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.

Canada: Assisted suicide for psychiatric patients.

This article was published by Nancy Valko on her blog on July 3, 2016.

Nancy Valko

By Nancy Valko

My first husband and the father of my children was a caring man and dedicated psychiatrist who himself eventually became disabled by mental illness. Early in our marriage, I helped him write his medical journal articles and we planned to eventually include me in his psychiatric practice to work with the families of his patients. As a nurse, I always believed that families were ideally the best support system for patients and our goal was to improve the care and outcomes of people with mental illness.

Tragically, my husband’s mental illness worsened despite intensive treatment. He ultimately abandoned our family and lived the next 26 years in and out of hospitals and assisted living places before he died of natural causes in 2014.

Thus I have a unique perspective on the legal, medical and personal aspects of mental illness.

At one point, a family member sympathetically suggested that it might be better for everyone if he committed suicide. I was horrified. You don’t give up on sick people and I told this person that I would do anything in my power to stop him if he tried to kill himself. Suicide would be the ultimate tragedy.

Canada and Its New Assisted Suicide Law

In February 2015, the Canadian Supreme Court ruled unanimously in the Carter v. Canada case to legalize physician-assisted suicide for competent, consenting adults whose suffering is due to a “grievous and irremediable” medical condition and gave Parliament a year to develop a regulatory regime along these “parameters.”

The Parliamentary Special Joint Committee on Physician-Assisted “Dying” suggested that the “grievous and irremediable” criterion includes nonterminal medical conditions, including psychiatric disorders.

The federal government’s Bill C-14, on the other hand, defined “grievous and irremediable” as an “advanced state of irreversible decline in capabilities” in a person for whom “natural death has become reasonably foreseeable.” The Senate ultimately passed the bill but the controversy about assisted suicide for psychiatric patients is still raging.

In a June 21, 2016 commentary in the Canadian Medical Association Journal “Should assisted dying for psychiatric disorders be legalized in Canada?”, authors Scott Y.H. Kim MD PhD and Trudo Lemmens LLM DCL warn against this.

As they note:

In Belgium and the Netherlands, medical assistance in dying has been provided to people with chronic schizophrenia, post traumatic stress disorder, severe eating disorders, autism, personality disorders and even prolonged grief.

The authors conclude that:

Because of the necessarily broad criteria used to regulate assisted dying (in Canada), legalizing the practice for psychiatric conditions will likely place already vulnerable patients at risk of premature death.

However, others like Belgium psychiatrist Joris Vandenberghe, MD, PhD disagree:

“I think the current approach taken by the Canadian government is a bit too strict because it doesn’t fully recognize the enormous impact that psychiatric disorders can have on patients,” Dr Vandenberghe told Medscape Medical News. (Emphasis added)

However, even Dr. Vandenberghe recognizes the problems while still calling for more “safeguards”:

“I am generally not opposed to our euthanasia legislation and agree that patients suffering from psychiatric conditions should not be excluded from our legislation. However, extra precautions are urgently needed. 

“I’m not happy with the way things work here [in Belgium]. Sometimes euthanasia is used with insufficient reluctance on the part of the healthcare professionals involved. We’re missing opportunities for treatment, and we need more safeguards,” said Dr. Vandenberghe. 

So for me, the answer lies in a thorough evaluation of a patient prior to euthanasia. There really is no time pressure in psychiatric disorders, and if you have a multidisciplinary committee involved in the evaluation, you can take care of lot of the concerns we now have about euthanasia in the setting of psychiatric illness.”

The reality is that very few psychological or psychiatric referrals are even now made for anyone considering assisted suicide either in the US or in Europe. The answer is not more “safeguards” for assisted suicide practitioners to disregard while enjoying virtual legal immunity but rather an emphatic “No!” from the public as well the legal and medical systems. We also need an unbiased media to publicly expose the real facts about legalized medical killing.

Will Johnston - speech euthanasia on euthanasia Bill C-14 - Victoria BC - May 12, 2016

Dr Will Johnston

Dr Will Johnston
Chair, Euthanasia Prevention Coalition of BC

I have a dream, and in that dream the Parliament of Canada debates far into the night to perfect a new law. The new Bill has the support of the majority of our elected representatives. It strives to get just the right balance between Federal and Provincial powers over matters of life and death. In my dream hundreds of Canadians testify before Committees and Panels and town hall meetings. They all want a better Canada. In my dream our Parliament is working against a deadline to get a law into place which honors the highest aspirations of our civilization. Finally the law has passed through the Senate and passed through Parliament and one day, let’s imagine June 6 of the year in my dream, the law goes into force.

What a law! What an achievement, worth every one of those late nights of intense Parliamentary debate and Special Joint Committees and Provincial Territorial Expert Panels and External Panels and town hall meetings and letters and papers and open-line radio shows and documentaries.

In my dream the new law says that anyone in severe pain anywhere in Canada is treated like a cardiac arrest, an emergency which activates a team of specially trained people. Anyone who is depressed and suicidal, anywhere in Canada, is treated like a house on fire, with immediate attention from another team of specially but of course differently trained people. People who are trying to live independently with major disabilities are funded and equipped like a Canadian Olympic team should be. Families with children with disabilities are treated like royalty. Having a disability or having a family member with a disability guarantees you will be kept far above the poverty line, never below that line and forgotten in the economic ditch. A report of possible elder abuse is by law to be treated like an Amber Alert, and abusers exposed to the clear light of emergency inquiry.

What a dream. When the real Canada wakes up on June 6th, it will be to a new law far removed from my dream. Instead, our great nation labored and brought forth – what?- a legal excuse to protect a doctor or nurse from a murder charge as long as they are under the opinion that you fit the right criteria before your death is inflicted. The law will let someone else sign you up, unlimited doctor shopping to find two of them to agree you are better off dead, no independent objective review before the planned death, no required notification of family members, no need for you to be actually dying, no need to be offered alternatives to suicide, no guarantee the death certificate will state the true cause of inflicted death, no requirement for a pain control assessment, no ban on health care workers being intimidated to cooperate.

The new law is careful to protect doctors. Mind you, doctors are not protected in order to use their consciences, they are protected while making mistakes causing wrongful death.

The polls show that people can imagine choosing the time of their own deaths. People expect that when that time comes , they will be in control. They think they have been given a new right, but instead they have lost the protections built into the old law. Someone will have control, all right, just maybe not always you.

To reassure those euthanasia activists for whom the new law could never go far enough, the preamble to the law promises that once the dust has settled we will look at killing children, and people whose only problems are psychiatric, and people who are cognitively disabled.

How could this happen? Parliament defeated at least 13 attempts to make such a law over the past 20 years. Basically, medically inflicted death got draped with medical prestige by the same brilliant marketing that sells everything else in our culture. The polls reflected a public who bought the marketing and didn’t get the whole picture. Then came the judges. Politicians are expected to watch the polls, judges are expected to apply the laws. Something got mixed up and judges started giving more deference to the polls than to Parliament. But judges who look to opinion polls are looking in the wrong place. Some things are wrong even when nobody will say they are. A wrong thing can’t be turned into something good and true by a poll, a judge, or a law.

So what can every one of us do?

Go to www.canadiansforconscience.ca and click on” Federal Government” and send a letter to Members of Parliament or Senators or our Justice Minister. Conscience protection is the only way that a safe haven can be maintained in our health care system. Remember that our Catholic hospitals are our best chance to keep safe places for our families in the health care system. Be ferocious in the defence of these hospitals and do anything you can to support them.

At the start of this speech I listed truly good things waiting to be done. Be full of gratitude for the freedom to do good and do it any way you can.

Thankyou.
Dr Will Johnston.

EPC: Write to Senators and Members of Parliament.

The Senate Standing Committee on Legal and Constitutional Affairs will be hearing interventions concerning Bill C-14, the bill that will legalize and “regulate” euthanasia and assisted suicide in Canada.

Last week, EPC urged you to contact the members of parliament on the House of Commons Committee on Justice and Human Rights, who hearing from groups and individuals from across Canada on Bill C-14

EPC needs you, to contact Canadian Senators, especially the members of the Senate Committee on Legal and Constitutional Affairs with your concerns about Bill C-14.

The Euthanasia Prevention Coalition (EPC) presented to the House of Commons Committee on Justice and Human Rights this week and next week we will be presenting before the Senate Legal and Constitutional Affairs committee. The Senate has the ability to amend or defeat Bill C-14. 

The Euthanasia Prevention Coalition is also organizing a rally on Parliament Hill on Wednesday June 1 from 12 noon to 1:30 pm.

Resources for your communicating with committee members:
Link to the article on Bill C-14 by Alex Schadenberg.
Link to the article on Bill C-14 by the Physicians Alliance Against Euthanasia.
Link to the article on Bill C-14 by Dr Will Johnston (EPC - BC).
Link to the article on Bill C-14 by Andrew Coyne.
Link to the article on Bill C-14 by Amy Hasbrouck (Toujours Vivant - Not Dead Yet).

Speech in parliament by Liberal MP Robert Falcon Ouellette opposing Bill C-14.

Contact information - Senate Committee on Legal and Constitutional Affairs members:

Committee Chair: Senator Bob Runciman (CPC) bob.runciman@sen.parl.gc.ca

Deputy Chair: Senator Mobina Jaffer (Lib) mobina.jaffer@sen.parl.gc.ca

Committee Member: Senator George Baker (Lib) george.baker@sen.parl.gc.ca

Committee Member: Senator Denise Batters (CPC) denise.batters@sen.parl.gc.ca

Committee Member: Senator Pierre-Hugues Boisvenu (IND) boisvp@sen.parl.gc.ca

Committee Member: Senator James Cowan (Lib) jim.cowan@sen.parl.gc.ca

Committee Member: Senator Nicole Eaton (CPC) nicole.eaton@sen.parl.gc.ca

Committee Member: Senator Serge Joyal (Lib) serge.joyal@sen.parl.gc.ca

Committee Member: Senator Thomas Johnson McInnis (CPC) thomasjohnson.mcinnis@sen.parl.gc.ca

Committee Member: Senator Paul McIntyre (CPC) paul.mcintyre@sen.parl.gc.ca

Committee Member: Senator Donald Plett (CPC) don.plett@sen.parl.gc.ca

Committee Member: Senator Vernon White (CPC) senatorwhite@sen.parl.gc.ca

EPC urges you to send letters to Members of Parliament and Senators. Link to contact Members of Parliament. Link to contact Senators.

Letters to Members of Parliament and Senators can be mailed (Postage Free) when using the following address:

(Name) Member of Parliament
House of Commons
Ottawa Ontario K1A 0A6

Senator (Name)

Senate of Canada

Ottawa Ontario K1A 0A4

The federal government provides exemptions for murder, aiding suicide and administering poison

FOR IMMEDIATE RELEASE 

Montreal, April 15, 2016

In the midst of one of the worst suicide crises in our country’s history, the federal government has tabled Bill C-14, which proposes to legalize both euthanasia and assisted suicide across Canada under the pseudonym “medical assistance in dying". The waltz of words continues, as we malign palliative care by presenting "medical assistance in dying" as the only alternative to an agonizingly painful death.

From the outset, the bill makes clear the gravity of what our society is about to accept: it amends the Criminal Code to "create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious substance, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process".

These people would not be criminally responsible if they practice euthanasia or helping a patient to commit suicide. Nor would the people helping the physician or nurse practitioner "if they do anything, at another person’s explicit request, for the purpose of aiding that other person to self-administer a substance that has been prescribed for that other person as part of the provision of medical assistance in dying". Therefore, every citizen will be able, without fear of prosecution, to help another person to commit suicide if his condition meets the criteria established by law: a parent, a friend, a brother, a sister, etc. 

Not surprisingly, there is no requirement that people who suffer be at the end of life to have access to assisted suicide. Only that “their natural death has become reasonably foreseeable (...) without a prognosis necessarily having been made as to the specific length of time that they have remaining". It seems to us that everyone’s death is reasonably foreseeable.

Moreover, the federal government casts a wide net in its list of lives that are not worth living, including people with a serious and incurable disease, condition or disability, those losing autonomy and those with persistent physical or psychological suffering "that is intolerable to them and that cannot be relieved under conditions that they consider acceptable." In drawing up a set of circumstances in which it is now acceptable to commit suicide with the help of a doctor and the complicity of the state, the federal government endorses the choice of death for a host of reasons... on the condition of being at least 18 years old.

We are already far from the idea that was sold to us when this debate began: from proposing death for a few exceptional cases, we’ve reached the point where it’s considered "health care" like any other. Access to euthanasia and assisted suicide is such a priority that the federal bill suggests that a person be allowed to shorten his time of reflection (fixed at 15 days) if natural death becomes imminent – which invalidates the argument of the Supreme Court of Canada who claimed that "medical assistance to die" would help prevent people from taking their life prematurely...

In short, after the smoke screen that was the scandalous report of the Special Joint Committee, Bill C-14 gives the false impression of being prudent and restrictive. But a further reading enables us to understand where we are heading: the government is already expecting a need for "further studies on requests by mature minors, advance requests and requests where mental illness is the sole underlying medical condition" after the implementation of the law.

An even more permissive law won’t be long in coming. As soon as the population has swallowed this first poison pill.

Anyone who still respects the inherent and inalienable dignity of every human person and is concerned for the common good has one thing to do right now: call his or her MP to try to block this Bill unworthy of Canadian society.

For more information contact:
Catherine Ferrier, president
Physicians’ Alliance against Euthanasia
438.938.9410  info@collectifmedecins.org

Aubert Martin, Executive Director
Living with Dignity
438.931.1233  info@vivredignite.org

Hugh Scher: Letter to Members of Parliament and Senators

From: Hugh Scher, Scher Law Professional Corporation (Toronto, Ottawa)

Hugh Scher

To: Member of Parliament

House of Commons, Ottawa ON K1A 0A6

Dear Honourable Member:

Re: Response to Joint Committee Report on New Assisted Suicide Law

I am a constitutional lawyer and authority on human rights and the rights of people with disabilities in Canada, particularly in respect of end of life issues. I have advocated on these issues for the past 25 years.

I have served as counsel or been consulted on virtually every end of life case in Canada over the past 15 years. Despite this, the joint committee investigating euthanasia and assisted suicide refused to hear my testimony.

My review of the joint Parliamentary Committee report highlights the following major concerns:

1. The Committee appears to unquestionably endorse a Benelux style regime of euthanasia, which has proven to be the most abused system of end of life practices in the world;

2. Even the Supreme Court of Canada recognizes that 32% of cases of euthanasia in Belgium were carried out without request and without consent, despite a legal requirement for these elements. In 47% of those cases, the doctors refused to report the matter to the overseeing body, despite a legal requirement to do so. Despite these clear breaches of the legal requirements of the Belgian law, not one Belgian doctor was prosecuted;

3. The joint Committee report suggests the broadest possible euthanasia regime in the world without any meaningful safeguards or effective oversight;

4. The joint Committee report and recommendations would extend access to euthanasia to children which is clearly contrary to the recommendations of the Supreme Court of Canada;

5. The joint Committee report would extend access to euthanasia to those acting based upon an advance directive and without the requirement for consent at the time of the act. This also contradicts the recommendations of the Supreme Court of Canada;

6. The joint Committee report further supports granting access to euthanasia to people with psychiatric conditions which fundamentally undermines both suicide prevention measures as well as requirements and safeguards for voluntariness, capacity and consent in end of life practices;

7. The joint Committee report explicitly rejects the means of effective oversight that have been implemented by the Supreme Court of Canada during the period of extended time to allow Parliament to respond to the Carter decision. In particular, the Supreme Court of Canada has implemented a regime of judicial oversight which requires that court applications be brought to ensure compliance with the legal requirements established by the Supreme Court. A similar approach to effective oversight was recommended by the Federal External Expert Panel charged to consult and advise the government on legislative implementation of the Carter decision;

8. Judicial or Tribunal oversight to ensure compliance with legislated requirements and to identify vulnerability before the fact is an essential requirement for effective oversight in respect of any regime of assisted suicide;

9. The joint Committee does not limit acts of euthanasia to those who are terminally ill, as in Quebec, Oregon and Washington State, but rather extends them to the broadest group of people ever permitted to access a state-funded regime of euthanasia in the world;

10. The joint Committee report says nothing about the fraud and lack of transparency on which the Benelux and present Quebec regimes are based by allowing doctors to falsify death certificates and indicate that the cause of death is not the intentional killing of a patient by a doctor, but rather the underlying illness. Such a measure makes it impossible to appropriately monitor and enforce compliance with legislative requirements, to identify vulnerability and prevent abuse. It also makes it impossible to accurately monitor these practices going forward and will inevitably lead to skewed data;

11. The joint Committee report extends those charged to engage in euthanasia to doctors, nurses, and registered practical nurses. Such an approach is broader than any other jurisdiction in the world and is a recipe for abuse and for incoherence. It renders it impossible to accurately monitor and track these practices to ensure compliance, oversight, to prevent abuse, and to enforce and punish breaches of legislative requirements, including for required consent;

12. The requirement of judicial or tribunal oversight and of vulnerability assessment and identification before the fact by way of prior review are an essential requirement of any regime of assisted suicide and must be implemented by Parliament in the event that there is to be any prospect of safe implementation of an assisted suicide regime. Failure to implement such measures will leave vulnerable Canadians at significant risk without any means of enforcement or protection from abuse;

13. The joint Committee report fails to properly recognize the conscience rights of health care practitioners and to protect those rights from being trampled under the guise of access;

14. The joint Committee report improperly and unwisely cedes Constitutional and practical authority over implementation of an assisted suicide regime to the Provinces and to doctors writ large. Such an approach belies the notion of national safeguards, effective legal oversight, and fails to ensure the level of knowledge, training and experience for those who are charged to carry out assisted suicide measures. The most appropriate approach would be to designate a specific federal employee who would be specially trained and empowered to carry out such acts of assisted suicide. This is something that should not be left simply to doctors and nurses. It should remain the responsibility of the Federal State. To do otherwise, unwisely and unnecessarily undermines the fiduciary nature of the doctor-patient relationship;

15. The joint Committee report would implement the widest ranging and most dangerous regime of euthanasia in the world, completely lacking in proper and appropriate safeguards or effective oversight.

The Supreme Court of Canada only agreed to strike down the criminal prohibitions against assisted suicide based on the belief that the Federal Parliament would introduce a carefully tailored and rigorously monitored and enforced regime of assisted suicide that would protect Canadians from the risks of abuse that have occurred in other jurisdictions, particularly in the Benelux states of Holland and Belgium. The recommendations of the joint Committee do exactly the opposite. They are completely lacking in proper safeguards or effective oversight and represent a recipe for abuse and for incremental expansion over the course of time in ways not yet contemplated and that would seek to undermine effective means of oversight and proper safeguards embraced by the Supreme Court.

To the extent that assisted suicide is to be implemented in Canada, regard should be had to the regime in Oregon and Washington State which are far more limited. The regime should be subject to more specific requirements for a witness at the time of death in order to ensure effective oversight and prevent abuse.

I respectfully request that you consider the above concerns and recommendations for more effective measures to give effect to the Carter decision of the Supreme Court of Canada. In that regard, I do refer you to the vulnerable person standard at the link set out here which provides for a series of safeguards and oversight measures that should form the basis for any law intended to give effect to the decision in Carter with respect to any assisted suicide regime in Canada.

Read the Vulnerable Persons Standard.

I have had the opportunity in past to address members of the Liberal, Conservative and NDP caucuses on these issues. Should members wish to speak further with me, I am pleased to make myself available to provide what advice and insight that I can with respect to this topic that I have studied and litigated over the past 25 years.

Yours truly,

Hugh R. Scher

Scher Law Professional Corporation

Cc. Prime Minister Justin Trudeau
Minister of Justice Jody Wilson-Raybould

Angus Reid survey: Canadians oppose euthanasia for psychiatric reasons and forcing hospitals to do euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition
 
An Angus Reid Institute survey of 1517 Canadians focusing on euthanasia and assisted suicide (also known as assisted death) done between March 21 - 24 found that the majority of Canadians oppose many of the recommendations in the Special Joint Committee on Physician-Assisted Dying report (report). The report made 21 recommenations including euthanasia for: people with dementia, people with dementia, and people with psychiatric conditions. The report provided recommendations for legislation on assisted death.

The survey found that 78% of Canadians opposed euthanasia for people with severe psychological suffering but no terminal illness, meaning they oppose recommendation 3, in the report, that supported euthanasia for people with psychological suffering.

The survey found that 68% of Canadians opposed forcing religiously affiliated hospitals to participate in euthanasia while 62% supported religiously affiliated nursing homes from having to participate in euthanasia. Therefore they oppose recommendation 11 in the report.

The euthanasia lobby has pressured the government to reduce funding for institutions that refuse to kill their patients. The survey found that only 24% of Canadians supported this idea.

The survey found that only 36% of Canadians supported forcing medical professionals who oppose euthanasia to refer their patients to a doctor who will kill their patient.

In the State of Oregon, where assisted suicide is legal, there is a two week waiting period before a person can obtain a lethal dose. Recommendation 14 in the report stated that there should be no waiting period. The survey indicates that respondents disagree with the report with only 12% opposing a waiting period.

The report of the Committee on Physician-Assisted Dying recommended wide-open rules for euthanasia but the survey found that the majority oppose "assisted death" for most reasons. The survey found that support for assisted death was limited based on circumstance: 

• 36% support when a person with multiple conditions like arthritis and diabetes feels overwhelmed and wants to die,
• 31% support when a person has no hope for the future and finds no meaning in their life, 
• 26% support when a person's care is perceived as a burden to their family, 
• 21% support when the cost of a patient's care is very expensive to the health care. 

The survey found that the majority of Canadians support “assisted death,” but 50% of the respondents wanted significant restrictions on killing or wanted “assisted death” completely prohibited.

The Liberal government is expected to present their euthanasia bill on April 11, 2016.

Canada: Caring Not Killing Letter writing campaign

The Euthanasia Prevention Coalition (EPC) launched the Caring Not Killing postcard campaign to members of parliament a few weeks ago. It is important to contact elected representatives to state your opposition to euthanasia, assisted suicide and the pro-euthanasia recommendations from the report of the Special Joint Committee on Physician-Assisted Dying and the report of the Provincial Territorial Expert Advisory Group on Physician-Assisted Dying.

The Caring Not Killing postcard campaign is an easy way to activate people to contact elected representatives, but letter-writing is a more effective way to get the attention of your political leaders. Order the Caring Not Killing postcards from EPC for free.

To write an effective letter - keep your letter short and use only one or two talking points. 

Links to information on topics related to euthanasia and assisted suicide:

1. A Personal story, 2. Elder Abuse, 3. Euthanasia: The theory and the reality, 4. Medical Error, 5. Euthanasia/Disability rights, 6. Euthanasia/Palliative care, 7. Euthanasia/Belgium, 8.Euthanasia for psychiatric reasons, 9. Assisted Suicide USA, 10. Abuse of euthanasia laws, 11. Conscience rights for healthcare professionals.

Send you letter to your member of parliament or to Prime Minister Justin Trudeau, Justice Minister Jody Wilson-Raybould, Health Minister Jane Philipott. Member of Parliament contact information.

Letters to federal politicians can be sent without postage. Send your letter to:

Name: .................
House of Commons or Chambre des communes
Ottawa Ontario K1A 0A6

You should also send the letter to your provincial/territorial political representative.

You should adjust your letter and then send your letter to the editor of your local or national newspaper. 

Contact information for letters to the editor:

The Globe and Mail: nhassan@globeandmail.com
The Gazette: letters@montrealgazette.com
Le Journal de Montréal: jdm.transmission@quebecormedia.com
La Presse: debats@lapresse.ca
Le Soleil: opinion@lesoleil.com
Le Journal de Québec: commentaires@journaldequebec.com
Le Devoir: redaction@ledevoir.com
Journal Metro: opinions@journalmetro.com
Halifax Chronicle Herald: letters@herald.ca
Ottawa Citizen: letters@ottawacitizen.com
Toronto Star: lettertoed@thestar.ca
Toronto Sun: http://www.torontosun.com/letter-to-editor
Hamilton Spectator: letters@thespec.com
London Free Press: letters@lfpress.com
Winnipeg Free Press: letters@freepress.mb.ca
Calgary Herald: letters@calgaryherald.com
Edmonton Journal: letters@edmontonjournal.com
Vancouver Sun: sunletters@vancouversun.com
Vancouver Province: provletters@theprovince.com
Victoria Times Colonist: letters@timescolonist.com
National Post:  http://www.nationalpost.com/contact/letters/index.html?name=Letters&subject=Letter+to+the+editor,

Senator Denise Batters: Help the mentally ill. Don’t kill them

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Senator Denise Batters

The National Post featured a guest column, on March 14, 2016, by Senator Denise Batters concerning her opposition to the legalization of euthanasia for people with psychiatric issues. Senator Batters is a lawyer and a mental health advocate.

Previous article by Senator Batters.

Batters was widowed when Dave Batters, her husband, died by suicide in 2009 while he was a sitting member of parliament. Senator Batters experience with her husband's suicide led her to strongly oppose euthanasia for people who live with psychological suffering.

Senator Batters writes in her National Post column:

Questions surrounding suicide are deeply personal to me. I lost my husband, former member of Parliament Dave Batters, to suicide in 2009, after his struggle with severe anxiety and depression. In the years following his death, I have worked to raise awareness and dispel the stigma surrounding mental illness and suicide. That has included communicating to those struggling with mental illness, particularly with those who harbour thoughts of suicide, to encourage them not to give up, but to instead reach out for help. 

This is why I have reacted so strongly against the recent majority report of the joint parliamentary committee studying physician-assisted suicide. Polls show that most Canadians agree with physician-assisted suicide, but usually those poll questions (and Canadians) assume that only those with terminal illnesses would be given the option. Canadians want strict safeguards on who is eligible for assisted dying and legislators have the responsibility to provide that clarity. The committee report failed to provide either. Instead, it threw open the door to a number of shocking scenarios.

Senator Batters then comments on the Committee report:

The committee did not require that illness be terminal or life-threatening. It included psychological suffering as grounds for physician-assisted death — without any requirement to consult a psychiatrist. It even recommended extending physician-assisted suicide to “mature minors,” those under 18. ... 

The committee argued that physical and psychological illnesses are essentially the same. But, the only evidence it cited was a one-line opinion from a brief letter, emailed by an individual who did not appear before the committee and had no identifiable credentials or expertise in the area. This is not “evidence-based decision-making.”

Senator Batters then explains why Psychological suffering is different than physical suffering:

Psychological suffering on its own is not terminal. It is usually treatable, can be episodic and demands a far more complex decision-making process, particularly in determining patient consent. 

Significant gaps currently exist in our mental health system, including a lack of access to treatment, long wait lists and insufficient training for health-care providers. ... 

Delivering the means to suicide straight into the hands of mentally ill individuals directly contradicts the suicide prevention standard in the mental health field. How can we expect mental health caregivers to advocate suicide prevention on one hand, while signing the death warrant for a mentally ill patient with the other? 

The preservation of hope for mentally ill people is absolutely paramount. Those who endure psychological suffering need our support, our resources and our promise that we will never give up on them, even when they can see no other option but to give up on themselves.

Senator Batters completes the article by sharing her personal experiences:

I have lived for almost seven years now without my husband. I have picked up the pieces and moved forward, trying to create something meaningful out of our personal tragedy. And yet, not a day goes by when I don’t wonder if there might have been another way out for Dave — another counsellor, another medical treatment, another conversation that might have made the difference. Because of the finality of his choice, I will never know. 

I don’t want more Canadian families to know that kind of pain. In good conscience, we cannot allow physician-assisted suicide to become just another option for those who struggle with mental illness.

Because of the Supreme Court ruling, physician-assisted suicide will be part of our reality in Canada. But if you believe it should only apply in cases of terminal illness, and not to minors or those who are mentally ill, we need to make our voices heard on this issue — and fast. Please contact your local MP and tell them where you stand. The lives of our vulnerable loved ones might just depend on it.

Please participate in the Euthanasia Prevention Coalition post-card campaign to members of parliament. It is even better to send letters to your member of parliament. The list of members of parliament.

Hospice and Hospital will not participate in euthanasia.

By Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

The recent report of the federal government's Special Committee on Assisted Dying stated (recommendation 11) that every publicly funded healthcare institution should be required to allow assisted death on its premises.

On March 5, the Windsor Star published an article by Brian Cross concerning Hotel Dieu Grace Hospital and the Hospice of Windsor and Essex County, since both institutions oppose euthanasia and assisted suicide.

Carol Derbyshire the CEO of the Hospice of Windsor stated that their philosophy of ca supports:

“respect for the dignity and sanctity of human life,” and ... that it’s (assisted death) not part of palliative care.

Janice Kaffer, the CEO of Hotel Dieu, that also operate a hospice, stated:

As a faith-based Catholic hospital, it does not believe it should participate in physician-assisted suicide.

Jean Echlin

Jean Echlin who is the President of the Euthanasia Prevention Coalition and a registered nurse who was instrumental in founding the Hospice of Windsor clinical and volunteer programs and recently co-authored a book titled: It's not that simple told the Windsor Star:

most Canadians don’t understand how dignified death can be when pain and symptoms are well managed. She fears the push for assisted suicide is being driven by a desire to control health costs. Little consideration is given to the “death squads,” the doctors and nurses expected to deliver the deadly drugs,

Dr Brad Burke

While Dr Brad Burke, a physical rehabilitation expert told the Windsor star:

“Whether I’m the executioner or I’m made to to refer someone to an executioner, I feel I’m still responsible,”

Burke is concerned that the Ontario College of Physicians would revoke his medical license if he refuses to kill his patients. The Windsor Star stated:

He worries that if he follows his conscience he may contravene the rules of the Ontario College of Physicians and Surgeons and end up losing his licence.

The Canadian Medical Association recently urged the federal government to respect the conscience rights of healthcare professionals.

Healthcare professionals and institutions must not be forced to participate in killing their patients. If Canada imposes euthanasia upon the nation, there needs to be "safe havens" where people can go and not be pressured to die by lethal injection.

Essential safeguards identified to protect vulnerable people from abuse in assisted dying law

The following article was published by Advocate Daily on March 3, 2016.

Hugh Scher

Toronto constitutional and human rights lawyer Hugh Scher is endorsing the Vulnerable Persons Standard, a list of evidence-based safeguards to protect Canadians requesting physician-assisted death who may be subject to coercion and abuse.

“There is certainly no guarantee that this standard alone is going to prevent unwanted deaths or the impact on our culture of legalized assisted death,” says Scher, principal of Scher Law and a frequent commentator on assisted dying issues.

“That said, the standard goes a long way to providing a level of protection against the risk of abuse of vulnerable people. It does provide for an effective means of oversight, which is essential in the event that this policy of assisted death is to possibly be safely implemented in this country.”

The Vulnerable Persons Standard includes the requirement for access to palliative care, and for two physicians as well as a judge or tribunal to sign off on a death. There is a requirement that consent be received at the time of the death, and that the consent is assessed at that time.

The standard has wide support among medical, legal and community-based organizations, including the Canadian Association for Community Living, the Council of Canadians with Disabilities, the Euthanasia Prevention Coalition, Vivre dans La Dignite and the Catholic Health Alliance of Canada.

Canada declares war on Christian doctors and nurses.

This article was published online by First Things on March 4, 2016.

Wesley Smith

By Wesley Smith

Last year, the Canadian Supreme Court created a right to euthanasia and assisted suicide. To qualify for death, the court ruled unanimously, one must be a competent adult with a medically diagnosed condition causing “irremediable suffering”—a circumstance wholly determined by the patient and including “psychological suffering.”

The decision went well beyond mere legalization. Indeed, the court manufactured an enforceable legal right for qualified patients to receive what Canadian policymakers are euphemistically calling “medical aid in dying” (MAID).

But what about doctors opposed to euthanasia? The court left with Parliament and the medical colleges (associations) the decision of whether and how to accommodate doctors with conscience objections, granting a one-year (now extended) period within which to enact laws to govern the practice. Since then, civil liberties groups, provincial medical colleges, and official government commissions have urged Parliament [see here and here] to pass laws that would coerce doctors who are religiously or philosophically opposed to euthanasia to cooperate actively in mercy killings by forcing them to procure death doctors for their patients. Here’s how the federal panel put it:

RECOMMENDATION 10 That the Government of Canada work with the provinces and territories and their medical regulatory bodies to establish a process that respects a health care practitioner’s freedom of conscience while at the same time respecting the needs of a patient who seeks medical assistance in dying. At a minimum, the objecting practitioner must provide an effective referral for the patient.

Gobbledygook: Requiring “effective referral” would materially violate—not respect—a “practitioner’s freedom of conscience” through forced complicity in euthanasia, thereby trampling his faith under the boot of the state.

All of this would seem to fly in the face of Canada’s 1982 Charter of Rights and Freedoms, which states, “Everyone has the fundamental freedom of conscience and religion.” Illustrating the utter lack of regard that secularized Canada now has for religious liberty, the Canadian Civil Liberties Association—that country’s counterpart to the ACLU—applauded the parliamentary committee’s call to stomp upon religious conscience as a “promising step forward.”

Doctors aren’t the only ones threatened with religious persecution under Canada’s looming euthanasia regime. Provincial and federal commissions have both recommended that nurses, physician’s assistants, and other such licensed medical practitioners be allowed to do the actual euthanizing under the direction of a doctor.

This is particularly worrying from a medical conscience perspective, because it leaves no wiggle room to say no. For example, objecting doctors might be able to defend their refusals by claiming that the euthanasia requester is not legally qualified. Nurses, however, would not even have that slim hope, since they would merely be delegated the dirty task of carrying out the homicide. This leaves nurses with religious objections to euthanasia with the stark choice of administering the lethal dose when directed by a doctor, or being insubordinate and facing job termination. The same conundrum would no doubt apply to religiously dissenting pharmacists when ordered to concoct a deadly brew.

Assisted dying report goes beyond scope, ignores evidence

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

On February 25, the Special Committee on Physician-Assisted Dying released its report advising the government on euthanasia legislation in Canada.

The Supreme Court struck down Canada's assisted suicide law (February 6, 2015) and have given parliament until June 6, 2016 to implement a new law.

Similar to the Provincial-Territorial panel report that was loaded with pro-euthanasia activists, the federal committee recommended euthanasia for people with dementia, for minors, for people with psychiatric conditions and without effective oversight.

EPC legal counsel and constitutional expert, Hugh Scher, called the committee proposal "a dangerous social policy experiment."

David Baker

On Saturday, February 27; the Globe Mail published an excellent commentary by constitutional lawyer, David Baker, who represented national disability groups in the assisted suicide case at the Supreme Court and Trudo Lemmens, University of Toronto Professor in health law and policy at the Faculty of Law.

Baker and Lemmens argue that the Assisted Dying report goes beyond the scope of the Supreme Court decision, and that they also ignored evidence. According to the article:

The court foresaw it (the government) enacting a “complex regulatory regime” of “carefully designed and monitored safeguards.” Unfortunately, the federal report released yesterday recommends exactly the opposite, and proposes the world’s most open-ended regime with arguably the lowest safeguards.

Trudo Lemmens

The article continues by defining what the Committee on Assisted Dying recommended:

the parliamentary committee seeks to expand the criteria for physician-assisted death way beyond what was required by Carter or Bill 52. It includes mental-health conditions and all other disabilities, including developmental disabilities, autism, acquired brain injuries, fetal alcohol syndrome, not to mention blindness and deafness. 

Essentially all disabilities can be included in the open-ended criteria for access, extending the law beyond the persons with irreversibly declining capacities at the end-of-life that the Supreme Court ruled upon, and disregarding the court’s determination that “psychiatric disorders” were expressly excluded, as well as children, even if children would only have access three years after the new legislation is introduced. The committee further recommends access by advanced directive for people suffering from dementia, which most agree would create a practical and ethical minefield.

The article documents some of the evidence that the Committee had received but ignored:

The committee disregarded strong evidence (detailed analyses as well as various case reports) from Belgium and the Netherlands, that confirms vulnerable people are put at risk when vague and expanding access criteria are employed. The risk worsens when the regulatory system relies on individual physicians for determining access and for assessing competency of patients. 

Physician-assisted death in those countries is increasingly being performed on people who are lonely and are concerned about becoming dependent on others, people who are tired of life, and people suffering from mental-health conditions, including depression, anxiety, schizophrenia, eating disorders, autism, post-traumatic stress, and even complicated grief. In many analyzed euthanasia cases, treatment options were available but not used. Reports from those countries raise questions about how some physicians assess competency, and about how vulnerable patients have been able to shop around until they find a physician who, having had no prior therapeutic relationship with them, are willing to end their life. 

In many reported euthanasia cases, treatment options were available but not used. The report raises questions about how some physicians assess competency, and about how vulnerable patients have been able to shop around until they find a physician who, having had no prior therapeutic relationship with them, are willing to end their life.

The article concludes by stating that experts and political commentators in the Netherlands and Belgium are now calling for an end to the open-ended, after the death review system that exists in their countries, and yet the Committee suggested we go in that direction. Baker and Lemmens state:

Imagine that Canada would become a country where people, including children, receive a physician-assisted death for lack of access to appropriate palliative or other health care.

It is time for Canadians to rise up and say NO.