Monday, January 15, 2024

The well-funded euthanasia lobby in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An interesting article about the euthanasia lobby group - Dying With Dignity (DWD) Canada was written by Miranda Schreiber and published by the Walrus on January 12, 2024. Schreiber provides important information about the financing and positions of DWD Canada.

DWD supports MAiD by advanced request
Schreiber sets up the article with the following paragraph:

Dying with Dignity Canada isn’t just a charity; it’s also the country’s biggest pro-MAID lobby group. Theoretically, lobby groups are meant to allow for the interests of all stakeholders to be represented to the government. But when a lobby group is so well funded that it wields disproportionate power over a debate, the voices of less powerful parties can be neglected. Some critics believe public conversations around MAID are skewed in Dying with Dignity Canada’s favour. And when it lobbies to expand access to assisted dying, few have the resources to push back.
Dying with Dignity lost their charitable status in February 2015 for "serious non-compliance issues" which made them become more politically oriented. But in 2018 DWD received regained charitable status and received a massive donation. Schreiber explains:
In 2018, Dying with Dignity Canada received a donation of $7 million from the late Vancouver entrepreneur David Jackson, an amount that’s been described as transformational. “Being handed 7 million without having to spend any money raising it would make any group [a] top lobby group [in Canada] right away on any issue,” says Duff Conacher, co-founder of Democracy Watch, a democratic reform and corporate responsibility advocacy group.

That year, the Supreme Court had thrown out the stipulation that to receive tax-exempt status, charities could direct only 10 percent of their funds toward political purposes. As a result, Dying with Dignity Canada had its status as a charitable organization reinstated, meaning it was eligible for government funding.
DWD was organizing events with the goal of expanding Canada's euthanasia law. Those events included Justice Minister David Lametti, as a speaker and other political leaders. Schreiber states:
In 2020, Dying with Dignity Canada registered with the federal government as a lobby group while still being recognized as a charity. The group sent Health Canada a letter proposing amendments to regulations, issued in 2022, for how to monitor and document MAID deaths. Dying with Dignity Canada also provided input to the Parliamentary Special Joint Committee on Medical Assistance in Dying (AMAD), which submitted a report in 2023 that reviewed key issues related to assisted dying, including the possibility of expanding eligibility to mature minors and people with mental illness.

Trudo Lemmens
Lemmens says that, having worked in his field since the early 1990s, “I don’t know of any bioethics debates . . . where the government have felt so comfortable appointing or basically promoting the view of specialists associated so directly with a lobby group in favour of one side of the issues.”

“Lobby groups and advocacy groups are obviously part of the political landscape,” Lemmens says. But a healthy democracy, he continues, requires “a certain distance between interest groups and decision makers.” Dying with Dignity Canada “established strong connections in the political and medical establishment,” he says. “Their strong funding base has enabled them to have a disproportionate impact on the legal developments and the public discourse.”
In its 2021 report DWD Canada acknowledged their meetings with cabinet ministers and their political pressure campaign to get Bill C-7 passed. Since Bill C-7 passed there have been many examples of people with disabilities, people living in poverty, people who are homeless, people who are unable to obtain medical treatment, and more, being approved or dying by euthanasia and yet DWD claims this is a myth. Schreiber reports:
Since then, there have been alarming media reports of people with disabilities applying for assisted death because they experienced poverty and had no viable options for living, a situation disability groups had been warning about for years. Studies have repeatedly shown that some MAID applicants are driven by squalid conditions in long-term-care homes, homelessness, lack of access to appropriate care, and insufficient disability welfare. During AMAD committee hearings, some disabled activists, doctors, and nurses said they had personally seen people apply for assisted death due to material privation and insufficient access to health care. It is sometimes the case that even if those applicants are approved for MAID based on their physical health, it may be their lack of financial and health care support that drives them toward this option.

But representatives associated with the MAID lobby continued to argue that access to assisted death for anyone with a chronic or terminal medical condition is an essential liberal right, and that excluding people from MAID eligibility on the basis that their deaths were not foreseeable was discriminatory. Dying with Dignity Canada’s website includes a post that lists myths and facts about MAID; the allegation that vulnerable people are eligible for MAID on the basis of insufficient social and financial supports is listed as a myth. Below it is a listed “fact”: “Suffering from a lack of social supports does not qualify a person for MAID. No one can receive MAID on the basis of inadequate housing, disability supports, or home care.” This is, strictly speaking, true, but many disabled people have testified that while their disability makes them eligible for MAID, their reason for acting on this eligibility is poverty.
DWD Canada claims that there is no evidence that (MAiD) euthanasia has been provided disproportionately and yet Schreiber reports:
A recent Al Jazeera Fault Lines documentary tells the story of forty-one-year-old Rosina Kamis, who taught statistics at a university. Diagnosed with fibromyalgia in her twenties, she eventually had to stop working and began relying on government support. “I can’t believe it’s so easy for me to get MAID,” she wrote in an email that appears in the documentary. In another email to a friend, she confides that “the suffering I experience is mental suffering not physical.” She explains in the email that part of the reason for her application was her exhaustion related to the health care that she needed, her poverty, and her feelings of isolation. “I think if more people cared about me I might be able to handle the suffering.” Kamis died by MAID in September 2021.
DWD Canada has worked to change the perception and meaning of palliative care. Schreiber explains:
The thinking goes that patients with chronic or terminal conditions still have the option to receive care that enhances their quality of life, thus alleviating their suffering, until they die a natural death; those who can no longer bear their agony can choose to turn to MAID. This framing has led to a perception that MAID is an offshoot of palliative care. But research the Canadian Society of Palliative Care Physicians (CSPCP) carried out in 2015 found that palliative care could not be reliably depended on as a safeguard for MAID because it was underfunded and underresourced. At the time, nearly 80 percent of Canadians in urban areas had access to palliative care; that figure fell to about 35 percent in some rural and remote areas. The CSPCP expressed concern that Canada did not have sufficient social infrastructure in place for MAID to be legalized safely. (A 2023 report from the Canadian Institute for Health Information found that while the number of people accessing palliative care has risen in recent years, “there are still signs of poor-quality palliative care, including people not getting palliative care until just before they die.”)

In 2015, Susan MacDonald, then president of the CSPCP, told Canadian Medical Association Journal that medically assisted death should not be classified under palliative care. Her concern was that ending life was in contradiction with the philosophy and practices of palliative care, the purpose of which is enhancing care for patients.
Leonie Herx
Schreiber interviews Leonie Herx, a palliative care practitioner and professor of medicine at Queen’s University who said:
“Lobby groups like Dying with Dignity [Canada] get these very loud spokespeople who are representing a very different view to the vast majority of palliative care clinicians and [use] that in their marketing strategies,” says Herx. Dozens of Dying with Dignity Canada’s webinars include guest interviews with palliative care physicians and nurses who express the view that offering MAID is part of palliative care. One consequence of this apparent integration is that some practitioners are noticing more hesitancy among patients to seek out palliative treatment because they are worried they will be offered MAID.

Meanwhile, some palliative care professionals feel increasingly ignored by the government. While appearing before the AMAD committee, Long split her five-minute testimony with former Canadian senator James Cowan, who retired from the Senate in 2017. But neither of the two national Canadian palliative care organizations was invited to speak.
I am convinced that DWD Canada lobbying has led to provincial governments forcing palliative care institutions to provide euthanasia.

Funding for DWD Canada has grown significantly with corporate donations and government grants. Schreiber reports:
Some of the lobby organization’s donors have included TD Canada Trust, Rogers, Google Ads, Mackenzie Investments, Telus, Sun Life Financial, RBC, and Pfizer. (Pfizer also makes three of the drugs recommended by the Canadian Association of MAID Assessors and Providers to facilitate MAID.) As a charitable organization, it received $222,077 in government assistance in 2020 and $204,655 in 2021, according to Charity Intelligence Canada. The Canadian Association of MAID Assessors and Providers (CAMAP), an organization founded by a member of Dying with Dignity Canada’s advisory council, received $3.3 million for the development of MAID training modules. In 2022, the Temerty Faculty of Medicine at the University of Toronto appointed a Bresver family chair in end-of-life care and medical assistance in dying, a new departmental role addressing both palliative care and MAID. The position was financed by a $1 million donation from Barbara Bresver, director-at-large of the GTA chapter of Dying with Dignity Canada.
Money buys influence as Schreiber reports:
By virtue of its financial resources, Dying with Dignity Canada has a higher degree of access to politicians than most palliative care workers or activists are able to get. It works with prominent PR firms such as Blackbird Strategies and, previously, Impact Public Affairs. From 2022/23, representatives of Dying with Dignity Canada have registered thirty-five pre-arranged oral meetings with politicians in Ottawa to discuss topics such as expanding eligibility for MAID.
Schreiber concludes the article by reporting how DWD Canada claims to represent marginal communities “through the lens of diversity, anti-racism and anti-oppression.” But disability advocate, Mitchell Tremblay explains the reality. Schreiber writes:
Meanwhile, Dying with Dignity Canada has responded to questions from disabled advocates with statements that are “very pro-MAID while dismissing the negative effects,” says Mitchell Tremblay, a disability advocate and host of The #Pwdcast. (He also appears in the Fault Lines documentary.) He says he talks to people every day who feel coerced into applying for MAID because it has become one of the only ways to escape poverty, homelessness, bad treatment from landlords, and the feeling that the government doesn’t care about them. “We want safeguards, proper mental health, addiction, and housing support,” says Tremblay. “So that MAID isn’t the better option for so many.”
The Euthanasia Prevention Coalition has a large base of financial supporters. Some of our donors are making very generous donations, and we thank you for your support.

More articles on this topic:

  • Euthanasia is being forced on Montreal palliative care home (Link).
  • Euthanasia lobby pressures BC government to force Catholic hospitals to provide euthanasia (Link). 
  • British Columbia government to build euthanasia center next to Catholic hospital (Link).
  • Canada: How Death Care is pushing out Health Care (Link).
  • The reality of medical assistance in dying in Canada (Link).

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