Canada is Killing Itself. Euthanasia (MAiD) for mental illness is already happening in Canada.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Elaina Plott Calabro wrote an exposé on Canada's euthanasia law that was published in the September edition of the Atlantic titled - Canada is Killing Itself. The article is too long to comment on in one article, so I have written a series of articles covering the important points.

One of the topics that Calabro tackles in are article is the question of further expansions of euthanasia in Canada. Calabro first tackles the topics euthanasia by advance request and euthanasia for children "mature minors" and writes:

Despite all of the questions surrounding Track 2, Canada is proceeding with the expansion of MAID to additional categories of patients while gauging public interest in even more. As early as 2016, the federal government had agreed to launch exploratory investigations into the possible future provision of MAID for people whose sole underlying medical condition is a mental disorder, as well as to “mature minors,” people younger than 18 who are “deemed to have requisite decision-making capacity.” The government also pledged to consider “advance requests”—that is, allowing people to consent now to receive MAID at some specified future point when their illness renders them incapable of making or affirming the decision to die. Meanwhile, the Quebec College of Physicians has raised the possibility of legalizing euthanasia for infants born with “severe malformations,” a rare practice currently legal only in the Netherlands, the first country to adopt it since Nazi Germany did so in 1939.

On February 15, 2023 a Canadian government committee recommended the extension of euthanasia for people who request it in advance and to children. During the committee meetings the Québec College of Physicians urged the committee to support euthanasia for newborns with disabilities (infanticide).

Calabro then focusses on euthanasia for mental illness alone, which is currently scheduled to go into practise in March 2027. 

As part of Track 2 legislation in 2021, lawmakers extended eligibility—to take effect at some point in the future—to Canadians suffering from mental illness alone. This, despite the submissions of many of the nation’s top psychiatric and mental-health organizations that no evidence-based standard exists for determining whether a psychiatric condition is irremediable. A number of experts also shared concerns about whether it was possible to credibly distinguish between suicidal ideation and a desire for MAID.

After several contentious delays, MAID for mental illness is now set to take effect in 2027; authorities have been tasked in the meantime with figuring out how MAID should actually be applied in such cases. The debate has produced thousands of pages of special reports and parliamentary testimony. What all sides do agree on is that, in practice, mental disorders are already a regular feature of Canada’s MAID regime. At one hearing, Mona Gupta, a psychiatrist and the chair of an expert panel charged with recommending protocols and safeguards for psychiatric MAID, noted pointedly that “people with mental disorders are requesting and accessing MAID now.” They include patients whose requests are “largely motivated by their mental disorder but who happen to have another qualifying condition,” as well as those with “long histories of suicidality” or questionable decision-making capacity. They may also be poor and homeless and have little interaction with the health-care system. But whatever the case, Gupta said, when it comes to navigating the complex intersection of MAID and mental illness, “assessors and health-care providers already do this.”

Alan Nichols

The argument was meant to assuage concerns about clinical readiness. For critics, however, it only reinforced a belief that, in some cases, physical conditions are simply being used to bear the legal weight of a different, ineligible basis for MAID, including mental disorders. In one of Canada’s more controversial cases, a 61-year-old man named Alan Nichols, who had a history of depression and other conditions, applied for MAID in 2019 while on suicide watch at a British Columbia hospital. A few weeks later, he was euthanized on the basis of “hearing loss.”

Euthanasia for mental illness is already happening in Canada, but the person is required to have another medical condition to be approved. As Mona Gupta stated:

“people with mental disorders are requesting and accessing MAID now.” They include patients whose requests are “largely motivated by their mental disorder but who happen to have another qualifying condition,” as well as those with “long histories of suicidality” or questionable decision-making capacity. They may also be poor and homeless and have little interaction with the health-care system. But whatever the case, Gupta said, when it comes to navigating the complex intersection of MAID and mental illness, “assessors and health-care providers already do this.”

The Euthanasia Prevention Coalition is urging the Canadian government to do a complete review of the euthanasia law, which was promised but has never been done (Link).

The Euthanasia Prevention Coalition is also asking our supporters to sign and share the petition in support of Bill C-218, the bill that will prevent euthanasia for mental illness alone (Link).

New York Post editorial opposing assisted suicide.

The Euthanasia Prevention Coalition sent an Action alert on April 30, after the New York state Assembly passed an assisted suicide bill by a 81 to 67 margin.

On April 24, the New York Post published an editorial opposing the legalization of assisted suicide. Here is what the New York Post published:

New York’s progressive legislators have reportedly gotten behind what may be their most morally disgraceful bill yet: an assisted-suicide legalization push.

Worse, per Assembly Speaker Carl Heastie (D-Bronx), the bill has the votes to pass, which may happen as early as next week.

This must. Not. Happen.

Assisted suicide is sold to the public as a form of compassion — yet another inversion of reality.

In practice, it is anything but.

The trouble is, the promised reservation of assisted suicide to the chronically ill and elderly seems somehow always to get expanded.

Until it encompasses young, physically healthy people like Zoraya ter Beek, whom the Dutch state permitted to take her own life because she was depressed.

Or, as is the case with Canada, the poor, the disabled and the marginalized.

Like Alan Nichols, a down-on-his-luck man with a history of mental illness who listed “hearing loss” as the only health reason for his own euthanasia — which, shockingly, was then granted.

The Trudeau government even tried to sell veteran and paralympian Christine Gauthier on suicide, simply because she fought to have the Veterans’ Affairs department install a wheelchair ramp at her house.

The idea that fiscal calculations, i.e. that it’s cheaper simply to kill people like Nichols and Gauthier than to help them, didn’t play some role here is dubious, at best.

In the US, Oregon — the pioneer on OKing this insanity — is already mulling the idea of expanding the class of people authorized to prescribe suicide drugs to include nurse practitioners and vastly shortening the wait time from 15 to two days.

Vermont might include literal quacks on the list of people allowed to help people kill themselves.

It’s the slipperiest of slippery slopes, in other words.

And a slap in the face to the nearly 3 million Catholics in the state who oppose assisted suicide on religious grounds.

And this is New York, remember, where the state couldn’t even manage to roll out a legal cannabis initiative without turning it into a complete disaster.

And where within recent memory, a governor shoved old people with COVID into nursing homes to die and kill others just to make himself look better on television and earn $5 million from a book.

Even under the sanest and stablest of governments, state-sanctioned euthanasia is obscene.

Here, it would be a Boschian nightmare.

Gov. Hochul, this issue is an easy win: Keep fighting the good fight, stand up to the extremists in your own party and stop this madness if and when it reaches your desk. 

Previous article on this topic:

Action is needed: New York state Assembly passes assisted suicide bill (Link).

 

The American Special Education System Helps Us Understand the Pitfalls Inherent in Assisted Suicide

Meghan Schrader

By Meghan Schrader

Meghan is an autistic person who is an instructor at E4 Texas - University of Texas (Austin) and an EPC-USA board member.
 
The coercion I experienced when I was enrolled in the Special Education system are what drives much of my staunch opposition to assisted suicide. It’s my observation of the systemic oppression enabled by that system that makes me say, “no, assisted suicide is not a good idea” no matter what pro-euthanasia argument I’m confronted with.

When I talk about my experiences in the Special Education system, I am not comparing having a learning impairment to having cancer, and I am not saying, “Oh, well, I suffered so you have to do it too.” I am not operating from a petty grudge along the lines of, “My Kindergarten teacher held my hand-crafted duck project up in front of the class and told them it was a bad duck because I didn’t follow her directions correctly, and so you have to die a painful death.”

What I mean is that there are instructive parallels between how the Special Education system works and the systemic oppression in the medical system, and that people in both systems engage in coercion of subjugated people. That makes assisted suicide unfair to subjugated people. In Special Education disputes about how to educate disabled children, school districts typically hold most of the cards. School systems will fight tooth and nail to avoid paying for services for disabled kids, no matter how badly not having those services harms the child. Wealthy, privileged communities will happily build multi-million dollar playgrounds for predominately able-bodied children while loudly complaining about the money spent on accommodating disabled students, no matter what consequences students with disabilities experience as a result of not having those services. Similarly, it’s clear that some government and private healthcare programs will fund lots of things for able-bodied people before taking care of disabled people’s basic needs. 

School systems have engaged in inordinate amounts of expensive legal maneuvering to force disabled students to stay in public schools where they are subjected to daily toxic stress so severe that it leads to serious physical and mental health problems, just as futile care impositions manipulate the medical system to force disabled people to die. What special education students often experience is a phenomenon that disability studies scholar Paul Longmore would call a “social death”: The person metaphorically “dies” because systemic oppression constrains equal participation in the activities that anyone would want to engage in-education, jobs, community engagement, etc.

It's pretty much the same thing with utilitarian bioethics, Quality Adjusted Life Years, forced DNRs and “termination without request or consent” and euthanasia in some countries. There’s a system that enables powerful people to bully disenfranchised persons. This systemic bullying of disabled people has seeped into pretty much all social institutions and drives much of our public discourse, making it easier for people in power to enact policies that literally kill disabled people. 

Peter Singer is a professor at Princeton who tells disabled people to kill ourselves so that the money spent accommodating us can be sent to third world countries, and there’s nothing we can do about it. Because of thinking like Singer’s, doctors in states with futile care laws bully the families of dying and severely disabled people to withdraw life-sustaining care from a loved one, and there’s nothing they can do about that, either. The doctors are in control, and no matter what emotional, financial, or physical consequences it has for the patient and her loved ones. Are disability rights activists really supposed to believe that doctors aren’t going to try to force people to die by assisted suicide?

The Special Education and medical systems also share commonalities in respect to the varying motivations for why people decide to pursue careers in those systems. Now, just as some disabled people are fortunate to have access to skilled and caring doctors, I did have some absolutely amazing teachers whose influence was critical in me accepting my disability, relying on my strengths and conscientiously working towards my goals. Those teachers loved me-they always had a hug for me, they valued my intelligence, they were more than happy to provide accommodations for my learning impairment. Similarly, many doctors are dedicated professionals who will do anything to care for their patients. But, not everyone goes into service professions out of love. Some special education teachers join that field because they like to be in charge of smaller, weaker people, just as some doctors go into the medical profession out of an arrogant desire to control sick people.

For instance, I once had a Special Education teacher who saw literally everything I did, even my smallest and most innocuous quirks, as “behavior.” She would punish me for something as small as fidgeting in my chair or not looking at her in the eye. At one point during mud season there was a group of bullies who would come up to me on the playground and repeatedly push me into the mud. I remember her angrily helping me take off my soiled jacket and jeans, and articulating what was essentially a utilitarian philosophy about her job: “I have multiple students that I have to be responsible for, and now I have to spend my time helping you take off your clothes,” she complained. This is essentially what some disabled people experience from nurses in hospitals-cleaning out bed pans is the nurses’s job, but the nurse is annoyed that they actually have to do that.

Neither the Special Education system nor the medical system can be trusted to implement legal procedures in a way that is fair to disenfranchised people, and that makes assisted suicide an unjust social policy. 

When I was growing up, I was fully aware that there were laws called Section 504 of the Rehabilitation Act, the Individuals with Disabilities Education Act, and the Americans with Disabilities Act. But, I also saw people blatantly violate those laws in spirit while using loopholes to essentially negate them. For instance, for whatever reason my high school Special Education team didn’t care that I was an honors student; they were dead set on forcing me not to take college preparatory classes or exams, because “Special Education students don’t go to college.” When I did those things anyway, they made sure that I suffered as much as possible. For instance, in addition to multiple other things my high school guidance counselor did to make the college application process miserable for me, he insisted on proctoring one of my college entrance exams. Even though my accommodations proscribed at quiet environment for ADHD, he made sure to tap papers against his desk, run his printer, and create various other sources of noise. When I asked him to stop, he said, “I’m only required to avoid unnecessary noise. I’m not making unnecessary noise. Other students have to deal with pencils scratching on paper and people breathing.” The toxic stress of being obliged to have my test proctored by this man was really, really unfair to me, but there was nothing I could do about that; the law allowed schools to pick whichever proctors they wanted to give tests to students, and if the evil guidance counselor wanted to force me to sit alone in a room with him for hours so that he could do disparaging things to me during a college entrance exam, well, tough crap.

What I experienced was essentially the non-lethal equivalent of what happened to Roger Foley. The guy was denied accommodations that he needed to live on his own, was confined to a hospital, an then was put in a room alone with a bioethicist who urged him to ask to be killed. Similarly, Canadian law did not allow Alan Nichols family to protect him. In the Netherlands, an advanced request for euthanasia led to a woman being held down and euthanized when she was clearly saying “no.” As a former Special Education student who was pressured to drop out of high school, I could see those scenarios coming, and that’s why I’ve always taken the position on assisted suicide that I do now.

I am sympathetic to people who want to legalize assisted suicide because they’ve had a deeply traumatic experience or they have no firsthand knowledge of how it will affect some people. It is not ethical for right to die activists to exacerbate already violent and unpredictable mechanisms of oppression and injustice so that they can die with a glass of rose champagne in their hand. (Article link) 

We live in a society where the able-bodied majority feels entitled to have what it wants at disabled people’s expense, and assisted suicide is just a very extreme form of that trend. Assisted suicide puts disabled people in a position in which it isn’t enough for us to be denied education and employment or endure various other forms of abuse, we also have to have our suicides turned into a “medical procedure” and maybe even be coerced into doing that so that the proponents can “chart their own end of life journeys.” That’s privileged arrogance. 

Disabled opponents of assisted suicide are not asking the proponents to die alone and in agony; we are simply asking that they use and improve the other multiple other techniques available to treat pain and disability at the end of life. We are asking that they give up some of the control they’d like to have so that disabled people do not experience even more vicious forms of oppression then we already do. That doesn’t seem like too much to ask to me.

Research: The Reality of Medical Assistance in Dying in Canada

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Cambridge University Press published an important research article on the realities of Canada's (MAiD) euthanasia law, on July 18, 2023. The research article, by Drs. Ramona Coehlo, John Maher, K Sonu Gaind, and Trudo Lemmens, provides clear research and explanations as to why other countries and jurisdications must reject the legalization of euthanasia and assisted suicide. 

Read the full article and acquire links to all references (Article Link).

Parliament legalized MAiD in June 2016 and expanded the legisation by passing Bill C-7 in March 2021. Bill C-7 expanded the law in the following way:

The legislation introduced a regime of 2 MAiD pathways. Several safeguards from the initial regime were removed from what was now called “Track 1,” a pathway for which an applicant still has to have an (Reasonably Foreseeable Natural Death) RFND. Bill C-7 added “Track 2,” a new pathway for those with a serious disease, illness, or disability and an irreversible decline of capabilities, but who are not approaching their natural death. This means de facto persons with disabilities. A delayed implementation clause for Track 2 (“sunset clause”) stipulated that those with sole mental disorders would become eligible for MAiD in March 2023.

The Truchon court decision, that led to Bill C-7, and the Supreme Court of Canada Carter decision, that led to the legalization of euthanasia in 2016, did not deal with the issue of euthanasia (MAiD) for mental illness. This is important because the Canadian government now claims that the Carter decision permitted euthanasia for mental illness.

The article discusses the increase in Canadian euthanasia deaths by comparing Canada to California. Canada and California have a similar population and both jurisdictions legalized assisted dying in June 2016. In 2021, Canada had 10,064 reported MAiD deaths and California had 486 reported assisted suicide deaths. Quebec now has the highest euthanasia rate in the world.

They then analyze Canada's experience with euthanasia by examining several categories.

They first analyze Canada's inadequate data collection:

The data are acquired from the MAiD providers via self-reporting. There is no mechanism for objectively, prospectively, or retroactively identifying or uncovering any errors or abuses of the process. Providing assisted suicide and euthanasia outside the parameters of the law remains prohibited. MAiD providers filling out the forms know that any deviation of the key criteria may result in criminal prosecution, making self-declarations of error or deviation unlikely.

Cases of non-compliance have been reported in Québec, Ontario, the Office of Correctional Investigator, and through several news articles. Yet, none of these stories or data appear in Health Canada's Annual reports. 

Under the heading, Lack of Oversight, they examine several known cases.

Donna Duncan's daughters.

They first examine the death of Alan Nichols. Alan died by euthanasia in Chilliwack BC in August 2019. Alan (61) had lived with recurrent episodes of depression. When entering care he was diagnosed as suicidal, but soon he was deemed capable of requesting MAiD.

The researchers then explain the case of Donna Duncan. Here is a link to the story of Donna Duncan's euthanasia death (Article Link).

Read the full article and acquire links to all references (Article Link).

The researchers state:

Rather than the government accepting responsibility for setting up procedures for investigation, the Justice Minister stated that oversight must be provided by family members complaining after the fact to initiate disciplinary actions or police investigations. Yet, the experiences of family members who have tried to pursue concerns suggest that cases cannot be transparently reviewed, and health authorities have invoked “best interest exceptions” to rebuff requests for access to medical records.

They show how Canada is Prioritizing access to MAiD over patient safety and needs:

Sathya Dhara Kovac, 44, ended her life through the MAiD program. Kovac lived with a degenerative disease and her condition was worsening, but she wanted to live. However, she lacked the home care resources to do so. “Ultimately it was not a genetic disease that took me out, it was a system,” Kovac wrote in an obituary to loved ones.

The researchers point out that  Canada's promotion of MAiD contravenes the Supreme Court of Canada Carter decision:

The Supreme Court’s decision that spurred the partial legalization of MAiD did not create an explicit “right to die with dignity” and left it to the legislature to design a “strict regulatory regime”. Regardless, the decision is being interpreted by many as creating a positive right of access to MAiD, even when other forms of medical care are available and when psychosocial suffering can be ameliorated.

This is an important section of the article. Use this link to read the full article (Article Link).

Christine Gauthier

The researchers write about how MAid is proactively offered to patients as though it is one of many standard treatment options. The case of Christine Gauthier:

A military veteran and former Paralympian who has been trying to get a wheelchair ramp installed at her home for the past 5 years testified that she was offered MAiD by her caseworker, and it has been confirmed that at least 4 other veterans were also offered the option of MAID when trying to access resources and care.

The researchers explain:

In Canada, the Canadian Association of MAiD Assessors and Providers (CAMAP) recommends that all those who “might qualify should be offered MAiD” as part of the informed consent process. No other country in the world has normalized assisted suicide or euthanasia in this way as a potential first line therapeutic option to address suffering. Offering MAiD to a patient who has not raised it could be interpreted as an indication that their suffering will likely become intolerable, and that MAiD is the recommended way out, impacting patient hope and resilience.

No other country in the world has normalized euthanasia or assisted suicide as a potential first line therapeutic option.

Read the full article and acquire links to all references (Article Link).

The problem of undefined terminology in the legislation:

The language in the Canadian MAiD legislation is imprecise and makes clear determinations and consistent implementation of clinical practice standards for MAiD difficult. Due to the imprecise term, “reasonably foreseeable natural death” (RFND), physicians’ interpretations of eligibility have been challenged in the courts.

They provide the following case as an example:

A man had a small stroke, affecting his balance and swallowing. The prognosis was that this man would be able to eat normally and regain most of his balance. The patient was depressed and isolated due to the COVID-19 outbreak on his ward. He declined all therapy and requested euthanasia. Neither of his MAiD assessors had expertise in stroke recovery. In this acute phase, while struggling with his mood and isolation, and with no therapy to gauge his final level of function, he received MAiD. He had no terminal diagnoses, but due to the fact that he was temporarily slightly undernourished, his MAiD assessors considered him Track 1 eligible. 

Track 1 eligible means he could have an immediate death.

Suffering is subjectively defined and can be rooted in psycho-social distress. The euthanasia lobby group Dying with Dignity states that people do not qualify for euthanasia on the basis of inadequate housing, disability supports, or home care. Whereas this statement is true it is also false.

The researchers refer to the story of Sophia:

A national CTV News story recounted how “Sophia” was unable to secure affordable housing compatible with her chemical sensitivities. She chose MAiD because she could not find a healthy and affordable place to live given her meager disability support income, and prior to her death by MAiD recorded a video where she stated “the government sees me as expendable trash”

People are qualifying for euthanasia based on their medical condition, but they are requesting euthanasia based on their social condition. The researchers explain the problem of how assessments are done:

To qualify for MAiD, a patient must be in a situation of irreversible decline of capability and experience intolerable psychological or physical suffering. These terms are not further defined by the legislation, and suffering is treated as purely subjective. If the patient says their suffering is intolerable, there is no requirement for further validation or requirement for clinicians to agree that there are no other options to address the suffering.

No standard treatments have been tried first or even been available to qualify for euthanasia:

In Belgium and the Netherlands, 2 other jurisdictions that allow euthanasia outside the end-of-life context, before euthanasia can be provided the physicians must agree that there are no further medical or social support options that can relieve a patient’s suffering. In Canada, patients are required to be advised of treatment options that may exist. For Track 2 cases, physicians have to verify that patients considered all other options, but it is left unclear what “considered” really means. There is no requirement that standard best-practice treatments have been appropriately attempted, or even that they are accessible. Tragically, some people are choosing to die while on wait lists for potentially effective treatment or because they are refused care.

Jennyfer Hatch

The researchers then write about the euthanasia death of Jennyfer Hatch:

A short film, titled “All is Beauty,” along with its advertising trailers, was promoted by Simons (an upscale department store in Canada). In the series, a young woman is encircled by people on a beach, in a candle-lit forest, and in other settings that depict a romantic and lovely tableau of her final days before MAiD. “Even now, as I seek help to end my life, … there is still so much beauty,” says Jennyfer Hatch. However, a national news agency has revealed that Jennyfer was the same woman who spoke up earlier (under a pseudonym) about her difficulties accessing treatment, prompting her to seek MAiD as a last-ditch effort for access to palliative care. Hatch died by MAiD in October 2022 at age 37. She was unsuccessful in her attempts to receive other care.

The issue of Suicide contagion:

We have long known that publicized suicides can lead to more people choosing suicide. Well-known is how suicide rates went up when Robin Williams completed suicide. This can also be seen in suicide clustering among Indigenous youth where 1 suicide can set off a series of suicides in a community. As well, literature has shown that increased exposure to lethal means increases rates of suicide.

Canada's Justice Minister stated that legalizing euthanasia is a more humane way to die than suicide. The researchers respond:

In reality, the evidence from reviews does not support the hypothesis that introducing MAiD reduces rates of (non-assisted) suicide. Further, data on suicide rates would not factor in people who may have been ambivalent and would never have attempted or completed suicide, but who chose to receive MAiD following social normalization of assisted suicide. In our view, the Justice Minister should be concerned about suicide contagion rather than normalizing what he acknowledges MAiD to be: “a species of suicide”.

MAiD in Canada is a Human rights outcry:

Three United Nations human rights experts, over a 100 Canadian disability and social justice organizations, Indigenous advocacy groups, and hundreds of medical and legal experts have argued that Canada’s euthanasia and assisted suicide laws put the lives of marginalized and vulnerable Canadians at risk.

Criticism is growing as an increasing number of media reports regarding worrisome MAiD stories are emerging in the Canadian press. Yet, those who support the expansion of MAiD tend to reject the claim that social service failures can create and sustain the predicaments that can make death an attractive choice.

Dr. Stefanie Green, President of CAMAP admits, “Our health system is woefully inadequate in serving our population with these resources.” Even so, she adds, “I do not think we can hold these patients hostage”. She seemingly condones the use of MAiD despite the lack of political will to provide necessary psychosocial supports. Bioethicists supporting MAiD expansion have argued that limiting MAiD for reasons of psychosocial suffering “would translate into removing the agency of decisionally capable patients without offering them a way out of their predicament” and have remarkably claimed that providing MAiD in response to social suffering caused by “unjust social circumstances” is a form of “harm reduction”. This is particularly troubling considering that harm reduction strategies precisely aim at saving lives. In addition to distorting the concept of “harm reduction,” from an equity and diversity point of view, the claim reflects a perspective based on privilege. This wrongly suggests MAiD is supporting the autonomy of marginalized people who are rather being driven to death by poverty and lack of care, despite knowing how to address poverty and improve care. Dr. Ellen Wiebe, a prolific MAiD provider (430 people as of May 2022) has said she will provide MAiD while people are on waitlists for medical treatment. 

They are concerned about the expansion of MAiD to those for the sole reason of mental illness. Euthanasia for the sole reason of mental illness was originally scheduled to be implemented by March 2023 but has been delayed until March 2024. They write:

Therefore, patients with mental illness, a population known for a high prevalence of psychosocial suffering, will be wrongly informed, during periods of despair and hopelessness, that their conditions are “irremediable” and will not improve, despite this being impossible to predict. In response to concerns that irremediability of any individual’s mental illness could never be predicted (a legal requirement to provide MAiD for mental illness in Canada), Dr. Justine Dembo, a MAiD activist and psychiatrist who sat on the 2022 federal panel on MAiD for mental illness, suggested she would simply advise the patient of the uncertainty that they could recover so they could make their own “informed decision” to receive MAiD, despite the fact that legal reporting forms require indicating that the medical condition is irremediable.

On top of offering MAiD under false pretenses for mental illness, equally concerning is the fact that in the few European countries that provide euthanasia for mental illness, the majority of those requesting it are women and marginalized individuals disproportionately seeking relief from suffering, not from their mental illnesses per se, but because of marginalization, including unresolved social and economic suffering and loneliness, all of which are remediable problems.

The researchers then ask the question, "What is next?"

A parliamentary committee released a report supporting euthanasia for "mature minors" and euthanasia by advanced directive. Quebec's Bill 11 expanded euthanasia by obliging all palliative care homes to provide MAiD and allows for MAiD by advance request for situations of dementia.

The researchers don't offer the reader signs of hope. They recognize the political pressure for further expansions of euthanasia. 

Read the full article and acquire links to all references (Article Link).

Canadian Health Authority promotes euthanasia to pensioners.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Fraser Health, a healthcare authority in British Columbia Canada, has been sending a slideshow promoting euthanasia to pensioners. Will Potter, reporting for the Daily Mail on July 1, obtained a copy of the slideshow promoting assisted death, that was sent to healthy pensioners. Potter reported:

The slideshow included advice on 'expressions of wanting to die', noting that it can be used to 'promote a sense of control'. Terminally ill patients are also seemingly offered the chance to die within 'a day'.

Potter explains that British Columbia had a 24% increase in euthanasia deaths in 2022 resulting in 2515 euthanasia deaths. Euthanasia has grown exponentially since March 2021 when Canada expanded the law to permit euthanasia for people who are not terminally ill. Potter explains

This was detailed in the slideshow allegedly sent by Fraser last week, which revealed its 'track system' included two options for when death is either 'reasonably foreseeable' or 'not reasonably foreseeable'.

For those whose death is 'not reasonably foreseeable', the healthcare provider said patients go through just 90 days of assessments. While symptoms that fall under the option were named as chronic pain and fibromyalgia, the Canadian government has announced plans to allow people to die under the practice solely due to mental illness by March 2024.

Potter reported that the slideshow was sent to people in the Fraser Health region as part of a pension package. Potter explains that a Canadian parliamentary committee has recently advocated for the expansion of euthanasia to children.

Amy Hasbrouck from Not Dead Yet commented to Potter on child euthanasia.

'I think it's horrible,' said Amy Hasbrouck, who campaigns against MAiD for the group Not Dead Yet.

'Teenagers are not in a good position to judge whether to commit suicide or not. Any teenagers with a disability, who's constantly told their life is useless and pitiful, will be depressed, and of course they're going to want to die.'

Christine Gauthier

Potter commented on the death of Donna Duncan (61) who died by euthanasia in October 2021 after experiencing mental health difficulties related to a concussion she experienced from a car accident in February 2020.

Potter then commented on Canadian military veteran Christine Gauthier:

In December, this was thrust into the spotlight when retired Army Corporal Christine Gauthier, a former Paralympian, was offered euthanasia by the Canadian government when she complained about delays to having a wheelchair lift installed in her home.

After years of frustrating delays in getting the home lift, Gauthier says a caseworker told her: 'Madam, if you are really so desperate, we can give you medical assistance in dying now.'

Alan Nichols died in the Fraser Health Region in August 2019. Alan was depressed and living with suicidal ideation. His request to be killed was taken as a request for euthanasia. Instead of being treated for suicidal ideation, as he had received in previous experiences with suicidal ideation, but rather he was approved for and died by euthanasia, even though his family begged the doctors who approved his death to re-assess him.

British Columbia: 24% rise in euthanasia deaths in 2022.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

James Reinl, the social affairs correspondent for the Daily Mail, published an article on June 13, 2023 about British Columbia's euthanasia data. Reinl obtained data from the BC Ministry of Health showing that there were 2515 (MAiD) euthanasia deaths in the province in 2022, up by 24% from 2030 euthanasia deaths in 2021. 

British Columbia had the highest 2021 euthanasia rate in Canada. Québec has the highest euthanasia rate in the world in 2022.

Reinl's article is part of a series of articles that he has written on research concerning Canada's euthanasia law. His last article was based on the Euthanasia Prevention Coalition prediction that there were approximately 13,500 euthanasia deaths in Canada in 2022, up from 10,064 in 2021. The prediction was based on data collected by the Euthanasia Prevention Coalition and data obtained by Reinl.

Reinl states:

British Columbia saw 24 percent more people getting assisted suicides last year — what campaigners call an 'alarming' sign of unraveling safeguards on euthanasia in the Canadian province.

Some 2,515 people received Medical Assistance in Dying (MAiD), as procedures are known, in the West Coast region, more than the 2,030 who did so in 2021, BC Ministry of Health figures show.

The data come amid concerns that BC and Canada as a whole are headed toward a euthanasia free-for-all, as federal officials weigh whether to extend the procedures to the mentally ill and even children.

Reinl continues:

'Not only has there been a 24 percent increase in the number of people who died by euthanasia, but the number of MAiD deaths relative to the overall deaths in the province continues to climb as well.'

Last year, some 5.5 percent of all fatalities in BC were assisted suicides, making it one of the top causes of death in the province after cancer, heart disease, and dementia, and roughly on par with drug overdoses.

Of particular concern was Vancouver Island, a pristine, forested territory on the Pacific Ocean with a population of only about 865,000 people.

Some 823 residents opted for MAiD last year, the data show.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said that amounted to 'an unbelievable' 10-15 percent of all deaths — perhaps the highest euthanasia rate of anywhere in the world.

Donna Duncan's daughters

For greater clarity concerning the experience with euthanasia in British Columbia, Reinl writes about the police investigation into the euthanasia death of Donna Duncan. Reinl quotes Donna's daughter Alicia:

'I don't want this to ever happen to another family ever again,' daughter Alicia told CTV.

'Ultimately, I want stronger laws and legislation.'

Alan with his brother Gary.

Reinl then compares the Duncan story to the euthanasia death of Alan Nichols.

The Duncan family tragedy echoes the case of Alan Nichols, a 61-year-old BC man with a history of depression who was greenlighted for euthanasia on the basis of a single health condition: hearing loss. 

Nichols submitted a request to be euthanized, and he was killed by lethal injection in 2019, despite concerns raised by his family and a nurse practitioner. His brother, Gary, says he was 'basically put to death.' 

Alex Schadenberg

Reinl examines why so many Canadians are dying by euthanasia. He explains the history of how euthanasia was legalized in Canada and then writes:

The law was later amended to allow people who are not terminally ill to choose death, significantly broadening the number of eligible people.

Critics say that change removed a key safeguard aimed at protecting people with potentially decades of life left.

Today, any adult with a serious illness, disease, or disability can seek help in dying.

Schadenberg said MAiD teams in clinics were aggressively pushing for sick people to opt for euthanasia.

He described cases of medics asking terminally sick people as many as five times if they wanted to end their lives. In some cases, they asked them when relatives were present, and again when alone, Schadenberg said.

'The selling of MAiD by the MAiD teams is a big reason why the numbers are skyrocketing.

'If you're going to pay people to be on a MAiD team, they will sell what they are offering,' Schadenberg said.

More articles on this topic:

• 2022 Projection: 13,500 Canadian euthanasia deaths in 2022 (Link). 
• Québec has the highest euthanasia rate in the world (Link). 
• Alberta euthanasia deaths increased by more than 40% in 2022 (Link).
• Ontario 2022 euthanasia deaths increase by 27% to 3934 (Link).
  

The problems with Canada's MAiD policy.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

...is medical assistance in dying really a choice, or is it coercion?

Jeremy Appel, who does not oppose the concept of euthanasia, has written an article that was published by Jacobin.com on January 8 titled: The Problems with Canada's Medical Assistance in Dying Policy. Appel begins his article by stating:

Canada’s Medical Assistance in Dying program seemed like a step forward for choice and dignity. But it is beginning to look like a dystopian end run around the cost of providing social welfare that can beat back the deprivations that make life unbearable.

Appel follows that by stating:

But the legalization of MAiD has brought to the fore some disturbing moral calculations, particularly with its expansion in 2019 to include individuals whose deaths aren’t “reasonably foreseeable.” This change opened the floodgates for people with disabilities to apply to die rather than survive on meager benefits.

I’ve come to realize that euthanasia in Canada represents the cynical endgame of social provisioning within the brutal logic of late-stage capitalism — we’ll starve you of the funding you need to live a dignified life, demand you pay back pandemic aid you applied for in good faith, and if you don’t like it, well, why don’t you just kill yourself?

The problem with my previous perspective was that it held individual choices as sacrosanct. But people don’t make individual decisions in a vacuum. They’re the product of social circumstances, which are often out of their control.

Appel is acknowledging that individual choice has not worked out with the issue of euthanasia because decisions to be killed are based on social circumstances.

Appel explains that there are endless examples of people with disabilities who were offered euthanasia as an alternative to living a life of pain and exclusion. And with the impending expansion of MAiD to include people with mental illnesses, the problem is only going to get worse. He continues:

At least four veterans suffering from post-traumatic stress have been offered MAiD, including one instance where a caseworker told a veteran that MAiD is a preferable alternative to “blowing your brains out against the wall.” Mark Meincke, a veteran of the Princess Patricia’s Canadian Light Infantry who on his podcast spoke to the veteran who was offered MAiD, told the House of Commons Standing Committee on Veterans Affairs that the individual in question had never even contemplated suicide. He just wanted help dealing with his PTSD and other ailments.

“He expressed to me that things were sunshine and roses prior to this phone call, he was feeling good about life,” Meincke told the committee.

“Post phone call, he left the country, because he was devastated by that call.

He continues with the story of Christine Gauthier:

In another instance, retired corporal Christine Gauthier, who is paraplegic and competed for Canada at the 2016 Rio de Janeiro Paralympics and the Invictus Games, was offered assisted suicide, with Veterans Affairs offering to provide her with the necessary equipment.

Gauthier had been fighting for five years to have Veterans Affairs provide her with a wheelchair ramp. They wouldn’t provide the ramp, but they would give her the means to end her life.

He quotes Brennan Leffler and Marianne Dimain who were published in the Globe and Mail as stating:

“How poverty, not pain, is driving Canadians with disabilities to consider medically-assisted death,” notes the “excruciating cycle of poverty” that leads disabled people to choose assisted death, rather than live a life filled with barriers to their existence. “The numbers are grim,”

Joannie Cowie

Leffler and Dimain explain that according to Statistics Canada (2017), 25% of people with disabilities are living in poverty. Appel then quotes Joannie Cowie who lives in poverty, has multiple disabilities, and is considering death by euthanasia as stating:

“People with disabilities have been put on the backburner and nobody gives a damn about them,” she told Global. “I’ve cried a lot at night. I usually stay up a lot of the night. I pray. I pray a lot.”

Alan Nichols with his brother.

Appel further explains the problem by telling the story of Alan Nichols.

The case of Alan Nichols demonstrates how uncomfortably permissive Canada’s euthanasia framework is. Nichols, who suffered from depression, was hospitalized in June 2019 over fears he was suicidal. Upon hospitalization he asked his brother Gary to “bust him out” as soon as possible.

A month later, Nichols successfully applied for MAiD, not for depression, which is not yet legal, but for hearing loss, which occurred as a result of brain surgery when he was twelve.

His family, who filed a police report and notified health authorities, said that there was no way that he was eligible for MAiD, arguing that he had refused to take his meds and use his cochlear implants, which would have helped his hearing.

“Alan was basically put to death,” Gary Nichols said.

Sean Tagert with his son.

Sean Tagert died by euthanasia in August 2019 and left behind his 11-year-old son rather than be institutionalized. Appel writes:

While his condition required him to receive twenty-four-hour care, the government would only provide funding for sixteen hours, forcing him to pay $263.50 a day for the remaining eight hours.

He called the option of institutionalization, as opposed to fully funded care, a “death sentence.”

Roger Foley

Another story is that of Roger Foley, who has fought to live. Appel explains:

Roger Foley, who was hospitalized with a degenerative brain disorder in London, Ontario, began surreptitiously recording his conversations with hospital workers who offered him euthanasia unprompted.

In one recording, the hospital’s director of ethics told him continuing care would cost “north of $1,500 a day,” the Associated Press reported, which he correctly regarded as coercive.

Appel asks the question based on people with disabilities who are living in poverty - is medical assistance in dying really a choice, or is it coercion? Appel quotes Dr. Naheed Dosani, a palliative care physician in Toronto who told Global news:

Combined with COVID policies that have consigned disabled and immunocompromised people to a life of perpetual self-isolation, a lack of funding for people on disability assistance makes MAiD an increasingly palatable solution to ending their suffering. In this context, the cavalier way in which MAiD has been implemented in Canada serves as a form of eugenics, where only the able-bodied survive.

Appel explains that Canada has fewer safeguards than other jurisdictions. In some jurisdictions doctors must exhaust medical treatment options before approving euthanasia. In Victoria Australia only the patient can bring up the option of euthanasia.

Appel loses his appeal by completing his article with the following statements:

I still believe it’s cruel to refuse MAiD for people on the verge of death, with no prospects for recovery. But it’s even crueler to offer death as an alternative to a properly funded social support system.

We’ve let the MAiD genie out of its bottle. There’s no going back. We must ensure that our health care systems have sufficient resources to guarantee everyone, regardless of ability or mental health, a dignified existence.

The genie may be out of the bottle but as Gordon Friesen, who lives with disability, recently wrote:

Poverty high-lights the problem of euthanasia in a particularly graphic way. But poverty is not the cause of this problem (and even doing away with poverty, entirely, would in no way solve it). For as long as there is legal euthanasia based on medical criteria, there will be discriminatory eligibility, and discriminatory death.

Most importantly: The shortest road to solving the euthanasia problem is to seek legislative initiatives narrowly designed to restrict this practice, or to remove it entirely.

Unlike Appel I recognize that the horrifying Canadian stories of euthanasia for poverty, homelessness, and a lack of medical treatment are the result of legalizing euthanasia. That as Friesen also stated: euthanasia is abhorrent on its own!

Canadian man claims that he was pressured to request euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Michael Kaplan wrote and indepth article that was published in the New York Post concerning Roger Foley, a Canadian man who was pushed to ask for an assisted death while being denied the care that he needed to live. Kaplan also researched the 2019 death of Alan Nichols, who died by euthanasia even though he was only depressed.

Kaplan reports on the Roger Foley case:

“I’ve been pressured to do an assisted suicide,” he told The Post, alleging this happened with caretakers at Victoria Hospital, a primarily government-funded center in London, Ontario.

“They asked if I want an assisted death. I don’t. I was told that I would be charged $1,800 per day [for hospital care]. I have $2 million worth of bills. Nurses here told me that I should end my life. That shocked me.”

Foley’s claims to The Post echo his allegations in a lawsuit filed against Victoria Hospital Health Services Centre, among others, in which he claims that healthcare workers have pushed him to end his life.

Foley was pressured to die and he was further pressured by a collection agency. Kaplan states:

“Mr. Foley was told by hospital staff that he had stayed at the hospital for too long and if he did not receive self-directed funding [from local agencies, covering home care], he should apply for assisted death as an option,” the lawsuit claims.

It goes on to accuse the defendants of “sending a collection agency after [Foley] to pressure him into a medically assisted death,” adding that “defendants have violated [Foley’s] rights and freedom.”

Alan (left) with his brother Gary

Kaplan then looks into the death of Alan Nichols.

The medically assisted suicide of Alan Nichols in 2019 has been held up as an example. The 61-year-old was depressive and reportedly suicidal. Canadian law requires patients can only legally undergo medically-assisted suicide if they suffer from a physical — not mental — ailment. Nichols, it is reported in an article by Associated Press, listed hearing loss as his reason for euthanasia. Relatives maintain that hospital employees helped him to put in the request.

“He didn’t have a life-threatening disease,” his brother Gary Nichols told CTV news. “I didn’t think he had a sound mind at all.”

Kaplan also reports that Foley claims in his lawsuit that the hospital denied him food and fluid.

The lawsuit references “the defendants denying him food and water, and failing to provide him with the necessities of life and endangering his life [by] making him critically acidotic [a condition in which there is too much acid in bodily fluids].”

Kaplan concludes the article with Foley stating:

Said Foley: “There is pressure on [disabled] people who should be treated equally and celebrated for their strength and diversity and difference.

“Society deems us better off dead. We have to justify being alive and [to pro-euthanasia contingents] our lives don’t matter.”

Previous articles related to Roger Foley:

• Abandoning people: Canada's broadening euthanasia law (Link). 
• Canada is getting comfortable with killing people with disabilities (Link).
• People with disabilities oppose Bill C-7 expansion of euthanasia (Link).