Catholic)
Marist College Canberra (Catholic)
Life, Marriage & Family Office (Catholic)
Infant Jesus Parish, Morley (Catholic)
MGL Priests and Brothers (Catholic)
Catholic Mission – Sydney, Broken Bay, Parramatta
Youth Mission Team Australia (Catholic)
Summer School of Evangelisation – Bathurst (Catholic)
Missionaries of God’s Live Sisters (Catholic)
Sisterhood National Catholic Women’s Movement
My Family My Faith (Catholic)
Catholic Talk
The Catholic Weekly
The Catholic Leader
Mercatornet (Catholic blog site)
BioEdge (Catholic blog site)
It’s clear that Branka van der Linden, like her predecessor Paul Russell, is very deeply invested in Catholic tradition. I will be the first to say I firmly believe that is entirely her right.
Yet how curious it is that while repeatedly advancing (secular) misinformation about VAD, Branka van der Linden doesn’t mention her profound religious convictions. It's surprisingly similar to the approach evidenced by Catholic Professor of Ethics, Margaret Somerville; and Catholic (then) Victorian MP Daniel Mulino; and Catholic Editor of The Australian, Paul Kelly (who warmly quotes Mulino); and Catholic director of the Euthanasia Prevention Coalition, Alex Schadenberg...
You get the idea: perhaps there's a pattern?
One possible source of pattern
What was it that the Catholic Archbishop of Sydney, Anthony Fisher, said at the 2011 Catholic Bioethics Conference in relation to opposing the legalisation of VAD?
"The most effective messengers may also vary: bishops, for instance, are not always the best public spokespeople for the Church on such matters."; and
"...the man or woman in the street ... may well be open to persuasion that permissive laws and practices cannot be effectively narrowed to such circumstances"; and
"We need to research and propose new messages also and carefully consider who should deliver them, where and how."
Nowhere in his address does Fisher propose actually testing whether his calamitous assumptions about VAD are true.
Gosh, another coincidence.
Epilogue
I want to be absolutely clear that I am not using a person’s religious conviction as a reason to dismiss their ideas. That’s called an ad hominem attack: an attack against the person rather than the substance of the argument (even assuming it has any substance to assess).
What I have done here and elsewhere, and I will continue to do, is to expose arguments that are false, misleading, illogical or otherwise unmeritorious on the basis of empirical evidence and reasoning.
It just turns out that organised misinformation against VAD law reform comes from deeply religious circles, and those religious circles often avoid mentioning their religiosity while spreading such nonsense under a ‘veneer of secularism’.
It’s in the public’s interest to understand where most organised misinformation against VAD comes from.
The F filesPosted on Tuesday 9th April 2019 at 7:15am
An article in 'Anasthesia' did NOT find high rates of regaining consciousness in contemporary VAD practice.
A recent article by Sinmyee et al, "Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying", published in the journal Anasthesia1 was an attempt to identify a professional standard for inducing and maintaining unconsciousness prior to voluntary assisted dying (VAD) death, a laudable aim.
However, the authors’ underlying premise of contemporary VAD practice failing to reliably maintain unconsciousness — potentially leading to 'inhumane deaths' — is not established by their cited sources. They cite exactly three sources to establish their claim: their citations 31, 32 and 33.
Citation 31 — Iserson et al 1992
This is a qualitative article by Ken Iserson and colleagues.2 Published in 1992, it outlines a single case of assisted suicide, forming the backdrop for several Californian ethics committees to comment.
Not only was this a single case rather tha a sample of dozens or hundreds of cases, but assisted dying was illegal right across the USA in 1992 and earlier. Therefore, the article is wholly uninformative to contemporary practice under assisted dying laws.
Citation 32 — Groenewoud et al 2000
This is a study by Johanna Groenewoud and colleagues.3 Published in 2000, it analyses Dutch data collected between 1990 to 1996 — long before the Netherlands’ 2001 euthanasia Act, which came into effect in 2002.
In 1997 the Dutch medical association (KNMG) formed the Support and Consultation on Euthanasia in Amsterdam (SCEA) network to assist doctors implement the practice more reliably. The successful program was made national (…in the Netherlands, SCEN) in 1999, with a four-year implementation resulting in strong consultation and positive outcomes.4
In addition, the KNMG and Dutch pharmacy association (KNMP) have improved their guidelines for euthanasia practice since 1996: in 1998, 2007 and most recently in 2012.5 Independent studies show that use of opioids (inappropriate method) was high in the Netherlands in 1995-96,6 but replaced entirely with (appropriate) barbiturates and neuromuscular relaxants in reported VAD cases in 2010.7
The most recent published report of the Dutch Euthanasia Commission, which assesses every reported case of VAD, did not note any failures of the VAD procedures.8
Citation 33 — Lalmohamed & Horikx 2010
This is a study by Arief Lalmohamed and Annamieke Horikx, published in 2010, of doctor responses to a survey the KNMP conducted between 2007 and 2009.9 The study reported on issues with the storage, preparation and administration of VAD drugs. It noted that the recommended dose of Thiopental was increased from 1500mg to 2000mg so that patient-dependent dosages need not be calculated.
The study noted one negative experience for some patients: pain on injection of Thiopental. Recommendations were made for preparation and administration of the drug to avoid this problem. No other negative patient outcomes were reported.
The upshot
Thus, of the three sources the authors employed to make the case of a significant and systematic problem in the conduct of contemporary VAD cases, none did so: the first was a single case outside the law in the early 1990s, the second a study from the early to mid 1990s from whence contemporary practice has greatly improved, and the third a 2010 pharmacological investigation that found some patients experiencing pain on injection and recommending improvements to avoid it. Nevertheless, Sinmyee et al concluded that:
“For all these forms of assisted dying, there appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and reawakening from coma (up to 4%), constituting failure of unconsciousness.”
These assertions are highly misleading in regard to contemporary VAD practice.
The most recent Oregon Death With Dignity Act annual report, covering all cases from 1997 to early 2019 reports that just eight of 1,467 deaths where lethal medication was consumed, resulted in the patient regaining consciousness.10 That’s an efficacy rate of 99.5%, a high standard for a medical procedure.
There have been no cases of regaining consciousness in Washington state under their Death With Dignity Act.11
In comparison, regaining consciousness under professional surgical anaesthesia is a problem12 with an incidence rate of around 0.13% in the USA13 though the rate appears to be much lower in the UK.14 Even over-the-counter analgesics like paracetamol, ibuprofen and aspirin have significant adverse effects rates of 14.5%, 13.7% and 18.7% (respectively).15
From unsubstantiated to polemical
While Sinmyee and colleagues were attempting, via their article in Anasthesia, to argue the case for improved VAD practice, it was inevitable that ginger groups opposing the legalisation of VAD would commandeer cherry-picked extracts from the article to further their cause, painting a picture of disaster and mayhem.
Sure enough, the Catholic-backed Euthanasia Prevention Coalition’s Alex Schadenberg ran with it, cherry picking the “190 times higher” rate the authors claim for “failure of unconsciousness” using their invalid citations. Schadenberg conspiratorially concluded that “the laws are designed to cover-up [sic] problems with the law”.16
Also, predictably, Catholic-backed HOPE’s Branka van der Linden followed suit, plucking quotes like “…failure rates of assisted dying by these other methods seems extraordinarily high” without similar context.17
It’s disappointing that the original article with its misleading statistics based on figures plucked from a single historical article and in the absence of considering significant intervening improvements, passed peer review. Its misinformation led to more nonsense being energetically pedalled by anti-VAD campaigners.
References
Sinmyee, S, Pandit, VJ, Pascual, JM, Dahan, A, Heidegger, T, Kreienbühl, G, Lubarsky, DA & Pandit, JJ 2019, 'Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying', Anaesthesia, 74(5), pp. 630-637.
Iserson, KV, Rasinski Gregory, D, Christensen, K & Ofstein, MR 1992, 'Willful death and painful decisions: A failed assisted suicide', Cambridge Quarterly of Healthcare Ethics, 1(2), pp. 147-158.
Groenewoud, JH, van der Heide, A, Onwuteaka-Philipsen, B, Willems, DL, van der Maas, PJ & van der Wal, G 2000, 'Clinical problems with the performance of euthanasia and physician-assisted suicide in the Netherlands', New England Journal of Medicine, 342(8), pp. 551-556.
Jansen-Van Der Weide, MC, Onwuteaka-Philipsen, BD & Van Der Wal, G 2004, 'Implementation of the project 'Support and Consultation on Euthanasia in the Netherlands' (SCEN)', Health Policy, 69(3), pp. 365-373.
KNMG/KNMP 2012, Guidelines for the practice of euthanasia and physician-assisted suicide, Utrecht, pp. 56.
van der Maas, PJ, van der Wal, G, Haverkate, I, de Graaff, CL, Kester, JG, Onwuteaka-Philipsen, BD, van der Heide, A, Bosma, JM & Willems, DL 1996, 'Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990-1995', N Engl J Med, 335(22), pp. 1699-705.
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.
Lalmohamed, A & Horikx, A 2010, '[Experience with euthanasia since 2007: Analysis of problems with execution] Ervaringen met euthanastica sinds 2007: Onderzoek naar problemen in de uitvoering', Ned Tijdschr Geneeskd, 154(A1983), pp. 1-6.
Oregon Health Authority 2019, Oregon Death With Dignity Act: 2018 data summary, Department of Human Services, Portland, pp. 16.
Washington State Department of Health 2018, Washington State Department of Health 2017 Death with Dignity Act Report, Olympia, WA, pp. 15.
Cook, TM, Andrade, J, Bogod, DG, Hitchman, JM, Jonker, WR, Lucas, N, Mackay, JH, Nimmo, AF, O'Connor, K, O'Sullivan, EP, Paul, RG, Palmer, JH, Plaat, F, Radcliffe, JJ, Sury, MR, Torevell, HE, Wang, M, Hainsworth, J, Pandit, JJ, Royal College of, A, the Association of Anaesthetists of Great, B & Ireland 2014, 'The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues', Anaesthesia, 69(10), pp. 1102-16.
Sebel, PS, Bowdle, TA, Ghoneim, MM, Rampil, IJ, Padilla, RE, Gan, TJ & Domino, KB 2004, 'The incidence of awareness during anesthesia: A multicenter United States study', Anesthesia & Analgesia, 99(3), pp. 833-839.
Thomas, G & Cook, TM 2016, 'The United Kingdom National Audit Projects: a narrative review', Southern African Journal of Anaesthesia and Analgesia, 22(2), pp. 38-45.
Moore, N, Ganse, EV, Parc, J-ML, Wall, R, Schneid, H, Farhan, M, Verrière, F & Pelen, F 1999, 'The PAIN Study: Paracetamol, Aspirin and Ibuprofen new tolerability study', Clinical Drug Investigation, 18(2), pp. 89-98.
Blog by Neil FrancisPosted on Tuesday 2nd April 2019 at 7:23pm
'HOPE' is pedalling assisted dying misinformation to politicians again.
The Catholic-backed anti-assisted-dying ginger group, HOPE, was represented for years by Paul Russell. He's retired and Branka van der Linden is now at the helm. But its penchant for pedaling egregious misinformation hasn't changed. Van der Linden recently sent an email to all WA members of parliament, containing three points.
Van der Linden's email reads:
Dear [MP salutation],
Did you know that the WA majority report that recommended assisted suicide for WA either dismissed or failed to report on the following statistics?
In the Netherlands in 2015, 431 people were euthanised without their explicit consent.
In Belgium, 8 per cent of all deaths were without explicit consent from the patient.
In Oregon in 2017, the ingestion status of 44 (out of 218) patients was ‘unknown’, making it impossible to ascertain if these 44 patients ended their lives voluntarily and without coercion.
Yours faithfully,
Branka van der Linden
Director, HOPE
The trouble is, all three claims by van der Linden are either directly false or egregiously misleading. Hereare the actual facts:
FACT: Peer-reviewed scientific research shows that the non-voluntary euthanasia rate of both the Netherlands and Belgium has droppedsignificantly since their assisted dying Acts came into effect in 2002, consistent with more careful end-of-life decision making across the board.
Fiction 1: van der Linden improperly cherry-picked a single year’s statistic for each country (and, incoherently, a raw count for one but a percentage for the other), implying that lawful voluntary euthanasia increases non-voluntary euthanasia, when the opposite is true.
Fiction 2: van der Linden claimed Belgium’s non-voluntary euthanasia rate is 8%. It has never been anywhere near that figure: the most recent figure is 1.7% and it was 3.2% before Belgium’s euthanasia law.
FACT: Oregon’s health department actively matches death certificates with prescriptions issued for assisted dying. At any time some prescriptions have not been taken and the person may still be alive, and for the deceased, death certificates are still being processed. This naturally means that some prescription/death statuses will temporarily be ‘unknown’ to authorities, even though they will be later determined.
Fiction 3: van der Linden comically implies that this proper process is sinister.
It's curious how 'HOPE' likes to repeatedly demonstrate how HOPElessly uninformed it is about the actual facts and that its methods include cherry-picking data which it thinks supports its anti-assisted dying case, but which don't.
Western Australians deserve better than HOPE's silly propaganda campaign.
Blog by Neil FrancisPosted on Monday 1st April 2019 at 9:59pm
A forensic analysis exposes Theo Boer's smoke and mirrors on 'suicide contagion'
In my most recent article in the Journal of Assisted Dying, I forensically analyse Dutch ethicist Professor Theo Boer’s 2017 paper purporting to find suicide contagion from assisted dying in the Netherlands. It doesn’t go well for Professor Boer, to put it mildly. You can find the full article here.
I also find an astonishing coincidence that occurred in 2014, the year Boer went feral against the Dutch euthanasia law.
Multiple fatal flaws
In the ‘analysis’ outlined in his article, Boer commits a number of fatal scientific no-noes, including failing to analyse the variable he actually surmised might cause suicide contagion, cherry-picking data that supported his conclusion while ignoring or offhandedly dismissing data at odds with his conclusion, and wrongly forming a causative conclusion from a simple correlation while failing to control for any confounding variables of which there are many.
A litany of scientific offences
In addition to the fatal flaws, Boer’s article contains numerous other scientific and academic offences. My forensic analysis concludes:
“In summary, Boer’s article contains a litany of scientific and scholarly failures. Its speculations are ill-informed, poorly-assembled, incoherent in places and mostly uncited, the data cherry-picked and invalidly interpreted, and the laissez faire methodology incapable of validly supporting its conclusion.
Boer conjures up mere smoke and mirrors to argue suicide contagion from VAD in the Netherlands. The article should be retracted.”
The article also reflects badly on the journal that published this smoke and mirrors: the Journal of Ethics in Mental Health. Neither peer review nor editorial effort identified or attempted to correct any of the nonsense in the article.
What was he thinking?
Professor Boer is an expert in Reformist Protestant theology. As a religious ethicist, it’s astonishing that he considered himself suited to conducting and publishing a ‘causative’ scientific study.
In his article, Boer proposed VAD as the only factor to contribute to changes in the Netherlands’ general suicide rate (and dismissed the Belgian data which contradicted his theory).
In reality, numerous risk and protective factors affect the suicide rate, and in the Netherlands as I’ve established using their official government data, just one factor — unemployment — explains 80% of the variance in the Dutch suicide rate since 1960. Boer casually dismisses this without providing the faintest fume of an empirical analysis himself.
Boer’s article did little but amply demonstrate his underlying anchoring and confirmation bias on the subject, his unfamiliarity with the complexity of suicide, and ignorance of proper scientific principles.
For good measure, he casually threw in a comment about “suicide contagion” or copycat suicides, without understanding that in suicide, copying is the method of causing death. But by definition, general suiciders don’t follow the provisions of the euthanasia Act.
His endeavour made as little sense as me writing a conclusive article about Reformist Protestant theology, about which I know very little.
A copycat analysis?
Coincidentally, the structure of the storyline, the litany of scientific offences committed, and the conclusions reached in Boer’s article were surprisingly similar to those in an ‘analysis’ of Oregon’s suicide rate in another paper by Jones and Paton. Like Boer, Jones and Paton start out by surmising that assisted dying ought to lower the general suicide rate, and conclude the opposite.
Boer approvingly cites the Jones and Paton article, even though a forensic analysis found no fewer than ten major scientific flaws in it and provided multiple sources of empirical evidence at odds with the article’s conclusions.
But Boer manages to cock even the citation up, referring to the article’s authors as Holmes and Paton.
Will the real Theo Boer please stand up?
Boer notes that he’s always been a euthanasia sceptic. Nevertheless, as a Reformist Protestant, he had long accepted assisted dying in “emergency” situations, of which intolerable and otherwise unrelievable suffering is a ‘qualifying’ criterion, and which is the substance of the Dutch euthanasia law (it’s regarded in legal circles as a law of “necessity”). He also opined that the Dutch model was a decent one that other jurisdictions could emulate.
Boer served as the ethicist member of one of the five Dutch euthanasia review commissions, examining every case reported to it between 2005 and 2014.
In 2014 he publicly quit his post on the review committee, slamming the Dutch assisted dying system. He’s been badmouthing it to anyone who will listen, since.
In preparation for this analysis, I asked Boer if his vocal opposition to the Dutch assisted dying model was now based on an in-principle opposition to assisted dying, or only in regard to more recent practice under the Dutch euthanasia Act. Despite a couple of iterations, I didn’t get a specific answer.
The law hasn’t changed
Here’s the point. While Boer repeatedly opines that things changed radically in the Netherlands around 2007, the country’s euthanasia Act hasn’t changed since it was passed in 2001 (and came into effect in 2002). Not. One. Word.
In addition, the Dutch Supreme Court determined in 1994 that individuals with mental (in the absence of concomitant physical) illness could qualify under the then regulatory euthanasia framework, and it was found that cases occurred every year.
And the 2001 Act formalised in statute the regulatory framework that had existed since at least 1984, when the Dutch medical association first published guidelines for euthanasia.
Thus, the Act reflects very long-standing practice, and it hasn’t changed since it was enacted, in contrast to Boer’s claim that things have radically changed.
Flimsy and incoherent ‘ethics’ part 1
This brings us to the first fatal incoherence of Boer’s “ethics”: that he now opposes the law because people with psychiatric illness and other conditions are, in slightly increasing numbers, availing themselves of the euthanasia law. It is these cases against which Boer rails, despite having previously said the Dutch model is a good example for the world, and having actively participated in the system.
Boer’s flip flop is to argue that a law that permits assisted dying under a range of medical conditions (and has done so for decades) is a good law, provided some of those who might qualify (like psychiatric cases) never use it.
Try and explain the ethics behind that position.
Flimsy and incoherent ‘ethics’ part 2
The second fatal incoherence of Boer’s ‘ethics’ is his repeated complaint that until around 2007, the numbers of euthanasia cases was “somewhat steady”, but increased after that. Never mind that the majority of the increase was still in relation to terminal cancer: Boer simply railed at the increased numbers as a major problem.
But, try and explain using ethical principles, why it is appropriate for 2,000 people a year to avail themselves of the euthanasia law, but inappropriate for 4,000 (who all qualify)?
Indeed, the Dutch euthanasia Act makes no mention of numbers: there is no legislated limit on the count of people who might choose to use the law. Rather, it is based on due care criteria, outlining the circumstances of who may qualify, and the process by which they may.
The legislature’s intent remains unchanged and is still being adhered to, though more people, the majority of whom have terminal cancer, are using the law.
It’s astonishing that a Professor of Ethics fails to reflect on the fatal incoherence of his own ‘ethical’ arguments.
What happened?
Boer, who had supported and promoted the Dutch euthanasia model suddenly and incoherently changed his position to vocally opposed in 2014. What happened?
One factor might shed some light. In 2014, Boer was appointed to the endowed professorship of Lindeboom Chair in Ethics in Healthcare at Kampen Theological University.
While Kampen Theological University is a Dutch Reformist Protestant institution and therefore may support assisted dying in “emergency” cases, the Lindeboom Institute, which endows Boer’s eponymous professorship, is less understanding.
The Lindeboom Institute was co-founded by several orthodox Christian institutions and cooperates with the Netherlands Evangelical University which studies science from an creationist Biblical perspective.
The Institute demands “biblically sound medical ethics” along with “Christian norms and values”. You’d be left wondering what that actually means, until you find on its website that the Board’s role is “the protection of people at all stages of life”.
In addition, participating organisations that fund the Lindeboom endowment, like the Dutch Patients Association, Pro Life Health Insurance and the Foundation for Christian Philosophy, are strongly opposed to assisted dying in any form.
It turns out that the authors of that other ‘analysis’ that commits numerous similar scientific offences which generate smoke and mirrors, Jones and Paton, are devout conservative Catholics.
Netherlands 'suicide contagion' from assisted dying: Theo Boer's smoke and mirrors
Author(s)
Neil Francis
Journal
Journal of Assisted Dying, vol. 4, no. 1, pp. 1–11.
Abstract
Background: Concerns had been raised about the scientific quality of a 2017 article by ethicist Theo Boer in which he theorised that lawful voluntary assisted dying (VAD) would potentially ‘dampen’ suicide rates, but drew the opposite conclusion: the suggestion that VAD cases have caused higher suicide rates. Methods: A structured, forensic examination of the article was conducted. Results: Numerous serious shortcomings were found, including (a) profound unfamiliarity with the complexity of suicide; (b) lack of a clear and specific pre-hoc methodology; (c) numerous unsupported speculations; (d) cherry-picked data and casual dismissal of data at odds with the conclusion; (e) a simple correlation interpreted as causation while failing to control for any confounding factors; (f) incoherent, contradictory and misleading statements; and (g) multiple editorial errors. Conclusions: Boer’s article is poorly conceived and carelessly assembled, revealing unfamiliarity with both the subject matter and with scientific principles. The conclusions drawn are not supported by the article’s methodology or data. The article offers mere smoke and mirrors to conclude that VAD may increase suicide rates, at odds with wider evidence.
Francis, N 2019, 'Netherlands "suicide contagion" from assisted dying: Theo Boer's smoke and mirrors', Journal of Assisted Dying, vol. 4, no. 1, pp. 1-11.
Blog by Neil FrancisPosted on Sunday 25th November 2018 at 9:03pm
The Canadian Medical Association (CMA) has quit the World Medical Association (WMA) over assisted dying and plagiarism.
The WMA has long held that assisted dying is unethical and must be condemned by the medical profession, despite a significant proportion of contemporary doctors believing it to be a valid and ethical option in restricted circumstances.
Assisted dying is lawful in Canada, where it is called Medical Assistance in Dying (MAiD).
The CMA has resigned from the WMA, citing a bad case of plagiarism by the current WMA head, but also reporting its considerable displeasure with the WMA's one-sided policy on MAiD.
This is the first example of a member medical society resigning from the WMA in part due to its assisted dying policy, and speaks volumes about medicine's slow but inevitable move to recognise patient well as doctor moral perspectives.
Predictably, Dr Kulvinder Gill (AKA Kulvinder Kaur) from tiny ginger group “Concerned Ontario Doctors”,1 which is strongly opposed to Canada's asssited dying law, slammed the CMA's resignation, claiming that the withdrawal leaves Canada's doctors "without international ethical oversight."
It's shabby framing to impute that Canadian doctors can't practice ethically without some kind of international Big Brother tapping in to their stethoscopes. Perhaps "Concerned Ontario Doctors" believes the Vatican should be monitoring and dictating doctors' conduct?
Predictably too, the Catholic church, with Dr Gill among them, as been actively advancing the right for doctors to ignore legal and valid patient requests to be considered for MAiD, refusing to refer them to other doctors for assessment.
The WMA will eventually have to update its stance to neutral, to honour the range of deeply-held perspectives across the medical spectrum instead of attempting to impose the views of just one end.
1 I was unable to find any other member or spokesperson for this “group” other than Kulvinder.