We mourn the death of Vincent Lambert, while thankful that an agreement will protect the life of Hannah Cement.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Vincent Lambert with his mother.

We mourn the death of Vincent Lambert, a cognitively disabled man who died by dehydration after France's highest court ordered that he be denied food and fluid, that they defined as medical treatment.

Our online petition pleading that President Macron save his life received more than 139,000 signatures.

While the death of Vincent Lambert is a tragic case of disability discrimination, Hannah Cement, a woman in Ottawa, will live until her natural death.

In early May, 2019, the United Nations Committee on the Rights of People with Disabilities intervened in the Lambert case stating that causing Lambert's death by dehydration contravened his rights as a person with disabilities. 

Section 25f of the United Nations Convention on the Rights of Persons with Disabilities requires nations to:

25(f) Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability.

The decision of the highest court of appeal in France, to withhold food and fluid from Lambert, was a death sentence and a denial his human rights.

Lambert was a cognitively disabled man who was not otherwise dying or nearing death. To directly and intentionally cause his death by withholding fluids is euthanasia by dehydration. Lambert's fluids were withheld for the purpose of causing his death, rather than allowing a natural from his medical condition.

Today EPC was informed that Hugh Scher, the lawyer for the Cement family, achieved a negotiated agreement whereby Hannah will continue to be fed and hydrated and receive basic medical care until she dies a natural death.

Hannah Cement is a 62 year-old woman with Down Syndrome and dementia, who is a life-long member of an Orthodox Jewish family and community. The substitute decision makers for Hannah, her family, refused to consent to a course of treatment that constituted the withdrawal of all treatment and care, including food and fluids and providing only comfort care.

The Euthanasia Prevention Coalition (EPC) was granted limited intervention standing, in the court, based on our concerns related to the definition of food and fluid as medical treatment.

In late March, 2019, the Consent and Capacity Board (medical decision making tribunal) made a terrible decision in the Cement case, essentially ordering the withdrawal of all medical treatment from Hannah. This would have led to Hannah dying a similar death as Vincent Lambert.

The family appealed the decision to the Ontario Court of Appeal and the Euthanasia Prevention Coalition, once again, sought intervention standing in the case.

The news that the doctor, the hospital and the Cement family reached an agreement to assure that Hannah will continue to receive basic medical care until she dies a natural death is an incredible victory.

While we mourn the death of Vincent Lambert, we are very thankful for the legal agreement to enable Hannah Cement to continue living until she dies a natural death.

Terrible decision by Ontario court in food and fluids case.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Several weeks ago the Euthanasia Prevention Coalition announced our intention to intervene in the Cement case, which was being heard by the Ontario Consent and Capacity Board. The Consent and Capacity Board is a judicial body that was established under the Ontario Health Care Consent Act to determine the course of treatment when a substitute decision maker disagrees with a proposed course of treatment that is being proposed by a hospital/doctors.

The Cement case concerns Hannah Cement, a 62 year-old woman with Down Syndrome and dementia, who is a life-long member of an Orthodox Jewish community and family. The substitute decision makers for Hannah, her family, refused to consent to a course of treatment that was comprised of the withdrawal of all treatment and care, including food and fluids and providing only comfort care.
 
John Campion, was the lawyer who represented the Euthanasia Prevention Coalition. EPC was granted a limited intervention standing based on our concerns related to the physicians defining food and fluid as medical treatment.

Donate toward the cost of the Euthanasia Prevention Coalition court intervention. (Link).

The substitute decision makers were willing to negotiate the level of care for Hannah but they were not willing to consent to the withdrawal of nutrition, hydration or ventilation.

The decision by Lora Patton, the Judge in this case, stating the following:

• No further antibiotics will be offered in the event of and for the treatment of aspirations although these may be offered as required for comfort measures to relieve discomfort; 
• No dialysis will be offered;
•  No vasopressors will be offered; 
• No CPR and no mechanical ventilation will be offered; 
• Feeding will cease if any of the above treatments are required but for the operation of this order. 
• All investigations and other interventions will cease. 
• Comfort measures consisting of the administration of medications to ease suffering, pain, shortness of breath, anxiety, nausea, or any other symptoms, including bacterial infections, will be provided.

Patton ordered that the decision must be implemented by April 5, 2019.

This decision undermines the clear and unified wishes of the substitute decision makers (her family), it ignores the position of her life-long faith tradition, it will result in her dying by dehydration, and it is based on a discriminatory premise that Hannah's clear wishes cannot be ascertained because she has Down Syndrome.

I hope that this decision will be appealed and I hope that the Euthanasia Prevention Coalition will once again be given intervention standing in this case to argue why nutrition and hydration does not constitute a form of medical treatment, but rather normal care.

The significance of the Cement case.

This is a precedent setting case in Canada concerning the definition and provision of assisted feeding.

In 2014, the Euthanasia Prevention Coalition intervened in the Bentley spoon feeding case. In February 2015, the BC Supreme court, in the Bentley case, decided that:

Oral nutrition – like spoon feeding – should not be considered health care or medical treatment, but rather seen as basic personal care and support.

The British Columbia Court of Appeal decided not to hear an appeal of the Bentley decision establishing the precedent that spoon feeding is not medical treatment.
 
If food and fluids are defined as medical treatment, then food and fluids can be withdrawn in the same manner as withdrawing or withholding any type of medical treatment.

For Hannah Cement, the withdrawal of fluids will cause her to die by dehydration.