Denise J. Hunnell, MD

Do no harm?: Medical journals show increasing support for euthanasia

Denise J. Hunnell, MD
By Denise Hunnell MD
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August 24, 2012 (Zenit.org) – Primum non nocere. First do no harm. This edict has been part of medical ethics since the time of the ancient Greek physician, Hippocrates, in the fifth century B.C. It is found in the Hippocratic Corpus, a collection of medical writing attributed to Hippocrates. The original Hippocratic oath includes:

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

For millennia the physician has been charged with being an advocate for the patient. Part of the impetus for the original Hippocratic oath was to ensure that doctors would not be paid by an enemy to give poison instead of medicine. Patients should be able to come to their doctor when they are sick and weakened, and have no fear that their vulnerability will be exploited.

Unfortunately, the sacred trust of the doctor-patient relationship is being strained by a new ethical model. Physicians are being urged to place the “greater good” above the needs of their individual patients. A disregard for the sanctity of human life as well as a utilitarian philosophy that judges the value of a patient to society is becoming more mainstream in the medical profession. This is evidenced by the increasing number of articles in respected medical journals that call for approval of assisted suicide and euthanasia, euphemistically called “assisted dying.”

The British Medical Journal (BMJ), a publication distributed to the members of the British Medical Association, devoted much of its June 14, 2012, issue to endorsing voluntary euthanasia and physician assisted suicide. Raymond Tallis, emeritus professor of geriatric medicine at the University of Manchester, argues in this issue that respect for patient desires and autonomy renders irrelevant any opinion on the matter by the Royal College of Physicians or the British Medical Association. Therefore, all opposition to euthanasia is merely inappropriate paternalism and should be dropped.

In this same issue, Tess McPherson relates the difficult last days of her mother, Ann McPherson, and uses this painful experience as a call for legalized physician assisted suicide and euthanasia. Rather than seeking better pain control, she argues that death is the best option for those suffering at the end of their lives.

Finally, Fiona Goodlee, editor in chief of the BMJ, rounds out the arguments by declaring that legalization of assisted dying is not a medical decision, but rather a societal question. She argues that the role of the physician is compatible with providing euthanasia or assisted suicide and if society wants it, they should get it.

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Amid these scholarly endorsements of euthanasia come the claims of British physician Patrick Pullicino that the National Health Service (NHS) is effectively killing 130,000 patients every year when doctors place these patients on the Liverpool Care Protocol (LCP) and deny them nutrition and hydration. According to the Daily Mail:

Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

The medical literature from the United States also shows an increasing acceptance of physician assisted suicide and euthanasia. The July 12, 2012, issue of the New England Journal of Medicine (NEJM) included an article by Dr. Lisa Soleymani Lehmann and Julian Prokopetz that suggested physician opposition to assisted dying was an unreasonable barrier to patients seeking lethal medications. They recommended that all patients who met the legal criteria for assisted suicide as outlined in the state laws of Oregon, Washington, and Montana should be able to obtain the drugs necessary for suicide without a physician’s prescription or approval.

Perhaps the most chilling example is the enthusiastic endorsement in the Journal of the American Medical Association (JAMA) for the book Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, by Drs. Franklin Miller and Robert Truog. This book seeks to do away with two core principles of medical care. The first is that a physician cannot intentionally cause the death of his patient. The second is that donors of vital organs for transplantation must be dead before the organs are harvested.

Catholic health care ethics, in accordance with natural law, holds that when the burden of life-sustaining extraordinary care such as a ventilator is greater than the benefit it provides, such care can be withdrawn. This is not seen as causing the death of the patient, but rather allowing the patient to die from his underlying illness. Miller and Truog disagree and assert that such an act directly causes the death of the patient. They then begin their descent down the slippery slope by claiming that if causing death by withdrawing life-sustaining care is acceptable, then active voluntary euthanasia by lethal injection should also be acceptable. Further, if voluntary euthanasia by injection is acceptable, then voluntary euthanasia by removal of vital organs to be used for transplantation should be equally acceptable. This radical argument could be disregarded as fringe thinking had it not been so prominently and positively recommended in JAMA.

It is reasonable to say that the notion that physicians should not kill their patients is still widespread among medical professionals. Indeed, several of the aforementioned authors take their colleagues to task for opposing euthanasia and physician assisted suicide. The growing numbers of prestigious medical journals that are routinely publishing support for all forms of “assisted dying” are, however, a clear indication that this approach to end of life “care” is making significant inroads in mainstream medical ethics. The foundational principles of health care that date back to Hippocrates are in jeopardy.

This has serious implications for patients. No longer can a patient assume that his physician has his best medical interests at heart. Now physicians are being urged to consider the cost to society of a patient’s care and judge whether a patient is worthy of such expense. Instead of seeking to provide comfort and authentic compassion at the end of life, there is increased support for hastening death as an expedient solution to suffering.

It is now incumbent upon every patient to explore the ethical principles of his doctor. Does he uphold the sanctity of life from conception to natural death? Does he understand that treatments can be deemed burdensome, but human life is never burdensome? Does he view nutrition and hydration as ordinary care as long as a patient can derive a benefit from it? Does he reject all justifications for intentionally causing the death of his patients?

If your physician does not answer unequivocally “yes” to each of these questions, can you really trust him with your life?

Denise Hunnell, MD, is a Fellow of HLI America, an initiative of Human Life International. She writes for HLI’s Truth and Charity Forum. This article appeared on Zenit.org and is reprinted with permission.


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Quebec groups launch court challenge to euthanasia bill

LifeSiteNews staff
By LifeSiteNews staff

As announced when the Quebec legislature adopted Bill 52, An Act respecting end-of-life care, the citizen movement Living with Dignity and the Physicians’ Alliance against Euthanasia, representing together over 650 physicians and 17,000 citizens, filed a lawsuit before the Superior Court of Quebec in the District of Montreal on Thursday.

The lawsuit requests that the Court declare invalid all the provisions of the Act that deal with “medical aid in dying”, a term the groups say is a euphemism for euthanasia. This Act not only allows certain patients to demand that a physician provoke their death, but also grants physicians the right to cause the death of these patients by the administration of a lethal substance.

The two organizations are challenging the constitutionality of those provisions in the Act which are aimed at decriminalizing euthanasia under the euphemism “medical aid in dying”. Euthanasia constitutes a culpable homicide under Canada’s Criminal Code, and the organizations maintain that it is at the core of the exclusive federal legislative power in relation to criminal law and Quebec therefore does not have the power to adopt these provisions.

The organizations also say the impugned provisions unjustifiably infringe the rights to life and to security of patients guaranteed by the Canadian Charter of Rights and Freedoms and the Quebec Charter of Human Rights and Freedoms. They further infringe the right to the safeguard of the dignity of the person, which is also protected by the Quebec Charter.

In view of the gravity of the situation and the urgent need to protect all vulnerable persons in Quebec, they are requesting an accelerated management of the case in order to obtain a judgment before the Act is expected to come into force on December 10, 2015.


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Colorado baker appeals gvmt ‘re-education’ order

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By LifeSiteNews staff

A Colorado cake artist who declined to use his creative talents to promote and endorse a same-sex ceremony appealed a May 30 order from the Colorado Civil Rights Commission to the Colorado Court of Appeals Wednesday.

The commission’s order requires cake artist Jack Phillips and his staff at Masterpiece Cakeshop to create cakes for same-sex celebrations, forces him to re-educate his staff that Colorado’s Anti-Discrimination Act means that artists must endorse all views, compels him to implement new policies to comply with the commission’s order, and requires him to file quarterly “compliance” reports for two years. The reports must include the number of patrons declined a wedding cake or any other product and state the reason for doing so to ensure he has fully eliminated his religious beliefs from his business.

“Americans should not be forced by the government – or by another citizen – to endorse or promote ideas with which they disagree,” said the cake artist’s lead counsel Nicolle Martin, an attorney allied with Alliance Defending Freedom. “This is not about the people who asked for a cake; it’s about the message the cake communicates. Just as Jack doesn’t create baked works of art for other events with which he disagrees, he doesn’t create cake art for same-sex ceremonies regardless of who walks in the door to place the order.”

“In America, we don’t force artists to create expression that is contrary to their convictions,” added Alliance Defending Freedom Senior Legal Counsel Jeremy Tedesco. “A paint artist who identifies as homosexual shouldn’t be intimidated into creating a painting that celebrates one-man, one-woman marriage. A pro-life photographer shouldn’t be forced to work a pro-abortion rally. And Christian cake artists shouldn’t be punished for declining to participate in a same-sex ceremony or promote its message.”

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In July 2012, Charlie Craig and David Mullins asked Jack Phillips, owner of Masterpiece Cakeshop, to make a wedding cake to celebrate their same-sex ceremony. In an exchange lasting about 30 seconds, Phillips politely declined, explaining that he would gladly make them any other type of baked item they wanted but that he could not make a cake promoting a same-sex ceremony because of his faith. Craig and Mullins, now represented by the American Civil Liberties Union, immediately left the shop and later filed a complaint with the Colorado Civil Rights Division. The case now goes to the Colorado Court of Appeals as Masterpiece Cakeshop v. Craig.

“Jack, and other cake artists like him – such as those seen on TV shows like ‘Ace of Cakes’ and ‘Cake Boss’ – prepare unique creations that are inherently expressive,” Tedesco explained. “Jack invests many hours in the wedding cake creative process, which includes meeting the clients, designing and sketching the cake, and then baking, sculpting, and decorating it. The ACLU calls Jack a mere ‘retail service provider,’ but, in fact, he is an artist who uses his talents and abilities to create expression that the First Amendment fully protects."

Celebrity cake artists have written publicly about their art and the significant expressive work that goes into the artistic design process for wedding cakes.


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Prisoner of conscience Mary Wagner appeals her conviction

Tony Gosgnach
By Tony Gosgnach

TORONTO -- As promised, Mary Wagner has, through her counsel Dr. Charles Lugosi, filed a formal notice of appeal on numerous points regarding her recent, almost two-year-long court case that ended on June 12.

Justice Fergus O’Donnell of the Ontario Court of Justice rejected every application made by the defence – including for access to abortion center records, public funding, standing for a constitutional challenge and for expert witnesses to be heard – before he found Wagner guilty and sentenced her to five months in jail on a charge of mischief and four months on four counts of failing to comply with probation orders.

He further levied two years of probation, with terms that she stay at least 100 metres away from any abortion site. However, because Wagner had spent a greater time in jail than the sentence, she was freed immediately. She had been arrested at the “Women’s Care Clinic” abortion site on Lawrence Avenue West in Toronto on August 15, 2012 after attempting to speak to abortion-bound women there. She then spent the duration of the trial in prison for refusing to sign bail conditions requiring her to stay away from abortion sites.

Wagner is using the matter as a test case to challenge the current definition of a human being in Canadian law – that is, that a human being is legally recognized as such only after he or she has fully emerged from the birth canal in a breathing state.

Wagner’s notice states the appeal is regarding:

  • Her conviction and sentence on a single count of mischief (interference with property),
  • Her conviction and sentence on four counts of breach of probation,
  • The order denying public funding,
  • The order denying the disclosure of third-party records,
  • The order denying the admission of evidence from experts on the applicant’s constitutional challenge concerning the constitutional validity of Section 223 of the Criminal Code,
  • The order denying the admission of evidence from experts concerning the construction of Section 37 of the Criminal Code,
  • The probation order denying Wagner her constitutional rights to freedom of speech, freedom of expression, freedom of conscience and freedom of religion on all public sidewalks and public areas within 100 metres of places where abortions are committed,
  • And each conviction and sentence and all orders and rulings made by O’Donnell.

In the notice of appeal, Lugosi cites numerous points on which O’Donnell erred:

  • He denied Wagner her constitutional right to make full answer and defence.
  • He denied Wagner her right to rely on Section 37 of the Criminal Code, which permits “everyone” to come to the third-party defence and rescue of any human being (in this case, the preborn) facing imminent assault.
  • He decided the factual basis of Wagner’s constitutional arguments was a waste of the court’s time and that no purpose would have been served by having an evidentiary hearing on her Charter application because, in the current state of Canadian law, it had no possibility of success.
  • He misapplied case law and prejudged the case, “giving rise to a reasonable apprehension of bias and impeding the legal evolution of the law to adapt to new circumstances, knowledge and changed societal values and morals.”
  • He accepted the Crown’s submission that it is beyond the jurisdiction of the courts to question the jurisdiction of Parliament legally to define “human being” in any manner Parliament sees fit.
  • He ruled Section 223 of the Criminal Code is not beyond the powers of Section 52 of the Constitution Act, 1982.
  • He ruled Section 223 of the Criminal Code does not violate the Preamble to, as well as Sections 7, 11(d), 15 and 26, of the Charter of Rights and Freedoms.
  • He denied Wagner standing to raise a constitutional challenge to the validity of Section 223 of the Criminal Code.
  • He ruled that Section 223 of the Criminal Code applied generally throughout the entire Criminal Code and used it to deny unborn human beings the benefit of equal protection as born human beings under Section 37 of the Criminal Code.
  • He denied the production and disclosure of third-party records in the possession of the “Women’s Care Clinic” abortion site, although the records were required to prove Wagner was justified in using reasonable force in the form of oral and written words to try to persuade pregnant mothers from killing their unborn children by abortion.
  • He denied Wagner the defence of Section 37 of the Criminal Code by ruling unborn children did not come within the scope of human beings eligible to be protected by a third party.
  • He ruled Wagner did not come within the scope of Section 37 because she was found to be non-violent (in that she did not use physical force).
  • He ruled the unborn children Wagner was trying to rescue were not under her protection.
  • He denied Wagner the common-law defences of necessity and the rescue of third parties in need of protection.
  • He denied Wagner public funding to make full answer and defence for a constitutional test case of great public importance and national significance.
  • He imposed an unconstitutional sentence upon Wagner by, in effect, imposing an injunction as a condition of probation, contrary to her constitutional rights of free speech, freedom of expression, freedom of conscience and freedom of religion.

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Among the orders Lugosi is seeking are:

  • That an appeal be allowed against conviction on all counts and that a verdict of acquittal be entered on all counts,
  • That Section 223 of the Criminal Code be found unconstitutional  and contrary to Section 52 of the Constitution Act, 1982, as well as the unwritten constitution of Canada,
  • That the sentence be declared unconstitutional and contrary to Section 52 of the Constitution Act, 1982, and the unwritten constitution of Canada or that a new trial be conducted, with Wagner permitted to make full answer and defence, be given standing to make a constitutional attack on Section 223 of the Criminal Code, with the admission of expert witnesses,
  • That the Women’s Care Clinic abortion site be made to produce third-party records pertaining to patients seen on August 15, 2012 (when Wagner entered the site),
  • And that there be public funding for two defence counsels at any retrial and for any appeal related to the case.

No date has yet been established for a decision on the appeal or hearings.

A defence fund for Wagner’s case is still raising money. Details on how to contribute to it can be found here.


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