Blog by Neil FrancisPosted on Wednesday 25th November 2015 at 8:00pm
St Patrick's Cathedral, Melbourne, Australia. Photo: Donaldytong
On Wednesday 19th November 2015, the Catholic Church appeared before the Victorian Parliament's Legal and Social Issues Committee. Monsignor Anthony Ireland, the Episcopal Vicar for Health, Aged and Disability Care, and Father Anthony Kerin, Episcopal Vicar for Life, Marriage and Family gave evidence about end-of-life decision making. They made a factually wrong allegation about Oregon during their testimony.
Anthony Ireland spoke first, making it clear that they were appearing before the Committee with delegated authority from the Catholic Archbishop of Melbourne (Denis Hart) and with the endorsement of the Victorian Catholic Bishops. He emphasised that "the Catholic Archdiocese of Melbourne does not come to this Committee with fanciful or frivolous arguments."
During question time. Committee Chair Edward O'Donohue asked the Vicars if they had any evidence from lawful jurisdictions to back up their claim that legalising assisted dying would result in a significant reduction in medical research. The Vicars flailed about with vague hypotheticals, but no evidence.
Committee Deputy Chair Nina Springle remarked that some of their testimony was inconsistent with direct evidence from lawful jurisdictions and invited them to reflect on the contradictions. To this, Anthony Kerin stated:
"We know, for example, since Oregon legislated, that the standard suicide rate has increased remarkably and alarmingly. It's not yet the largest rate in the US, but it's getting there, when Oregon had a very, very low suicide rate prior to that."
Let's not mince words: the allegation is comprehensively false. In fact it's three false statements all wrapped up into one.
The USA government's CDC mortaility database provides solid empirical data. Here's Oregon's longitudinal suicide rate statistics, including sixteen years before its Death With Dignity Act (DWDA), and sixteen years after.
Here are the pertinent facts about Oregon's general suicide rate:
The average for the 16 years after the DWDA is lower than, but not statistically different from, the 16 years prior to the Act.
There was a massive drop in the suicide rate two years after the DWDA came into effect, and the rate has risen only from there.
The rise from 2000 onwards is repeated in the majority of USA states and in the national average. The trend increase in Oregon is not statistically different from the national trend increase.
By way of comparison, here's Vermont's suicide rate for the same period.
Now, Vermont didn't have an assisted dying law until 2013, and no assisted deaths occurred under the law in that year, so the suicide rate cannot have been affected by an assisted dying law. Yet the picture is similar to Oregon's.
Here's the USA national suicide rate for the same period, with the unemployment rate added.
There are numerous and complex reasons for suicide and for changes in the rate, but a key one in this USA case is unemployment, which after falling in the 1990s rose abruptly from 2000 onwards.
Has Oregon's suicide rate been worsening relative to other USA states, though? The state annual suicide rankings are informative.
Prior to the DWDA, the trend in Oregon's suicide ranking among all USA states was deteriorating (where ranking number one is the highest suicide rate). Since the Act came into effect, the trend is improving. The difference in trends is statistically significant. In the sixteen years since the Act came into effect, Oregon has appeared in the "top ten" six times, compared with twelve times in the 16 years prior to the Act.
So, let's examine the three elements of the Catholic Church's statement:
1. "Since Oregon legislated, the standard suicide rate has increased remarkably and alarmingly"
This statement is false by omission. It is critically relevant to mention that Oregon's suicide rate dropped massively two years after the DWDA came into effect. Only after 2000 did it begin to rise—like most states and nationally—and in response to a rising unemployment rate.
2. "Oregon had a very, very low suicide rate prior to that [the DWDA]"
This statement is completely false. Oregon's mean rate suicide for 16 years after the act is not significantly different from the mean for 16 years prior to the Act. Indeed, government data back to 1968 shows Oregon's general suicide rate has always been high and never "low", let alone "very, very low".
3. It's not yet the largest rate in the US, but it's getting there"
This statement is completely false. Oregon's suicide ranking amongst USA states was worsening prior to the DWDA, but has been improving since.
It's very disappointing indeed that the Catholic Archdiocese of Melbourne would offer such profoundly false testimony to a legislative committee making inquiries on behalf of the people of Victoria. The offense is all the more grevious because of the unequivocal manner in which the statement was made, and that the witnesses specifically stated they did not bring any fanciful or frivolous arguments to the Committee.
It's time to comprehensively stamp out false information about assisted dying, no matter how fervently it might be believed by its proponents. Watch this space: there's plenty more to come!
Blog by Neil FrancisPosted on Thursday 17th September 2015 at 6:06am
On 16th September 2015, the Victorian Director of the Australian Christian Lobby (ACL), Dan Flynn, appeared as a witness to the Victorian Parliament’s end of life choices inquiry being conducted by the Legal and Social Issues Committee. He made a number of mistaken statements, but what was most worrisome was the revelation of the ACL’s real agenda: to wind back patient rights more than a quarter century.
In his opening address, Mr Flynn opined that assisted dying was 'not supported' by a 'broad base' of Victorian Christians (not just the ACL). This belief is diametrically at odds with clear and repeated evidence from multiple sources.
In 2012, I reported on a Newspoll study into Australian attitudes towards assisted dying. Not only did a whopping majority of citizens support assisted dying, but so did a great majority of Anglicans, Catholics and other Christians (Francis 2012).
Newspoll 2012: Australian attitudes to assisted dying law reform by religion (green=support, red=oppose)
These national results are reflected by a sample of over 60,000 Victorians through the VoteCompass system during the 2014 Victorian election (Stayner 2014). It confirms a substantial majority of Catholics, Protestants, other religious and non-religious Victorians support assisted dying law reform.
VoteCompass 2014: Victorian attitudes to assisted dying law reform by religion (grey=population average)
Out of date
Mr Flynn then referred to a Tasmanian Parliament’s inquiry into assisted dying which rejected law reform. However, the inquiry to which he refers was held in 1998, when Oregon’s Death With Dignity Act had barely been established, the Northern Territory’s Rights of the Terminally Ill Act had been extinguished within just eight months of coming into operation, and the Dutch, Belgian, Luxembourg, Washington and other legislation and judgements did not yet exist.
So, the Tasmanian Parliament’s rejection came from a position of a then general lack of information. The Oregon law has been in effect since 1997, the Netherlands and Belgium since 2002, Washington since 2008, Luxembourg since 2009, and so on. There is now plenty of evidence that assisted dying law reform doesn’t cause slippery slopes that opponents love to theorise about.
Wrong about ‘United Nations’
Mr Flynn then said that the United Nations had in 2012 expressed concern about a ‘lax attitude’ towards euthanasia in Europe, specifically mentioning the Netherlands and Belgium. This is completely untrue. Because it’s easy to make a simple blooper during a presentation, we’ll put aside the fact that he meant to refer to a completely different organisation: the Council of Europe.
We know this because he read directly from Council of Europe declaration 1859 (Council of Europe Parliamentary Assembly 2012). His ACL submission (Australian Christian Lobby 2015) reports (as he read out) exactly one sentence of the declaration, with his added emphasis, as:
"Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited."
But presented in this manner the statement is quite misleading. As I explain in a forensic analysis of the misinformation campaign about this resolution (Francis 2015), the resolution was utterly clear about its intent: it was not about euthanasia (it explicitly said so), but rather about advance care planning. What the resolution spoke against (in the one sentence conveyed above) is non-voluntary euthanasia, not voluntary euthanasia. Both sides of the assisted dying debate agree that non-voluntary euthanasia (one person deciding for a hastened death on behalf of another) is not acceptable. It is not contentious.
In no way did the Council of Europe's resolution critique voluntary euthanasia or comment on any jurisdiction in which it is legal. And, the United Nations source to which the ACL submission refers was released in 2001, fourteen years ago and at the time of the Netherlands' Euthanasia Act was before the Dutch Parliament. With then limited information about how such laws work in practice, it expressed concern about the upcoming Act.
Wrong about Belgium’s law and practice
Mr Flynn referred vaguely to two cases of euthanasia in Belgium in which persons who requested and received euthanasia were not experiencing intolerable pain, which Mr Flynn asserted was a required safeguard in Belgium’s euthanasia Act. This was another supposed example of transgression of safeguards. Wrong again.
While the Belgian Euthanasia Act is officially published only in Dutch and French, a robust English translation has been prepared under the supervision of Professor Herman Nys of the Centre for Biomedical Ethics and Law at the Catholic University of Leuven (see Parliament of Belgium 2002). The word ‘pain’ does not appear in the Act… at all. What does the Act have to say about the legislature’s intent on who may qualify? The relevant clause in Section 1 says:
— "the patient is in a medically futile condition of constant and unbearable physical or mental suffering that can not be alleviated, resulting from a serious and incurable disorder caused by illness or accident."
It’s abundantly clear: mental suffering from an illness or accident qualifies as much as physical suffering, and the suffering does not need to be ‘pain’ as Mr Flynn mistakenly asserted to the Parliamentary Committee.
Mr Flynn also stated that there are mobile end-of-life units in Belgium. There aren’t. (But there are in the Netherlands, and they must follow precisely all the same requirements as anyone else. They operate to provide choice to patients whose regular or reachable doctors disagree with assisted dying and therefore decline to evaluate whether the patient may qualify under the Act.)
Confused about Advance Care Directives
In further testimony, Mr Flynn opined that the degree to which a doctor should be allowed to override a patient’s Advance Care Directive (ACD) is in part influenced by whether the doctor can speak with the patient.
But if the patient can currently speak and participate in decision-making, the advance care directive doesn’t apply: it is mute and of no effect. An ACD only applies when the patient cannot currently participate in their own decision making. That’s (only) what it’s for.
Winding rights back more than a quarter century
But the most worrying aspect Mr Flynn’s testimony was the revelation of ACL’s opposition to the right to refuse unwanted medical treatment.
The Medical Treatment Act 1998 (Vic) has enshrined for now more than twenty five years a patient’s right to refuse any unwanted medical treatments. In 2003 the Supreme Court of Victoria determined that artificial nutrition and hydration (i.e. via tubes) is medical treatment and can therefore be refused under the Act.
But Mr Flynn repeatedly argued that withholding or withdrawing artificial nutrition and hydration, if the patient’s body could ‘absorb’ them, could amount to physician-assisted suicide, and that doctors must be allowed to override refusals. On the matter of patient autonomy, he said that some autonomy rests "with the patients, but a lot of the autonomy in fact is with the doctor”.
When asked if a Jehovah's Witness who refuses a life-saving and simple blood transfusion ought to be allowed to do so, he conceded that they should be entitled to, but that such a case was a “bit of an outlier”. He didn’t explain on what moral grounds one person could refuse a simple procedure to save their life, but another person mustn’t be allowed to even if the likelihood of saving life was doubtful.
So, the ACL’s real agenda is revealed: it recommends winding back the legislative clock more than a quarter century so as to force patients to endure some medical interventions that they don’t want and firmly refuse, if the doctor wishes to proceed.
No wonder the Committee repeatedly questioned Mr Flynn to ensure they had heard and understood his testimony correctly. In conclusion, Committee Chair Edward O’Donohue observed that Mr Flynn’s evidence was “quite surprising” and “quite contrary” to wide evidence already given.
And it’s no wonder that Theo Mackaay, General Secretary of the Victorian Council of Churches—a group of 30 member churches representing mainstream Christianity—criticised the ACL as “fundamentally conservative” and expressed “deep concern that media portrayal of statements from an established and narrow focused lobby group is presented as being representative of the entire Christian community” (Uniting Church in Australia 2011).
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References
Australian Christian Lobby 2015, Submission to the Legal and Social Issues Committee on the Inquiry inito End of Life Choices, Parliament of Victoria, Melbourne, pp. 1-17.
Council of Europe Parliamentary Assembly 2012, Resolution 1859 (2012): Protecting human rights and dignity by taking into account previously expressed wishes of patients, Europe, 25 Jan, pp. 2.
Francis, N 2012, Australian public desire for legalisation of assisted dying in restricted circumstances, YourLastRight.com, Melbourne, pp. 11.
Parliament of Belgium 2002, 'The Belgian Act on Euthanasia of May 28th 2002 (unofficial English translation)', Ethical Perspectives, vol. 9, no. 2-3, pp. 182-188.
Uniting Church in Australia 2011, Australian Christian Lobby does not represent all Australian Christians, nor all Christian viewpoints, 8 Dec, Media Room, viewed 11 Dec 2011, <http://blogs.victas.uca.org.au/mediaroom/?p=971>.
Bulldust is often advanced by opponents of assisted dying law reform—a reform which most citizens want—to scare or bamboozle us against the reform.
Why is there so much misinformation about? The answer is straightforward: because so far it's worked.
More than academic niceties
This isn't just an academic argument about getting the facts right. It's a fundamental battle between different world views, where misinformation against assisted dying law reform has often held sway. Here are just two real examples:
Examples of real impacts of misinformation
In Australia, in every Parliamentary debate over an assisted dying Bill before them, numbers of opposed politicians have quoted the rhetorical sham "the vulnerable will be at risk" (see why it's a sham here). With the exception of the Northern Territory's Rights of the Terminally Ill Act in 1996, every Bill before Australian Parliaments has been lost or filibustered until the end of the Parliamentary term on this fearmongering. And the Rights of the Terminally Ill Act was annulled by the Federal Parliament in 1997 on the same grounds.
In Ireland, the High Court made a determination as to whether Marie Fleming, with advanced multiple sclerosis, was constitutionally allowed to receive assisted dying (Fleming v. Ireland and Ors 2012 10589 P). The court rejected Fleming's claim, saying that the "strikingly high" rates of non-voluntary euthanasia in Switzerland, Netherlands and Belgium "speaks for itself as to the risks involved". But sound research shows that the rates in these countries are similar to rates in other countries without assisted dying laws: evidence of the high degree of 'evidential' bull that was served up to their Honours.
It's time to stop the bull in its tracks
DyingForChoice.com believes it's time for the bull, the misinformation, to stop. It is unacceptable for rational citizens to be denied freedoms on the basis of scaremongering and erroneous information. This is the purpose of the F files. It provides citizens, politicians, policy advisors, healthcare workers, media professionals, researchers and others the evidence, arguments and resources to be properly informed and to avoid misinformation.
The public conversation about assisted dying law reform has been influenced by misinformation from opponents for far too long. Often, misinformation is simply given in ignorance, but sometimes not. It is mandatory that a conversation as important as assisted dying for those suffering at the end of life is informed by accurate information and evidential and reasoned views. Arguments that deceive or attempt to shut down the conversation have no place.
Whether misinformation is Fearmongering, Filibuster, Flip-flop, Flapdoodle, Fudge, or Fiction or Faith, the F files identifies misinformation and those who are providing it.
You can help by sending records of misinformation claims to us, and asking claimants to correct the errors.
Fundamental forms of misinformation
Fearmonger
Represent something as considerably more sinister or dangerous than it is when judged by objective criteria.
Filibuster
Artificial and overly-lengthy process used in an attempt to stall or block a political outcome.
Flip-flop
Multiple inconsistent or opposed arguments used to justify a position.
Flapdoodle
An argument that superficially seems intuitively attractive, true or real, but is in fact meaningless or nonsensical.
Fudge
Unscientific analysis (e.g. selective data) used to support an argument that is not supported by proper, full analysis.
Fiction
A thing that is untrue, or invented or feigned by imagination with no sound or verifiable evidence.
Faith
An argument that all others should adhere to a particular religion's values, tenets and rules.
VideoPosted on Saturday 21st September 2013 at 5:45pm
Opponents of assisted dying law reform often invoke fictional slippery slopes as objections to law reform. In this video, Neil Francis gives three examples of supposed slippery slopes argued by opponents, explains why they are fictional, and shares the perspectives of several recognised experts from the USA state of Oregon about their Death With Dignity law which has been in effect since 1997. Three long-time Oregonian Death With Dignity Act opponents also admit there's no cause-and-effect relationship established between law reform and supposed slippery slopes.
This is the second of three videos sent to South Australian MPs in 2013.
