A Plea to Legalize 'Death with Dignity' - Based on My Parents' Own Experience

As Canada revisits a ban on doctor-assisted suicide, I think of my mom Pat, who died in needless pain

Pat and Bill Tieleman in July 2008 - Janice Porteus photo

Bill Tieleman’s 24 Hours Vancouver / The Tyee column

Tuesday January 21, 2014 

By Bill Tieleman

"It doesn't make any sense that it's legal for me to commit suicide, but it's illegal for someone to help me to die at peace, without pain, in the comfort of my home, with family and friends surrounding me."

- Gloria Taylor, plaintiff

Mother's Day will always be difficult for our family, because it's the day my mom started coughing up blood and was rushed by ambulance to the hospital.

As I looked in her eyes before the paramedics arrived, we both wordlessly knew that she would never again set foot in her cozy apartment filled with the treasures of a rich life.

Pat Tieleman died three weeks later of lung cancer. And at the end, she needlessly died in pain -- because of an unjust law she opposed.

I applaud the B.C. Civil Liberties Association (BCCLA) for taking on that law, which stops doctors from helping suffering, terminally ill patients leave this world with the aid of a merciful dose of drugs.

The Supreme Court of Canada last week agreed to hear an appeal of a lower court ruling that upheld a ban on physician-assisted suicide.

The B.C. Appeal Court split decision overturned an eloquent, well-researched and compassionate decision by B.C. Supreme Court Justice Lynn Smith, saying that the right to die with dignity is protected by Canada's Charter of Rights and Freedoms.

Gloria Taylor was one of the BCCLA plaintiffs, a brave woman suffering from Amyotrophic lateral sclerosis (ALS) -- also known as Lou Gehrig's Disease -- that cruelly paralyzes the body and kills two to three Canadians every day.

When she could no longer deal with the pain and agony of terminal illness, Taylor wanted the right to die on her own terms. She won a personal exemption to do so through Smith's decision, but died of other causes before she could exercise it.

But thanks to her, Canada's highest court will rule again on physician-assisted suicide, revisiting issues narrowly decided in the famous case of Sue Rodriguez 20 years ago.

Witnessing death without dignity

My mom's death on May 26, 2010 convinced me overwhelmingly that the ban on physician-assisted suicide is unjust.

Pat Tieleman was a registered nurse who worked with the elderly for part of her career. She and my father, Harry, always believed that individuals should have the right to decide when the suffering of their terminal illness should stop, as well as the right to a doctor to help ease the inevitable end.

Sadly, my father also died in pain. His life ended after a battle with Alzheimer's in 2000.

In both cases I watched my parents' disease-ravaged bodies convulsively shut down for hours before death came. It was extremely difficult to witness, and in my mom's case I insisted a nurse administer additional morphine.

The medical team at Nanaimo Regional General Hospital's palliative care unit was excellent and compassionate, and it was not their fault a law they must obey is so wrong.

Gov't resists public opinion

Other countries including the Netherlands -- ironically my father's homeland -- Belgium, and our American neighbours in Washington, Oregon and Vermont States have done the right thing and carefully legislated rules that allow physician-assisted suicide for the terminally ill.

And Canadians are overwhelmingly in favour of the same, in public opinion poll after poll.

An Environics survey released in Oct. 2013 found that 71 per cent of those polled supported the right of "a terminally ill or severely disabled person to end their life," while 19 per cent disapproved.

But both the federal and British Columbia governments disagree, fighting to overturn the original Gloria Taylor decision and now defending the ban on euthanasia in the Supreme Court of Canada. The court agreed to hear the case but rejected a request for an expedited hearing.

That likely means no decision until 2015 -- far too late for many terminally ill Canadians.

It's time Canadians spoke out against this cruel law that imposes suffering on those already dying in pain. It could and should be changed by Parliament before the hearing.

No one should face death the way my parents did. If you agree, tell your Member of Parliament and B.C. Member of the Legislative Assembly that outlawing mercy is wrong.

What I say to doubters

Not everyone agrees with me. I recently debated euthanasia with Barbara Kay of the National Post on CBC Radio's The 180 with host Jim Brown.

Kay stated that contrary to my parents' experience, her parents died peacefully with appropriate medical care and pain management, and argued that physician-assisted suicide is unnecessary.

I'm glad for her and anyone else whose loved ones pass without pain. But far too many people do not, and their right to end their life free of suffering is what's at stake.

Those who worry about euthanasia becoming a widespread practice to get rid of the elderly, people with disabilities and others simply for "convenience" should look at the reports from places where physician-assisted suicide is legal.

Washington State's annual Death With Dignity Act report for 2012 -- the state legalized the practice in 2009 after a voter initiative passed -- shows that relatively few people need to take this option.

In 2012, just 121 participants requested a lethal dose of medication. The legislation requires a doctor to write a prescription after determining their patient has less than six months to live.

Of the 104 patients who died in 2012, 73 per cent suffered from cancer and another 10 per cent with neurodegenerative disease, including ALS. The remaining 17 per cent had other illnesses, including heart and respiratory disease.

At the end

Some very prominent people support physician-assisted suicide, including renowned theoretical physicist and author professor Stephen Hawking, who has ALS.

"I think those who have a terminal illness and are in great pain should have the right to choose to end their lives, and those who help them should be free from prosecution," Hawking told the BBC.

Hawking is not alone. Prominent doctor Donald Low, who was microbiologist in chief at Toronto's Mount Sinai Hospital and leading medical spokesperson during the 2003 SARS crisis, made a video plea for physician-assisted suicide days before he died of terminal brain cancer on Sept. 18, 2013.

"I know I'm going to die, what worries me is how I'm going to die," the 68-year-old Low said in the moving video.

"What the end is going to look like, that's what's bothering me the most," he said, referring to dying without assistance.

He outlined what happens elsewhere but not in Canada: "They give you a very simple way out. You drink a cocktail and you fall asleep, and you do this in the presence of your family. In countries where it's legal, it's quite easy to do. In countries where it's not legal, it's pretty well impossible."

It's time to listen to people like Hawking and Low, as well as ordinary Canadians like Pat and Harry Tieleman, and demand that legislators allow the terminally ill the death with dignity they deserve.

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Canada Day BC Legislature bomb plot suspects appear in BC Supreme Court - and I can't tell you almost anything about it!

Alleged pressure-cooker bombs and materials in BC Legislature plot - RCMP photo handout

Alleged BC Legislature bomb plot conspirators John Nuttall and Amanda Korody appeared in BC Supreme Court on Thursday morning for a trial management conference - and that's almost all I can tell you because of a sweeping publication ban covering all pre-trial motions and more.

On Friday I confirmed with a Court criminal registry official that the publication ban issued December 17, 2013 applies to all discussions of pre-trial motions or possible motions that were raised in Court and pretty much everything else to do with this case.

As readers here know, I have raised serious questions about RCMP conduct in this alleged case of domestic terrorism.  

I have asked how two recovering addicts on methadone in a basement apartment in Surrey could possibly mastermind a sophisticated plan that allegedly saw three pressure-cooker bombs - disarmed without their knowledge - placed at the BC Legislature to explode on Canada Day as thousands of people gathered for celebrations.

But as the Supreme Court Publication Ban states:

"No details of any Pre-Trial conferences and other appearances may be published in terms of anything that will disclose the nature of any proposed evidence or any pre-trial applications. What can be reported is the dates of any hearings set or any next appearance. For more details about the specific nature of the publication ban, please contact the Criminal Registry." 

Outside the Court, lawyer Mark Jette - representing Korody - briefly explained to myself and other media attending that because a jury trial is being requested by the defence, the publication ban is intended to ensure the jury pool is not "tainted" by information being disclosed and potential jurors being influenced by those stories.

That did not happen in the David Basi-Bob Virk / BC Legislature Raid trial that saw the two former BC Liberal Ministerial Aides charged with breach of trust and fraud related to passing on confidential information about the $1 billion BC Rail privatization because the accused elected for a trial by judge only - and the courts feel a judge can insulate themselves from reading or being affected by media coverage of pre-trial procedures.

If not, almost all of my reporting and that of others on Basi-Virk would have also been impossible due to the publication ban.  

Bill Tieleman outside BC Supreme Court

The only media coverage would then have been at the start of the short-lived trial in 2010 - and the public would have had no idea what happened for the roughly 5 years prior in lengthy and acrimonious court hearing.

So without breaching the publication ban and bringing the wrath of the Court on my head, I can only tell you that Nuttall and Korody were again very pleased to see each other; that Nuttall was wearing new dark framed stylish glasses on his closed shaved head, wearing a red-orange t-shirt and pants.  

Nuttall is powerfully built and appears to be about 6 feet 4 inches tall.  He also smiled at those attending the hearing but did not appear to know anyone there.

Korody was in green with short pigtails.  Sheriffs cautioned them from touching each other as the pair sat just 3 feet apart in the prisoners' dock.

I can report that tentative Court dates have been set for April 7 to 11; June 9-12 and June 16-20, along with a possible Court date February 28.  

Nuttall was represented in Court by Marilyn Sandford, a veteran criminal lawyer who has previously defended Robert William "Willy" Pickton with law firm partner Peter Ritchie and other high profile cases.  Sandford, who is working with Nuttall's original lawyer Tom Morino, declined all comment on the case outside court.

Federal Crown prosecutor Martha Devlin also appeared before Justice Terence Schultes in BC Supreme Court. 

And that's it - at least until the trial begins, when evidence presented in open court will be reportable - but for now, you can only surmise what happened.

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The future for newspapers is digital or dismal - how Internet advertising is forcing a massive transition

Farewell Kamloops Daily News, Hello Digital Future 

Bill Tieleman at The Ubyssey student newspaper, UBC, circa 1979

Bill Tieleman's 24 Hours Vancouver / The Tyee column

Tuesday January 14, 2014

By Bill Tieleman 

"Our goal is to keep our papers loaded with content of interest to our readers and to be paid appropriately by those who find us useful, whether the product they view is in their hands or on the Internet." 

- Billionaire Warren Buffett, March 1, 2013

Saturday's untimely death of the 80-year-old Kamloops Daily News is yet another reminder to those who love newspapers that the future is either digital or dismal.

Newspapers are hemorrhaging ad revenue to Internet advertising in stunning amounts that no transfusion can stem. It requires radical surgery to save the patient.

But when brilliant investors like Buffett are buying -- not selling -- newspapers, and committing to content in print and online, then hope is not lost.

Unfortunately, the Kamloops Daily News didn't make it to the operating table. The sudden shutdown by owner Glacier Media and loss of 46 jobs was the result of insufficient advertising to cover its costs, said publisher Tim Shoults.

Unifor Local 2000 President Mike Bocking declined to comment to The Tyee last week, saying the union was in talks with the company on behalf of its members.

Internet advertising's steep rise

The transition from newspaper to Internet advertising is truly stunning.

In Canada in 2012, Internet advertising was $3 billion compared to daily newspaper ad revenue at just over $2 billion, according to Interactive Advertising Bureau figures reported in September 2013.

Internet advertising, including on mobile phones, was only worth $237 million in 2003 but has now captured 27.5 per cent of all major media advertising. It's only $382 million behind television ads at $3.5 billion and 31 per cent.

But Canadian television ad revenue shrunk by two per cent in 2012 while Internet ads jumped 15 per cent, which is remarkably the smallest jump since 2003. The earlier years saw growth rates of 29 per cent to 60 per cent annually, rising from $237 million in 2003 to $3.085 billion in 2012.

Fortunately, there are many reasons newspapers and their reporters, columnists and editors will still thrive in the years ahead.

Many newspapers -- including 24 Hours Vancouver, where I write -- have a significant online presence and significant online advertising.

And since 2003, The Tyee has been one of the new breed of online "newspapers" or "magazines" that produce unique news, opinion, arts and other copy every day without ever being in print.

The Tyee's nearly 10 million pageviews in the last year make it effectively one of British Columbia's largest daily publications -- and with reader support, it may become a national entity in the near future.

What's more, The Tyee currently has 28,000 Twitter followers, 22,000 subscribers getting headlines by email, 4,000 Facebook fans and more than 19,000 registered commenters.

'TBD'

That fact won't be very remarkable in the future. After all, no less than Arthur Sulzberger Jr., publisher of the New York Times, said in 2010 that: "We will stop printing the New York Times sometime in the future, date TBD."

That kind of thinking is why the San Francisco Chronicle -- one of the oldest big city newspapers left in the United States -- announced this month that all its staff will be attending a digital and social media "boot camp" to reduce circulation loss and remain relevant.

"Failure only means we all lose our jobs -- and the Bay Area loses its number one news source. Failure to reach our goals -- both individual and team -- is simply not something we can tolerate, and we won't," says Audrey Cooper, 36, and the first female managing editor in the paper's 148-year history.

I agree with her urgency, especially after the loss of the Kamloops Daily News.

But I hope newspapers continue to literally publish, as well as online, because there is an irreplaceable pleasure in a physical newspaper, even in getting ink on your fingers as you turn the pages.

Ode to newsprint

I can't remember when I didn't love newspapers. As a young boy I read them, and at about 12 I delivered the Vancouver Sun in Abbotsford every afternoon, even through winter blizzards.

Taking the copper baling wire off my bundle and first reading part of the paper before delivering it gave me a lifelong thrill that comes from cracking open each fresh newspaper.

As soon as I arrived at the University of British Columbia at age 18 I joined The Ubyssey student newspaper, a venerable publication that boasted a stellar cast of then-budding journalists, photographers, cartoonists, and editors authors who went on to long careers in the business, many working today in major media.

Imagine working on the paper that had helped launch famous journalists and authors like Pierre Berton, Joe Schlesinger, and Allan Fotheringham on their way to newspaper and literary stardom.

But the links to the past were still present then at The Ubyssey -- the classified ads in the mid-1970s were set in hot lead type at the venerable and now deceased College Printers on Maple Street in Kitsilano then, a living reminder of the golden days of newspapers.

I watched newspapers go from hot type to galley paste-up with X-Acto knives, line tapes and rollers to full computer layouts with no one touching the paper 'til it came off the press.

At 21 back in 1978, I also became a part-time reporter at the Vancouver Sun, wandering wide-eyed into a hallowed newsroom where you could see legends like Denny Boyd, Marjorie Nichols, Patrick Nagle, Fotheringham and a unique collection of characters, the likes of which I've never since encountered.

This was still the time of whisky bottles in the drawer and many drinks in the Press Club after work -- or even during.

But it was also the dawn of the computer age, and the typewriter jockeys were being dragged kicking and screaming into what became a very unsettling future that continues to be fraught with peril decades later.

Dimmed light

Sadly, today's Sun newsroom is a model of decorum -- and dullness -- by comparison.

Newspapers are ultimately no different than other businesses in that there are no guarantees for succeeding indefinitely while technology changes -- think about Blockbuster video or even Blackberry cell phones -- but if you have to make bets, it's hard to beat Buffett's optimistic advice on newspapers.

"Papers delivering comprehensive and reliable information to tightly-bound communities and having a sensible Internet strategy will remain viable for a long time," Buffet told his Berkshire Hathaway investors. "We do not believe that success will come from cutting either the news content or frequency of publication."

We may mourn more individual losses, but the daily newspaper that adapts to changing times and provides online content should be around for centuries to come.

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Jack the Tax on Tobacco, but Make It Prescription-Only Too – a Controlled Substance

Should prison time and fines by the penalty for possession of poisonous tobacco without a prescription for nicotine addicts? 

The poisonous, cancerous impact of smoking tobacco

Bill Tieleman’s 24 Hours Vancouver / The Tyee column

Tuesday January 7, 2014

By Bill Tieleman

"Smoking is the only honourable form of suicide."

- Kurt Vonnegut

Should tobacco be a controlled substance, with prison time and fines for those caught illegally possessing it without a doctor's prescription?

That's one proposal from an Oregon legislator to deal with the devastating scourge of cancer and other illnesses caused by cigarettes.

Last week, a Canadian-led medical study proposed tripling the tax on tobacco in order to prevent the 200 million premature deaths this century caused by smoking.

But making tobacco a prescription-only controlled drug is an even better idea to start eliminating the deadly substance entirely.

A public health silver bullet

The tripling of cigarette taxes, proposed in the prestigious New England Journal of Medicine by the Centre for Global Health Research at Toronto's St. Michael's Hospital, argues convincingly that dramatically increasing the tax deeply reduces consumption.

"Our evidence suggests that, even in Canada, a big increase in the federal excise tax could get about one million smokers to quit and save about 5,000 lives a year," says study leader Dr. Prabhat Jha.

"There are no magic bullets in public health. But tobacco taxes are as close to a silver bullet as you can think of," Jha told CBC News.

France and South Africa both cut smoking rates in half in less than 15 years by increasing the tax that much.

In Canada, the two provinces with the lowest cigarette taxes by far -- Quebec and Ontario -- have the most smokers and lowest tax revenue per smoker, according to a fact sheet by Physicians for a Smoke-Free Canada.

But a more effective way to save lives and reduce the misery caused by tobacco-related cancer and other illnesses is to make tobacco a controlled substance, only available with a doctor's prescription to current nicotine addicts.

No more sales of cigarettes, cigars, pipes, or chewing tobacco in stores, bars or anywhere else.

Far fetched?

Sound far fetched? Not really.

Portland, Oregon State Representative Mitch Greenlick has put forward a bill that would make tobacco a controlled substance, with possession of more than 0.1 milligrams punishable by a year in prison or a $6,250 fine -- unless the user has a doctor's prescription.

Of course, right-wing zealots like radio host Rush Limbaugh immediately denounced Greenlick's bill.

"These are the liberals. We've been nice. We've tried every which way we know to get you to stop smoking, and you won't. You keep smoking. And so now you're going to need a prescription for it. If you don't have a prescription, if this bill passes in Oregon, you go to jail for a year if you're caught with a pack of cigarettes. Because you can't be trusted to do the right thing," Limbaugh wrote.

Greenlick isn't fazed by rants from Limbaugh and others. In a newsletter last February, he wrote: "I have received hundreds of emails on the topic, most providing a coherent argument, such as 'You suck, you liberal moron.'"

Iceland is also considering making tobacco a prescription-only restricted drug. The country's former health minister and doctors are promoting a proposal similar to Greenlick's that would make cigarettes only available in pharmacies, with the cost increased by 10 per cent every year. Eventually cigarettes would be prescription-only, with the cost reduced for those too addicted to quit.

In the meantime, Iceland increased its tobacco tax by 20 per cent in 2012 and saw cigarette sales drop 10 per cent through Sept. 2013.

No more excuses

For those who think this way of taking on tobacco addiction is too extreme, here's my reply: I watched my mom Pat die painfully from lung cancer in 2010, more than 20 years after she had quit smoking.

She took up cigarettes -- despite being a registered nurse -- in her earlier days, because it wasn't known how toxic smoking was.

Today, we have no such excuse. It's time to save lives by making tobacco prescription-only and start jacking the tax.

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