British Section of the World Federation of Doctors Who Respect Human Life

SIR - Professor Stuart Campbell (Features, April 30) says he does not foresee an increase in abortions as a result of the proposal to abolish the requirement for two doctors' signatures.

In 1967, David Steel did not foresee that his Bill legislating for "hard cases" would lead to an increase in abortions.

More than six million mainly social abortions later, Prof Campbell advocates making abortion even easier to obtain, with the support of David Steel.

Ann Farmer, Woodford Green, Essex

By Nic Fleming, Science Correspondent

Scientists have created stem cells from skin taken from patients with seven different diseases, raising hopes for potential new treatments.

The breakthrough will allow researchers to gain insights into the cause of illnesses including Type 1 diabetes, Down's syndrome and Huntington's disease.

Last November researchers in Japan and America developed induced pluripotent stem (IPS) cells, which can apparently transform into any of the 200 or so different cells found in the body.

Dr Willy Lensch and colleagues at the Harvard Medical School have used this technique to develop IPS cell lines from seven diseases.

Dr Lensch said: "This will help us to understand the environmental causes that push these undefined cells to become diseases.

A team at the Whitehead Institute for Biomedical Research in Massachusetts also reported that they had seen improvements in rodents with Parkinson's disease using reprogrammed IPS cells.

Rudolf Jaenisch, who led the research, said: "This experiment shows that in-vitro reprogrammed cells can in principle be used to treat Parkinson's disease."

Sir, I will happily respond to David Aaronovitch’s challenge (Comment, March 25) when he will answer me these questions.

First, does he think that there is any difference between humans and other animals, and does this difference matter? Secondly, what makes him think he can reduce the function of religion (which Jews, Christians and Muslims have traditionally seen as being about public truth) to the provision of “comfort and companionship”? Thirdly, where in St Paul’s letters to the Corinthians — or anywhere else for that matter — does the Apostle attack the “sinful mixing” which Mr Aaronovitch seems to think is the sole subject matter of Leviticus?

The Right Rev Tom Wright

Bishop of Durham

Sir, Once the sanctity of human life is abandoned in favour of utilitarian solutions, however admirable, justifications will in time be found for just about anything. Of course, we will always have the good old liberal conscience to restrain us. But evidence demonstrates how easily the liberal conscience deceives itself.

Jonathan Luxmoore

Religious News, Warsaw

Sir, Some journalists and politicians may have missed the point regarding the Catholic Church’s position in relation to hybrid embryos. Even if scientific advances showed that this research could lead to a cure for every known disease, Catholics and many others would still be opposed. This is because the research involves the interference and destruction of human life at an early stage, with potentially catastrophic consequences. In the same way that it is not in the remit of scientists to pronounce on metaphysical issues such as the cause of the material Universe and the “big bang”, scientific advances cannot make experimentation on human embryos morally acceptable. This research has rightly been banned in the majority of other European countries with good reason; to belittle the Catholic Church’s stance on this serious issue is unfair and dangerous.

Dermott O’Gorman

Wallington, Surrey

Sir, It should not be forgotten that the present view about the human embryo was not always held by the Catholic Church. In the Middle Ages its status was argued over seriously, and Thomas Aquinas himself held that for the first few months of life it was, in Aristotle’s classification, only a vegetable. Without wishing to support that, I suggest that the view that at the very first stage of conception the embryo is fully human is only a dogma.

Pamela Huby

Harlington, Beds

Sir, I have been greatly disappointed to learn that the Prime Minister has pledged a free vote on elements of the Human Fertilisation and Embryology Bill. This is not because such an issue does not warrant such freedoms of conscience. Maintaining unquestionable ethical standards is vital to any new statute. The reason is that, once again, a religious organisation has successfully managed to introduce its own moral dimension to an issue that will affect the lives of millions of people regardless of their individual beliefs.

Any religious organisation is entitled to air its views and some, if not many, may choose to listen. Some adherents may even choose not to avail themselves of the derived benefits of such scientific programmes. Others, however, will choose to benefit, and no religious group has the right to interfere with freedom of choice. Once again, religion has provided us with a compelling reason for keeping it thoroughly divorced from matters of state.

Dr Stephen Merron

Wolverhampton

Sir, Professor Colin Blakemore (letter, March 24) is right to draw attention to the plight of patients with incurable diseases, but is mistaken in his belief that embryo stem-cell research is the way forward. Despite the huge sums of money that the Government has spent so far in supporting this research, to date it has yielded nothing of significant therapeutic value.

On the other hand, adult stem-cell research is actually yielding promise along several lines of research into serious diseases. Professor Shinya Yamanaka and his team at Kyoto University have now found a way of programming adult stem cells to have the same properties as embryo stem cells. Similar work is going on by Professor Boris Reizis and team at Columbia University Medical Centre, New York, and by Professor Robert Blelloch and colleagues in California. Professor Ian Wilmut, who led the team that created Dolly the sheep, has publicly backed Professor Yamanaka’s work (indicating that cloning is no longer essential). The adult stem-cell route is now being researched for use in a vast range of diseases including heart disease, leukaemias, Parkinson’s disease and motor neuron disease.

Dr Matthew Thalanany

Colchester

Sir, Many opponents of this Bill are concerned less by the issues at hand and more by the failure to make legislation stick. Rabbi Jonathan Romain (letter, March 24) is right that there are many aspects that could be justified, but we know that, like the the gun crime laws, legislation will not be enforced. The Bill must be rejected until we have a legislature that can be trusted to ensure effective implementation of the safeguards he mentions.

G. Sasse

Broughton Astley, Leics

Read the original here.

The news that Gordon Brown has thrown his weight behind a move to register everyone automatically as an organ donor unless they opt out has all the hallmarks of a major spin operation.

The Sunday newspapers ran prominent stories about the proposal, which is piggy-backing on tomorrow's government review aimed at boosting the number of organs donated for transplant.

Mr Brown himself penned an article arguing that voluntary organ donation should be replaced by an opt-out system.

Similarly, the BBC had clearly been primed with information to promote the story to pride of place. If this is supposed to assist Mr Brown's new year campaign to restore his waning political fortunes, it's a pretty rum way of going about it.

To begin with, the idea is not even new. England's Chief Medical Officer, Sir Liam Donaldson, first proposed such an opt-out system last summer.

Maybe Mr Brown thinks he can humanise his image by capitalising on the distress of people suffering or dying for want of a transplantable organ.

Undoubtedly, the impulse to give people the gift of life after one's own death is a noble one.

But if Mr Brown really imagines that he will win popular acclaim by saying that the state will whip out people's hearts or kidneys without their consent, his advisers undoubtedly need a brain transplant. For the implications are truly terrifying.

There is no more fundamental human right than control over our own bodies and what is done to them, both in life and death. The inescapable implication of a donor opt-out is that we no longer possess such control.

The presumption instead is that the state controls our bodies and can do what it likes with them after it declares us to be dead.

If the medical profession alone were to suggest this - as its leadership most lamentably is doing - it would be alarmingly coercive.

For the Government to be backing it, however, deepens coercion into something even more threatening. Volunteering to donate your organs is one thing.

Making it compulsory unless you opt out transforms an act of altruism into state oppression.

Sir Liam attempts to defuse public hostility by saying soothingly that opting out would be an 'inalienable right'.

On the contrary - being forced to opt out of automatic donation destroys our inalienable right to control what happens to us.

It is a weaselly, back-door means of trapping people into having something done to them when they are declared to be dead which may be unacceptable to them in life. Opting out requires an effort.

Many will simply forget to do so. That is the cynical calculation behind the scheme. In addition, what will happen - as inevitably as night follows day - is that people will be put under great pressure not to opt out.

Patients who have done so may well be discriminated against.

Chillingly, hospitals are to be rated according to the number of dead patients they "convert" into donors.

It is hard to imagine a more sinister incentive for the wholesale abuse of vulnerable patients.

There is, however, a yet more fundamental objection to the opt-out proposal. This is the serious doubt whether people whose organs are harvested are indeed dead.

All the evidence suggests that organs are harvested not from the dead but from the dying. In other words, at the time the organs are removed the patients are still alive.

This is because, in these cases, the criterion doctors use to decide that someone has died is the death of the brain stem. This is said to be "brain death", and thus death itself.

However, it does not follow at all that the rest of the brain has also ceased to function. Yet no tests are carried out on other parts of the brain to establish whether all activity there has actually ceased or not.

As a result, people are declared dead while their heart is still beating unassisted and blood is still circulating round the body. Most of us would think such patients are not dead but very much alive.

Indeed former transplant doctors, who became so horrified by the implications of what they were doing that they abandoned the practice, say that organs for transplant are only viable if the donor is still alive - since when the body is really dead the organs become useless to anyone else, as they die too.

Brain stem death is in fact merely a convenient definition that allows surgeons to remove organs from a living body while they are still being nourished by its blood supply.

Such observations provoke outrage in transplant doctors who claim there is no basis for such "scaremongering", which will cause more people to die because potential organ donors will be unreasonably frightened off. But among such doctors, their own behaviour gives the game away.

Some give "brain stem dead" patients a general anaesthetic before removing their organs. But whoever heard of anaesthetising a corpse?

The reason they do it is because of a sharp rise in blood pressure during the organ removal.

Some doctors claim they administer the anaesthetic simply because it stops the excessive bleeding caused by this blood pressure rise.

But a rise in blood pressure during any surgical procedure is an indication that the body is experiencing physical distress.

Dr David Hill, a retired anaesthetist who has long expressed deep concern about organ donation, has written that if patients react in similar fashion when their organs are being removed, the most logical conclusion is that they are not in fact dead.

In recent years, "brain stem death" has been increasingly questioned as we realise how little we know about the brain.

Doctors are discovering that, among patients in a persistent vegetative state whose brains are presumed to have stopped functioning, there is in fact a large amount of brain activity.

The implications for what patients presumed to be "brain dead" might be experiencing are simply unknowable.

More and more experts have been expressing increasing concern about brain stem death and organ donation.

Three doctors wrote in a medical journal last year that declaring patients dead for the purposes of harvesting their organs was in effect a fiction, and that prospective organ donors were not being told the truth.

And a professor of philosophy and expert in medical ethics, Michael Potts, has drawn the horrifying conclusion: "Since the patient is not truly dead until his or her organs are removed, it is the process of organ donation itself that causes the donor's death."

In Britain, however, the medical establishment backs organ donation and the proposed opt-out scheme.

This is because the British Medical Association and the medical royal colleges long ago lost their own ethical plot.

Renouncing the core medical precept, "First do no harm", they have come to believe instead in the amoral doctrine that the end justifies the means.

As a result, from abortion, embryo research and cloning to starving and dehydrating "dispensable" patients to death, respect for human life has been replaced by the belief that individual lives are merely instrumental to the creation of the happiness of the greatest number.

This way lies the most alarming infringement of human rights and a descent into tyranny.

A system the public believes embodies the highest form of altruism rests instead on deception and unlawful killing. Far from being forced into an automatic/opt- out donation system, people should finally be told the truth.

February 7, 2008
Volume 11, Number 8
http://c-fam.org/

(NEW YORK — C-FAM) In recent years abortion advocates have watched dismayed as hundreds of millions of government dollars have flowed into the fight against HIV-AIDS because they have felt the money has been taken in part from them. Abortion advocates are taking steps in Washington DC this week to right this perceived wrong by connecting HIV-AIDS money to the spread of abortion.

The US Congress began consideration this week to reauthorize the President’s Emergency Plan for AIDS Relief, a $50 billion pot of money. The draft bill, sponsored by Tom Lantos (D-CA) guts funding for abstinence programs and shifts the focus of the President's Emergency Plan for AIDS Relief (PEPFAR) to family planning which will open up the proposed $50 billion program to abortion groups now barred due to the U.S. Mexico City policy. International Planned Parenthood Federation (IPPF) has launched a campaign to block all amendments and any proposals to reinstate funding for abstinence programs in the bill.

A document circulating by IPPF told supporters, “Thanks to advocacy efforts over the last few years, the draft prepared by Chairman Lantos' office does not contain an earmark for abstinence-until-marriage programs, includes important funding increases, and emphasizes the integration of HIV and AIDS prevention programs with family planning programs.” The document asks supporters to “oppose harmful amendments, especially those that would reinstate a funding earmark for abstinence-until-marriage programs.”

< The Lantos bill encourages “linkages” and “integration” with family planning programs. In recent months, abortion proponents have advocated strategies to get more funding for abortion through family planning programs by linking it to HIV/AIDS. This plan was unveiled by top UN officials at the Women Deliver conference held in London last October. Nafis Sadik, special advisor to the UN Secretary General for HIV/AIDS, and Thoraya Obaid, executive director of the United Nations Populations Fund (UNFPA), amongst others, argued that the abortion rights agenda can advance by linking HIV/AIDS to reproductive health under UNFPA. The US stopped funding UNFPA in 2002 after receiving evidence that the UN agency was complicit in China’s brutal one child policy. UNFPA supporters hope the US will reinstate funding and allow access to PEPFAR funds when the Bush administration leaves office in 2009.

While PEPFAR funds could not be directly used for abortions, the draft bill would fund aid organizations which do advocate abortions as part of their family planning programs. Critics are also concerned about the draft bill’s many references to “reproductive health services,” language which is defined as including “obstetric services” and which could be misused to include abortion. Pro-life advocates are urging decision-makers to ensure that the resources are spent on evidence-based programs with proven track records.

< Rep. Chris Smith (R-NJ) told the Friday Fax, “By making billions of U.S. taxpayer funds available to pro-abortion organizations the bill unnecessarily puts countless children directly in harms way. No child should suffer the cruelty of abortion because U.S. legislation integrated and enhanced pro-abortion organizations role in PEPFAR.”

The Committee on Foreign Affairs in the U.S. House of Representatives will hold a meeting of the full committee next Thursday, February 14th to debate the draft bill.

If you kill another human being, however much you love them, you should face a court of law

Shockingly, even today, it appears that the British courts can get it right. Their record in dealing with “mercy killings” provides evidence that we do not need the blunt instrument of a new law legalising euthanasia/assisted suicide.

Robert Cook, 60, suffocated his wife of 29 years with a plastic bag after she took an overdose. Vanessa Cook had worsening multiple sclerosis and had written of her wish to die. On Friday her husband received a 12-month suspended sentence, after pleading guilty to manslaughter on the ground of diminished responsibility. The judge called it an exceptional case. Last November Stephen Jobling, 52, was also given a 12-month suspended sentence after a bungled suicide pact with his ailing 72-year-old wife. Both survived taking a drug overdose.

Not all “mercy killings” are seen in the same way. Last May a jury found Frank Lund, 52, guilty of murder for smothering his wife. Patricia Lund, 62, suffered from depression and irritable bowel syndrome, but was not terminally ill. The judge called the case “highly unusual, if not unique” and imposed a tariff of only three years.

All of which proves that courts are still capable of deciding each case on its merits, taking a humane view of people whose lives are blighted by the suffering of loved ones while starting from the premise stated by the judge in the Lund case: “It is the duty of citizens in this country not to take any steps which might lead to the death of another citizen.”

The danger now is that a sweeping new law on euthanasia and assisted suicide would give the official nod to taking “any steps which might lead to the death of another citizen”. We could end up with Swiss-style euthanasia clinics, where Brits who are not dying but feeling depressed have already gone to kill themselves.

Even without a law, the trend for viewing euthanasia as legitimate can lead to tragic cases. A drunken Jennifer Allwood decided it would be a “mercy” to smother her 67-year-old cancer-stricken father - who didn't want to die. He fought back and survived. In December Allwood received a 12-month suspended sentence for attempted murder after the court decided she had not hastened his subsequent death. Her bitter family said she got off far too lightly: “It's just giving the impression that any relative who's got cancer, let's kill them off, it's quicker.”

That impression would be written into law by legalising assisted suicide. You don't have to be a religious nutter to oppose it. The libertarian Marxist in me is against giving the courts wider jurisdiction over our lives. But one thing that should still come before a judge and jury is the taking of a life, however much the accused loved the deceased. One universal right I don't want from the State is the right to kill my wife - or vice versa.

DEFENDING THE UNBORN: In Wilberforce’s day, defenders of the slave trade alleged that the British economy would collapse if it were ended.

In 1967, the fear of the “population bomb” persuaded many to accept the Abortion Act. Today, even with global warming to worry us, the realisation that we are attacking the unborn on a massive scale makes people uneasy.

Those who believe in the value of all human life are called many names, as Wilberforce was; “ghoulish” is new. But pretending that killing is curing is only effective for a limited time.

Dr Mary Knowles
Chair, Doctors who Respect Human Life
London SW3

Thursday, January 31, 2008

By Jo Steele

(Metro)

The debate over Britain's 24-week legal limit on abortions could be re-ignited after new research showed a dramatic improvement in survival rates for premature babies.

More than double the number are surviving now than 20 years ago at London's University College Hospital.

Only 32 per cent of babies born between 22 and 25 weeks survived in 1981 – that soared to 71 per cent in 2000.

On average around 50 per cent of Britain's most premature babies survive.

'This study is hugely important because it provides information on the survival rates that can be achieved with consistent levels of staffing and resources, and consistent ethical policies,' said Prof John Wyatt, of University College London.

The study also showed almost a quarter of very early babies were disabled.

When the abortion laws, introduced in 1967, were last amended 18 years ago premature babies had a survival rate of ten per cent.

Abortions may be performed up to 24 weeks if two doctors agree that continuing with the pregnancy involves a greater risk to the physical or mental health of the woman, or her existing children, than having a termination.

January 31, 2008

Volume 11, Number 7

By Samantha Singson

(NEW YORK — C-FAM) At the European Union in Brussels this week, C-FAM Senior Fellow Douglas A. Sylva testified before the European parliamentary committee on women’s rights and gender equality, urging them to resist efforts by pro-abortion advocates to manipulate international law. He warned that giving in to those who would abuse international law to advance abortion risks undermining the consent of nations which undergirds the legal system.

At the public hearing chaired by Anna Zaborska, Member of the European Parliament from Slovakia, speakers on both sides of the abortion debate addressed the topic of sexual and reproductive health and rights, a confusing term that has been used to advance abortion. Abortion advocates from International Planned Parenthood and the ASTRA Network called for the EU institutions to make reproductive rights a priority and called for the removal of barriers to sexuality education, access to contraception and abortion.

Wanda Nowicka of the ASTRA Network based her argument for abortion on the UN's Beijing Platform for Action and a handful of EU reports, using these as evidence of what she called “international consensus” on "reproductive rights." Nowicka also claimed that religious fundamentalism was an obstacle to the spread of contraception and the acceptance of abortion and asked Member States to base their policies on "scientific evidence, not on religious ideology."

Sylva refuted all of her claims by reminding the committee that there are no binding international legal instruments which establish a right to abortion, and pointed out that reproductive health advocates acknowledge as much. According to Sylva, abortion advocates also admit that getting such a binding law would be impossible given widespread opposition and so they have turned to an alternate approach that claims to make “settled international law in the face of unsettled international debate.”

This “soft law” strategy devised in the mid-1990s by the UN Population Fund (UNFPA), the UN High Commissioner for Human Rights and the UN Division for the Advancement of Women consists chiefly of using interpretive recommendations made by treaty monitoring bodies which are charged with overseeing state compliance to UN conventions and treaties. Rather than sticking to the terms of treaties that were negotiated by sovereign states, the treaty monitoring bodies were taught how to “find” rights, such as a right to abortion, embedded within already existing human rights. Sylva charges that this strategy has been increasingly applied over the last ten years with at least sixty nations being pressured by the six treaty bodies to legalize or increase access to abortion.

The problem with this approach, Sylva warned the committee, is that erodes nations’ trust in the system. Sylva explains, “If member states believe that specific commitments they have ratified can expand, and expand in a manner without national oversight, they may grow distrustful of the entire regime of international law. It is therefore in the best interests of the UN system that international law should only reflect explicit consensus between and among national actors.”

Washington Times

From combined dispatches

VATICAN CITY — Pope Benedict XVI yesterday defended the Vatican's right to speak out on bioethics, including its opposition to artificial procreation methods and embryonic-stem-cell research.

He also dismissed criticism that the Roman Catholic Church blocks scientific progress.

"Church teaching certainly cannot and must not weigh in on every novelty of science, but it has the task to reiterate the great values which are on the line and to propose to faithful and all men of good will ethical-moral principles and direction for new, important questions," Benedict said.

He brushed off those who criticize the church "as if it were an obstacle to science and to humanity's true progress."

The pope singled out as "new problems" the freezing of embryos, selecting which embryos should be implanted after testing them for defects, research on embryonic stem cells and attempts at human cloning.

He decried them as proof that "the barrier protecting human dignity has been broken."

Benedict was addressing a meeting of the Congregation for the Doctrine of the Faith, a powerful Vatican office that safeguards doctrinal orthodoxy. He headed the office before being elected pope in 2005.

"When human beings in the weakest and most defenseless state of their existence are selected, abandoned, killed or used as pure 'biological material,' how can one deny that they are being treated not as 'someone' but as 'something,' " he said.

It was the pope's latest foray into scientific issues. On Monday, he warned against the "seductive" powers of science, saying it was important that science did not become the sole criteria for goodness.

U.S. Cardinal William Levada, Benedict's successor as head of the doctrinal department, said it was mulling the possibility of preparing a new Vatican document on bioethical issues.

Korean scientists have created pluripotent stem cells from normal skin cells and have further improved the technique. From the story:

Park said the overall process of making the stem cells is similar to those by U.S. and Japanese scientists, there has been a marked improvement in the success rate. "Foreign scientists used the so-called retrovirus, but we made headway by attaching the lentivirus to the transporting vector, and inserted it into the somatic cell of the lab animal," he said.

This process resulted in a stem cell being confirmed by a fluorescent microscope. The team claimed it was able to push these stem cells to differentiate into liver, nerve and muscle tissues. They said efforts are underway to recreate the process using human somatic cells.

Patent applications are also being filed. The lawsuits to come as various bioetechnology companies vie to become the next Microsoft or Google are sure to keep lawyers happily litigating for years to come.

Surrogate mothers could be given up to £15,000 of Health Service money to have children for gay couples, it emerged yesterday.

An NHS trust is considering funding the service for infertile couples - whether they are heterosexual or of the same-sex. If the proposals are approved, the Health Service will pay for IVF cycles and the expenses surrogate mothers are allowed...Surrogates would also be able to claim damages if things went wrong.

Ignoring that New Jersey voters recently rejected a $450 boondoggle bond issue to pay for embryonic stem cell research, New York State is funding the research to the tune of $600 million without even giving the people a chance to vote on the issue. And those behind the effort have no intention of letting nonsense like ethics get in the way. From a column by members of the New York Task Force on Life and the Law:

Ian Wilmut's old cloning team is furious, apparently, that he is receiving a knighthood for his "service to science." Their point is that Wilmut did not actually clone Dolly or do anything other than administer the lab in which the groundbreaking cloning experiment took place. From the story:

The admission by Sir Ian Wilmut in 2006 that he did not personally create Dolly the sheep set tongues wagging across the world of science. His name had been synonymous with the breakthrough that led to the first clone from an adult mammal, but he made clear that his role was a supervisory one.

So when Sir Ian was knighted at New Year for "services to science", controversy was to be expected.

The latest rumblings have come in the form of a petition to the Queen requesting that his knighthood be revoked. It is signed by four former employees of the Roslin Institute, where Dolly was created in 1997. "Wilmut's knighthood is seen as the crowning insult to honest endeavour," they write, adding that their sentiment is shared by others who signed severance deals with Roslin. "Roslin, the University of Edinburgh and Scotland are all tarnished with this grant. We beg

reconsideration."

I have been warning anyone who will listen about the coming huge policy fight over medical futility--what I call Futile Care Theory--that allows a doctor to refuse wanted life sustaining treatment when the doctor doesn't believe that the quality of the patient's life is worth sustaining (or spending money on). This isn't about asking for treatment that won't work, but withholding treatment that will or may work. Usually futile care protocols--where they have been promulgated--allow an ethics committee to make this decision after a quasi-judicial hearing. Texas has been a big center of futilitarian advances.

There is a futile care case right now in the courts of Winnipeg. In this regard, it is worth noting--and being very alarmed about--the futile care protocol adopted by The College of Physicians and Surgeons of Manitoba, which permits the doctor to make the call, after consultation with a second physician, without even having to pass it by an ethics committee. And this is in cases in which the minimal goal of the patient is likely to be met! From the protocol:

WHERE THE PHYSICIAN CONCLUDES THAT THE MINIMUM GOAL IS REALISTICALLY ACHIEVABLE BUT THAT TREATMENT SHOULD BE WITHHELD OR WITHDRAWN, that physician must consult with another physician...
2. Where the consultation supports the conclusion that treatment should be withheld or withdrawn:

a. The physician who sought the consultation must advise the
patient/proxy/representative that the consultation supports the initial assessment that treatment should be withheld or withdrawn .

b. If there is still a demand or request for treatment, the physician must attempt to address the reasons directly and with a view to reaching consensus...

c. If consensus cannot be reached, the physician must give the patient/proxy/representative a reasonable opportunity to identify another physician who is willing to assume care of the patient and must facilitate the transfer of care and...

d. Where, despite all reasonable efforts, consensus cannot be reached the physician may withhold or withdraw life-sustaining treatment, but: i) in the case of a patient/proxy who is still not in agreement with the decision to withhold or withdraw treatment, the physician must provide at least 96 hours advance notice to the patient or proxy as described below.

There you have it: Doctors think that their values should rule over those of their patients.

This is the beginning of the institution of a duty to die that we ignore at our peril. It also threatens the trust of people in medicine. My prediction: A lot of fireworks ahead!