Ontario 2022 euthanasia (MAiD) deaths increase by 27% to 3934.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Office of the Chief Coroner of Ontario released the December 2022 MAiD data which indicated that in 2022 there were 3934 reported euthanasia deaths up by 27% from 3102 in 2021.

The Ontario euthanasia data indicates that have been 13,732 (MAiD) deaths since legalization in June 2016. For clarity, there were 13,729 euthanasia deaths and 3 assisted suicide deaths.

According to the data, of the 3934 euthanasia deaths in 2022, 121 were people who were not terminally ill, 20 of the deaths were followed by organ donation and the final consent was waived in 190 deaths. The final consent is waived when a person has become incompetent.

A 27% increase in Ontario euthanasia deaths is significant but less than the 51% increase reported in Québec. (Link to article).

The seventh annual report from Québec’s Commission on end of life care was filed in Québec’s National Assembly on December 9, 2022 covering the (April 1, 2021 to March 31, 2022) period. The report declared that there were 3663 reported euthanasia deaths representing 5.1% of all deaths.

Unlike Ontario, Québec has a multiple reporting system. The Québec report indicated that a discrepancy of 289 euthanasia deaths were reported when comparing the practitioner reports to the Collège des Médecins du Québec reports.

The Ontario data may not be accurate because it only relies on the voluntary reports submitted by the practitioners who cause the death.

The trends in Ontario mirror the national trends.

Health Canada released the Third Annual Report on Medical Assistance in Dying in Canada (2021) in July 2022. According to the Third Annual report there were:       

10,064 assisted deaths in 2021 up from 7603 in 2020, 5661 in 2019, 4480 in 2018, 2838 in 2017 and 1018 in 2016. The report indicated that in 2021  the number of assisted deaths increased by 32.4% representing 3.3% of all deaths with the total number of reported (MAiD) assisted deaths in Canada from legalization until December 31, 2021 at 31,664.

Is there enough killing yet?

In April, 2022; CTV news story reported on a euthanasia death in February 2022 of a 51-year-old Ontario woman who had multiple chemical sensitivities (MCS). According to report, the woman was not terminally ill but living with a chronic condition that made her highly sensitive to chemicals and environmental allergies. This woman was killed not because of an “irremediable medical condition” but because she couldn't afford appropriate housing.

Soon after CTV news reported on a 31-year-old Ontario woman with MCS who was also approved to be killed by euthanasia. These reports of euthanasia for MCS created awareness that euthanasia was becoming a “treatment” for people with disabilities who were living with poverty or issues related to housing or other social conditions. The good news was that this story resulted in a GoFundMe campaign that raised money to enable this woman to afford a clean place to live.

There was the story in September 2022 of a mother who started a campaign to prevent the euthanasia death of her 23-year-old son with diabetes. EPC launched a petition campaign and the mother successfully challenged the euthanasia doctor, who then cancelled the death.

There was the October 2022 story of a disabled Ontario man who was seeking death by euthanasia to avoid homelessness. He was unable to find a new place to live after the building he was living in was sold. This man relied on a disability benefit and he was unable to find an affordable place to live. He said that he would rather die than become homeless. Thankfully a  GoFundMe campaign raised enough money to enable him to find a place to live.

I was very pleased by the recent news that Portugal's Constitutional Court rejected a euthanasia bill for the second time based on the imprecise language of the bill.

Canada's euthanasia law employs imprecise language that has been loosely interpreted. Sadly the deaths by euthanasia continue to increase exponentialy in Canada.

More information:

• Québec Euthanasia deaths increase by 51% in 2021-22 annual report. A discrepancy of 289 deaths (Link).
• Canada releases 2021 euthanasia report. More than 10,000 deaths representing 3.3% of all deaths (Link).
• Ontario euthanasia deaths increase by more than 30% in 2021 (Link).
  

Portugal's Constitutional Court rejects another euthanasia bill.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

Portugal's Constitutional Court has once again rejected, a euthanasia bill that was passed by Portugal's parliament. President Marcelo de Sousa vetoed another euthanasia bill last year before the election.

André Ventura, who is the leader of the Chega party, is calling for a referendum on euthanasia.

The Portugal News reported:

The Constitutional Court considered that “an intolerable lack of definition as to the exact scope of application” of the decree on medically assisted death had been created, noting that the parliament went “further”, changing “in essential aspects” the previous bill.

This was the third decree approved by parliament to decriminalise medically assisted death in a period of about two years.

The first was also declared unconstitutional by the TC, in March 2021, following a request for preventive inspection by the President of the Republic, due to insufficient normative densification.

In November of the same year, Marcelo Rebelo de Sousa used the political veto in relation to the second parliamentary decree on this matter, as it contained contradictory expressions.

The current bill passed on December 9. Similar to the previous two bills, the bill uses vague language, as the Constitutional Court stated, the bill had "an intolerable lack of definition as to the exact scope of the application."

The European Institute of Bioethics reported on January 12 on the concerns with the text of the bill (google translated):

In the new text adopted at the end of 2022 by the parliament, the “intolerable” character of the suffering is no longer required in the patient; henceforth, only “great intensity” suffering would suffice. This condition is not, moreover, required in the case of “permanent damage of extreme gravity”. In addition, the term “fatal disease” is removed in favor of “serious and incurable diseases”, thus positioning the act of euthanasia as a means of causing death and not of accelerating it.

More broadly, the Portuguese law in itself raises serious ethical concerns, because it entails, in the words of Marcelo Rebelo de Sousa, a "considerable change from the point of view of the balance between the value of life and the right to self-determination", authorizing euthanasia even when the patient is not at the end of life.

On January 29, 2021, Portugal's parliament passed the first euthanasia bill. On February 19, President de Sousa referred the bill to Portugal's Constitutional court for evaluation. President de Sousa stated that the bill was:

"excessively imprecise," potentially creating a situation of "legal uncertainty."

On March 15, the Portuguese American Journal reported that the Constitutional court rejected the first bill and stated:

“the law is imprecise in identifying the circumstances under which those procedures can occur.” The court stated the law must be “clear, precise, clearly envisioned and controllable.” The law lacks the “indispensable rigor."

On November 30, 2021, President de Sousa vetoed the second euthanasia bill because of contradictions in it's language. The Associated Press reported:

This time, the president is returning the reworded law to the national assembly, according to a statement posted on the Portuguese presidency’s website late on Monday, arguing that further clarification is needed in “what appear to be contradictions” regarding the causes that justify resorting to death with medical assistance.

Whereas the original bill required “fatal disease” as a pre-requisite, the president’s argument followed, the renewed version mentions “incurable” or “serious” disease in some of its formulation. No longer considering that patients need to be terminally ill means, in De Sousa’s opinion, “a considerable change of weighing the values ​​of life and free self-determination in the context of Portuguese society.”

The Associated Press reported in June 2022 that the new euthanasia bills, that were being debated, did not fulfill President de Sousa's concerns. According to the article:

...none of the four new bills addresses Rebelo de Sousa’s specific concerns. Instead, they attempt to simplify circumstances where euthanasia and physician-assisted suicide are justified by referring to “a situation of intolerable suffering, with a definitive injury of extreme seriousness or a serious and incurable disease.”

A new concerns is that André Ventura, the leader of the Chega, has called for a referendum. The Portugal News quoted Ventura as stating:

"this process can only be resolved with a referendum", maintaining that "an issue of this importance, twice declared unconstitutional by the TC, can only be resolved with the direct participation of Portuguese citizens."

All three euthanasia bills were either declared unconstitutional or vetoed based on the imprecise language of the bill. The euthanasia lobby appear to be following Canada's lead by passing euthanasia bills that lack definition. Legislation that are not sufficiently defined will naturally expand over time.

Euthanasia directly and intentionally causes the death of a person by lethal injection. Portugal needs to commit to a culture that cares for its citizens in need, not kills.

Alzheimer’s Association Terminates Partnership with Assisted-Suicide Advocacy Group

This article was published by National Review online on January 30, 2023.

By Wesley Smith

Alzheimer’s disease runs in my family. My mother and uncle both died from it, so I have intimately witnessed the worst that the disease can inflict.

I also know how much people with the condition need love, understanding, and patience. They are still the persons they have always been, just compromised and dependent.

I also know how vulnerable people with dementia are and how easily they can be manipulated. I am also aware that too many denigrate them as less than human — so-called non-persons — and view their lives as no longer worth living.

People are understandably terrified of the disease. Consequently, as the Catholic bioethicist Charles Camosy has written, people with dementia are targets of the euthanasia movement. That is why I was appalled when Compassion and Choices — the country’s most prominent assisted-suicide advocacy organization — bragged that it had partnered with the Alzheimer’s Association to advocate on behalf of Alzheimer’s patients. C & C talks a good game about end-of-life care, but their primary mission is to push suicide as an answer to serious illness.

An association dedicated to the care of people with the disease had no business affiliating in any way with a group that advocates assisted suicide.

Now, the Alzheimer’s Association has seen C & C for what it really is and has terminated the relationship. From the AA press release:

Alzheimer’s disease, the Alzheimer’s Association entered into an agreement to provide education and awareness information to Compassion & Choices, but failed to do appropriate due diligence. Their values are inconsistent with those of the Association. We deeply regret our mistake, have begun the termination of the relationship, and apologize to all of the families we support who were hurt or disappointed. Additionally, we are reviewing our process for all agreements including those that are focused on the sharing of educational information.

As a patient advocacy group and evidence-based organization, the Alzheimer’s Association stands behind people living with Alzheimer’s, their care partners and their health care providers as they navigate treatment and care choices throughout the continuum of the disease. Research supports a palliative care approach as the highest quality of end-of-life care for individuals with advanced dementia.

Right. Care — not killing! Good for the Alzheimer’s Association. I just wish more such organizations understood that the activists of C & C are suicide pushers. They are not the friends of the ill and afflicted.

EPC February 9 Webinar: Where can we go from here?

Join the Euthanasia Prevention Coalition Zoom webinar on Thursday, February 9 at 7 pm (Eastern Time) with Gordon Friesen and Alex Schadenberg titled: Where can we go from here?

Register in advance: (Registration Link)

The webinar will include an update on Canada's euthanasia law and provide some direction related to Canada's healthcare system and the need for creating Compassionate Community Care.

Gordon Friesen is the President of the Euthanasia Prevention Coalition and a disability leader. He has studied and followed the euthanasia issue since the 1990's.

Alex Schadenberg is the Executive Director of the Euthanasia Prevention Coalition since 1999 and the International Chair since 2007.

The webinar will include up-to-date information and direction while providing an opportunity for people to share questions and concerns.

Register in advance: (Registration Link)

Alzheimer's Association ends agreement with assisted suicide group. Killing is not caring.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Alzheimer's is a terrible condition. Research, treatment and care is needed for people with Alzheimer's and their families. 

The Alzheimer's Association announced that they have ended their agreement with an assisted suicide group.

Contact the Alzheimer's Association at: media@alz.org and thank them that they have recognized that: 

Assisted suicide does not maximize quality care and support. 

A world without Alzheimer's must not be achieved by killing people with Alzheimer's

Assisted suicide is the ultimate form of abandonment. People with Alzheimer's deserve to be cared for and upheld as a human person deserving of life with dignity.

The Alzheimer's Association sent out a media release on January 29 stating that they have ended their agreement with Compassion & Choices. Here is the release:

January 29, 2023
Email: media@alz.org

Chicago, January 29, 2023 — In an effort to provide information and resources about Alzheimer’s disease, the Alzheimer’s Association entered into an agreement to provide education and awareness information to Compassion & Choices, but failed to do appropriate due diligence. Their values are inconsistent with those of the Association. We deeply regret our mistake, have begun the termination of the relationship, and apologize to all of the families we support who were hurt or disappointed. Additionally, we are reviewing our process for all agreements including those that are focused on the sharing of educational information.

As a patient advocacy group and evidence-based organization, the Alzheimer’s Association stands behind people living with Alzheimer’s, their care partners and their health care providers as they navigate treatment and care choices throughout the continuum of the disease. Research supports a palliative care approach as the highest quality of end-of-life care for individuals with advanced dementia.

About the Alzheimer's Association

The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Our mission is to lead the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia®. Visit alz.org or call 800.272.3900.

The Alzheimer's Society has recognized that promoting assisted suicide denies their clients the human and dignified care that they need and deserve. Killing is not caring.

Canada’s Euthanasia (MAiD) law is the most permissive in the world. How did this happen?

Alex Schadenberg

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 2015 the Supreme Court of Canada struck down Canada’s laws that protected people from euthanasia and assisted suicide. The case, known as the Carter case, was based on Kay Carter (89), who was not terminally ill but lived with spinal stenosis and died by assisted suicide in Switzerland, and Gloria Taylor, who lived with ALS.

At that time I wrote how the Supreme Court of Canada's decision was irresponsible and dangerous, but the Supreme Court did state that the federal government was to create a “carefully-designed system” with “stringent limits that are scrupulously monitored and enforced.” Clearly, the government ignored that requirement.

In 2016, while the federal government was debating euthanasia Bill C-14, there were many attempts to amend the bill or to define the language in the bill to fulfill the requirement of the Carter decision. The problem with Bill C-14 was evident, the bill gave doctors and nurse practitioners the right in law to cause the death of their patients, without defining the terminology within the law.

For instance, Bill C-14 stated that euthanasia would be restricted to people “whose natural death was deemed reasonably foreseeable.” The government claimed that this phrase would limit euthanasia to terminally ill people but because the phrase was not defined it created confusion.

Based on a lack of definition I predicted that the euthanasia law would expand based on the practise and the law would be interpreted in an expansive manner.

Soon after the passing of Bill C-14 a couple of people with disabilities launched court challenges to the legal requirement that that their “natural death must be deemed reasonably foreseeable.” They argued that it was discrimination to deny euthanasia to someone who is suffering but not terminally ill.

Even though the interpretation of “reasonably foreseeable” had expanded beyond its original interpretation, in September 2019, a Québec lower court struck down the requirement that a person’s death must be “reasonably foreseeable” in the Truchon decision. Even though this was a lower court decision, the federal government did not appeal the decision, thus expanding euthanasia to people who are not terminally ill.

The original law required that a person must have an “irremediable medical condition” combined with that their “natural death being reasonably foreseeable.” By removing the reasonably foreseeable death requirement, euthanasia became available to nearly anyone with a disability or chronic condition.

The federal government “codified” the Truchon decision into the law by passing Bill C-7 in March 2021. Bill C-7 removed from the original law that death must be “reasonable foreseeable” but C-7 also eliminated the 10-day waiting period for people who are terminally ill, it created a 90-day waiting period for those who are not dying and it permitted euthanasia for people with mentally illness. The government declared a two-year moratorium on euthanasia for mental illness, meaning that on March 17, 2023 euthanasia for mental illness could begin. On December 15, 2022 the federal government announced that they will delay the implementation of euthanasia for mental illness alone.

During the C-7 debate, the disability community were adamant that, if passed, it would lead to people with disabilities dying by euthanasia for social reasons. Due to a lack of definition in the law, they predicted that almost everyone with a disability would qualify for death yet the reason people would ask for death may be related to poverty, an inability to receive medical treatment and other social concerns.

Canada has the most permissive law.

In April, 2022; CTV news story reported on a euthanasia death in February 2022 of a 51-year-old woman who had multiple chemical sensitivities (MCS). According to Favaro, the woman was not terminally ill but living with a chronic condition that made her highly sensitive to chemicals and environmental allergies. I stated that this story represented the ultimate form of abandonment whereby this woman was killed not because of an “irremediable medical condition” but because she couldn't afford appropriate housing.

Soon after CTV news reported on a 31-year-old woman with MCS who was also approved to be killed by euthanasia. These reports of euthanasia for MCS created awareness that euthanasia was becoming a “treatment” for people with disabilities who were living with poverty or issues related to housing or other social conditions. The good news was that this story resulted in a GoFundMe campaign that raised money to enable this woman to afford a clean place to live.

Donna Duncan's daughters

CTV news also reported that the euthanasia death of Donna Duncan was being investigated by the Abbotsford police. Duncan (61) was diagnosed with a concussion after a car accident in February 2020. Due to Covid restrictions, Duncan was unable to access medical treatment or rehabilitation. The concussion symptoms led to other health problems as well as deep depression. Duncan was assessed, approved and then died by euthanasia even though her condition was treatable.

After these stories were published, other stories began to be featured by reporters. There have been several stories concerning people who were approved for euthanasia but were unable to access medical treatment. Some of these people with disabilities required treatment for their symptoms and found that getting approved to be killed was easier than accessing treatment. 

Canada had now become the most permissive jurisdiction in the world for euthanasia and the world began to wonder why Canada is euthanizing the poor.

Another powerful story was the Canadian veteran who was seeking treatment for PTSD and a Veteran’s Affairs worker told him that he should apply for “MAiD.” When this story was reported, the Ministry of Veteran’s Affairs stated that it had only happened once. Since then it has been reported that several veterans died by euthanasia and at least 6 veterans were told to apply for “MAiD.”

There was the story of a disabled man who was seeking death by euthanasia to avoid homelessness. He was unable to find a new place to live after the building he was living in was sold. This man relied on a disability benefit and he was unable to find an affordable place to live. He said that he would rather die than become homeless. Thankfully a GoFundMe campaign raised enough money to enable him to find a place to live.

Alan Nichols with his brother

A woman with disabilities died by euthanasia based on inadequate home care, a 23-year-old with diabetes was approved for euthanasia, and the story of Alan Nichols keeps coming back as his family wonders why they killed their brother.

To make matters worse, the Quebec College of Physicians are now urging the federal government to legalize euthanasia for newborns, otherwise known as infanticide.

In a few short years Canada went from legalizing euthanasia for terminal illness, then extending it to people with chronic conditions and disabilities and Canada is now considering euthanasia from "mature minors," newborns, people with dementia and more.

There is only one clear line in the sand, that being, is it acceptable for one group of people to kill other people. By legalizing euthanasia, Canadian doctors and nurse practitioners gained the right in law to kill their patients. Once Canada decided that it was acceptable to kill, the only remaining questions are who can be killed and for what reasons. 

Further reading:

• Supreme Court of Canada Assisted Suicide decision is irresponsible and dangerous (Link).
• Quebec Court expands euthanasia law by striking down the terminal illness requirement. (Link).
• Canada passes Bill C-7 allowing euthanasia for mental illness (Link).
• Canada's law will provide not prevent suicide for some psychiatric patients (Link).
• Euthanasia for mental illness. Killing people with an uncertain prognosis (Link).
• Abbotsford police investigating euthanasia death (Link).
• Canada is not as advertised. Euthanasia is eugenics (Link).
• Canada's euthanasia law is the most permissive in the world (Link).
• (MAiD) euthanasia for disability and poverty (Link).
• (MAiD) euthanasia for mental illness and poverty (Link).
• Veterans affairs worker advocates euthanasia for PTSD (Link).\
• Abandoning people. Canada's broadening euthanasia laws (Link).
• Mother wants to stop 23-year-old son from dying by euthanasia (Link).
• Bereaved mother speaks out against euthanasia (Link).
• Woman died by euthanasia because of inadequate home care (Link).
• Infant euthanasia proposed by Quebec College of Physicians (Link).
• How poverty not pain is driving people with disabilities to euthanasia (Link).
• Ontario man seeks euthanasia to avoid homelessness (Link).
• Why did they kill my brother? (Link).
• Canada's doctors offer euthanasia before receiving a request (Link).
• Food bank clients asking for euthanasia based on poverty (Link).
• No other options. An expose on euthanasia in Canada (Link).
• Poverty and euthanasia creates public interest but euthanasia is abhorent on its own (Link).

Vancouver doctor euthanized a man who was deemed unable to consent.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Ellen Wiebe

An article by Alexander Raikin published by The New Atlantic last December tells a story of Ellen Wiebe, who runs a euthanasia clinic in Vancouver. This part of the article refers to the fact that Canada's euthanasia law allows death doctor shopping and virtual approvals for death. Raikin wrote:

What if a doctor dutifully screens for eligibility, and rejects someone? Then the person can just go elsewhere.

In another CAMAP seminar recording, we learn of a man who was rejected for MAID because, as assessors found, he did not have a serious illness or the “capacity to make informed decisions about his own personal health.” One assessor concluded “it is very clear that he does not qualify.” But Dying with Dignity Canada connected him with Ellen Wiebe (pronounced “weeb”), a prominent euthanasia provider and advocate in Vancouver. She assessed him virtually, found him eligible, and found a second assessor to agree. “And he flew all by himself to Vancouver,” she said. “I picked him up at the airport, um, brought him to my clinic and provided for him,” meaning she euthanized him.

Raikin then reminds us that Wiebe has stated during public speaking this is “the most rewarding work we’ve ever done.” 

Killing a person who is deemed incompetent is the most rewarding work she has ever done?

Wiebe's long distance killing came back to mind when I published a commentary on the recent article by Erin Anderssen published by the Globe and Mail on January 18 concerns the experience of several families as they grieve the death of family members who died by euthanasia.

Anderssen shares the story of an Ontario woman who was approved for euthanasia in British Columbia without her family knowing. Anderssen wrote:

In Ontario, for instance, a father learned this fall that his adult daughter was being assessed for MAID when she forwarded an e-mail from a B.C. doctor proposing that she travel west to complete the process. By then a plane ticket had already been booked for November. Her parents, who had been caring for her since she was diagnosed with schizophrenia as a young woman, were distraught.

The father, whom The Globe and Mail is not identifying to protect his daughter’s privacy and his relationship with her, says he’d watched, over many months, as MAID consumed his daughter’s day; she pored over how-to information online.

His daughter’s life is not easy, he conceded in an interview. Her mental illness causes fearsome bouts of anger, she spends most of her time alone, and she is plagued by delusions that she is rotting inside from a terminal physical illness.

But certainly, he didn’t think she’d be eligible for an assisted death. While she has some physical health issues, he could not imagine they were serious enough to qualify for MAID....

So it was unfathomable, he says, that a physician was counselling his daughter, who suffers from psychosis, to travel alone halfway across the country. Or that two MAID assessors might approve her without insisting on input from her treating psychiatrist or family doctor. Yet the e-mail suggested an expeditious outcome: If she could get to B.C. – where ostensibly a physical illness might make her eligible – she could qualify within weeks.

The father doesn’t know what illness his daughter used to apply, and was not privy to all the discussions with the MAID clinician. But in the end, the parents managed to persuade their daughter to cancel the plane ticket.

There is no indication in the article that Ellen Wiebe in Vancouver was involved with this case but Wiebe admits to approving euthanasia online and picking up that person at the airport for being killed.

 

Remember, the case that Anderssen is writing about concerned a woman with schizophrenia. Wiebe approved her death even though parliament has a moratorium on euthanasia for mental illness.

Wiebe was the same doctor who lethally injected a man who was living in a Jewish care home with a "no euthanasia" policy.

 

Wiebe admitted last year that she had killed at least 400 people by euthanasia.  

Montana Bill (SB 210) prohibits assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Over the past few years Montanans have had a confusing situation concerning assisted suicide. 

In 2009, the Baxter court decision declared that Montanans had a right to assisted suicide. The Baxter decision was appealed to the Montana Supreme Court where it was decided that Montanans do not have a right to assisted suicide but the Court found a defense of consent. Therefore, if a Montana physician assists a suicide the physician must prove that there was consent.

Physician-Assisted Suicide is not legal in Montana.

State Senator Carl Glimm

Since the Montana Supreme Court decision, the assisted suicide lobby has claimed that assisted suicide is legal in Montana. Even though assisted suicide is technically prohibited, Montanans have been dying by assisted suicide.

In 2023, Montana State Senator, Carl Glimm has introduced Bill SB 210 to reverse the effect of the Montana Supreme Court decision by clarifying that consent is not a defense for homicide or assisted suicide.

Bill (SB 210) to reverse Baxter and prohibit assisted suicide will be heard by the Senate Judiciary Committee on Feb 1. Written testimony supporting SB 210 must be submitted by February 1 at: (Link).

SB 210 states:

3 (a) For the purposes of subsection (2)(d), physician aid in dying is against public policy, and a patient's consent to physician aid in dying is not a defense to a charge of homicide against the aiding physician.

3 (b) (1) For the purposes of this subsection (3), "physician aid in dying" means an act by a physician of purposefully prescribing a lethal dose of medication to a patient that the patient may self-administer to end the patient's life.

3 (b) (ii) The term does not include an act of withholding or withdrawing a life-sustaining treatment or procedure authorized pursuant to Title 50, chapter 9 or 10."

SB 210 effectively closes the loophole and prevents assisted suicide in Montana.

Written testimony supporting SB 210 must be submitted by February 1 at: (Link).

Complicated grief: When a family member dies by euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Erin Anderssen published by the Globe and Mail on January 18 concerns the experience of several families as they grieve the death of family members who died by euthanasia. Anderssen begins with the story of Gary Hertgers:

Gary Hertgers learned that his sister, Wilma, had received a medically assisted death when her apartment manager called to say that her body was being carried out into the street.

“You mean, my sister is dead?” he asked.

“I thought you knew,” the manager said. “She told me the family knew.”

But, in fact, none of her immediate family knew that Ms. Hertgers had been approved for medical assistance in dying, let alone set a date. Not her 88-year-old mother, whom she called twice a day. Not her older brother, who lived one town over. And not Mr. Hertgers, 61, who had only that Friday, after driving the four hours to Chilliwack, B.C., shared a pot of tea at Ms. Hertgers’s kitchen table.

Gary Hertgers

Anderssen continues:

They’d chatted as usual, mostly about Ms. Hertgers’s health; at 63, she experienced chronic pain, and wrestled with depression. She told him the location of her will. But she had done that before, so the clue didn’t register. They parted with a hug. See you soon, he said.

Two days later, in the same apartment, someone said a prayer at her side while she died. At least, that’s what Mr. Hertgers was later told by the doctor who delivered the fatal medication. The identity of that person is still a mystery, like many of the details around his sister’s death.

When Canadians receive MAID, families and caregivers are often with them, providing comfort along the way. But the situation becomes much more fraught, ethically and emotionally, when patients don’t want relatives and friends involved.

Anderssen explains that Canada's MAiD law does not require the person requesting death to inform their family and the euthanasia assessor is also not required to speak to family, making it difficult to accurately assess a person who is asking to be killed.

Hertgers feels at a loss.

“You feel like you’re taken for granted, like the relationship you’ve built over all these years is superseded by someone who has known her a few months, that your care has been for naught,” says Mr. Hertgers. “At the end of the day, did all that time and effort mean anything?”

I have published several articles on the grief related to death by euthanasia. In October 2018 I received a call from a grieving woman after her grand-father died by euthanasia (Link).

Anderssen reports that some experts say that the role of families needs to be clarified before MAID extends to patients with mental illness. 

In December, responding to concerns raised by doctors and health care organizations, the federal government announced it would ask Parliament to delay the MAID expansion, to allow more time to establish clear safeguards. Toronto’s Centre for Addiction and Mental Health, the country’s largest psychiatric teaching hospital, has suggested that should include more consultation with patients and their families.

Anderssen shares the story of an Ontario woman who was approved for euthanasia in British Columbia without her family knowing.

In Ontario, for instance, a father learned this fall that his adult daughter was being assessed for MAID when she forwarded an e-mail from a B.C. doctor proposing that she travel west to complete the process. By then a plane ticket had already been booked for November. Her parents, who had been caring for her since she was diagnosed with schizophrenia as a young woman, were distraught.

The father, whom The Globe and Mail is not identifying to protect his daughter’s privacy and his relationship with her, says he’d watched, over many months, as MAID consumed his daughter’s day; she pored over how-to information online.

His daughter’s life is not easy, he conceded in an interview. Her mental illness causes fearsome bouts of anger, she spends most of her time alone, and she is plagued by delusions that she is rotting inside from a terminal physical illness.

But certainly, he didn’t think she’d be eligible for an assisted death. While she has some physical health issues, he could not imagine they were serious enough to qualify for MAID....

So it was unfathomable, he says, that a physician was counselling his daughter, who suffers from psychosis, to travel alone halfway across the country. Or that two MAID assessors might approve her without insisting on input from her treating psychiatrist or family doctor. Yet the e-mail suggested an expeditious outcome: If she could get to B.C. – where ostensibly a physical illness might make her eligible – she could qualify within weeks.

The father doesn’t know what illness his daughter used to apply, and was not privy to all the discussions with the MAID clinician. But in the end, the parents managed to persuade their daughter to cancel the plane ticket.

It was likely the euthanasia clinic in Vancouver that was involved with this case. Dr Wiebe is reported to have approved euthanasia by Zoom and was willing to pick people up at the airport for being killed. 

Christopher Lyon

Anderssen then told the story of Dr Christopher Lyon father, who died by euthanasia in Victoria.

Before his father died, Dr. Lyon, an environmental social scientist, says his family tried to share what they consider to be important context for the MAID providers and assessors. When his father was first assessed for MAID, the family wrote up a detailed history of his physical ailments and mental health struggles, his alcohol use and personality quirks – and sent it to the office of the MAID co-ordinator. Dr. Lyon knew his father experienced bouts of depression, especially around negative events. Hospitalized after a fall, he now faced moving into an assisted-living apartment. He had been openly talking about suicide for months. The family expressed their opinion, however, that with time, social support and mental health care, their father would improve.

Even today, Dr. Lyon is not sure who read it. He doesn’t know the content of his father’s assessments, or what information was collected. He says the health authority has declined to release the full records, deeming it not to be in the “patient’s best interest.” A late-stage psychiatrist report that he has seen contained so many errors and omissions that he worries about what else was overlooked.

When the MAID provider phoned to give him 48 hours’ notice, it was the first time they had spoken. By then, Dr. Lyon and his family had been trying for weeks to find a solution to keep his 77-year-old father alive. They thought they had time; his chronic health conditions had qualified him for MAID as a non-terminal patient, which required a 90-day waiting period, and there was still a month to go. But his dad stopped eating a few days after moving, reluctantly, into the new apartment. He was admitted to hospital after another fall, and fast-tracked to receive an assisted death.

Dr. Lyon rushed to Victoria from Montreal, and on a sunny afternoon, he gathered at his father’s hospital bed with his two siblings, and his mother. He remembers that the MAID provider was running late. “We were just watching the clock tick down until someone was going to come and kill him, which is, you know, an excruciating, unbearable thing to experience.” Arriving, Dr. Lyon recalls, she said, “I hear it’s someone’s birthday,” as if joining a party; by awful chance, the procedure had been scheduled on a family member’s birthday. “Get me the hell out of here,” his father declared, giving his consent. He was dead 20 minutes later. His son still has nightmares about it.

“It was like some sick, dystopian Black Mirror or Squid Game,” Dr. Lyon says. “You, family member, have 90 days to convince a doctor, whose name you don’t know and cannot directly contact, to save your father’s life.” To pass on important information the patient might conceal. To scramble when the date is unexpectedly moved up. To make sure, before the lethal injection, that all options have been fully explored. It felt, he said, that “if we want to save our loved one’s life, we are actually in competition with the assessors and providers.

Duncan sisters

The article then tells the story of Donna Duncan who died by euthanasia in October 2021 after having a head injury from a car accident in 2020, that she didn't receive treatment for, due to Covid restrictions. The article states:

Christie Duncan, and her sister, Alicia, learned their mother, Donna, who lived near Abbotsford, B.C., was starting the MAID process when their mom’s husband texted them a link to a support group in October, 2021.

Their mom’s decline began after a car accident in early 2020, Christie says, and she was losing weight, without a clear diagnosis. But her daughters worried that the pandemic had made it hard to get treatment, and lockdowns had affected their mom’s mental health.

When they found out a MAID date had been set, the sisters successfully appealed to the courts for a delay. A few days later, Donna was admitted to hospital after cutting her wrist – an event her daughters hoped would postpone their mom’s assisted death indefinitely.

In the hospital, on Oct. 29, Christie says, “I hugged her goodbye, and I went home, thinking I will talk to my mom in the morning.” Donna was released a few hours later, and that night, her daughters received a text from her husband that their mom had received MAID, “as per her wishes.” (A police investigation, prompted after her daughters filed a complaint, did not find any evidence of criminality.)

The police investigation did not find evidence of criminality because Canada's euthanasia law makes it nearly impossible to prosecute any doctor or nurse practitioner for their role in a death. The law states that the doctor or nurse practitioner only need to be "of the opinion" that the person fits the criteria of the law. In all of these cases, the assessor was "of the opinion" that the person fit the criteria of the law.

Euthanasia is not a revocable decision once you are dead.

The grief associated with family members who have lost a loved one to euthanasia, is rarely discussed, but it is real. There have been many controversial euthanasia deaths in Canada that may have led to complicated grief. A study needs to be done concerning the grief associated with deaths by euthanasia.

Nine things to know about euthanasia for mental illness in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

CTV news Medical Correspondent, Avis Favaro, has provided in-depth investigative reports into euthanasia (MAiD) in Canada. Favaro does not oppose euthanasia but she has reported on the controversial deaths. The reporting that we have seen by Favaro has opened the door to a real debate on the reality of Canada's euthanasia law.

The recent W5 report titled: 9 things to know about euthanasia for mental illness provides an interesting insight into the direction in Canada to allow people to die by euthanasia for mental illness. It is also worthwhile to watch some of the interview video's that are connected to the article. 

This is my commentary on Favaro's - 9 things to know about euthanasia for mental illness.

1. It is part of the changes to the MAiD law that began in 2021.

Favaro explains that Bill C-7 expanded Canada's euthanasia law to include people who are not terminally ill and it also legalized euthanasia for mental illness. Bill C-7 established a two year moratorium on euthanasia for mental illness to study the issue. Favaro provides links to the Interim report on euthanasia for mental illness and the report from an "expert panel" on euthanasia for mental illness.

Favaro doesn't state that the interim report and the "expert panel" report did not provide specific direction for responding to requests for euthanasia for mental illness. The "expert panel" suggested that the current rules concerning euthanasia for people who are not terminally ill will suffice for people with mental illness. Members of the "expert panel" who disagreed with the majority opinion resigned when they were not offered an opportunity to provide a different perspective.

2. No specific type of mental disorder is excluded from qualifying for a medically assisted death.

Favaro states that: Like physical illnesses, a person asking for MAiD must be found by assessors to have a "grievous and irremediable" medical condition -- meaning a serious and incurable illness, disease or disability in an advanced state of irreversible decline with intolerable suffering.

Euthanasia for mental illness is loosely defined and would be available to anyone who is approved to be living with a "grievous and irremediable" condition, terms that are completely subjective. There would be a 90 day waiting period.

3. Defining an "incurable" mental illness isn't always easy.

Favaro states that the "expert panel" suggested that with euthanasia for mental illness that the second assessor should be a psychiatrist who is an expert in the mental disorder that the requestor has.

Favaro wrote that it is difficult to determine that the mental illness is "incurable" In fact, it is impossible to determine that the mental illness is incurable. Experts testified that some people with mental illness will not be cured but it is impossible to know if any one person with a mental illness is incurable.

The expert panel suggested that the psychiatrist be an expert in the concerning condition, but it does not make this an obligation. Further to that, Canada has long waiting lists for psychiatric treatment. It would be very difficult, and in some cases nearly impossible, to have the second assessor be a psychiatrist who is an expert in that condition.

4. As with all forms of medically assisted death, the patient's doctor, psychiatrist, or family don't have to be part of the decision, and may not know about the MAiD until after the person has died.

Favaro is correct when she states, that based on privacy, an assessor can only contact the family, a family physician, or a treating psychiatrist if the requestor agrees. People with treatable conditions can be killed even though the assessor lacks information due to privacy.

5. Additional mental health treatments can be recommended before a MAiD approval, but the patient can also say no to any additional therapy.

Canada's law does not require that a person attempt effective medical treatment before being approved for death by euthanasia, therefore, people with treatable conditions are being killed by euthanasia.

The Netherlands requires people, who have requested euthanasia for mental illness, to attempt all effective treatments before being approved for death. This policy does not force them to attempt treatments, it only states that if someone wants to die by euthanasia they must be willing to attempt effective treatment.

6. People can have a medically assisted death even while they’re waiting for treatment.

Since Canada does not require a person to attempt effective treatment, a person can be approved to be killed, even though they are waiting for treatment.

This is particularly concerning for people who are approved for death based on a mental illness. The waiting lists for receiving psychiatric care are long. A person could be approved for death even though they have not received treatment for their condition. The same problem exists for people with disabilities and people with other chronic conditions.

7. Some doctors are calling it state-sanctioned suicide.

Many leading psychiatrists have testified that their patients with mental illness live with suicidal ideation. Killing a patient by lethal injection because they have suicidal ideation is like saying the treatment for suicidal ideation is death.

8. Some experts believe the number of MAiD deaths among those with mental disorders is likely to be low while others believe it will be high.

Data shows that a small number of euthanasia deaths in Belgium and the Netherlands, where euthanasia for mental illness is permitted are for mental illness. The data from 2021 Belgian euthanasia report indicates that of the 2700 reported euthanasia deaths, 45 were based on psychiatric conditions. The data from the 2021 Netherlands euthanasia report indicated that of the 7666 reported euthanasia deaths 115 were based on psychiatric conditions. Canada had more than 10,000 reported euthanasia deaths in 2021.

Favaro is correct when she states that Canada will likely permit euthanasia for mental illness without requiring the requester to attempt effective treatment. It is likely that Canada's percentage of euthanasia deaths for mental illness will be higher than the Netherlands and Belgium.

9. In the past mental illness hasn't prevented a person from accessing assisted dying.

It is true that Canadians with mental illness are dying by euthanasia based on also having a terminal or chronic medical condition. In the case of euthanasia for mental illness it is impossible to determine if a person with mental illness alone has an irremediable medical condition.

More articles on euthanasia for mental illness:

• Canada to delay implementing euthanasia for mental illness (Link).
• Toronto Star: Canada is going too far with euthanasia (Link).
• Globe and Mail Editorial: No to euthanasia for mental disorders (Link).
• Euthanasia panel member quit: Proposals don't adequately protect Canadians with mental illness (Link).
• Offering euthanasia to a suicidal person leads to premature deaths (Link).
• Euthanizing the mentally ill without providing proper supports is reprehensible (Link).
• Euthanasia for mental illness. Killing people with an uncertain prognosis (Link).
• Profound social change with euthanasia for mental illness (Link).
• Euthanasia for mental illness. Myth and Facts (Link).