Cheryl Lowen and Alan Nichols died by (MAiD) euthanasia, even though they did not qualify to be killed.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kristen Holliday wrote a ground breaking article that was published in the Vancouver Sun on December 11. Holliday examines how Bill C-7, the bill to expand euthanasia in Canada, creates a situation where it is easier to die by MAiD (euthanasia) rather than receive effective medical treatment. Holliday examines several stories of deaths that were "outside" of the law.

Holliday tells us about the euthanasia death of Cheryl Lowen, who died in December 2019 by MAiD. Cheryl did not have terminal condition. Ray Chwartkowski, Lowen's brother, comments on the death of his sister. Holliday reports:

The last time Ray Chwartkowski saw his sister, Cheryl Lowen, was two days before she died in December, 2019.

On that day, he was shocked to learn that her death was scheduled, as she had been approved for medical assistance in dying, often referred to as MAID.

“She never had a diagnosis for any terminal illness,” he said. “I consider her death a total tragedy.”
Chwartkowski is convinced that his sister did not qualify for MAiD:

He said Lowen, who was 50 when she died, had a difficult childhood and struggled with physical and mental health problems throughout her life. In mid-2019, she was diagnosed with median arcuate ligament syndrome, a chronic illness that causes severe abdominal pain.

Chwartkowski said he has compassion for her pain but is certain she didn’t meet MAID’s criteria of a reasonably foreseeable death. He also questions her ability to make a well-informed decision after receiving the difficult diagnosis.

“From what I understood, she was refusing to eat, she was refusing immediate medical attention,” said Chwartkowski, adding that she also refused surgery to treat her condition.

Chwartkowski believes his sister, confronted with a chronic medical condition after a life filled with difficulty and mental health struggles, simply gave up hope.

“It’s like she just had so much heartache,” he said. “It just doesn’t make sense. She had so much going for her.”

Chwartkowski said, to his knowledge, Lowen applied for MAID twice and was denied the first time.

Alan (center) in July 2019

Holliday also tells us the story of Alan Nichols, who died by MAiD in July 2019, even though he was not physically ill, but rather living with chronic depression. Holliday interviews Gary Nichols, Alan's brother:

Gary said Alan was a healthy child and an excellent hockey goalie until he was diagnosed with a brain tumour at the age of 12. After two brain surgeries, he suffered from hearing loss, loss of co-ordination, and the occasional seizure. He also suffered from severe depression, said Gary.

“After a while, he really started to withdraw from people. He’d go through cycles, wanting to die. But then, he would change his mind, find something good.”

Gary moved to Edmonton in 2011, where he works as an accountant, while Alan remained in their hometown of Chilliwack.

In 2019, when Alan was admitted to a Chilliwack hospital and his family was notified that he was scheduled to die by MAID, Gary said he was appalled. He received the news four days before his brother’s death.

He believes Alan should not have been approved under current legislation.

“He didn’t have a terminal illness, his natural death was not foreseen,” Gary said.

Gary is convinced that if Alan received the proper care that he would be alive today.

“Of course, we would have tried to stop it because we know that probably in a week or two he’s going to change his mind,” Gary said. “Overall, they don’t know how to handle mental illness. It’s quite obvious. There’s such a high percentage of suicide with mental illness.”

Krista Carr

Holliday interviewed Krista Carr, a leader with the disability organization, Inclusion Canada, who are concerned about how euthanasia has been implemented:

Carr said she receives calls from Canadians with physical and mental disabilities who say health providers have suggested MAID is now available to them.

Carr said advocates for MAID stress the importance of personal autonomy and the right to choose. However, people living in poverty and social isolation, and those without access to treatment, sometimes feel they don’t have a real choice, she said.

“They can’t get assistance in living, but they can get quick assistance in dying,” Carr said.

The question is how many stories, like Alan Nichols and Cheryl Lowen exist? How many lives have been ended by euthanasia (MAiD) rather than providing the necessary care to enable that person to live? 

The government should have tried to assess how many abuses of the current MAiD law existed before expanding the law. This could have been one of the topics examined in the Five-year review of the law that was supposed to begin in June 2020.

If you have a story, please contact info@epcc.ca

We want to help you find justice.

Advocates call for Disability-Rights Based Appeal of the Québec Superior Court's MAiD Decision in Truchon & Gladu.

 

October 4, 2019

Hon. David Lametti, MP. Attorney General

Dear Minister Lametti,

Re: Advocates Call for Disability-Rights Based Appeal of the Quebec Superior Court’s Decision in Truchon & Gladu

We, the undersigned members and supporters of the Canadian disability community, are deeply troubled by the Quebec Superior Court’s decision of Truchon c. Procureur général du Canada. As you are aware, the decision has struck down the “reasonable foreseeability of natural death” criterion of Canada’s medical assistance in dying legislation. As Attorney General of Canada, we urge you to file an appeal of the decision immediately.

We find this decision to be concerning for the following three reasons:

1) It fails to respect Parliament’s authority to balance the interests of individuals with the interests of society[1], effectively limiting Parliament’s capacity to pursue social targets such as substantive equality and inclusion.

Justice Christine Baudoin arrives at the conclusion that the end-of-life criterion violates section 7 and section 15 of the Charter by rejecting a key objective of Parliament, erasing any need for a section 1 analysis of reasonable limits. Parliament outlined the following societal objective in the preamble of the legislation:

It is important to affirm the inherent and equal value of every person’s life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled.

In fully rejecting this objective, the court has limited the authority of Parliament to govern toward an inclusive and equitable Canada. This is a dangerous precedent. Parliament intentionally included the end of life criterion in the legislation as a way of achieving the above objective. Is it reasonable for Parliament to limit the individual interests of Truchon and Gladu (autonomy) in order to promote the interests of society (equality and inclusion)? Without an appeal, we may never know. The Supreme Court must weigh in on this flawed analysis.

2) The decision will entrench stereotypes and exacerbate stigma for Canadians with disabilities, contributing to the adversity and oppression experienced by this vulnerable group.

Without the equalizing effect of the end-of-life criterion, which guarantees that the common thread between all persons who access an assisted death in Canada is that they are all dying, persons with disabilities will be able to gain access ultimately because they have a disability. A worse stereotype couldn’t be institutionalized in law - that disability-related suffering, largely caused by lack of support and inequality, justifies the termination of a person’s life.

Canada must avoid sending a message that having a disability is a fate worse than death. Canadians with disabilities are already bombarded daily with reminders that they are unwelcome and under-valued. We must not compound this harm by entrenching in law the message that others who share their condition will receive our full support if they choose to die prematurely. This message fits too neatly into the stereotype that a life featuring disability is a bad life, full only of suffering and pity. Such a narrative already exists. Canada must appeal the decision to prevent additional stereotyping and stigma, and to substantively protect the section 15 Charter rights of persons with disabilities.

3) Without the end-of-life criterion in place, Canada’s medical assistance in dying legislation will further violate article 10 of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD).

Article 10 of the CRPD reads as follows:

States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others.

By offering medical assistance in dying to persons with disabilities on the basis of disability, Canada would be further violating international law. If every Canadian who suffers cannot access a medically assisted death, and yet a Canadian who suffers and has a degenerative disability can, it is precisely their disability status that sets them apart.

Canada is already not taking necessary measures to ensure the effective enjoyment of life by persons with disabilities on an equal basis with others. There is case after case of Canadians whose medical and support needs are not being met, causing them to consider, if not seek out, death. [2]

Canada’s medical assistance in dying regime already concerns the UN’s Special Rapporteur on the rights of persons with disabilities, Catalina Devandas-Aguilar, who shared at the conclusion of her study visit to Canada that she is “extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective” and this is before the end of life criterion was struck down.

Minister Lametti, as Attorney General of Canada, we urge you to appeal this decision up through to the Supreme Court. Not to do so, we believe would be a failure on the part of your government to defend persons with disabilities from significant and tangible harm. After extensive consultation by Parliamentary Committees and public debate, your government crafted this legislation intentionally and purposefully. We trust that as Attorney General you will take the steps needed for its vigorous defence. Canadians’ human rights are at stake.

Link to the letter with signatures (Link).

[1] https://www.justice.gc.ca/eng/rp-pr/cp-pm/just/06.html

[2] Think of Sean Tagert, Archie Rolland, Natalie Jarvis, and Arleen Reinsborough as examples. Read more here:

https://www.cbc.ca/news/canada/british-columbia/als-bc-man-medically-assisted-death-1.5244731

https://montrealgazette.com/news/local-news/saying-goodbye-to-archie-rolland

https://www.cbc.ca/news/canada/nova-scotia/lung-transplants-atlantic-canada-toronto-financial-cost-1.5047818

https://www.thestar.com/news/canada/2019/01/20/hamilton-senior-in-unbearable-pain-wants-assisted-dying-to-save-her-from-nursing-home.html

Canadian man wants assisted life not assisted death.

Sign the petition: I support Roger Foley's plea assisted life not assisted death (Link).

Roger Foley

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

CTV News reported that Roger Foley, who lives with cerebellar ataxia, a degenerative neurological condition, has launched a lawsuit naming the London Health Sciences Centre and the Southwest Regional LHIN, stating that they are offering him assisted death (MAiD) but they are not willing to provide him with an assisted life.

CTV News reported Foley as stating:

a government-selected home care provider had previously left him in ill health with injuries and food poisoning. Unwilling to continue living at home with the help of that home care provider, and eager to leave the London hospital where he’s been cloistered for two years, Foley is suing the hospital, several health agencies and the attorneys general of Ontario and Canada in the hopes of being given the opportunity to set up a health care team to help him live at home again -- a request he claims he has previously been denied.

“I have no desire to take up a valuable hospital bed,” Foley explained. “But at this point, it’s my only option.”

Foley has been offered euthanasia (MAiD), but Foley does not want to die - he simply wants to live at home. CTV News reported:

“I have been given the wrong medications, I have been provided food where I got food poisoning, I’ve had workers fall asleep in my living room, burners and appliances constantly left on, a fire, and I have been injured during exercises and transfers, When I report(ed) these things to the agency, I would not get a response.” 

“Unfortunately, the Ontario health-care system and the Ontario home-care system has broken my spirit and sent my life into a void of bureaucracy accompanied by a lack of accountability and oversight,”  

Foley has asked to manage his own home care team. Doing that is called “self-directed care,” and Ontario recently created an agency called Self-Directed Personal Support Services Ontario (SDPSSO) to help co-ordinate such activities. 

“I need self-directed funding in order to return to my home, I need to be able to hire my own workers to build my (home) care to work with me”

Foley's lawyer, Ken Berger, doesn't understand why they have not offered a solution for Foley. Berger stated:

the only two options offered to him have been a “forced discharge” from the hospital “to work with contracted agencies that have failed him” or medically assisted death. Refusing to leave the hospital and unwilling to die by a doctor’s hand, Foley claims he has been threatened with a $1,800 per day hospital bill, which is roughly the non-OHIP daily rate for a hospital stay. 

Foley’s statement of claim also alleges that his Charter rights “to life, liberty and security of the person” were violated when he was offered the above options without being given the chance to create a “safe and available self-directed assisted care option that would substantially alleviate his irremediable and intolerable suffering.”

Sign the petition: I support Roger Foley's plea assisted life not assisted death (Link).

 The Euthanasia Prevention Coalition supports Foley's case and all others who require assisted living not "assisted death." We believe in caring for people, not killing.

Vulnerable Persons Standard - protecting people from assisted death.

The Council of Canadians with Disabilities and the Canadian Association for Community Living, in conjunction with many groups and advisors, have launched the Vulnerable Persons Standard as a way to protect Canadians who are vulnerable and that they not die an assisted death based on unresolved physical, psychological or social requirements or based on discrimination.

Link to the Vulnerable Persons Standard  website.

The Vulnerable Persons Standard

The Vulnerable Persons Standard is a series of evidence-based safeguards intended to protect the lives of Canadians.

These safeguards will help to ensure that Canadians requesting assistance from physicians to end their life can do so without jeopardizing the lives of vulnerable persons who may be subject to coercion and abuse.

We are calling on all members of Parliament to ensure that federal legislation regulating physician-assisted death incorporate these safeguards. 

Why is vulnerability important?

Vulnerable persons who request physician-assisted dying may be motivated by a range of factors unrelated to their medical condition or prognosis. These factors are important and can often be addressed with adequate and appropriate care. As a society, we have both moral and legal obligations to address the needs of vulnerable persons. Access to physician-assisted dying cannot be allowed to diminish or undermine these important obligations.

Unmet needs should not be a cause of death

Extensive research shows that a wide range of factors related to social, financial, psychological and spiritual suffering can lead patients to request physician-assisted death.

The U.S. National Cancer Institute describes such requests as “a sign that unmet needs have built to an intolerable level.”

Vulnerability has many causes

There are many important factors which contribute to a person’s vulnerability and which can often be alleviated by adequate and appropriate care. These can include:

• Psychosocial factors and mental health issues causing distorted insight and judgment. These may include depression, hopelessness, loneliness, fear, grief, shame; coercion by others; and the psychodynamics of the physician-patient relationship.

• Lack of access to disability-related supports that can improve a person’s resilience and ability to live with greater dignity, comfort and self-determination.

• Insufficient or inaccessible palliative care options which can alleviate pain and suffering and improve well-being of patients and their loved ones.

• Poverty and unemployment which can cause significant mental anguish, social stigma and a sense of hopelessness.

• On-going physical, mental or emotional violence.

• The likelihood or experience of abuse and fraud, especially affecting elders and people with disabilities.

The Vulnerable Persons Standard introduces a series of safeguards that are designed to identify and address these and other forms of vulnerability. In this way, we can ensure that those accessing physician-assisted death will do so without jeopardizing the lives of Canadians who may be subject to coercion and abuse.

Who is at risk?

Canadians living with severe disabilities, mental illness and dementia, as well as seniors living in long term care may be more vulnerable to stigma, abuse, coercion, isolation and depression. Consequently, they may be more inclined to suicidal ideation, intent and behaviour. The psycho-social needs of vulnerable Canadians can be met by providing appropriate care and support, significantly reducing mental anguish as well as a person’s motivation to request physician-assisted death.

Link to the Vulnerable Persons Standard website.

Recommendations Contained in Report of Joint Committee on Physician-Assisted Dying Pose Significant Risk to Vulnerable Canadians

For Immediate Release - February 25, 2016 - Toronto

The Council of Canadians with Disabilities (CCD) and the Canadian Association for Community Living (CACL) are extremely dismayed that the recommendations contained in the report released today by Parliament’s Special Joint Committee on Physician-Assisted Dying will jeopardize the lives of vulnerable Canadians. They do not follow the Supreme Court’s call for “stringent limits that are scrupulously monitored and enforced.”

“We are concerned that the Committee’s permissive approach would put vulnerable people at risk. Their recommendations exceed guidance from the Supreme Court, as well as UN Conventions to which Canada is a signatory” states Tony Dolan, CCD Chair. 

“We appreciate that members of the Joint Committee were alert to concerns about vulnerable persons,” says Michael Bach, Executive Vice-President of the Canadian Association for Community Living. “Nevertheless, we are alarmed by the committee’s conclusions. We believe the recommendations contained in the Committee Report fall well short of the minimum safeguards we believe are essential to protecting vulnerable Canadians. Clearly there is a lot of work still to be done.”

Together CACL and CCD represent the concerns of Canadians with disabilities. Both organizations believe that their members will be harmed if the government adopts the committee’s recommendations. They have four principle concerns.

First, both organizations believe the committee has erred by not accepting the trial judge’s definition of “grievous and irremediable medical conditions” to exclude psychosocial suffering as an eligible condition, and meaning an advanced state of weakening capacities with no chance of improvement.

Second, the Committee suggests that concerns about vulnerability can be addressed within the context of physician assessments of decision making capacity. The evidence does not support this claim. Physicians are not generally trained or have expertise in the kinds of vulnerabilities that are known to motivate requests for assisted death. For example, a survey of U.S. physicians found that only 2% had training, experience or expertise in identifying signs of elder abuse in their patients, despite this growing demographic. “The Committee’s recommendation, which instructs decision makers to pay attention to vulnerability does nothing to assuage our concerns,” states Rhonda Wiebe, Co-Chairperson of CCD’s Ending of Life Ethics Committee.

Third, the Committee recommends allowing for advance directives. This is not consistent with the Supreme Court decision which clearly stated that a person has to be capable in the actual circumstances of taking the intervention intended to cause death. Advance directives would empower substitute decision makers to determine when someone should die. This should be explicitly prohibited in federal legislation. The risks to the most vulnerable in society are obvious.

Fourth, the Committee rejected proposals that requests be authorized through an independent prior review, instead relying on two physicians to make the assessment and authorize the intervention to terminate a person’s life. These are fundamentally irreconcilable roles, and combining them exposes physicians and patients to conflicts of interest and increases risk of abuse. A check and balance of prior review is essential.

CCD and CACL will be urging the government to adopt a stronger system of safeguards, and to adopt a clear standard for protecting vulnerable persons. Canadians requesting assistance from physicians to end their life should be able to do so without jeopardizing the lives of vulnerable persons who may be subject to coercion, inducement and abuse.