In light of its Trillium Foundation grant, Euthanasia Prevention Coalition Director of Research George Dienesch looks at the euthanasia advocacy of Dying with Dignity

The Ontario Trillium Foundation Grant

Controversy has been growing following the discovery by the Euthanasia Prevention Coalition of a $177,800 grant by the Ontario Trillium Foundation to Dying with Dignity. DWD, Canada’s largest organization promoting euthanasia and assisted suicide, received a three-year grant for the purpose of establishing a counselling program for terminally ill people. The EPC expressed shock that an organization, dedicated to building public support for a legal change to permit voluntary physician-assisted suicide, would be granted substantial government funding to set up a counselling program. The question must be asked: “Would an organization that exists to promote and encourage present illegal activity – i.e. euthanasia and assisted suicide – be tempted to counsel suicide methods to its terminally ill clients?”

Dying with Dignity’s executive director, Kathy St. John, has responded vigorously to EPC questioning. She told the Ottawa Citizen, “This is libelous and I’m contacting my lawyer. We absolutely do not counsel, aid or abet assisted suicide.” She stated that, “The program will be for members of Dying with Dignity who are faced with important end-of-life decisions … The program will provide information on such issues as care options, the formulation of wills and pain management.” St. John further emphasized to the Catholic Register, “We absolutely do not aid, abet or counsel suicide, ever, not ever! To even intimate that is what this program is about I find appalling.”

Does the evidence indicate that Dying with Dignity plans to counsel suicide?

EPC has done extensive background research, and has uncovered information that seems to indicate that, despite DWD’s strong denials, initial suspicions are well founded. In the January 2000 issue of the Dying with Dignity newsletter, then executive director, Cynthia St. John, declared that, “There is no doubt that this service is needed. The weekly calls to our office from individuals wanting a dignified death on their own terms are steady … we will enhance our services by offering this much-needed counselling program.”

In the May 2000 DWD newsletter, it was stated: “To collect information for the Counselling and Patient Advocate program, Cynthia St. John, executive director, attended the Hemlock Society of the U.S.A.’s Caring Friends Training Program. The Caring Friends Program is a model for Dying with Dignity’s Counselling & Patient Advocate Program. Their program offers information, resources and support to individuals seeking self-deliverance. Our program will cover the issues of self-deliverance, as well as other needs identified by our members.”

“Self-deliverance” is a euphemism for suicide, invented by Derek Humphrey, the founder of the Hemlock society. In the fall 2002 DWD Newsletter, a glossary of terms concerning end-of-life issues defines “self-deliverance” as: “a person irreversibly ill who makes a rational decision to end his or her own life. This term is preferred by those who consider it mistaken to equate this type of action with suicide.”

It is important to note that however DWD may like to view “self-deliverance,” Canadian law views it as suicide. To aid, abet or counsel suicide is contrary to section 241 of the Canadian Criminal Code;,which states unequivocally that: “Everyone who

(a) counsels a person to commit suicide, or (b) aids or abets a person to commit suicide whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding 14 years.”

It is interesting to scrutinize the Caring Friends Program of the Hemlock Society, which has trained DWD personnel, and which Cynthia St. John admits provides a model for the DWD counselling program.

The World Right to Die Newsletter, a publication of the World Federation of Right to Die Societies, of which DWD is a member, has stated: “The first year of operation of the Caring Friends program of the Hemlock Society has been a significant success. Scores of Hemlock members in terminal conditions have been counselled about self-deliverance and assisted death, with some dozen dying with the dignity and control which they desired. The Hemlock national membership was informed at the end of 1998 that it is now Hemlock policy that no member should have to die alone and that any who choose to hasten dying, when suffering an incurable illness, would have the availability of helpful advice to make sure no attempts were botched.”

The World Right to Die Newsletter reports further that in the face of legislative failures to legalize euthanasia and assisted suicide: “Circumventing physicians, Hemlock started the Caring Friends Program in 1998, to work with members who suffer from a hopeless physical condition and are considering a hastened death. New technologies are used that do not require physician-prescribed medication. The goals are to make sure all alternatives have been considered, that – if a hastened death is chosen – (it) is gentle, quick and certain and not botched, and that no Hemlock member has to die alone. Trained volunteers provide information and support to those members for whom the program is appropriate.”

Cynthia St. John left her post as executive director of DWD in the fall of 2000 to become the executive director of the St. Thomas-Elgin Health unit. Cynthia’s sister, Kathy St. John, replaced her. The direction of the counselling program did not change after Kathy became the leader.

A front-page article in the DWD Newsletter on the OTF grant, “DWD’s counselling program gets financial boost,” states: “The program model will be similar to the Caring Friends Program that is run by the Hemlock Society of the U.S.A. – a program that offers personal support and information to irreversibly ill individuals who are considering a hastened death. DWD’s program will cover questions of self-deliverance, as well as other needs identified by program participants.” St. John continues: “Over the last three years, DWD’s counselling committee has worked very hard to revitalize the counselling program, a program identified by many DWD members as critical to the organization. In addition, we have had the benefit of attending the Hemlock Society of the U.S.A.’s Caring Friends Training Program and of gleaning much knowledge and information from a similar program already in existence.”

With money guaranteed from the OTF grant, the DWD Newsletter informs us in a cover article that it has hired Martin Frith to direct its counselling program. A member of the Humanist Association of Canada and the Humanist Association of Toronto, Frith is a registered humanist officiant at secular/non-religious marriage, funeral and child naming ceremonies.

An advertisement in the Humanist Association of Toronto Newsletter about a future Humanist Association of Toronto meeting provides a sense of the humanist attitude towards euthanasia and human life in general. The advertisement for this event states:

“Guest speaker: Cynthia St. John, executive director, Dying With Dignity. Topic: life is a sexually transmitted terminal disease, so we might as well learn what our options for leaving it are. We’ll be brought up to date on the current legal problems affecting living wills, organ donations and voluntary euthanasia.”

In January of 2002, Martin Frith attended a Caring Friends Training Program in Scottsdale, Az. “Not only was the Caring Friends training invaluable, it provided a great opportunity for Martin to network with our colleagues in the right-to-die movement,” reported the DWD Newsletter. The article listed a number of very worthy goals for the counselling program, such as “emotional, spiritual and practical support for members exploring their end-of-life options,” but it added the goals of “information and personal support for terminally ill members considering a hastened death.”

The above quotes should raise serious questions about the suitability of the OTF grant. A Ms. Pashley of the OTF told the Ottawa Citizen that there are stringent criteria to receiving grants. She went on to state that, “Before we make any grant we research the organization extensively.” That research, at least in this case, did not seem to involve reading the organization’s recent newsletters.

In a response to an EPC supporter, the OTF stated: “The counselling activities OTF is funding do not include counselling to commit suicide, but rather a range of assistance to terminally ill individuals regarding care options, living wills, pain management, and relationships with their families and friends. OTF staff are investigating the allegations and will also ensure that OTF funds have been used as approved.”

If the “extensive research” the OTF did in this case is their common practice, we contend that they cannot be depended upon to remedy the scandal.

The Euthanasia Prevention Coalition renews its demand that the Ontario Ministry of Culture be responsible for the $100 million it allocates through the Ontario Trillium Foundation annually by conducting an impartial and independent investigation of the Dying with Dignity grant. We further demand that if an error has occurred, the funds thus allocated be recovered and reallocated to one of the many deserving charities. With charitable dollars so scarce, there must be plenty of uses for $177,800, uses better then an in-house, members-only counselling program that appears, from DWD documents, to counsel terminally ill clients as to how to achieve “self deliverance/suicide.”

Dying with Dignity
Public Image vs. Private Reality

Dying with Dignity has successfully created the public image of a middle-of-the road organization that educates Canadians about their end-of-life options. Its full name of incorporation is Dying with Dignity: A Canadian Society Concerned with the Quality of Dying. Formed in 1980, DWD’s website is widely linked on public information internet links.

The Peel Community Information Database says of DWD that it, “Educates and informs Canadians about end-of-life issues and how to prepare for these. Services include: public education; advocacy for the rights of patients; counselling for the terminally ill; consulting (living wills etc.); and library resources.”

The Hospice Association of Ontario LifeLine links DWD under the category of legal information and living wills. It states that, “Dying with Dignity is a registered charitable society whose mission it is to improve the quality of dying for all Canadians in accordance with their own wishes, values, and beliefs. The website has a question-and-answer section, newsletter, and more.”

The Bereavement Self-Help Resources Guide simply describes DWD as, “A Canadian society concerned with the quality of dying.”

Reader’s Digest, in its online version, describes DWD as “a national, non-profit organization dedicated to fostering communication about end-of-life decisions and improving the way people die. A Canadian pioneer of living wills, DWD has helped countless people ensure that their final wishes are carried out.” The Reader’s Digest description is in an article on living wills which quotes Kathy St. John extensively.

In describing its mandate on its webpage, DWD states: “Dying with Dignity is a registered, charitable society whose mission it is to improve the quality of dying for all Canadians in accordance with their own wishes, values, and beliefs. To accomplish this we: inform and educate individuals about their rights to determine and choose health care options at the end of life; provide counselling and advocacy services to members, upon request; build public support for legal change to permit voluntary, physician-assisted dying; provide living wills, enduring powers of attorney for personal care and other advance health care directives; and, work for the legal recognition of health care directives across Canada.”

It is not surprising that many people view DWD as a patients’ rights advocacy group. At most, they may regard DWD’s stands on euthanasia and assisted suicide as a secondary issue, a mere philosophical abstraction, outside the organization’s primary focus of “improving the quality of dying of all Canadians.”

DWD – The Reality

The following information from DWD internal documents and other sources will show that, contrary to public perceptions, DWD exists fundamentally to promote euthanasia and assisted suicide. The third goal of DWD’s mandate (to “build public support for legal change to permit voluntary, physician-assisted dying”) is actually the focal point of DWD’s activities, with the other goals serving as justifiers, instruments of normalization to attain the actual goal: legalized euthanasia and assisted suicide.

Founded in 1980, DWD was led in its formative years by the indomitable Marilynne Seguin, who committed suicide on Sept. 9, 1999, following a two-year battle with leukemia. Seguin, who led DWD for 18 years, was very close to Derek Humphry, the founder of the Hemlock Society. DWD and Hemlock were both founded in 1980, and their stories are closely linked. The two organizations are co-founding groups of the World Federation of Right to Die Societies.

In a 1998 article, “Right-to-die advocate confronts her own death,” reporter Joan MacFarlane noted that. “unlike fellow right-to-die advocate … Dr. Jack Kervorkian, Seguin chose a more quiet path for her cause. While Kervorkian stages demonstrations and manages to stay in the legal spotlight, Seguin is more focused on generating material to educate people on the issue of dying. She has produced dozens of films, published the book A Gentle Death and helped her organization grow to some 7,800 members. She prefers to work privately with doctors, families and the Canadian legislature.”

Seguin was responsible for the careful cultivation of a moderate image for DWD. “A registered nurse, Sequin has counselled and cared for some 2,000 people all over the world,” yet the moderate image is not the whole story, for as Joan MacFarlane noted, Sequin’s counselling and care included “assisting some in their deaths.”

As a founding member of WF, DWD has been integrally involved in many of its projects. In the words of a former WF president, “As an umbrella organization, the World Federation of Right to Die Societies covers many strands of thought about our common aim: self-determination in dying.” The World Federation is a venue for communication, co-operation, liaison and support between right-to-die groups. It also provides a united voice for euthanasia advocacy with international organizations.

At the 12th WF international Conference in Zurich, Switzerland in 1998, the Zurich Declaration on Assisted Dying was issued. It stated:

“We are medical professionals attending the 12th international conference of the World Federation of Right-to-Die Societies, being held in Zurich from 12 to 15 October 1998. We believe that we have a major responsibility for ensuring that it becomes legally possible for all competent adults, suffering severe and enduring distress, to receive medical help to die, if this is their persistent, voluntary and rational request. We note that such medical assistance is already permitted in the Netherlands, Switzerland and Oregon, U.S.A. We are familiar with the different scenarios which occur at the end of life. We know that if we should find ourselves in such situations, many of us have the knowledge to achieve self-deliverance, and we wish to extend this privilege to our patients. At this most critical time, we must never abandon our patients. Excellent palliative care should not exclude the right to choose assisted dying. In the past decade, an increasing number of doctors and nurses in different countries have stated publicly and courageously that they have actively helped their suffering patients to die, even when it was illegal. Now we, as medical professionals, must state our support for assisted dying and our commitment to such humane medical care. Therefore, we support the right of competent, adult patients, who are suffering severely, to seek our assistance, if this should be their enduring request. We know that many medical professionals around the world share our views and we ask them to make similar declarations.”

Signed by 14 doctors and four nurses, the Zurich Declaration was a gauntlet thrown down before the world. It represented a Rubicon crossing for the world right-to-die movement. Institutionally, the declaration committed the WF and its groups to acceptance in principal of the breaking of laws for the sake of assisting people in suicide. Did the moderate DWD distance itself from the Zurich Declaration?

The DWD Newsletter has quoted the Zurich Declaration in full. The newsletter concludes the declaration with the commentary: “DWD invites all health care professionals to request a declaration form for their signature, so that we may add a Canadian voice to the above initiative.”

In a cover article in the DWD Newsletter, we read, “Attention health care professionals. William E. Goodman, MD, and Marilynne Seguin, RN, have made some modest changes in the Zurich Declaration On Assisted Suicide to make it compatible for Canadian health care professional use. In the next few weeks, all those health care professionals who are so designated on the DWD membership records, and other friends and colleagues who have expressed support of our ideals, will receive a copy of the declaration and a covering letter explaining our objective. We ask each of you to add your voice to the growing number of caring, compassionate professionals who wish to have their beliefs and support register an important statement in this vital issue … Accumulated results can be sent to the World Health Organization, the United Nations, and other organizations, thereby raising the visibility of right-to-die issues universally.”

Again in the DWD Newsletter, a full-page article was dedicated to summarizing the results of the DWD Zurich declaration campaign. “Good support for Zurich Declaration following the initiative of Dr. Richard MacDonald (WF president 2000-2002) from the U.S., who spearheaded the wording of the Zurich Declaration at the last meeting of the World Federation of Right-to-Die Societies in October 1998. DWD started a project of its own. Some 145 letters were sent out under the signatures of Dr. William Goodman and Marilynne Seguin to members in the health care professions and an additional 40 letters were sent to personal contacts of the two signatories.” Recipients were asked to add their names to the 18 medical practitioners who had signed the original declaration. To date, some 50 signatures have been received, which is about a 25 per cent return. Names continue to come in and it is hoped that others will add their names to the list in the coming weeks. These names will be forwarded to the World Federation as part of its global initiative, and there are plans to use this response in places like the World Health Organization and other international associations.”

So stated, we see that DWD crossed the Rubicon by accepting in principal the breaking of the law for the sake of assisting in suicide.

DWD is anything but a moderate educational group for whom legalizing euthanasia and assisted suicide is a mere philosophical abstraction.

DWD – Its real purpose

A front page of the DWD Newsletter was very indicative of the real purpose for which the organization strives. It was emblazoned with the announcement that, “Derek Humphry discusses self-deliverance. Saturday, Oct. 23, 1999 at 1:30 p.m., First Unitarian Church 175 …” Following the announcement, an article told us:

“Dying with Dignity is pleased to announce that Derek Humphry will speak about self-Deliverance on Oct. 23, 1999. He is the author of several books, including Final Exit and Freedom to Die. He is the founder of the Hemlock Society in the United States and a leader in the right-to-die movement. Presently, he is the president of ERGO (the Euthanasia Research & Guidance Organization). Tickets are $10 (member rate) and $15 (non-member rate) per person. Please complete the enclosed ticket request form and send your payment to the Dying with Dignity office. Space is limited! Reserve your seat now! There will be lots of time for questions and answers during the two-hour session. Refreshments and goodies will be served afterwards.”

In other words, Derek Humphry was coming to speak about committing suicide. After the talk, while listeners had milk and cookies, they could ask him lots of questions about the best ways of doing so. Clearly, it was to be a very edifying afternoon.

The DWD Newsletter heralded, “Derek Humphry’s visit a success!” “Dying with Dignity joined approximately 130 guests in welcoming Mr. Derek Humphry. For two hours, Mr. Humphry spoke about self-deliverance, different methods used, and answered questions from the audience. It was a wonderful opportunity to learn more about this subject, to meet Mr. Humphry, and to mix and mingle among friends.”

Mr. Humphry’s talk represents another Rubicon crossing for the DWD organization. Beginning with this article, DWD has regularly advertised materials on “self-deliverance.” “Mr. Humphry was also selling his brand new Final Exit video. Those who are interested in having this video can purchase it through Dying with Dignity at a cost of $30, plus $2.10 GST, for a total of $32.10. Please call or write the office if you would like to order one.”

Humphry’s how-to-commit-suicide video was also promoted in another DWD newsletter. The article stated: “On the subject of the Final Exit video, there has been a great deal of press concerning the release of this video on Public Access Television. We’re pleased that stations in Oregon, Hawaii and the U.K. have had the courage to air this video.”

In an age of rapidly rising suicide rates, the showing on public television of a program about how to commit suicide was a travesty. Suicide deaths can only mount as Humphry’s work becomes normalized. When in a transitory depression, someone should not have suicide instructions ready at hand.

Suicide promotion has become a hallmark for DWD. The DWD fall 2000 newsletter advertised how-to-commit-suicide materials with a 1/3-page ad for Derek Humphry’s new Supplement to Final Exit: The Latest How-To and Why of Euthanasia/Hastened Death.

In the spring-summer 2001 newsletter (the same issue in which DWD announced its OTF grant), there were no less then four how-to-commit-suicide products promoted under the “excellent resources” category. On sale were Humphry’s 1997 book Final Exit, his 2000 video Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, his 2000 Supplement to Final Exit: The Latest How-To and Why of Euthanasia/Hastened Death, and the audiotape of Humphry’s presentation on self-deliverance presented at DWD’s 1999 annual general meeting. These same items have been for sale in the “excellent resources” section of every DWD newsletter since.

We recognize that DWD, under the leadership of Marilynne Seguin, developed a widely accepted moderate image. Since she was reported to have assisted many people with their suicides, the cultivation of a moderate image for DWD was simply a strategy for attaining an acceptance in society for the goal of legal, assisted death.

It is clear that since the suicide death of Seguin, the leadership of the St. John sisters has resulted in a growth in extremism for DWD.

Due to DWD statements in their newsletters, concerning their activities and their impending counselling program, it seems clear that DWD is intending to aid, abet and counsel their members to commit suicide, if requested. It also seems clear that DWD no longer fits the definition of a charitable organization, according to revenue Canada rules. Their newsletters are unequivocally oriented to the change of public opinion rather than a Canadian society concerned with the quality of dying.