Tuesday, October 11, 2022

Canada's Euthanasia Program.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A few weeks ago, Rupa Subramanya called the Euthanasia Prevention Coalition and asked many questions about what is happening with (MAiD) euthanasia in Canada. We had a challenging conversation but I found Rupa to be wanting to report the truth about Canada's (MAiD) law.

Today I received a link to Rupa's article - Scheduled to Die: The Rise of Canada's Assisted Suicide Program that was published on October 11 by Common Sense news. 

The Euthanasia Prevention Coalition helped Margaret with her petition and her letters that she sent to groups and individuals. We are happy that Kiano remains alive.

Rupa sets up her article by telling the story of Kiano Vafaeian, a 23-year-old with Type 1 diabetes who was approved for MAiD by Dr Joshua Tepper and his mother Margaret Marsilla, who did everything that she could to prevent her son's death. Rupa writes:

Image from Margaret's petition
On September 7, Margaret Marsilla called Joshua Tepper, the doctor who planned to kill her son.

Marsilla is 46, and she lives outside Toronto with her husband and daughter, a nursing student. She had known that her 23-year-old son, Kiano Vafaeian, was depressed—he was diabetic and had lost his vision in one eye, and he didn’t have a job or girlfriend or much of a future—and Marsilla asked her daughter to log onto Kiano’s account. (Kiano had given his sister access so she could help him with his email.) He never shared anything with his mother—what he was thinking, where he was going—and Marsilla was scared.

That was when Marsilla learned that Kiano had applied and, in late July, been approved for “medical assistance in dying,” aka MAiD, aka assisted suicide.

His death was scheduled for September 22.

In a September 7 email from Tepper, the doctor, to Kiano and Tekla Hendrickson, the executive director of MAiDHouse, the Toronto facility where Kiano’s death would take place, Tepper mapped out the schedule:

“Hii,” he emailed. (Apparently, Tepper did not use spell check.) “I am confirming the following timing: Please arrive at 8:30 am. I will ask for the nurse at 8:45 am and I will start the procedure at around 9:00 am. Procedure will be completed a few minutes after it starts.”

The procedure entailed administering two drugs. First, a coma-inducing agent. Then, a neuromuscular blocker that would stop Kiano’s breathing. He would be dead in five to ten minutes.
Margaret, Kiano's mother wanted to stop her son from being killed. Rupa reports:
The day after she discovered the email, Marsilla called Tepper. She pretended to be a MAiD applicant. She called herself Joann and said she “wanted to go through the whole process in general, from A to Zed, before the Christmas holidays—if you know what I mean.” Tepper indicated he understood.

Tepper, sounding matter of fact, ran through the list of requirements: “You have to be over 18. You have to have an OHIP card.” (He was referring to her Ontario Health Insurance Plan.) “You have to have suffering that cannot be remediated or treated in some way that’s acceptable to you.”

Marsilla, who recorded the conversation and shared the five-and-a-half-minute recording with Common Sense, told Tepper that she was diabetic and blind—more or less, her son’s condition. Tepper said he’d “had patients a lot similar to you.”

Then, the doctor said, “If you wanted, I could do a formal assessment with you.” Marsilla asked if she should come in. Tepper replied: “We do them remotely, often by video of some type: WhatsApp, Zoom, FaceTime, something like that.”

A few minutes later, Marsilla hung up. She had just over two weeks to stop her son from dying.
Rupa continues her article by telling the history of MAiD in Canada and then interviewing several people who are seeking death by euthanasia and several people who oppose killing by MAiD. Rupa then returns to the story of Marsilla and Kiano. Rupa reports:

Dr. Kristen Creek, in Winnipeg, messaged her (Marsilla). As it turned out, Creek was a family physician, and she provided MAiD. She was surprised to hear that a young man with diabetes had been approved for it. She urged Marsilla to call Tepper back and be up front about who she was.

Marsilla did just that. Soon after, Marsilla, Kiano, Kiano’s aunt, and Tepper spoke on the phone. That call led nowhere, Marsilla said. By now, a right-wing, Canadian Catholic news site had picked up on Marsilla’s post, which mentioned Tepper by name, and the doctor was getting pummeled by outraged readers.

On September 16, Tepper texted Marsilla to say that he’d postponed Kiano’s death until September 28. Five days later, the doctor texted her again to say that, actually, he wasn’t going through with it. He apparently wanted nothing more to do with Kiano Vafaeian. 

Rupa explains that she tried to interview Kiano and then finally arranged to do a facetime interview. Rupa writes:

Kiano told me he was “baffled” by everything that had happened the past three weeks: his mother’s social-media campaign, Tepper’s decision not to help him die. “I didn’t know what to say,” Kiano said. “It’s how she knows how to love me.”

Still, he was furious with her. He didn’t know what came next, whether he’d find another doctor. The MAiD people didn’t want to touch his case.

Dr Ramona Coelho
The other key interviews include Rupa's interview with Dr Ramona Coelho who emphasized her concerns for people seeking death based on a lack of resources. Rupa wrote:
“I do worry MAiD is an easy solution to bed shortages and the terrible lack of resources patients are facing,”

 “the perverse disincentive that exists for administrators and governments with providing MAiD rather than care and resources to live can present a real danger to the lives of vulnerable or marginalized persons.”

Coelho’s comments jibed with a 2021 letter, from three UN officials to the Canadian government, about MAiD having “a potentially discriminatory impact on persons with disabilities and older persons who are not at the end of their life or nearing death from natural causes.” The letter added that “there is a real risk” that those “who may be further marginalized by their racialized, indigenous, gender identity or other status, will be more vulnerable to being induced to access MAiD.”

Dr Sonu Gaind
Dr. Sonu Gaind, a professor of psychiatry at the University of Toronto and a former president of the Canadian Psychiatric Association, told Rupa that the expansion of MAiD was “built on a house of cards.” Rupa reported:
“While pretending to provide MAiD for an irremediable condition, we actually end up taking the lives of non-dying people—who could get better—for all sorts of other psychosocial suffering,” Gaind told me. “That’s not compassion.”

He added: “When we have people who are genuinely suffering, and we don’t provide them options for dignified living, but we provide them with what we label as a painless death, it provides these people with the enticement of a means to escape their suffering, when we could have helped them escape otherwise—by overcoming their problems and moving on and living.”

Nor, Gaind said, is expanding MAiD about personal autonomy—at least, not for everyone. In a recent article, he wrote: “It is a myth that expanded MAiD is just about autonomy. Expansion may increase privileged autonomy for some to die with dignity, but it does so by sacrificing other marginalized Canadians to premature deaths for escaping painful lives that we failed to allow them to live with dignity.”
From its inception, Canada's MAiD law was designed to expand. The law employed undefined terminology and it was clearly written to protect the doctors and nurses who were willing to kill their patients. Bill C-7, in March 2021, clearly expanded euthanasia to include people with disabilities. Bill C-7 created a dichotomy whereby a person who is having difficulty receiving the necessary treatment or care is not having the same difficulty obtaining MAiD (euthanasia).

The fears of the disability community were correct. Extending euthanasia to people who are not dying but are living with chronic or disabling conditions would lead to euthanasia based on social conditions because many people with disabilities are living in poverty and/or unable to access the treatment or care that they require.

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