Friday, June 26, 2020

Stealth euthanasia. How many Canadian seniors with COVID-19 were killed?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On June 25 I published the article - 81% of Canada's COVID-19 deaths were long-term care residents. I based my article on the report by Globe and Mail Health Reporter Kelly Grant, who was writing about the Canadian Institute for Health Information (CIHI) report: Pandemic Experience in Long-Term Care Sector. This article focuses on the CIHI report.

Why is this important?

The data from the CIHI report indicates that up to May 25, 81% of all Canadian COVID-19 deaths were long-term care residents. This is tragic and criminal. How many Canadian seniors were killed rather than treated for COVID-19?

CIHI report: Pandemic Experience in Long-Term Care Sector.

The data in this report was collected up to May 25.
1. While Canada’s overall COVID-19 mortality rate was relatively low compared with the rates in other OECD countries, it had the highest proportion of deaths occurring in long-term care. LTC residents accounted for 81% of all reported COVID-19 deaths in Canada, compared with an average of 42% in other OECD countries (ranging from less than 10% in Slovenia and Hungary to 66% in Spain).
The total number COVID-19 deaths in Canada was similar to the OECD average, but there was a disproportionate number of seniors dying by COVID-19.
2. As a proportion of total COVID-19 cases in Canada, about 1 in 5 (18%) were among LTC residents. Internationally, this proportion ranged from under 1% of total cases in Australia to 51% in France and 73% in the U.K.
Therefore 81% of the COVID-19 deaths happened to 18% of the COVID-19 patients.
3. The mortality rate for those infected with COVID-19 in LTC was about 35% as of May 25. The number of LTC residents infected by COVID-19 and the percentage who died by COVID-19 varied from province to province in Canada.
I am convinced that the COVID-19 pandemic protocols and guidelines led to more elderly Canadian deaths. Decisions to cause death must have been made for Canada to have twice the percentage of seniors dying by COVID-19, than the OECD average and 15% worse than Spain, the second worst country.

I suggest that stealth euthanasia was the reason for number of elderly Canadians who died  from COVID-19. When I refer to stealth euthanasia I am referring to giving large doses of morphine "comfort care" to palliate symptoms and intentionally hasten death. 

It is true that many of these seniors may have died anyway, but based on the data, many of these seniors died who would have survived.

I commented on this issue early.

On March 30 I commented on the triage protocol that was developed for Ontario Health by Dr James Downar, the former chair of the physicians advisory committee for Dying with Dignity, a Canadian euthanasia lobby group. 

Downar's triage protocol was based on a utilitarian calculation as to when a patient would receive treatment. If the patient did not "qualify" for treatment, palliative care protocols were mandatory. This led to the abuse of palliative care.

On April 6 I further commented on Downar's Pandemic Palliative Care Protocol: Beyond Ventilators and Saving Lives that was published in the CMAJ. The authors of the protocol outlined the parameters for providing treatment and emphasized when treatment is not provided that palliative care protocols must be followed. Downar advocated for the improper use of palliative or terminal sedation.

In my commentary I stated that the proper use of palliative or terminal sedation is for a patient who has symptoms that cannot be effectively alleviated in any other way. For instance, a person who is living with neuropathic pain may only be relieved of pain by sedation. The protocol authors proposed the use of sedation as a means of causing death.

I then stated that the protocol changes palliative care. Proper palliative care provides pain and symptom relief but never to hasten death. The protocol allowed the use of palliative care  drugs to replace active treatment, even when treatment could lead to recovery. So palliative care becomes a way of providing a comfortable death when a person has been medically abandoned. I continued:
The protocol claims that it will lead to greater equity. The protocol acknowledges that people who live with mental illness or other conditions face substantial challenges to receiving healthcare and they conclude that: "Palliative care thus becomes the compassionate option to counterbalance this inequality." 
...but this protocol institutionalizes the inequality and injustice. The protocol states that you must be kept comfortable as we abandon you. But it doesn't stop there, the protocol advocates for the abuse of the use of "palliative sedation" meaning, we will not only palliative your symptoms, but in certain circumstances we will end your life without your explicit consent.
On April 9, I commented on the CMA approval of a Framework for Ethical Decision Making During the Coronavirus Pandemic that was based on the protocol by Ezekiel J Emanuel et al that was published in the NEJM on March 23, 2020 titled: Fair Allocation of Scarce Medical Resources in the Time of Covid-19

The utilitarian guidelines, such as the one's designed by Emanuel et al, and Downar ingrain negative and discriminatory attitudes towards vulnerable populations.

Medical decisions should be based on Justice and equality (non-maleficence) and not the elimination or abandonment of the weak.

Decisions to deny long-term care residents access to hospital care may have been based on a fear that hospitals would have be over-run with COVID-19 patients but it was also based on an ideology that these seniors were futile, even when treatment was not futile.

The pandemic protocols that were instituted in Canada led to many unnecessary intentional deaths of elderly persons with COVID-19. Decisions to live or to die were made by doctors and nurses who denied effective treatment to long-term care residents and then placed them on a "program" that nearly guaranteed their death. This is stealth euthanasia.

A better option is the pandemic decision making protocols developed by the disability community which represent a fair and equitable response to scarcity of resources. (Link to the protocol). The quality of life ethic, mixed with a utilitarian and discriminatory ethic towards people with disabilities and the elderly leads to ingraining decisions that results in the deaths of vulnerable persons.

Investigations must be done. These may have been criminal acts of elder abuse and intentional killing. Society must begin to recognize that the utilitarian ethic does not bring equality and justice but rather death and abandonment.

We need to rethink nursing homes and support community based care.


Unknown said...

Good analysis but this issue is not new to covid. But maybe the large numbers of fatalities bring it to public attention.

My Mom died in a sr. facility in 2012 in BC Cda. from what appears to be over medication. I have the pharma purchase records. Coroners dept tried to argue natural causes but i told their consultant i had drug records so did not believe their story. End of conversation, its not rocket science.

Its a sad situation and just another reason we need to elect an honest Fed gov't this time.

Brenda L said...

Thank you Alex for bringing clarity to the issue of elder abuse in nursing homes. This is indeed stealth euthenasia. God help us to see the truth in this article and the blatant disregard for human life.

janey83 said...

Thank you for your dedication to this cause. It is truly sad when the unborn and the elderly are seen as a drawback to society, to the point that people are taking their lives.

Brenda L said...

Dear "Unknown", I am so sorry about what happened to your mother. Thank you for shedding light on further abuses. When a society decides that "only certain lives matter", then anything goes.

adoption blog said...

What a sad day we live in. Those grey heads who nurtured and cared for us are now considered a burden to society. God help us!

As a young boy growing up my father said to me, "why don't you learn from from others instead of making your own mistakes". I started a quest at that time to seek out the grey heads in my community to gain wisdom. I spent untold hours on the front porch in in their living rooms to gain insight and wisdom for my life. These times truly changed my life. I am now close to retirement and have sought to pass on wisdom to the next generation if they see any value in that, or maybe I'll be considered a burden to society.

Michelle said...

I'm a retired physician in Ontario.

My father contracted Covid at the beginning of the pandemic in a nursing home in Ontario. He had moderate to advanced Lewy body Dementia, but no other health conditions. They did not allow me to visit him until he was gravely ill and unresponsive.

I watched the nurse give him Hydrocodone IM while he was unconscious.
Before I could stop her, she came into the room and gave him the injection, which I knew would suppress his respiratory rate and effectively euthanize him! Yes he was on oxygen with low O2 sats, but it was totally unnecessary to give him narcotics as he was breathing comfortably (rapidly) and in no distress. They didn't even give him a chance to wait overnight to see if his condition improved!

Within 2 hours after the injection he was dead.

I know that with his advanced dementia, my father may have only lasted another year, but it was still chilling to watch him be euthanized right in front of me!

Michelle Boivin MD

Julie, retired dietitian said...

Among these statistics as one who has worked in health care I have to ask if there are any statistics based on the long term care resident’s level of intervention? In principle I agree with opposition to medical assistance in dying (euthanasia), however, if the person has end stage dementia or is palliative for some other reason it is generally agreed by medical ethicists that aggressive treatment, which certainly includes intubation and artificial ventilation, is inappropriate. The level of care status of the resident, usually agreed to and signed by the family and, where possible the resident, determines whether or not oxygen, intravenous support etc are deemed appropriate to their baseline medical stats. Level of care status does not excuse the unnecessary use of opioids to suppress breathing, rather than provide pain or distress relief.