Showing posts with label Ontario Medical Association. Show all posts
Showing posts with label Ontario Medical Association. Show all posts

Sunday, November 13, 2022

Canada Legalizes Assisted Death for the Mentally Ill; Doctors Call the Law “Unethical” and “Coercive.”

By Judith Robinson

Patients in Canada can legally request a medically assisted death for conditions such as depression, bipolar disorder, personality disorder, schizophrenia, PTSD or any other mental affliction under the new Bill C-7. Almost 1500 of the nation’s publicly funded psychiatrists, paediatrians, medical professors and general practitioners have joined an organization to fight the government’s horrific cost-cutting measure.

While Canada has been criticized for neglecting its elderly, through offering inadequate old-age pensions, shoddy long-term care facilities and negligent health care, an even more disturbing trend has recently emerged.

In March of 2021, Bill C-7 passed making it legal for mentally ill adult and adolescent patients to request a medically assisted suicide. The government is currently discussing making it possible for parents and guardians to request an assisted death for children they feel unable or unprepared to care for. A mother in Quebec has already requested an assisted death for her four-year-old with severe disabilities. Some politicians she met with and are sympathetic to her cause.

Medical professionals state they are being pressured to promote assisted death because suicide is cheaper than providing care under Canada’s publically funded medical system. A group of 1,490 Canadian doctors, including medical professors and specialists, calling themselves Physicians Together with Vulnerable Canadians, have publicly expressed their concerns about the situation on their website:
“Medicine… has been transformed into a technical occupation that allows physicians to deliberately end the lives of their suffering patients. Forced participation in arranging and facilitating euthanasia and assisted suicide is now required by certain regulatory colleges…The shock of a sudden illness, or an accident resulting in disability, can lead patients into feelings of anger, depression, and guilt for requiring care – emotions that, with proper support and attention, can resolve over time. The care and encouragement shown by physicians may be the most powerful force in overcoming despair and providing hope. Unfortunately, patients can no longer unconditionally trust their medical professional to advocate for their life when they are at their weakest and most vulnerable. Suddenly, a lethal injection becomes part of a repertoire of interventions offered to end their pain and suffering.”
When Canada passed its first euthanasia law in 2016, the high court ruled that only competent adults suffering from a “grievous and irremediable” medical condition had a right to receive a lethal injection. There were safeguards in place such as a 10-day waiting period to allow the patient time to change their mind and there was an. onus on the physician to provide alternative treatments to euthanasia to alleviate pain and suffering — such as government-funded palliative care programs.

Under the provisions of Bill C-7 patients could request and receive a lethal injection within the same day without ever having been offered any other treatment options. “MAID (medical assistance in dying) has been deemed an essential service under the Canada Health Act and palliative care has not,” the signatory doctors stated. As of March 2023, a Canadian citizen “whose sole underlying condition is depression, bipolar disorder, personality disorder, schizophrenia, PTSD or any other mental affliction” can request a medically assisted suicide if two medical professionals agree.

Psychiatrist Dr. Grainne Neilson, past president of the Canadian Psychiatric Association is struggling “to conclude, with any certainty or confidence, that a mental illness has no prospect of ever improving.” Neilson said psychiatrists will be looking for “a robust, eligibility assessment process” before they will be willing to consider authorizing MAID for their patients. Psychiatrists will want to know that “standard treatments have been offered, attempted and failed, with no other reasonable alternatives.”

Only 28 percent of physicians recently surveyed by the Ontario Medical Association said that MAID should be permitted with sole mental illness as an underlying condition and only 12 per cent said they would support it for their own patients.

“Whether children and adolescents can have legal access to MAID is a complex question that has yet to be fully considered and adjudicated by Canadian society, in Parliament and through courts of law,” according to the Canadian Paediatric Society.

In a paper entitled Medical Assistance in Dying: A Paediatric Perspective principal author Dawn Davies wrote that “governments at every level develop policies and procedures to safeguard young people from possible risks, harms or abuses of MAID, given their unique vulnerabilities.”

Dr. Ramona Coelho, a family physician to marginalized communities and a founding member of Physicians Together with Vulnerable Canadians said that The Special Joint Committee on Medical Assistance in Dying is currently considering MAID for children. She adds:
“In an increasing number of reported cases, MAID is taking the place of medical treatment and government assistance for those with social, economic and psychiatric issues… How can we keep MAID from being used as a tool to absolve governments of their obligation to provide for those living in poverty, with disability, or with mental illness their equal rights as citizens to health, economic security, and life? That is the question the Special Joint Committee should be considering. But instead, expanding MAID for children is on the agenda.”
An article in The Spectator UK asserts that Canadian authorities are encouraging doctors to adopt MAID in order to save costs. In an article entitled “Why is Canada Euthanizing its Poor?” the world’s oldest weekly magazine disclosed that:
“The old MAID regime saved $86.9 million per year --- a ‘net cost reduction’, in the sterile words of (a Canadian Parliamentary) report – Bill C-7 would create additional net savings of $62 million per year. Healthcare, in particular for those suffering from chronic conditions, is expensive; but assisted suicide only costs the taxpayer $2,327 per ‘case.’ And, of course, those who have to rely wholly on government-provided Medicare pose a far greater burden on the exchequer than those who have savings or private insurance…. There is already talk of allowing ‘mature minors’ access to euthanasia too – just think of the lifetime savings.”
The situation is so dire that the stoic, penny-pinching former head of the Hollinger Newspaper empire, Conrad Black, stepped into the fray writing a protest column in The National Post:
“When a health-care system is insolvent and inadequate, that fact should be admitted and addressed by comprehensive reforms. Encouraging large numbers of people to consent to die prematurely will neither save the healthcare system nor seriously address the profound philosophical and practical implications of vastly increasing the number of unnatural deaths. I believe that assisted dying is sometimes appropriate and a right of the individual involved. But the ennobling and promotion of a vast increase in the numbers of suicides in the guise of health-care reform is a fraud, a secular and ecclesiastical heresy and, in many cases, arguably a crime.”
Dr. Paul Saba, a physician from Quebec and co-chair of the Coalition of Physicians for Social Justice, stated on his blog, “We need to care for people with cognitive impairments — not euthanize them.” Dr. Saba is asking doctors not to perform euthanasia because it “contravenes the legal and ethical practice of modern medicine.” He said that “the government wants to force doctors to do what is illegal and unethical.”

Dr. Coelho, and her cohorts at Physicians Together with Vulnerable Canadians, wrote:
“Our profession has been coerced into facilitating suicide rather than preventing it, for ever-increasing numbers of citizens. We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws. We, the undersigned, declare that the passage of Bill C-7, if left unchecked, will contribute to the destruction of much more than our medical profession, but fundamentally, of a Canadian society that genuinely values and cares for its most vulnerable members. Canadians deserve better.”
More articles on this topic:

Friday, May 28, 2021

Kelly Block (MP) speech in support of conscience rights for medical professionals.

The following speech was by Kelly Block (MP) in the House of Commons on May 27, 2021. Kelly Block has sponsored conscience rights Bill C-268.


Kelly Block (MP) Carlton Trail - Eagle Creek

Madam Speaker, I am proud to rise today to begin the debate on my private member's bill, Bill C-268, the protection of freedom of conscience act. I would be remiss if I did not acknowledge this bill is built on the hard work and determination of former members of Parliament. The first iteration that sought to address this issue was introduced by the late Mark Warawa in 2016, but it did not progress when the government introduced Bill C-14.

I do consider it a tremendous honour that my bill is the same number, C-268, as his was. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, which died on the Order Paper when the election was called in 2019.

I would like to thank all those who have been championing this issue for many years and for their willingness to work with me.

Experts throughout Canada provided information and advice, while thousands of Canadians have voiced their support for protecting our fundamental freedoms. While there are numerous dictionaries that define conscience, they are consistent in defining it as an individual's inner sense of knowing the difference between what is right and wrong and that guides their behaviour.

An article by Cardus called “The Imperative of Conscience Rights” references the following:
“Conscience” traces to the Latin conscientia, and is related to the Greek synderesis. While conscientia refers to the application of our moral knowledge to particular situations, synderesis refers to the moral awareness built into each person and that urges us to do good and avoid evil.
Bill C-268 is straightforward as it seeks to enshrine in law a minimum national standard of conscience protections for medical professionals while respecting the jurisdiction of my provincial colleagues to expand on it. It is a response to calls from disability rights groups, first nations, the Ontario Medical Association and many hundreds of medical and mental health professionals to protect conscience rights.

It would ensure the medical professionals who choose to not take part in, or refer a patient for, assisted suicide or medical assistance in dying would never be forced by violence, threats, coercion or loss of employment to violate the freedoms protected in section 2(a) of the charter. This bill also serves to protect the rights of patients to receive a second opinion, and by doing so, would protect our health care system.

In my consultations, I spoke with disability rights advocate Heidi Janz. She told me about being born in the Soviet Union. Doctors told her parents that Heidi would never walk, talk or think and that she would be dependent on others for the rest of her short life. They told her parents to put her into an institution and forget they ever had her. Heidi Janz has severe cerebral palsy.

Her parents did not listen to the dominant narrative of their day. They loved their daughter and believed her life had value. Eventually, they found the support they needed. Today, Dr. Heidi Janz holds a Ph.D. and is an adjunct professor of ethics at the University of Alberta. In her spare time she is a playwright and author, and somehow, despite how busy her life is, she also serves as the chair of the ending of life ethics committee for the Council of Canadians with Disabilities.

Dr. Janz is a remarkable woman. While some might pity her, she will have none of it. She says that everyone talks about how bad it must be to have a disability, but that she chooses daily to live in opposition to that narrative. She also says that disabled people can be so much more than their diagnosis, and that she is proof of that fact.

If it had been up to the dominant view of her day, she would never have had the chance to disprove that narrative. If her parents did not have the option to find the help they wanted to get that crucial second opinion, none of my colleagues in this place would be hearing about this marvellous woman. This is not just a theoretical story.

In a similar vein, earlier this year the Minister of Crown-Indigenous Relations, who is a doctor herself, wrote to her constituents about her experience of ageism in our health care system as it related to her 93-year-old father.

While I will not repeat the whole story, I will just quote her last two sentences:
My Dad got better without needing the ICU, but I remember thinking that as an MD I had been able to firmly take a stand. I worried that other families wouldn’t have been able to question the clear ageism in the choices being put in front of them.
The minister's father and all Canadians have the right to find a doctor who will offer them hope, offer them another choice, offer them a second opinion. All Canadians deserve that same right.

Now, this is anything but a guarantee in Canada. We have passed laws that have the unintended consequence of forcing doctors and medical professionals to provide patients death, regardless of whether they believe it is in their patient's best interest. Bill C-14 and Bill C-7 create a federal standard for medical assistance in dying and assisted suicide, but not for conscience protections. Despite the claims of some, it is patently absurd to argue that a conscience rights bill would somehow interfere with the role of the provinces while the legalization of medical assistance in dying does not.

We are speaking of the very first fundamental freedom laid out in the charter. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed. Above all, it is the right thing to do for patients and medical professionals.

Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth. In fact, conscience rights are critical to how our health care system works. Patients have the right to a second opinion, but there can be no second opinion if every medical professional is forced to provide the exact same list of options.

Health care is fundamentally about the doctor-patient relationship. Take the case of a psychiatrist who supports MAID in certain circumstances, but who has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built up an understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under the current law, that psychiatrist would be forced to refer the patient to someone else so that the patient could die. The psychiatrist must do this, despite knowing that the suicidal thoughts are temporary, that otherwise the patient is joyful and loves life, and that ending that life is wrong. The psychiatrist's hands are tied. Is that what passes for medical care?

Some might claim that there are safeguards in place to prevent such tragedies, but I ask, are members completely sure? With the passage of Bill C-7, many of the safeguards have been removed. We are talking about ending a human life. There is no room for “maybe” when a life hangs in the balance. Should the first line of safeguards not be the expertise of the medical professionals who know best? If they do not believe death is the answer, should we not at least consider if they are right? This is, after all, a matter of life and death.

Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID is becoming the status quo. To claim that protecting the conscience rights of medical professionals will somehow block access for those who truly want it is both misleading and nothing but baseless fearmongering.

The Canadian Medical Association stated clearly that conscience protections would not affect access, because there were more than enough physicians willing to offer MAID. This is further reinforced by a McGill study that showed that 71% of recent medical school graduates would be willing to offer MAID.

Every court case on the subject, as well as common sense, has stated clearly that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we are clever enough to ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.

I believe it is no accident that former prime minister, Pierre Trudeau, placed conscience rights as the first of the enumerated rights in our charter. It is an acknowledgement that the state cannot and should not attempt to force any one of us to do what we believe is immoral.

Dozens of first nations leaders wrote to every MP and senator. They said that, “Given our history with the negative consequences of colonialism and the involuntary imposition of cultural values and ideas, we believe that people should not be compelled to provide or facilitate in the provision of MAiD.”

We claim to be a pluralistic, free society. If that is true, it demands of us a tolerance of the moral views of others. Some have argued that protections already exist in Bill C-14. While I applaud the former minister of justice, the hon. member for Vancouver Granville, for ensuring that conscience rights were acknowledged in that legislation, acknowledgement is no longer enough. There are examples of medical professionals being forced or bullied into participation in assisted suicide against their conscience.

Dr. Ellen Warner, an oncologist who has served her patients for 30 years, told me about her experiences. She said:
I think it will shock Canadians to hear of healthcare providers being coerced into participating in MAID, yet such coercion has been happening frequently. A brilliant colleague of mine was bullied into becoming the physician legally responsible for MAID on his hospital ward. It was a great loss to us when he left for a different position. Two other co-workers told me that, despite strong, moral objections, they would carry out MAID if asked to do so for fear of losing their jobs. At one of our staff meetings, a psychiatrist stood up and announced that any physician who does not actively support MAID should not be working at our hospital.
Finally, some have suggested that medical professionals should leave their morality at the door. However, no one truly believes or wants that. As an example, no one would want a doctor to forget their morality if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. As Dr. Ellen Warner stated, “In the absence of conscience protection, the group with the most to lose are the patients—the people we are all trying to help,”

This bill would protect the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patient. Canadians need this bill to pass. Canada's medical professionals need this bill to pass. Additionally, they will need individual provincial governments to protect their rights through provincial regulations and legislation.

I encourage all members in this place to do our part and pass the protection of freedom of conscience act.

Tuesday, February 9, 2021

Senate expected to vote on Bill C-7 (bill to expand euthanasia law) on February 17.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Joan Bryden is reported for the Canadian Press that Bill C-7, the bill to expand euthanasia in Canada, is scheduled to be voted on in the Senate on February 17.

The Feb 17 date is based on giving the House of Commons at least one week to debate possible Senate amendments to Bill C-7 before the February 26 Quebec Superior Court imposed deadline.

Bryden points out that this is a tight time-frame considering that some Senators are proposing amendments to Bill C-7. Bryden explains:

An amended version of the bill would have to go back to the House of Commons for MPs to decide whether to accept or reject the amendments before shipping it back to the Senate, where senators would have to decide whether to approve the bill even if some or all of their amendments were rejected.

In theory, the bill could bounce repeatedly back and forth between chambers.

The Ontario Medical Association has asked the Senate to amend Bill C-7 by including conscience rights for medical professionals (Link).

Article: Parliament passed Bill C-7 without amendments. Contact the Senators (Link).

Join 50,000 people who have signed the petition: Reject euthanasia Bill C-7 (Link).

What does Bill C-7 do?

1. Bill C-7 removes the requirement in the law that a person’s natural death be reasonably foreseeable in order to qualify for assisted death. Therefore, people who are not terminally ill can die by euthanasia. The Quebec court decision only required this amendment to the law, but Bill C-7 went further.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by euthanasia.

3. Bill C-7 waives the ten-day waiting period if a person's natural death is deemed to be reasonably foreseeable. Thus a person could request death by euthanasia on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

4. Bill C-7 creates a two track law. A person whose natural death is deemed to be reasonably foreseeable has no waiting period while a person whose natural death is not deemed to be reasonably foreseeable would have a 90 day waiting period before being killed by lethal injection.

5. As stated earlier, Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The euthanasia law permits MAiD for people who are physically or psychologically suffering that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. However, mental illness, which is not defined in the law, is considered a form of psychological suffering.

Canada's Justice Minister, David Lametti, announced on November 24 that, once Bill C-7 is passed, he wants to expand euthanasia to people with mental illness alone.

Contact two or more Senators today. Tell them why you oppose euthanasia. Link to the Senate contact information.

Bryden explains that there are divergent views on amending Bill C-7. She wrote:

Sen. Pierre Dalphond, a former judge who sits in the Progressive Senate Group, argued that the exclusion of those suffering solely from mental illnesses is unconstitutional, violating their right to equal treatment under the law regardless of physical or mental disability.

Dalphond said he believes it's reasonable to propose a sunset clause to put a time limit on that exclusion, giving the government time to come up with guidelines for providing assisted dying to people with mental illnesses.

And he said he'll introduce another amendment to specify that the ill-defined concept of mental illness does not include neuro-congnitive disorders such as Alzheimer's disease, dementia, Parkinson's disease and Huntington's disease.

There is support among senators for referring the bill to the Supreme Court for advice on its constitutionality, both from those who think it's too restrictive and those who think it's too permissive.

Sen. Don Plett, leader of the Conservatives in the Senate, questioned why senators are rushing to expand access to what he termed "physician-induced death," based on "a lower court decision made by one judge in one province" that the government chose not to appeal.

He implored his colleagues to listen to disability rights advocates who have denounced the bill for sending the "harmful and tragic message" that the lives of people with disabilities are not worth living.

Plett argued that extending access before improving palliative care and support services for people with disabilities will make it "easier to die than to live" and doesn't give vulnerable people a real choice.

Conservative Sen. Denise Batters said it's "disgraceful" that the government is pushing a bill to expand access to assisted dying in the midst of a pandemic, when vulnerable people are even more "alone, isolated and economically disadvantaged" and with even less access to support services.

She argued that Black, racialized, Indigenous and poor Canadians with disabilities, "people who have been routinely pushed to the margins of our society," are "crying out to us for help but they don't want help to die, they want help to live."

Contact two or more Senators today. Tell them why you oppose euthanasia. Link to the Senate contact information.

Ontario Medical Association asks Senators to amend Bill C-7 by including conscience rights for medical professionals.


February 3, 2021

Senator Mobina Jaffer
Chair
Standing Senate Committee on Legal and Constitutional Affairs
The Senate of Canada
Ottawa, Ontario
Canada, K1A 0A4

Dear Senator Jaffer,

I am writing you to provide our position as you consider Bill C-7, An Act to amend the Criminal Code (medical assistance in dying--MAID), at the Standing Senate Committee on Legal and Constitutional Affairs.

It is important that patients have access to all forms of care regardless of the personal beliefs of their physician. However, it is also important to protect the legal rights of physicians who have conscientious objections – moral or religious – to providing MAID.

Doctors should not be asked to provide care that is in contradiction to their deeply held beliefs. This is especially the case when there are reasonable alternatives that are consistent with providing timely access to care.

It is the view of the OMA that introducing conscience rights directly into legislation would be a positive solution that would strike the right balance between the Charter rights of physicians and their patients.

We respectfully urge your committee to take our views into consideration and incorporate the appropriate changes to the Bill as you consider it for clause by clause.

Sincerely,

Dr. Samantha Hill
President
Ontario Medical Association
cc: The Honourable David Lametti, Minister of Justice and Attorney General of Canada

(Link to the original letter)