Canadian Virtual Hospice promotes euthanasia book for children

 The Canadian Virtual Hospice (virtualhospice.ca) has published an "activity book" aimed at normalizing euthanasia (MAiD) for children.

A web-based resource launched in 2004 to be a “platform [that] could address some of the national gaps in palliative care,” the Canadian Virtual Hospice was the first attempt at connecting Canadians with an array of health specialists online to help them face the daunting task of accompanying their ill and dying loved ones at the end of their lives. As reported on its website, “visits to Virtual Hospice continue to climb – from 34,000 in 2004 to 2.3 million in 2020,” which bespeaks the desperate need to shore up this crucial yet often-overlooked segment in healthcare.

On July 26th, 2022, The Canadian Virtual Hospice, which gets funding from such organizations as the Winnipeg Regional Health Authority, Health Canada, and Veteran Affaires Canada, announced its newest children's resource available on its website:

https://t.co/eZbZLrz4Bu is home to The Medical Assistance in Dying (MAiD) Activity Book! Created for young people who have someone in their life who may have MAiD, this resources if available for free download. https://t.co/ugopiHYWus pic.twitter.com/um13rVqItL

— Canadian Virtual Hospice (@VirtualHospice) July 26, 2022

The activity book is replete with vibrant colours, graphics, and a juvenile font, and includes a section that explains the three "medicines" taken to kill a human being. On page 4, Step number 3 states:

The third medicine makes the person’s lungs stop breathing and then their heart stops beating. Because of the coma, the person does not notice this happening and it does not hurt. When their heart and lungs stop working, their body dies.

Meanwhile, some doctors have actually been frank in their admissions that they have no idea whether euthanasia “does not hurt,” since, as reported in a recent National Post article, during the euthanasia procedure: 

Monitors aren’t used. There are no monitors measuring brain waves or heart activity. Doctors say it would take away from the intimacy of the experience for the person and the family. 

This reassurance has also been challenged by Dr. Joel Zivot, an anesthesiologist and critical care doctor at Emory University School of Medicine who has studied how lethal injections impact prisoners' bodies; he has called both for autopsies to be done on MAiD deaths to see exactly how the poison impacted the body, and for paralyzing agents to not be used in the procedure in order to have a more realistic assessment of the MAiD recipient’s experience (link).

Christopher Lyon

While the activity book contains “helpful” exercises such as suggested questions the child can ask the would-be MAiD recipient and a feelings chart, Twitter user Dr. Christopher Lyon (@ChristophLyon) pointed out the inability of the activity book to address the fundamentally flawed premise behind assisted death – the fact that doctors cause a death instead of stopping it – and thus, it can't help the child process the trauma of a betrayal of their trust in healthcare providers:

However, kids who lose a parent or sibling to suicide can be deeply traumatised by the experience. What happens with children when doctors *help* the suicide instead of stop it? #MAiD https://t.co/VOQgbR9Irw

— Dr. Christopher Lyon (@ChristophLyon) July 26, 2022

Even more disturbing, the MAID to MAD initiative (@VulnerableC7) pointed out the similarity in branding between the “Medical Assistance in Dying (MAiD) Activity book” and the “Me and My Illness” activity books that The Virtual Hospice provides, both aimed at children:

The branding and design continuity across these @VirtualHospice documents - both aimed at children - is striking. Wondering about associations being made in the minds of sick kids and #MAiD especially as #AMAD considers expanding MAiD to children (mature minors). pic.twitter.com/esjd550TMK

— MAID to MAD initiative AMM devient MAM (@VulnerablC7) July 28, 2022

If the message being sent with this colourful and engaging activity book is that euthanasia is a normal, innocuous act that *doesn’t hurt* and is appropriate for anyone who is in pain, how can a sick and/or suffering child escape the conclusion that it may be an appropriate solution for them - especially once MAiD is extended to mature minors?

Dr Ramona Coelho: Offering euthanasia to a suicidal person leads to premature deaths.

By Michalina Ratajczak
Assistant to the Euthanasia Prevention Coalition Executive Director

Dr. Coelho's presentation to the Special Joint Committee on Medical Assistance in Dying. (Youtube Link).

On May 13th, 2022, the Canadian government’s expert panel on MAiD and Mental Illness released its final report, which recommended no added legislative safeguards to Bill C-7 for those living with mental illness. Dr. Ramona Coelho, who recently presented at a meeting of the federal Special Joint Committee examining the provisions of the Criminal Code relating to medical assistance in dying, noted that the expert panel’s report:

...is more dangerous than I could have anticipated. It recommends no added safeguards in the legislation for those living with mental illness and rather suggests the assessor use certain cautions as a guide but that decisions should be made on a case-by-case basis without any operational guidance.

In her opening remarks to the the Special Joint Committee, Dr. Coelho, who was a witness representing the marginalized patients she frequently sees in her practice, noted how vulnerable such populations are to MAiD being raised as a legitimate course of treatment by their physicians:

I warned [at prior committees discussing Bill C-7] that many injuries and illnesses are accompanied by transient suicidality that ends with adaptation and support but that, on average, [lasts for] two years... the overwhelming majority of persons after those two years rate their quality of life as the same as age-matched healthy individuals. Offering MAiD in a period of known suicidality would lead to premature deaths of those who would have recovered. Now Bill C-7 is legal.

Coelho went on to describe some of the concrete outcomes of Bill C-7's passing which belie the final report’s assessments that it needs no further legal safeguards, including the following case:

A man had a small stroke affecting his balance and swallowing. The patient was depressed and isolated due to Covid-19 outbreak on his ward. The stroke neurologist anticipated the man would be able to eat normally and regain most of balance. He declined all therapy and psychiatry diagnosed him with an adjustment disorder, but they felt he would improve. However, he requested MAiD. Neither of his MAiD assessors had any experience in stroke rehabilitation and recovery. In this acute phase while struggling with his mood and isolation, with no therapy to gauge his final level of function, he received MAiD. He had no terminal illness but due to the fact that he was adapting to a slightly thickened diet, and was temporarily slightly undernourished, they considered him Track One eligible, and he received MAiD the following week. No safeguards were technically broken and yet he died when acutely down, isolated, and had not experienced living with maximal recovery from his stroke.

Under the two-track MAiD legislation, a patient is eligible for Track One if their providers deem that natural death is reasonably foreseeable.

Coelho went on to mention that “there is no safeguard in Bill C-7 that forbids raising MAiD” to mentally vulnerable patients, and “...the related amendment was voted down by the Senate. This ignores current suicide research that shows messaging promoting suicide may lead to more people choosing it.”

Dr. Coelho's excellent response to committee questions (Link).

 

In her follow-up remarks to the committee, Coelho summarized the witness reports to the committee as demonstrating that “MAiD regime safeguards do not work to protect Canadians.” The recommendations of the final report, which are mere recommendations and do not have the force of law, leave vulnerable Canadians open to the personal value judgments of physicians and MAiD assessors, who have varying opinions about what irremediable suffering entails. 

For example, Coelho mentioned that:

Ellen Wiebe [a doctor who operates a MAiD clinic in Vancouver] testified that if someone wanted MAiD because it took five years to access a service, she would consider that irremediable. Patients with unaddressed psychosocial suffering will be therefore given MAiD by assessors like her.

Instead of introducing strict medical standard of care and legal safeguards that would protect the vulnerable from the subjective value judgments of individual health practitioners such as Wiebe’s, the panel’s final report announces nineteen “recommendations” that:

...in its view, can be fulfilled without adding new legislative safeguards to the Criminal Code. The Panel found that the existing MAiD eligibility criteria and safeguards buttressed by existing laws, standards, and practices in related areas of healthcare can provide an adequate structure for MAiD MD-SUMC so long as they are interpreted appropriately to take into consideration the specificity of mental disorders.

Two crucial recommendations in the final report (Link), establishing incurability and irreversibility, betray the supremacy of such individual interpretation - Recommendations 2: Establishing Incurability, and Recommendation 3: Establishing Irreversibility:

The Panel is of the view that the requester and assessors must come to a shared understanding that the person has a serious and incurable illness, disease or disability.

and

The Panel is of the view that the requester and assessors must come to a shared understanding that the person is in an advanced state of irreversible decline in capability.

Dr. Ramona Coelho specializes in caring for immigrants and persons from marginalized communities. Thank you Dr. Coelho for your continued advocacy.

Previous articles by Dr. Coelho:

• Why euthanasia for children is wrong (Link). 
• Profound social change with euthanasia for mental illness (Link) 
• Why expanding euthanasia keeps us up at night (Link).
• Why I oppose euthanasia (Link).