Friday, May 29, 2020

Starvation led to approval for euthanasia in Canada.

This article was published by Toujours Vivant - Not Dead Yet on May 29, 2020.

By Amy Hasbrouck

In June of 2016, just as medical aid in dying (MAiD) was adopted in Canada, a British Columbia woman known as Ms. S. who had Multiple Sclerosis was evaluated for MAiD by Dr. Ellen Wiebe. According to Jocelyn Downie, Dr. Wiebe concluded that Ms. S. met most of the eligibility criteria (incurable condition, advanced state of decline in capability, and enduring and intolerable suffering) but the doctor did not believe Ms. S. would die “in the foreseeable future,” so she was determined ineligible. 

As we reported in March of 2018, the Final Disposition Report of the Inquiry Committee of the College of Physicians and Surgeons of British Columbia, found that Ms. S. was “suffering from … trigeminal neuralgia and gastrin [sic] intestinal symptoms for which treatment had been only minimal [sic] effective.” Elsewhere in the report, another physician said Ms. S. had declined “potentially effective” treatment.

Dr. Wiebe exchanged correspondence with Ms. S. in December of 2016 and January of 2017, to the effect “that the patient’s life expectancy was not short enough to qualify for medical aid in dying.” Then in mid-February of 2017, “Ms. S decided to starve herself to death at home, with the support of palliative-care nursing.”

Her husband called Dr. Wiebe two weeks later, and Dr. Wiebe visited Ms. S. on March 3. At that time, Dr. Wiebe determined that she met all eligibility criteria, and she was euthanized on March 6, 2017.

The Inquiry Committee, in its final disposition report of February 13, 2018, found that:

  • “MAiD is intended to be restricted to those individuals who are declining toward death, allowing them to choose a peaceful death, as opposed to a prolonged, painful or difficult one.”
  • “In view of the foregoing standard, a patient cannot be forced to take treatment they do not consider acceptable.” 
  • “Ms. S. met the requisite criteria and was indeed eligible for medical assistance in dying despite the fact that her refusal of medical treatment, food, and water undoubtedly hastened her death and contributed to its ‘reasonable foreseeability’.” 
Ms. S.’ suicidal act highlights a basic flaw of assisted dying: governments have put their efforts toward the goal of ending lives, rather than ending suffering. 

From the information provided, we don’t know what symptoms Ms. S. had, how her family and friends reacted to her disability, whether she had peer support, whether she’d received specialist care for her multiple sclerosis, what treatment(s) had been tried, and whether she had received effective palliative care and mental health services. But when the government, in the person of a euthanasia provider, puts its thumb on the scale in favour of death, it makes the struggle to live well with a disability just that much harder.

At the same time, the public policy conclusion drawn by this case is that the person asking to die should not be burdened with the obligation of first trying to improve their quality of life. This might make sense if there were no social costs from assisted suicide and euthanasia (AS & E). But there are very significant social costs, not just to those who choose to die, their families and medical practitioners, but to all people whose lives are devalued and put in danger by the practice.

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Thursday, May 28, 2020

4500 New York patients who tested positive for COVID-19 were sent to nursing homes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Governor Andrew Cuomo
On May 13 I reported that New York Governor, Andrew Cuomo, had just rescinded a policy forcing nursing homes to accept Covid-19 positive patients.

I stated that a policy forcing nursing homes to accept residents who are infected with a deadly virus that spreads was a policy that would lead to many deaths.

On May 22, Bernard Condon, Jennifer Peltz and Jim Mustian reported for the Associated Press that more than 4500 COVID-19 patients were sent to nursing homes in New York. The report stated:

More than 4,500 recovering coronavirus patients were sent to New York’s already vulnerable nursing homes under a controversial state directive that was ultimately scrapped amid criticisms it was accelerating the nation’s deadliest outbreaks, according to a count by The Associated Press.

AP compiled its own tally to find out how many COVID-19 patients were discharged from hospitals to nursing homes under the March 25 directive after New York’s Health Department declined to release its internal survey conducted two weeks ago. It says it is still verifying data that was incomplete.
The AP article quoted Daniel Arbeeny, who took his 88-year-old father out of a nursing home that had 50 COVID-19 deaths. Arbeeny stated:
“It was the single dumbest decision anyone could make, ...This isn’t rocket science,... We knew the most vulnerable -- the elderly and compromised -- are in nursing homes and rehab centers.”
Gurwin Jewish home.
The AP article reported that nursing homes were flooded with COVID-19 positive residents. 

Gurwin Jewish, a 460-bed home on Long Island, seemed well-prepared for the coronavirus in early March, with movable walls to seal off hallways for the infected. But after the state order, a trickle of recovering COVID-19 patients from local hospitals turned into a flood of 58 people.

More walls were put up, but other residents nonetheless began falling sick and dying. In the end, 47 Gurwin residents died of confirmed or suspected COVID-19.
Tobias Hoonhout, in his article published by the National Review, suggests that the New York Department of Health is hiding the fact that the order existed. Hoonhout wrote:
The New York Department of Health has apparently deleted a March order issued by Governor Andrew Cuomo that forced nursing homes to admit Covid-positive residents.

The order, which was implemented on March 25, stated that “no resident shall be denied re-admission or admission to a nursing home solely based on a confirmed or suspected diagnosis of COVID-19,” and also prohibited nursing homes from requiring testing prior to admission or readmission. But the order is no longer visible on the state’s website.
The AP article reported that the March 25 directive was based on a fear that the hospital system would be overwhelmed.

There must be an independent investigation into the March 25 order by Governor Cuomo that possibly led to thousands of nursing home resident deaths.

A recent Canadian military nursing home report uncovered disturbing conditions. COVID-19 positive residents sharing a room with healthy residents, COVID-19 positive residents wandering the hallways, staff not following infection control rules and more.

Based on the number of COVID-19 New York nursing home deaths, silence is unconscionable,  the truth must be known. 

This may be the worst case of elder abuse in the history of America.

Wednesday, May 27, 2020

Military reports disturbing conditions in Ontario nursing homes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have been writing about the tragic COVID-19 nursing home deaths. On April 14 I wrote about COVID-19 Triage guidelines and nursing home deaths and on May 13 I wrote about the New York State policy that may have led to thousands of nursing home resident deaths

In Ontario, nursing home residents comprise more than 75% of the COVID-19 deaths.  The Canadian military was called in to provide needed care and support in nursing homes that were strained by the COVID-19 outbreak.

According to a Global news report:
A total of 285 military members were working in Ontario care homes. In Quebec, more than 1,500 soldiers were sent to 25 long-term care homes, with up to 60 at each facility. More than two dozen Canadian soldiers have now tested positive for COVID-19.
This military intervention not only provided care for vulnerable people, it also provided an impartial witness to the care (or lack thereof), that the residents were receiving.

Military member providing care
Military personnel who were caring for nursing home residents released an horrific report of systemic nursing home elder abuse. According to the CBC News Report by Nick Boisvert:
Military service members, who have been providing assistance at the homes since April 28, say they have observed numerous forms of unhygienic and dangerous behaviour. 
The list of allegations includes:
  • Repeated use of medical equipment between COVID-19 patients and others who had not tested positive, without it being disinfected.
  • Improper use of personal protective equipment (PPE) by staff and doctors.
  • Housing of COVID-19 patients with residents who had not tested positive.
  • Staff reusing gloves or not washing hands between resident interactions.
  • Staff being aggressive with residents during medical procedures.
  • Residents calling for help with no response for up to two hours.
  • The presence of insects, including cockroaches and ants.
Ontario Premier Doug Ford
Boisvert reported Ontario Premier Doug Ford stating in his press conference:

"It was so disturbing ... It was the worst report, most heart-wrenching report I have ever read in my entire life"
A Global News report stated:
The soldiers reported witnessing cockroaches, flies, rotten food, as well as residents left in soiled diapers or crying out for help for lengthy periods, the documents allege. At one facility, residents had not been bathed in weeks, they said. 
At a facility in Etobicoke, residents who tested positive for COVID-19 shared rooms with uninfected residents, separated only by a curtain, the documents said. 
It found “major concerns” at Eatonville about care, infection control and narcotics abuse. 
The Orchard Villa home had cockroaches and flies, and residents were “left in beds soiled in diapers.” New staff were not trained adequately, nor was protective gear used properly. 
It said staff were not always sitting residents up before feeding them, and that this may have contributed to the death of a resident who choked after being fed “while suppine.”
All of this and more is occurring in Ontario where we have universal healthcare. Please read the Global news report.

The horrific incidents outlined in the report reveal a culture disrespect and dehumanization towards people needing care. Philosophers like Peter Singer, who teach that people with certain cognitive conditions cease being persons have contributed to this epidemic of disrespect and harm.
This military report confirms the truth of what the community living movement believes, that it is essential for all human beings to have equality and inclusion in society. Institutionalizing people with disabilities or the elderly leads to exclusion and discrimination and eventual abandonment.

The abusive behaviour, mismanagement and dehumanizing conditions is heart breaking and leads me to state that: 
  1. Doctors and nurse practitioners, who kill people by euthanasia make decisions based on societal attitudes towards living with physical and psychological needs.
  2. The concept of "freedom of choice" does not apply to conditions and attitudes that lead someone to believe that people living with certain conditions are better off dead. Subtle and overt social pressures creates a cultural shift from a "choice to die" to an expectation to die.
  3. Some people have asked to die by euthanasia to avoid living in a nursing home. This report may lead to a "clean-up of nursing, it will also lead to more euthanasia deaths.
We need a caring culture: a culture that does not institutionalize the elderly, infirm or people with disabilities, but rather offers compassionate community care. 

Policies that promote home care and enable people to live independently need to be implemented. For people experiencing dementia or Alzheimer's, a community such as Hogeweyk, in the Netherlands provide an excellent example of how this is done.

Institutionalizing and warehousing people results in a culture of abandonment, abuse and often death. 

Tuesday, May 26, 2020

Oklahoma Bans ‘Quality of Life’ Health-Care Rationing

This article was published by National Review online on May 26, 2020

By Wesley J Smith

Wesley Smith
As many in the bioethics movement push various schemes to ration health care based on “quality of life” — such as the odious QALY (quality adjusted life year) system beloved of the New England Journal of Medicine — some are pushing back and insisting that health-care coverage and treatment public policy be predicated on the intrinsic equal dignity and moral worth of all patients.

Toward that end, Oklahoma’s governor just signed into law a bill that outlaws such invidious and bigoted discrimination. From HB 2587:

The Legislature finds and declares that:
  1. Physical and mental disabilities, age or chronic illness should in no way diminish a person’s right to life, human dignity and equal access to medical care;
  2. Historically, persons with disabilities, advanced age or chronic illness have faced discrimination in the health care system, including the denial of access to life-sustaining care;
  3. Such discrimination is inconsistent with our society’s commitment to human dignity and the full inclusion of persons with disabilities throughout society;
Such discrimination is now legally prohibited:
An agency shall be prohibited from developing or employing a dollars-per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual’s disability, including age or chronic illness, as a threshold to establish what type of health care is cost effective or recommended. 
An agency shall be prohibited from utilizing such adjusted life year, or similar measure, as a threshold to determine coverage, reimbursement, incentive programs or utilization management decisions, whether it comes from within the agency or from any third party.
More of this please, the sooner the better! Considering how shamefully and lethally New York and some other states treated the elderly residing in long-term care facilities during the worst days of the COVID-19 crisis, it is very clear that these laws are desperately needed.

Uruguay bill would legalize wide open euthanasia and assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A bill to legalize euthanasia and assisted suicide was introduced on March 11 in the Uruguayan Congress. The Uruguay bill lacks definition allowing it to be have a wide interpretation.

My commentary of the bill is based on a google translation of the text of the bill.

Article one of the bill provides legal protection for doctors who are willing to cause the death or assist the suicide of:

“a person of legal age, psychologically fit, ill with a terminal pathology, irreversible and incurable or afflicted by unbearable suffering, kills you or helps you kill yourself.”
It is clear that the bill legalizes euthanasia and assisted suicide because it states that the doctor will kill you or help you kill yourself makes.

Euthanasia is an intentional act to kill a person, upon request, who is disabled, sick or suffering. In most countries, euthanasia is prohibited by homicide or murder laws.

Assisted suicide is to intentionally provide the means for another person to kill oneself.

The Uruguay bill allows for a wider interpretation because it does not define the terms terminal pathology or unbearable suffering. 

The bill does not require a person to try effective treatments. There are many terminal conditions, where the person, with treatment may have years to live.  The term unbearable suffering is subjective. Some people find their condition to be unbearable but once they have received pain or symptom management, they change their mind. If terms are not defined or subjective, the doctors who participate in euthanasia will interpret the meaning of these terms over time.

Article two of the bill requires a second doctor to examine and confirm the medical diagnosis of the person requesting death.

Article three of the bill requires the primary doctor to confirm that the person requesting death is competent, free from coercion, has a continuous desire to die, and knows about alternatives. This article requires a second interview be done at least 30 days after the first request. The bill allows someone else to sign for the person requesting death. Allowing another person to sign-off is inappropriate and dangerous.

Article four of the bill requires the formal request for death to be made 3 days after the second interview. Once again, the bill allows someone else to sign. The bill also allows one of the witnesses to be a beneficiary. In most jurisdictions, a beneficiary is unable sign a will. This issue deals with life and death, rather than property and finances.

Article five of the bill states that the request is revocable.

Article six of the bill requires that the doctor who prescribes the lethal drugs (assisted suicide) must assure that the drugs are only used by the person who they are prescribed for. If the prescribing doctor is not present at the time of death, how will the prescribing physician assure that this happens?

Article seven of the bill requires the doctor who does the act or prescribes the lethal drugs to report the death to the Commission on Bioethics and Integral Quality of Health Care of the Ministry of Public Health, whether the doctor was present at the death or not.

This bill provides the physician with the: power to decide if the person should die, legal protection to cause the death, and then legal oversight to self-report the death to the authorities. Self-reporting systems provide the perfect legal cover since the only person who would know if the law was broken is the person who is dead.

Comments: The bill does not define the key terms, therefore the Uruguay euthanasia and assisted suicide bill can be interpreted in wide manner. For instance, most US states define terminal illness with a six month prognosis. 

The bill does not require a person to at least try effective treatments. There are many medical conditions that, if untreated, become terminal. Unbearable suffering is a subjective term. A person may be depressed or experiencing suicidal ideation and decide that their health condition is unbearable in order to be put to death.

Canada’s euthanasia law does not define key terms, creating a natural slippery slope with the number of euthanasia deaths and reasons for killing expanding very quickly.

The bill gives the power to decide life or death to the primary doctor with confirmation by a second doctor. Nowhere does the bill prohibit doctor shopping which is common in jurisdictions that have legalized medical killing.

This bill is accurate when it states that the doctor can kill you or help you kill yourself. Most jurisdictions employ softened language such as assisted death or medical aid in dying.  We must call it what it is.

Legalizing euthanasia permits medical murder. It kills the patient, who is in need of care not killing, and it changes the doctor who turns from healing to killing.

Uruguay needs to rejects this bill.

Canadian Bar Association: Canada's euthanasia bill C-7 will be challenged in the court.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Petition: Reject euthanasia Bill C-7 (Link).

A recent report from the End of Life Working Group of the Canadian Bar Association suggests several problems with Bill C-7, the bill to expand euthanasia in Canada.

Bill C-7 goes much further than the Quebec Superior Court Truchon decision but not as far as The Canadian Bar Association wants.

On February 24, the federal government introduced Bill C-7 in response to the Quebec Superior Court Truchon decision that struck down the requirement in the law that a person’s "natural death must be reasonably foreseeable" before qualifying for death by lethal injection.

Bill C-7 creates a two track law. A person whose natural death is not reasonably foreseeable has a 90 day waiting period while the bill waves the 10 day waiting period for people whose natural death is deemed to be reasonably foreseeable. Therefore a person can request and then die by lethal injection on the same day.

The Canadian Bar Association stated:
The criterion of “reasonably foreseeable death” has caused significant uncertainty and difficulty in practice and Bill C-7 does not give any guidance on how to apply it.

We recommend that guidance be given to avoid confusion on which safeguards apply and ensure appropriate access to MAiD.
I have stated that, if Bill C-7 is passed, a future court decision will strike down the 90 day waiting period for people whose natural death is not reasonably foreseeable because, it would be argued that this provision represents an inequality in the law.

Since the Canadian Bar Association supports euthanasia for mental illness they recommended that:

Mental illness should not be excluded from the definition of “serious and incurable illness, disease or disability”.
I am convinced that Bill C-7 already allows euthanasia for mental illness. 

Bill C-7 permits MAiD for people who are physically or psychologically suffering in a manner that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. However, mental illness, which is not defined in the law, can be considered a form of psychological suffering and therefore has not been excluded by Bill C-7.

If the government wants to exclude euthanasia for mental illness, Bill C-7 would need to define psychological suffering in a manner that excludes euthanasia for mental illness.

I agree with the Canadian Bar Association when it stated:

"The general exclusion of all persons suffering from mental illness is likely to be constitutionally challenged."
Petition: Reject euthanasia Bill C-7 (Link).

Why should I be concerned?

Euthanasia (MAiD) was legalized in June 2016. From that date until December 31, 2019, there have been more than 13,500 MAiD deaths in Canada, with more than 5,400 in 2019 alone.

Bill C-7 expands the law to permit anyone who considers their physical or psychological suffering to be intolerable to qualify for death by lethal injection, even if effective medical treatments for their condition exists. Bill C-7 allows medical homicide for people who need treatment and care. (Link to Bill C-7)

The Canadian government must reject Bill C-7 and begin the promised 5-year review of the euthanasia law with an open view to what is actually happening rather than continuing to expand euthanasia, making Canada the most permissive euthanasia regime in the world.

Articles on Bill C-7:

Monday, May 25, 2020

Suicide Prevention Researchers Leave Out Assisted Suicide

This article was published by National Review online on May 22, 2020.

Wesley Smith
By Wesley J Smith

It almost never fails. A learned article in a medical or bioethics journal laments our suicide crisis and urges greater efforts at prevention. And yet somehow, the authors never once mention the elephant in the room: i.e., the impact of ubiquitous suicide promotion by “death with dignity” activists, boosted by media commentators, in popular culture features, and as furthered by politicians.

It just happened again. An article published in the AMA’s JAMA Psychiatry: promises to “flatten the curve” of our rising suicide numbers, but doesn’t once mention assisted suicide as a contributor to the problem:
To drive this research agenda, we are acting on research that indicates suicide prevention efforts in health care settings have the potential to significantly reduce suicide rates. Nearly 30% of decedents had a health care visit in the 7 days before suicide; half were seen in health care settings within the preceding 30 days; and around 90% had visits in the year before death. Second, applying universal screening in the emergency care setting could double the number of individuals identified within usual care.
Similarly, the application of risk prediction algorithms to electronic health records can enhance prediction of suicide attempts and deaths, particularly when the data are enriched with screening information. Third, there is a growing suite of effective interventions and care practices that include medications and psychotherapies, a brief safety plan intervention, and follow-up efforts at high-risk, critical points of care transition such as “caring communication” contacts, and telephone calls to encourage ongoing social connection and care engagement. These practices can improve function and reduce the frequency of suicide attempts between 30% to 50% over the following year. The NAASP recommends that these practices be combined in a system of care and that health care organizations strive for this “Zero Suicide” approach.
I’m all for it. But pretending assisted-suicide deaths are not “suicide,” as most laws require, doesn’t make them not suicide, and merely sweeps that aspect of our crisis under the rug.

Active suicide promotion for the ill and disabled is something new in our history. Unless suicide-prevention researchers include the impact of such advocacy in their studies, assess the consequences of the “some-suicides-are-good” message communicated by laws legalizing doctor-prescribed death, and explore the shameful failure of doctors and hospice professionals to call in prevention services when someone asks for help in dying where assisted suicide is legal, this will be for naught.

To paraphrase Lincoln, we can’t be half suicide prevention and half suicide promotion. Sooner or later, we will be all one or the other.

Friday, May 22, 2020

Do you have a story about euthanasia or assisted suicide?

We need stories to effectively oppose euthanasia and assisted suicide and convince politicians that legalizing or expanding MAiD legislation is bad public policy.

The Euthanasia Prevention Coalition is seeking stories that can be shared with others and decision makers.

The story of Alan Nichols is important when speaking about how our current law is not protecting depressed people or why we should not extend MAiD to people with Mental illness.

Alan Nichols (62) was not sick or dying yet he died by euthanasia on July 26 at Chilliwack General Hospital in BC. His family is shocked that he was approved for and died by euthanasia. They were powerless to stop it.

Alan struggled with chronic depression. He often isolated himself, refusing to take medication or see a doctor. He needed support and encouragement during difficult times, not euthanasia.

Alan's story has been seen Canada-wide through CTV News coverage and social media (Link to Alan's story). His story is helping Canadians understand the consequences of legalized euthanasia.

Was Alan pressured or influenced to choose euthanasia?
Was Alan of sound mind to provide informed consent?
Was Alan offered any caring supports?

What could have been done to protect him?

Do you have a story to tell?

Canada's euthanasia law has opened the door wider to the abuse of people living with vulnerable conditions. The Euthanasia Prevention Coalition is sharing real life stories to show what is happening.

Your voice has the power to influence people, inspire action and affect decisions.

Sharing your experience can help you find closure and justice and honour the memory of a loved one lost to assisted death.

We believe in caring not killing.

If you have a story, email or call EPC at: 1-877-439-3348. 

We will not publicize your story without consent.

EPC is distributing the flyer at the top for $30 for 100 flyers or $50 for 200 flyers (tax and shipping included).

No free choice: Remember four suicides.

This article was published by Toujours Vivant - Not Dead Yet on May 22, 2020.

By Amy Hasbrouck

In the year before euthanasia came into effect in Québec, between April, 2014 and March of 2015, four Québecers with disabilities ended their lives because they didn’t have the supports they needed to remain independent. Despite efforts by advocates, conditions in the province have worsened since then.
  • In April of 2014, Mario Beaudoin and his wife were found dead in their home following what was believed to be a suicide pact. Mr. Beaudoin had been injured in a car accident 16 months earlier, and had been unable to get home modifications, medical equipment and personal assistance services they needed. 
  • In September, three months after Québec’s National Assembly adopted the province’s euthanasia law, Yvan Tremblay killed himself because he was being forced to move out of his apartment due to new security regulations imposed by the government. Management claimed that it would be impossible to evacuate Mr. Tremblay in case of fire, so he would have to move to a smaller apartment without a kitchen. 
  • Two days later, on September 16, Pierre Mayence died of starvation at the nursing home where he lived, after a court ruled that the staff could not force-feed him. 
  • Finally, in March of 2015, Gabriel Bouchard died, also of starvation, because he could not get the supports he needed to remain in his own apartment. (You can watch our Interview with him on our website.)
What has changed since 2015?

In Québec, from December of 2015 to April of 2019, 2,909 people were euthanized, and 2,947 people received continuous palliative sedation, for a total death toll of 5,856.

Neither Québec nor the Federal government has released reports from the monitoring system for medical aid in dying (MAiD). However in introducing bill C-7, the Department of Justice mentioned that more than 13,000 euthanasia had been performed since June of 2016.

As of May 20, 3,718 people had died of COVID-19 in Québec, most of whom were residents of long-term care institutions. Deaths by COVID-19 in Canada totalled 6,030.

What hasn’t changed in the last five years?

  • Public policy still favours warehousing disabled people in institutions, rather than giving them the choice to control their lives by employing their own personal support workers. 
  • The public, including progressives, continue to believe in the myth that assisted suicide and euthanasia (AS & E) is a free choice. 
  • Disability groups remain timid about opposing AS & E.
While we’ve focused on events in Québec, the same problems apply in the rest of Canada. People talk about the health care workers who are the “front-line heroes” of the COVID-19 pandemic, and that’s absolutely true; many are going above and beyond the call of duty. But most of these workers get to leave the heartache behind when they go home at the end of the day. Disabled activists don’t stop being disabled when their shift is over, just as single parents, women, people of colour and poor people can’t leave behind the discrimination that affects their lives.  

For more information on the subjects we discuss: