WORLD RIGHT TO DIE SOCIETY NEWSLETTERS
WORLD RIGHT-TO-DIE NEWSLETTER Issue No. 36
ISSN 0742-535X April 2000
on Euthanasia in Belgium Parliament
by Jacqueline Herremans (WF Board)
Ten years ago it was clear that the Belgian political world was not disposed to engage in a new clinical ethical debate on euthanasia after a difficult battle on abortion: Belgian had just experienced a constitutional crisis linked to voting on an abortion law of April 3, 1990.
Several bills on right-to-die were regularly submitted by socialists, liberals or ecologists members of the Parliament without having the chance to be challenged in open debate. This tendency seems now to be reversed in the public debate is progressively taking form.
Senator Roger Lallemand, the father of the law on abortion, accomplish the first step in April 1996 when he asked the Senate to debate the problems of the end of life.
The bioethics consultation committee was charged with these matters and its first report of May 12, 1997 was devoted to the question of voluntary euthanasia requested by a capable and conscious patient. On the basis of this report, the Senate held a discussion on the 9th and 10th of December 1997.
Since then discussion of euthanasia has no longer been a taboo. On February 12, 1999, before the elections of June, senators Lallamand and Erdman submitted a bill concerning the problems of the termination of life and the situation of incurable patients.
The law would imply a modification of the Criminal Code with depenalisation of euthanasia under precise conditions and recognize the "will of life" under the terms of "anticipated declaration".
One of the issues of the electoral campaign concerned the ethical problems with euthanasia. But the surprise came with the new government: no longer was CVP, the powerful Catholic political party for the Dutch-speaking part of Belgian, a member of the government. No longer was there opposition to such debate in Parliament.
In November 1999, the Senate began to discuss several bills about euthanasia. Six senators-members of the majority-took the initiative to submit a common proposal of bill around three points: question of euthanasia, the creation of a commission of evaluation, and the right to obtain palliative care. These are the essential points of the proposed bill:
1. The request, both firmly and persistently made, by an incurable person with unbearable suffering (to be estimated by the patient him or her self and no nobody else);
2. A second opinion of a doctor outside the existing therapeutic relationship; and freedom of conscience for doctors;
3. The patient's agreement to any further consultation, without any constraint on him/her as a result of the opinions gathered, the final decision remain the exclusive joint responsibility of the patient and the doctor;
4. Assurance of legal security for the doctor might be depenalisation of euthanasia;
5. For a patient who has sunk into an irreversible state of unconsciousness, account being taken of his/her declaration previously written out by him/her (The Living Will);
6. The expansion of palliative care, without the option's being transformed into an obligation for the patient.
Since February hearings have taken place in the Senate. Specialists in ethical problems, members of associations like ADMD, physicians, nurses, patients, and lawyers all came to testify in front of the Commissions of Justice and Social Care if involved in these questions.
It takes time and energy, but the most important thing to emphasize is the recognition of the fact that voluntary euthanasia does exist and that the demand to get euthanasia is justifiable. The task now for the Belgian Parliament is to make it lawful.
Jacqueline Herreman, president of the Association for the Right to Die with Dignity, ADMD, Belgian.
For persons able to understand French and Dutch, is possible to read the text of the hearings on the web site of the Belgian Senate: http: //www.senate.be (subject: euthanasia).
World Federation Appoints First Staff Member
Stephen Jamison has been appointed the first development officer of the World Federation of right-to-die societies. Is it paid, halftime position. Steven has considerable background in the right-to-die movement, first supporting AIDS victims in San Francisco and 1980's, then as regional director for Northern California for the Hemlock Society, and later as a counselor on pro-choice issues. He is author of two hard-cover books: Final Acts of Love: Families, Friends, and Assisted Dying and Assisted Suicide: A Decision Making Guide for Health Professionals.
Designing a Future for the World Federation
by Stephen Jamison (WF staff)
I am honored that I have been selected by the Board to serve as the first Development Officer for the World Federation.
Over the past several years I have had the opportunity to participate in various ways in the right-to-die movement, and have watched with great interest the gains of the movement and the work of the World Federation and its member societies.
I see the designated tasks of the Development Officer position as a means to continue these gains by helping the World Federation fulfill its objectives. These objectives have been stated quite well in the Federation's Constitution. Some of these objectives include taking necessary steps to:
1. Promote the cause of self-determination in dying by making representations to any appropriate international organisation and by commissioning and publishing research into any aspect of that issue;
2. Provide a means for the exchange between member organisations;
3. Promote co-operation and liaison between organisations whose aim is to advance the individualÃ•s right to self-determination in dying; Â· promote and hold international conferences;
4. E ncourage the formation of organisations with similar aims in countries where they do not exist.
These objectives are not easily accomplished. Nevertheless, the Development Officer position can aid the World Federation Board through several designated tasks. These include:
Many of these tasks are interrelated, and several are centered around development of a World Federation web site, which will enable the World Federation to have a daily presence on the Internet. The importance of htis cannot be overstated. For example, the Web pages on the ERGO site recently have been visited more than 1,100,000 times a month.
An expanded Web site can continue to ensure public visibility for the Federation and for all our member societies, and can serve both the public and activists alike. In particular:
More importantly, it can serve the needs of World Federation member societies, by providing them a means to exchange information and to keep informed of relevant worldwide events. Although member societies may have their own specific needs and goals, they can learn from the experiences of others or they can share their own hard-earned knowledge with newer members.
The value of the Internet is in its instant access to both written materials and to individuals who can assist them. It is not always easy to wait for the next international conference to have one's questions answered. Nor is it always easy to pick up the telephone and call someone at another member society.
Key questions can be posted on a belletin board accessible only to members, and answers can be obtained through email messages sent anytime day or night. In this way, instead of being isolated by political boundaries, a society can can begin to view itself as part of a larger worldwide movement. In this regard, it is my hope that all member societies will eventually see the benefit of the Internet.
The World Federation and the position of Development Officer can play crucial roles in facilitating the sharing of this information, and I would like to thank you in advance for your help in allowing me to carry out my tasks.
I view my role as a serious obligation, and look forward to working on behalf of all of you. If you have any suggestions, or would like to send me any written materials about your own organisation, please don't hesitate to contact me.
Stephen Jamison can be contacted by email at firstname.lastname@example.org or email@example.com or by mail at P.O. Box 570, Mill Valley, California, 94942, USA. By phone at +415-256-9885, or by fax at +415-381-4257.
Internet Speeds Contacts, Adds to Workload
by Mary Gallnor (WF President)
I'm now coming to the end of my presidency of the World Federation of Right-to-Die Societies which I took over at the conference in Zurich in 1998. I will relinquish the position at the next conference in Boston on September 1 to 3, 2000, and take the position of past president for the following two years.
I will not pretend that it is an easy position to hold because is a very cumbersome organization to work within. To be on the board of any international organization with member societies in 23 different countries would always bring difficulties. However, in our case we had no paid executive officer whose work is to administrate day to day affairs.
We are a Board of 10 volunteers some of whom do not have English as their first language. That can present problems with understanding of the finer details of a proposal. This can cause frustration on all sides. It also slows down progress immensely and that slowness can frustrate some of our member societies which wonder what we do.
Slow progress is exacerbated by the fact that we do not have the luxury, which the societies have, of meeting each month around a table, where proposals can be talked through thoroughly, with everyone being able to provide input before a decision will be arrived at. Even so, we all know that discussion can be lengthy and may need to be brought back to the next meeting. Imagine doing that via the medium of email.
In the past , slow progress was not a major problem but with the advent of the Internet and email the speed of communication is bringing an added pressure to volunteers with personal busy lives to lead. On the good side, it will also mean, of course, that we are able to network on voluntary euthanasia (VE) issues throughout the world and the more remote countries may not feel so cut off.
It is a morale booster to become aware of events which may lead to legalization of VE in another country. It can be disheartening to be continually banging our heads against the wall of religious and political intransigence. The latest good news seems to be coming from the Belgian Parliament which is currently debating a Bill, as well as the Dutch Parliament. So watch out for details.
In an attempt to improve the relationships between societies I proposed to to the board at the Melbourne conference in 1996 that we make an appeal to member societies for donations to fund the appointment of a development officer. This again made slow progress for the reasons I have already outlined but we're now close to achieving our goal.
Recently we put an advert on some e-mail lists and in the newsletter of the World Federation and we had over 30 expressions of interest. Some the applicants were of high caliber with proven track records and work ethics. We are seeking someone to work from home and in any country because the Internet now allows this to be done successfully.
Because English is the official language of the World Federation the successful candidate had to have excellent written and spoken English, with other languages a bonus. The contract is for one year, initially.
As you can read on the other pages of this newsletter, Stephen Jamison,of Northern California, was awarded the post.
Some Historical Background
The first voluntary euthanasia society was formed in England in 1935. The advent of the second World War and then coming to terms with the course of the Holocaust, caused discussion of the matter to be put to one side until the 1970's.
In 1976 the president of the Japanese society called an international meeting of the existing societies which go under the ambiguous umbrella term of "right-to-die societies."
Only groups in the UK, NZ and Australia call themselves voluntary euthanasia society is, while some of our members aim no higher than a Living Will.
The World Federation of Right to Die Societies was founded at the third international conference hosted by the UK Society in Oxford in 1980. At that conference the following resolution was unanimously adopted:
1) That a World Federation of right-to-die side is be set up to promote:
2) That all voluntary euthanasia and right-to-die societies be invited to affiliate with the federation.
From that small beginning has grown an organization which is now represent in 21 countries. There were delegates from 18 countries present at the World Federation conference held in Zurich in October 10th to 13th 1998.
The reports from these societies show that there has been a paradigm shift in thinking worldwide for support for change to the present law. The support has grown markedly since the World Federation of Right-to-Die Societies was established in 1980.
I am looking forward to the 20th anniversary conference to be held in Boston September 1st to 3rd, 2000 which will also celebrate the 20th anniversary of the Hemlock Society USA which was formed by Derek Humphrey.
Euthanasia Advisory Clinics Help in Many Ways
By Philip Nitschke, MD Darwin, Australia
The philosophy behind my euthanasia clinics is to bring into the open the fact that voluntary euthanasia did not disappear with the overturning of the Australian (Northern Territory) euthanasia law in 1998.
Our political strategy mirrors that used by abortion clinics in the 1960's. We argue that there is no point running a clandestine, backyard operation; the have always been run and although they help some people, they achieve nothing politically.
Media attention is essential. To minimize risks to the clinics we constantly indicate that we do not advise, council or assist people to suicide.
Information is given, questions answered, drugs demonstrated, videos shown, methods explained, options outlined. The required involvement in final events are discussed and arrangements made. These details are kept confidential.
To provide a national service we have systematically extended the concept to all states (except Western Australia where my registration has been refused). There is no "secret" location; which would totally defeat the purpose. The numbers in each state do not warrant continuous clinics. This year 2000, there will be for clinics in NSW and Victoria, three in South Australia and Queensland, two in Tasmania and ACT, each lasting about a week. Bookings are heavy this year, doubling from 110 in 1999, to an anticipated 250 this year. We depend on the donation of premises for the period of operation of the clinics. Some of those supporters who donate their premises have insisted that the locations be kept secret to protect their poperty. This is the only reason we will accept secrecy is a condition. Most patients are too sick to be seen in the clinic, and it is easier for them to be seen in their own homes. This is because of their physical condition, NOT because we wished to avoid attention. It would suggest if we could increase the current percentage of those who physically attend the clinics (30%), as this would allow greatest numbers to be seen and facilitate media attention.
I receive constant legal advice about how to run the clinics.
Clinics are free, but people attending are asked to donate. And there has been significant support from the VE societies of NSW and Victoria. Operations for 2000 have a budget of $25,000.
Details of the demographics of those attending is becoming available. Average age is 67, of which 70% are women, 40% are terminally ill. Ten of those attending last year's clinics have died, six making use of information obtained. (This data is incomplete). Evidence is becoming available that clinic attendance prolongs life.
Information on details on the clinic's operation is best obtained from: V E R F, P.O. Box 37781, Winnellie, Northern Territory, 0821. Telephone 0500-83-1929, fax: 08-8339-7563. E mail: firstname.lastname@example.org
Death of DMD President
Death of D and D president death of diem the present Bogota, Colombia - Pro Derecho a Morir Dignamente announces that its president, Dr. Miguel Trias Fargas, died of a pulmonary arrest on April 11, 2000. "We will miss this unique and valuable man who helped DMD in these last troublesome years," said Mrs. Beatrice Gomez, the organization's founder.
Passing the Word in Israel
by Richard MacDonald, MD
education in medical schools' -
This conference was organized by the International Center for Health , loan ethics , Univ. of Haifa, School of law. It was under the auspices of the secretary-general of the Council of Europe, the European Association of global by the ethics, UNESCO, and other non-governmental organizations.
Attending were professors and researchers of University medical schools from over 30 countries as well as representatives of the World Health Organization and president of the world medical society.
Due t o the efforts of the treasurer of the World Federation of right-to-die societies, Ollie Pentilla, my presentation was accepted for the program. I had the honor to be co-chair of the session on euthanasia and presented a paper on the "Ethical Basis for Including Assisted Dying in End-of-Life Care". It was possible to include information about the World Federation in my talk which introduced many of those attending to the existence of our organization.
My principal goal was to inform the audience of the issues surrounding the current ethical debate about physician-assisted suicide and what the progress had been toward accepting the concept of hastening the dying process when a patient suffers a terminal or hopeless illness.
In particular, I presented thesituation that exists in Oregon and the re
Background of the subject, such as the technological advances that have made it possible to prolong or delay dying in those with incurable illness, was discussed, as was the creation of grass-roots groups, such as our member societies, seeking legalization of assistance in obtaining a more peaceful, hastened death.
The Caring Friends program of the Hemlock Society USA was also explained. This has been in existence less than two years but has been successful in offering a peaceful, sure alternative in dying to an increasing number of Hemlock members who have chosen to hasten the process as death nears.
It is a program that could be utilized in many countries, I believe, while avoiding the legal, religious and professional prohibitions that prevent most physicians from responding to requests from patients for aid in dying. As usual in such programs, the full continuum care that should be available to those near death was outlined, including hospice and palliative care.
It was explained that both organized religion and medicine accepted some of what is clearly aid in producing a more rapid and comfortable death. Methods that do so include increasingly higher doses of narcotics, withdrawal of life supporting technology, and terminal sedation.
Opponents of aid-in-dying claim that the intention in these applications is to relieve suffering, not cause death, although death results. The only method that is not approved is that used in Oregon, where the patient must obtain a prescription from the doctor for a lethal dose of Nembutol or Seconal, which the patient can consume.
It is my contention that the doctor is the more active person in all the other approaches, while the patient is the active one in the Oregon situation.
Many in the audience apeared to accept our philosophy that there should be more teaching about end-of-life care, and the ethical questions attached thereto and discussions about hastening dying should be part of the curriculum for medical students.
I believe we made many friends at this meeting and I have already had communication with some of them and have had an invitation to speak at a philosophy symposium in the next two months.
Of great interest to us was the new situation in South Africa. Physicians and an attorney for that country presented papers on the evolving social revolution going on in the past two years. This includes a proposal for physician-assisted dying and euthanasia.
It was clear the these representatives of South Africa felt there was a good possibility that legalization would be presented this year probability that it would be adopted.
Sudden Death of Luxembourg's Henri Clees
By Marthy Putz
Son of a General Practitioner, Henri Clees set new goals in his field as gynecological surgeon in the early 1950's. He did not limit his work to gynecology or surgery but took great interest in the psychological and social aspects of his patients.
He was one of the first to prescribe the 'Pill' and to perform sterilizations where necessary - and did not shy away from publicly admitting this, challenging the State to take legal action against him. In the same spirit, he defended women's right to self-determination and the right to abortion.
Not surprising then that when in the 1980's the need arose for founding an "association pour le droit de mourir dans la digniti" in Luxembourg, Henri Clees came up to the challenge and with a few dedicated people got the ADMD-L on its way.
For the last 12 years he stood up for the legalization of the Living Will and for voluntary euthanasia in debates, TV interviews as well as in open confrontation with parliamentarians and the Church.
During his presidency, ADMD-L made strides ahead with a membership of over 800, with conferences and publications and a debate in Parliament. It was also Henri Clees who brought the AGM of the European Division of the World Federation to Luxembourg in 1997.
With a sudden death dates at 72 of Dr. Clees, we can but hope that the committee will be able - with a new president - to continue the pioneering work for a cause so many believe in and defend despite the many taboos yet to overcome.