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Human Exceptionalism

Life and dignity with Wesley J. Smith.

Belgian Euthanasia Opens Other Killing Doors



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This is not surprising, and parallels the methods doctors in the Netherlands use to kill that are not formal euthanasia (lethal injection). 

A study in the Journal of Medical Ethics finds that nearly 80% of palliative or terminal sedation cases are done without permission. From the abstract:

In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lack clear correspondence with definitions of sedation as presented in existing guidelines. In these cases, an explicit life-shortening intention by means of drug administration was present in 21.6%, life shortening was estimated at more than 24 h in 51% and an explicit patient request was absent in 79.7%.

As I explained in more detail here, there is a difference between “palliative” and “terminal” sedation, properly understood, and the article mentions some confusion in terms by Flanders’ doctors in this regard.

The former does not aim at ending life, but keeping a patient comfortable. It can be titrated to allow greater and lesser states of awareness as needed. PS is a legitimate medical treatment. In PS, the patient dies of the underlying disease.

On the other hand, terminal sedation is a blunt instrument that puts a patient unconscious until death, sometimes accompanied by denying food and water to make that happen.  In TS, the patient often dies of the sedation or dehydration. The abstract appears to indicate that nearlry 22% of all sedations are of the terminal variety.

In all cases–whether lethally intended or not–consent should be given. But once killing becomes an acceptable “treatment,” what’s consent got to do with it? 

One last point: Legitimate PS is needed in, maybe, 2 or 3% of cases. But in the Netherlands, about 13% of patients die while sedated, meaning about 10% are TS cases. When euthanasia, assisted suicide, termination without request or consent, and TS are added up, it amounts to about 14% of deaths in the Netherlands caused by intentional killing by physicians.

The toll is probably higher in Belgium, which has enthusiastically embraced the euthanasia culture of death.

A similar pattern in the USA would amount to 300,000 annual deaths from lethal actions taken by doctors! 

Here’s the moral of the story: Allowing euthanasia in the door also increases the use of other lethal methods, since making the patient dead becomes the point of the medical presence.



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