Monday, December 3, 2018

Is Child Euthanasia Next in Canada?

Canada legalized euthanasia and assisted suicide in June 2016 under the term Medical Assistance in Dying (MAID).

Download the petition to the House of Commons and collect signatures opposing child euthanasia. (Petition Link)

Please sign our online petition to the Canadian government.

In December 2016, the federal government announced that the Council of Canadian Academies (CCA) would research and provide recommendations in December 2018 concerning the expansion of euthanasia in three areas:

  1. Mature minors (child euthanasia), 
  2. People who are incompetent but previously requested MAID, and 
  3. For psychological suffering alone. 
This pamphlet concerns the issue of child euthanasia. (Pamphlet Link).

In September 2018, the Journal of Medical Ethics published a paper titled, “Medical Assistance in Dying at a paediatric hospital.” This paper concerns a proposed policy for implementing euthanasia for children that was developed by a committee at the Hospital for Sick Children in Toronto. The paper states that it: intended as a road map through the still-emerging legal and ethical landscape of paediatric MAID.
Based on the influence of the Hospital for Sick Children, the Euthanasia Prevention Coalition (EPC) is concerned that the proposed policy outlined in this paper would impact the direction that the Canadian government follows if it extends euthanasia to children.

What did the Hospital for Sick Children’s committee recommend?

The paper considered several issues of which we will focus on two: 

  1. Is euthanasia (MAID) the same or different than other end-of-life (EOL) medical decisions? Is killing different than a decision to withhold or withdraw medical treatment that may lead to death?
  2. Is the decision-making process the same or different than other EOL medical decisions? 
Is euthanasia the same or different than other EOL medical decisions?
The federal government legalized euthanasia in Canada by defining it as an exception to homicide in the Criminal Code rather than defining it as medical treatment. This means that they intended euthanasia to be different than EOL medical decisions. The government justified restrictions on euthanasia, such as limiting it to competent adults over the age of 18, since euthanasia was seen as an exception in the law.

The Québec government, unlike the federal government, legalized euthanasia by regulating it as a medical act. These divergent euthanasia laws in Canada create confusion.

The Hospital for Sick Children’s committee recognized that euthanasia is seen as different than EOL medical decisions but in its deliberations they rejected this position.

The committee redefined the nature of euthanasia based on the request to die rather than the act of causing death. The committee suggested that when euthanasia is defined by the reason it is requested, it becomes the same as EOL medical decisions. The paper states:

This position shifts attention away from the ethical obligations of the clinician and, instead, towards what is morally at stake for the person who is requesting MAID. Seen in this way, an important point of similarity emerges between MAID and other medical practices that result in the end of life.
Withholding or withdrawing treatment is different than euthanasia. When treatment is withheld or withdrawn, death may occur, and if it does, may take days or weeks. When a person is lethally injected, there is no question if and when the person will die.

Is the decision-making process the same or different than other EOL medical decisions?

By deciding that euthanasia (MAID) is the same as other EOL medical decisions, the committee decided that the decision-making process for euthanasia should also be the same.

Since “mature minors” under the age of 18 already have the right in Ontario to make EOL medical decisions without the consent of parents, a child who is deemed capable of consenting could also decide to die by lethal injection (euthanasia) without the consent of parents. The paper states:

Usually, the family is intimately involved in this decision-making process. If, however, a capable patient explicitly indicates that they do not want their family members involved in their decision-making, although healthcare providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected.
The committee decided to compromise on the issue of how requests for euthanasia would be made. Since other EOL medical decisions are initiated by medical professionals, the committee thought that the same process should be instituted for euthanasia. But the committee experienced “push-back” from medical staff so they decided to compromise, for now, deciding that discussions about euthanasia would only be initiated by the patient. The paper states:
In light of these concerns, our drafted policy makes discussing MAID permissible when patients express suffering and request information about ending their life, but stops short of a prima facie obligation to inform patients about the existence of MAID. We plan to revisit this issue in future iterations of the policy when some of the contemporary social controversy and uncertainty around the practice of MAID has become more settled.
The EPC is concerned that the committee stated that it may allow physicians to initiate euthanasia discussions when the practice of euthanasia has become more accepted.

We fear that the Hospital for Sick Children in Toronto published their proposed policy on child euthanasia to influence the deliberations of the CCA who will be releasing recommendations in December 2018 on extending euthanasia to children.

The Canadian law states that MAID can be done when it is approved by two doctors or nurse practitioners when the person fulfills all of the following conditions:

  • is at least 18 years old, 
  • has a serious and incurable illness, disease or disability,
  • has an advanced state of irreversible decline in capability, 
  • has enduring physical or psychological suffering that is intolerable, and 
  • their natural death is reasonably foreseeable (undefined). 
Canada’s euthanasia law does not permit euthanasia for children.

The Euthanasia Prevention Coalition opposes euthanasia and assisted suicide and we are concerned that Canada may decide to extend euthanasia to children.

Please sign our online petition to The Hon. Jody Wilson-Raybould, Minister of Justice and Attorney General of Canada and The Hon. Ginette Petitpas Taylor, Minster of Health, opposing the extension of euthanasia to children.
Contact us to request a digital file of the petition and/or to order free copies of this pamphlet. A donation for shipping costs is appreciated. Please mail in all original signed petitions to our address below. 


gadfly said...

Q: If the hospital is doing the right thing on euthanasia, why are they worried about push-back? Another Q: why is it that the hospital isn't giving a full list of doctors willing to kill, citing 'safety' reasons? Have they had threats? Doesn't the public and those who are patients have a right to know if they are potentially unsafe right now? A: They haven't had threats. It's ideological steering to position pro-life people as 'dangerous'.

Paul Anderson said...

Very disturbing. One of the members of the committee at the Hospital for Sick Children was quoted as saying "We're not talking about killing children". Someone needs to clarify to this person that MAiD involves actively causing death to occur. Eventually, the discussion will arrive at the question of when MAiD ought to be administered presumptively, without request, in the "best interest" of the patient.