Thousands of Canadians dying on healthcare wait lists

When the number of Canadians who die while on a waiting list for treatment is combined with the number of euthanasia deaths, the number of deaths is overwhelming.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dan died by euthanasia while waiting for treatment

Jane Stevenson was published in the Toronto Sun on January 15, 2025 reporting that at least 15,500 Canadians died between April 1, 2023 to March 31, 2024 while on a waiting list for healthcare according to data collected by SecondStreet.org through the Freedom to Information Act. Stevenson reported that:

However, SecondStreet.org says the exact number of 15,474 is incomplete as Quebec, Alberta, Newfoundland and Labrador don’t track the problem and Saskatchewan and Nova Scotia only provided data on patients who died while waiting for surgeries – not diagnostic scans.

SecondStreet.org says if it extrapolates the unknown data, then an estimated 28,077 patients died last year on health care waiting lists covering everything from cancer treatment and heart operations to cataract surgery and MRI scans.

On December 11, 2024, Canada's Ministry of Health released the Fifth Annual Report on Medical Assistance in Dying which indicated that there were 15,343 reported euthanasia deaths representing 4.7% of all deaths in 2023.

Since euthanasia was legalized in June 2016 until December 31, 2023 there have been at least 60,301 euthanasia deaths in Canada since legalization.

Stevenson reported that SecondStreet.org identified at least 74,677 Canadians who died while waiting for care between April 2018 and March 31, 2024.

Statistics Canada states that there were 326,571 Canadian deaths in 2023.

When the number of Canadians who die while on a waiting list for treatment is combined with the number of euthanasia deaths, the number of deaths is overwhelming. This data does not include deaths from medical error.

Some euthanasia deaths are connected to Canadians who "choose" to die by euthanasia because they have waited in a queue for treatment and give up.

For instance, a National Post story reported on December 5, 2023 that Dan Quayle died by euthanasia in Victoria BC while awaiting treatment:

Dan Quayle marked his 52nd birthday on Oct. 7 in Victoria General Hospital waiting to find out when chemotherapy would start for an aggressive form of esophageal cancer. He would die waiting.

After 10 weeks in hospital, Quayle, a gregarious grandfather who put on his best silly act for his two grandkids, was in so much pain, unable to eat or walk, he opted for a medically assisted death on Nov. 24. This was despite assurances from doctors that chemotherapy had the potential to prolong his life by a year.

There is also the story of Allison Ducluzeau reported by Amy Judd and Kylie Stanton for Global News on November 27.

Ducluzeau, diagnosed with abdominal cancer, was offered euthanasia rather than treatment. She was successfully treated in the USA.

Euthanasia and medical error. Revisiting the issue.

"patient deaths from avoidable causes ... are the third leading cause of mortality in Canada."

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

An article by Michael Tutton published by the Canadian Press on February 9 concerns the recent promise by Canada's federal government to increase funding to the provinces for healthcare. Tutton questions whether the provinces will deal with the medical error that is happening in Canada's healthcare system.

Tutton begins with the story of Diane Breen who died in February 2022 after a medical error. He writes:

Kim and Jennifer DeWolfe say their 74-year-old mother spent eight hours waiting on Feb. 28 last year at the Aberdeen Hospital in New Glasgow, N.S., before being briefly seen by a doctor about a urinary tract infection.

Her charts said Breen — a runner without health conditions — told medical staff about a week of chills and cold sweats, but she was nonetheless discharged to her home with an antibiotic prescription.

Within hours, she was dead due to sepsis — the body's extreme reaction to infection.

Her daughters applied for a quality review of her care, but instead of learning what happened, they were launched into an opaque process that experts say is typical of the frustrating experiences shared by families across Canada.

"What perhaps could have saved my mother was a doctor who saw her at intake, or a nurse who authorized blood work, or being screened for sepsis," Jennifer DeWolfe, 49, said in a recent interview.

The article interviews Dr Rob Robson, a primary care physician and patient safety advocate who refers to a Canadian Patient Safety Institute report that states:

patient deaths from avoidable causes — ranging from long wait times to wrong diagnoses — are the third leading cause of mortality in Canada, following cancer and heart disease.

Tutton then reports that patient death reviews are secretive.

Robson said that in Nova Scotia, for instance, the law allows authorities to prevent detailed information about patient deaths from being released to families. The opaqueness of the quality-review process creates a "straitjacket where whatever was discussed in the review committees isn't shared," he said.

Nova Scotia Health spokesman Brendan Elliott said in a recent email that quality reviews are kept confidential to so that "everyone is free to discuss and share information. That confidentiality, he said, ensures the "frank and forthright participation" of those involved.

Kim DeWolfe said that after two meetings with the committee reviewing the care her mother received, "we still knew nothing more about how my mother died that night."

"This is nonsense," Robson said. "Explain to me how it makes sense that we spend time, effort and money to find out what happened, why it happened and how, and we're not going to tell you?"

Medical errors should be a central concern when considering approvals for euthanasia. Canada's euthanasia approval process requires one doctor or nurse practitioner to assess the requester and a second doctor or nurse practitioner to sign off on the assessment. This system of approving death does not catch cases of medical error.

Research by Dr Mark Graber that was published in the British Medical Journal titled: The incidence of diagnostic error in medicine reported that 10 - 20% of autopsies indicate that the person who had died was misdiagnosed.

The research states, with reference to medical error in the US health system:

Knowing the incidence of diagnostic error may be less important than being able to measure the likelihood of harm that results. Extrapolating from the Class 1 errors (a major discrepancy that likely leads to the patient's death) identified at autopsy, Leape, Berwick and Bates estimated that 80 000 deaths per year might be caused by diagnostic error, including both ambulatory and inpatient errors. A recent systematic review of autopsy data concluded that 36 000 deaths a year were due to diagnostic errors in just ICUs alone. These estimates, of course, do not include the many instances of non-fatal injury related to misdiagnosis, events that will be far more numerous, and the many instances where the harm is psychological or financial more than physical.

The autopsies were not related to assisted suicide deaths. In fact, rarely is an autopsy done after euthanasia or assisted suicide since the cause of death is not in question.

Nonetheless, someone who is misdiagosed and then approved for euthanasia will die 100% of the time. This should concern everyone.

Jennifer Monaghan

A CityTV news story by Meredith Bond from February 2022 concerned Jennifer Monaghan, who lived with chronic pain for 17 years, but had been misdiagnosed. The significance of the story is that Monaghan was planning to die by euthanasia because she was losing hope that her health could be restored.

Her correct diagnosis was not connected to an application for euthanasia, nonetheless Bond reported that Monaghan is happy to be alive. Her pain began to disappear and she became a grandma at about the same time.

The question is - how many people are being killed by euthanasia who have been misdiagnosed or was a victim of a medical error?

According to Brian Mastroianni who published an article in healthline.com in February, 2020 medical error is more common than you think. According to the data: In the United States, 12 million people are affected by medical diagnostic errors each year.

An estimated 40,000 to 80,000 people die annually from complications related to medical error and a similar number of people will experience a permanent disability related to misdiagnosis.

In October 2016 Mya DeRyan survived a suicide attempt. While recovering DeRyan learned that the terminal diagnosis that she was trying to escape from was in fact a wrong diagnosis.

In April 2013, Pietro D’Amico, a 62-year-old magistrate from Calabria Italy, died by assisted suicide at a Swiss assisted suicide clinic. His autopsy found that he was misdiagnosed.

Considering the data, it is dangerous and irresponsible to legalize euthanasia and assisted suicide. Many people, such as Jennifer Monaghan, lived with undiagnosed chronic pain for many years. We need to improve the healthcare system not kill the patient.

Can I trust the medical community to protect my life?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On September 14 Jennifer Henderson wrote an investigative report for Medpage Today focusing on Canadian born New Hampshire Cardiac surgeon Yvon Baribeau, who after his forced retirement, at 63, the Boston Globe learned that:

Ultimately, there has been no U.S. physician with more settlements involving surgical deaths over the last two decades, the Globe reported, citing an analysis of a national physicians' database. And there has been no physician in New Hampshire with more settlements of any kind, the Globe added. 

The investigative report doesn't only determine that Baribeau caused a significant number of surgical deaths, but the report also determines that the hospital was made aware of the issue and didn't stop him from doing surgery. According to the investigative report:

Though the public remained largely in the dark when it came to Baribeau's troubles, his institution long knew of them, the Globe reported.

"Hospital executives were well aware for years how dangerous he had become," the Globe wrote. "They knew because they had been repeatedly warned by surgeons and other medical professionals at Catholic Medical Center that Baribeau's errors were harming, even killing, patients."

"And yet for years hospital management resisted reining in one of their leading rainmakers," the Globe added.

As much as this tragic story makes me wonder how Baribeau was allowed to continue doing surgery for 20 or more years with such a high medical error and death rate. What makes this story even more concerning is the fact that Baribeau was considered a "star" surgeon who was often featured by the hospital.

Charles Cullen

The Medpage Today article only came to my attention because I was reading an interview by Kristina Fiore with Dr Steven Marcus published by Medpage Today on September 22, 2022. Marcus was the physician who uncovered the medical serial killer nurse Charles Cullen.

Marcus explained to Fiore that they only became suspicious because they "received two unusual calls about digoxin toxicity in two different patients at Somerset Medical Center within 2 weeks of each other in June 2003." Marcus was the director of the New Jersey poison control center.

Two weeks later Bruce Ruck, the head pharmacist at the poison control center, was speaking to another "whistle blower" who was concerned about strange deaths at the Somerset Medical Center. This person was calling about two other deaths.

Marcus contacted the hospital about the possibility that one of their medical workers was killing patients. Marcus told Fiore:

We wanted to be sure that these four events were real and were documented. Then we would work together to try to come up with an approach to see if, in fact, there is somebody there that's attempting to kill people -- or is there a breakdown in their system someplace that allows for really severe medical errors to recur?

We did get into a telephone call, but there was a complete denial by the hospital. [They said] there was no way that this could be happening, and that there are obvious other reasons that it could occur. They were not willing to get involved, as far as we could tell, with any investigation.

The hospital refused to acknowledge that there was a possible problem and they refused to participate in an investigation.

Since the hospital was unwilling to investigate Marcus tried to find another organization that was willing to investigate. He contacted the Hospital licensing group which was part of the department of health. He told them that if they don't find a logical explanation for these deaths that they would probably need to reach out to the Attorney General's Office.

That was July. Marcus did not receive a call until October from the Somerset County Prosecutors office. The rest is history, nonetheless, similar to the first story of Dr Baribeau, there were nurses who reported Cullen, but the hospital did nothing. To make things worse, when Cullen moved to another hospital, the previous hospital did not warn the next hospital that there were complaints about Cullen.

The article ends with Marcus stating:

In our case, just think about the serendipity involved. Had we not had two calls -- one from a nurse, one from a pharmacist -- to the poison center within a couple of weeks; had I not been consulted on the first case; had I not walked by Bruce on the second case, Cullen might never have been stopped.

There are probably murderers out there killing people as we speak.

Am I suggesting that there are medical murderers lurking in hospitals throughout the world. I really don't know.

But I do know that the euthanasia laws in Canada, Belgium and the Netherlands and the assisted suicide laws in the United States give doctors, and in some cases nurse practitioners, complete legal coverage when they kill someone. I also know that there is little to no oversight of these laws.

For instance, Canada's law states that the medical practitioner only needs to be "of the opinion" that a person fits the criteria of the law. This type of loose language encourage people who already have a propensity to kill.

Sadly, there have always been killers. The only difference with euthanasia is that the act of killing is legal and even in some cases promoted.

Euthanasia promoting doctor admits that safeguards fail.

When safeguards fail, in the case of euthanasia, it means that someone has wrongfully died.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week, the Psychiatric Times published Part 2 of his series of articles titled: The Case for Medical Aid in Dying. by Dr Douglas Heinrichs.

In Part 2 Hendrichs responds to the arguement against MAiD concerning the consequences of legalization. Hendricks, who supports euthanasia, doesn't actually analyse the opposition to killing based on consequences but rather he examines the issues of safeguards and whether or not euthanasia undermines other policy priorities.

For those who oppose euthanasia, among other things, we oppose giving government, or another groups, such as physicians and nurses, the right in law to kill. This is the same reason that many people oppose capital punishment. Essentially opposition to MAiD is based on the belief that no group or individual should have the right in law to kill people.

It is interesting that Hendrichs acknowledges that "safeguards" fail. Hendrichs states:

This is not to say that every effort should not be made, both in formulating MAID legislation and fine-tuning it once it is enacted, to optimize safeguards that are effective as well as practical. But such safeguards will never be perfect. All laws about anything result in some instances in which the outcome is other than what the law intends.

Hendrichs is correct, but unlike other circumstances, MAiD is the intentional killing of a person. If the "safeguard" fails, it doesn't mean, as one of his examples state, that a person who is not disabled collects disability benefits, but rather it means that the person is dead.

Hendrichs then states:

Models designed to project risk and harm can be useful to consider, but they are notoriously unreliable, given that they always involve a host of assumptions that are only approximately true in the real world. As fallible human beings, the best we are likely to do is to make reasonable attempts to provide sensible safeguards and be prepared to fine-tune over time as experience accumulates. This is the equivalent of post-marketing reports of adverse effects with a new therapeutic agent.

I think that Hendrichs is correct but once again, with MAiD, when fallible human beings wrongly kill someone, that person is now dead. This is precisely why drug companies are expected to spend millions of dollars on research to ensure that the public will not expericne adverse effects of a new therapeutic agent. Nonetheless, if the therapeutic agent caused the recipients to die, the agent would hopefully be stopped.

Hendrichs, in part 1, argues that people who oppose MAiD usually do so from a religious point of view. Many people come from many different points of view nonetheless what unifies people who oppose MAiD is the belief that the government or a group of people, must not have the right in law to kill.

My life became less safe after Canada has legalized euthanasia.

Doctors warn: One in ten wrongful assisted suicide deaths.

This article was published by the Australian Care Alliance on September 16, 2021

Professor Paul Glare

Thoracic physician, Dr Luke Garske and Professor Paul Glare, Specialist Physician, Pain medicine have warned that under Queensland's Voluntary Assisted Dying Bill 2021 an estimated 10 out of 100 Queenslanders who access assistance to suicide or euthanasia will end their lives based on a wrong belief that they have a terminal illness.

As euthanasia enthusiast, comedian Andrew Denton admits "there is no guarantee ever that doctors will be 100% right".

Dr Garske and Professor Glare explain:

The Queensland Bill simplistically assumes that doctors can accurately predict how long patients with severe life limiting disease will live. It requires two doctors to agree that a patient is expected to live for less than 12 months (compared to less than 6 months in four other states). It is known that doctors are very poor at accurately predicting whether you will live less than 12 months.

At least 10% of patients predicted to live less than 12 months would have still been living in three years.

If the Queensland bill is passed, we estimate that 10 out of 100 Queenslanders who choose assisted suicide will have done so based on the wrong belief that they had a terminal illness. In contrast, in the four other states, which offer assisted suicide when you are expected to live less than 6 months, we estimate that 1 out of 100 patients will have chosen to have an assisted suicide, based on the wrong belief that they had a terminal illness.

Is it acceptable for Queenslanders to have so many extra wrongful deaths, because of an arbitrary extension of an eligibility criterion that isn’t based on expert medical advice? Why is this extra 6 months even necessary, when the assessment process takes only 9 days, and we are supposedly doing this to prevent suffering at the end of life?

Dr Luke Garske

They also note that:

The Queensland bill does not require the doctor to have any expertise in predicting death, or expertise in identifying depression. And it is very loose in its requirements to assess decision making capacity. We should identify and treat depression to relieve the desire to suicide, rather than promoting your suicide if this is caused by mental illness.

The bill also assumes that an accurate diagnosis will always be made of an incurable disease, and doctors will never miss the diagnosis of a condition that could have been treated. Yet it allows doctors in training, without any knowledge of the condition you have, to make a diagnosis that they have not been trained to make, and certify you for [assisted suicide or euthanasia]. This compares to other states, which have the advantage of specialists with experience in the disease you have. People with curable diseases have been wrongly assisted to suicide in other jurisdictions, because of a wrong diagnosis. The inexperience of the Queensland doctors would cause more wrongful assisted suicides based on incorrect diagnoses of treatable diseases.

The two experienced physicians warn of the impossibility of always identifying coercion and elder abuse and the inevitability that some Queenslanders will die wrongful deaths after being coerced by others to "request" assistance to suicide or euthanasia.

Everald Compton is a longstanding campaigner for [euthanasia], who has stated that he “has faith” that this law won’t be abused. This is a fantasy land where no-one lies, cheats or steals; in the real world, this law will be abused. It is naïve to believe that doctors, family members and others will not sometimes pressure vulnerable patients to have an assisted suicide. Elder abuse is common and the Queensland Bill would create the perfect scenario for this.

The people charged with detecting coercion are time pressured doctors, who unlike judges and lawyers, have no expertise or skills to detect coercion. If a loved one pressured you to have an assisted suicide, or you felt such a burden that you felt obliged to choose it, would you tell your doctor, or would you “go quietly”? Based on our professional experience, we strongly disagree with the “faith” that Everald Compton has, that the Queensland bill has any realistic ability to prevent or detect abuses.

For example, Queensland doctors would be able to initiate the conversation about assisted suicide. In other states the patient must initiate the discussion. It is fanciful to believe that a doctor would not sometimes guide a patient to have assisted suicide because of their own prejudices or opinions. Many patients will trust their doctor and follow their advice, and these conversations will be occurring within private non-recorded medical consultations. The fact that this change has been allowed into the legislation underlines the lack of medical experience in guiding the supposed attempts to protect the vulnerable.

Dr Garske and Porfessor Glare call for the Parliament to reject the Bil, and instead to adequately fund palliative care for all Queenslander.

We know that in overseas jurisdictions where assisted suicide has been going for about 2 decades, there is an ongoing rapid growth of numbers, and a gradual extension of indications to less serious conditions. With all of the unsafe aspects of the Queensland legislation being proposed from the outset, how can we have any confidence in how many Queenslanders will have wrongful and coerced deaths in 10-20 years? The only reliable safeguard is to keep the current law, and reject the bill.

Let’s instead focus on properly resourced palliative care. Why is it good enough for Premier Palaszczuk to provide only a fraction of the funds required to provide all Queenslanders with access to quality palliative care - when billions can be found for the 2032 Olympics? Why doesn’t parliament just properly fund palliative care for all? This is the far more compassionate option, which in clinical reality will relieve suffering for many more people. Properly funded palliative care can terminate the suffering, which is far safer than terminating the sufferer.

More articles from the Australian Care Alliance (Link).

Canadian man dies by euthanasia after adverse drug reaction.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Avis Favaro, the CTV National News Medical Correspondent recently did a news program on the issue of adverse drug reactions in Canada. 

According to Favaro, advocates say that adverse drug reactions are the leading cause of death for Canadians and they are pushing for new rules for monitoring the side effects to track the reactions to adverse drug reactions.

What makes this story different than the many other stories of people who have suffered after an adverse drug reaction is that Mike Sawatsky, who Favaro follows in the report, has applied for and was approved for euthanasia (MAiD) in order to end his suffering.

When debating euthanasia I have referred to the data indicating that medical error is the third leading cause of death. The adverse drug reaction activists claim that adverse drug reaction is the leading cause of death.

People who ask for death by lethal injection are sometimes misdiagnosed, but in this case Sawatsky, who will die by euthanasia, was horribly affected by a terrible medical error.

Favaro reports on Sawatsky's story:

Crystal is Sawatsky’s wife. She witnessed her husband turn into a totally different person following his treatment.

“It completely changed our lives because we were active outdoors people. We had kids, we had lots of friends, we're very social. And we went to being a recluse,” she said. They stopped many of their previous social and outdoor activities, and sold their cabin on the lake.

Worse, Sawatsky was navigating fruitlessly through the health-care system, seeing countless specialists, trying to get someone to acknowledge what had happened and get a proper diagnosis.

Not knowing what was wrong with him, doctors would prescribe more drugs.

“I was like, look, I'm obliterated. I don't need any more drugs,” he said. “None of them would accept the fact that it was an adverse drug reaction.”

Sawatsky knew if he continued down that path he was not going to last long. After two and a half years, his nephrologist finally attributed his condition to an adverse drug reaction, he said.

After Favaro reports on how reporting and treatments for adverse drug reactions will improve the situation, she then reports that Sawatsky will die by euthanasia.

But all of these potential solutions come too late for Mike Sawatsky, however. With his health still declining, he applied for and was approved for a medically assisted death that would allow him to end his suffering at a time of his own choosing.

Once again, I recognize the suffering that Sawatsky and his family experienced, but death by lethal injection is not the answer, but rather a further medical abandonment. It may be true that Sawatsky's health has been so damaged that he won't effectively recover, nonetheless, his life and story are important and his death, by lethal injection is a tragedy.

Nick Goiran Makes The Case: No Safe Euthanasia Law

This article was published by the Care Alliance on October 16, 2019.

Hon Nick Goiran

In the lead speech opposing the Voluntary Assisted Dying Bill 2019 which would legalise euthanasia and assisted suicide in Western Australia, the Hon Nick Goiran powerfully enunciated the case that it was impossible to create a scheme which could guarantee that there would be no wrongful deaths due to medical errors, elder abuse and patient steering and a lack of equitable access to palliative care.

In his conclusion summing up the argument he made five statements:

• Firstly, the desire of a significant proportion of confident people for ready access to lethal injections ought never to override the rights of the quiet vulnerable to safety and protection.
• Secondly, if we are intellectually honest and reason through the theory of a euthanasia regime, we should conclude that it is inherently unsafe. The insufficiency of the criminal justice safeguards informs us of this. The prevalence of medical negligence informs us of this. The ease of doctor shopping informs us of this. The existence of elder abuse informs us of this, and the reality of doctor bias informs us of this.
• Thirdly, when we engage with the lived experience of the few jurisdictions that have legalised euthanasia or assisted suicide, we know that the theory of an inherently unsafe regime has resulted in casualties of wrongful deaths. In other words, the theory has translated into practice and wrongful deaths have ensued, and there have been casualties.
• Fourthly, there is another way; there is a better way. There is a safe approach to end-of-life choices; however, it will require all of us to persistently insist that quality palliative care is made available to every Western Australian and until we, the 36 of us, have exhausted ourselves in fulfilling this duty, we should not contemplate a euthanasia regime, let alone this bill, which is more dangerous than the Victorian legislation and more dangerous than the now inoperative Northern Territory legislation.
• Finally, I oppose this bill because the risks in legalised assisted suicide are simply too great, not the least of which is because the consequences are final.

Read the whole of the Hon Nick Goiran's speech here

Debate on the Bill continues with further second reading speeches.

What happened to do no harm? Protecting you from medical homicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

I just re-published the excellent article concerning the involuntary euthanasia deaths at Mount Carmel hospitals in Ohio. (Link to the article).

It is shocking that 34 people are known to have died after allegedly receiving an intentional lethal overdose of painkillers from Dr William Husel. Husel had his medical license suspended and he was fired from the hospital, while 20 other hospital employees have been suspended. 

Last night I received a call from a physician who was seeking advice about launching a criminal case into the death a close family member. The cover-up for the death started immediately and no one would have suspected anything if this doctor didn't arrive the afternoon before the death and start asking questions about the lethal levels of drugs that the family member was administered.

We spoke for a long time about his frustration about the lack of response from the local police. We have referred him to an excellent lawyer.

It is not easy to bring medical homicide cases forward. Usually the victim's family do not have a medical background and only suspect that something wrong occurred while the police view medical homicide complaints as "medical error" cases or simply as not in their jurisdiction.

We hope that this case will go forward since the plaintiff is an experienced physician and the circumstances are similar to Ohio.

Become a member of the Euthanasia Prevention Coalition (membership) or make a (donation) to enable us to help you in your time of need.

• More than 1000 Belgian deaths were hastened without request in 2013 (Link).
• 431 deaths without request in the Netherlands in 2015 (Link).
• 456 patients killed in a British hospital (Link).

Intentional ending of a patient’s life more than ‘ medical error’?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Last week, Limaohio.com columnist, Melissa Martin comments on the Ohio Department of Health investigation concerning 27 cases of massive overdoses of pain medication by a Ohio doctor and assisted suicide.

Melissa Martin

Commenting on the Ohio overdoses, Martin writes:

According a 2019 article in the Columbus Dispatch, “The Ohio Department of Health has begun an investigation into a Mount Carmel doctor accused of ordering potentially fatal doses of painkiller for 27 near-death hospital patients, all of whom have died. Mount Carmel officials fired the doctor and placed 20 pharmacists and nurses on leave while they look into the cases.” 

“Eighteen months ago, Mount Carmel began work to stop preventable medical errors — work that puts systems into place to make the care we provide highly reliable and consistent,” is another statement on the Mount Carmel website. 

Why is a policy to prevent medical errors not ongoing? Why 18 months ago? Why not prior to opening the hospital for business? It appears that whistle-blowing employees came forth with the allegations. When did the intentional ending of a patient’s life by a physician become ‘a medical error’?

Martin puts the Ohio investigation into the context of other medical professionals. She writes:

Donald Harvey, a nurse’s aide, dubbed “the Angle of Death,” pleaded guilty in 1987 to killing 55 patients in Cincinnati and Kentucky hospitals. Many of his victims were chronically ill patients. He claimed he was ending their suffering. “Harvey told a newspaper after he pleaded guilty to avoid the death penalty that he liked the control of determining who lived and died. Former Hamilton County Prosecutor Arthur Ney Jr. who prosecuted the cases in Cincinnati said Harvey was not a mercy killer,” according to a 2017 article in USA Today. 

Lisa Schattinger, a nurse, founded Ohio End of Life Options in 2015. The members support a Death with Dignity law in Ohio...

Dr. Jack Kevorkian, a medical pathologist, was arrested, tried in a court of law, and convicted of physician-assisted suicide. According to a 2011 article in the New York Times, “The American Medical Association in 1995 called him “a reckless instrument of death” who “poses a great threat to the public.”

Martin concludes the article by stating:

The phrase ‘physician-assisted suicide’ has been replaced by ‘death with dignity.’ Loaded language is a persuasive technique used to heighten emotion, gain support, and sway voters. And loaded phrases are changed to make horrific acts more palatable to the public. 

Do you support or oppose a Death with Dignity law in Ohio for the terminally ill? 

Do you support or oppose the alleged acts of a rogue physician to end the suffering of terminally ill patients by injecting lethal doses of fentanyl at Mount Carmel hospital in Columbus? Mercy killings or playing God?

If you think the article by Melissa Martin is extreme, maybe you need to read about Charles Cullen, a nurse who killed at least 40 patients and said "I thought I was helping."

John Kelly: Massachusetts Legislature Should Reject Assisted Suicide. People lose their lives to misdiagnosis, coercion. abuse and depression.

This article was published by the Worcester Telegram on December 24, 2018.

John Kelly

By John Kelly director of the disability rights group - Second Thoughts Massachusetts

In a recent Wicked Local Lexington commentary (“Medical aid in dying important for some with disabilities,” Sept. 28), Michael Martignetti argues for the legalization of assisted suicide from the perspective of someone with the progressive neurological disability, Friedrichs ataxia. I can relate to the author’s disability experience, as 35 years ago a spinal cord injury left me paralyzed from the neck down. Like Martignetti’s, my disability will present challenges as I age.

But whereas Martignetti frames assisted suicide as a personal choice in the face of “unbearable suffering,” I see a state-run program that will result in people losing their lives to misdiagnosis, treatment denial, and coercion/abuse, and depression. Not all families are united in loving and supporting us.

Doctors often make diagnostic mistakes: between 12 percent to 15 percent of people admitted to hospice as “terminally ill” outlive the six-month prediction. Many more who never enter hospice also outlive their diagnosis. For example, the late Senator Ted Kennedy lived a full year longer than his diagnosis of 2 to 4 months, while Florence resident John Norton credits 60 years of good life to the unavailability of assisted suicide after a mistaken prognosis.

Late last year, the Oregon Health Authority explained that people can become “terminally ill” through insurance denial and unaffordability. For example, Nevada Dr. Brian Callister had two patients denied by California and Oregon insurers for what used to be routine, lifesaving, operations. The insurers only offered the “choice” of hospice or assisted suicide. It’s impossible to talk about individual choice when profit-maximizing companies can – with no accountability – make you terminal.

The Health Authority admits its involvement ends with the dispensing of the drugs by the pharmacy. Of the many reported abuses, see the cases of Thomas Middleton (financial abuse), Wendy Melcher (attempted murder of a trans woman), and Kathryn Judson (physician pressure).

The bill requires no independent witness at the death, so the supposed safeguard of “self-administration” is empty. Especially vulnerable will be the 10 percent of Massachusetts seniors estimated to be abused yearly. A caregiver or heir to an estate can witness a person’s request, pick up the prescription, and then administer the lethal dose without worry of investigation — the bill immunizes everyone involved.

Another safeguard requires applicants to be evaluated by a mental health professional, who in a one-time meeting is tasked with “determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” A survey of psychiatrist revealed that most said they could not diagnose depression in a single visit. Meanwhile, “impairing judgment” is what depression does. As peer advocate Ruthie Poole has testified,

“Depression does not cause black and white thinking; it causes black and blacker thinking. Absolute hopelessness and seeing no way out are common feelings for those of us who have experienced severe depression. Personally, as someone who has been suicidal in the past, I can relate to the desire for ‘a painless and easy way out.’ However, depression is treatable and reversible. Suicide is not.”

Martignetti insists that disability does not make people eligible, but the Oregon reports show that the 5 leading “end-of-life concerns” are not pain-related but the “existential distress” (New England Journal of Medicine) experienced through “loss of autonomy” (91%), lost abilities (90%), “loss of dignity” (76%), incontinence (46%), and feeling like a burden (44%).

Indeed, I have found that social prejudice and discrimination are far more injurious than the actual loss of abilities. People have told me to my face that they would rather be dead than like me, while the culture promotes a theme of “better dead than disabled.” Movie examples include “Me Before You,” “Whose Life Is It Anyway,” and “Million Dollar Baby.”

This helps explain why every major national disability rights organization that has taken a position on assisted suicide has come out in opposition.

The legislature should continue rejecting a bill that trades on disability prejudice to push vulnerable people toward early deaths.

John B. Kelly is director of Second Thoughts Massachusetts: Disability Rights Activists Against Assisted Suicide, a grassroots group opposing assisted suicide since 2011.

Are Euthanasia Errors Acceptable?

By Fabian Stahle, a Swedish researcher.
Edited by: Alex Schadenberg, Euthanasia Prevention Coalition

When the advocacy for legalisation of euthanasia/assisted suicide approach a new jurisdiction it is always with the assurance that the proposed practise will only be used for extreme cases – persons in extreme pain and on their death bed. The advocates emphasize that strict safeguards will prevent anyone from being killed by mistake.

Dr Johan Andreen

These two speaking points in their sales pitch - only extreme cases and no mistakes – are constantly repeated in the first phase of introducing the idea of medical killing.

Currently the Swedish debate is in the introduction phase. A Swedish opponent of euthanasia, psychiatrist Johan Andreen, recently addressed the allegations about the proposed strict safeguards in an article in the Swedish Psychiatric Magazine, No 3, 2018. See page 54-56, (link) with translated title: "Taking Position In The Question About Euthanasia."

His article is a sharp and in-depth analysis of the weakness of the proponents claims and a passionate appeal for true compassion for the vulnerable.
The author asks the following question to those who propose euthanasia (and PAS) regime and to those who haven't yet made up their mind:

". . . Is it acceptable that any erroneous deaths at all take place in the context of something that should be a care measure?"

He then continues:

"If your answer is yes, the next question is: “why should we accept that when we do not accept it for other care measures?” Furthermore, how big a proportion is acceptable? Finally, how will we be able to establish and ensure safe control of that proportion of error with “assisted death"?

If the answer is no (which it reasonably ought to be), some of the follow-up questions would instead be: How can the law and its application ensure that mistakes and abuse of the law do not result in patients – who should have had care and support in a dignified life – having their lives shortened as well as a dishonourable ending to their life?

We had better watch out and navigate right in this paradoxical context. Because, although the existence and purpose of the act is to bring about death, and that this has been achieved, it will inevitably also have occurred in cases where care and treatment to live a meaningful and reasonably comfortable life should have been given. The assisted death will have the effect that some patients pass away as a result of the medical act, when this was incorrect and not the patient's actual desire and need. In the name of common sense and honesty, we should all be able to assume and agree that this will be unavoidable. In what world are there laws, doctors and healthcare systems that have no shortcomings and risks, or legal institutions that cannot be used for unintended and therefore illegal purposes?

The starting point must be, for empirical and logical reasons, that it will not be possible to introduce a "Swedish improved" version of the Oregon model that will not kill a number of people in error. . . . Let it be clear that this unintentional mortality would take place at a percentage or even permille level. It would also occur in a Swedish model.

Is any such mortality at all acceptable then? In our current situation, it is difficult to see, let alone find the opportunity to talk about this lethal side-effect or risk in the assisted death debate, since the act itself has the purpose of bringing about death!

So, here we need to see before us people who are depressed or just lonely and despondent. People who with pharmacological, psychotherapeutic and other treatment or just good care, compassion and counselling, together with their near and dear ones receive the support they need – but do not believe they can wish for – to be able to live out the time they have left. And no one can know the length of that time. 

There may be individuals who perhaps enter [into] their terminal condition due to the fact that in a state of depression – or sheer resignation – they stop taking or continuing treatment or investigation, or fail to ensure necessary intake of nutrition, fluid and basic activity and therefore become terminally ill. Is an outcome, involving an act that leads to death, acceptable in any or a few cases of these treatable and care-demanding non-terminal conditions? Should not our compassion, our strength and our resources instead be spent on scientifically developing – and with the use of care programs, focus and standardize – the help provided in cases of such suffering, the underlying disease and the social vulnerability?

In order to see with sharp clarity what we are talking about here – in a concrete corresponding care and treatment scenario – we need to begin to make comparisons with scientific pharmacological treatments.

When certain drugs appear to have clearly identified serious side-effects including fatality, severe illness or foetal damage, they are immediately withdrawn (the list could be long and will not here be encumbered with names). It does not matter that they have cost billions to develop and it does not matter that they may have a very good and important effect for the vast majority. It does not matter that these side effects are rare, if they cannot be safely prevented by any possible method. In those cases, we consider that to be enough. Our modern legislation guarantees that we should not have such drugs. The market for that drug will fall as soon as repeated reports of these outcomes occur. The company loses its credibility and status if, when the risk is clear, it does not immediately withdraw the drug before the drug authority in every country does.

In summary, the questions asked here are necessary and sufficient, and therefore crucial, to answer concerning euthanasia – regardless of model. Do we accept that the medical sector will be required to abolish and violate the thousands of years old parameters in our social contract – between individuals, people and the social system/state – that "you/we shall not kill"? Disregarding that a few countries have introduced euthanasia, do we not in the name of health care security and basic ethics have to talk about the fundamental risk to patients that this entails?

Do we accept that a societal change should be made that involves doctors and nurses participating in something that most of us agree is not, and can never be scientific treatment? Do we accept a state-imposed measure performed on the basis of patients' supposedly well-founded requests, following an arbitrary assessment by doctors – no science for this procedure exists – resulting in the death of a patient, a fellow human being, and that the possibilities for giving proper treatment and care are extinguished – forever? When this, apart from a series of risks and consequences for our society that have not been raised here, actually means that people who would have wanted and could have been helped to live will die of "assisted death"?"

As for Sweden we can already anticipate the second phase in the debate when it becomes clear for everyone, even for the proponents – although not admitted – that some collateral damage is inevitable. But the advocates play down the issue just like the Canadian doctor Ellen Wiebe, who in a debate in The Economist Magazine confessed (Link):

”I agree that one day I may make an error in my assessment and not realise that someone has been pressured into a decision to hasten their death. And the other independent assessor might make the same error. That might mean a person would die earlier than she or he may have preferred.”

Dr Wiebe continues with a rhetoric question that clearly demonstrates how the advocates in the implemantation phase shamelessly propagate for a miserable standard for protecting people from being killed.

"Should that error be the reason hundreds or thousands suffer needlessly against their will at the end of life? I am so glad to be Canadian in 2018 and to say, “No, that is not how it is here."

The confession that she "one day may make an error" may be an understatement in the view of her extensive experience of providing about 150 assisted deaths according to another article by her published in the The Economist Magazine (Link). 

Fabian Stahle is a Swedish researcher who, last year, uncovered hidden problems with the Oregon assisted suicide model.

The Importance of Talking to Patients

This article was published by Nancy Valko on October 29, 2018.

Nancy Valko

By Nancy Valko

As I have related before, back in the early 1970s when I was a new ICU nurse, I was teased for talking to comatose patients. I was even asked if I talked to my refrigerator. I explained that if hearing was truly the last sense to go, it made sense to talk to the patients and explain what we were doing just as we would for any other patient. The other nurses thought this was ridiculous-until “Mike”.

“Mike” was a 17-year old boy who was admitted to our intensive care unit in a deep coma with massive injuries caused by a terrible car crash. The neurosurgeon on duty pronounced, “He won’t live until morning and it’s a good thing, because he’d be a vegetable.” I was shocked that he said this in front of “Mike”!

But “Mike” didn’t die. I kept talking to him and eventually he could even move a finger on command. But he would not respond to the neurosurgeon, even with tests to see if he would move with pain stimuli.

Later on, when “Mike” was able to breathe on his own, he would even say “Hi” for me on command but it was only after I repeatedly begged that Mike finally said “Hi” to the neurosurgeon. The neurosurgeon called this a “miracle” but shortly after that, Mike was transferred to a nursing home. None of us ever expected to see him again.

However, about 2 years later, a handsome young man strode into our ICU and asked “Do you remember me?” It was Mike! He said he had driven 60 miles to tell us thanks for saving his life and we all dissolved in happy tears.

I told him that he wouldn’t remember this, but he would move and say “Hi” for us nurses but not for the neurosurgeon. Mike got very serious and said “I remember him calling me a vegetable and I wouldn’t move for him!”

After that, every nurse on our unit was told to talk to every comatose patient as if he or she was totally awake and soon we found more patients who unexpectedly woke up or improved.

And no one ever teased me about talking to “comatose” patients again.

Throughout the decades since, I have talked to other patients who were considered comatose or otherwise unconscious, not just to patients with a major brain injury but also to patients approaching death and to patients sedated while on a ventilator for breathing. I’ve always considered this talking and explaining just basic respect for every patient. I was pleasantly surprised when I followed up with patients and families after they left our ICU and found many who remembered and told me how much this had helped them.

“Observations From ICU Patients We Thought Were Asleep, But Were Not”

So I was thrilled to see this title for a new Journal of the American Medical Association (JAMA) learning audio for doctors with stories from patients about what they experienced in an ICU while their treating doctors and nurses thought they were “asleep”.

In the audio, most of the patients were on sedation while on a ventilator and assumed unaware. One such woman related how she became so angry at her doctor’s attitude that she wanted to throw something at him and was frustrated when she couldn’t. Another man related how painful it was when the electrodes checking for his level of sedation were used without explanation or warning. Another complained about hearing nurses talking about her mom and dad poorly and their lack of empathy.

But there were also good stories about nurses or doctors taking the time to explain what was happening, talking as if the patient could hear everything and helping patients communicate without words. One doctor told about how his own father was in a hospital for an extended time and his dad remembered hearing the doctor talking about all the things he couldn’t do instead of what he could do. This doctor says that his father’s discouraging experience made him a better doctor.

The audiotape also explains how difficult it can be to not over or under-medicate people, especially when it comes to pain, confusion and anxiety. The audiotape recommends that health care professionals try to avoid long acting drugs with potential side effects and continuous medication infusions and to use simple tools to assess delirium, confusion and anxiety.

The audiotape also recommends that health care professionals “treat patients like real persons”, “take the time to explain”, “be careful to assess level of awareness”, “realize that every action and word have real consequences” and that the “human element” is the most important.

Conclusion

Being in an ICU can be especially stressful for patients and their families and I hope this information is helpful. Medicine can do wonders today but it is the human connection that provides the best environment for healing for both patients and their families.

Nancy Elliott: People who qualify for Assisted Suicide are not necessarily dying.

The following testimony was submitted by Nancy Elliott Chair, EPC-USA to each Rhode Island committee member and the committee clerk on behalf of EPC USA.

Dear Health, Welfare and Human Services Committee Member,

Nancy Elliott

Please reject H7297. Proponents say that this is about autonomy and choice. Nothing could be further from the truth. There are no safeguards that ensure that the choice is yours and not someone else's. As a matter of fact all the “so called” safeguards can be gone around. Proponents claim there is no “slippery slope” yet we see as soon as something is passed they go in to expand their death policies. Oregon, where assisted suicide is legal, just passed legislation that will allow for the starvation and dehydration of incompetent people. Belgium’s law has expanded to euthanize children, those who are incompetent and people who are not dying at all. And Canada who recently passed it is has already expanded it to prisoners.

I would like to point out a few of the people who will be hurt. Three groups that are the target for Assisted Suicide are the sick, the elderly and the disabled. While there are many other problems with this kind of law, I want to focus in on them.

It is said this is only for the sick and dying. One of the biggest problems is people who qualify for Assisted Suicide are not necessarily dying. Think of a 21-year-old otherwise healthy insulin dependent diabetic. He qualifies if he rejects his insulin. This would be the same for many other people with serious conditions, who take prescription medications. What about all the curable cancers? They qualify. What about incorrect medical diagnosis? With Assisted Suicide on the table these mistakes can be deadly.

I was at an oral submission on Assisted Suicide in Massachusetts a few years back when a gentleman named John Norton gave evidence, that as a young man he was diagnosed with ALS. He stated that had Assisted Suicide been legal at that time he would have used it. A few years in, the disease’s progression just stopped. Now in his late 70’s he stated he has had a great life with children and a grandchild. With Assisted Suicide on the table he would have lost all of that.

Steering is a big deal with all three of the groups that I mentioned. At that same Massachusetts proceeding, a doctor stated that Assisted Suicide laws were something he was in favor of. He continued with his points and ended by saying that He felt it was the responsibility for a good doctor “to guide people to make the right choice”. I do not think he intended to say that, but is there any doubt that this pro suicide doctor would try to persuade his patients to follow his wishes concerning their Assisted Suicide.

These laws are abusive in their very nature. To suggest to someone that they should kill themselves is abuse. My husband was terminally ill and I went to a lot of doctor appointments with him. If medical personnel were to suggest Assisted Suicide to him, he would have been devastated. While he never would have done that, it would be like saying to him, “You are worthless and should die. That is abuse! The proponents say that would never happen, but that did happen to an Oregon woman named Kathryn Judson. She had gone to a doctor’s appointment with her seriously ill husband and exhaustedly sunk into a chair where she overheard the doctor pitching Assisted Suicide to her husband with the clincher, “Think of your wife.” They left and never came back. The husband went on to live another five years.

Next seniors are at risk and very easily fall victim to coercion as the process is very open to that. In most states, heirs can be there for the request and even speak. Anyone can pick up the lethal dose. Once in the house all oversight is gone, there is no witness required at the death. Even if they struggled who would know. If that is not enough, the death certificate is falsified to reflect a natural death. All the information is sealed and unavailable to the public. Even if someone suspected foul play, the death certificate says no crime here. Taking advantage of seniors is epidemic in the States. Look at the case of Thomas Middleton. He made Tami Sawyer his trustee and moved into her home. Within a month he was dead by Oregon’s Assisted Suicide law. Two day after his death Ms. Sawyer listed his house and sold it and deposited the money into three companies she owned with her husband. We will never know if or how much coercion or foul play took place in this case.

Finally those with a disability are at risk. Most people that “qualify” for Assisted Suicide at that point in their life have a disability. Many with long term disabilities have been labeled terminal all their lives. Without meds, treatments, and assistance they would not survive. This is about disability. If you have a disability you are encouraged to give up, commit suicide. If, on the other hand, you are young and healthy, you are given suicide counseling. This is discrimination against people with disabilities. Why should they trust that they will not be coerced into Assisted Suicide, when they are already discouraged to seek treatments and are not treated fairly? When you think about it this is a law that is written just for them. It is a “special” carve out, for the sick, elderly and disabled.

In closing, I just want to add that Assisted Suicide has been rejected in over 100 legislative, ballot initiative and judicial attempts in the USA, including my state New Hampshire. The more it is studied the more uncomfortable people become with it.

Nancy Elliott 
Former three term NH State Representative 
Chair - Euthanasia Prevention Coalition - USA