Sonu Gaind: Unravelling MAiD in Canada.

EPC has copies of the book Unravelling MAiD in Canada available for purchase.

Purchase the book from EPC for $40 (after tax) + shipping (Order Link).

Previous article: Ramona Coelho: Unravelling MAiD in Canada (Link).

The following speech was presented by Dr Gaind for the April 15 launch of the book: Unravelling MAiD in Canada.

Dr. Sonu Gaind is a Professor of Psychiatry at the University of Toronto and Chief of Psychiatry at Sunnybrook Health Sciences Centre. He is an Executive Member and Medical Practice & Tariff Chair of the Ontario Medical Association (OMA) Section on Psychiatry and Chair of the OMA Relativity Advisory Committee, and a Past-President of the Canadian Psychiatric Association.

Sonu Gaind speaking at book launch.

Dr K. Sonu Gaind

You know, we often say it’s the journey and not the destination, but in this case I’m not so sure. It’s been a pretty rough journey for many advocating in this area, and it is pretty great to finally see this important work see the light of day. 

I’m so appreciative of the chance to be standing here with my co editors, Ramona Coelho and Trudo Lemmens, as we launch this book. I truly hope it contributes to our national discourse as we, as a society, continue navigating the challenging waters of how, and what, we should or should not be helping people die for. I also want to thank all of our authors, whose wisdom and compassion shine through both in this volume and through their own advocacy, and also our publisher McGill/Queen’s University Press for their support and guidance through this process.

And of course, thank all of you for being here today, both in person and online (we have another about 40 or 50 people online ). A particular shout out to my dad, who couldn’t be here for health reasons but is watching - Dada, I think by now you’ve probably read and re-read the book more carefully than me, Trudo and Ramona put together. And while I’m doing shout outs, the loudest has to be to my wife Lystra and my kids Dante and Sabine even when this work has taken me away from you, you’ve always still been there for me.

When I look around this room I’m amazed by the range of friends and colleagues who have come out to celebrate this occasion with us. Thank you all so much. We have university colleagues, hospital and workplace colleagues, old friends and new confreres we’ve met and made through this journey. The diversity is remarkable, and I think a testament to how important this issue is, and how deeply people want to think about and engage in it, if given a chance.

Why we might choose, as a society, to provide death to fellow Canadians is a hugely complex issue, and one that should engender robust and honest debate. It’s legitimate to debate when it might be compassionate to help relieve suffering, versus when it might be abandonment to facilitate suicide.

Unfortunately that honest debate is not what has driven our MAiD expansion so far. Instead, as outlined in my chapter, Fall of Duty: The Breach of Trust and Moral Failure of Canada’s Entrusted Experts, and other chapters in the book, we’ve had troubling processes that have led to Canada becoming the world’s canary in a coal mine on euthanasia expansion. As Trudo will mention, the United Nations has explicitly raised concerns that our own policy makers refuse to acknowledge, of the existential risks our current MAiD expansions pose to marginalized Canadians.

That’s why I think this book is so important. From lived experience, expertise, cultural considerations and lenses of diversity, the authors unflinchingly explore not only why our most privileged, who have lived well and want autonomy to die well, might seek MAiD; but also why our most marginalized, struggling with access to social care, who society never afforded a chance to live with dignity, might (and are) increasingly seeking available euthanasia to escape life's suffering.

What we provide death for is the flip side of how we help people live.

It’s not an easy message to hear, but it’s an essential one, since I can’t think of much that defines us more as a society is that we help people live with dignity before they need to "choose" death as their only option. And for bringing these perspectives forward with eloquence, clarity, humanity and humility, often in the face of privileged voices trying to stifle any cautions, I’m deeply grateful to all our authors and co-editors to have been part of this endeavour.

Book Launch on April 15, 2025 (Link to Video)

Ontario man arrested for selling suicide substance.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An Ontario man, Kenneth Law, has been arrested and charged with two counts of assisting a suicide and is known to have assisted the suicide of at least 7 people in the US and the UK.

Neha Raju and Tom Parfett

Lucas Casaletto reported for City News that:

Peel Regional Police announced the arrest of a 57-year-old Ontario man stemming from the online distribution of sodium nitrite across the Greater Toronto Area (GTA) that resulted in two deaths.

Authorities in Peel Region opened an investigation following a report from the Times of London in the United Kingdom. It mentioned that a GTA resident named Kenneth Law had been selling sodium nitrite, a legal but lethal drug, to people in the U.K. and the U.S., which resulted in seven suicides.

On March 31, officers in Peel Region began investigating the circumstances of a sudden death in Ontario. It is believed that Law distributed and marketed the substance online to target individuals at risk of self-harm.

Law was arrested by Peel police on Tuesday and charged with two counts of counselling or aiding in suicide. He appeared briefly in a Brampton court on Wednesday, where his case was put over to next week. 

An article by George Odling for the Daily Mail explains that Kenneth Law is linked to four suicide deaths in the UK including Neha Raju and Tom Parfett. Odling reported that: 

Law allegedly gave instructions about the poison to an undercover reporter posing as a suicidal customer, and boasted that some buyers had told him he was doing 'God's work'.

He claimed to have sent the poison to hundreds of buyers in Britain and pledged to continue to do so until he had exhausted his inventory - despite pleas from UK police forces and coroners.

Odling also reported that Anthony Jones, an American who also died after consuming the substance obtained from Law told his mother, as he was dying, that he wanted to live. 

Ximena Knol

Similarly, a Netherlands man was arrested on Febuary 21, 2022 in the deaths of four people who died after ingesting a suicide powder.

Ximena, who was 19 years-old, died in February 2018 after ingesting the suicide powder.

 

The Netherland Coöperatie Laatste Wil (CLW) assisted suicide group has promoted the suicide powder. The Public Prosecution Service arrested the CLW chairman, Jos van Wijk, in September 2021 for his alleged involvement in promoting and distributing the suicide powder.

 

Kenneth Law was distributing the same suicide powder as the The Netherland Coöperatie Laatste Wil (CLW) group was promoting.

EPC published an article by Randy Knol, the father of Ximena. Since then Randy has been working to ban the lethal suicide powder. Randy is the founder and chairman of the Ximena’s Butterfly Foundation.

Seattle Times article pushes for Canadian style assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Seattle Times Opinion article published on January 13, 2023 advocates for the removal of the terminal illness requirement before dying by assisted suicide.

In the article, Peter Haley writes about a woman in Washington State who died by suicide because she did not qualify for assisted suicide since she didn't have a six-month terminal prognosis.

The advocacy article urges Washington State to change their assisted suicide law to become similar to the Canada's law. It states:

...I’m also angry because we, as citizens in charge of our laws, have badly failed her and many others. We need to improve these laws as Canada’s Parliament did in 2016.

We should drop the six-month requirement and keep the requirements that a patient have a grievous and irremediable medical condition, an advanced state of decline and unbearable suffering from the illness. And we should keep the more general safeguards regarding the patient’s age, mental health, informed consent, unacceptable motives, pressure from family or others, et cetera.

By removing the terminal illness requirement, Canadians with disabilties have died an assisted death because of poverty, homelessness, an inability to receive necessary medical treatment, and more. Veterans with PTSD were offered an assisted death rather than receive treatment. Canada has approved euthanasia for mental illness, even though it is currently on hold, and Canada is discussing euthanasia for children.

America's death lobby wants to follow Canada's disasterous assisted death law. Be careful about what you wish for.

Links to stories of concerning Canada's assisted death law:

• No other options: An exposé on euthanasia in Canada (Link).
• Toronto Star: We need to put the brakes on euthanasia (Link).
• Globe and Mail: No to euthanasia for mental disorders (Link).
  
• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Canadian man claims that he was pressured to request euthanasia (Link).
  
• Why did they kill my brother (Link).
  
• Manitoba woman died by euthanasia based on inadequate home care (Link).
• Quebec man seeks euthanasia based on changes to home care (Link). 
• Alberta man requests euthanasia based on poverty (Link).
• Ontario man approved for euthanasia because he can't get medical treatment (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

Food Bank clients asking for euthanasia because of poverty.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Meagan Nicholls who is a director of a food bank in Mississauga Ontario, near Toronto, wrote an article that was published by Maclean's Magazine on November 30, 2022 stating that:

“Clients are telling us they're considering medically assisted death or suicide because they can’t live in grinding poverty anymore.”

Nicholls states that demand on the food bank has increased by 60% since the pandemic. She stated that in the past they served 19,000 people per year and they are now serving 30,000 people per year. She also said that the increase in the cost of food has led to a 30% increase in demand for the food bank this year.

Nicholls then writes:

Meanwhile, the government has weakened our social safety net to a disheartening degree. At the provincial level, Ontario Works (our welfare system) and the Ontario Disability Support Program are woefully underfunded. We’re at the point where clients on these programs are telling us they’re considering medically assisted death or suicide because they can’t live in grinding poverty anymore. A client in our Food Bank 2 Home delivery program told one of our staff that they’re considering suicide because they’re so tired of suffering through poverty. Another client asked if we knew how to apply for MAID for the same reasons. We can’t underestimate the effect that poverty has on someone’s mental health. Our clients live with constant worry, and cut corners on needed items like medication, fresh food, or warm clothes—constantly living under that stress takes its toll mentally, emotionally and physically.

I don’t know how to ring the alarm bell any louder. When people start telling us they’re going to end their life because they can’t live in poverty anymore, it’s clear that we’ve failed them.

This is a significant article because Nicholls is genuinely shocked that people would be seking to be killed because of poverty. 

Since expanding euthanasia to people with chronic conditions who are not terminally ill, Canada has had a large number of euthanasia of people with disabilities who are asking to be killed because of poverty, homelessness and an inability to get necessary medical treatment.

Links to more stories of the euthanasia experience in Canada:

• Man changed his mind about euthanasia after receiving a wheelchair lift (Link)
• Veterans affairs offers euthanasia to former paralympian (Link).
• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Canadian man claims that he was pressured to request euthanasia (Link).
  
• Why did they kill my brother (Link).
  
• Manitoba woman died by euthanasia based on inadequate home care (Link).
• Quebec man seeks euthanasia based on changes to home care (Link). 
• Alberta man requests euthanasia based on poverty (Link).
• Ontario man approved for euthanasia because he can't get medical treatment (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

MAiD (euthanasia) for mental illness ignores safeguards for vulnerable people

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr K. Sonu Gaind

Dr. K. Sonu Gaind who is an associate professor of psychiatry at the University of Toronto, a past president of the Canadian Psychiatric Association (CPA) and a member of the Council of Canadian Academies expert advisory group on MAiD was published yesterday by the Conversation concerning the approval of euthanasia for people with mental illness alone.

Gaind explains why this topic is being considered:

People whose suffering is caused by mental illness alone do not currently have access to MAID. However, the Senate recommended Bill C-7 contain a “sunset clause” that would lift this exclusion in 18 months. The Trudeau government has extended the clause to 24 months but has otherwise accepted it, meaning that in 18 to 24 months, MAID will be provided to those suffering solely from a mental illness.

Gaind examines the known evidence on this topic:

The fundamental underpinning of all MAID requests is supposed to be the presence of “a grievous and irremediable medical condition.” The blunt and indisputable reality is that, unlike for much more predictable medical conditions with better understood biologies, it remains currently impossible to predict whether mental illness is irremediable.

The Centre for Addiction and Mental Health has concluded: “There is simply not enough evidence available in the mental health field … to ascertain whether a particular individual has an irremediable mental illness.”

After 15 months of studying global evidence, the Council of Canadian Academies came to the same conclusion, as did the Expert Advisory Group on MAID. Both the American Psychiatric Association (APA) and Royal Australian and New Zealand College of Psychiatrists (RANZCP) have also concluded that there’s no evidence to support providing MAID solely for mental illness.

Sign the petition: No to euthanasia for mental illness and incompetent people! (Link)

Gaind explains why safeguards are not effective for people with mental illness:

Those who advocate expanding access to MAID propose mitigating this reality with “safeguards.” This ignores the fact that irremediability is itself the primary safeguard built into the MAID framework, and bypassing it renders all other supposed “safeguards” meaningless.

Because we cannot predict irremediability, there is 100 per cent certainty that MAID will be provided to some people who could recover — there is no safeguard against that. Suggesting otherwise is akin to a society that declines to use the death penalty over concerns of potentially executing the innocent, but then implements the death penalty anyway with false “safeguards” to reassure the public even as the wrongly convicted are executed.

Gaind challenges the Canadian Psychiatric Associations for focusing on opinion and ignoring evidence:

Regrettably, while the APA and RANZCP have provided meaningful evidence-based guidance in their societies’ debates on MAID and mental illness, Canadian psychiatric associations have not. After failing to consult members for two years, the Canadian Psychiatric Association released its position statement in 2020 that “patients with a psychiatric illness … should have available the same options regarding MAID as available to all patients.” Remarkably, the association also said that its statement was “never intended to … examine whether psychiatric conditions are irremediable and if so, how this should be assessed.”

Equally remarkably, the president of the Québec Psychiatric Association (AMPQ) responded to concerns about the lack of supporting evidence by saying in recent Senate hearings: “This is not a data-driven question, this is an ethical question.” That sentiment is reflected in an AMPQ document offering guidance on developing a MAID framework for mental illness.

Gaind continues by presenting his position based on the evidence:

Other evidence highlights the risks of providing access to easy death to suicidal, vulnerable and marginalized people who are not dying but suffering from psychosocial life stress. Even the Office of the United Nations High Commissioner for Human Rights has raised the alarm that Canada’s pending MAID policy will prematurely end vulnerable lives.

These concerns simply serve as icing on the cake to the indisputable, evidence-based reality that there is no predictably irremediable mental illness for which MAID can be provided. And the government’s 24-month sunset clause is as meaningful as a decree telling coronavirus to disappear — non-existent evidence cannot simply be commanded to appear.

Gaind continues with his concerns based on how common mental illness is:

We are poised to provide death for mental illness to potentially suicidal, non-dying marginalized people suffering from life distress who have the potential to recover — all based on less evidence than is required for the approval of any sleeping pill. Given the ubiquity of mental illness, no family needs to look very far to appreciate the implications.

Years ago, I had the pleasure of meeting our prime minister’s mother, Margaret Trudeau, to present her a mental health advocate award from the Ontario Psychiatric Association. I recall her vibrancy as she spoke of her life experiences and graciously mingled with my colleagues and me after dinner. I also recall the poignancy of her descriptions of despair during her periods of deep depression, including hopeless times she wished to die.

Gaind finishes his article by calling for honesty in the debate:

If Canada wants to provide MAID to people who are suffering but whose illness might get better, we should have an honest debate and our MAID framework should reflect that. But if MAID is meant for irremediable conditions, evidence shows it would be a dishonest and hypocritical deception to offer it for mental illness.

Unfortunately, in Canada’s debate about medical assistance in dying, evidence has already been provided a medically assisted death.

More articles on this topic:

• Article: Canadian Psychiatric Association position on euthanasia for psychiatric reasons is an embarrassment (Link).
• Article: Canadian Psychiatric Association approves euthanasia (Link). 
• Article: Is euthanasia psychiatric treatment? (Link).
• Article: Why legalizing medical assistance in dying for people with mental illness is misguided (Link).
• Article: Canada's Justice Minister says that euthanasia may be extended to people with mental illness (Link). 
• Article: Quebec court expands euthanasia by striking the terminal illness requirement. Euthanasia for psychiatric reasons is next (Link).  
• Article: Psychiatrists must prevent suicide, not provide it (Link).
•  Article: Physically healthy depressed man died by euthanasia in BC (Link). 
• Article: Dr Mark Komrad: Why psychiatrists should oppose euthanasia (Link).

Canada's Parliament to debate euthanasia for mental illness and incompetent people.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week I reported that Canada's Senate passed Bill C-7, the bill to expand Canada's euthanasia law, with dangerous amendments that would further expand the law. 

The Senate passed five amendments to Bill C-7. The primary amendments were expanding euthanasia to people with mental illness (with an 18 month reprieve for the federal government to develop rules) and incompetent people who had requested death in their advanced directive.

By passing Bill C-7, on February 17, with amendments, the bill now goes back to parliament for debate on the amendments.

Article: Senate passes Bill C-7 to allow euthanasia for mental illness and incompetent people (Link).

Join more than 52,000 people who have signed the petition: Reject euthanasia Bill C-7 (Link).

You need to contact your member of parliament to reject the Senate amendments and Bill C-7. The link to the list of Members of Parliament:

https://www.ourcommons.ca/Members/en/search

In September 2019, Québec Superior court Justice Christine Baudouin, in Truchon, struck down the requirement that a person's natural death be reasonably foreseeable in Canada's euthanasia law and gave the federal government until March 11, 2020 to amend the law. At that time, Canada was in the middle of a federal election. The government decided not to appeal the decision.

On February 17, Canada's Justice Minister, David Lametti asked the Quebec Superior court for a four month extension to incorporate the court decision into the law. The Quebec court agreed to the four month extension, giving the federal government until July 11, 2020 to extend the euthanasia law.

On February 24, the federal government introduced Bill C-7 in response to the Quebec Superior Court decision Truchon decision. Bill C-7 goes far beyond Truchon. Due to the COVID-19 crisis Bill C-7 was re-introduced on October 5, 2020. Canada's Justice Minister, once again, requested an extension from the Quebec Superior court and it was granted for December 18, 2020. 

In early December, parliament passed Bill C-7, without amendments and sent it to the Senate, but due to time restriction, the Justice Minister asked the Quebec Superior court for a third extension, that was granted, giving the federal government until February 26 to pass Bill C-7.

Justice Minister David Lametti has now asked the Quebec Superior court to for a fourth extension to stay the Truchon decision until March 26.

What is exasperating is the fact that the court imposed deadline should not be a primary concern. Even if the Quebec Superior court does not extend the stay of the Truchon decision, all it means is that the decision comes into effect without the actual law changing. Normally this would be a concern but since Bill C-7 goes far beyond Truchon, it is not an important deadline.

All this has happened without the government first completing its required parliamentary review of the law, a review that was legislated by the original euthanasia law that was passed in 2016. The government has no right expand MAiD without first reviewing the law.

For instance, as bad as Bill C-7 was, the Senate expanded the bill to include people with mental illness (with an 18 month "moratorium" to develop rules) and for incompetent people who request death in their advanced directive.

The mental illness alone amendment seemed like a "set-up" after Justice Minister Lametti, announced on November 24 that, once Bill C-7 passed, he wanted to expand euthanasia to people for mental illness alone.

The Senate had no right to even consider expanding euthanasia to people who request death in their advanced directive since the issue was not even studied by the House of Commons or Senate hearings on Bill C-7. The Senate simply reacted to an emotionally compelling speech by Senator Wallin.

What did  Bill C-7 do before it was amended?

1. Bill C-7 removes the requirement in the law that a person’s natural death be reasonably foreseeable in order to qualify for assisted death. Therefore, people who are not terminally ill can die by euthanasia. The Quebec court decision only required this amendment to the law, but Bill C-7 went further.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by euthanasia.

3. Bill C-7 waives the ten-day waiting period if a person's natural death is deemed to be reasonably foreseeable. Thus a person could request death by euthanasia on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

4. Bill C-7 creates a two track law. A person whose natural death is deemed to be reasonably foreseeable has no waiting period while a person whose natural death is not deemed to be reasonably foreseeable would have a 90 day waiting period before being killed by lethal injection.

5. As stated earlier, Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The euthanasia law permits MAiD for people who are physically or psychologically suffering that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. However, mental illness, which is not defined in the law, is considered a form of psychological suffering.

Bill C-7 went much further than the Quebec Superior Court Truchon  decision and now the Senate has made it worse. 

Join more than 52,000 people who have signed the petition: Reject euthanasia Bill C-7 (Link).

You need to contact your member of parliament to reject the Senate amendments and Bill C-7. The link to the list of Members of Parliament:

https://www.ourcommons.ca/Members/en/search

Media Release: Delta Hospice Society - Layoffs and Eviction.

Members of the media are urged to view the attached video link that explains why the Delta Hospice Society has been forced to issue layoff notices to all clinical staff prior to our role concluding inside our Hospice effective Feb. 25, 2021. 

Link to the Press release (Link). Link to the youtube message: (Link).

The board of DHS deeply regrets being compelled to take this action. Tragically, as the video and the attached background document make clear, we have been left no other choice due to the Fraser Health Authority canceling our service agreement and 35-year lease. Fraser Health is about to evict us and expropriate approximately $15 million of our assets simply because we decline to euthanize our patients at our 10-bed Irene Thomas Hospice in Ladner, B.C.

To be clear, we accept that the provision of MAiD is an elective, legal service across Canada. Nothing in Canadian law, however, requires medically assisted death to be made available everywhere, at all times, to everyone. The Constitution of our private Society and our commitment to palliative care, bars us from offering it. Neither the board of the DHS, nor the vast majority of our patients and members want to change that.

“This is not a debate about MAiD,” says board President Angelina Ireland. “A person who wants MAiD can have it at the hospital right next door to us. This is about the B.C. government destroying a sanctuary for dying patients who want the choice to stay in a palliative care facility where MAiD is not offered. They now find their rights to equal choice being revoked. They are being disenfranchised by the very system they pay for."

Ireland notes the DHS has been so committed to protecting the right to a sanctuary for the dying that it offered to forego $750,000 in public funding last February in order to operate as an authentic palliative care centre. The Fraser Health Authority rejected the proposal without negotiation. Instead, it served DHS with a one-year notice of eviction with the intent to expropriate its assets.

“The Society has done all it can to have discussions with Fraser Health about the conflict with its Constitution. It has done all it can to follow its service agreement and required legislation. Fraser Health has made no attempt to understand the 30-year relationship with the Society, which has always been recognized for its exemplary care,” says founder and former Executive Director Nancy Macey.

Journalists and the Canadian public at large are urged to recognize where that approach has led: working notice slips for dedicated palliative care employees, and the destruction of a sanctuary for the dying. The Society is dedicated to the future of palliative care and is continuing with its supportive care services such as: bereavement counseling, vigils, spiritual care, volunteer coordination, education, social work and the many other ways it provides care directly to the community.

To arrange interviews, please contact:
Angelina Ireland, President Delta Hospice Society Board,
778-512-8088
irelandangelina@gmail.com

Canada's Correctional Investigator calls for a moratorium on MAiD (euthanasia) in prisons.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ivan Zinger

The Annual Report of the Office of the Correctional Investigator is calling on the federal government to enact a moratorium on MAiD (euthanasia) in prisons.

Dr Ivan Zinger, the Correctional Investigator for the federal government outlined his concerns in his annual report concerning the known MAiD deaths in the prison system. The report states:

There are three known cases of MAiD in federal corrections, two carried out in the community, and each raises fundamental questions around consent, choice, and dignity. In the two cases reviewed in the reporting period, my Office found a series of errors, omissions, inaccuracies, delays and misapplications of law and policy.

In reference to the first case, the report states:

As I have discussed numerous times before, questions of autonomy and free choice in the context of incarceration are difficult to square. In this case, the “wishes of competent patients” must be seen in context of the seemingly inflexible system of sentence administration and lack of viable release alternatives for non-violent offenders, including medical parole. It would seem that this man “chose” MAiD not because that was his “wish,” but rather because every other option had been denied, extinguished or not even contemplated. This is a practical demonstration of how individual choice and autonomy, even consent, work in corrections.

The report states that the second case concerned both mental and physical illness issues:

The other case of MAiD investigated this past year revolves on the intersection of mental and physical illness and the capacity to provide informed and voluntary consent for assisted death. In that case, the inmate was suicidal and suffering from mental illness. He was terminally ill and a designated Dangerous Offender. He would threaten suicide if he was not provided MAiD. His prospects for release, even considering the advanced stages of his illness, were minimal. 

Once again, these are circumstances that would never be confronted by free citizens in the community when choosing to end life. Hopelessness, despair, lack of choice and alternatives, conditions imposed by the fact and consequence of incarceration, are issues magnified in the correctional setting. As the Government considers extending MAiD beyond physical illness to intolerable psychic pain, there must be careful deliberation of the mental health profile of Canada’s prison population.

The report challenges the status quo:

My review of these cases suggests that the decision to extend MAiD to federally sentenced individuals was made without adequate deliberation by the legislature. ...two aspects of how MAiD was legislated and later applied in the correctional context seem to make little sense from an accountability and public transparency point of view. 

The first is the decision to exempt CSC from reviewing or investigating MAiD deaths. This exemption is untenable given that CSC is, de-facto, the state agent that enables or facilitates assisted death to people under federal sentence. There just has to be some degree of internal scrutiny, transparency and accountability that goes with the exercise of such ultimate and extreme expressions of state power, even if MAiD is provided for compassionate reasons. By removing the legislative requirement for CSC to investigate, this measure also removes the obligation for the Service to provide notice “forthwith” of an inmate death involving MAiD to my Office. In effect, there is no legal or administrative mechanism for ensuring accountability or transparency for MAiD in federal corrections. Surely, this exemption was an oversight that demands correction. 

Secondly, that MAiD is allowed to be carried out in a penitentiary setting, under so-called “exceptional circumstances,” seems inconsistent with the legislation’s intent to provide Canadians with a legal option to end their life with dignity at a time and place of their choosing. It is simply not possible or desirable to provide or meet those intents in context of incarceration.

Dr Zinger is right. The government simply reacted to a request for MAiD by a prisoner by approving the death. 

Dr Zinger may not be aware that there is no effective oversight of Canada's MAiD (euthanasia) law throughout Canada. Zinger questions how there can be no legal or administrative mechanism for ensuring accountability. 

I would suggest that a similar reality exists for people with disabilities and elderly people who live in institutions. Similar to the prison population, these people lack the same level of freedom and autonomy as the rest of the population.

All Canadian MAiD deaths are approved by two doctors or nurse practitioners and then, after the death, are reported by the doctor or nurse practitioner who carried out the death. Even in circumstances, such as the Sorenson case, where there were euthanasia assessments stating that Jack didn't qualify for MAiD and other assessments saying he did. The law is only concerned that two doctors or nurse practitioner approved his death. There is no oversight to determine why some assessments said he didn't qualify and some assessments said he did.

Dr Zinger has made some important points. He questions the oversight of the law, as it pertains to the prison population while emphasizing that prisoners do not share the level of freedom and autonomy as the rest of the population. 

Jack Sorenson RIP.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Katherine Sorenson

Taryn Grant reported on October 6 for CBC news that Jack Sorenson, Katherine's husband, died on Saturday, after the Nova Scotia Court of Appeal decided that they had no role in reviewing euthanasia assessments, even if a euthanasia assessment was wrong.

Katherine believed that her husband of 48 years, who was approved for (MAiD) euthanasia even though he received conflicting assessments, is not dying, has questionable capacity, and is delusional about his medical condition.

Katherine's lawyer, Hugh Scher, sought an injunction to prevent the euthanasia death. The affidavit's state that Jack was not terminally ill, that he had questionable capacity to decide and he had "delusional" beliefs concerning his medical condition.

Grant interviewed Katherine for the CBC news article. Katherine stated:

She learned of his death when the funeral home called to tell her they had his body.

She said that after months of separation, his passing was not a shock and she was doing "pretty well, considering."

"I've had a wonderful life with Jack. There have been, as with any marriage, lots of varying opinions between the spouses and I thought we did a pretty good job of reconciling two pretty opposite views," she said, referring to their difference of religion. She is a practising Christian and he had been an atheist since his early adulthood.

When communicating with Katherine, it was sad to learn that she was not informed about her husband's death until after the funeral home received him.

Katherine told CBC news that Jack probably wouldn't like that she requested that donations go to the Euthanasia Prevention Coalition (EPC), but EPC covered Katherine's legal expenses.

Donate to the Euthanasia Prevention Coalition (Link) by: 

Paypal (Link),
Donate by credit card by calling the EPC office at: 1-877-439-3348, or
Send a cheque to the Euthanasia Prevention Coalition, Box 25033, London ON., N6C 6A8.

More information on this story.

• Court of Appeal decides that the court has no role to review euthanasia (MAiD) assessments even when assessments differ (Link).
• Nova Scotia court decides that a man who is not dying and may be delusional can die by euthanasia (Link). 
• Woman goes to court to prevent her husband's assisted death (Link). 
• Nova Scotia woman seeks to prevent her husband's death by euthanasia (Link).

Court of Appeal decides that the court has no role to review euthanasia (MAiD) assessments even when assessments differ.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

When Canada's parliament passed Bill C-14 legalizing euthanasia (MAiD) the legislation required two doctors or nurse practitioners to agree that a person qualified for death by lethal injection. As long as two euthanasia assessments approve death, it doesn't matter if several euthanasia assessments determine that a person doesn't qualify under the law.

Katherine's Sorenson believes that her husband of 48 years, who is approved for (MAiD) euthanasia even though he received conflicting assessments, is not dying, has questionable capacity, and is delusional about his medical condition.

Katherine's lawyer, Hugh Scher, sought an injunction to prevent the euthanasia death based on an assessment by a physician, an affidavit from a physician who has known her husband for years, and Katherine's affidavit. These affidavit's state that her husband is not terminally ill, that he has questionable capacity to decide and he has "delusional" beliefs concerning his medical condition.

Today, the Nova Scotia Court of Appeal decided that:

there is no role for courts in the review of MAiD eligibility assessments. ... Parliament considered, and rejected a role for judges in the pre-approval or review of MAiD eligibility assessments. Parliament made clear that the role rests with approved healthcare assessors.

In other words, if two doctors or nurse practitioners approve a death by lethal injection, that it doesn't matter that other doctors or nurse practitioners assessments disagree that the person qualifies to be killed under the law.

Further to that, if a euthanasia assessment is false, such as, if a MAiD assessor accepting a person's delusional beliefs about their medical condition, that there is no legal way to challenge the assessment, even if the challenger has been married to that person for 48 years.

Katherine Sorenson

Katherine stated:

I am committed to seeing this matter through for the benefit and protection of my husband of 48 years and for the benefit of others across Canada in the public interest, who may lack capacity and who otherwise will remain unprotected by a MAID law that clearly lacks adequate safeguards to protect those who are vulnerable.

Katherine's lawyer Hugh Scher noted that; 

Doctor shopping is a serious concern that must be addressed. Court or tribunal oversight are essential in those rare cases where there are multiple conflicting medical reports over the core issue of capacity which is an essential condition of eligibility for MAID.

Hugh Scher

Hugh Scher also noted that: 

The federal MAID law requires application in accord with provincial laws including those regarding consent and capacity.  Where capacity is at issue provincial consent and capacity laws across Canada call on courts or tribunals to resolve conflicts and disputes over capacity. 

It would be criminal to subject terminal treatment decisions under MAID to less protection than any other treatment decision. 

Toronto lawyer John Campion stated that: 

A more nuanced test for injunctions should be developed for end of life cases as the present tests of serious issue to be tried, irreparable harm and balance of convenience are inadequate and/or obviously determined in favour of the applicant (wife in this case) when the result is so final - death. The process should identify the single issue- in this case capacity - and design a process that brings the central concern into timely focus with evidence and argument as part of the balance of convenience... 

Lawyer Kate Naugler noted that: 

The dignity and autonomy of all Canadians is threatened where a person who lacks capacity is permitted to access MAID.

Katherine Sorenson and her legal team have not yet decided their next course of action.

The Euthanasia Prevention Coalition needs your help. EPC is paying the legal bills, but in turn, we need your financial support.

Donate to the Euthanasia Prevention Coalition (Link) by:

Paypal (Link),
Donate by credit card by calling the EPC office at: 1-877-439-3348, or
Send a cheque to the Euthanasia Prevention Coalition, Box 25033, London ON., N6C 6A8.

More information on this story.

• Nova Scotia court decides that a man who is not dying and may be delusional can die by euthanasia (Link). 
• Woman goes to court to prevent her husband's assisted death (Link). 
• Nova Scotia woman seeks to prevent her husband's death by euthanasia (Link).