Rethinking nursing homes. Supporting community based care.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The recent reports of nursing home abuse and the horrific number of COVID-19 nursing home deaths, and other nursing home deaths, should make not only think about improving nursing home care but to rethink nursing homes.

A Canadian military report recently uncovered disturbing conditions in Ontario nursing homes from unsanitary conditions to an alleged choking death that was caused by improper feeding practices.

The response that we are hearing is that we need to improve nursing homes. I agree that existing nursing home care is often substandard, but the answer to the problem is to move to a system of home care.

Canada appears to be committed to providing institutional care for our elderly citizens even though the system of institutional care is broken, expensive and does not provide the care that people want or need.

Fiona Whittington-Walsh in her article published in Rabble.ca examines the problem by comparing the experience with COVID-19 in Denmark to Canada. She writes:

Denmark has a home-based care policy priority for seniors, and has transformed its senior care delivery model into a community-based model -- and has not invested in new congregate facilities since 1987. Reducing the number of nursing homes was matched with a steady increase in the number of home nurses. The decline in long-term congregative facilities for seniors in Denmark is evident in the fact that as of April 24, 2020 only 33 per cent of confirmed COVID-19 deaths were connected to these facilities, while in Canada, 62 per cent of all confirmed COVID-19 deaths are connected to such facilities.

Whittington-Walsh then refers to an Ontario study  suggesting that home care provides better care and is also economically a better option. 

Paul Caune

Whittington-Walsh explains the benefits of home care with stories of people with disabilities. Paul Caune, a disability advocate who was born with muscular dystrophy was at one point in his life forced to live in the George Pearson Centre in Vancouver. Whittington-Walsh writes:

Caune's experiences at Pearson were traumatic. For two years he lived in an environment of fear and abuse. He and the other residents lost their autonomy, lacked basic rights, were forced to abide by curfews, were confined to their beds on scheduled bowel movement days, were only allowed one transfer in or out of bed per day, and were forced to take anti-psychotic drugs to keep them placid. It is the institutional model that is the problem, and Caune's experiences are consistent with the current and historical examples discussed in the first article. 

Caune's battle to ensure home care for people with disabilities is also relevant for people living in nursing homes.

The report of the Parliamentary Committee on Palliative and Compassionate Care that was published in November 2011 is a fundamental guide to moving healthcare systems forward. 

In its recommendation XV on page 52, concerning Palliative and End-of-Life care the report states:

Home care is foundational to transforming Canada’s health care system. In reality it is a paradigm shift in our vision of health care. Allowing patients to stay at home has pronounced benefits for everyone involved, not least of which, the person being cared for in their own home and community. This is important as our nation seeks ways to improve the care of the elderly and vulnerable. 

...A continuing care system can relieve burdens on the acute care system, in a way that doesn’t harm quality of care and perhaps even enhances it. This is not to deny the importance of surgical, diagnostic and specialist interventions, clearly the domain of the hospital. We now know that the majority of care that can be delivered to a person with chronic conditions in an institution can be delivered just as well at home. Home, family and community are too fundamental to the identity of the person, to be ignored in the basic care of the chronically ill or dying person.

The recent military report on nursing home abuse in Ontario confirms the truth of what the community living movement believes, that it is essential for all human beings to have equality and inclusion in society. Institutionalizing people with disabilities or the elderly leads to exclusion and discrimination and eventual abandonment.

I believe in the philosophy of the community living movement and I recognize that the needs of people with disabilities can be very similar to the needs of the elderly.

Canada needs to stop building institutional care that requires people to fit into a model of care that does not provide them with the options that they want and does so in a restrictive and expensive manner.

Canada needs models of compassionate community care. A model that cares for people in their home and community that doesn't segregate people and provides them with the respect and dignity that they deserve.

Military reports disturbing conditions in Ontario nursing homes.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have been writing about the tragic COVID-19 nursing home deaths. On April 14 I wrote about COVID-19 Triage guidelines and nursing home deaths and on May 13 I wrote about the New York State policy that may have led to thousands of nursing home resident deaths. 

In Ontario, nursing home residents comprise more than 75% of the COVID-19 deaths.  The Canadian military was called in to provide needed care and support in nursing homes that were strained by the COVID-19 outbreak.

According to a Global news report:

A total of 285 military members were working in Ontario care homes. In Quebec, more than 1,500 soldiers were sent to 25 long-term care homes, with up to 60 at each facility. More than two dozen Canadian soldiers have now tested positive for COVID-19.

This military intervention not only provided care for vulnerable people, it also provided an impartial witness to the care (or lack thereof), that the residents were receiving.

Military member providing care

Military personnel who were caring for nursing home residents released an horrific report of systemic nursing home elder abuse. According to the CBC News Report by Nick Boisvert:

Military service members, who have been providing assistance at the homes since April 28, say they have observed numerous forms of unhygienic and dangerous behaviour. 

The list of allegations includes:

• Repeated use of medical equipment between COVID-19 patients and others who had not tested positive, without it being disinfected.

• Improper use of personal protective equipment (PPE) by staff and doctors.

• Housing of COVID-19 patients with residents who had not tested positive.

• Staff reusing gloves or not washing hands between resident interactions.

• Staff being aggressive with residents during medical procedures.

• Residents calling for help with no response for up to two hours.

• The presence of insects, including cockroaches and ants.

Ontario Premier Doug Ford

Boisvert reported Ontario Premier Doug Ford stating in his press conference:

"It was so disturbing ... It was the worst report, most heart-wrenching report I have ever read in my entire life"

A Global News report stated:

The soldiers reported witnessing cockroaches, flies, rotten food, as well as residents left in soiled diapers or crying out for help for lengthy periods, the documents allege. At one facility, residents had not been bathed in weeks, they said. 

At a facility in Etobicoke, residents who tested positive for COVID-19 shared rooms with uninfected residents, separated only by a curtain, the documents said. 

It found “major concerns” at Eatonville about care, infection control and narcotics abuse. 

The Orchard Villa home had cockroaches and flies, and residents were “left in beds soiled in diapers.” New staff were not trained adequately, nor was protective gear used properly. 

It said staff were not always sitting residents up before feeding them, and that this may have contributed to the death of a resident who choked after being fed “while suppine.”

All of this and more is occurring in Ontario where we have universal healthcare. Please read the Global news report.

The horrific incidents outlined in the report reveal a culture disrespect and dehumanization towards people needing care. Philosophers like Peter Singer, who teach that people with certain cognitive conditions cease being persons have contributed to this epidemic of disrespect and harm.

This military report confirms the truth of what the community living movement believes, that it is essential for all human beings to have equality and inclusion in society. Institutionalizing people with disabilities or the elderly leads to exclusion and discrimination and eventual abandonment.

The abusive behaviour, mismanagement and dehumanizing conditions is heart breaking and leads me to state that: 

1. Doctors and nurse practitioners, who kill people by euthanasia make decisions based on societal attitudes towards living with physical and psychological needs.
2. The concept of "freedom of choice" does not apply to conditions and attitudes that lead someone to believe that people living with certain conditions are better off dead. Subtle and overt social pressures creates a cultural shift from a "choice to die" to an expectation to die.
3. Some people have asked to die by euthanasia to avoid living in a nursing home. This report may lead to a "clean-up of nursing, it will also lead to more euthanasia deaths.

We need a caring culture: a culture that does not institutionalize the elderly, infirm or people with disabilities, but rather offers compassionate community care. 

Policies that promote home care and enable people to live independently need to be implemented. For people experiencing dementia or Alzheimer's, a community such as Hogeweyk, in the Netherlands provide an excellent example of how this is done.

Institutionalizing and warehousing people results in a culture of abandonment, abuse and often death. 

Let's rethink the concept of nursing homes.

More articles on this topic:

• Report into nursing home deaths will not protect people from suspicious euthanasia deaths (Link).
• New York policy may have led to the deaths of thousands of nursing home residents (Link).
• COVID-19 Triage guidelines and nursing home deaths (Link).
• Pandemic palliative care protocol. Selecting people to die and abusing the purpose of palliative care (Link).
• Euthanasia doctor developed COVID-19 Triage guidelines (Link).

More than 15,000 Canadians have died by euthanasia (MAiD) .

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I conservatively estimate that there has now been more than 15,000 (MAiD) euthanasia deaths in Canada since it was legalized.

On January 30, 2020 I published an article stating that, in Canada, there had been more than 5000 MAiD assisted deaths in 2019 and at least 13,000 assisted deaths since it was legalized. 

That article was written to correct the media who were reporting that there had been 6700 euthanasia deaths in Canada since legalization.

Petition: Reject euthanasia Bill C-7 (Link).

On February 24, at the press conference announcing Bill C-7, the bill to expand euthanasia, the federal government estimated that there had been more than 13,000 assisted deaths, since legalization, with 5444 in 2019 and 4438 in 2018.

The Third Interim report on MAiD stated that there were 3714 reported assisted deaths up to December 31, 2017. Since the government estimated that there were 4438 in 2018 and 5444 in 2019, therefore I can estimate that 13,596 Canadians died by MAiD up to December 31, 2019.

The data indicates that the number of assisted deaths is continuing to increase but based on 2019 data I can state that there has been at least 1814 (more likely 2000) assisted deaths in 2020. Therefore as of April 30, 2020, there has been at least 15,410 euthanasia deaths.

This data does not account for the under-reporting that was uncovered in the Quebec euthanasia report.

The federal government is slow in releasing official assisted death statistics but we do have accurate 2019 data from Ontario, Nova Scotia, and Alberta.

According to the data from the Ontario Office of the Chief Coroner there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing nearly a 20% increase in Ontario assisted deaths in 2019.

The new Ontario assisted death data indicates that there were 570 reported assisted deaths in the first three months of 2020 with 199 in March alone. The euthanasia rate is sadly increasing, even during the Covid-19 crisis.

Petition: Reject euthanasia Bill C-7 (Link).

The Canadian government must reject Bill C-7 and begin the promised 5-year review of the euthanasia law with an open view to what is actually happening rather than continuing to expand euthanasia, making Canada the most permissive euthanasia regime in the world.

Do you have a personal euthanasia story? Sharing your story may help us prevent other euthanasia deaths. Contact the Euthanasia Prevention Coalition at: 1-877-439-3348 or info@epcc.ca.

Ontario MAiD (euthanasia) deaths increase during Covid-19 crisis.

Sign the Petition: Stop euthanasia Bill C-7 (Link)

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Ontario Office of the Chief Coroner has released new data for MAiD (euthanasia and assisted suicide deaths). In Ontario between June 17, 2016 and March 31, 2020, there have been 4888 reported assisted deaths with 199 reported assisted deaths in March 2020 alone.
 
In Ontario there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017, and 189 in 2016. 

The new data indicates that there were 570 reported assisted deaths in the first three months of the year with 199 in March alone. The euthanasia rate is sadly increasing.

Sign the Petition: Stop euthanasia Bill C-7 (Link)

Parliament is currently debating Bill C-7, a bill to expand euthanasia in Canada. Bill C-7 amends the euthanasia law by eliminating the "terminal illness" requirement, allowing advanced requests for euthanasia, eliminating the 10 day waiting "reflection" period and it falsely claims to prohibit euthanasia for mental illness.

If Bill C-7 passes without amendments, it will give Canada the most extreme euthanasia law in the world and result in a greater increase in deaths by lethal injection.

A recent CBC Radio show by Duncan McCue, interviewed Stephanie Green, president of the Canadian Association of MAiD Assessors and Providers who explained how MAiD can be done on a patient with Covid-19. Green stated:

"I have provided for MAID on the same day that I've met someone on certain occasions," 

"It's not common … MAID is a process that requires rigorous procedure and safeguarding and is meant to be that way."

Green then explained that "MAID applications can be expedited if two assessing physicians agree a patient is at "imminent risk" of losing their capacity or life, they can forgo the typical 10 day reflection period required by law. Green then stated:

"If they're about to die, or we think they're going to die within 10 days, we actually can go ahead and waive that reflection period and move quicker,"

I recently reported on an article written by Globe and Mail reporter Kelly Grant stating that the Ottawa and Hamilton regions temporarily stopped providing euthanasia "MAiD services" during the Covid-19 pandemic. Grant wrote:

The Champlain Regional MAID Network, which serves Ottawa and the surrounding area, issued a notice on Wednesday that it was shutting down the service in hospitals and homes to prevent the transmission of COVID-19 and to conserve health-care resources. 

Hamilton Health Sciences, a hospital network with 10 sites, has also stopped providing assisted dying within its walls.

It is possible that the MAiD (euthanasia) data will indicate a slowing trend in April 2020 due to Covid-19.

Do you have a personal euthanasia story? Sharing your story may help us prevent other euthanasia deaths. Contact the Euthanasia Prevention Coalition  at: 1-877-439-3348 or info@epcc.ca.

Covid-19 crisis demonstrates the need for euthanasia and assisted suicide is abstract rather than practical.

Euthanasia is not an essential service.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill

Kevin Yuill, the author of the book Assisted Suicide: The Liberal, Humanist Case Against Legalisation, and Theo Boer, a former member of a Netherlands Regional Euthanasia Review Committee (2005 - 14) collaborated to write the article: What Covid-19 has revealed about euthanasia, that was published by Spiked on April 14, 2020.

The authors begin the article by commenting on Covid-19 and healthcare:

There has not been, in living memory, more focus on healthcare, the vital role of doctors, the sacrifices made by nurses, and the wonderful efforts of everyone involved in the sector. Amid the coronavirus crisis, daily heroism, the scale of human loss, and the awful scenes in hospitals underline what is important – and what is not.

Theo Boer

They authors comment on euthanasia and Covid-19 in the Netherlands:

It will surprise some that in the Netherlands, the only dedicated clinic providing euthanasia and assisted suicide has closed. Euthanasia Expertise Centre (formerly known as End of Life Clinic) has suspended all euthanasia procedures. The clinic’s website says that existing procedures have been put on hold and new patients are no longer admitted. The centre – which in 2019 alone ended the lives of 898 patients suffering from cancers, psychiatric problems, early on-set dementia, and accumulated age-related complaints – is willing to make an exception only for those expected to die soon and those who may soon lose their capacity for decision-making.

They comment on euthanasia and Covid-19 in Belgium:

Similarly, in Belgium, Jacqueline Herremans, a member of the federal commission reviewing euthanasia, has noted that there are few resources and even fewer doctors available for euthanasia at the moment: ‘The most important thing right now is that we fight the coronavirus.’

They then comment on euthanasia and Covid-19 in Canada:

In Canada, authorities are also shutting down services. For a process that requires two different medical assessments and witnesses, the lives involved are not worth the risk. According to the Globe and Mail, two places in Ontario, where euthanasia and assisted suicide have been legal since 2016, have stopped providing medical assistance in dying (MAID) because of the coronavirus pandemic (one has since resumed for existing patients and those whose deaths are imminent).

In Ontario, only Hamilton and Ottawa are known to have decided that euthanasia is not an essential service. 

The authors point out that the Netherlands euthanasia clinic state that euthanasia is not a priority during the Covid-19 crisis. The statement from the euthanasia clinic follows an opposite statement last year where Steven Pleiter, the director of the clinic said:

‘If the situation is unbearable and there is no prospect of improvement, and euthanasia is an option, it would be almost unethical [of a doctor] not to help that person’

The authors say that palliative care institutions have not shut-down during the Covid-19 pandemic.

So what has the Covid-19 pandemic taught us about euthanasia? The authors state:

What the Covid-19 crisis has demonstrated is that the need for euthanasia and assisted suicide is abstract rather than practical. In the Netherlands in the 1980s, assisted dying started out as the ultimate solution to impending horrible deaths. In present times, with a high level of care for the dying available in most countries with good healthcare, assisted dying is not about actual deaths, but about deaths that people fear. The reality is that most people die peaceful deaths. But many fear loss of control and find the prospect of others caring for them terrifying. 

Covid-19 brings the reality of death, the necessity of caring for others and being cared for by others, into our living rooms, making the preciousness of all lives and the tragedy of all deaths real. We see the humanity of the elderly and frail; no longer are they burdens to be dispatched from this world, but victims of horrifying disease that all are invested in fighting.

The authors conclude by stating:

"Perhaps, though, we can remember this time when we made huge sacrifices to preserve every life, no matter how frail and vulnerable. We can remember this time when euthanasia no longer seemed necessary."

Thank you Kevin and Theo. Euthanasia is not an essential service and it is not healthcare.

Euthanasia (MAiD) is not an essential service during Covid-19 crisis.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kelly Grant, the health reporter for the Globe and Mail, reported on March 27 that at least two regions in Ontario have stopped doing euthanasia during the Covid-19 crisis since it is not an essential service and the need to conserve healthcare services.

According to Grant, the Ottawa and Hamilton regions have temporarily stopped providing euthanasia "MAiD services" during the Covid-19 pandemic. Grant wrote:

The Champlain Regional MAID Network, which serves Ottawa and the surrounding area, issued a notice on Wednesday that it was shutting down the service in hospitals and homes to prevent the transmission of COVID-19 and to conserve health-care resources. 

Hamilton Health Sciences, a hospital network with 10 sites, has also stopped providing assisted dying within its walls.

Grant reported that in the Hamilton region:

Several of the hospital network’s MAID providers have already been redeployed and elective procedures of all kinds are being delayed to make room for an expected surge of coronavirus patients.

While in Ottawa, Grant reported that the Champlain Regional Medical Assistance in Dying Network sent out the following bulletin:

“After careful consideration of the principles to prevent COVID-19 transmission and conserve health-care resources, and in alignment with the provincial ramp-down of elective services, effective immediately, we will not be providing community MAiD procedures or in-patient procedures at The Ottawa Hospital,” 

“Additionally, our partners at Home and Community Care will not be in a position to provide nursing support for independent practitioners who wish to provide MAiD in the community.”

Killing people by lethal injection is not healthcare. Canada's MAiD (euthanasia and assisted suicide) law creates an exception in the criminal code to homicide. Since it is a criminal code statute it is technically not healthcare, therefore it cannot be an essential healthcare service.

The euthanasia clinic in the Netherlands also announced that it has temporarily shut-down due to healthcare priorities during the Covid-19 crisis.

But in Victoria BC and the Toronto region euthanasia (MAiD) has been deemed an essential service. Grant reports:

Stefanie Green, a Victoria doctor and the president of the Canadian Association of MAID Assessors and Providers (CAMAP,) said the health authority on Vancouver Island has also deemed assisted dying an essential service.

Killing is not healthcare.

Ontario Medical Association President - Conscience Rights Matter

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Petition: Protect Conscience Rights for Healthcare workers in Ontario (Link).

Several years ago, the Ontario College of Physicians passed an edict requiring physicians, who oppose euthanasia (MAiD) to do an effective referral to a physician who is willing to kill a patient. Physicians who oppose euthanasia rights responded that to effectively refer a patient for euthanasia was similar to doing the act itself. These physicians began a campaign to demand conscience protections in law.

The case for conscience protection was then brought to the Ontario court where the Ontario Court of Appeal found that physicians who challenged the College of Physicians and Surgeons of Ontario (CPSO) policy requiring an "effective referral" for Medical Aid in Dying (euthanasia and assisted suicide) and other morally contentious issues, that their Charter rights were infringed by the policy, but the infringement is reasonable in a free and democratic society. Link to Court of Appeal decision.

The Physicians for Healthcare and Conscience have now been working to convince politicians to protect conscience rights for healthcare workers through legislation.

Dr. Sohail Gandhi

This week Dr Sohail Gandhi, the Ontario Medical Association (OMA) President, published a personal blog supporting conscience rights, titled:  Conscience Rights Matter. In his blog Gandhi states:

In particular, I think of the decision by the divisional court of Ontario, and then the Ontario Court of Appeal to deny physicians conscience rights. The courts claimed they struck a “reasonable balance”. But they also went on to expressly state in their ruling that the “referral requirement does infringe on doctors’ religious freedoms.” Make no mistake about this, rights and freedoms of certain individuals are being violated by this ruling.

Gandhi continues:

Many physicians’ groups have expressed concern about being forced to make a referral for this service, in violation of their morals and ethics. This concern has been expressed not just by physicians of faith, but by secular groups like the Canadian Society of Palliative Care Physicians.

Gandhi then states that he supports a system that protects conscience rights for physicians that requires a physician, who oppose euthanasia, to provide patients with the contact information for the MAiD coordination service, which he says is not a referral.

I agree that the MAiD coordination service contact information is available to everyone anyway and the physician is only providing contact information that can be found on the internet, nonetheless, it remains a lesser form of a referral.

I thank Dr Gandhi for his courage to write this blog article. There are euthanasia doctors in Ontario who will attack him simply for presenting this balanced point of view.

I hope that Dr Sohail Gandhi's support for conscience rights will move the Ontario government to protect conscience rights for healthcare workers in Ontario.

Further reading on the Ontario Conscience Rights issue:

• November, 2017 - the Manitoba Legislature unanimously passed Bill 34: The Medical Assistance in Dying (Protection for Health Professionals and Others) Act.
• Dr Ramona Coelho: We are a nation of Laws and Conscience.
• Alex Schadenberg: Ontario doctors will leave the Province if they are forced to participate in assisted dying.
• Alex Schadenberg: Health professionals opposing euthanasia require conscience protection.
• Alex Schadenberg: Ontario doctors shouldn't be forced to refer their patients for euthanasia.

Canadian euthanasia study offers more questions than answers.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A study examining MAID data from Ontario, the largest province in Canada, reports confirms much of what we knew already about euthanasia/assisted suicide deaths worldwide, but the data actually opens questions about the use/misuse of euthanasia in Canada.

Article: Euthanasia deaths rise quickly in Ontario. Nearly 1800 reported assisted deaths in 2019 (Link).

The data indicates that many of those who died by euthanasia were not terminally ill and had decided to die by lethal injection rather than live in a nursing home / institutional setting.

The lead study author, Dr James Downar, is a founder of the Dying with Dignity physicians advisory council and a long-time euthanasia promoter. 

This study will be used to assure politicians that Canada's euthanasia law can be expanded without fear of negative effects to vulnerable groups. It will also be used to undermine the resistance of palliative care doctors to euthanasia.

The data in this study was obtained from the euthanasia reports submitted to the Chief Coroner of Ontario. The reports are submitted by the doctors or nurse practitioners who lethally injected the person. This data was submitted, in a self-reporting system, to justify the act of euthanasia.

Since doctors don't self-report controversial decisions, it is unlikely that comments from these reports will uncover abuse.

Kelly Grant, writing for the Globe and Mail newspaper reported:

Patients who choose medically assisted death are wealthier, younger, more likely to be married and less likely to live in long-term care than those who die naturally, according to a major study of assisted dying in Canada’s most populous province.

The media suggests that this study proves that euthanasia does not negatively effect people who are poor or vulnerable, but in fact this study simply confirms what we have always known that people who are white, wealthy and worried are more likely to die an assisted death.

The study examined the data from 2241 reports from the euthanasia deaths in Ontario between June 17, 2016 and October 31, 2018.

Grant reports on the data in the study:

Patients who received an assisted death were more likely to be wealthy, with 24.9 per cent of MAID recipients earning enough to be in the highest of five income brackets. By contrast, 15.6 per cent of patients who died naturally were in the top income bracket. 

The study found that Ontario MAID recipients were, on average, two-and-a-half years younger when they died, and less likely to have been living in an institution, usually a nursing home, before they died. 

Of those who died naturally, 28 per cent lived in institutional settings, while only 6.3 per cent of MAID recipients did. 

The data in the study indicates that those who died by euthanasia died at age 74.4 (average) whereas those who died a natural death died at age 77 (average). 

Why are people dying by euthanasia 2.6 years younger than those who die a natural death? 

Why are people who die by euthanasia less likely to live in an institution (nursing home etc).

The data suggests that many of those who died by euthanasia were not terminally ill and decided to die by lethal injection rather than live in a nursing home / institutional setting.

Canada's euthanasia law stated that: natural death is reasonably foreseeable, but the law did not define this. It appears that most doctors had a wide interpretation of natural death being reasonably foreseeable.

Those who died by euthanasia stated that they were experiencing physical suffering (99.5%) of the time and psychological suffering (96.4%) of the time. The Canadian law states that physical or psychological suffering "is intolerable to them and that cannot be relieved under conditions that they consider acceptable." which is completely subjective.

The study states that:

Psychiatric consultations were performed in 6.2% of cases. In 4.3% of cases, the MAiD recipient had been found ineligible for MAiD on a previous request.

Considering the conditions that people may experience as they approach death, it is surprising that only 6.2% of the MAID deaths had a psychiatric consultation.

The data indicates that people who died by euthanasia had access to palliative care (74.4%) of the time suggesting that people are not asking to be killed due to lack of alternatives.

Grant reported that Ebru Kaya, a Toronto palliative care specialist questioned this assertion:

...“They use this blanket term. Palliative care providers could mean anything. The MAID assessor who is also a palliative care physician may use that clinical encounter to assess for MAID as a palliative care encounter, but the two are very different.”

Similar to previous studies, this study examines data from reports submitted by doctors and nurse practitioners who did the lethal injection. There are no interviews with patients, before they died, to determine why are they asked for death. There are no "third party" reports to ensure that the "letter of the law" was followed.

We do not know why people are dying 2.6 years earlier than those who died a natural death.

It is likely that many of the people were not terminally ill but facing the dilemma of having to live in a long-term care institution because their health condition required care.

I suggest that this study proves that people with disabilities are right. Canadians are deciding that death is preferable to living with a disability.

More than 5400 Canadians died by euthanasia in 2019 more than 13,000 since legalization

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The media was reporting that there have been more than 6700 MAID deaths in Canada since it was legalized. I estimate that there have been at least 13,000 euthanasia deaths and here is how I defend this estimate.

The 6700 deaths was based on the Fourth Interim Report on Medical Assistance in Dying released by Health Canada on April 25, 2019 which stated that there were 6700 assisted deaths up to October 31, 2018. The data in the report from Quebec and the three Territories was incomplete. The Quebec data in the Health Canada report was up until March 31, 2018. (Link to my commentary on the report)

The Health Canada report was sloppy by stating that the number assisted deaths represented 1.12% of all deaths. The Health Canada report divided the number of reported assisted deaths into the total deaths, but they did not remove the total Quebec deaths from March 31 - October 31 from the equation.

The number of assisted deaths as of December 31, 2018, was approximately 7949.

(The government of Canada estimated that there were 5444 assisted deaths in 2019 and 4438 assisted deaths in 2018 in Canada on February 24, 2020)

On March 21, 2019 I reported that there were 7949 assisted deaths in Canada as of December 31, 2018 representing 4235 assisted deaths in 2018, an increase of 50% over 2017, representing almost 1.5% all deaths in 2018. The data from my report was obtained from a presentation by Jocelyn Downie, an academic euthanasia activist, who spoke on March 15, 2019 to a Royal Society of Canada luncheon in Ottawa. 

Similar to the Netherlands and Belgium, nearly all of the assisted deaths are euthanasia (lethal injection) rather than assisted suicide.

We don't have national assisted death statistics for 2019 but we do have accurate data from Ontario and Alberta. 

According to the data from the Ontario Office of the Chief Coroner there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing nearly a 20% increase in Ontario assisted deaths in 2019. 

What is more striking about the data is the increase in the second half of 2019 where there were 1015 assisted deaths in the second half of 2019 up from 774 in the first six months of 2019, meaning that Ontario will likely have more than 2000 assisted deaths in 2020.

Alberta Health Services updates there assisted death data regularly. The Alberta data indicates that there were 377 assisted deaths in 2019 up from 307 in 2018, and 206 in 2017. The data indicates a 23% increase in Alberta assisted deaths in 2019.

A report by Marney Blunt for Global News stated that the number of assisted deaths are increasing quickly in Manitoba. Blunt reported that the number of Manitobans dying by euthanasia skyrocketed. The report stated:

When medically-assisted death first became legal in 2016, 42 people requested the service and 24 received it. That number rose in 2017, when 142 people requested MAiD and 63 people received it. 

Those numbers almost doubled in 2018, when 239 requested and 138 received. Last year, 313 people asked for a medically-assisted death, and 177 people received it.

The data indicates a 28% increase in Manitoba reported assisted deaths in 2019.

Since Ontario, Alberta and Manitoba had approximately a 20% increase in 2019, I would assume that there was a similar increases nationally. Therefore there approximately 5000  (4235 + 20%) assisted deaths in Canada in 2019 and 13,000  assisted deaths since legalization. Even if the numbers were slightly lower than 5000 in 2019, today is January 20, so it is safe to say that there has been 13,000 assisted deaths since legalization.

But that is not the whole story.

Canada's data collection system does not account for under-reporting of assisted deaths, but Quebec's data collection system can account for under-reporting. Quebec employs a multi report system making it possible to uncover the number of times a physician didn't report the assisted death.

Based on an analysis by Amy Hasbrouck and Taylor Hyatt, the Quebec interim report indicated that between April 1, 2017 – March 31, 2018 there were 142 unaccounted assisted deaths in the data representing 17% of all assisted deaths. The Quebec Interim report also indicated that 7 assisted deaths did not fit the criteria of the law, 22 assisted deaths did not follow procedural safeguards and in 67 assisted deaths, the physician did not provide the necessary information to determine if the patient fit the criteria of the law.

Based on the Quebec Interim report, if we extrapolate the data to all of Canada, it would suggest that there may have been more than 2000 (17%) unreported assisted deaths in Canada and approximately 60 assisted deaths that did not fit the criteria of the law.

This article is based on hard facts and conservative estimates. The fact is that Canada's assisted death law is quickly going out of control. The recent federal government consultation, that employs biased questions, is not concerned about Canadians whose lives are taken without due process.

Manitoba: MAID euthanasia deaths are increasing quickly.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week I reported that there were approximately 5000 assisted deaths in Canada in 2019 and 13,000 since legalization.

On January 20th I reported that, in Ontario there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing an almost 20% increase in 2019.

The increase in the second half of 2019 is striking. In Ontario there were 1015 assisted deaths in the second half of 2019 up from 774 in the first six months of 2019. Ontario will likely have more than 2000 assisted deaths in 2020.

On January 14th I reported that the Alberta data indicates that there were 377 reported assisted deaths in 2019 up from 307 in 2018, and 206 in 2017. The data indicates a 23% increase in Alberta assisted deaths in 2019.

A report by Marney Blunt for Global News states that the number of assisted deaths is increasing quickly in Manitoba. Blunt reported that the number of Manitobans dying by euthanasia skyrocketed in the past few years. The report stated:

When medically-assisted death first became legal in 2016, 42 people requested the service and 24 received it. That number rose in 2017, when 142 people requested MAiD and 63 people received it.

Those numbers almost doubled in 2018, when 239 requested and 138 received. Last year, 313 people asked for a medically-assisted death, and 177 people received it.

The data indicates a 28% increase in Manitoba reported assisted deaths in 2019.

Sadly, I expect a further increase in assisted deaths now that a Quebec court struck down the "terminal illness" requirement in the law. The Quebec court decision was not appealed by the government causing an incremental extension of the law to people who are not terminally ill and may be psychologically suffering.

After the election, Prime Minister Trudeau announced that a first priority for the government is to amend Canada's euthanasia law.

Do you have a personal euthanasia story? Sharing your story may help us prevent other euthanasia deaths. Contact us at: 1-877-439-3348 or info@epcc.ca.