Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
The article explained that both of them work with patients with advanced cancer and have counselled and assessed patients for euthanasia and one of them has administered the drugs (poison) to end a persons life.
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| Dr's Madeline Li & Gary Rodin |
We’ve seen how beneficial it is to pause and reflect with our own patients. One of them, a woman in her 70s, was the matriarch of her family, the one who made Sunday dinners. She sought and received approval for assisted dying after she lost the ability to cook. She felt she had lost her value to her family. Through counselling, she came to understand that her family valued who she was, not what she did for them. She decided not to go through with ending her life, at least for now. That Christmas, her family gathered and she sat proudly at the table, while others did the cooking and serving.
The woman was approved for euthanasia, based on her medical condition, but she was seeking death based on losing her ability to cook. The authors show how this woman found personal meaning in caring for her family and through counselling she was assured that she continued to have meaning for her family.
The next story was less uplifting, even though it showed counselling enabled this man to delay being killed.
Another patient, a man in his 80s, refused a new treatment that might extend his life and instead requested and was approved for assisted dying. He survived the Holocaust as a child and viewed the freedom to choose the timing of his own death as a way of reclaiming what Hitler had taken away from his parents. However, his living family’s grief mattered to him, too, and they had concerns about him giving up too soon. With counselling, he chose to delay. Months later, he had adapted to his illness and continued to find meaning in his life. Eventually he got sicker and Dr. Li told him he was at risk of losing capacity to consent to assisted dying. This time, he chose the procedure, fully supported and surrounded by his family.With the second story, Dr. Li suggests that his time to be killed had come. I understand that his medical condition had progressed, but the answer to human difficulty should never be medical homicide.
This man could have had a fulfilling final months of life as he approached natural death. Counselling is a good response, but caring not killing, provides hope.
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| Dr Madeline Li |
Calabro interviews Madeline Li, an early euthanasia pioneer who had developed the euthanasia program at the University Health Network in Toronto in 2017. In 2018 Li started questioning the euthanasia program.
It was not long into her practice, however, that Li’s confidence in the direction of her country’s MAID program began to falter. For all of her expertise, not even Li was sure what to do about a patient in his 30s whom she encountered in 2018.
The man had gone to the emergency room complaining of excruciating pain and was eventually diagnosed with cancer. The prognosis was good, a surgeon assured him, with a 65 percent chance of a cure. But the man said he didn’t want treatment; he wanted MAID. Startled, the surgeon referred him to a medical oncologist to discuss chemo; perhaps the man just didn’t want surgery. The patient proceeded to tell the medical oncologist that he didn’t want treatment of any kind; he wanted MAID. He said the same thing to a radiation oncologist, a palliative-care physician, and a psychiatrist, before finally complaining to the patient-relations department that the hospital was barring his access to MAID. Li arranged to meet with him.
Li explained that the prevailing view was that a medical condition was considered incurable if it could not be cured by means acceptable to the patient.
In other words, the law is completely subjective. Someone who has a treatable condition can be killed by euthanasia. Li told Calabro that she agreed with this. Calabro continued:This had made sense to Li. If an elderly woman with chronic myelogenous leukemia had no wish to endure a highly toxic course of chemo and radiation, why should she be compelled to? But here was a young man with a likely curable cancer who nevertheless was adamant about dying.
What was Li left with? According to prevailing standards, the man’s refusal to attempt treatment rendered his disease incurable and his natural death was reasonably foreseeable. He met the eligibility criteria as Li understood them. But the whole thing seemed wrong to her. Seeking advice, she described the basics of the case in a private email group for MAID practitioners under the heading “Eligible, but Reasonable?” “And what was very clear to me from the replies I got,” Li told me, “is that many people have no ethical or clinical qualms about this—that it’s all about a patient’s autonomy, and if a patient wants this, it’s not up to us to judge. We should provide.”
In the end, Li killed this man but she regretted it. This is the crux of the issue. Euthanasia is sold as choice and autonomy, but it requires another person to do the killing.
Rodin and Li are suggesting that a medical "pause" in euthanasia, through counselling, gives patients a chance to discover alternatives or to establish that their life has meaning.
I agree with their premise but I find it to be counter intuitive if it still leads to killing.





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