Wednesday, November 2, 2022

Canadian doctors offer euthanasia before receiving a request.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Many people are wondering why Canada's euthanasia (MAiD) statistics indicate that Canada is quickly becoming the leading euthanasia country. The Netherlands and Belgium legalized euthanasia in 2002 and have experienced a steady growth in euthanasia deaths while Canada legalized euthanasia in 2016 and almost surpassed those countries.

Canada's 2021 euthanasia report indicated that there were 10,064 reported euthanasia deaths in 2021 representing 3.3% of all deaths, which was up from 2.5% in 2020. The data indicates a big difference in the percentage of euthanasia deaths between provinces with euthanasia representing 4.8% of all deaths in British Columbia and 4.7% of all deaths in Quebec.

Article: Canada releases 2021 euthanasia report. More than 10,000 reported deaths (Link).

Sharon Kirkey wrote an article for the National Post on November 2 that partially explains why euthanasia deaths have increased so quickly in Canada. Kirkey reports that unlike other jurisdictions, doctors in Canada are introducing the option of euthanasia rather than waiting for patients to bring it up. Kirkey wrote:

In most jurisdictions in the world with legalized euthanasia, doctors are explicitly prohibited, or strongly discouraged from raising assisted dying with a patient.

The request must come from the person.

But a guidance document produced by Canada’s providers of medically assisted death states that doctors have a professional obligation to bring up MAID as an option, when it’s “medically relevant” and the person is likely eligible, as part of the informed consent process.
University of Toronto ethicist, Kerry Bowman tells Kirkey that this is an ethical problem. Kirkey reports:
But some ethicists argue that introducing death as a “treatment option,” without the person suggesting it first, is seriously problematic, especially within the expanding realm of MAID, and that people could be unduly influenced to choose to have their life intentionally ended, given the power dynamics of the doctor-patient relationship.

“Some people, no matter how well-handled your conversation, may infer that it’s essentially a suggestion,” said University of Toronto bioethicist Kerry Bowman.

“They would also definitely infer that they have the strong potential to meet eligibility criteria, or you wouldn’t be offering it.”
Kirkey explains that The Canadian Association of MAiD Assessors and Providers (CAMAP) published a euthanasia guide in 2019 that opened the issue of doctors offering euthanasia rather than waiting for a patient request. CAMAP’s vice president, Dr. Konia Trouton told Kirkey:
Canada’s assisted dying law states that no health-care professional commits an offence “if they provide information to a person on the lawful provision of medical assistance in dying.” Canada’s MAID providers and assessors said that there is also no provision in the law that prohibits clinicians from initiating the discussion and raising the possibility of MAID.

While it is absolutely illegal to counsel someone to die by suicide, to “counsel,” from a doctor-patient perspective, means to “inform and discuss,” the group’s guidance reads.

“The clinical perspective of the meaning of the word ‘counsel’ has no bearing on the legal meaning.”
Bowman commented on the Canadian Veteran with PTSD who was told to die by euthanasia. Kirkey reports:
The case of a Veterans Affairs caseworker who reportedly suggested to a combat veteran with PTSD that MAID was a better option than “blowing your brains out against the wall” drew outrage.

“We don’t know how that conversation played out,” Bowman said. “But I suspect what is happening across the country is that some people are bringing it up regularly and some people aren’t.”
Bowman is also concerned about doctors offering euthanasia to a patient who is struggling to pay their rent. Kirkey writes:
The expansion of MAID to those not at imminent risk of dying adds another layer of complexity and debate, he said. “I also see it as very problematic when we bring (MAID) up to people who can’t pay the rent, or people who are living with disability who don’t have adequate access to the things that they need,” Bowman said.
Trudo Lemmens
Trudo Lemmens, a professor of health law and policy at the University of Toronto told Kirkey that he is concerned about depressed people who are being offered euthanasia. Kirkey reports:
“You have a person who is severely depressed where the nature of the illness is often accompanied by a desire to die. The person takes a step to go and see a mental health counsellor to get help, and is being told, as part of the informed consent procedure, we can have treatment a, b, c or MAID.”

In Canada, in contrast to just about all other jurisdictions, MAID is no longer seen as an exceptional procedure, Lemmens said.

“The fact that this has been presented as, ‘This has to be on the table because it’s part of informed consent,’ reflects, overall, an attitude that has developed in the Canadian context,” he said. “It’s being sold as a normal medical practice.”
Lemmens told Kirkey that doctors who introduce the topic of euthanasia to patients is unique to Canada. Kirkey reports:
In New Zealand and Victoria, Australia, two jurisdictions where assisted dying for the terminally ill was recently legalized, doctors are explicitly prohibited from bringing it up. While it’s not explicitly prohibited in Belgium and the Netherlands, “it is generally not considered appropriate,” Leemens said, especially outside the end-of-life context.

“The emphasis is on how the request must come from the patient.”
As I stated at the beginning of the article, one of the reasons that euthanasia in Canada has expanded so quickly is that doctors are introducing the topic of MAiD and not waiting for a patient to request it.

More articles on this topic: 

5 comments:

Tershia said...

I have been aware for quite some time that this is happening in the small town where I live.
Canada has become the devil’s playground!

Sswan said...

What the hell is wrong with these doctors.. suggesting this to anyone ... .good God...I have on my papers with the hospital to resesistate no matter what ...under no circumstances giving me the jab and kill me because the doctors think it's the best ...

Dr. Arnold Voth said...

Tragic, but not new and so very predictable. A scant few weeks after the original MAID act was passed, a nurse on my ward directly suggested to my patient (leaving her shaken and in tears) who had no indications whatsoever for it.

Anonymous said...

The absence of a federal and provincial legislation on implementation of palliative care makes it a challenge for palliative care experts advocating for right to live until natural death.

For example in the province of BC, the NDP finalized the provincial policy on MAiD on July 2018 and left the provincial policy on a draft stage.BC provincial palliative and dementia care should have been developed and implemented by April 2018.
BC NDP prioritizes MAiD implementation over standardizing and improving the delivery of palliative care services. Palliative care budget is being utilized to promote MAiD...poor budget utilization. Fraser health hospice admissions referral are deciding, referral to their MAid coordination are on the rise. MAiD coordination centre are collaborating with dying with dignity for witnesses to sign the request. Witnesses are not even sure ofvthe capacity of a depressed person to understand the form bring witnessed .

SAD reality of a poor public administration of healthcare in BC

LT said...

The mention of the Veterans Affairs caseworker (not healthcare worker) in this article makes me think of the latest news about this particular caseworker. It has now been brought to light that this person has done the same thing with 4 people in total now. The 1 we heard about in Aug plus 3 others!
It's obvious that it has become a free-for-all when it comes to who can make the suggestion for someone to request this potential painful death. Even Dr. Voth's nurse (see his comment above) went over his head to make the suggestion. And I thought it was the Dr. who was supposed to diagnose and offer treatment options, not the nurses.
And then to have this painful death be called a 'treatment.' That's the problem ... death is not a treatment. Treatment is something that is done to prevent death. How on earth did killing someone become labelled as a treatment? Are we seeing a modern form of eugenics play out here with Trudeau wanting to have the designation of the most efficient killer of the people he governs that don't live up to his idealistic criteria? I don't understand his hunger for death! That's not an accusation, it's just an observation with a tiny bit of imagination.