February 25, 2015
John Harrison: Hello and welcome to the radio program Brave New World. My name is John Harrison. In Aldous Huxley’s book of the same name, death is celebrated. Most of those who reach sixty and become economically “useless” are euthanized. Hearses are gaily colored, people are sent to die in comfortable primrose colored apartment blocks, which are alive and gay with synthetic melodies and where there’s a TV at the foot of every bed. Today people aren’t euthanized en masse but we do have the bizarrely called idea of ‘right to die,’ particularly in certain left-leaning circles. The colorful cheerful death centers of the Brave New World are perhaps reflected in the euthanasia clinics in modern Europe, where one can request a good death in comfortable surroundings if you are terminally ill or in the case of Belgium simply suffering from depression. Is this the direction we should be going in? To discuss the issue I welcome to the show Gert Huysmans, the President of the Federation of Palliative care of Flanders, Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition in Ontario, and John Kelly, the New England Regional Director of the Not Yet Dead anti-Euthanasia activist group in Boston.
Thank you all very much indeed for joining us today.
Alex Schadenberg: Thank you for having us.
JH: Could we just go quickly around the panel here and just tell us, the listeners, what is the legal situation in your country? So we can start with you, Gert Huysmans.
Gert Huysmans: What you mentioned in Flanders and in Belgium, euthanasia is not a right. You have the right to request for euthanasia, and that’s a world of difference. So it’s not that you have the right to choose your moment of dying with euthanasia. You have to follow certain conditions that are mentioned in the law. You have to have unbearable suffering caused by a disease or an accident, and the physician you request your euthanasia [from] should have the internal persuasion that euthanasia is the only proper solution for your problems and in some cases and in some circumstances euthanasia is acceptable, but it is not a right as such.
JH: Ok. Thank you very much. Alex Schadenberg from Canada.
AS: Well, in Canada euthanasia and assisted suicide were technically just legalized, even though it’s held off twelve months by the Supreme Court of Canada, so at this moment our Canadian parliament is looking at the question as to how to frame legislation in order to continue protecting Canadians. The fact is the Supreme Court made a very irresponsible decision, because of the language it used. But at the moment it remains – at this very second it [assisted suicide] remains illegal, until the Supreme Court’s twelve-month open window closes, and then there would have to be legislation in place. The fact of it is the courts used a very similar model to Belgium, meaning they said it was acceptable for both physical and psychological suffering – as well as – they defined it as being acceptable for people with disabilities, and they defined it fairly openly so someone who’s a person with disabilities like John Kelly – who is on the call – if he were considered competent he could simply be euthanized, if it were approved by a doctor. The concept with this I have an issue with is about choice, because it’s not always about choice. It’s often about people in a difficult time of their life and their being – they feel because of the system and because of what’s going on or because of other pressures, they really have no other choice.
JH: OK, so both in Belgium and Canada we seem to be entering into a gray area. We don’t seem to be sure whether it’s illegal or not.
AS: Well in Belgium it’s definitely legal, as the doctor just explained.
JH: John Kelly, situation in the States please.
JK: Yes, in three of the fifty states assisted suicide is legal, in which a doctor judges whether someone is making a choice without impaired judgement and can prescribe a lethal dosage barbiturate. What the problem for that is people’s lives will be ended through mistakes and abuse, because no safeguards can ever be enacted or proposed that can prevent innocent people from losing their lives, and in the disabled community we are full of people who have had our lives judged to be terminal or not worth living by a hostile medical establishment, so we are working to uphold our lives and everyone’s lives against this “quality-of-life” judgement.
JH: Ok, let me play the devil’s advocate here. If I personally, John Harrison, am disabled and have been disabled for most of my life, and my condition is deteriorating, it is getting worse. I have absolutely no hope. Who are you to stop me from making the decision to end my own life?
JK: We do not make that decision that you cannot end your own life, because suicide is not illegal anywhere, and people can find a way. What we are against is setting a social policy in which some people’s lives are not valued and are offered suicide, where other people’s lives who are valued receive suicide prevention services.
JH: Yeah and I guess that I would bring in here Baroness Warnock in the UK who said that elderly people should ask themselves if they have a duty to die, because if you are demented, you are wasting the resources of the NHS. And the point that you’re making, I believe, John is that if this becomes a social policy, then government around the world can get on board this and decide this category of people cost an awful lot of money. Let’s euthanize them. I’m putting it awful bluntly.
JK: Well that’s exactly what’s going on, because insurance companies, all they have to do is delay or withhold treatment. The state-run programs are always cutting costs, and we’ve already seen people offered assisted suicide in order to save the state money.
JH: Gert alright—
GH: I’d like to intervene, because that’s just what we in palliative care try to prohibit. It can never be the reason that people choose for euthanasia for lack of good care. If you want to legalize euthanasia in the country, I think you have to have the commitment of the government that good care and good palliative care is any circumstance and in any setting is available for every people and is affordable, because otherwise people don’t have really a free choice.
JH: It’s problem though isn’t it? Because the way that our societies are constructed, we’re led to believe that we can be a burden. I read every other day in the paper that the over-sixties or over-fifty-fives rather do plant a huge burden for society, that we do cost a lot of money, and that when our bodies aren’t functioning that we can’t as hard as everybody else. I mean why should we be allowed to live? Let’s try to answer this question after a short break.
Welcome back to Brave New World Radio program. My name’s John Harrison. Today we’re talking about the terrible theme of euthanasia. I’m joined by Gert Huysmans, the president of the Federation of Palliative care of Flanders, Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition of Ontario, and John Kelly, New England Regional Director of the Not Dead Yet anti-euthanasia activist group, in Boston. Just before the break we were trying to answer the question as why over fifty-fives who feel themselves – and who perhaps are – a burden to society should be able to live.
AS: Well, I think the point the physician just made is important about the doctor deciding, because he said someone would request it, and the doctor should turn them away in circumstances, and the fact is the euthanasia concept is being sold to the culture as it’s all about my freedom of choice, when in fact it’s really not about my freedom of choice. The person might have the ability to request it. The question is who’s actually making the decision and under what circumstances? So when John’s talking about the fact that people with disabilities really in most cases or many cases don’t feel they have the choice. It is because that is the reality. It’s not because that’s some social worry. It’s the reality, and it’s the doctor making the decision.
JK: This is John Kelly. Out in Oregon up to half the program participants who’ve died under the program have been reported feeling like a burden. That puts the lie to any notion of free individual choice.
JH: Yeah, being a burden. It’s a psychological state, isn’t it? As well as a physical state. I mean I can get myself into a situation of depression, where I can convince myself very easily I’m a burden to somebody somewhere or a whole society. So why not get rid of the problem and just go? And I can imagine there are millions of people out there who feel exactly that, and if they are allowed to legally end their suffering quickly, they probably will do. Now that’s the problem with society isn’t it?
GS: It is not, and I intervene because it’s not legal to end someone’s life with a depression that can still be cured, so that’s legal. Also not in Belgium – we cannot do so. Also as a physician, if you have a feeling that there is any pressure or you feel there is a reasonable medical solution for the suffering of someone, well, then you simply cannot perform within the law euthanasia, so it’s very important to deal with these kinds of requests very careful, very caring, taking enough time, and then you come to a good decision. It is not the decision of the doctor. It’s the decision of the patient, doctor, and even you have thorough dialogue with relatives. We think also in palliative care that it should be a multidisciplinary team that is surrounding the patient to have good quality of decision.
JH: So all such decisions should be made independently, because otherwise subjective criteria are going to come in and of course the person, him or herself, cannot say, “Well I am too depressed to talk about this. I just want it all to be over.” Parents – friends that know that person will probably say the same thing, right?
AS: But the doctor has just given us the theory of how it’s supposed to work.
JH: How it’s supposed to work.
AS: That people who are depressed are not qualified for it, that they’re not competent, but in fact we’re seeing in Belgium – from the, especially from the euthanasia clinic – that certain cases have come through that seem very, very controversial, because these people in all intents and purposes in any other situation would have been considered treatable, but they died by euthanasia, because the doctor in the end agreed, “Oh yes, you do qualify.” So the fact is as much as it’s supposed to be careful, it’s only careful based on the willingness of a physician in this case to make it careful, and it’s not always careful. And you see in the Netherlands in several cases that seem to be almost ridiculous in nature in what the decision was to kill someone that way, and yet the law seems to be reasonable, but it’s applied by people who are not applying it in a reasonable way.
JH: So Alex are you saying that there should be either yes or no? You know, either it’s possible or it isn’t possible. There’s no gray area.
AS: In fact, the gray area will always find abuse.
JH: Yeah Ok. So there shouldn’t be a gray area.
GH: There will always be a bit of a gray area, but I don’t work, for good order, in a euthanasia clinic. I work in a palliative care unit, and there’s a palliative physician for a home care team. We have now more than twelve years experience with embedding euthanasia in palliative care, and I think our experience is that we can make proper decisions, in a good way, in a proper way, in a really careful way, and then you come – in some situations – to the conclusion that euthanasia really is the best option there, when it’s the request of the patient.
JK: We in the United States, the disability rights movement have fought [for] a generation against the arrogance being displayed by the doctor, where the doctors can presume to judge the quality of life, and when it is correct to end it. We have a history of being judged to not have high quality of lives, and whenever suffering is the subjective criterion for deciding who gets to die, people with disabilities will always be the ones who are targeted.
JH: But John there’s a couple of things here. Firstly, we’re moving into a very high-tech medical world aren’t we, where more and more situations are outsourced. I actually remember the last time I saw a doctor. Most of my ailments are solved over the phone, or I go to the chemist and buy my drugs and pop them, and I’m ok again. I mean physical contact between patients and doctors is being reduced in many countries. We’re moving into a high-tech medical world. Isn’t it now possible, where governments can just say “This disease and this disease it’s already been decided. You know, we’re not going to treat them, because we can’t afford it. There’s no money there. The insurance companies hugely important in this, aren’t they?
JK: They are, and this is a neoliberal assault on people’s right to live in the community with support around them and not to be targeted for killing for the bottom line. No matter what goes on here. People will lose their lives because of mistaken diagnoses, because of pressures, because of lack of services and what we’re seeing here is a rush to judgement in which some people’s lives are judged not to be as valuable as others and that’s a violation of Enlightenment ideal of—
JH: We’ve got to finish the program, and I think the situation in Belgium is absolutely amazing and the amount of money and resources and care that you’re describing Gert Huysmans is absolutely amazing, but it’s not like that all over the world is it? I’m sure it’s not really like that in the States. And God help us! God help us if we were to live in India or in a—
GH: It is a condition to have good care to perform in a good way euthanasia, because otherwise it is a choice under pressure, I think.
JH: Ok well thank you very much indeed. We certainly haven’t come to a conclusion and we certainly wouldn’t ever be able to in a fifteen minute program like this. Thank you very, very much indeed to all my guests, Gert Huysmans, the president of the Federation of Palliative care of Flanders, Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition of Ontario, and John Kelly, New England Regional Director of the Not Dead Yet anti-euthanasia activist group in Boston.