Belgium becomes world leader in organ removal after euthanasia as Oxford academics suggest the practice could generate 2,200 more organs a year in UK

According to a recent report Belgium is now the ‘world leader’ in organ removal after euthanasia.

The practice of transplanting organs from voluntary euthanasia patients in this small European country has become increasingly common since it was first reported that it had become an established procedure in June 2011.

The recent report mentions at least nine cases since 2005 but suggests that there would have been many more had the patients had transplantable organs.

Only a small proportion of euthanised patients are able to donate organs, since most of them are terminally ill with cancer and therefore regarded to be ‘unsuitable’ as donors.

Two Oxford academics last year argued that ‘organ donation euthanasia’ would be ‘a rational improvement over current practice regarding withdrawal of life support’, would ‘increase patient autonomy ‘ and ‘would give individuals the greatest chance of being able to help others with their organs after death’.

In a paper published in the journal Bioethics, Julian Savulescu (pictured) and Dominic Wilkinson, argued that such an approach is ethical:

‘Why should surgeons have to wait until the patient has died as a result of withdrawal of advanced life support or even simple life prolonging medical treatment? An alternative would be to anaesthetize the patient and remove organs, including the heart and lungs. Brain death would follow removal of the heart (call this Organ Donation Euthanasia (ODE))…. Organs would be more likely to be viable, since they would not have sustained a period of reduced circulation prior to retrieval. More organs would be available (for example the heart and lungs, which are currently rarely available in the setting of DCD). Patients and families could be reassured that their organs would be able to help other individuals as long as there were recipients available, and there were no contraindications to transplantation.’

They estimate that although ‘it is difficult to estimate the effect of introducing ODE on overall organ donation rates’ that ‘it could be up to an additional 2,201 organs per year in the UK’.

Professor Savulescu is no stranger to controversy. He has previously defended the publication of an article defending infanticide for disabled newborns, in the Journal of Medical Ethics, for which he is editor.

I suspect a lot of readers will be genuinely shocked by these revelations. But in fact ‘organ donation euthanasia’ follows logically from the acceptance of both euthanasia and the harvesting of organs from beating heart donors. It is, after all, happening already in Belgium.

I wonder how long it will be before elderly people who have ‘already had a good life’ start being eyed up by those with organ failure who are not yet ready to die and being accused covertly, or overtly, of selfishness for being unwilling to hand their fresh healthy organs over.

Given that one third of euthanasia cases in Belgium are already involuntary I wonder if any patients have yet had their organs harvested without their consent because someone had ‘greater need’ of them?

Once we start believing that it is admissible to kill people and that some lives are more worth living than others these kinds of developments will inevitably follow.

It sounds like another good reason to oppose the legalisation of euthanasia here in Britain. 

Britain’s growing elderly population is a massive challenge which requires a radical solution

The UK is ‘woefully under-prepared  for the social and economic challenges presented by an ageing society, a House of Lords committee has warned this week.

The committee predicts ‘a series of crises’ in public service provision and says that big changes in pensions, health care and employment practices are needed to help people ‘sustain a good quality of life’ as they age.

The committee is calling on the government to set out its thinking on the issue before the next election and for all parties to consider the implications for public spending, in their next election manifestos.

A leading think tank, the International Longevity Centre UK, said the report should be a wake-up call for government and society as a whole and that individuals would have to take more responsibility for their health and income in retirement.

I consider this to be a massive understatement.

The demographic winter, whereby shrinking birth rates and increasing longevity, contribute to a falling population and distorted age structure is most marked in Japan. The bar graphs above (from the Economist) show the structure of Japan’s population in 1950, 2012 and 2055 (more detail here).

For about 50 years after the second world war the combination of Japan's fast-growing labour force and the rising productivity of its famously industrious workers created a growth miracle. Within two generations the number of people of working age increased by 37m and Japan went from ruins to the world's second-largest economy.

In the next 40 years however that process will go into reverse. The working-age population will shrink so quickly that by 2050 it will be smaller than it was in 1950, and four out of ten Japanese will be over 65. Unless Japan's productivity rises faster than its workforce declines, which seems unlikely, its economy will shrink.

The changes in the UK’s age structure are not as dramatic as those in Japan but follow a similar pattern. The graph (right) shows the change between 1901 and 2010. 

The UK’s population is both larger and older than it was a hundred years ago, and most of the difference in size is due to an increase in the older population.

Between 1901 and 2010, the population under 40 increased only modestly, from 28.5m to 31.5m. But over the same period, the number of people aged 40 and older has more than trebled, from 9.7m to 30.8m.

Among the over 65s, the increase has been still more dramatic. Around 5% of the population was aged 65 and older in 1901, compared with 17% in 2010. The proportion of the population in this age group is projected to rise to 23% by 2035.

More than 320,000 of the 400,000 people living in care homes in England, Wales and Northern Ireland now have dementia or severe memory problems.

Around one in three people over the age of 65 will develop dementia in their lifetime and the number of people with dementia is increasing - 800,000 now will become 950,000 by 2021 and is estimated to double in the next 40 years. So will the current costs of care.

The £23bn figure being quoted for dementia care today is nearly double the figure spent on cancer and three times the sum for heart disease. And all this is in the face of £20bn ’efficiency savings’ needed in NHS spending over the next few years.

Given that 50% of healthcare costs go on people in the last six months of life, and that people are more likely to die the older they get (see chart left) an age structure such as a the UK's is becoming generates massive healthcare costs. 

We have a growing elderly population supported by a smaller and smaller working population – fuelled by elderly people living longer and an epidemic of abortion, infertility and small families.

These demographic changes, together with economic pressure from growing public and personal debt, and increasing pressure for a change in the law to allow euthanasia, produce a toxic cocktail indeed.

Some European politician and economists have been chillingly open about the economic necessity of euthanasia. Jacques Attali, the former president of the European Bank for Reconstruction and Development, said in 1981 in an article in L’Avenir de la vie :

‘As soon as he gets beyond 60-65 years of age, man lives beyond his capacity to produce, and he costs society a lot of money... euthanasia will be one of the essential instruments of our future societies.’ 

Sunday Times journalist Minette Marin in 2011 in an even more apocalyptic analysis called the demographic timebomb ‘an enormous grey elephant in the room’ and argued that euthanasia will become an economic necessity.

'In 1950 there were 7.2 people of working age (20-64) in the OECD member states for every person more than 64 years old. By 1980 the ratio had fallen to 5.1; now it is about 4.1 and by 2050 it will be 2.1….’  

It is abundantly clear that unless something is done to reverse demographic trends, ‘economic necessity’, together with the ‘culture of death’ ideology which is becoming more openly accepted, may well mean that the generation that killed its children through abortion will in turn be killed by its own children through euthanasia.

But the answer is not euthanasia and this makes it even more imperative that we fight hard to combat the two British bills and court cases which threaten to legalise it this year.

The real answer to Britain’s crisis is in our grasp, but it requires a completely different mind-set to that which has led us as a nation, in our reckless pursuit of affluence and personal peace to mortgage our present, bankrupt our futures, and see those who rely on us as a burden rather than a privileged responsibility.

The demographic time-bomb is a challenge but as Christians it should lead us to live more simply, give more, save more, serve more, love more, value those who are dependent, both old and young, more deeply, have more children younger and earlier to reverse the demographic trends and replenish the workforce, and work harder to provide good care for all. 

Over all it should lead us to preach the Gospel more.

Woman refuses $10,000 to abort surrogate baby with special needs

This is a bizarre story from the US state of Connecticut which appeared on CNN today but deserves far wider distribution. 

The original account titled ‘Surrogate offered $10,000 to abort baby’ runs to 3,500 words so I have cut it to 1,400 (see here). The story has now gone viral (see here).

I run the story here without comment, but it demonstrates just how complicated things can become in a world where IVF, commercial surrogacy and abortion come together. 

It is poignant that it has come to light the day before submissions close for Fiona Bruce’s parliamentary inquiry on abortion for disability.

Crystal Kelley, 29, who already had two daughters of her own, hired herself as a commercial surrogate for $22,000 to carry a couple’s two frozen embryos. The couple already had three children and desperately wanted a fourth child, but the mother couldn't conceive.

One embryo survived after implantation but the five month ultrasound scan showed the baby had a cleft lip and palate, a cyst in the brain, and a complex heart abnormality.

The doctors explained the baby would need several heart surgeries after she was born. She would likely survive the pregnancy, but had only about a 25% chance of having a ‘normal life’. The commissioning parents wanted an abortion but Kelley felt that all efforts should be made to 'give the baby a chance'.

The parents tried to convince Kelley to change her mind and said that they had pursued surrogacy in order to minimize the risk of pain and suffering for their baby.

The two sides were at a standoff. The doctor and the genetic counselor offered an amniocentesis in the hope that by analysing the baby's genes, they could learn more about her condition.

Kelley was amenable but the parents felt that the information gained from this testing would not influence their decision to opt for abortion. They were very upset and said that Kelley ‘should try to be God-like and have mercy on the child and let her go’.

Kelly told them that they had chosen her to carry and protect this child, and that was exactly what she was going to do. She told them it wasn't their decision to play God and walked out of the room.

She then received an e-mail from Rita Kron at Surrogacy International telling her that if she chose to have the baby, the couple wouldn't agree to be the baby's legal parents.

Kelley didn't want to be the baby's mother - she'd gotten pregnant to help another family, not to have a child of her own. She was then told that the parents would pay her $10,000 to have an abortion.

The offer tested Kelley's convictions. She'd always been against abortion for religious and moral reasons, but she really needed the money.

Kron took Kelley to lunch. Kelley said, ’She painted a picture of a life of a person who had a child with special needs. She told me how it would be painful, it would be taxing, it would be strenuous and stressful. She told me it would financially drain me, that my children would suffer because of it.’

Kelley made a counter offer. ‘In a weak moment I asked her to tell them that for $15,000 I would consider going forward with the termination’, she said. But as soon as she got in the car to go home, she regretted it.

Kron let Kelley know the parents had refused to pay $15,000 but by that point, it didn't matter to Kelley -- she'd decided against abortion no matter what.

On 22 February 22 2012, six days after the fateful ultrasound, she received a letter from the parents’ lawyer saying that she was obligated to terminate the pregnancy immediately. The lawyer informed her that she had  signed a contract, agreeing to ‘abortion in case of severe fetal abnormality’ and was in breach of contract.

If she did not abort, the parents would sue her to get back the fees they'd already paid her -- around $8,000 -- plus all of the medical expenses and legal fees.

Kelley found a lawyer who was willing to take on her case free of charge who  explained that no matter what the contract said, she couldn't be forced to have an abortion. She wrote back to the couple’s lawyer saying that ‘abortion is off the table and will not be considered under any circumstance’.

The couple’s lawyer then phoned telling Kelley’s lawyer that the parents had changed their minds and now planned to exercise their legal right to take custody of their child -- and then immediately after birth surrender her to the state of Connecticut. She would become a ward of the state.

Kelley couldn't stand the thought of the baby in foster care but was advised by her lawyer that under Connecticut law she'd likely lose in court.

Her only option was to move to another state where, under a different law, where she and not the genetic parents, would be considered the baby's legal mother. That place was 700 miles away.

On 11 April 11, in her seventh month of pregnancy, Kelley and her daughters left for Michigan.

She chose Michigan because of its laws, but also its medicine: she'd been doing research on the baby's condition, and concluded CS Mott Children's Hospital at the University of Michigan had one of the best pediatric heart programs in the country.

When she arrived, she found an inexpensive summer sublet from a University of Michigan student and applied for Michigan Medicaid. She made appointments with a high-risk pregnancy specialist and a pediatric cardiologist.

There was one thing left to do: She had to decide if she would keep the baby. She was a single mother with no job and no permanent place to live, but she'd grown emotionally attached to the life inside her, and some days she wanted to keep her. She finally decided she wasn't the right person to raise the child but through a support group found a couple who were willing to adopt.

But about one month before the baby's due date, the original parents filed in Connecticut Superior Court for parental rights. They wanted to be the legal parents with their names on the birth certificate. The legal papers included a stunning admission: the wife was not the baby's genetic mother -- they'd used an anonymous egg donor.

The case had now become very complicated. The lawyers were still negotiating about who would be the legal parents when the baby was born on 25 June.  Three weeks later, the two sides struck a deal: The father agreed to give up his paternal rights as long as he and his wife could keep in touch with the adoptive family about the baby's health.  Since then, the couple has visited the baby and the father has held her.

The baby's medical problems turned out to be much more extensive than the ultrasound at Hartford Hospital had revealed. She had a birth defect called holoprosencephaly, where the brain fails to completely divide into distinct hemispheres. She also has heterotaxy, which means many of her internal organs, such as her liver and stomach, are in the wrong places. She has at least two spleens, neither of which works properly. Her head is very small, her right ear is misshapen, she has a cleft lip and a cleft palate, and a long list of complex heart defects, among other problems.

‘Baby S’, now nine months old, has a long road in front of her. She's already had one open-heart surgery and surgery on her intestines, and in the next year she'll need one or two more cardiac surgeries in addition to procedures to repair her cleft lip and palate. Later in childhood she'll need surgeries on her jaw and ear and more heart surgeries.

Her adoptive parents, who asked to remain anonymous to protect their family's privacy, know Baby S  might not be with them for long. The cardiac procedures she needs are risky, and her heterotaxy and holoprosencephaly, though mild, carry a risk of early death, according to doctors. If Baby S. does survive, there's a 50% chance she won't be able to walk, talk or use her hands normally.

Her adoptive parents know some people look at her and see a baby born to suffer -- a baby who's suffering could have been prevented with an abortion. But that's not the way they see it. They see a little girl who's defied the odds, who constantly surprises her doctors with what she's able to do -- make eye contact, giggle at her siblings, grab toys, eye strangers warily.

Kelley says, ‘I can't tell you how many people told me that I was bad, that I was wrong, that I should go have an abortion, that I would be damned to hell.’

But in the end, she feels like she did the right thing. ‘No one else was feeling this pregnancy the way that I was. No one else could feel her kicking and moving around inside,’ she said. ‘I knew from the beginning that this little girl had an amazing fighting spirit, and whatever challenges were thrown at her, she would go at them with every ounce of spirit that she could possibly have. No matter what anybody told me, I became her mother.’

Speaking out for truth and justice – a Christian responsibility

Speaking out for truth and justice is just one of many responsibilities we have as Christians. But I suspect it is the one that we most willingly shirk, simply because it can be so costly. 

Being a Christian is costly in many ways. It is costly to live a life of obedience and service, costly to go on loving against the odds, costly to persevere when we are tempted to give up and costly to give generously of our energy, time and money. But when we speak out we pay a cost of a different kind, because speaking out makes us a target for attack.

John the Baptist lost his head for speaking out about vice and corruption – but he did not shrink from confronting individuals in power when it was appropriate to do so. The prophets and apostles were persecuted for what they said, rather than what they did. Jesus himself was crucified for his words, rather than his healing or his miracles.

And yet Christians are often reluctant to risk ridicule, attack or ‘loss of influence’ by putting their heads above the parapet. Karl Marx was particularly disdainful of Christian priorities, ‘You Christians have a vested interest in unjust structures which produce victims to whom then you can pour out your hearts in charity.’ And whilst we would not embrace his communist philosophy or solutions he did have a point. Real concern for the marginalised is evidenced both by charity and by speaking out.

Bishop Dom Header Camara of Recife, Brazil, who lived as a bishop among the poorest of the poor during the Brazilian dictatorship (post 1964), made this observation. ‘When I served the poor they called me a saint, when I asked why they were poor, they called me a communist.’ Camara understood the structural reasons for the deep poverty of so many of his fellow Brazilians. He challenged the obscene wealth of the rich, and the embarrassing linkage of the Church with the powerful in his country.

As Christian doctors we have a responsibility to speak out on behalf of the marginalised, the disempowered and those who have no voice– the poor, elderly or confused, those with head injuries, dementia or strokes, those suffering from chronic or psychiatric illness, the terminally ill, children, unborn children and human embryos.

We need to speak out in everyday conversation, through our NHS trusts and hospitals, through the BMA and Royal Colleges, through government and on the Christian, secular and medical media – both nationally and internationally. And we need to encourage one another to make and create opportunities and remember that we are not alone.

Mordecai’s words to Esther urging her to speak out when her own people were under threat are just as relevant to us today: ‘If you remain silent at this time, relief and deliverance… will arise from another place, but you and your father’s family will perish. And who knows but that you have come to royal position for such a time as this?’(Esther 4:13-14)

Speak up for those who cannot speak for themselves, for the rights of all who are destitute.

Speak up and judge fairly; defend the rights of the poor and needy… If you say, ‘But we knew nothing about this,’ does not he who weighs the heart perceive it? Does not he who guards your life know it? (Proverbs 31:8,9 and 24:12)

The duties of a physician - a Puritan's prescription

Richard Baxter (1615-1691), author of The Saint's Everlasting Rest and The Reformed Pastor, was known as 'an eminent curer of souls'. 

This advice for Christian Physicians (taken from his 1673 Christian Directory) gives interesting insights into the doctor-patient relationship in the 17th century and good guidance for us today.

Baxter did not want to 'intermeddle in the mysteries of (physicians') art' but wanted to tell 'the learned men of this noble profession... what God and conscience will expect from them'. His directives can be summarised as follows:

1. Put the patient first

We are to 'be sure that the saving of men's lives and health' is 'first and chiefly in (our) intention, before any gain or honour of (our) own'. This is the only way to ensure that 'it is God that (we) serve' rather than ourselves.

2. Serve the poor

We are to 'be ready to help the poor as well as the rich; differencing them no further than the public good requireth (us) to do'. Christian service honours the vulnerable.

3. Know your limits

We are to 'adventure not unnecessarily on things beyond (our) skill' but rather, in difficult cases, to be ready to 'persuade (our) patients to use the help of abler physicians'.

4. Depend on God

We are to 'depend on God for our direction and success' by earnestly 'craving his help and blessing in our undertakings'. God is the source of all our ability, knowledge and skill.

5. Prepare for eternity

We are to 'let (our) continual observation of the fragility of the flesh, and man's mortality, make (us) more spiritual than other men, and more industrious in preparing for the life to come'. Death and suffering should produce seriousness and not cynicism in us.

6. Share Christ

We should 'exercise (our) compassion and charity to men's souls, as well as to their bodies' by '(speaking) such words as tend to prepare them'. We are reminded that as doctors we 'have excellent opportunities, if (we) have hearts to take them'.

Fresh warning sounded to UK as euthanasia deaths increase by 25% in Belgium in just one year

Things are moving at a frightening pace in Belgium. 

Further to my recent ten year review in December and report on the twins’ euthanasia case that made international headlines in January Alex Schadenberg has just published the following review on Belgium’s 2012 figures just out. 

I’ve reproduced it here from his blog.

Recent studies concerning the Belgian euthanasia law found that: 32% of the assisted deaths are done without request and 47% of the assisted deaths go unreported in the Flanders region of Belgium. Another recent study found that even though nurses are prohibited from doing euthanasia, that in fact nurses are euthanizing their patients in Belgium. There has never been an attempted prosecution for abuses of the Belgian euthanasia law.

Confirming that euthanasia is out-of-control in Belgium the 2012 euthanasia statistics indicate that there was a 25% increase in the number of assisted deaths in Belgium.

Recent government statistics indicate that the number of reported assisted deaths increased from 1133 in 2011 to 1432 in 2012, representing 2% of all deaths in Belgium. The number of reported assisted deaths inBelgium in 2010 was 954. It is important to note that these statistics do not include the unreported assisted deaths.

The study that found that 32% of the assisted deaths are done without request, indicated that the people who died by euthanasia without request were usually: incompetent, did not have cancer, were over the age of 80, and living in a hospital. The same study indicated that these deaths represented "a vulnerable patient group."

Further to that doctors who admit to not reporting assisted deaths usually do not follow the guidelines of the Belgian law. A recent study found that 73.1 % of the reported assisted deaths followed the guidelines while only 12.3% of the unreported assisted deaths followed the euthanasia guidelines in the Belgian law.

The response by Belgian legislators to the abuses of the euthanasia law is to widen the definitions of the law to include children with disabilities and people with dementia. By widening the definitions in the law, fewer doctors will be abusing the law. It is also feared that the proposed changes to the euthanasia law may effect the freedom of conscience for health care workers in Belgium.

The proposed changes to the Belgium euthanasia law, combined with the lack of attempted prosecutions for abusing the Belgium euthanasia law, in conjunction with the massive increases in the number of euthanasia deaths, indicates that a slippery slope, also known as incremental extensions, has occurred in Belgium.

If you think that is bad enough, consider the fact that a woman with anorexia nervosarecently died by euthanasia, a man wrote that his depressed mother died by euthanasia, belgian twins who were born deaf were euthanized out of fear of blindness, and Belgium is experimenting with euthanasia/organ donation.

A recent 10 year report of the Belgian euthanasia law that was done by the European Institute of Bioethics found:

• A written declaration of a desire for euthanasia is required, either by the patient or a surrogate. However, the Commission often waives this obligation. 

• Initially patients had to have a life‐threatening and incurable illness. Nowadays, the illness need only be serious and debilitating. 

• The pain is supposed to be unbearable, unremitting and unrelievable. However, a patient can refuse medication to relieve the pain. The Commission, says the IEB, has ‘decided not to carry out its mission ‐ so central to the law ‐ of verifying the unbearable and unrelievable nature of the suffering’. 

• The ambit of ‘psychological suffering’ is ever-expanding. 

• Doctor-assisted suicide is not authorised by 2002 legislation. However, the Commission has ignored this and regularly signs off on such cases. 

• If a patient is to be euthanised at home, the doctor himself is supposed to fetch the lethal medications at a pharmacy from a registered pharmacist and to return left-over drugs. In practice, family members often get the drugs; unqualified personnel hand them over; and no checks have ever been made about surplus drugs.’ 

To learn more about the current practice and abuses of the Belgian and Netherlands euthanasia laws, by ordering the book, by Alex Schadenberg ($20 includes shipping): Exposing Vulnerable People to Euthanasia and Assisted Suicide. Exposing Vulnerable People will prepare you to oppose the legalization of euthanasia and assisted suicide.

The Euthanasia Prevention Coalition (EPC) hopes that Belgian legislators will open their eyes to the reality of their euthanasia experiment and reverse their direction. If not, we hope that the rest of the world will recognize how dangerous legalized euthanasia and assisted suicide is and how it threatens the lives of their citizens.

‘Amour’ is a dangerously seductive piece of pro-euthanasia propaganda

Margaret Morganroth Gullette (pictured) is Resident Scholar of the Women's Studies Research Center, Brandeis University and author of ‘Agewise: Fighting the New Ageism in America’.

She has just written a brilliant review of the award winning film ‘Amour’ for the Guardian Film blog which is well worth reading.

Amour (literally, ‘Love’) is a 2012 French-language film written and directed by Michael Haneke which won the Palme d’Or (top prize) at the 2012 Cannes Film Festival and is now screening in Britain. 

The narrative focuses on an elderly couple, Anne and Georges, retired music teachers with a daughter living abroad. Anne suffers a turn, from which she recovers and is then found to have a blocked carotid artery, but the surgery goes wrong leaving her partially paralysed and confined to a wheelchair. 

She makes Georges promise not to send her back to the hospital or go into a nursing home but suffers a further stroke and her condition worsens. 

Georges continues to look after Anne, despite the strain it puts on him to do so, until one day he grabs the pillow on the bed and smothers her with it.

The narrative is powerful in portraying the deep bond between the characters and understandably evokes a huge amount of sympathy for them. This naturally leads the viewer to be drawn to see Georges’ ending of his wife’s life as an act of love and compassion rather than one of desperation. 

Gullette argues, ‘For a film in which a husband murders his wife, Amour has been shown a lot of love. It was nominated for five Oscars, including best actress for Emmanuelle Riva, and best foreign language film, which it won.’

‘But the manner in which the movie ends, and the apparent inevitability of such an ending,’ she says,  ‘have gone largely unexamined’.

She then artfully probes and exposes the films unstated presuppositions that, by going unchallenged, subtly prepare the viewer to embrace euthanasia uncritically as a solution to irreversible disability:

‘One of the implicit convictions of the film is that a carer – even one as assiduous as Jean-Louis Trintignant's Georges – will crack under the strain of caring for a stroke victim… yet the circumstances shown in Amour are highly unusual. Money is no object for this couple. The carer has no pressing health issues of his own. He is also a man. And, though highly educated, he is a man who apparently has never received any advice about caregiving.’

This set of circumstances, she argues, is rather contrived:

‘ Carers are now advised to arrange respite care: to get out, eat properly, enjoy a social life. It's understood that their own health and mental wellbeing is at stake. As well as this, Georges could easily have secured more help from other agencies…  a daughter better educated about disability might have said words of love to her mother, and persuaded her – while it was still possible – to go out for tea, out in her wheelchair, to visit a friend. The family doctor, who makes house calls, could certainly have provided adequate pain medication for Anne; morphine could have eased her passing. Georges had more compassionate alternatives available to him than smothering his wife with a pillow.’

Gullette makes the point that the ’film's largely adulatory reception has implications for people with no knowledge of living with disability’ and ‘raises cultural risks in a western world that is already ageist, and in which stretched medical resources are meted out to older patients much less generously than to the young’.

The film is constructed in such a way that ‘it becomes hard to disagree with Georges' masochistic choices, or even notice that he has broken down’, whereas the reality is that ‘many seriously ill people find the “morbid phase” of their lives well worth prolonging’.

By presenting ‘a nonconsensual termination of life as a solution for the carer: it justifies euthanasia’ and in the fact that it has been ‘ so widely acclaimed while remaining so ill-examined’ is,  she concludes, ‘a dangerous thing’.

‘Amour’, as I previously argued, is a dangerously seductive piece of pro-euthanasia propaganda which will help fuel and justify elder abuse and will further erode the public conscience.

I have been particularly struck by its strong similarity with another made in Europe just over 70 years ago. 

Ich klage an (Eng: I Accuse) is a 1941 film, directed by Wolfgang Liebeneiner, which depicts a woman with multiple sclerosis who asks her husband, a doctor, to relieve her of her suffering permanently. He agrees to give her a lethal injection of morphine while his friend (who is also a doctor) plays tranquil music on the piano. 

The husband is put on trial, where arguments are put forth that prolonging life is sometimes contrary to nature, and that death is a right as well as a duty. It culminates in the husband's declaration that he is accusing them of cruelty for trying to prevent such death. 

Ich klage an was actually commissioned by Goebbels at the suggestion of Karl Brandt to make the public more supportive of the Reich's T4 euthanasia program, and presented simultaneously with the practice of euthanasia in Nazi Germany.

Along with similar propaganda films it greatly influenced German public opinion, and it is therefore perhaps not surprising, then, that the first phase of the Nazi euthanasia program (titled Operation T4) actually began with parental requests for the ‘merciful deaths’ of their severely disabled or ill children.

As they say, ‘the rest is history’. 

The film was banned by Allied powers after the war.

Our current generation sadly is a long way from possessing the same courage or powers of discernment.