This Report covers the Carter Trial from November 21 – 23, 2011
Day 6: Monday, Nov. 21, 2011 Prof John Keown (Expert for Canada)
Professor John Keown is Rose Kennedy Chair of Christian Ethics, Georgetown University. Prof Keown’s law publications are critical of Dutch euthanasia policies. He
testified that he opposes any form of assisted suicide or voluntary euthanasia because human life is inviolable. Prof Keown told the Court that he is Catholic but his legal research on assisted suicide and euthanasia is secular, not informed by religion.
Keown believes that regulation and legalization of euthanasia do not work. He said that the Netherlands provides evidence of a slippery slope and that the Dutch have extended the criteria for euthanasia from voluntary to non-voluntary and involuntary. He has written that Dutch citizens have to “make it clear, when competent, if they do not want to be given a lethal injection should they become incompetent.” Counsel for the plaintiffs spent much time trying to convince Keown that his statement was false, and that he knew it to be false when he wrote it. Keown insisted that he accepted his source, Dr. Richard
Fenigsen. In response the plaintiff’s counsel gave the court evidence showing that reputed Dutch legal scholars have long accused Fenigsen of “being a quite unreliable (guide) to the Dutch situation.”
Justice Smith asked Keown, if, since he believed the Dutch had not enforced and monitored their law, that it followed that no other country could? Keown was adamant that his opinion is the same conclusion of numerous other government bodies—policing euthanasia law is too difficult.
Day 7: Tuesday, Nov. 22, 2011 Prof. Jose Pereira (Expert for Canada)
Dr. Pereira is Head and Professor of Palliative Care in Medicine and the University of Ottawa. He has a long history in palliative medicine but is a newcomer to research on assisted suicide and euthanasia. He became interested in assisted suicide while working in
Switzerland where some assisted suicides were allowed in his hospital. Dr. Pereira has a recent paper in Current Oncology that says safeguards and controls for assisted suicide and euthanasia are illusions. He testified all day Tuesday and most of Wednesday.
The first day of testimony centred on definitions about palliative sedation, how it is done, and whether it obviates the need for assisted suicide or euthanasia, as claimed by the
witness. Dr. Pereira was taken to task for inappropriately using the term involuntary euthanasia (against consent) for situations that were really non-voluntary euthanasia (without explicit consent).
Dr. Pereira volunteered evidence that doctors abuse palliative sedation and violate practice
guidelines, facilitating the deaths of patients inappropriately. When asked if this “abuse” implied a kind of slippery slope, Dr. Pereira said that the solution was not to stop palliative sedation, but to educate doctors and improve standards.
Day 8: Wednesday, Nov. 23, 2011 Prof Luc Deliens (Expert for
Professor Luc Deliens is a medical sociologist at Vrije Universiteit Amsterdam and Vrije Universiteit Bruxelles. He has authored many of the studies that examine the implementation of the 2002 law on euthanasia in Belgium. Prof Deliens gave his testimony by video conference from a Canadian Embassy in Europe, and because of the time differences court convened at 07:00 instead of the normal 10:00.
Most of the cross-examination by the AG Canada focussed on how the Belgian research counts euthanasia cases and whether there is evidence of abuse. Belgian doctors are not 100% compliant in reporting cases to the Euthanasia Commission, but they are good about reporting cases to university researchers. This, says Prof Deliens, helps to show what practices really are, and this information is useful for finding ways to improve the system. Deliens said that he did not want to be provocative, but compared to Canada, Belgium
has much more information about physician conduct in care at the end of life, and this knowledge allows for improvements in education and practice. Deliens appeared to suggest that the Attorney General of Canada should be careful not to judge the success of euthanasia law in Belgium since Canada has very little information on the success of its prohibition law and has not taken steps to find out.
Prof Deliens testified for 3 hours, even though he was very ill. The Attorney General of Canada wants to recall him at a later date for “extensive” questioning. Justice Smith left this possibility open but also said that the success of the Belgian system may not need much more elaboration since it is not central to the question for this Canadian court.
Following Prof Deliens, Canada’s witness, Dr. Pereira, returned to the witness stand to continue his testimony from the previous day. Counsel for the plaintiffs spent hours grilling Dr. Pereira about his Current Oncology paper, which says safeguards are illusory. Again and again, counsel for the plaintiffs handed up the references that Dr. Pereira had cited, saying that his references did not seem to support the propositions he was making in his paper. Repeatedly, Dr. Pereira conceded that he had not provided an
appropriate source for various propositions and facts. Sometimes he even interrupted counsel, admitting “That was an error,” because he could see the improper citation before counsel could finish the question.
Dr. Pereira’s research paper was strongly discredited. When asked if his Catholic faith informed his view, Dr. Pereira said that he would not call himself a practicing Catholic
and religion did not inform his perspective. He said his professional view, which is stated in his affidavit is informed by a medical oath: “I am sworn to do no harm and I consider that taking someone’s life intentionally, even with his or her request, constitutes harm.”
[Note] Many people believe that physicians swear to the Hippocratic Oath, which has its origins in 5th century. Today’s physicians have no duty to swear to the original gods in the oath, Apollo Physician, Asclepius, and Hygieia, and the original oath’s prohibition against abortion no longer applies.
A 1997 paper in Journal of Clinical Ethics surveyed the oaths in 150 medical schools in the USA and Canada. Only 14 percent of the oaths prohibited euthanasia.
The next report will cover the appearances of two psychiatrists: Dr. Herbert Hendin, November 24th, and Dr. Harvey Chochinov, November 25th. Both are witnesses for the Attorney General of Canada.