Canada's Correctional Investigator calls for a moratorium on MAiD (euthanasia) in prisons.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ivan Zinger

The Annual Report of the Office of the Correctional Investigator is calling on the federal government to enact a moratorium on MAiD (euthanasia) in prisons.

Dr Ivan Zinger, the Correctional Investigator for the federal government outlined his concerns in his annual report concerning the known MAiD deaths in the prison system. The report states:

There are three known cases of MAiD in federal corrections, two carried out in the community, and each raises fundamental questions around consent, choice, and dignity. In the two cases reviewed in the reporting period, my Office found a series of errors, omissions, inaccuracies, delays and misapplications of law and policy.

In reference to the first case, the report states:

As I have discussed numerous times before, questions of autonomy and free choice in the context of incarceration are difficult to square. In this case, the “wishes of competent patients” must be seen in context of the seemingly inflexible system of sentence administration and lack of viable release alternatives for non-violent offenders, including medical parole. It would seem that this man “chose” MAiD not because that was his “wish,” but rather because every other option had been denied, extinguished or not even contemplated. This is a practical demonstration of how individual choice and autonomy, even consent, work in corrections.

The report states that the second case concerned both mental and physical illness issues:

The other case of MAiD investigated this past year revolves on the intersection of mental and physical illness and the capacity to provide informed and voluntary consent for assisted death. In that case, the inmate was suicidal and suffering from mental illness. He was terminally ill and a designated Dangerous Offender. He would threaten suicide if he was not provided MAiD. His prospects for release, even considering the advanced stages of his illness, were minimal. 

Once again, these are circumstances that would never be confronted by free citizens in the community when choosing to end life. Hopelessness, despair, lack of choice and alternatives, conditions imposed by the fact and consequence of incarceration, are issues magnified in the correctional setting. As the Government considers extending MAiD beyond physical illness to intolerable psychic pain, there must be careful deliberation of the mental health profile of Canada’s prison population.

The report challenges the status quo:

My review of these cases suggests that the decision to extend MAiD to federally sentenced individuals was made without adequate deliberation by the legislature. ...two aspects of how MAiD was legislated and later applied in the correctional context seem to make little sense from an accountability and public transparency point of view. 

The first is the decision to exempt CSC from reviewing or investigating MAiD deaths. This exemption is untenable given that CSC is, de-facto, the state agent that enables or facilitates assisted death to people under federal sentence. There just has to be some degree of internal scrutiny, transparency and accountability that goes with the exercise of such ultimate and extreme expressions of state power, even if MAiD is provided for compassionate reasons. By removing the legislative requirement for CSC to investigate, this measure also removes the obligation for the Service to provide notice “forthwith” of an inmate death involving MAiD to my Office. In effect, there is no legal or administrative mechanism for ensuring accountability or transparency for MAiD in federal corrections. Surely, this exemption was an oversight that demands correction. 

Secondly, that MAiD is allowed to be carried out in a penitentiary setting, under so-called “exceptional circumstances,” seems inconsistent with the legislation’s intent to provide Canadians with a legal option to end their life with dignity at a time and place of their choosing. It is simply not possible or desirable to provide or meet those intents in context of incarceration.

Dr Zinger is right. The government simply reacted to a request for MAiD by a prisoner by approving the death. 

Dr Zinger may not be aware that there is no effective oversight of Canada's MAiD (euthanasia) law throughout Canada. Zinger questions how there can be no legal or administrative mechanism for ensuring accountability. 

I would suggest that a similar reality exists for people with disabilities and elderly people who live in institutions. Similar to the prison population, these people lack the same level of freedom and autonomy as the rest of the population.

All Canadian MAiD deaths are approved by two doctors or nurse practitioners and then, after the death, are reported by the doctor or nurse practitioner who carried out the death. Even in circumstances, such as the Sorenson case, where there were euthanasia assessments stating that Jack didn't qualify for MAiD and other assessments saying he did. The law is only concerned that two doctors or nurse practitioner approved his death. There is no oversight to determine why some assessments said he didn't qualify and some assessments said he did.

Dr Zinger has made some important points. He questions the oversight of the law, as it pertains to the prison population while emphasizing that prisoners do not share the level of freedom and autonomy as the rest of the population. 

The Dutch government wants to avoid the debate by permiting child euthanasia without changing the law

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sign and share the Petition opposing child euthanasia in the Netherlands (Link).

The Dutch government is planing to extend euthanasia to children, while avoiding the debate on this contentious issue.

The Dutchnews.nl reported on October 13 that Dutch Health Minister, Hugo de Jonge announced that the Dutch government will amend or permit child euthanasia. According to the DutchNews.nl:

Health minister Hugo de Jonge has told MPs in a briefing that work is progressing on plans to make it possible to help terminally sick children aged between one and 12 to die, in limited circumstances.

De Jonge said that he wants to ensure there are ‘more legal guarantees for doctors’ who take the decision to end the life of a child, as well as transparency for healthcare staff and parents, and protection for the rights of children. 

Recent reports indicate that de Jonge plans to amend the euthanasia regulations, but not amend the law. DW news reported that:

De Jonge added that current laws would not need to be amended. Rather, doctors would be exempted from prosecution for carrying out an approved euthanasia on a child.

The current Netherlands law permits euthanasia for children as young as 12, with parental consent, people over the age of 16 can consent to euthanasia. The Groningen Protocol permits euthanasia of newborns with disabilities. The proposed change would allow euthanasia for children (1 - 12).

Similar to the Groningen Protocol, that permits euthanasia of newborns with disabilities, the government plans to approve a set of guidelines to permit euthanasia for children under the age of 12 without actually changing the law.

The Dutch government wants to avoid the debate because of the contentious nature of the issue, but also because the four party coalition government includes two Christian parties who don't want to vote on the issue which may lead to their political defeat in the upcoming March 17, 2021 election.

For instance, Health Minister Hugo deJonge is the leader of the Christian Democratic Appeal party, who have supporters that are critical of euthanasia.

The Netherlands is very sensitive to international criticism of their euthanasia regime. With this in mind, the Euthanasia Prevention Coalition set-up an international petition opposing child euthanasia in the Netherlands that has now been signed by more than 24,000 people.

Since the Dutch government won't publicly debate the issue, then we will create the debate.

Sign and share the Petition opposing child euthanasia in the Netherlands (Link).

Don't let the Dutch government avoid the public debate. Dutch voters deserve to know if their elected representives support child euthanasia before voting in the March 17, 2021 election.

Who really wants to die? Part VI: Aids in the Eighties and Nineties and the literary ritual of assisted suicide.

Gordon Friesen

Gordon Friesen, EPC board member
http://www.euthanasiediscussion.net/

A fundamental discrepancy between appearance and reality

Without a doubt, the historical and cultural phenomenon which most influenced public perception of the “right to die” movement, was the horrendous AIDS epidemic of the eighties, and nineties.

Great sympathy was felt towards the victims of this atrocious disease, and great solidarity was expressed for those who chose to take their own lives. However, as we shall see, only two percent of people with Aids actually resorted to suicide, assisted or otherwise. And thus, as with the victims of catastrophic injury, the public vision of an ideal and noble suicidal response to the apprehended loss of physical function and control, was wildly at odds with real choices observed among those personally affected.

AIDS and the homosexual community: a perfect storm

To understand the collective reaction of homosexuals to the original Aids epidemic (which affected them in such a massive and specific way), it is first necessary to recall the social conditions in which this culture existed at that time. For today, thanks to the extraordinary cadence of recent social change, it is becoming increasingly difficult to communicate (or even to credit) the legal, social, and psychological conditions which were commonly imposed upon the members of this group, barely forty years ago, and that, even for those of us who remember these events at first hand.

Let us merely recall, in this connection, that the behaviors typical of male homosexuality were entirely prohibited, as criminal offenses in Canada, until 1969 (while only then permitted, subject to residual conditions); and the homosexual orientation, itself, was defined in terms of mental pathology, by the American Psychiatric Association, as late as 1973.

Frequently met with hostility, the homosexual community was understandably animated by a powerful sense of injustice. These feelings, in turn, were embodied in a shared cultural mood which combined a traditionally resigned resentment, with a newer and politically articulated combativity -- doubted by many, while desired by all – which still remained to bear conclusive legal fruit. And then suddenly, into this complex mix, came the terrible scourge of Aids.

The primary epidemic of Aids

In 1992, Aids was recognized as the greatest cause of death among American (and Canadian) men between the ages of 25 and 45. Aids had no cure; Aids ended inevitably in death; advanced patients could expect to suffer atrocious symptoms. Collectively, moreover, in a culture deeply imbued with erotic ideals of youth and beauty, this was a disease which seemingly delighted in attacking precisely the most youthful, and the most beautiful.

A secondary epidemic of suicide

Even without any consideration of Aids, the risk of suicide has always been a danger for young men, and even more so among homosexual youth. Indeed, much of the traditionally shared autobiographical and fictional representation of homosexual experience -- while often romantic and even defiant – also demonstrated a strong tendency towards the tragic tone. With the arrival of this apparently ineluctable violence of fate, however, a new vision of reality emerged, of almost apocalyptic urgency, in which it seemed that only the choice of the time and of the manner -- of his own death -- remained as the inalienable right of the encircled hero.

And thus, in the continuing wake of the post-war countercultural revolution: where political consciousness was already coalescing around the notion of sexual identity, enshrined as a civil right in the image of race and gender; where the word “choice” was found on the lips of all: it became inevitable that this last ultimate “right”, of voluntary death, should be revendicated with an ardor never matched before, or since. And so it is, that the conjugation of Aids and “right-to-die” produced the most far-reaching suicide trend ever witnessed.

Assisted suicide as spectacle and ceremony

More than ever, isolation of institutions is no solution to COVID risks

By Taylor Hyatt
Euthanasia Prevention Coalition board member & disability rights activist

Taylor Hyatt

Much ink has been spilled over the state of Canada’s long-term care homes since the coronavirus pandemic arrived here. At first, it was understood that only the frail elderly, or those who had a “pre-existing condition” – in other words, an illness or disability – were at risk of becoming seriously ill. Therefore, it has become popular in some circles to suggest that these populations are safest in the facilities where they already live.

Unfortunately, this line of thinking is based on, at least, a few erroneous assumptions. 

First, “life” in an institution (or confined to one’s home for reasons of disability, while non-disabled people are encouraged to move freely) is not well-intended protection – it’s segregation. Besides being inhumane and a tremendous step backwards for disability rights, true segregation is impossible since disabled people rely on personal support staff. Like any other human being these staff also have social lives and needs that cannot be met within the facility; at some point, they must leave. There is still a chance, then, that they could contract the Coronavirus and carry it into the workplace. Second, extremely common conditions leave people of all ages at increased risk of complications. Finally, not everyone residing in an institution is an elder.

Chyanne

Chyanne, a resident of Midland Gardens Community Care in Scarborough, is the same age as me – 28. She moved into the facility in 2017, a year after acquiring her disability in a bus accident. Even before the pandemic, life in the facility left much to be desired. She has noticed “bruises and injuries on her fellow residents.” She has been documenting meals, which are “bland” and hardly filling. One morning’s breakfast consisted of “pre-packed fruit cups and muffins, with a single hard-boiled egg” – especially unappetizing for a woman who is hardly ever seen without a Starbucks cup in hand. She also sees a lot of death. In her words, it’s like watching her “grandmas and grandpas” pass away, and she remembers every one.

Midland Gardens breakfast

CBC Marketplace found that from 2015 to 2019, “her home (Midland Gardens) had 212 violations of the Long-Term Care Homes Act and Regulations. [That makes it the home with the most violations in Toronto [and] third-highest in Ontario.” Midland Gardens repeatedly violated the minimum standards for long-term care in Ontario. There were “infection control issues, injuries due to falls, medication errors or storage issues, abuse, and neglect.” Of the 632 homes for which there are records, 538 — or 85 per cent — had repeat violations…and faced no consequences from provincial authorities. Again, all of this took place before the pandemic began.

When the coronavirus reached her facility, Chyanne felt like “[she] was in a fishbowl, waiting…to get it.” At the beginning of May, she lost the ability to taste and smell. However, staff didn’t take her concern seriously, nor did they use proper protective equipment. They called an ambulance on May 17 after she had a dangerously high fever. Chyanne stayed in the hospital for a few weeks, relying on oxygen, until she returned to the institution on June 10th. Months later, she still has “breathing issues,” and struggles with being surrounded by death. She's “desperate” to reach the top of a waiting list for a proper home, but has a mission in the meantime: “accountability” for places like the one where she now lives.

Jonathan Marchand

Chyanne isn’t the only disabled Canadian fighting to leave institutional living. Earlier this year, Jonathan Marchand locked himself in a cage in front of Quebec’s National Assembly, symbolizing his “captivity” in a long-term care home. His goal was to meet with provincial government representatives to discuss the creation of a self-managed personal assistance program. (Government programs in Manitoba and Ontario – to name just two provinces – already offer financial help for people with disabilities to hire, train, pay, supervise, and fire their own support staff.) 

Daniel Pilote

In 2017, Daniel Pilote became the lead plaintiff in a class-action suit against the Quebec government, meant to compensate long-term care residents living in “shameful” conditions. (The text of Mr. Pilote's complaint is available online.) He’s compared his experience to living in a prison without being guilty of a crime. At times, the humiliation, depression, and abuse Mr. Pilote has faced has even “affected his desire to live.” Both have remained in the news as they cope with pandemic-related restrictions at their facilities.

As I write this, I'm cooking a huge pot of tomato soup. My spoiled cat is trying to climb in my lap to steal a piece of bacon. I'm thinking about what to write in a letter to a friend, which I’ll probably stay up late tonight to finish…and of course, all good writing requires a cup of tea in hand. I make all of these choices for myself, along with more fundamental ones – what to wear, and when to wake up, for example. None of this would be possible if I lived in an institution. No wonder it’s becoming increasingly common for people to say they would rather die than move into one.

None of the demands made by these advocates are new. Disability rights activists have been promoting self-directed home-based supports since the 1960s. The most popular reasons given for requesting euthanasia include ability “to participate in activities that made life enjoyable” or a loss of autonomy – and here’s a fix. Lives could be saved if only our society was willing to put as much work into allowing people to thrive in their own homes – on their own terms – as it does into permitting death.

The Canadian government is expanding (MAiD) euthanasia before the 5-year review of the law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On February 24, Canada's federal government introduced Bill C-7, claiming it was in response to the Quebec Superior Court decision striking down the requirement in the euthanasia law that a person’s "natural death must be reasonably foreseeable" to die by MAiD. Due to the COVID-19 crisis and then the prorogation of parliament, Bill C-7 was re-introduced on October 5, 2020.

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

If Bill C-7 was limited to the court mandated changes, one would understand the need for this legislation, but Bill C-7 expands Canada's euthanasia law far beyond Justice Baudouin's, September 2019, court decision, a decision that should have been appealed by the government.

It is also concerning that Bill C-14, the bill that legalized euthanasia in Canada, legislated that a Review of the law be done. Bill C-14 stated:
Review by Committee

10 (1) At the start of the fifth year after the day on which this Act receives royal assent, the provisions enacted by this Act are to be referred to the committee of the Senate, of the House of Commons or of both Houses of Parliament that may be designated or established for the purpose of reviewing the provisions.

Report
(2) The committee to which the provisions are referred is to review them and the state of palliative care in Canada and submit a report to the House or Houses of Parliament of which it is a committee, including a statement setting out any changes to the provisions that the committee recommends.

Bill C-14 was passed on June 17, 2016, therefore the review the law was to begin on June 17, 2020. The fact that the government prorogued parliament on August 18 does not negate the fact that the legislated review has not begun and yet Bill C-7 significantly expands euthanasia in Canada without reviewing the current law.

It is inconceivable that parliament pass Bill C-7 without first fulfilling it's legislative requirement to first review the law.

Further to that, Justice Minister David Lametti seems to be changing the scope of the review. Minister Lametti stated in parliament on October 9 that:

We know that Canadians are also concerned about other issues that are not addressed in this bill. I am thinking, in particular, of access to medical assistance in dying on the basis of mental illness. I am also thinking about advance requests for medical assistance in dying for people who are not yet suffering but fear they will be after they have lost their ability to request this assistance and who want to making their wishes known before that happens. 

The upcoming parliamentary review of the medical assistance in dying regime and of the state of palliative care in Canada will provide an opportunity to give these complex issues the time and attention they deserve.

The purpose for the review is to examine the euthanasia law, not to simply review further expansions to the law, such as euthanasia for mental illness, euthanasia for children and advanced requests for euthanasia.

The fact that the government, through Bill C-7, is expanding Canada's euthanasia law beyond the parameters of the Quebec court decision without first reviewing the law, as legislated, is simply wrong. Bill C-7 must be defeated.

What changes does Bill C-7 make to the law?

1. Bill C-7 removes the requirement in the law that a person’s natural death must be reasonably foreseeable to qualify for death by lethal injection. Therefore, people who are not terminally ill can die by euthanasia. The Quebec court decision only required this amendment to the law, but Bill C-7 went further.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by euthanasia.

3. Bill C-7 waives the ten-day waiting period when a person is deemed to be “terminally ill.” A person could request death by euthanasia on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

Sign the parliamentary petition: No Same Day Death (Link).

4. Bill C-7 creates a two track law. A person who is deemed to be terminally ill would have no waiting period while a person who is not terminally ill will have a 90 day waiting period before being killed by lethal injection.

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, this provision represents an inequality in the law.

5. Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The euthanasia law permits MAiD for people who are physically or psychologically suffering 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, is considered a form of psychological suffering.

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.

Bill C-7 permits anyone who believes that their physical or psychological suffering is intolerable to qualify for death by lethal injection, even if effective medical treatments for their condition exists, only requiring a 90 day waiting period. (Link to Bill C-7).

Contact your Member of Parliament and say that you oppose Bill C-7.  The list of Members of Parliament: https://www.ourcommons.ca/Members/en/search

More Articles on Bill C-7:

• Stop Bill C-7 from expanding Canada's euthanasia law (Link).
• Does Bill C-7 prevent euthanasia for mental illness? (Link).
• Canadians oppose euthanasia for mental illness and child euthanasia (Link).
• Canadian Bar Association. Bill C-7 will be challenged in the court (Link).

We must ensure revised assisted dying law will not threaten lives of people with disabilities.

This article was published by the Calgary Herald on October 26, 2020.

Heidi Janz

By Professor Heidi Janz

In recent months, horrific acts of violence and abuse against racialized people who were in distress have forced Canadians to begin to wake up to the reality of systemic racism in Canada. While the need to address systemic racism remains urgent, the fact that our country is on the verge of expanding eligibility for Medical Aid in Dying to include people with disabilities who are not at end-of-life creates an equally urgent need for Canadians to wake up to another form of systemic discrimination that is just as widespread and just as deadly. It’s called ableism.

Ableism is discrimination and social prejudice against people with disabilities based on the belief that typical abilities are superior. Like racism and sexism, ableism classifies entire groups of people as “less than,” and perpetuates harmful stereotypes. Clear, yet unacknowledged, evidence of ableism can be seen in everything from the way in which buildings are built to exclude people who do not walk or see, to the way in which terms associated with disability are used as insults in common parlance. Unlike racism or sexism, however, ableism remains, in the words of Canadian disability scholar Gregor Wolbring, “one of the most societally entrenched and accepted isms.”

The COVID-19 pandemic has laid bare the systemic ableism that relegates people with disabilities to the margins of society. Running contrary to the oft-repeated public health mantra of “We’re all in this together” have been stories of COVID-19 outbreaks in long-term care facilities and group homes causing personal support workers to fall ill themselves, and prompting those who remained to abandon their elderly and disabled clients. We’ve also seen elderly and disabled people who fall ill being left to die in nursing homes and never sent for medical care in hospitals. We are promised better facilities for warehousing elderly and disabled people, rather than in-home supports where the risk of contagion is lower.

COVID-19 coupled with systemic ableism has also exacerbated the financial challenges that people with disabilities face. Increasing numbers of disabled people are in extreme financial distress as the pandemic drives up costs while already-meagre provincial income support remains stagnant. What’s more, some provinces have recently been publicly musing about reducing, or altogether scrapping, their income support programs for people with disabilities. Recent news reports from Ontario indicate that some people with disabilities living in poverty are being driven to end their lives through MAID, because they lack the means to survive.

Systemic ableism creates a disparity in societal reactions to suicidal behaviour. When a non-disabled person is suicidal, they are directed towards suicide prevention resources. But suicide is assumed to be a “rational” choice for a person with a disability — solely because a disability is present. People with disabilities are at a higher risk of suicide, yet they face substantial barriers when trying to access suicide prevention services. Medical professionals overlook typical sources of stress; problems arising from relationship breakdowns, depression and isolation are wrongly attributed to disability.

It is stunning that federal legislators are attempting to expand the eligibility criteria for MAID in the middle of a pandemic, which is not only exacerbating existing barriers for disabled Canadians but also creating new ones. Bill C-7 will legally entrench systemic ableism by enshrining assisted death as an alternative to assistance in living. Policymakers need to wake up to the lethal realities of systemic ableism, and ensure that Canada’s MAID law has adequate safeguards to prevent MAID from weaponizing ableism.

Heidi Janz is an adjunct professor with the University of Alberta’s John Dossetor Health Ethics Centre. She is chair of the Council of Canadians with Disabilities’ ending-of-life ethics committee and is a member of a disability advisory group for the federal minister of disability inclusion. Her interest in disability ethics grew out of her lived experience with disabilities.

Cathay Wagantall speech in parliament opposing euthanasia Bill C-7

The following is the Hansard of the speech by Cathay Wagantall (Yorkton - Melville) on October 19, 2020

Cathay Wagantall

Madam Speaker, I am pleased to rise today, but I find it difficult to be speaking to another attempt by the Liberal government to endanger the most vulnerable in our society.

After just four years, when the original euthanasia and assisted suicide legislation came in through Bill C-14, we find ourselves considering legislation that would further loosen restrictions, eliminate safeguards and confuse our country's understanding of the sanctity of life and the government's role in end-of-life decisions. Once again, we have been told that in order to uphold the charter rights of some we must endanger the rights and freedoms of others.

I did not support Bill C-14 for many reasons. The first is the fact that the Supreme Court of Canada invoked such controversial and flawed legislation, which has been proven to be poorly applied around the world. The Liberals also chose to broaden the scope of the legislation, going far beyond the Carter decision. Another reason is that it has been placed ahead of and continues to overshadow any significant palliative care initiative.

In 2019, the Prime Minister promised to expand eligibility criteria, and on September 11 of last year, the Superior Court of Quebec ruled that it is unconstitutional to limit assisted suicide or euthanasia only to those whose death is reasonably foreseeable. Without even appealing the ruling and seeking the advice of the Supreme Court, which has been long occupied with this matter, the Liberals accepted the ruling. They are now rushing to change the law for our entire country.
They gave Canadians a mere two weeks to have their views heard on this deeply personal and complicated issue through a flawed online consultation questionnaire. The use of convoluted and biased language left little to the imagination in terms of how the government planned to legislate assisted death. I too tried to fill it out, and I would argue that many opposed would have been discouraged in participating due solely to the language used.

With such a flawed method, and with no idea if the feedback even remotely reflects the actual views of Canadians, how can the government proceed with this legislation in good faith? This is a rhetorical question because it does not seem to matter to these Liberals. It is clear they used this brief window for feedback to satiate the need for a consultative process.

We also know the government ignored its own timeline for a review of the original assisted suicide legislation, Bill C-14. It was planned for this summer, and instead, we have been presented with this reckless legislation. In the midst of COVID, this was still something very important. Without a proper review and without input from the Supreme Court, this House has been asked to greatly broaden the scope of assisted suicide and euthanasia without a clear enough understanding of whether the current regime is being consistently interpreted or properly enforced.

Bill C-7 is being rushed through. This is concerning. When reading through this bill, I see elements that go beyond the scope of the Superior Court of Quebec's decision, namely, Bill C-7 would eliminate the 10-day waiting period between the date the request is signed and the day on which the procedure is carried out.

The application of the law pertaining to those whose death is reasonably foreseeable has been problematic from the very start of this debate. We know a person's reasonably foreseeable death is a flexible estimation, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time they have remaining. The elimination of the 10-day waiting period for persons whose death is reasonably foreseeable would create the conditions for someone with an indeterminate length of time remaining in their life, possibly years, to be rushed to the decision to receive assisted suicide and euthanasia.

Aside from simply eliminating what most Canadians would consider to be a reasonable period of reflection, this element of the bill also ignores the possibility of medical advances and improved treatment methods in an incredibly innovative medical science environment. As Cardinal Collins has said, Bill C-7 creates the conditions where an individual can seek a medically assisted death faster than the wait time for a gym membership or a condominium purchase.

I also see no logical reason why the government would reduce the number of independent witnesses required for when the request is signed. It is down from two to one. The government has even relaxed the definition of someone who may serve as a witness, including medical professionals or personal care workers, even those who are paid to provide euthanasia and assisted suicide on a daily basis. This is in clause 1(8).

Surely we can agree that, for the vast majority of those requesting euthanasia and assisted suicide, the requirement for two independent individuals to witness a request to end a life is a reasonable safeguard. How do the Liberals plan to properly protect patients from potential malpractice? How does the government plan on ensuring requesters are presented with a myriad of treatment options rather than just one opinion?

The legislation continues as a series of safeguards the medical practitioner must adhere to before providing assisted suicide to those whose death is not reasonably foreseeable. One of these safeguards would require a medical practitioner to discuss with the person the means available to relieve their suffering, including palliative care.

The safeguard is even weaker for those whose death is reasonably foreseeable, requiring the medical practitioner to merely inform the person of these vital options. The government failed to follow through on its promise to invest $3 billion in long-term care, which includes palliative care. There does not appear to be any political will whatsoever to improve palliative care.

Canadians have also been calling on the government for a long-awaited national strategy for palliative care. There is a thirst among Canadians for real solutions to end-of-life care. The government seems all too willing to ignore the 70% of Canadians without access to palliative care and, instead, attempts to impose on them a flawed, one-size-fits-all regime. We can already see the consequences of pushing forward an assisted dying agenda when there is little regard for palliative care.
In British Columbia, the Delta Hospice Society was stripped of 94% of its operating budget for refusing to provide euthanasia in a facility intended for the provision of palliative care. Despite repeated attempts to defend its Charter-protected, faith-based objection to being required to provide euthanasia and reach a compromise in good faith, 10 hospice care beds are now at risk and will be surely defunded.

Why do the Liberals continue to ignore the voices of those who have a different perspective on the issue of end-of-life care? People who seek hospice care are seeking it for a reason. They do not desire a medically assisted death. In effect, what has happened in B.C. is an attempt to redefine what constitutes palliative care.

In fact, the Fraser Health Authority's decision flies in the face of the Canadian Society of Palliative Care Physicians, which has clarified that euthanasia and assisted suicide are distinct from palliative care. I caution Canadians not to regard the Delta Hospice Society's situation as an isolated one. The government has shown little interest in supporting hospice care, and I would not be surprised by further attacks on the ability of Canadians to chose to end their lives naturally.
In The Globe and Mail, Sarah Gray put it well, stating, “The hospice isn’t a place where people come to die. It is where they come to live — to live well for the little time they have left. It is a place of celebration, connection, comfort and support. It is a place of safety for the dying and the grieving.” In Cardinal Collins' words, let us work to create a “culture of care”, rather than rush toward a culture of “death on demand”.

The government would also be wise to recall that much of the debate on Bill C-14 revolved around calls for a solid framework of conscience protection for medical practitioners involved throughout the end-of-life process. At committee, witnesses stated that the protection of conscience should be included in the government's legislative response to Carter v. Canada.

The Canadian Medical Association confirmed conscience protection for physicians would not affect access to physician-assisted suicide or euthanasia. Its statistics indicated that 30% of physicians across Canada, or 24,000, are willing to provide it. I live in a rural area of Canada, and I can assure members there are many provisions that are not available to me directly where I live.

Unfortunately, the Liberals failed to defend the conscience rights of Canadians in Bill C-14. I also found it disappointing that they failed to support, in the last Parliament, critical legislation put forward by David Anderson in Bill C-418, the protection of freedom of conscience act. It would have made it a criminal offence to intimidate or force a medical professional to be involved in the procedure. It would also have made it a criminal offence to fire or refuse to employ a medical professional who refuses to take part directly or indirectly in MAID.

Here we are four years later, and Bill C-7 is also void of any provisions that would protect the section 2 rights of Canadians. In Canada, everyone has freedom of conscience and religion under section 2 of the Canadian Charter of Rights and Freedoms. No one has the right to demand all services from all providers in all circumstances. As David stated, protections are needed for doctors and health care providers who are not willing to leave their core ethics behind when they are at a patient's bedside. Access to euthanasia and conscientious objection are not mutually exclusive.

We, as legislators, must ask ourselves where the Liberals will draw the line. There will always be the voices of those in our society who feel that the limitations and safeguards are too stringent. When will it be enough for the Liberal government? How far are they willing to go? What message are we sending to the most vulnerable and fragile in our society?

Over the last five years I have advocated for our veterans. I know there are countless veterans who appear able to cope with debilitating physical injuries, but they are extremely vulnerable in their mental health. We are all concerned about the number of them choosing to end their lives by suicide because of complications after serving our country. It is antithetical to try to prevent them from taking their own lives, yet tell them that there are government-designed opportunities to do so.

Bill C-7 fails to provide conscience protection and fails to protect the vulnerable.

Report: Concerns about euthanasia in Belgium.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A broadcast from September 30 examines concerns about euthanasia in Belgium. The broadcast in Dutch (Link to the broadcast) examines several euthanasia stories while interviewing a member of the Belgium euthanasia Commission and a well-known researcher concerning the Belgium euthanasia law.

The European Institute of Bioethics reports:

(Concerns about euthanasia) is indicative of the growing unease that reigns in Belgium with regard to euthanasia. Misunderstandings on the part of patients, discomfort of doctors faced with the demands of their patients, disobedience of the law, suffering of families, ... This podcast of about thirty minutes plunges the viewer into the heart of the world of euthanasia, world at the same time bureaucracy of the Commission responsible for controlling euthanasia, and a world full of emotion in the face of the suffering of patients who testify.

The European Institute of Bioethics (Google translated) reports that the broadcast interviews Nancy and Ruth:

Nancy, who is 48 years old and suffers from several pathologies: asthma, weakened immunity, brain tumors… requested euthanasia 4 years ago, but does not meet the criteria for an incurable and hopeless disease. The podcast also gives voice to Ruth, 28, who has suffered from severe psychiatric conditions since being sexually abused at the age of 5.

The broadcast interviews Dr Luc Proot, a long-time member of the Committee who is concerned about the increase in euthanasia deaths. The European Institute of Bioethics reports (Google translated):

The a posteriori control, that is to say once the person has already been euthanized by the doctor. According to Dr Luc Proot, member of the Commission, an a priori check would take too long and would lead to a much lower number of euthanasies ... He is nevertheless worried about the meteoric increase in the number of cases (2,655 in 2019 , ten times more than in 2003). The Commission must process more than 200 euthanasies at each of its monthly meetings, in one evening. “If we reach three or four thousand cases per year, we will no longer be able to do the job,” he says.

The broadcast interviews Belgian euthanasia researcher, Sigrid Sterckx. The European Bioethics Institute reports (Google Translated):

Sigrid Sterckx, professor of ethics at the University of Ghent, assesses at least 1/3 euthanasia not declared to the Commission in Flanders. She drew attention to the lack of transparency in the work of the Commission. Over the course of the report, we learn that the medical members are sometimes called upon to vote on their own euthanasia files. They are then not supposed to take part in the discussion, but must not withdraw when their files are analyzed. These are anonymous, but the members of the Commission often recognize the handwriting of their colleague ... It takes at least 2/3 of the votes to send a file to the Public Prosecutor. This quorum was not reached in the case of a doctor who had given a lethal drink to a lady no longer wishing to live after the death of her daughter. For Dr Proot, this quorum is “too severe.”

It is important that Sterckx upholds the truth, that studies prove least 1/3 of the euthanasia deaths are not declared to the Commission and since the Belgian Euthanasia Commission requires 2/3 of the members to demand an investigation before it is done. The one comment that is missing is the fact that Dr Wim Distelmans both operates the euthanasia clinic and chairs the Euthanasia Commission.

Euthanasia by dehydration and expanded Assisted Suicide promoted in New England Journal of Medicine

This article was published by The National Review online on October 21, 2020

Wesley Smith

By Wesley J Smith

The New England Journal of Medicine is a progressive menace when it comes to policy and cultural issues.

In our latest example, the Journal published a doctor who helped his non-terminally ill grandfather starve himself to death–and it is presented as a reason to expand assisted suicide eligibility.

The 103 year-old had the usual and difficult afflictions of very old age and had been widowed. But the prime reason for wanting to hasten his death was the isolation caused by COVID in his assisted-living facility.

“Grandpa” doesn’t qualify for assisted suicide in New Jersey as he was not diagnosed as terminally ill. So, Dr. Scott D. Halpern, suggests to Grandpa that he starve himself to death. From, “Learning About End-of-Life Care From Grandpa:”

I described another option to Grandpa: he could voluntarily stop eating and drinking. He’d never considered this possibility (which reminded me again how one’s family members and clinicians contribute to inequities in end-of-life care). The option intrigued Grandpa, and during subsequent visits he reinforced his plan to pursue it. I insisted that he first move into my home. I wanted to ensure the quality of his care, knowing that I could enroll him in my health system’s hospice program. But I also wished to test his resolve, reasoning that his mind might change once his isolation ended.

For a while, the old man thrives and enjoys life again. Good for Halpern!

Then, Grandpa decides to go through with making himself dead. He tried to do the deed, but the thirst was too much. So, physician grandson palliates his grandfather so he can complete his suicide by starvation–which in my mind is morally close to committing euthanasia:

When I asked whether he was having second thoughts about hastening his death or just wanted relief from thirst, he resoundingly replied, “I just want it over with. Scott, do whatever you need to do.”

I was now responsible for the success of his voluntary act — a responsibility that has been described by caregivers of other patients who have attempted to stop eating and drinking. When swabbing Grandpa’s mouth no longer provided relief, and after consultation with his hospice team, I began treating his thirst as I treat other forms of discomfort — with morphine and lorazepam. He became more tired, eventually bedbound and unable to interact, and after another 12 days that felt like a lifetime, he died peacefully.

First, nothing stopped Halpern from saying no. I don’t care who one is, they have no right to make someone else complicit in their suicide.

Second, by keeping Grandpa sedated, Halpern made it almost impossible for the old man to change his mind–as the article states, he had done before.

Halpern ends with a call for expanded assisted-suicide eligibility:

I’ve learned many things in living this story that no amount of studying, teaching, or providing palliative care could ever reveal: the power of isolation and the countervailing force of family, the devastation of existential suffering and the paucity of options for relieving it, and the inequities at play, such that stopping eating and drinking is largely impossible without knowledgeable family members and dedicated hospice care.

And I’ve learned that despite many problems with physician-assisted dying, it may provide the most holistic relief possible for people who are not immediately dying, but rather are done living.

This is known in euthanasia parlance as the “completed life.” The aim is to expand assisted suicide to elderly people who want to die even if they are not ill. In other words, rather than helping such people with existential despair overcome the darkness, the goal is to validate their termination. It’s an insidious abandonment in which death, rather than life, becomes the impetus.

I am sure Halpern thought he was doing the loving thing for his grandfather. But beneath the veneer of compassion, his article illustrates the yawning moral chasm into which a society will fall once it broadly accepts the assisted-suicide value system now promoted in the NEJM.

Child euthanasia comes to the Netherlands

This article was published by First Things on October 21, 2020

Wesley Smith

By Wesley J Smith

Once a society accepts the noxious notion that killing is an acceptable answer to human suffering, the definition of “suffering” never stops expanding.

The history of euthanasia in the Netherlands proves that maxim. The Dutch have allowed doctors to kill sick patients since the ’70s, taking an approach of quasi-decriminalization. Euthanasia was formally legalized in 2002. Over the decades, Dutch doctors “progressed” from euthanizing the terminally ill who ask for it, to the chronically ill who ask for it, to people with disabilities who ask for it, to the mentally ill who ask for it, and even to people with dementia who are unable to ask for it (as long as they left written instructions requesting it). The Dutch have also conjoined euthanasia with organ donation, creating a utilitarian impetus for lethal injection for both despairing patients and society. There have even been joint euthanasia killings of elderly couples who don’t want to experience the grief of widowhood.

*Sign and share the Petition opposing child euthanasia in the Netherlands (Link).

Now the country is getting ready to allow little children to be euthanized. When euthanasia was first legalized, 16 was the age limit. Later, it was lowered to 12. Now, the government is proposing legislation that will allow pediatric euthanasia starting at age 1. From the NL Times story:

For the children referenced in the new policy, doctors are only allowed to give palliative care, like sedation, or withhold nutrition over an extended period of time until the patient dies. Doctors describe this as “a gray area” between normal palliative care and active life termination, he said, and they have been calling out for more regulation. . . . [Health Minister Hugo] De Jonge said his proposal will protect the interests of children, and will afford more transparency to the “gray area.”

Four points bear making here. First, the story notes that young children can already be killed via slow-motion euthanasia, known in bioethics parlance as “terminal sedation.” Unlike legitimate pain control, terminal sedation aims to cause death by keeping the patient in an artificial coma and withholding all sustenance until the patient dies of dehydration (thirst) in about two weeks. This is not the same procedure as “palliative sedation,” an ethical pain-controlling technique that puts the patient into lesser or deeper levels of sedation as the patient requires. The purpose of palliative sedation is to maximize the patient’s comfort. In such cases, death comes naturally from the underlying condition—not from the sedation or withheld food or water.

Second, given the steady expansion of euthanasia eligibility in the Netherlands over the years, there is no reason to believe that the “terminal diagnosis” restriction will be followed—much less stick—for long. Some mentally ill people who are killed would otherwise live a normal lifespan, but that fact has been used as a justification for killing because it means the patient could experience many years of suffering.

Third, doctors already euthanize terminally ill and seriously disabled babies—that is, they commit infanticide—thanks to a bureaucratic checklist known as the Groningen Protocol. If a three-week-old baby with, say, spina bifida can be killed in the Netherlands without legal repercussions, eventually it will be permissible to kill children who become seriously disabled (particularly if the disability is cognitive).

Finally, the Dutch frequently justify expanding euthanasia eligibility by claiming they are merely coloring in “gray areas” to permit greater certainty and transparency. Yet these redefinitions of the law only go in one direction—increasing the number of people eligible for lethal injection. Besides, transparency does not transform an act that is immoral into somehow being moral. It just makes the entire society complicit.

The Netherlands won’t be the first country to permit child euthanasia. Belgium removed all age restrictions a few years ago. We know, based on government reports, that children as young as nine have been killed by doctors. One assumes their parents gave the go-ahead. But children are not so many pets to be put down when the owners think the time has come.

Pediatric euthanasia may soon come to this side of the Atlantic. Canada permits lethal injection euthanasia for adults—known as “medical assistance in dying” (MAID). As the country is preparing to expand its eligibility criteria, some hope that will include children—perhaps without parental consent. An article published last year in the Journal of Medical Ethics supported pediatric euthanasia. It was written by doctors who practice at a Toronto children’s hospital. Since Canadian children considered sufficiently mature may legally refuse life-extending care without parental consent, the doctors wrote, they should also be allowed to request a lethal injection. From “Medical Assistance in Dying at a Paediatric Hospital”: 

If . . . a capable [legally underage] patient explicitly indicates that they do not want their family members involved in their decision-making, although healthcare providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected. If we regard MAID as practically and ethically equivalent to other medical decisions that result in the end of life, then confidentiality regarding MAID should be managed in this same way.

Can you imagine visiting your sick child, only to learn that hospital doctors killed her without your knowledge or consent? The rage and agony would be unimaginable.

So what is the bottom line? Once a society embraces killing as an acceptable answer to human suffering and redefines assisted suicide as a “medical treatment,” the culture’s entire mindset shifts. Helping suffering people live ceases to be the overriding objective: These patients are rarely offered suicide prevention. Instead, death becomes the imperative, and not just for adults but eventually for sick and disabled children too—perhaps with organ donation thrown in as a plum to society.

It’s all so disheartening. As Canadian journalist Andrew Coyne once wrote about the growing popularity of euthanasia: 

“A society that believes in nothing can offer no argument even against death. A culture that has lost its faith in life cannot comprehend why it should be endured.” 

When the euthanasia death angel comes for children, who can say he is wrong?

Wesley J. Smith is a senior fellow at the Discovery Institute. His latest book is Culture of Death: The Age of “Do Harm” Medicine.