Monday, November 30, 2020

Canadian Senators state that parts of euthanasia Bill C-7 are unconstitutional.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Joan Bryden published by the CP Press on November 29 interviews several Canadian Senators who believe that sections of Bill C-7, the bill to expand (MAiD) euthanasia in Canada, are unconstitutional. 

Bryden explains that in 2016, the Senate voted to remove the requirement in Bill C-14 that a person's natural death must be reasonably foreseeable to qualify for euthanasia because the Senate believed that this requirement was unconstitutional, but the Senate compromised and passed Bill C-14.

Article: Canadian Senate passes Bill C-14 in time for the summer break (Link).

In September 2019, Québec Justice Baudouin, in Truchon, struck down the requirement that a person's natural death be reasonably foreseeable in Canada's euthanasia law and the government did not appeal the decision. The court gave the federal government six months to amend the law based on the court decision. Since then Justice Baudouin has given the federal government until December 18 to amend the law.

On February 24, the federal government introduced Bill C-7 in response to the Quebec Superior Court decision in response to the Truchon decision, but Bill C-7 goes far beyond Truchon. Due to the COVID-19 crisis and then the prorogation of parliament, Bill C-7 was re-introduced on October 5, 2020.

In her article, Bryden is suggesting, through interviews with Senators, that parts of Bill C-7 are also unconstitutional. She states:

Now, some senators are convinced the bill introduced to bring the law into compliance with that ruling is also unconstitutional. And they're pondering how far they should go to protect the rights of Canadians seeking access to medically assisted death.

“If it's a very clear violation of a constitutional right, I think we have the right, the moral obligation even, to stick to our position and to insist (on amendment),” says Sen. Pierre Dalphond, a former Quebec Appeal Court judge who sits with the Progressive Senate Group.

Dalphond is highly skeptical that the government's latest assisted-dying bill, C-7, is constitutional. He's awaiting further explanations from the government before making a final decision.
Senator Claude Carignan believes that the exclusion for mental illness alone and the two track approach (no waiting period for people who are dying, a 90-day waiting period for those who are not dying) are unconstitional. Bryden reports Carignan as stating:
Bill C-7 violates the guarantee of equality rights in the Charter of Rights and Freedoms by specifying that people suffering solely from mental illnesses will not be allowed access to an assisted death.

He thinks the proposed two-track approach to eligibility - one set of rules for people who are near death and more restrictive rules for those who aren't - is similarly problematic.

“I think the government has created another bill that will have to come back in two or three years after a court challenge,” Carignan says.
I agree with Senator Carignan that the two-track approach to eligibility creates an inequality in the law that a future court decision will strike down, but I disagree that Bill C-7 actually restricts euthanasia for mental illness alone.

The government claims that Section (2.1) of Bill C-7 excludes euthanasia for mental illness alone. Since Canada's law permits euthanasia for physical and psychological suffering, therefore Bill C-7 must define psychological suffering as excluding euthanasia for mental illness alone.

In total, Bill C-7 needs to define the phrase “natural death is reasonably foreseeable,” and it needs to define the terms psychological suffering and mental illness. Without defining the parameters of the law, the law will be unequally applied and it will be applied beyond the claimed scope of the bill.

EPC is convinced that if the government defines psychological suffering to exclude euthanasia for mental illness alone, that would make the exclusion constitutional and effective.

Sunday, November 29, 2020

Belgian authorities investigating alleged illegal euthanasia deaths

This article was published by Bioedge on November 29, 2020.

Michael Cook

By Michael Cook
Editor of BioEdge
 

Officials in the Belgian city of Leuven are investigating about ten euthanasia cases which may not have been done legally.

The public prosecutor was tipped off by an anonymous letter to the De Standaard newspaper. comes from a letter sent anonymously to the paper’s editorial desk. Until the investigation has been completed, police are keeping mum.

The letter says: “Our family member passed away two years ago, and we were told that euthanasia was presumed to have been carried out without the doctors informing us or following the necessary procedure. This is a very traumatic experience for us.”

Doctors are not required to notify the family if a person wants to be euthanised, but various medical associations strongly recommend it.

Two doctors were named in the letter, both of them associated with nursing homes in the Emmaus group. The head of the group, a former federal minister, Inge Vervotte, confirmed that the two doctors work with the homes, but she insisted that stressed that the cases being investigated involved patients in their private practice, and not residents of the nursing homes.

Professor Wim Distelmans, Belgium’s chief euthanasia overseer, said that his committee is supposed to be informed about every case of euthanasia, but it doesn’t always happen. “Some doctors are happy to admit that,” he admitted.

“What doctors write down, we naturally take for granted as true,” he said. “Apart from that, and rightly so, everyone is free to file a complaint with the public prosecutor’s office if they think they have reason to.”"



This article was published by Mercatornet on November 30, 2020.

Belgium’s complacent euthanasia regime under threat

More complaints have been made about doctors who break the law with impunity

By Michael Cook

Editor of Bioedge

In northern latitudes the sound of spring begins with the booming of snow-covered ice cracking in frozen rivers. Is something like that happening in Belgium?

Officials in the Belgian city of Leuven are investigating about ten euthanasia cases which may not have been done legally.

The public prosecutor was tipped off by an anonymous letter to the De Standaard newspaper. Until the investigation has been completed, police are keeping mum.

The letter said: “Our family member passed away two years ago, and we were told that euthanasia was presumed to have been carried out without the doctors informing us or following the necessary procedure. This has been a very traumatic experience for us.”

Doctors are not required to notify the family if a person wants to be euthanised, but various medical associations strongly recommend it.

Two doctors were named in the letter, both of them associated with nursing homes run by the Emmaus group. The head of the group, a former federal minister, Inge Vervotte, confirmed that the two doctors work with the homes, but she insisted that stressed that the cases being investigated involved patients in their private practice, and not residents of the nursing homes.

Professor Wim Distelmans, Belgium’s chief euthanasia overseer, said that his committee is supposed to be informed about every case of euthanasia, but it doesn’t always happen. “Some doctors are happy to admit that,” he admitted.

“What doctors write down, we naturally take for granted as true,” he said. “Apart from that, and rightly so, everyone is free to file a complaint with the public prosecutor’s office if they think they have reason to.”

In other words, according to Belgium’s Grand Poobah of Euthanasia, move along please, there’s nothing to see here.

But there is.

 

Wim Distelmans
Regulation of euthanasia in Belgium would not pass the smell test for conflict of interest in countries like the US or the UK.

Dr Distelmans, a photogenic, charismatic oncologist, is the most egregious example of a bizarre euthanasia Mafia which appears to set the agenda for euthanasia in Belgium. He is the head of the regulatory body; he is perhaps the country’s best-known practitioner of euthanasia (he has reportedly killed hundreds of people); he is the chairman of the country’s leading euthanasia lobby, LEIF; and he is the media’s go-to man for comment on euthanasia.

Conflict of interest, anyone?

The European Court of Human Rights is currently considering the case of a Belgian woman, Godelieva De Troyer, who was euthanised in 2012. Wim Distelmans was her doctor. Her son, Tom Mortier, claims not only that he was left out of the process, but that there were legal irregularities in the way that the euthanasia was carried out.

“The facts of this case, and the requirements of the law in Belgium, are so far apart that it demonstrates that if you legalize euthanasia, you cannot control it,” says Robert Clarke, an English barrister acting for Mortier.

Local authorities have dismissed the long-running case as a smear campaign. A leading Belgian intellectual, the late Etienne Vermeersch, the former president of the Belgian Advisory Committee on Bioethics, defended Distelmans in a 2014 newspaper op-ed. In it he declared, in a baffling display of chauvinistic delusion, that Belgium, together with the Netherlands and Luxembourg, where euthanasia is also legal, “stands, ethically, at the top of the world.”

Now it appears that the tragic death of Godelieva De Troyer may not have been an outlier.

Stay tuned.

Friday, November 27, 2020

Euthanasia Bill C-7 must be defeated. Changes to the law are premature since the government has not done its Mandated parliamentary review.

Alex Schadenberg,
Executive Director, Euthanasia Prevention Coalition

Bill C-7 was introduced on February 24, 2020 in response to the September 11, 2019 Superior Court of Quebec Truchon decision. The federal government should have appealed Truchon based on the language and the precedent of the decision. Bill C-7 was re-introduced on October 5, after parliament returned from prorogation.

The Truchon decision found that the "reasonable foreseeability of natural death" criterion in the Criminal Code, as well as the "end-of-life" criterion from Quebec’s Act respecting end-of-life care, was unconstitutional (Truchon v. Attorney General of Canada).

*Join almost 50,000 people. Sign and share the EPC Petition: Reject euthanasia Bill C-7 (Link).


Bill C-7 is the federal government’s response to Truchon, but it extends the law in a much wider manner than Truchon required.

Bill C-14, when passed in June 2016, included a provision that the MAiD law undergo a five-year full review beginning in June 2020. Further expansions of the law are premature since the federal government has not completed the legislated five-year review of the law.

It is concerning that Bill C-7 continues to use the phrase: “natural death is reasonably foreseeable.” Experts who support or oppose MAiD agree that the term “natural death is reasonably foreseeable” lacks effective meaning. Since Bill C-14 was passed in June 2016, the accepted understanding of this phrase has expanded.

In response to the Truchon decision, Bill C-7 implements a two-track approach to procedural safeguards based on whether or not a person’s “natural death is reasonably foreseeable.”

The first track is based on someone whose natural death is deemed to be reasonably foreseeable. For these cases, Bill C-7 removes the 10-day reflection period. Bill C-14 already permitted a waiving of the 10-day reflection period. Bill C-7 reduces the requirement from two independent witnesses to one witness and it permits a person, who was previously approved for MAiD, to die by MAiD even if that person loses their ability to consent at the time of death.

The second track is based on someone whose natural death is not reasonably foreseeable. The main difference is that these people will be subject to a 90 reflection period.

Without a clear definition to determine if a person’s “natural death is reasonably foreseeable” decisions become subjective. Determining whether a person qualifies for MAiD based on the first or second track will be difficult to determine and will be unequally applied based on the lack of definition.

What does Bill C-7 do?

1. Bill C-7 removes the requirement in the law that a person’s natural death is reasonably foreseeable in order to qualify for MAiD, as required by Truchon. Therefore people who are not terminally ill can die by MAiD. The Truchon decision only required this amendment to the legislation.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who cannot consent, if that person was previously approved for MAiD. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by MAiD.

3. Bill C-7 waives the ten-day waiting period when a person is deemed to be “terminally ill.” Thus a person could request MAiD on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

4. Bill C-7 creates a two-track law. A person whose death is deemed to be reasonably foreseeable would have no waiting period while a person whose death is deemed to be not reasonably foreseeable would have a 90-day waiting period.

5. Bill C-7 claims to prevent MAiD for people with mental illness. The law permits MAiD for people who are physically or psychologically suffering that they find intolerable and that cannot be relieved in a way that the person considers acceptable.
Bill C-7 states: Exclusion (2.1) For the purposes of paragraph (2)(a), a mental illness is not considered to be an illness, disease or disability.

The government claims that (2.1) excludes MAiD for mental illness alone. To exclude MAiD for mental illness alone, the bill must define psychological suffering and mental illness. Mental illness is currently considered a form of psychological suffering which MAiD is permitted for in the law.

Bill C-7 needs to define the phrase “natural death is reasonably foreseeable,” and it needs to define the terms psychological suffering and mental illness. Without defining the parameters of the law, the law will be unequally applied and it will be applied beyond the claimed scope of the bill.

Bill C-7 does not protect the conscience rights of medical professionals who oppose MAiD.

Bill C-7 expands the law to permit anyone, who considers their physical or psychological suffering to be intolerable, to qualify for death by lethal injection, even if effective medical treatments for their condition exists. The lack of parameters directly threatens the lives of people with disabilities.

There was no requirement in Truchon to remove the 10 day reflection period. Studies show that the will to live fluctuates over time.

Removing the requirement of consent at the time of death is inconsistent with the Carter decision and it denies a person the right to change their mind.

We are convinced that the two-track approach will be struck down by a future court decision based on it being an inequality in the law. If that happens Canada would have a wide open MAiD law.

As stated earlier, the additional changes to the MAiD law were not required by Truchon. These changes are premature, at best, considering that the five-year review of the MAiD law which was to begin in June 2020, has not yet been done.

The government needs to shelve Bill C-7 until after the five-year review is completed. If the government insists on passing Bill C-7 then it must limit the legislative changes to the Truchon decision which required removing the phrase: “natural death is reasonably foreseeable.”

Wednesday, November 25, 2020

A patient's journey: If we jumped on the death train, that man would have died.

Dr Leonie Herx is the past President of the Canadian Society of Palliative Care Physicians and chair of the division of palliative medicine at Queen’s University.


I have an example of a very beloved patient of mine, who first came to my clinic asking for MAiD. So, he gave me permission to actually just sit with him and tell him that he mattered to me.

That takes a lot of courage, as a gentleman in his eighties, who's used to being independent and he'd been a single dad. And for me to, he gave permission for me to say "you're worth something just because you're you and you actually deserve to be taken care of." "And what is it that really is going on here?"

He was afraid that he was going to be a burden to his daughter, who is his only child, and that she had to work and had to make a living and he didn't want to have to compromise her quality of life and impact on her by being a burden.

So, we were able to facilitate that conversation and it gave a chance for him to hear from his daughter that she actually valued being able to provide care for him and support him as he had done for her, her whole life.

And I watched them, then, over the next nine to ten months as he lived and got back to being a pool shark and passed all of his pool tips on to his daughter and enjoyed beers with his buddies and everytime I saw him, he would just give me a big hug and say, "thank you for helping me see all the good in my life again." And now he reconnected with his daughter and they had these memories together before he died and he went on to have a very peaceful, natural death.

But that's not an uncommon story in my work. I see that everyday, but if we jumped on the death train, that man would have died and not had all of that year, you nine or ten months with his daughter and that joy despite living with an illness, he found profound joy in his relationship again, with his daughter and his life had good meaning.

Tuesday, November 24, 2020

Canada's Justice Minister wants to expand euthanasia to people with mental illness alone.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Brian Platt published on November 24 in the National Post indicates that Canada's Justice Minister David Lametti told the Senate Legal and Constitutional Affairs committee, that is studying euthanasia Bill C-7, that he hopes that the euthanasia law will expand to people with mental illness. Platt reported:

Lametti said he believes the government has found the right balance in respecting the dignity of people with disabilities, and also their right to end their life if their suffering is too great.

Lametti also said he hopes the medical assistance in dying (MAID) regime will eventually be further expanded to people who are suffering solely from mental illness, but the government doesn’t have enough time to do it before a court-ordered deadline of Dec. 18 for this bill to pass.
The Canadian government introduced Bill C-7 in February, claiming that it was in response to the Quebec Superior Court decision that struck down the requirement in the law that a person’s "natural death be reasonably foreseeable" to die by MAiD. Bill C-7 was re-introduced on October 5, 2020 after parliament returned from being prorogued. 

*Sign and share the EPC Petition: Reject euthanasia Bill C-7 (Link).

Lametti told the Senate committee that the government  euthanasia for mental illness out of legislation for now, due to a lack of consensus. Platt reported that Lametti stated:

“We know that those with mental illness can suffer unbearably, that mental illness can be debilitating and that it can profoundly impact quality of life,” he said. But he said some mental illnesses “present unique, practical and ethical challenges.”

“Unlike most physical illnesses, many mental illnesses follow unpredictable illness trajectories for which there is always the possibility of a sudden improvement or recovery,” he said. “This means that in some experts’ view it is impossible to predict for any given individual whether their symptoms will one day show improvement or endure for the rest of their lives.”
Platt explains that critics of Bill C-7 include people with disabilities, palliative care experts and even Jody Wilson-Raybould, the former Justice Minister, who steered Bill C-14 through parliament in 2016.

Platt also wrote that disability rights group, Inclusion Canada, told the Senate committee that Bill C-7: 

“would signal that these Canadians are expendable and threaten their lives, dignity and belonging.”
Hon Jody Wilson-Raybould
In the House of Commons Wilson-Raybould questioned the decision of the government to remove the 10-day reflection period in the law. Wilson-Raybould reportedly said:
“Nothing in the Truchon decision of the Quebec (court), which the government chose not to appeal, requires this, and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent,”

“Palliative care physicians, disability advocates and other experts insist that this is an important safeguard.”
The Euthanasia Prevention Coalition presented to the Senate Justice committee on November 24.

Monday, November 23, 2020

I hate to say that we were right but Canada’s law did not prevent euthanasia for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alan Nichols died by euthanasia for mental illness in 2019
Parliament is currently debating Bill C-7, a bill to expand Canada’s euthanasia law.

During the debate on Bill C-14 (2016) we argued that the lack of definition in the bill would enable the law to be continuously expanded by doctors who support euthanasia.

Joan Bryden published an article for CP Press on November 22 titled: Exclusion of mental illness in assisted dying bill slammed by psychiatrists. In her article Bryden writes:

“Vancouver psychiatrist Dr. Derryck Smith, who has personally been involved in two cases where people suffering solely from severe mental disorders received medical help to end their lives. And he says he knows of other similar cases.”

One of the cases Smith took part in involved a woman of about 40 years old who suffered from a "severe, intractable eating disorder" and was intending to starve herself to death if she did not receive medical help to end her life.

"She was approved for assisted dying and received assisted dying just for a psychiatric illness, in this case anorexia nervosa."
When Smith admits to being involved with cases of euthanasia for mental illness alone, he is admitting that Bill C-14, in 2016, did not prevent euthanasia for mental illness or even prevent euthanasia for a person who was not terminally ill.

Since Bill C-14 did not define the phrase: natural death is reasonably foreseeable, and it did not define the term psychological suffering, therefore it did not prevent euthanasia for mental illness or limit it to terminally ill people.

In August 2019, Alan Nichols died by euthanasia in British Columbia, even after his family insisted that Alan was not competent to make this decision and that he was living with chronic depression

Bill C-7, also does not define psychological suffering or the meaning of natural death is reasonaby foreseeable. Bill C-7 makes the situation worse because it also eliminates some key safeguards in the law.

If the government wants to exclude euthanasia for mental illness, Bill C-7 needs to define psychological suffering in a manner that excludes euthanasia for mental illness.

What does Bill C-7 do?

Bill C-7 removes the requirement in the law that a person’s natural death be reasonably foreseeable to qualify for MAiD. People who are not terminally ill can be killed by MAiD. The Quebec Truchon court decision, that led to Bill C-7, only required this amendment to the law, but Bill C-7 goes further.
1. Bill C-7 permits a medical practitioner to lethally inject a person who is not capable of consenting, if that person was previously approved for MAiD. The current law required consent at the time of death.

2. Bill C-7 waives the ten-day waiting period when a person is deemed to be “terminally ill.” A person could request death by euthanasia on a "bad day" and die the same day.

3. Bill C-7 creates a two track law. A person who is deemed to be terminally ill would have no waiting period while a person who is not terminally ill would have a 90 day waiting period.
If Bill C-7 is passed, a future court decision will strike down the 90 day waiting period for people whose natural death is not reasonably foreseeable because, this provision represents an inequality in the law.
4. Bill C-7 reduces the number of independent witness from two to one.

5. Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The law permits MAiD for people who are physically or psychologically suffering in a manner that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. This is a completely subjective evaluation.
Since mental illness is already considered a form of psychological suffering, and since psychological suffering is not defined in the law, therefore Bill C-7 does not prevent euthanasia for mental illness.

Contact your Member of Parliament and tell them that Bill C-7 is a sham because it does not define the key terms, natural death is reasonably foreseeable and psychological suffering. The list of Members of Parliament: https://www.ourcommons.ca/Members/en/search

Sunday, November 22, 2020

The Netherlands expands the rules for euthanasia of people with dementia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Euthanasia for people with dementia paves the way for non-voluntary euthanasia.

The Netherlands is quickly expanding the euthanasia rules The Netherlands government recently announced that they plan to extend euthanasia to children, they are also expanding euthanasia for people with dementia while, at the same time, the Netherlands government is debating euthanasia for healthy people who claim to have lived a "completed life."

The NL Times reported that the five regional euthanasia review committee's have agreed to expand euthanasia for people with dementia by loosening the requirements in four areas. The article stated:
The updated Euthanasia Code says that a dementia patient's statement requesting euthanasia does not have to be legally perfect. The statement, in which the patient describes the circumstances under which they want euthanasia, can sometimes be interpreted in multiple ways. Doctors will now have more room to interpret what the patient meant, for example by consulting family members.

Doctors will also be allowed to give a sedative to advanced dementia patients if they expect the patient will become aggressive or restless because they don't understand what's happening. The doctor also does not have to request a verbal confirmation from a patient with advanced dementia before the euthanasia procedure is performed. "Such a conversation is pointless, because such a patient lacks understanding of these topics," is stated in the code.

And it will be up to the doctor to assess whether a patient is suffering unbearably and hopelessly, the updated code reads. "The RTE should test that medical professional judgment with caution."
Not only do these new rules deny people with dementia the right to change their mind or consent at the time of death, but since they can be sedated, they will not even be aware that they are being killed.

The change in the rules for people with dementia is based on the decision by the Netherlands Supreme Court in April 2020, concerning the euthanasia death of an incompetent woman with dementia who resisted at the death.

According to the case, a woman with dementia stated in her advanced directive that she wanted euthanasia but when the doctor came to inject her she resisted. The doctor put drugs in her coffee to sedate her but the woman continued to resist so the doctor had the family hold her down while the doctor injected her.

The Netherlands euthanasia law which came into effect in 2002. In 2017 there were 6585 reported euthanasia (lethal injection) deaths representing almost 4.5% of all deaths.

According to the DutchNL news, the number of assisted deaths for dementia or psychiatric reasons also increased in 2017, with 169 people dying by euthanasia for dementia (3 were advanced dementia) and 83 people dying by euthanasia for psychiatric reasons. The new rules concerning euthanasia for dementia will likely lead to many more deaths.

When the Netherlands legalized euthanasia, they required the person to consent to their death. The Netherlands has now come full circle as they are now willing to kill people who cannot consent, whether they have dementia or are children.

Euthanasia for people with dementia paves the way to non-voluntary euthanasia.

Saturday, November 21, 2020

Canada’s claim to value seniors & disabled people rings false during COVID-19 pandemic

By Taylor Hyatt

Euthanasia Prevention Coalition board member & disability rights activist 

Canada's Maclean’s magazine has been running a series of articles on aspects of life turned upside down in the chaos of 2020. On their list of “14 things 2020 proved wrong” is the assumption that “Canada values its seniors” – not to mention younger disabled people who also live in congregate care settings.

Author Christina Frangiou’s piece begins on a jarring note, quoting a nurse in a Toronto-area hospital who called octogenarian Mary Wilton “a waste of space” while caring for her in the summer of 2019. Ms. Wilton’s daughter, Alison, says that her mother has been on the receiving end of many forms of age discrimination in the last decade as her needs changed. In addition to “callous comments, she condemns “unaffordable housing, insufficient home care, wait lists for long-term care and a lack of support for [caregivers].” As Alison Wilton notes, “[All of these problems] existed prior to the pandemic but worsened over 2020,” and it’s all dismissed as people in power say “Well, they’re old anyway.” In addition to the ageism the Wiltons observed, these problems stem from an apathy towards disability – both in younger people and as an effect of aging.

For nearly two decades, government officials have repeatedly promised to improve long-term care, and provide other services that older adults need to remain in their homes safely. Ms. Frangiou quotes former Ontario minister of health and long-term care George Smitherman; he said in 2004: “We need to change the culture of long-term care in this province…”.

Little has changed since then. The coronavirus pandemic has exposed authorities’ lack of action – and willpower – in this department. Ms. Frangiou quotes some sobering facts:
  • “[By] the summer, over 80 per cent of all COVID-19 deaths in Canada occurred in nursing and retirement home settings – nearly twice the Organisation for Economic Co-operation and Development (OECD) average, even though Canada’s total COVID-19 mortality rate was comparatively lower.”
  • “[The] military was called into long-term care homes in Quebec, [and] the Canadian Red Cross was summoned into some Ontario homes” when staff became overwhelmed with the number of sick residents, or homes faced staffing shortages when personnel themselves became ill. 
  • Finally, provincial leaders are dismissing the deaths of elderly, ill, and disabled people as acceptable losses. “In Manitoba, Minister of Health Cameron Friesen [has said] that deaths in personal care homes are ‘tragic’ but ‘unavoidable.’ In Alberta, Premier Jason Kenney noted this spring that many people dying from COVID had already surpassed their life expectancy.” 
I find that last point particularly revolting. To rephrase it: because a long-term care resident has already lived longer than estimated, their preventable death – from an illness that has devastating effects even on younger people who contract it – is suddenly something we should shrug our shoulders at? Of course, we can't and shouldn't expect to prolong life, especially with the use of painful and extraordinary measures. Yet why should age, or associated disabilities, make someone less worthy of treatment? 

Healthcare systems in Quebec and Ontario have already faced criticism for ableist triage protocols implemented earlier in the pandemic, and these politicians’ remarks are rooted in the same attitude. Last but not least – as I've written before, not everyone who lives in an institution is an elder at the end of life.

Ms. Frangiou continues: 
“Even before the pandemic…430,000 [Canadians] reported having unmet home care needs, according to the National Institute on Aging. Many lack the funds to pay out of pocket for care: in 2016, 14.5 per cent of older Canadians lived in low-income households, according to census data from Statistics Canada.” 
The idea that aging in place depends on how much a person can afford to save is – as Toronto geriatrician Dr. Amina Jabbar says –  “grossly inequitable.”

Euthanasia Prevention Coalition executive director Alex Schadenberg calls attempts to reform long-term care facilities “band-aids.” He hopes that, if sufficient supports are provided that “more family and community support would develop over time.” Although he “applauds” provincial governments who fund renovations to make houses more accessible, these programs are “too little, too late” compared to the much greater cost and ease of keeping someone in an institution.

Dr. Vivian Stamatopoulos, a teaching professor at Ontario Tech University, sums up the truth at the heart of the situation. 
“People don’t want to think about the elderly because it’s sad, [or] because they just don’t see them.” 
This is largely true of younger disabled people as well. Initiatives to help them live in their own homes – outside of institutions – began in earnest with Ed Roberts and other disabled American students in the 1960s. Although Canada likes to present itself as a defender of equality, we must remember that this movement only reached Canada a few decades ago. (I'm at the end of my twenties, and my parents were young children then!) Even today, advocates such as Daniel Pilote, Jonathan Marchand, Tyson Sylvester and Amy Hampton work to make a truly dignified life in the wider community possible. Unfortunately, it seems decades will pass before more Canadians realize the importance of their efforts and the thanks they are due.

Friday, November 20, 2020

A suicide prevention story from a Canadian psychiatrist.

I received the following message from a Canadian psychiatrist who gave permission to publish it.

From the diary, a lived experience of a psychiatrist:

“I spent over 4 hours on Tuesday night talking a chronically suicidal patient out of jumping off a bridge after multiple suicide attempts in the past two months, and convinced her to meet me at the hospital to get treatment that she needed to stay stable. A phone conversation that began with her at the bridge saying: “I just want to die”, ended 5 hours later, not with tragedy, but thankfully with a renewed sense of hope in the patient, and a desire to try again to work together toward a better path.

That critical conversation was a continuous see-saw, a battle between the will to live and the desire to die. The turning point arrived with the offer to accompany her to hospital. She needed someone trustworthy to be there for her, to be present with her, and to stand beside her in her darkest hour. It required a firm stance on the part of her doctor, a firm commitment to not give in to the deception of death, and a literally extended hand (albeit gloved during this pandemic) to pull someone back from the brink of death. Deeds of love and compassion, words of faith, hope, and affirmation offer dignity to broken souls, heals the body, eases the mind, and revives the spirit.

Are we our brother’s keeper? In today’s world, we must rise to the call to care for one another, especially for those who are most helpless. We must be the ones to stand in the gap and give hope and reason to pursue life again. When the medical system had nothing left to offer my patient (hospital admission was deemed ineffective and usually more harmful) after her more than 7th attempt in the last couple of months and a revolving door pattern in and out of hospital, she cried through her tears: “Doctor, thank you for not giving up on me.” And when I asked her after, as she contemplated ending her life after she had already called other supports and didn’t find them to be helpful, what stopped her from jumping? She looked directly into my eyes and exclaimed: “YOU! When you called me! THAT's what stopped me!”

Never underestimate the power of one’s words, the power of one's presence, the impact of love, genuine care and compassion, and the effect that one's willingness to go that extra mile in accompanying another in their pain can have in a moment of great darkness. Be a light, a firm sturdy hand to show the way. And never, never, give up.”
Celebrating more than 1025 signatures on the MAID2MAD.ca declaration!

90-year-old woman dies by (MAiD) euthanasia rather than go through another COVID-19 lockdown.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Canada's parliament is currently debating Bill C-7, a bill to expand (MAiD) euthanasia in Canada to people who are not dying.

Even though Bill C-7 is not yet passed,  CTV News Medical Correspondent, Avis Favaro, reported that Nancy Russell, a 90-year-old long-term care resident, who was not chronically ill or dying, died last month by euthanasia (MAiD) to avoid living through another COVID-19 lock-down. 


Favaro reports:
Across Canada, long-term care homes and retirement homes are seeing rising cases of COVID-19 and deaths yet again, a worrisome trend that is leading to more restrictions for the residents. 
But these lockdowns are taking another toll among those who don’t get COVID-19.

Residents eat meals in their rooms, have activities and social gatherings cancelled, family visits curtailed or eliminated. Sometimes they are in isolation in their small rooms for days. These measures, aimed at saving lives, can sometimes be detrimental enough to the overall health of residents that they find themselves looking into other options.

Russell, described by her family as exceptionally social and spry, was one such person. Her family says she chose a medically-assisted death (MAID) after she declined so sharply during lockdown that she didn’t want to go through more isolation this winter.
Nancy Russell
Russell, who was a supporter of euthanasia, when first requesting "MAiD" was turned down. The doctor told her that she had "too much to live for." But she was then approved after her second request. The report stated:
By the time she applied a second time, “more concrete medical health” issues had developed, her daughter said.

This time, doctors approved her. Russell would not have to go through another lockdown in her care home.

“She just truly did not believe that she wanted to try another one of those two-week confinements into her room,” her daughter said.
Doctor shopping is a clear concern with Canada's euthanasia law. Russell was probably sent, the second time, to a doctor who provides euthanasia. Canada's euthanasia law is based on subjective rules.

In August 2020, Rob Munro reported a similar story for the Kelowna Infonews. Shirley Turton (78), asked her family to arrange a "MAiD" death because she felt "locked into a long term care prison" due to COVID-19.

Munro reported that the daughter of Shirley Turton said that her mother is not terminally ill but she had become:

depressed, not interested in eating and can’t even put a glass of water to her lips but, most of all she is lonely.
Turton didn't die by euthanasia, but it is impossible to know how many Canadians have died by euthanasia based on the COVID-19 lock-down.

For instance, the Ontario data does not indicate how many MAiD deaths are based on similar reasons to Nancy Russell's death but recent Ontario MAiD statistics indicate that the number of euthanasia deaths is increasing.

From June 17, 2016 to October 31, 2020, there were 6266 reported assisted deaths in Ontario. There have been 1948 reported assisted deaths in 2020 representing 1127 in the first six months of 2020 and 821 in the last four months (now averaging more than 200 assisted deaths per month) in Ontario.

Canada's MAiD law permits euthanasia for people who are physically or psychologically suffering that is considered intolerable to the person and that cannot be relieved in a way that the person considers acceptable.