Friday, December 14, 2018

Third Report From Québec’s Euthanasia Commission - 142 unaccounted deaths.

Published by Toujours Vivant - Not Dead Yet.

This report was researched and written by Amy Hasbrouck and Taylor Hyatt.

Three years ago, on December 10, 2015, Québec’s euthanasia program went into effect. Unlike the federal law, Québec provides euthanasia upon request to eligible persons, as well as “Continuous Palliative Sedation” without the eligibility requirements and safeguards connected to a euthanasia request.

The Commission on end of life care released its third report on the province’s euthanasia program on December 7, covering the period from July 1, 2017 to March 31, 2018, with cumulative data from December of 2015. The Commission adjusted the reporting period to coincide with Québec’s fiscal year, which runs from April 1 to March 31.

As in previous reports from Québec, the most striking fact in this third report is the difference between the number of euthanasia reports submitted by doctors, and the number of euthanasia reported by institutions and the Collège des médecins du Québec. During the reporting period, the Commission received 708 forms (including five for deaths administered in previous years) while this second stream of information from the College de medecin du Québec showed 845 cases of euthanasia (a difference of 142 deaths during the reporting period) representing almost 17 % of the deaths. The report does not acknowledge, or attempt to explain this difference.

We did a summary of the report’s statistics, which we will put up on our website in the documents/reports section.

The Commission reported that 45% of the forms filed by doctors needed follow-up for additional information. Letters and telephone calls were required for 334 forms, and 90 doctors received a second letter when they failed to provide the information the Commission asked for.

The Commission examined a total of 782 forms during the reporting period,

  • 741 were looked at for the first time. 
  • 41 were given a second look, in light of additional information received.  
  • 658 were forms that came in during the current period. 
  • 83 cases were held over from year.
727 cases were decided during the reporting period. Of those, the Commission found:
  • 90% (658) complied with the Québec eligibility criteria and safeguards; 
  • In 7% of cases (50) no determination of compliance was possible, because:
    • Additional information was not provided (23 cases) 
    • In 27 cases, the information provided was still not enough to decide whether the doctor complied with the law.
  • 3% (19 cases) did not comply with the eligibility criteria and safeguards. This included: 
    • three people who were not eligible because they did not have a “serious and incurable illness;” and
    • two instances where the doctor who approved and performed euthanasia only met with the person on the day euthanasia was provided.
Similar figures are shown in the cumulative statistics of Québec’s program for the period from December 10, 2015 to March 31, 2017. While the Commission states that 1,493 euthanasia reporting forms were received from doctors during the period, Institutions and the CMQ report 1,664 euthanasia deaths. Thus, 171 deaths are unaccounted for, probably unexamined and may or may not comply with eligibility requirements and safeguards.

In the past three years, the number of euthanasia has increased steadily in every six month period.

  • 161 – 1st period (12/15-6/16) 
  • 280 – 2nd period (7/16-12/16) 
  • 344 – 3rd period (1/17-6/17) 
  • 437 – 4th period (7/17-12/17) 
  • 542 – 5th period (1/18-6/18) (estimate based on 271 from 1/18-3/18)
Of the 1,374 total cases decided up until March 31, 2008,
  • 90% (1,245 cases) complied with the eligibility requirements and safeguards; 
  • In 4.8% (67 cases) no determination of compliance was possible: 
  • 4.5% (62 cases) did not comply:  
  • 9 cases – Doctor didn’t speak to the person on different occasions to ensure persistence of suffering and wish to die, and capacity;* 
    • 7 cases – Person was not eligible:  
      • 5 cases – Person did not have a “serious and incurable illness”; 
      • 2 cases – The person was not at the end of life;
  • 6 cases – Second doctor signed off before euthanasia request was signed;* 
  • 5 cases – The person who countersigned the request was not a health care professional;* 
  • 4 cases – The person did not have health insurance; 
  • 2 cases – Doctor did not ensure compliance with safeguards.* 
  • In the 29 remaining cases, the second doctor was not independent of the first. However this legal requirement was removed by the minister of health in February of 2017.
* In these cases, the failure of administrative safeguards could put the person’s life at risk.
  • So to recap, we have: 
    • A “medical treatment” that was supposed to be an exceptional option in exceptional cases, that is now in regular use, regardless of whether palliative care is in place; 
    • Substantial increases in the number of people being euthanized every six months, for a total of 1,664 (as of last March); not counting 1,831 continuous palliative sedations performed since 2015; 
    • 171 deaths unaccounted for; 
    • 67 deaths where compliance could not be determined; 
    • 22 deaths where important procedural safeguards were not followed; 
    • 7 deaths of people we know were not eligible for euthanasia; and 
    • Hundreds of instances where doctors don’t file reports, refuse or were unable to provide information necessary to determine whether they complied with safeguards or the person was eligible for euthanasia.
Isn’t that enough evidence to show that something's amiss?

Toujours Vivant-Not Dead Yet is a non-religious organization by and for disabled people. Its goal is to inform, unify and give voice to the disability rights opposition to assisted suicide, euthanasia, and other ending-of-life practices that discriminate against people with disabilities.

They present a weekly online discussion in English every Friday at 3 p.m. to offer up-to-date information about assisted suicide, euthanasia and ending-of-life practices for the disability community.

Please click on the link: to join the webcast.

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