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.