North Bay Ontario Hospice is being pressured to do euthanasia

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

For the past several months the Euthanasia Prevention Coalition has been writing about the plight of the Delta Hospice Society. The British Columbia Minister of Health, Adrian Dix, ordered the Delta Hospice to do euthanasia or lose government funding.

Sign the petition: Hospice Organizations Must NOT be Forced to do Euthanasia (Link).

A similar situation exists in North Bay Ontario where the Nipissing Serenity Hospice is being pressured by four local euthanasia doctors to allow lethal injections on the premises. The Hospice, which only opened its doors on January 11 does not permit euthanasia on its premises. According to the North Bay Nugget:

The four medical providers of MAiD say they “absolutely disagree” with the hospice’s position that MAiD “is not one of the tools in the palliative care basket.”

Doctors Renee Gauthier, Mike Leckie, Paul Preston and John Seguin say in the letter MAiD “is, in fact, a tool, a very special, humane tool that thousands of Canadians have accessed and the Canadian government, under law, has permitted.”

The latest data indicates that there have been 4318 assisted deaths in Ontario (June 17, 2016 - December 31, 2019) with 95 assisted deaths reported in the Nipissing region.

Vivian Papaiz

Vivian Papaiz, chair of the Nipissing Serenity Hospice, does not provide euthanasia. Papaiz told the North Bay Nuggett that the Hospice has discussed the issue but supports the position of the Canadian Hospice Palliative Care Association and the Canadian Society of Palliative Care Physicians. 

The North Bay Nuggett reported:

In a joint statement, the CHPC and the CSPCP say MAiD and palliative care “substantially differ in multiple areas, including in philosophy, intention and approach.

Hospice palliative care focuses on improving quality of life and symptom management through holistic person-centred care for those living with life-threatening conditions. It sees dying as a normal part of life and helps people to live and die well.

Hospice palliative care does not seek to hasten death or intentionally end life.

Hospice organizations should not be coerced into providing euthanasia. Hospice and palliative care are different than MAiD and coercing hospice organizations to do euthanasia, changes hospice.

Canada must learn lessons from Belgium on assisted dying

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Trudo Lemmens

I had the opportunity to attend a presentation, yesterday, by Trudo Lemmens a Professor and Scholl Chair in Health Law and Policy at the University of Toronto, who spoke about the lessons Canadians need to learn from Belgium's euthanasia law.

On January 29, the Montreal Gazette published a special article by Lemmens summarizing his presentation to Canada's consultation on MAID (euthanasia).

Lemmens explains how expanding Canada's euthanasia law in haste is fraught with risks. He writes:

The same week our federal government launched public consultations on proposed revisions to our Medical Assistance in Dying (MAID) law, criminal proceedings started in Belgium against three physicians for their role in the death of Tine Nys. Diagnosed in 2010 at age 37 with Asperger’s, Nys received MAID under Belgium’s liberal euthanasia regime. 

Regardless of the trial’s outcome, the case highlights the challenges of allowing MAID for persons with chronic physical, developmental and mental disabilities not being close to their natural death. Belgium and the Netherlands are the only jurisdictions that allow this. Now we might be heading on the same path in response to the recent Truchon decision by the Superior Court of Quebec, which declared the “reasonable foreseeable death” criterion of MAID unconstitutional.

Lemmens tells the story of Alan Nichols to show how Canada already has a problem with the use of its euthanasia law.

Alan Nichols (Center)

One can think here of 61-year Alan Nichols, who died with MAID in June 2019. The RCMP brought him to hospital because he was confused and suicidal. Deemed capable to consent to MAID shortly after admission, the B.C. man received it one month later. 

His family learned only four days before that his life would be ended. He had a cognitive disability and profound hearing loss, which hindered communication. Nichols’s family begged to halt the procedure to get time to set up better social and health care supports. To no avail. 

If we already see questionable applications with our albeit-vague concept of “reasonable foreseeable death,” what happens when MAID becomes by law a matter of whether we live at all rather than a matter of controlling our manner of dying?

Article: Physically healthy man died by euthanasia in BC.

Lemmens explains the problem with expanding euthanasia to people who are not otherwise dying. He writes:

Legalizing MAID outside the end-of-life context explicitly confirms the ableist presumption that people with chronic disabilities may be better off dead. It opens up MAID for a host of developmental and mental health conditions, characterized by often vague diagnostic criteria and challenging predictions of treatment success. 

Autism, profound grief, schizophrenia, depression, bi-polar disorder, PTSD and anxiety have all been accepted as a basis for MAID in Belgium and the Netherlands. True, these conditions often create immense suffering; but evidence shows that with support and quality care, most learn how to cope and obtain a good quality of life. We cannot predict who does not. 

In the absence of a more objective end-of-life criterion, “unbearable suffering” will become the litmus test for determining whether someone gets MAID. But suffering is shaped by the legal, social, familial and health care context around us, and by health care providers’ perceptions of the quality of a life with disabilities. 

Moving outside of the end-of-life context creates additional concerns about capacity to consent to MAID. With many forms of mental illness, the desire to die is a component of the illness we need to address, not a carefully weighed autonomous choice.

Lemmens concludes by urging the government to examine the experience with euthanasia in the Netherlands and Belgium and then to enhance protections. He states:

Rather than radically expand our current MAID law in haste, and surrender to the court’s short timeline, the government should discuss with Parliament the complex evidence from the two jurisdictions that have taken this path. And Quebec should do the same at the National Assembly with its version of the law. 

We should also assess problems with our current MAID regime and strengthen safeguards for all, including persons with disabilities. This should include a more precise, objective end-of-life-style criterion. If it has doubts about the constitutionality of safeguards, government should submit a stronger law for reference to the Supreme Court. 

When drafting policies involving life and death, we should err on the side of life, not on the side of its termination.

Article: Belgium 2018 euthanasia report.

Article: Netherlands 2018 euthanasia report.

Belgium clears doctors in euthanasia death of a woman diagnosed as autistic.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Three Belgian doctors were prosecuted in the euthanasia death of Tine Nys (38). The family are convinced that Tine was diagnosed as autistic in order to approve her for euthanasia.

Tine Nys (center) with her sisters.

A jury in Belgium has cleared all three doctors in the euthanasia death of Tine Nys (38) who was diagnosed as autistic to qualify for euthanasia. Sadly, this is not surprising.

The Independent News reported:

Three Belgian doctors accused of murder for wrongly helping a woman end her life have been cleared by a court in a landmark case concerning euthanasia.

Relatives of Tine Nys, 38, who was given a lethal injection in April 2010, argued her death was unlawful as she wanted to die due to a failed relationship rather than an “incurable disorder” as required by Belgian law.

BBC News reported that one of the physicians was acquitted because the jury had "reasonable doubt":

The court ruled that in the case of Joris Van Hove, "there was reasonable doubt… and if there is reasonable doubt it is to the benefit of the accused"

A International Business Times article in November 2018, reported that the family believed that Tine was falsely diagnosed as Autistic so that she would qualify for euthanasia and that the law was broken because Tine never received treatment. The IBTimes reported:

Her sisters, however, told investigators that her suffering was caused by a broken heart after a failed relationship and not by autism. They also accused the doctors of making a rushed decision. They said the law was broken because Nys was never treated for autism and hence it had not been proven that she was suffering “unbearably and incurably.”

This was the first attempted prosecution for a Belgian euthanasia death. The attempted prosecution likely resulted in a slowed growth in Belgian euthanasia deaths. In January 2019, Europe's top human rights court agreed to hear the case of a depressed Belgian woman who died by euthanasia and in November 2018 three Belgian doctors were charged in the euthanasia death for psychiatric reasons. of Tine Nys.

In 2018 there were 57 (2.4%) of the euthanasia deaths were for mental or behavioral conditions, 83 (3.5%) for psychiatric reasons alone and 1% of the reported euthanasia deaths were incompetent people who had made a previous request. No children were reported to die by euthanasia in 2018.

No Free Choice To Die for Archie Rolland

Toujours Vivant - Not Dead Yet (TVNDY) is a non-religious organization by and for disabled people. (Link).

By Amy Hasbrouck and Taylor Hyatt
Toujours Vivant - Not Dead Yet.

Since last summer, TVNDY has been gathering stories of people who have been caught in the gears of the medical aid in dying (MAiD) machinery. Most were people who asked to die, but really needed help to live. Many were euthanized, or had life-sustaining care withdrawn or withheld, or simply pled their case via the media in the court of public opinion.

Over the next few months, we’re going to tell these stories of how and why the system has failed people who needed help to live, not to die, in preparation for the five-year review of the MAiD law that is supposed to begin this summer.

Archie Rolland was a landscape architect who lived with Amyotrophic Lateral Sclerosis for 15 years. From 2007 to 2015 he was treated at the McGill University Health Centre’s Chest Institute. In 2013 he wrote an opinion piece in the Montréal Gazette about his experience of “incarceration” in long-term care, and his fears about upcoming changes in his living situation.

In January of 2015 Mr. Rolland was among 17 people, most of whom used respirators, who were transferred to Lachine Hospital’s Camille-Lefebvre long-term care wing, in advance of Montreal Chest’s move to the newly-built “super hospital.” According to a report in the Montreal Gazette, “only 70 per cent of the nursing staff made the transfer, and fewer than half the hospital attendants.” As well, attendants were put on a rotating schedule, which disrupted continuity of care.

According to the Gazette, problems arose as soon as residents moved to the Lachine facility, and Mr. Rolland documented them in emails to the head nurse, the ombudsman, hospital officials and a patient’s committee representative. He reported long delays after pressing the call button, not being provided water, poor positioning causing bed sores, and more dangerous problems. In one incident, staff failed to remove mucus from his throat, then ignored the respirator alarm until his mother ran to get help. On another occasion, attendants leaned on his bed rail, jamming the call button against his head and “laughed at me in my distress.”

Other families also contacted the media about problems caused by staff shortages and rotating schedules, and multiple reports appeared in the Gazette detailing the problems at the Lachine facility. In the summer of 2016, three doctors resigned because their “pleas for additional support led nowhere.”

By July of 2016, Mr. Rolland had had enough. In emails to the Gazette reporter he emphasized that it wasn’t his illness that was killing him; he was tired and discouraged from having to fight for necessary and compassionate care. On July 4 he left the Lachine facility and made the 10-hour trip to the family’s country home in Métis-sur-Mer. Three days later he ordered that his respirator be turned off.

Though transfer to another facility was mentioned as a potential solution, in none of the reports was the possibility raised that Mr. Rolland could have lived at home with attendant services. The residents of the long-term care facility (referred to as “patients” rather than “people”) and were described as “hooked up to” respirators and feeding tubes, rather than “using” such equipment. 

Where is the choice in that?

More than 5400 Canadians died by euthanasia in 2019 more than 13,000 since legalization

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The media was reporting that there have been more than 6700 MAID deaths in Canada since it was legalized. I estimate that there have been at least 13,000 euthanasia deaths and here is how I defend this estimate.

The 6700 deaths was based on the Fourth Interim Report on Medical Assistance in Dying released by Health Canada on April 25, 2019 which stated that there were 6700 assisted deaths up to October 31, 2018. The data in the report from Quebec and the three Territories was incomplete. The Quebec data in the Health Canada report was up until March 31, 2018. (Link to my commentary on the report)

The Health Canada report was sloppy by stating that the number assisted deaths represented 1.12% of all deaths. The Health Canada report divided the number of reported assisted deaths into the total deaths, but they did not remove the total Quebec deaths from March 31 - October 31 from the equation.

The number of assisted deaths as of December 31, 2018, was approximately 7949.

(The government of Canada estimated that there were 5444 assisted deaths in 2019 and 4438 assisted deaths in 2018 in Canada on February 24, 2020)

On March 21, 2019 I reported that there were 7949 assisted deaths in Canada as of December 31, 2018 representing 4235 assisted deaths in 2018, an increase of 50% over 2017, representing almost 1.5% all deaths in 2018. The data from my report was obtained from a presentation by Jocelyn Downie, an academic euthanasia activist, who spoke on March 15, 2019 to a Royal Society of Canada luncheon in Ottawa. 

Similar to the Netherlands and Belgium, nearly all of the assisted deaths are euthanasia (lethal injection) rather than assisted suicide.

We don't have national assisted death statistics for 2019 but we do have accurate data from Ontario and Alberta. 

According to the data from the Ontario Office of the Chief Coroner there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing nearly a 20% increase in Ontario assisted deaths in 2019. 

What is more striking about the data is the increase in the second half of 2019 where there were 1015 assisted deaths in the second half of 2019 up from 774 in the first six months of 2019, meaning that Ontario will likely have more than 2000 assisted deaths in 2020.

Alberta Health Services updates there assisted death data regularly. The Alberta data indicates that there were 377 assisted deaths in 2019 up from 307 in 2018, and 206 in 2017. The data indicates a 23% increase in Alberta assisted deaths in 2019.

A report by Marney Blunt for Global News stated that the number of assisted deaths are increasing quickly in Manitoba. Blunt reported that the number of Manitobans dying by euthanasia skyrocketed. The report stated:

When medically-assisted death first became legal in 2016, 42 people requested the service and 24 received it. That number rose in 2017, when 142 people requested MAiD and 63 people received it. 

Those numbers almost doubled in 2018, when 239 requested and 138 received. Last year, 313 people asked for a medically-assisted death, and 177 people received it.

The data indicates a 28% increase in Manitoba reported assisted deaths in 2019.

Since Ontario, Alberta and Manitoba had approximately a 20% increase in 2019, I would assume that there was a similar increases nationally. Therefore there approximately 5000  (4235 + 20%) assisted deaths in Canada in 2019 and 13,000  assisted deaths since legalization. Even if the numbers were slightly lower than 5000 in 2019, today is January 20, so it is safe to say that there has been 13,000 assisted deaths since legalization.

But that is not the whole story.

Canada's data collection system does not account for under-reporting of assisted deaths, but Quebec's data collection system can account for under-reporting. Quebec employs a multi report system making it possible to uncover the number of times a physician didn't report the assisted death.

Based on an analysis by Amy Hasbrouck and Taylor Hyatt, the Quebec interim report indicated that between April 1, 2017 – March 31, 2018 there were 142 unaccounted assisted deaths in the data representing 17% of all assisted deaths. The Quebec Interim report also indicated that 7 assisted deaths did not fit the criteria of the law, 22 assisted deaths did not follow procedural safeguards and in 67 assisted deaths, the physician did not provide the necessary information to determine if the patient fit the criteria of the law.

Based on the Quebec Interim report, if we extrapolate the data to all of Canada, it would suggest that there may have been more than 2000 (17%) unreported assisted deaths in Canada and approximately 60 assisted deaths that did not fit the criteria of the law.

This article is based on hard facts and conservative estimates. The fact is that Canada's assisted death law is quickly going out of control. The recent federal government consultation, that employs biased questions, is not concerned about Canadians whose lives are taken without due process.

Manitoba: MAID euthanasia deaths are increasing quickly.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week I reported that there were approximately 5000 assisted deaths in Canada in 2019 and 13,000 since legalization.

On January 20th I reported that, in Ontario there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing an almost 20% increase in 2019.

The increase in the second half of 2019 is striking. In Ontario there were 1015 assisted deaths in the second half of 2019 up from 774 in the first six months of 2019. Ontario will likely have more than 2000 assisted deaths in 2020.

On January 14th I reported that the Alberta data indicates that there were 377 reported assisted deaths in 2019 up from 307 in 2018, and 206 in 2017. The data indicates a 23% increase in Alberta assisted deaths in 2019.

A report by Marney Blunt for Global News states that the number of assisted deaths is increasing quickly in Manitoba. Blunt reported that the number of Manitobans dying by euthanasia skyrocketed in the past few years. The report stated:

When medically-assisted death first became legal in 2016, 42 people requested the service and 24 received it. That number rose in 2017, when 142 people requested MAiD and 63 people received it.

Those numbers almost doubled in 2018, when 239 requested and 138 received. Last year, 313 people asked for a medically-assisted death, and 177 people received it.

The data indicates a 28% increase in Manitoba reported assisted deaths in 2019.

Sadly, I expect a further increase in assisted deaths now that a Quebec court struck down the "terminal illness" requirement in the law. The Quebec court decision was not appealed by the government causing an incremental extension of the law to people who are not terminally ill and may be psychologically suffering.

After the election, Prime Minister Trudeau announced that a first priority for the government is to amend Canada's euthanasia law.

Do you have a personal euthanasia story? Sharing your story may help us prevent other euthanasia deaths. Contact us at: 1-877-439-3348 or info@epcc.ca.

The Extreme Ableism of Assisted Suicide

The following article was published by Not Dead Yet on January 28, 2020

By Diane Coleman, President & CEO Not Dead Yet

Diane Coleman

I just came across a brilliant letter that John Kelly sent to the Washington, D.C. Council when they were considering an assisted suicide bill in 2016. I should have posted it here then, but I am doing so now because it’s one of the best discussions I’ve read of the core problem that assisted suicide advocates have with disability.

Let me just highlight one example from the letter, a Washington Post quote from Dan Diaz, who is still working for Compassion and Choices, traveling around the country doing press conferences and testifying on their behalf in favor of these dangerous bills.

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bedsores, I would then submit, ‘Is that really living?’ ” Diaz said. 

Although assisted suicide proponents often accuse opponents of fearing death, the letter below demonstrates how profoundly proponents fear and loath disability. Their ableism is so extreme that they want to carve a vaguely defined segment of old, ill and disabled people out of suicide prevention, enlist our healthcare system in streamlining our path to death, and immunizing everyone involved from any legal consequences, thereby denying us the equal protection of the law.

November 1, 2016

Chairman Mendelson, Councilmembers:

John Kelly

My name is John Kelly. I am the New England Regional Director for Not Dead Yet, the national disability rights group that has long opposed euthanasia and assisted suicide. I am also the director of Not Dead Yet’s Massachusetts state affiliate, Second Thoughts MA: Disability Rights Advocates against Assisted Suicide.

I refer you to two recent articles in the Washington Post. Read together, they must lead you to vote against assisted suicide bill B21-38. Assisted suicide isn’t about physical pain at all, despite what proponents have told you. And assisted suicide benefits one specific group in the district and country, wealthier white people, while disadvantaging poorer people, and people of color specifically.

The first article came out last Monday, October 24. Titled “‘Death with dignity’ laws and the desire to control how one’s life ends,” this article exposes the main argument for assisted suicide, “that terminally ill patients have the right to die without suffering intractable pain in their final days or weeks,” as a big lie.

Author Liz Szabo reports that assisted suicide proponent group Compassion & Choices “focuses heavily on the need to relieve dying patients of pain.” One ad has the assisted suicide bill giving “a dying person the option to avoid the worst pain and suffering at the end of life.”

Yet the latest research shows that terminally ill patients who seek aid in dying aren’t primarily concerned about pain. Those who have actually used these laws have been far more concerned about controlling the way they exit the world than about controlling pain.

As one California doctor said, “It’s almost never about pain. It’s about dignity and control.”

And that’s what the Oregon and Washington data show. Pain is the least of people’s concerns. Doctors report people requesting the lethal drugs because of psychosocial suffering about becoming disabled through their illness. It’s mental distress about becoming dependent on other people (“losing autonomy” 92%), losing abilities (“less able to engage in activities making life enjoyable” 90%), shame and perceived/actual loss of social status (“loss of dignity” 79%), needing help with incontinence (“losing control of bodily functions” 48%), and believing that suicide would leave loved ones better off (“burden on family, friends/caregivers” 41%).

Dr. Ira Byock, a leading palliative care expert, told the Post, “it’s a bait and switch. We’re actually helping people hasten their deaths because of existential suffering. That’s chilling to me.” As Byock said, almost all pain is controllable. Hospice staff are on call 24 hours a day, and caregivers can be trained in administering emergency pain medication until staff arrive.

The real reasons that people want to commit assisted suicide, proponents admit, are about being dependent on other people for personal care. We disability rights activists have been pointing this out all along.

Barbara Coombs Lee, who as an insurance company executive wrote Oregon’s assisted suicide law, brought up the case of the woman who committed assisted suicide because she was incontinent. The woman wrote that “the idea of having somebody take care of me like I am a little 2-month-old baby is just absolutely repulsive. It’s more painful than any of the pain from the cancer.”

Lee described scenarios of disability that she said were “worse than death.” Proponent Dan Diaz emphasized the supposed horrors of disability.

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bedsores, I would then submit, ‘Is that really living?’

This isn’t a public health bill, it’s a death before disability bill.

So this is what some of you are planning to vote for. You are not protecting DC residents from agonizing pain. You are promoting the particular views of one specific group of people, described by Obamacare architect Ezekiel Emanuel as predominantly “white, well-insured, and college-educated.” People who are used to being in control of every aspect of their lives.

So, like so much in the US, assisted suicide is an issue that cuts across class and race. The 2012 election map in Massachusetts shows that wealthier, whiter areas voted heavily for legalization, while working-class whites and people of color voted strongly against. People turning out for Barack Obama and current Sen. Elizabeth Warren defeated the proposal.

The second article, from October 17, by reporter of color Fenit Nirappil, was titled “Right-to-die law faces skepticism in nation’s capital: ‘it’s really aimed at old black people.’” It details the opposition to assisted suicide of Washington’s black majority.

Many in the black community distrust the health-care system and fear that racism in life will translate into discrimination in death, said Patricia King, a Georgetown Law School professor who has written about the racial dynamics of assisted death.

“Historically, African Americans have not had a lot of control over their bodies, and I don’t think offering them assisted suicide is going to make them feel more autonomous,” King said.

District residents told Nirappil of concerns that “low-income black senior citizens may be steered to an early death”, and that in the end, assisted suicide is really all about reducing government healthcare costs.

Derek Humphry, who founded the Hemlock Society (Compassion & Choices’ original name), wrote years ago of the “unspoken argument,” that assisted suicide will gain traction because of “the realities of the increasing cost of health care in an aging society, because in the final analysis, economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice.”

Assisted suicide, like suicide in general, is primarily practiced and promoted by white people. Nirappil reported that national leaders in the assisted suicide movement are all white, and that most of the participants at a recent rally were white. In the 18 year history of the Oregon assisted suicide law, only one black person has used the program. In a state that is now 22% nonwhite, 97% of assisted suicide deaths have been white.

Non-Hispanic whites also commit regular suicide at a rate 2.5 times that of blacks. Rather than importing a predominantly-white practice as a solution for the district, you must say no to this bill and the big lie it hides behind. Assisted suicide is not about protecting suffering people from physical pain, it’s about satisfying the control needs of a group of people, predominantly white, who would rather die than become dependent on another human being.

Please respect your constituents, understand the danger this bill represents, and reject this bill. Thank you.