Researcher argues health-care serial killer could take advantage of Canada's assisted dying program

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Christopher Lyon

Professor Christopher Lyon, who teaches at the University of York in the UK, recently published a research article concluding that Canada's (MAiD) euthanasia law enables healthcare serial killers (HSK).

(Read the research article with references (Link).

The National Post published an article by Sharon Kirkey on August 9, 2024. Kirkey interviews Lyon and tries to challenge his research.

Previous article: Does Canada's euthanasia law enable healthcare serial killing? (Link).

 Kirkey introduces her article by stating:

“Canada’s MAID (medical assistance in dying) system is criticized as the most permissive or least safeguarded in the world, raising the question of whether it could protect patients who fit the clinical profile of adult victims of HSK (health-care serial killers) from a killer working as a MAID provider,” Christopher Lyon, a Canadian social scientist who teaches at the University of York in the United Kingdom, wrote in a newly published paper.

Insufficient vetting of staff, poor surveillance and oversight, and a failure by authorities to act on concerns raised by suspicious colleagues or witnesses have allowed health-care serial killers to go undetected for considerable periods, Lyon wrote in the journal HEC (HealthCare Ethics Committee) Forum, a partner journal of the American Society for Humanities and Bioethics.

Canada’s MAID regime “has similar features,” Lyon wrote, “with added opportunities for killing” afforded by broad Criminal Code exemptions from homicide and suicide offences “amid broad patient eligibility criteria.”

MAID’s oversight and delivery needs a “radical restructuring” to help mitigate the possibility of abuses, he said.

Kirkey gives some insight into Lyon's concerns. Kirkey writes:

Lyon’s 77-year-old father died by MAID in 2021 in a Victoria hospital room, over the family’s objections that he had not been properly assessed. He’d had bouts of depression and suicidal thinking, but was approved for MAID nonetheless. In essays, Lyon has described his father’s MAID provider as “Death.”

Lyon explains to Kirkey that he is not saying that there are criminally culpable homicides occurring within Canada's MAiD regime, but rather he is saying that based on the law it could happen because the MAiD regime protects homicidal personalities and enables them to legally kill.

Kirkey quotes Lyon as stating:

“I want to be clear: I’m not calling anybody out there a murderer or a serial killer in a culpable sense,” Lyon said in an interview. No police investigations or criminal charges are known.

Euthanasia “is fundamentally homicide by lethal injection,” he said. “Whatever one’s views are on MAID, it should be foremost in our minds that, at a basic level, we are empowering a privileged class of people to poison disabled and distressed people to death.

“A key reference point is health-care serial killers,” Lyon said. “Patient safety and ethical and rigorous medical practice demands that we be extremely careful about who we let do this, but I don’t see that happening in Canada.”

“Disabled people have been raising the risks of MAID being attractive to ‘angel of death’ characters for a very long time,” he added.

Kirkey attempts to undermine Lyon by interviewing Dr. Konia Trouton, a euthanasia doctor in Victoria BC. Trouton seems to take Lyon's research personally and she defends all doctors who kill by euthanasia, but she misses the point. Lyon is saying that the euthanasia law enables health care serial killers to do so under the guise of a legal act without effective oversight to prevent it.

Kirkey interviews ethicist Kerry Bowman, who is not a euthanasia zealot, but who also defends euthanasia doctors. Bowman also misses the point for the same reason as Trouton, he considers individual cases that he has knowledge of rather than examining the law, as Lyon has done, based on what it allows.

Bowman does state that he is concerned that doctors will initiate conversations with their patients about euthanasia. Bowman states:

What he does see, “and where I think we need a lot more attention — and I’m not talking homicide here — is the fact that you can, and some clinicians do, bring (MAID) up with patients” before the patient raises it first.

In most jurisdictions in the world with legalized euthanasia, doctors are explicitly prohibited, or strongly discouraged, from raising assisted dying.

“If you bring this up, is it a muted recommendation? ‘Why are you bringing it up?’ We need more attention to the question of putting it out there as an option,” Bowman said

Kirkey reports that Lyon is also concerned about the feelings that euthanasia doctors express after killing a patient. Kirkey reports:

While watching a documentary on Charles Cullen, a former American nurse imprisoned for murdering 29 elderly or seriously ill patients, Lyon said he was struck by how often statements Cullen made in his police interviews sounded “very similar to the things that I’ve read from MAID providers.”

In one study, Canadian MAID providers described the delivery of a medical death as “heartwarming,” “the most important medicine I do,” “an ultimate act of compassion,” “liberating,” like being on a “mission” and “almost an adrenaline rush. I was surprised at how good I felt.”

Lyon finds the language alarming. “In my view it should be a very sober and reluctant job.”

While studies have shown that the very old and very young are most likely to be victims of serial murderers, other victims had cognitive capacity, he said.

“One of the reasons health-care serial killers are often hard to detect is because they are so often not nightmarish,” Lyon added. “Some are even well-regarded by some of their colleagues, who defend them in disbelief.

“Like MAID providers, some health-care serial killers strongly believe they are helping and relieving suffering. MAID seems to provide the perfect legal cover for these personalities.”

Kirkey reports that Lyon also points out that the law is so permissive that its nearly impossible to determine that a the situation was a manslaughter case. Kirkey writes:

“It appears that at least some providers are breaking the law,” Lyon said. “But because the MAID law is so permissive it’s hard to differentiate between someone who may be mistaken — but even then, would be a manslaughter case — to someone who is intentionally pushing the boundaries of the law or using the law maliciously.”

“We also know from research that at least some MAID assessors and providers avoid capacity assessments and rely on their own gut feelings,” Lyon said.

“I think when you are giving somebody a legally protected status that allows them to kill, we should ask hard questions about what happens to a person when they’re given that power, how they might use it, what that power might do to that person and who might be drawn to that power, and why.”
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Pro-actively suggesting MAID, as medical staff have been encouraged by guidance from MAID leaders to do, “gives somebody who is enjoying this the licence to seek new opportunities to do this,” Lyon said. “If you believe very strongly in it, or you’ve been given the power to do this, some people might take advantage of that.”

The article ends with Kirkey's interview with Dr Trouton, the euthanasia doctor from Victoria. Trouton defends euthanasia doctors and suggests that every doctor is very careful when killing their patients.

Previous articles by Professor Christopher Lyon:

• Does Canada's euthanasia law prevent healthcare serial killing? (Link).
• Kevorkian's ghosts (Link)
• Dying Indignity: Witnessing my father's medically assisted death (Link).