Canadian euthanasia study offers more questions than answers.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A study examining MAID data from Ontario, the largest province in Canada, reports confirms much of what we knew already about euthanasia/assisted suicide deaths worldwide, but the data actually opens questions about the use/misuse of euthanasia in Canada.

Article: Euthanasia deaths rise quickly in Ontario. Nearly 1800 reported assisted deaths in 2019 (Link).

The data indicates that many of those who died by euthanasia were not terminally ill and had decided to die by lethal injection rather than live in a nursing home / institutional setting.

The lead study author, Dr James Downar, is a founder of the Dying with Dignity physicians advisory council and a long-time euthanasia promoter. 

This study will be used to assure politicians that Canada's euthanasia law can be expanded without fear of negative effects to vulnerable groups. It will also be used to undermine the resistance of palliative care doctors to euthanasia.

The data in this study was obtained from the euthanasia reports submitted to the Chief Coroner of Ontario. The reports are submitted by the doctors or nurse practitioners who lethally injected the person. This data was submitted, in a self-reporting system, to justify the act of euthanasia.

Since doctors don't self-report controversial decisions, it is unlikely that comments from these reports will uncover abuse.

Kelly Grant, writing for the Globe and Mail newspaper reported:

Patients who choose medically assisted death are wealthier, younger, more likely to be married and less likely to live in long-term care than those who die naturally, according to a major study of assisted dying in Canada’s most populous province.

The media suggests that this study proves that euthanasia does not negatively effect people who are poor or vulnerable, but in fact this study simply confirms what we have always known that people who are white, wealthy and worried are more likely to die an assisted death.

The study examined the data from 2241 reports from the euthanasia deaths in Ontario between June 17, 2016 and October 31, 2018.

Grant reports on the data in the study:

Patients who received an assisted death were more likely to be wealthy, with 24.9 per cent of MAID recipients earning enough to be in the highest of five income brackets. By contrast, 15.6 per cent of patients who died naturally were in the top income bracket. 

The study found that Ontario MAID recipients were, on average, two-and-a-half years younger when they died, and less likely to have been living in an institution, usually a nursing home, before they died. 

Of those who died naturally, 28 per cent lived in institutional settings, while only 6.3 per cent of MAID recipients did. 

The data in the study indicates that those who died by euthanasia died at age 74.4 (average) whereas those who died a natural death died at age 77 (average). 

Why are people dying by euthanasia 2.6 years younger than those who die a natural death? 

Why are people who die by euthanasia less likely to live in an institution (nursing home etc).

The data suggests that many of those who died by euthanasia were not terminally ill and decided to die by lethal injection rather than live in a nursing home / institutional setting.

Canada's euthanasia law stated that: natural death is reasonably foreseeable, but the law did not define this. It appears that most doctors had a wide interpretation of natural death being reasonably foreseeable.

Those who died by euthanasia stated that they were experiencing physical suffering (99.5%) of the time and psychological suffering (96.4%) of the time. The Canadian law states that physical or psychological suffering "is intolerable to them and that cannot be relieved under conditions that they consider acceptable." which is completely subjective.

The study states that:

Psychiatric consultations were performed in 6.2% of cases. In 4.3% of cases, the MAiD recipient had been found ineligible for MAiD on a previous request.

Considering the conditions that people may experience as they approach death, it is surprising that only 6.2% of the MAID deaths had a psychiatric consultation.

The data indicates that people who died by euthanasia had access to palliative care (74.4%) of the time suggesting that people are not asking to be killed due to lack of alternatives.

Grant reported that Ebru Kaya, a Toronto palliative care specialist questioned this assertion:

...“They use this blanket term. Palliative care providers could mean anything. The MAID assessor who is also a palliative care physician may use that clinical encounter to assess for MAID as a palliative care encounter, but the two are very different.”

Similar to previous studies, this study examines data from reports submitted by doctors and nurse practitioners who did the lethal injection. There are no interviews with patients, before they died, to determine why are they asked for death. There are no "third party" reports to ensure that the "letter of the law" was followed.

We do not know why people are dying 2.6 years earlier than those who died a natural death.

It is likely that many of the people were not terminally ill but facing the dilemma of having to live in a long-term care institution because their health condition required care.

I suggest that this study proves that people with disabilities are right. Canadians are deciding that death is preferable to living with a disability.