Canada: Recent History of Euthanasia Legalisation

By Richard Egan (with the Australian Care Alliance)

On 21 April 2010 the Canadian House of Commons defeated Bill C-384 An Act to amend the Criminal Code (right to die with dignity) by 228-59.

The Quebec National Assembly passed an “An Act respecting end-of-life care” by a vote of 94-22. It came into effect on 10 December 2015. This Act permits euthanasia on the request of an adult who is “at the end of life; with a serious and incurable illness; and in an advanced state of irreversible decline in capability”.

On 6 February 2015 the Supreme Court of Canada in Carter v Canada (Attorney General) declared that provisions in the Canadian Criminal Code making it an offence to aid or abet suicide “unjustifiably infringe” section 7 [“Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”] of the Charter of Rights and Freedoms “and are of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” The declaration was suspended for a year, giving the opportunity for the Parliament to amend the offending laws by providing a scheme for physician assisted suicide.

The core paragraph in the judgement reads that: “The right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. Here, the prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable. The rights to liberty and security of the person, which deal with concerns about autonomy and quality of life, are also engaged. An individual’s response to a grievous and irremediable medical condition is a matter critical to their dignity and autonomy. The prohibition denies people in this situation the right to make decisions concerning their bodily integrity and medical care and thus trenches on their liberty. And by leaving them to endure intolerable suffering, it impinges on their security of the person.”

The argument based on the right to life is specious as it takes no account of the inevitability that a law permitting euthanasia will result in wrongful deaths based on medical errors, coercion, discrimination against or differential treatment of the disabled and mentally ill and suicide contagion.

The argument from liberty, if pressed to its logical conclusion, would require a law permitting assisted suicide or euthanasia on request by any person, including a minor, with capacity.

The argument from security is based on a false claim that pain and other physical symptoms cannot be relieved by best practice palliative care.

In response to the Supreme Court judgment, the Canadian parliament passed Bill C-14 which came into effect on 17 June 2016 and legalised euthanasia and assisted suicide on request for any adult who has “a serious and incurable illness, disease or disability”; is in “an advanced state of irreversible decline in capability”; and whose “natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining”.

Increase in numbers

There have been three interim reports providing national data on euthanasia as well as reports on the data from Quebec, the most recent of which covers 1 July 2017 to 31 March 2018.

First report.

Comparing the data for the three six month periods covered by the national data reports - 17 June 2016-31 December 2016; 1 January 2017-30 June 2017 and 1 July 2017-31 December 2017 – the number of deaths by euthanasia almost doubled (189%) between the first and third six month periods from 805 to 1525 increasing from 0.6% of all deaths in Canada to 1.07% of all deaths.

Similarly the data for Quebec shows that official reports of euthanasia almost doubled from an average of 46 per month for the six month period 1 July 2016-31 December 2016 to an average of 90 per month for the three month period 1 January 2018-31 March 2018.

Reported acts of euthanasia in Quebec accounted for 1.18% of all deaths in 2017.

Unreported cases

There is a discrepancy of 171 cases of euthanasia between the number of official reports received (1493) and the number of cases reported by institutions (1664) in Quebec suggesting a failure by physicians to report in 10.3% of euthanasia cases.

Failure to comply with the legal processes

Quebec euthanasia

Six per cent of all forms reporting euthanasia in Quebec are received late and 42% off all forms received have insufficient information and require follow up requests.

Even after repeated requests for further information there is insufficient information to conclude whether or not the act of euthanasia complies with the law in 5% of cases.

In a further 5% of cases (62 cases out of 1374 for which a final assessment has been made) there was a failure to comply with the law, including:

• 29 cases in which the consulting physician was not independent from the physician who carried out euthanasia. However, this has been addressed by officially slackening the interpretation of the requirements for independence! 
• 9 cases in which the physician who performed euthanasia did not ensure that the request for euthanasia was voluntary, informed and persistent  
• 6 cases in which the consulting physician examined the person before a request for euthanasia was formally made
•  5 cases in which the approval was countersigned by an unqualified person  
• 5 cases in which the person did not have a serious and incurable illness  
• 4 cases in which the person did not have the required Quebec health insurance  
• 2 cases in which the person was not at the end of life  
• 2 cases in which the physician failed to verify that all the conditions for euthanasia were met.
  

In summary of these 62 cases at least 23 could be characterised as possible wrongful deaths.

Underlying conditions

Very limited data is provided on the underlying condition for which euthanasia is performed. In the last reporting period 9% of cases involved either an unreported condition or a condition other than cancer related, neurodegenerative or circulatory/respiratory system.

Some of the “other” conditions have included osteoarthritis, rheumatoid arthritis and “age-related frailty”.

The Canadian law only requires that “death be reasonably foreseeable”. The decision of the Ontario Superior Court of Justice in AB v Attorney General of Canada delivered on 19 June 2017, in paragraph 81, interpreted this requirement as not requiring any connection whatsoever between the underlying conditions for which euthanasia is sought and the reasonable foreseeability of death – which can be based simply on advanced age. The woman in this case was 79 years old.

Additionally there are the 5 cases from Quebec in which the person did not have a serious and incurable illness and the 2 cases from Quebec in which the person was not at the end of life.

Short time between initial request and euthanasia being performed

Section 29 (c) of the Quebec law requires that before performing euthanasia the physician must verify “the persistence of suffering and that the wish to obtain medical aid in dying remains unchanged, by talking with the patient at reasonably spaced intervals given the progress of the patient’s condition”.

Section 241.2 (3) (g) of the Canadian Criminal Code requires a physician to “ensure that there are at least 10 clear days between the day on which the request was signed by or on behalf of the person and the day on which the medical assistance in dying is provided or — if they and the other medical practitioner or nurse practitioner referred to in paragraph (e) are both of the opinion that the person’s death, or the loss of their capacity to provide informed consent, is imminent — any shorter period that the first medical practitioner or nurse practitioner considers appropriate in the circumstance”.

Nonetheless according to a recent study of euthanasia at three institutions in Quebec the median number of days between the request for euthanasia and the patient’s death was just 6 days.

This study also found that in 32% of cases a palliative care consultation only took place less than 7 days before euthanasia was requested and in a further 25% of cases it took place on the same day or AFTER euthanasia was requested. This suggests that euthanasia is being routinely provided to people before they have had a chance to experience the full effect of palliative care to relieve their suffering and concerns.

Reasons for requesting euthanasia

A study from an Ontario hospital reported that those who received euthanasia tended to be white and relatively affluent and 95% of them indicated that loss of autonomy was the primary reason for their request. Other common reasons included the wish to avoid burdening others or losing dignity and the intolerability of not being able to enjoy one’s life. Few patients cited inadequate control of pain or other symptoms.

Disability – the story of Candice Lewis

Candice Lewis with her mother.

Candice Lewis is a 25 year old Canadian woman who happens to have been born with cerebral palsy.

In September 2016 Candice went to the emergency room at Charles S. Curtis Memorial Hospital in St. Anthony after having seizures.

Dr. Aaron Heroux told her she was very sick and likely to die soon. He offered her assisted suicide. The doctor also proposed assisted suicide for Candice to her mother Sheila Elson.

This offer was repeated despite both Candice and her mother making it clear that this was not an option Candice would consider. Dr Heroux told Sheila she was being selfish by not encouraging her daughter to choose assisted suicide.

Candice describes how bad it made her feel that a doctor was offering her assisted suicide.

More than twelve months later Candice has recovered well and her health was much improved. Candice hasn’t been having any seizures, is now able to feed herself, walk with assistance, use her iPad. She is more alert, energetic and communicative. She was able to "walk" down the aisle as a bridesmaid at her sister’s wedding in August 2017. She is doing what she loves most, painting and being with her family.

Candice and her mother Sheila have been interviewed by Kevin Dunn, who produced a film on euthanasia and assisted suicide called Fatal Flaws. The film of the interview can be viewed here.

There are several take home lessons from Candice’s experience:

• Doctors can get the prognosis wrong. Candice was told she was dying but was flourishing twelve months later. A wrong prognosis can lead to assisted suicide or euthanasia. A life can be thrown away needlessly;
• People with a disability already suffer discrimination in health care. When assisted suicide and euthanasia are legal, people with a disability are more at risk of being offered death as a solution because doctors and others consider that they would be better off dead; 
• Once doctors are authorised by the law to provide assisted suicide and euthanasia some of them will feel empowered to offer it to anyone they think would be better off dead. This undermines patients’ trust in doctors and can cause great distress.

Roger Foley

Financial issues: Denied assisted living but offered assisted suicide
Roger Foley, who has a crippling brain disease, has been seeking support to live at home. He is currently in an Ontario hospital that is threatening to start charging him $1,800 a day. The hospital has told Roger that his other option is euthanasia or assisted suicide under Canada’s medical assistance in dying law.

Disability advocate: Supreme court is wrong on assisted suicide.

This letter was published in the Hamilton Spectator on March 3, 2015.

By Steven Passmore

As a person living with a disability, I am deeply concerned with the Supreme Court of Canada ruling, which struck down Canada's laws protecting me from assisted suicide. As a non-elected body, the Supreme Court has made a bad decision which will negatively affect all 35 million Canadians.

We are a nation that prides itself on democracy. In April, 2010, Parliament defeated an assisted suicide bill by a vote of 228 to 59. That was a pretty strong consensus. Nine Supreme Court Justices should not be able to overrule 308 members of parliament (MPs).

In Canada, does democracy still rule?

The Supreme Court of Canada has overstepped its mandate; the justices should have upheld the law and not struck down our current law. I would urge Parliament to use the notwithstanding clause to overrule the Supreme Court of Canada's decision on the basis of democracy.

Steven Passmore, Hamilton, Advocate for Persons with Disabilities and Board Member of Euthanasia Prevention Coalition

Assisted suicide: the issue we can’t afford to get facts wrong

By Margaret Somerville, the director of the McGill Centre for Medicine, Ethics and Law.

Margaret Somerville

Globe and Mail columnist Jeffrey Simpson recently wrote a pro-euthanasia column entitled “Assisted suicide – the issue we can’t ignore.” If he’s correct, it’s also the issue where we can’t afford to get our facts wrong. So, looking at his column, where might some people be doing so? Responding to that question can provide important insights in relation to euthanasia, in particular how pro-euthanasia advocates present “facts” to support their case.

Mr. Simpson writes:

“Canada has been around the issue of physician-assisted suicide many times in the past two decades … but we have never arrived at a consensus to allow the practice, as some European countries have done.”

But no country has a real consensus either for or against euthanasia. In Canada our “consensus,” in this sense, as manifested by the Canadian Parliament, which voted down legalizing euthanasia in April 2010 by a vote of 228 to 59, has been to reject euthanasia as incompatible with foundational Canadian values; not ethically acceptable; seriously harmful to the institution of medicine; and too dangerous in terms of abuse, especially of vulnerable people.

There are several problems with Mr. Simpson’s statement that

“A bill introduced by the Parti Québécois government [the government of Quebec] would have allowed physician-assisted suicide with a range of appropriate safeguards and checks involving patients, physicians and families.”

Bill 52 would have allowed euthanasia, but it’s quite unclear whether it would have allowed physician-assisted suicide. The reports that informed the bill had rejected the latter, for reasons that we can only speculate about.

Clarifying what the bill was allowing is the first safeguard needed. The term “medically assisted death” was used as a euphemism for euthanasia. In an Ipsos Marketing poll carried out September 2013, which covered 2,078 Canadian respondents, 1,010 of them from Quebec, two thirds of Quebecers didn’t understand this meant a physician could give a lethal injection to a patient, and 40 percent didn’t understand that was what euthanasia meant.

And the safeguards were based on the Belgian law allowing euthanasia which have been spectacularly ineffective in containing its expanded use or preventing its abusive use.

Legalizing euthanasia or assisted suicide is not safe.

This letter was submitted to the Globe and Mail, but not printed, in response to an article that was written by Jeffrey Simpson.

Oppose euthanasia and assisted suicide. Sign the Declaration of Hope.

Alex Schadenberg

By Alex Schadenberg

Executive Director 
Euthanasia Prevention Coalition

I would like to thank Jeffrey Simpson for his comments on assisted death, but his inaccurate analysis actually shows why assisted suicide should not be legalized.

Canada has debated assisted death on many occasions with the most recent vote in parliament occurring in April 2010 when assisted death was defeated by a vote of 228 to 59. That was a pretty strong consensus, even if Simpson was not pleased with its result.

One reason the bill in 2010 was overwhelmingly defeated was that the language of the bill was imprecise and permissive. When Simpson refers to the recent bill in Quebec he stated that it contained appropriate safeguards, and yet the language of the Quebec bill was also imprecise and permissive.

The Quebec euthanasia bill and Bill C-384 would have allowed euthanasia for psychological pain such as chronic depression or mental illness, which are treatable conditions, and these bills were not limited to terminally ill people.

When examining Fletcher’s euthanasia bills we see the same language being used except that Fletcher is not imprecise but rather intentional. The language of Fletcher’s bills specifically focus on assisted death for people with disabilities and once again he specifically allows assisted death for psychological conditions. Fletcher’s bills are also not limited to terminal illness.

Simpson states that there is no consensus among medical professionals. A Canadian Medical Association poll in 2013 found that only 16% of its members were willing to participate in assisted death and a 2010 survey of Canadian palliative care physicians  found that 88% were opposed to assisted death. A consensus appears to exist.

Simpson referred to the jurisdictions where assisted death is legal and stated that it represents a very small percentage of the deaths. The number of assisted deaths in the Netherlands doubled in the past 6 years, with 23% of the assisted deaths being unreported while assisted death for psychiatric reasons tripled last year alone.

This year Belgium extended euthanasia to children and in the Netherlands the Groningen Protocol allows assisted death for children born with disabilities.

In response to the Fletcher bills, the Euthanasia Prevention Coalition (EPC) stated that we welcomed an open debate on euthanasia and assisted suicide. Ignoring the facts is at our own peril. 

Legalizing euthanasia or assisted suicide is not safe.

Attorney General of Canada, responds to euthanasia and assisted suicide.

Correspondence from the Minister of Justice and Attorney General of Canada

Thank you for your correspondence concerning euthanasia and physician‑assisted suicide. I regret the delay in responding.

Many Canadians are concerned about this complex ethical, legal, and medical issue. We recognize that people have widely divergent and strongly held views about this issue.

As you know, the Criminal Code prohibits the practices of euthanasia and physician‑assisted suicide in Canada. These laws exist to protect all Canadians, including the most vulnerable members of our society, such as those who are sick or elderly and persons with disabilities.

We believe that the provisions prohibiting a medical professional, or anyone else, from counselling or providing assistance in a suicide are constitutionally valid. As you know, in April 2010, the legalization of euthanasia and physician‑assisted suicide under certain conditions was debated in the House of Commons. A majority of Parliamentarians voted against changing our criminal laws. I personally voted against this bill.

As you may be aware, on January 16, 2014, the Supreme Court of Canada granted leave to appeal the decision of October 10, 2013, by the British Columbia Court of Appeal in Carter v. Canada (Attorney General), which found that the prohibition against physician‑assisted suicide was unconstitutional. Please be assured that the Government of Canada will vigorously defend the constitutionality of the existing laws in this area before our country’s highest court.

Thank you again for writing.

Yours truly,

The Honourable Peter MacKay

Liberal's to debate euthanasia at their February 20 - 23, 2014 convention in Montreal

Post Media News is reporting that the Liberal Party of Canada will likely debate euthanasia at their February 20 - 23 party convention in Montreal.

Resolution 90: Assisted suicide:

"BE IT RESOLVED that voluntary euthanasia and assisted suicide be permitted under the Criminal Code of Canada in the circumstances set out by Justice Smith in her decision in the British Columbia case of Carter v. Canada (Attorney General)."
Post Media News reported:

The Young Liberals of Canada are the driving force behind the move after they agreed to sponsor a resolution calling for the legalization of doctor-assisted suicide, Postmedia News has learned. 

While a proposal to support legalizing prostitution may not even make it onto the larger convention floor, the resolution on euthanasia is expected to be tagged a priority, which would mean it must be debated by all delegates during the Feb. 20-23 policy convention. 

Euthanasia has emerged as a hot political topic given Canada’s aging population and several high-profile cases, including one legal challenge in British Columbia that the Supreme Court said Thursday it would hear.

Conservative Party of Canada voted to protect people from euthanasia and assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

At their national policy convention in Calgary, the Conservative Party of Canada supported a resolution that the government will not support any bill that would legalize euthanasia or assisted suicide.

The Conservative Party Calgary convention opposed the legalization of euthanasia and assisted suicide by a vote of 615 to 502. The Calgary Herald stated:

"The Conservative Party will not support any legislation to legalize euthanasia or assisted suicide. This was a motion that sparked strong debate on either side, with one delegate warning that legalized euthanasia would give doctors “the right to directly and intentionally cause your death.”

Quebec is currently debating euthanasia bill (Bill 52) that would legalize euthanasia by defining it as medical treatment. If passed, Bill 52 will need to be challenged through the court as unconstitutional because Bill 52 attempts to redefine euthanasia as medical treatment, when it actually falls within federal jurisdiction as a form of homicide. Bill 52 is a very dangerous bill.

The BC Court of Appeal recently upheld the laws protecting Canadians from euthanasia and assisted suicide by overturning the lower court decision of Justice Smith in the Carter case. The Carter case sought to decriminalize euthanasia and assisted suicide through the courts.

The BC Civil Liberties Association has asked the Supreme Court of Canada to hear an Appeal of the BC Court of Appeal decision.

In April 2010, the federal government overwhelmingly defeated Bill C-384, a bill that would have legalized euthanasia and assisted suicide in Canada, by a vote of 228 to 59.

Hon. Peter MacKay

Justice Minister, Hon Peter MacKay recently stated that:

"The laws surrounding euthanasia and assisted suicide exist to protect all Canadians, including those who are most vulnerable."

It is very good that the governing Conservative Party of Canada have maintained a policy of protecting Canadians from euthanasia and assisted suicide.

BC Court of Appeal upholds protections in law from euthanasia and assisted suicide. The Supreme Court of Canada is next.

By Alex Schadenberg, executive director - Euthanasia Prevention Coalition.

On Thursday, October 10; the British Columbia (BC) Court of Appeal upheld Canada’s laws prohibiting euthanasia and assisted suicide, in a 2 to 1 decision by overturneding the disturbing lower court decision in 2012 by Justice Smith in the Carter case.

The Euthanasia Prevention Coalition (EPC), who intervened in the Carter case, applauded the BC Court of Appeal decision by stating:

“EPC is pleased that the Court has followed the lead of Canadian Parliament, the Supreme Court of Canada, and of the majority of Parliaments and Supreme Courts around the world in finding that the prohibitions against assisted suicide represent an important protection against abuse of vulnerable people.”

The Carter case, was launched by the family of Kay Carter, a woman who died by assisted suicide in 2010 in Switzerland. The Carter family claimed that Kay was denied the “right” to die with dignity in Canada and her family were forced to break the law by assisting her travel to Switzerland for suicide. The BC Civil Liberties Association represented the Carter family.

On June 15, 2012, Justice Smith wrongly decided that Canada’s assisted suicide law was unconstitutional. Smith found that people with disabilities who are unable to kill themselves by suicide without assistance were discriminated by the law. 

Smith also decided that “safeguards” can effectively protect vulnerable people. Smith gave parliament one year to pass a law allowing assisted suicide and a limited form of euthanasia in Canada.

Fortunately, the federal government appealed the decision of Justice Smith to the BC Court of Appeal.

The BC Court of Appeal found that Smith did not have the right to strike down Canada’s assisted suicide law and that she made several errors and incorrect assumptions in her decision.

The BC Court of Appeal stated that Smith was wrong when she found that the circumstances had sufficiently changed since 1993, giving her the right to strike down the 1993 Rodriguez decision.

In 1993, the Supreme Court of Canada upheld Canada’s assisted suicide law in the Rodriguez case, a case that was based on Sue Rodriguez. Rodriguez, who was living with ALS, petitioned the courts to grant her the right to die by assisted suicide.

The BC Court of Appeal also found that Smith was wrong when she assumed that the Rodriguez decision did not consider certain constitutional analysis. The BC Court of Appeal concluded that only the Supreme Court of Canada has the right to overturn its decisions.

The BC Court of Appeal decision challenged Smith’s assertion that Canada’s assisted suicide law discriminates against people with disabilities. The majority stated that:

“those who have only a limited ability to enjoy life are not less alive and have no less a right to life, than able-bodied and fully competent persons.

EPC was pleased that the BC Court of Appeal recognized that Canada’s laws prohibiting assisted suicide meet the legislative objective that is grounded in respect for and the desire to protect human life and the current assisted suicide law is rationally connected to its purpose.

The BC Court of Appeal also acknowledged that parliament had recently considered a bill (Bill C-384) that would have legalized euthanasia and assisted suicide in Canada. On April 21, 2010, parliament overwhelmingly defeated Bill C-384 by a vote of 228 to 59.

The BC Civil Liberties Association announced that it will appeal the BC Court of Appeal decision to the Supreme Court of Canada.

The Euthanasia Prevention Coalition (EPC) will seek to intervene, if the Supreme Court of Canada decides to hear the Carter case.

Laws that prohibit euthanasia and/or assisted suicide provide equal protection in law for all people and uphold the safety of all people, in every life conditions, from having their life taken from them.

Dr. Will Johnston, the EPC - BC chair talks about the Carter Case after the BC Court of Appeal overturned the lower court decision by upholding Canada's laws protecting Canadians from euthanasia and assisted suicide. 
http://www.youtube.com/watch?v=CfoA71TGTf0&feature=youtu.be

Links to other similar articles.
EPC applauds BC Court of Appeal ruling  in assisted suicide case.
Irish Supreme Court upholds protections in law from assisted suicide using similar evidence as in the Carter case.
EPC wants BC Court of Appeal to reverse errors by the lower court in Carter case.

Canada's Federal government will not support assisted suicide.

The Canadian Press reported that Canada's Minister of Health, the Hon Rona Ambrose unequivocally stated:

"We do not support assisted suicide--that is our government's clear position."

Rona Ambrose

Following the discussion on Friday, October 4, 2013 between the federal and provincial health ministers, Ambrose said to the media:

"Quebec is going through the motions of debate in their legislature, and should that pass, then obviously we would look to see what to do with that, and if it does end up in court, then the courts would decide about the jurisdiction."

The Quebec government introduced Bill 52, a bill that would legalize euthanasia through the back-door by re-defining euthanasia as medical treatment, even though euthanasia is defined in the Federal Criminal Code as a form of homicide.

Bill 384, a bill that would have legalized euthanasia and assisted suicide in Canada, was debated in Canada's parliament in 2009-10. In April 2010, the Bill 384 was defeated by an overwhelming margin of 228 to 59, with the majority of the Conservatives, Liberals and NDP rejecting the legalization of euthanasia and assisted suicide in Canada.

Rejean Hebert

At the same press conference, Quebec's Health Minister, Rejean Hebert said about Bill 52:

"Its not assisted suicide, It's medical aid for dying"

Hebert is right. Bill 52 legalizes euthanasia, under the euphemism "medical aid in dying" it does not legalize assisted suicide. 

Bill 52 gives physicians the right to lethally inject their patients, but Bill 52 does not allow physicians to write lethal prescriptions for a patient to "self-administer."

If Bill 52 passes, without amendments, in the Quebec National Assembly it appears that the Federal government will launch a court challenge. 

The federal government has a very strong case because lethal injections (euthanasia) are not a form of medical treatment (provincial jurisdiction) but rather a form of homicide (federal jurisdiction).

EPC urges the Government of Canada to appeal the constitutional exemption granting Gloria Taylor death by euthanasia.

For Immediate Release

Link to the decision by Justice Minister Honourable Rob Nicholson to appeal the August 10 decision by Justice Prowse.

The Euthanasia Prevention Coalition (EPC) is troubled that the constitutional exemption granted to Gloria Taylor, to die by euthanasia or assisted suicide, was not stayed by the BC court.

Alex Schadenberg, EPC executive director states:

EPC is concerned that this court order may prompt other people with similar conditions to apply for a constitutional exemption to die by euthanasia before the Supreme Court and Parliament have ruled on the matter.

 Hugh Scher, EPC legal counsel comments:

The existing laws prohibiting euthanasia and assisted suicide remain in effect.
 Parliament and the Supreme Court of Canada have endorsed the constitutionality of the law.

 In April 2010, Canada’s parliament overwhelming defeated a bill that would have legalized euthanasia and assisted suicide.

In 1993, the Supreme Court of Canada ruled that Canada’s assisted suicide legislation was constitutional.

Dr. Will Johnston, EPC – BC Chair states:

Most elder abuse is hidden from view - and if we can't detect the abuse now, how are we going to do it when the stakes are raised? I have seen how easily influenced older people can be, and how inadequate are our national strategies against suicide.

Alex Schadenberg concludes: 

It is not appropriate for any single judge to over-ride parliamentary sovereignty and the rule of law.

EPC urges the Government to appeal the court order that maintains a constitutional exemption for Gloria Taylor to die by euthanasia.

Contact Justice Minister Rob Nicholson at: http://www.justice.gc.ca/eng/contact/Comm3.html.

For further information

Alex Schadenberg, EPC Executive Director:  (519) 851-1434, info@epcc.ca
Dr. Will Johnston, EPC-BC Chair:                (604) 220-2042, willjohnston@shaw.ca
Hugh Scher, EPC - Legal Counsel:                (416) 816-6115, hugh@sdlaw.ca

Talking Points: National letter writing campaign

It is important to send letters to local and national newspapers or media expressing your opposition to the legalization of euthanasia and assisted suicide. When writing a letter you should to tell a personal story (if you have a story) and it is important to remain focused on one or two talking points.

The following is a list of talking points to help write letters to the media or to your member of parliament.
 
Talking Points:

1.  The Canadian government has made the prevention of elder abuse a national priority. Elder abuse is rarely reported and is usually done by someone who the abuser is dependent upon. If euthanasia and assisted suicide becomes legal, it will be the ultimate form of elder abuse.

2.  Recently Parliament passed Bill C-300, an act respecting a Federal Framework for Suicide Prevention. In Oregon, where assisted suicide has been legal for 14 years, the suicide rate has been rising since 2000. The suicide rate in Oregon is now 35% higher than the national average. Legalizing assisted suicide has a suicide contagion effect.

3. Canada prohibited capital punishment based on the possibility that the death of an innocent person may occur. Euthanasia and assisted suicide may result in the deaths of people without request or consent. Canada needs to continue prohibiting euthanasia and assisted suicide.

4. Depression is a primary risk factor for requests for euthanasia or assisted suicide. Depression is a common response of people living with chronic conditions or terminal illness. It is not possible to safeguard depressed people from euthanasia or assisted suicide. 

5. The Carter decision stated that prohibiting assisted suicide is an infringement upon the: right to life, liberty and security of the person, for people with disabilities. In fact the opposite is true. Legalizing euthanasia or assisted suicide will result in persons with disabilities losing their right to life, liberty and security of the person.

6.  In April 2010, Parliament defeated Bill C-384, a bill that would have legalized euthanasia and assisted suicide by a vote of 228 to 59. Judges should respect the role of Parliament. Issues such as euthanasia and assisted suicide should be decided by Parliament.

The Leblanc Case in Quebec: A Recipe for Elder Abue and a Threat to the Individual

"Those who believe that legal assisted suicide/ euthanasia will assure their autonomy and choice are naive."

William Reichel, MD

Montreal Gazette, May 30, 2010[1]

By Margaret Dore

January 26, 2012

A. Introduction

Leblanc vs. Attorney General of Canada brings a constitutional challenge to Canada's law prohibiting aiding or abetting a suicide. Leblanc also seeks to legalize assisted suicide and euthanasia as a medical treatment. In 2010, a bill in the Canadian Parliament seeking a similar result was overwhelmingly defeated.

Legalization of assisted suicide and/or euthanasia under Leblanc will create new paths of elder abuse. This is contrary to Canadian public policy. Legalization will also empower the healthcare system to the detriment of individual patients. There will be other problems.

B. Parliament Rejected Assisted Suicide and Euthanasia

On April 21, 2010, Parliament defeated Bill C-384, which would have legalized assisted suicide and euthanasia in Canada.[2] The vote was 228 to 59.[3]

C. The Notice of Civil Claim

In Leblanc, the Notice of Civil Claim seeks to strike down § 241(b) of the Criminal Code of Canada as contrary to the Canadian Charter of Rights and Freedoms.[4] § 241(b) states:

"Every one who . . . (b) aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years."[5]

If § 241(b) would be struck down, it appears that any person, without restriction, would be allowed to assist another person's suicide.

The Notice of Claim also seeks to allow a healthcare professional, not necessarily a doctor, and/or a person acting under the professional's supervision, to "obtain and/or administer medication and/or the necessary treatment to end [the plaintiff's] life."[6] This request, to allow someone to actively administer a lethal modality to another person, is a request for euthanasia. The Canadian Medical Association states:

"Euthanasia means someone taking active measures to end life."[7]

In the context of traditional medical treatment, a person acting under the "supervision" of a healthcare professional would include a family member.[8] An example would be an adult child who administers medication to a parent under the supervision of a doctor who is not present.[9] This would typically be in a home setting.[10]

The Notice of Claim does not define any particular eligibility for assisted suicide/euthanasia other than a description of the plaintiff.[11] She is a disabled woman with ALS.[12]

D. A Comparison to the United States

In the United States, there are two states where assisted suicide is legal: Oregon and Washington.[13] The laws in these states were enacted via ballot initiatives, which are similar to a referendum in Canada.[14] No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[15]

The Oregon and Washington laws apply to patients predicted to have less than six months to live, who are typically age 65 or older.[16] The statutes have safeguards, for example, two doctors are required to approve a lethal prescription; there are also waiting periods.[17] These laws nonetheless leave patients unprotected against elder abuse, coercion and even murder. Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, states:

"With assisted suicide laws in Washington and Oregon, [elder abuse] perpetrators can . . . take a 'legal' route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over the administration. . . . [E]ven if a patient struggled, 'who would know?'" [18]

E. Elder Abuse

Preventing elder abuse is official Government of Canada policy.[19] Elder abuse includes physical, psychological and financial abuse.[20] Financial abuse is the most commonly reported type.[21] Elder abuse is, however, largely unreported and can be very difficult to detect.[22] This is due in part to the reluctance of victims to report. The Government of Canada website states:

"Older adults may feel ashamed or embarrassed to tell anyone that they are being abused by someone they trust."[23]

Will Johnson, MD, echoes these themes as follows:

"I see elder abuse in my practice, often perpetrated by family members and caregivers. A desire for money or an inheritance is typical. To make it worse, the victims protect the perpetrators. In one case, an older woman knew that her son was robbing her blind and lied to protect him. Why? Family loyalty, shame, and fear that confronting the abuser will cost love and care. . . .

Under current law, abusers take their victims to the bank and to the lawyer for a new will. With legal assisted suicide, the next stop would be the doctor’s office for a lethal prescription. How exactly are we going to detect the victimization when we can’t do it now?"[24]

If assisted suicide and/or euthanasia are legalized via Leblanc, new paths of abuse will be created against the elderly, which is contrary to Government of Canada public policy. For this reason alone, the relief requested in Leblanc should be denied.

F. Empowering the Healthcare System

In Oregon, where assisted suicide has been legal since 1997, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead.[25] The most well known cases involve Barbara Wagner and Randy Stroup.[26] Each wanted treatment.[27] The Plan offered them suicide instead.[28]

Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: “I'm not ready to die.”[29] Stroup said: “This is my life they’re playing with.”[30]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering. If assisted suicide and/or euthanasia are legalized in Canada, the Canadian health care system will be similarly empowered. Indeed, even the plaintiff could find herself pushed to her death before she is ready. She could be a Canadian "Barbara Wagner." Her "choice" would be compromised and/or denied.

F. Suicide Contagion.

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[31] Just three years prior, Oregon legalized assisted suicide.[32] This increased suicide rate is consistent with a suicide contagion.[33] In other words, legalizing one type of suicide encouraged other suicides. In Canada, preventing suicide is a significant public health issue.[34]

G. Conclusion

In Leblanc, the relief requested should be denied.

***

Margaret Dore

Margaret Dore is President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia with a focus on the US and Canada. In November 2010, she appeared as an expert witness before the Select Committee on Dying with Dignity of the National Assembly of Quebec, Canada. She was an amicus curie in Baxter v. Montana, which is similar to Leblanc v. Attorney General of Canada.

Ms. Dore has been licensed to practice law in Washington State since 1986. She is a former Law Clerk to the Supreme Court of the State of Washington. She worked for the United States Department of Justice for one year. She has published multiple articles on elder abuse topics and against assisted suicide and euthanasia.

For more information, see: http://www.choiceillusion.org/ and http://www.margaretdore.com/.