Brampton woman declared brain dead. But is she dead?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Taquisha's daughter holding her picture.

Taquisha McKitty (27) of Brampton Ontario was declared brain dead on September 20 after having a cardiac arrest on September 14 related to a drug overdose. Her parents immediately sought a court injunction to prevent the William Osler Health System in Brampton from removing her life-support.

On September 28 Ontario Superior Court Justice Lucille Shaw granted an injunction in order to allow Taquisha to be evaluated by another doctor.

Watch the City TV news clip.

Stanley Stewart, Taquisha's father, told CP 24 news, after being granted an injunction, that:

“If you are there with her and you touch her and you grab her feet, she will pull her feet from you. If you tickle her she will move her feet. In one instance one of her cousins was squeezing her hand and asked her to show her thumb and she moved her thumb,” 

“We know for a fact that she is alive because if she was dead and her brain was dead there is no way that a week-and-a-half later she would still be moving. If you are brain dead then no parts should be moving.”

Dr Paul Byrne, a retired American expert on brain death criteria told CP 24 news:

“What’s going on here is the young lady is living,”

“A declaration by a doctor does not make someone dead. There is clearly a difference between being alive and being dead and she is alive. Her heart beats, she has circulation, she moves her legs and she responds to the family.”

Byrne told CP 24 that it appears that the hospital rushed to declare Taquisha as brain dead because she had signed her organ donor card.

The injunction will remain in effect until the family’s next court date on Oct. 17 or 18.

This is not the first time that the William Osler Health System in Brampton is embroiled in a controversial withdrawal of care case. In August 2010 Joshua Myandi, a pastor of a small Church, was dehydrated to death after a controversial capacity board hearing.

A GoFundMe account to help with legal costs has been set up.

Killing the vulnerable by dehydration.

Recently an Italian newspaper, Avvenire, interviewed bioethicist Wesley Smith about the deaths of Terri Schiavo and Eluana Englaro,. Schiavo and Englaro had similar cognitive disabilities and both of them were directly and intentionally dehydrated to death.

Last fall, Canada had a similar case when Pastor Joshua Mayandi, who had a cognitive disability, but who was not otherwise dying, was dehydrated to death.

The comments by Wesley Smith were particularly insightful and worth reading. The english translation is as follows:

What is the importance of cases like Eluana and Terri Schiavo, what is the public's reaction to them?

The country (USA) is generally unaware of the Eluana Englaro case. Ever since the Terri Schiavo media circus, I think that the attention to these issues has waned, especially if they are overseas stories --perhaps because the media think the issue has been settled.

From a legal point of view, what are the repercussions of the Schiavo case in the United States?

After Terri's death, there have been a few attempts to make it more difficult to dehydrate people with cognitive disabilities. But politicians were scared off by the media outcry against Terri's family and the "religious right", ignoring the fact that disability rights activists were also part of the movement to save her life.

The issue of artificial nutrition as a medical treatment is of very topical interest in Italy. What do American doctors think about it?

I don't think that doctors behaved differently after the Terri Schiavo case. Food and water are pulled almost as a matter of routine. Most doctors think of it as just part of the practice of medicine. It is only when families disagree that these cases go to court or make news.

What are the consequences of these definitions?

Because the tube requires a minor surgical procedure and the sustenance is specially prepared to have a proper balance of nutrients, in the United States it is defined as a medical treatment. But if it means that it can be refused as you can refuse an aspirin, then there are ethical problems, because refusing food and water will have only one possible outcome: death. So I think artificial nutrition and hydration should be in a category of its own and not so easily withheld or withdrawn.

Society needs to protect vulnerable people by recognizing that the provision of hydration and nutrition, for people who are not otherwise dying, is very different than other cases of withholding or withdrawing medical treatment.

Remains found in hospital graveyard in Austria, likely victims of the euthanasia program

An article written by Kate Connolly and published in the Guardian newspaper in the UK on January 4, 2011; explains that a mass grave was found by an Austrian hospital which is likely where the victims of euthanasia were buried.

The Tyrol Psychiatric Institute has recently uncovered records and a mass grave that indicates that approximately 220 people were killed by euthanasia between 1942 - 1945 at this institution in Austria.

It is significant that Oliver Seifert, an historian, told a press conference that many questions remained unanswered. He article reported:

"At this stage we can't say that all 220 people were victims of the Nazi euthanasia programme but one of the central questions we will be looking into is how they died," he said.

He added that his discovery of the documents, during a reorganisation of the hospital archives, showed the death rate of patients at Hall went up considerably towards the end of the war, despite the fact that the institution was not officially part of the Nazis' euthanasia programme, under which tens of thousands of people with disabilities were killed. The graves may throw light on the way in which euthanasia as a policy was decentralised and, even without orders from on high, became systematic in many psychiatric institutions across the Third Reich whose head doctors bought into the Nazi belief that people with mental disorders were unworthy of life.

Even though this institution was not part of the T4 euthanasia programme, that in fact doctors and possibly administrators took it upon themselves to kill people with disabilities.

People say, don't bring up the Nazi doctors, they were forced to kill people by a criminal regime.

The fact is that the doctors at this institution and many other institutions were not forced to kill people, but chose to do it because they believed that these people were "better off dead."

The article continued by quoting Seifert. It stated:

"We know that murder was actively carried out at other psychiatric institutions, by overdosing patients, neglect or undernourishment," Seifert said.

Until now there had been no official documentation supporting the idea that patients at Hall, which still operates as a psychiatric institution, had been murdered, although at least 360 patients from Hall are believed to have been taken to other institutions to be killed.

In other words, directly and intentionally killing people by neglect (abuse) or undernourishment was an accepted method to kill people within the Nazi regime. Now we do the same but we call it withdrawing medical treatment. Consider the cases of Terri Schiavo or Pastor Joshua Mayundi.

The article concluded by explaining that:

A commission has been given two years to investigate. Excavation of the graves is to start in March, by which time the area's snow should have melted.

Scientists will study each of the bodies in an attempt to ascertain their identities and causes of death.

The hospital launched a global appeal for those who believe their relatives might be among the victims to contact them. It also called for witnesses to come forward with any information that might help.

"Every memory has the potential to help us in researching the history of this cemetery," a spokesman said.

Many people will tell you that society wouldn't do these horrific crimes today. There is only one way to protect people from similar crimes and that is by maintaining a social and legal prohibition on euthanasia and assisted suicide.

I must admit that today the euthanasia lobby is more sophisticated. They use the illusion of choice to sell an imposed death on society. The fact is that choice is an illusion.

Consider the recent reports concerning euthanasia in Belgium that found that 32% of all euthanasia deaths were done without explicit request or consent and that nearly half of all euthanasia deaths were not reported.

Consider the Groningan Protocol in the Netherlands which authorizes the euthanasia death of children born with disabilities.

The more things change the more they stay the same.

Choice is an illusion.

Who decides when you die?

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Joy Wawryzniak

The case of Joy Wawrzyniak who is sueing the Sunnybrook hospital based on the death of her father Douglas DeGuerre’s. DeGuerre had legally assigned his daughter, Joy Wawrzyniak, as his Substitute Decision Maker (SDM) and his Power of Attorney for personal care document stated he wanted full code medical treatment.

On September 4, the Toronto Star published the article on the Wawrzyniak case.

Link to my comments on this case: http://alexschadenberg.blogspot.com/2010/09/lawsuit-could-set-precedent-about-end.html

Over the past few days there have been a significant number of letters printed in the Toronto Star about this issue. You need to know that the paper picks and chooses the letters it publishes, therefore the letters that were published represent a cross-section of the letters that were received.

Here is a cross-section of the comments that have been published in the Toronto Star:

Dr. Bernard Dickens says, “If the patient’s life cannot be saved in a meaningful way and if intervention would deny resources that would benefit other patients . . . then the doctor is justified in clinical judgment to withhold treatment.”

This seems to be the policy prevailing in Canadian hospitals, making elderly patients fearful of being hospitalized because tests and treatments will be considered in the context of their cost effectiveness and age appropriateness.

Ageism doesn’t appear to matter in the medical field, and a tragic proof was Douglas DeGuerre’s dying plight trying to breathe, with no doctors willing to help him.

I wish Joy Wawrzyniak success in her litigation. It may be too late for her father, but it could help save countless lives. 

Jaime Oksemberg, Toronto

“Physicians are not obligated to provide treatment that will almost certainly be of benefit to the patient” (2006 CPSO End of Life Policy).

What is a benefit and who defines it? The ambiguity of this definition allows doctors to use their clinical judgment along with their own value judgment to determine whether a patient is worthy of treatment. Every vulnerable patient is at risk.

Barbara Farlow, Mississauga

My blood boiled as I read this article. In December 2009 my elderly mother was admitted to Sunnybrook Hospital. My mother also had a strong will to live. It was very clear from the start that the attending physician had “written her off” due to her age and co-morbidities and had no interest in optimizing her medical condition.

It was only due to a combination of both physician family members and other persistent family members who screamed and begged for treatment that the attending physician and his team begrudgingly gave it (by then, in an untimely manner).

The experience has haunted our family and left deep, lasting scars. It is frightening that his approach is being taught to residents and medical students on his team who follow him at this renowned teaching hospital.

Decisions about the extent of medical care need to be discussed with the patient and the family, and decisions to not provide active medical treatment cannot be a unilateral physician decision. Otherwise, this bodes extreme danger for the future medical care of our aging population.

Carolyn Telner, Toronto

Your article about Ms Wawrzyniak’s horrifying experience in Sunnybrook conjured up the demons of the past in me. A mere 65 years ago, doctors in my home country decided whose life is not worth living and who should not raise children. Doctors, assisted by nurses and social workers, “euthanized” and sterilized tens of thousands of people they, with their professional expertise, deemed too ill to live, too disabled to raise children or in general too much of a burden for society. ...

...Doctors may make suggestions — even recommendations — but certainly not decisions. This is entirely up to the patient. Or would you like to have your hairdresser decide what haircut is right for you, or let your real estate agent buy a house he finds appropriate for you?

The idea that doctors decide who is worthy of their help and who isn’t would make hospitals a scary place. Better not contradict your doctor or you might regret it later?

And think about the influence of economic circumstances in this equation. Better switch off that senior over there so we can use our resources more economically?

We must fight this at the beginning so this inhumanity can never again get a hold in our societies. If Ms Wawrzyniak needs support for her legal fight, I would gladly donate. And hope these arrogant doctors get a well-deserved slap on their hands.

Tom Wiedemann, Toronto

In 1996 the Ontario legislature passed the Health Care Consent Act, which clearly sets out that the wishes of a person are to be followed by health professionals, and that substitute decision makers are obliged to follow those wishes as well.

The legislation provides a mechanism for physicians to challenge a person’s decision to determine if it is appropriate. The legislation does not envisage physicians making unilateral decisions. The Consent and Capacity Board of Ontario was entrusted with the duty to adjudicate these issues and it has done so for the past 16 years, including many end-of-life issues.

People in this situation should know their rights and physicians should be more aware of the mechanisms in place to deal with these complex and emotional issues.

Theodore Nemetz, Barrister and Solicitor, Former lawyer member and past chair, Consent and Capacity Board

Considering the recent case of Joshua Kulendran Mayandy who was denied fluids and nutrition, even though he was not otherwise dying, and the hospital and the lawyers pressured the potential SDM was accepted only because he succumbed to the demand that no IV fluids, nutrition and medicine be provided to Joshua.

My biggest questions are related to definitions and false legal precedents. Since when was it in the "best interests" of the patient to deny them any medical treatment, including fluids, hydration and or oxygen, when they are not otherwise dying?

Link to the comments: http://www.thestar.com/opinion/letters/article/858858--decisions-about-dying

Joshua (Kulendran Mayandy)

Yesterday afternoon (September 6), Pastor Joshua (Kulendran Mayandy) passed away at the Brampton (Ontario) Civic Hospital.

We mourn his death, yet his death was not in vain.

The death of Joshua Mayandy represents a wake up call for everyone who believes in the equality and dignity of all human life.

Joshua had fluids and nutrition withheld from him based on a cognitive disability that was caused by a heart attack, where he stopped breathing for several minutes.

Joshua was left without IV fluids, nutrition and medication from August 17 until the SDM agreed to have him fed orally on August 28 by a nurse from his Church. At that time, Joshua was not otherwise dying.

Last week Joshua had a seizure, making it impossible to continue feeding him orally.

You need to protect yourself.

The Euthanasia Prevention Coalition has distributed several thousand copies of the Life-Protecting Power of Attorney for Personal Care to protect people from these situations. This is a document that is designed to protect you from being dehydrated to death or denied basic care. You can obtain a copy at: http://www.euthanasiaprevention.on.ca/lifeprotectingpowerattorney/index.htm.

We thank everyone who wrote letters or did anything to attempt to bring justice for Joshua.

We attempted to intervene and had some success. We will be discussing this case and other related cases in order to establish further response.

Alex Schadenberg
Euthanasia Prevention Coalition

Still Dying of Thirst: Joshua (Kulendran Mayandi)

After a long discussion with our legal counsel concerning the possible legal avenues that could be taken to stop the dehydration of Joshua (Kulendran Mayandi) the Euthanasia Prevention Coalition has determined that a legal action is possible.

For those who have not followed the story of Joshua, he is a pastor of a small pentecostal church in Brampton Ontario who is currently in the Brampton Civic Hospital (William Osler Health Centre) where IV fluids, nutrition and medicine has been completely withdrawn since August 17.

Links to the story:
http://alexschadenberg.blogspot.com/2010/08/joshua-kulendran-mayandi-case-continues.html

http://alexschadenberg.blogspot.com/2010/08/brampton-civic-hospital-imposes.html

The problem is that the cost of a legal intervention, which may or may not be successful, is significant and the Euthanasia Prevention Coalition needs to know if we will have the financial support of our donors and members to go ahead with this endeavour?

Our original goal was to convince the court appointed Substitute Decision Maker (SDM) to change his mind and have the IV re-inserted.

Time is running out. If action is not taken soon, Joshua will begin to die.

You need to know that Joshua was a loved pastor. The members of the Church have been with him constantly.

If you are willing to help please email me your commitment. If you decide to make a donation today you can do so by contacting the Euthanasia Prevention Coalition at: 1-877-439-3348 or online at: http://www.euthanasiaprevention.on.ca/Donations.htm

If you haven't sent a letter in support of Joshua yet send letters and emails to:
Brampton Civic Hospital - email: communications@oslerhc.org or call the Communications Hotline at: 905-494-2120, ext. 22505.
Consent and Capacity Board of Ontario - email: ccb@ontario.ca, Phone: 416-327-4142, Fax: 416-924-8873.
Letters to the editor - Brampton Guardian: letters@thebramptonguardian.com

Alex Schadenberg
Euthanasia Prevention Coalition
Phone: 1-877-439-3348
Email: euthanasiaprevention@on.aibn.com
Website: www.euthanasiaprevention.on.ca

Dying of Thirst: Joshua (Kulendran Mayandi)

Brampton Civic Hospital

On Friday, August 20, 2010, I published a blog post about Joshua (Kulendran Mayandi), a 48 year old pastor of a small pentecostal Church in Brampton who had a heart attack on May 29. Joshua is at the Brampton Civic Hospital (William Osler Health Centre) where his IV fluids, food and medication have been removed since Tuesday, August 17.

Link to my August 20 blog comment: Brampton Civic Hospital imposes euthanasia by dehydration through pressure tactics: http://alexschadenberg.blogspot.com/2010/08/brampton-civic-hospital-imposes.html

Joshua was first in coma. He then came out of coma and has recovered a little but he remains cognitively disability.

He has the ability to recognize his closest friends and respond with one-word answers and sometimes with multi-word responses. He is able to move his body and appears to be physiologically stable.

Joshua is not otherwise dying. There is no indication that Joshua will experience a heart attack again. Other than the fact that Joshua is cognitively disabled he is otherwise healthy and could possibly live many years in this condition.

I have received an incredible number of emails supporting Joshua. Thank you to everyone who sent an email or a letter.

I have also received several emails questioning my point of view, especially in relation to the use of assisted techniques to provide hydration (fluid) and nutrition (food).

Therefore I will clarify my position.

Euthanasia is an action or omission of an action which of itself and by intention causes the death of a person for the reason of suffering.

In other words, to directly and intentionally cause the death of a person by action or omission, whereby the death is the result of the action or omission, is euthanasia, when the intention is to relieve suffering.

It is not euthanasia to withhold or withdraw medical treatment, especially when it is burdensome, extra-ordinary, disproportionate, etc.

Joshua is not otherwise dying. The intention is to directly cause his death by dehydration. If the SDM or the hospital do not provide hydration or nutrition, Joshua will intentionally die from dehydration.

Even if the law fails to recognize it, this is a form of euthanasia because death is directly and intentionally caused by dehydration and not by his medical condition.

In this case, Joshua may be capable of effectively eating and drinking by mouth, but due to the traecheotomy, he is currently unable to be fed or hydrated effectively without medical assistance.

Joseph has been breathing for a long period of time without medical assistance, why has the traech not been plugged?

Many people believe that providing assisted hydration and nutrition is always a form of medical treatment and therefore always optional. This is a false concept.

To provide fluids and food, by assisted means, should be considered normal care. Normal care is what we owe everyone in society. It is part of our social contract that enables us to live together in society in peace and harmony.

Fluids and food are not a type of medical treatment. In and of itself, fluids and food do not treat a condition but rather they simply allow the normal process of living to continue.

Assisted fluids and food can be provided at home by most people, when provided with a minimal level of training. It is not extra-ordinary, it is not disproportionate, it is not excessive or burdensome.

Fluids and food are a basic necessity of life.

Recently, Dr Jean Turner - executive director of Scotlands Patients Association (SPA), a GP and former independent MSP - warned that hundreds of patients, particularly the elderly, are languishing in hospital beds because they are not given help with feeding or hydration.

Turner referred to this problem as a form of euthanasia. She was right. We need a Canadian Patients Association to fight for people like Joshua.

Link to my blog comment on the Scottish article: http://alexschadenberg.blogspot.com/2010/08/intentional-malnutrition-of-scottish.html

Joshua's case should not be compared to palliative care cases, when the person is actually dying and nearing death.

Joshua is not otherwise dying, but if his treatment plan is not changed, he will directly and intentionally die from dehydration.

When a person is actually dying the circumstance and the intention is very different. Providing fluids and food to a dying person will often, but not always, be more of a burden than a benefit.

When a person is dying they experience a process related to the shutting down of the body. When the body shuts down, the provision of fluids or food loses its purpose because the body becomes unable to absorb or assimilate it.

People with acquired disabilities, such as Joshua, should not be dehydrated to death because they are unlikely to fully recover. Many people live with cognitive, or other disabilities, and society does not have the right to determine whether they should live or whether they should die.

The hospital/doctor and the Substitute Decision Maker (SDM) should not have the right to decide who should live and who should die.

We need a legal system whereby the best interest of a person is guaranteed under the law.

Article 25 (f) of the Convention on the Rights of Persons with Disabilities states: Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability. (http://www.un.org/disabilities/convention/conventionfull.shtml)

Just because a hospital and an SDM have agreed to withhold all IV fluids, food and medication, does not mean that they should have the legal right to do so. The law must always prevent the direct and intentional causing of death by medical means or omissions. Direct and intentional killing must be illegal outside the accepted practise of medicine.

For the sake of justice and equality for all, Joshua needs hydration (fluids) and nutrition, to once again be provided to him. He deserves the opportunity to recover, to whatever degree possible, and he deserves the right to live, even when society and others deem his life as not worth living.

Signs of dehydration: http://bodyandhealth.canada.com/channel_condition_info_details.asp?disease_id=153&channel_id=9&relation_id=10860

To prevent yourself from being dehydrated to death, contact the Euthanasia Prevention Coalition at: euthanasiaprevention@on.aibn.com and order the Life Protecting Power of Attorney for Personal Care for $25 each.

Brampton Civic hospital imposes euthanasia by dehydration through pressure tactics.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Y

Alex Schadenberg

esterday, I received a phone call and then an email from Bernard Stephenson, concerning Joshua (Kulendran Mayandi) the pastor of a small christian Church in Brampton Ontario. The email outlined several significant concerns for the Euthanasia Prevention Coalition.

First: Joshua (48), who is not otherwise dying, is being dehydrated to death (euthanasia by omission). This is not a case when hydration and nutrition need to be withdrawn because he is actually dying and nearing death, but rather the decision appears to have been made to intentionally cause his death by withdrawing IV hydration and nutrition probably because he is unlikely to recover from his disability.

Joshua has otherwise stabilized and would likely live for many years in this condition. Society cannot condone intentionally dehydrating a person to death because of their disability or the potential cost of long-term care. Article 25 (f) of the Convention on the Rights of Persons with Disabilities states: Prevent discriminatory denial of health care or health services or food and fluids on the basis of disability.

Second: It is deplorable that the Consent and Capacity Board in Ontario, the hospital and the lawyer for the hospital, who are all paid by the government and have nearly unlimited resources to pressure people to consent to their will, appeared to appoint a Substitute Decision Maker (SDM) to make decisions on behalf of Joshua, based on that persons willingness to agree to a non-treatment plan, even though there is no proof that the plan of non-treatment represented the values of the person.

The Consent and Capacity Board was established to ensure that consent to treatment is based on the prior wishes or values of a person, before that person became incapacitated to make decisions for themselves. The fact that Joshua did not write down his personal wishes or assign a person to make legal and health care decisions on his behalf in these circumstances, does not negate the fact based on his religious convictions it is unlikely that he would have agreed to death by dehydration.

To pressure a person to agree to intentionally dehydrate a person to death, (euthanasia by omission) based on the cost of continuing the legal battle to defend the values of a person, is unconstitutional and inconsistent with Ontario law.

Everyone needs to strongly respond by sending letters and emails to:
Brampton Civic Hospital - email: communications@oslerhc.org or call the Communications Hotline at: 905-494-2120, ext. 22505.

Consent and Capacity Board of Ontario - email: ccb@ontario.ca, Phone: 416-327-4142, Fax: 416-924-8873

The letter should state:

I am disgusted with the decision by the Brampton Civic Hospital, its lawyer, and the physician for (Joshua) Kulendran Mayandi, to intentionally cause his death by removing his IV hydration and nutrition even though he is not otherwise dying (euthanasia by omission). If this decision is not reversed, it will create fear among the citizens of Brampton that if they experience a disability that they too would be killed by dehydration and starvation. 

For the sake of justice and equality, I demand that you change your policy and once again continue feeding.

The following is the email from Bernard Stephenson:

Joshua is a 48 year old pastor of a small Brampton Church. He was admitted to the Brampton Civic Hospital (William Osler Health Centre), after collapsing in front of the ER on May 29, 2010.

He was revived but not before sustaining a significant cognitive disability.

He remained in the ICU, but after regaining the ability to breathe on his own, he was transferred to the respirology ward, where he remains.

He has regained some ability to communicate despite the fact that he has a significant cognitive disability.

He has progressed from being in a deep coma with signs of decerebration and decortication to almost full movement of his arms and legs and coherent use of mostly one-word answers and occasionally multi-word sentences with his sister over the phone.

He recognizes the family he was living with for the past 10 years, who have been at his bedside from morning to evening, 7 days a week.

From the beginning of his stay in the ICU until now, the doctors have repeatedly asserted that there is no hope of recovery, from a medical point of view, and they have strongly suggested that all life-sustaining treatment be removed.

His family, who live in Sri Lanka, and his supporters here have rejected these suggestions.

Nevertheless, the fact is that he had assigned no Substitute Decision Maker (SDM), and he has no immediate family living in Canada.

His first physician in the ward, removed his feeding tube, without consent, leaving him only IV fluids.

He was in this situation for over three weeks until his supporters appealed to the Ethics Committee adn the Consent and Capacity Board through a lawyer and forced the hospital to restart feeding through a nasogastric (NG) tube. Even though he was entitled to a long term gastric (G) tube the physicians refused the latter option, even though they had initially suggested it, citing that it is 'artificial' and possibly 'harmful'.

Currently, the only option the hospital and his current physician is offering is to withhold all life-sustaining treatment and care including IV fluids, food and medication.

The court first rejected Joshua's sister, Mallika Arumugan, as his (SDM) because they did not consider her capable of making medical decisions for Joshua, but she also did not agree to the demands of the hospital.

After the court rejected Joshua's sister as his SDM, a friend for 25 years became the next option. We were told that this friend would only be accepted as the SDM if he agreed to the preconditions – palliative care with the removal of all medications, IV hydration and nutrition. The alternative was a continuation of the costly legal battle before the Consent and Capacity Board or allowing the Public Guardian to take over. Since we were not able to sustain the costly legal battle and the family did not want Joshua to fall into the hands of the Public Guardian, this friend decided to accept the terms. He was subsequently granted SDM status with those limiting conditions.

Personally, I disagreed with the decision as it was immoral, unethical, inappropriate and wrong besides being totally useless.

Brampton Civic hospital on August 17 withdrew all life-sustaining treatment and care, including fluids and food, based on the forced agreement between the hospital and the SDM.

I deplore what the hospital and doctors are doing. They have a duty to inform people about quality of life and treatment options in a given situation, such as Joshua's, but they do not have the right to impose their preference for death or to assume that Joshua would not want to live the rest of his life in this condition. The Hospital and doctor's actions are both unethical and inappropriate.

Bernard Stephenson, M.D., M.Div.

To contact Alex Schadenberg at the Euthanasia Prevention Coalition call: 519-851-1434 (cell phone)

To order the Life-Protecting Power of Attorney for Personal Care: http://www.euthanasiaprevention.on.ca/lifeprotectingpowerattorney/index.htm