Canada is not better than the United States

Meghan Schrader

By Meghan Schrader

With the exception of those who have blithely stated their intention to kill members of a marginalized group because they are members of that group, such as people like Peter Singer, Thaddeus Mason Pope, Christopher Riddle and some other “MAiD” supporters, and members of hate groups like the KKK, I don’t choose my friends and associates based on ideology. I have friends and family from all over the political spectrum that have been good to me. I also think it is imperative that people from all over the political spectrum unite to correct the serious problems that disabled people face, sort of like people might unite if someone’s house were on fire.

So, I don’t generally comment on political candidates or parties. But there have been a lot of policies being proposed or implemented lately that my experience indicates would be very bad for disabled people. I feel like my role as a disability justice advocate requires me to comment on these policies. So, I have had to talk about politics a little bit. In that vein, this post is intended as a disability justice response to Americans who are currently thinking that Canada might be a nice place to live.

In my opinion there are some really, really bad policies being implemented in the United States right now; I discuss what I think are destructive disability rights policies at length in my “Opposition to Recent/Proposed Disability Policy Changes Is Not “Hysteria” post. 

In my experience, ableism is not unique to this administration or to the Republican Party, but from my perspective it’s as though this administration got a list of almost every ableist thing it could possibly do and shouted, “Leeroy Jenkins!” And, Conservative-identitying members of this administration are the ones leading efforts to implement the aforementioned policies, so it’s justifiable for people to talk about ableist and/or generally prejudiced conservative policies and ideas.

Nevertheless, it bothers me to see many Americans, especially Americans who identify as politically progressive, holding up comparatively leftist Canada as a place to move to and extolling the wisdom of its leaders. Although I believe that many of the policies that this administration has championed are unethical and prejudiced, Canada is also implementing unethical and prejudiced policies; it is NOT any better than the United States, at least not for people with disabilities.

If one compares the disability policies that this administration has implemented to Canada’s, there are disturbing parallels. For instance, President Trump signed an executive order making it easier to institutionalize people with severe mental illnesses like I have experienced. This is horrible, but did Canada not do the same thing when it passed the More Beds Better Care Act, which allows health authorities to forcibly transfer disabled and elderly people to institutions far away from their families? The prevailing worldview among members of the mainstream disability studies/advocacy communities that I interact with is that this administration’s policies have made America’s issues with systemic racism worse, but did Canada’s government not ignore the majority of its indigenous community that asserted that Canada’s healthcare system was rife with systemic racism and “Track 2 MAiD” would make that worse? I’ve observed some disabled friends who identify as LGBT talking about moving to Canada, and although I can’t speak to their experiences, I worry that Canada would not be a better environment for them, given that Canada is aggressively suggesting “MAiD” to disabled people who identify with any gender or sexual orientation. People from across my Facebook feed are expressing concern that this administration has implemented policies that seem designed to impose its worldview on everyone, but has Canada’s government not shut down hospices that decline to participate in “MAiD”? I know from personal experience that America’s policies often further systemic ableism, but at least we passed the Americans With Disabilities Act in 1990. Canada passed “ADA lite” legislation in 2019, and has set a goal of the law being fully implemented in 2040. Current Prime Minister Carney didn’t even bother to appoint a disability justice minister and is continuing Trudeau’s pattern of starving and killing people with disabilities. Is that the world that Canada’s admirers want for Americans with disabilities?

As I’ve noted, it seems that people who admire Canada the most tend to identify as political progressives. Unfortunately, Canada’s current Center-Left government has taken ableism to a lethal extreme, and in my experience USA citizens from that political contingent have not collectively earned the disabled community’s trust either.

For instance, one of the most aggressively ableist progressive-identifying people I have ever met, the guidance counselor who attempted to force me to drop out of high school because I was a Special Education student, posted on the public part of his Facebook page:

“I just listened to Prime Minister Trudeau’s speech on Canada’s response to Trump’s tariffs. He would, if Trump follows through, concomitantly place tariffs on U.S. goods. He spoke like a true, sensible and sane leader. I was proud for the Canadian people and shame for our country’s leadership…It seems that if more people who typically vote democratic did not sit it out in 2024 things might have been different. But we must move on.”

No. Prime Minister Trudeau was not a “true, sensible” leader. He helped create a world where disabled people are starving and killing themselves. It scares and offends me to observe people like that guidance counselor praising Trudeau as a “true, sensible leader;” I think that’s a sign that Canada is correctly controlled by people like that guidance counselor: people who virtue signal about how progressive they are while treating disabled people of all backgrounds like garbage.

With regard to how attitudes toward Canada intersect with the right to die debate, the attitudes of mainstream US “MAiD” leaders toward Canada are concerning. As noted, Compassion and Choices leaders Kevin Diaz and Bernadette Nunley’s article on the differences between US and Canadian “MAiD” laws declined to criticize Canada’s approach. Also, I don’t mean to be creepy, but I noticed that Compassion and Choices National Campaign Director Tim Appleton posted this comment about Justin Trudeau on his BlueSky account:

“After watching this, I cannot imagine #JustinTrudeau leaving the world stage. Canada, America, and the world need him, now more than ever.”

The fact that Tim thinks that Canada, America and the world needs Justin Trudeau, even after Trudeau allowed policies that lead to disabled people starving, being homeless and dying early deaths strikes me as indicating that the American “MAiD” movement’s outreach to people with disabilities is largely performative.

Tim also posted a quote from Canadian Prime Minister Carney asserting that this administration’s tariffs were an indication that the 80 year period in which the United States “formed alliances rooted in mutual trust and respect” was over. I agree that this administration’s tariffs are ridiculous, but Carney has no right to lecture anyone about “trust and respect.” His party gives disabled people no reason to afford his government any level of trust and Carney treats his disabled citizens with extreme disrespect. Tim might respond that his posts aren’t meant to communicate agreement with everything Canada does, but Canada’s leaders have created an environment where disabled people are starving and killing themselves. Compassion and Choices likes to frame itself as part of the political left, but praising such a country doesn’t seem very progressive or responsible to me. Would C&C’s leaders praise Vladimir Putin? Or apartheid South Africa? By equivocating about and praising Canada, C&C’s leaders are reinforcing the message that its disability policies aren’t contemptible and that it would be acceptable for America to copy them.

My perspective that Canada is not better than the United States is not unique. When Canada was passing Bill C-7 to expand “MAiD” to people with disabilities, a disabled Canadian X user named Tweedy Mutant posted:

“Let me talk to Americans for a second about #KillBillC7. Look, I grew up in the US, so I know that Canada holds a special place in the hearts of US leftists, but the Canada that people threaten to move to every election and the ACTUAL country of Canada are different places. In cases of discrimination, the ACTUAL country of Canada offers completely inadequate "protection" through a slow and retraumatizing Human Rights Tribunal process riddled with barriers that disproportionately impact disabled ppl, making it an ineffectual option for redress.

Oh and the threat to move to Canada the next time the GOP takes the White House? Good luck if you're disabled. In the ACTUAL country of Canada, would-be immigrants can be denied on the grounds of disability. Furthermore, the ACTUAL country of Canada does not provide disabled ppl with adequate supports to live -- and instead of ensuring better quality-of-life, Parliament passed Bill C7, which removes important safeguards on medical assistance in dying.

The ACTUAL country of Canada has a long history of institutionalization and sterilization. The ACTUAL country of Canada passed a toothless version of the ADA (the ACA) 19 years AFTER the US. (Do the math: we got our "ADA lite" in 2019!)”

Disabled Canadian X user Sarah Colero stated:

“The treatment of developmentally disabled folks by the United States does not take away from the active disabled eugenics in Canada in which the UN CRPD called out earlier this year. You can maplewash all you want, Canada is actively killing disabled folks including Autistics.”

American disability justice leader Imani Barbarin responded to a post from a Canadian expressing derision for the USA’s current policies by asserting: 

“Your healthcare system has been essentially euthanizing disabled people en masse.”

Indeed. As a disabled person, Canada doesn’t sound like a place that I would want to live.

Disabled people in the United States do not need leaders like Canada’s in charge of our lives. We need people from across the political spectrum to listen to us and create policies that help us thrive, not make us so oppressed that we die.

Euthanasia court decision in Québec was "fixed" from the beginning.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Prime Minister Trudeau with
Justice Minister Lametti.

In her National Post article: Thanks to Trudeau, Canada's death-care system is top of the line, Barbara Kay makes a strong statement that the 2019 Truchon euthanasia Québec court decision was a "fix" from the beginning. Here's what Kay wrote:

This deliberate obfuscation is consistent, however, with the honed tactics of boundary-pushing activists whose Dignity-R-Us rhetoric ... Liberals settled on a winning strategy. Don’t make euthanasia a political plank; do use the courts to keep the expansion ball rolling. The fix was always in for expansion of the death as “reasonably foreseeable” guardrails established by the 2015 Carter decision. Thus, the 2019 Quebec Truchon decision that found Carter’s limits to MAiD access unconstitutional went unchallenged by Quebec and Ottawa, in spite of a flawed trial process.

The trial judge for Truchon, Christine Baudouin, was a lawyer only recently promoted to Superior Court. Her father, retired Court of Appeal judge Jean-Louis Baudouin, a longtime proponent of state-executed euthanasia, wrote several publications urging decriminalization of assistance to suicide. Christine Baudouin shared his views. Her law firm, Heenan Blaikie, had financially supported her father’s advocacy for state-delivered euthanasia.

The lawyer for the titular disabled plaintiff seeking MAiD, Jean Truchon (who admitted in an email to a friend he didn’t really want to die, he only wanted greater assistance to live with dignity, but couldn’t get it) relied on Jean-Louis Beaudoin’s pro-euthanasia publications, which were accepted into evidence by Christine in the trial.

That Christine Baudouin did not recuse herself in such circumstances compromises the decision. The Quebec and Canada attorneys general knew that, but did not appeal the judgment, an appeal they likely would have won. They welcomed it as a springboard to new legislation. As evidence of their satisfaction with Christine’s ruling, Quebec’s A-G gave Truchon’s lawyer a justice award just days after the decision. And rookie judge Christine Beaudoin was elevated by David Lametti to the Quebec Court of Appeal.

Kay then states that her greatest concern is for people with disabilities. Kay continues by outlining the work of Roger Foley from London Ontario:

For years I’ve followed the vicissitudes of — and several times commented on — 48-year-old Roger Foley, who suffers from cerebellar ataxia, a fatal neurological disorder that limits his ability to move his arms and legs. His physical condition has not dimmed his intellect, his passion for life or his meticulously focused disability-rights activism. Supportive details regarding the Truchon decision and other pivotal moments in MAiD’s history can be found on Foley’s website, assisteddying.ca. I particularly recommend his well-crafted “public-interest evidence video,” instructive as to the rather incestuous relationships amongst euthanasia ideologues, their justice-system enablers, political foot soldiers and the highly supportive Trudeau Foundation.

Kay then explains how Canada's euthanasia directly affects the disability community. She writes:

In 2019, Justin Trudeau promised Canadians they wouldn’t have to choose MAiD because “you’re not getting the supports and cares (sic) that you actually need.” But Catalina Devandas Aguilar, a lawyer from Costa Rica and the UN’s first ever Rapporteur on the Rights of Persons with Disabilities, who explored Foley’s and other Canadian cases, found that was precisely what is happening. “Persons with disabilities have to initiate very lengthy and onerous legal procedures to get their rights recognized,” Devandas Aguilar said in a report to the Governor General. This visit and the rapporteur’s worthy recommendations apparently sank like a stone.

You can wait five years to see a medical specialist in this country. The disabled can wait forever to see their living-with-dignity rights honoured. But the euthanasia doctor is always there for you. Nobody, including our prime minister, denies Canada’s health-care system is broken. But cheer up: Our death-care system is top of the line.

Previous articles from Barbara Kay: (Link).

Previous articles concerning Roger Foley: (Link).

Barbara kay: Canada's Death System is Top of the Line

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Barbara Kay

Barbara Kay wrote an excellent opinion column that was published in the National Post on Saturday March 18 titled: Thanks to Trudeau, Canada's death-care system is top of the line.

Kay begins her article by announcing that Ed Fast MP introduced Bill C-314 titled the Mental Health Protection Act which would prevent euthanasia for mental illness alone. She then points out that Senator Stan Kutcher, who was responsible for the amendment to Bill C-7 that extended euthanasia for mental illness alone is arguing against Bill C-314 by stating that the issue is already decided.

• Sign our petition supporting Bill C-314 (Link).

Kay states that with reference to Canada's euthanasia law, slippery slope which conjures up an avalanche is more like a toboggan ride.

Kay continues:

Writing in National Review in the fall, one American commentator called Justin Trudeau “modernity’s Doctor of Death,” whose willed expansion of MAiD makes Canada “arguably the assisted-death capital of the world.” An exaggeration? Consider that California, with the same population as Canada, and universally regarded as a singularly progressive domain, legalized medically assisted death in 2016, just like Canada. In 2021, 486 Californians availed themselves of the program. In the same year, 10,064 Canadians ended their lives with MAiD (a term for euthanasia used only in Canada, and brazenly stolen from palliative care, where it rightly belongs.)

Kay points out how Canada's MAiD law has become an international cautionary tale. A British writer used Canada's euthanasia law as an example bad public policy that is based on "good" intentions. Kay writes:

Canada’s MAiD, “originally marketed as a rational choice for sensible adults and therefore an indisputable moral good, it is now being used to kill the poor and the mentally ill as well as the physically sick and the elderly.”

Kay continues:

Too many reported incidents of MAiD chosen and executed for bad reasons — including credit card debt, poor housing, and difficulties getting medical care — attest to the truth of this criticism. In the legislative pipeline are “advance requests” — and consent by “mature minors.” Be afraid , be very afraid.

Kay then refers to the $86 million in health-care spending savings due to the original euthanasia law, as stated by the parliamentary budget office in October 2020. The budget office estimated, based on the expansions of euthanasia in Bill C-14, that there would be $149 million in health-care savings. 

I estimated that the numbers in the report were low based on several factors. First, I stated that there would be more deaths than predicted. Sadly I was right. Secondly, the shortened time of life was under-estimated by the budget office, meaning many people would die months, if not years before their death would otherwise had been. Sadly I am right.

Kay then writes about the fact that doctors are required to falsify the death certificate:

the medical certificate of death, physicians are obliged to list the illness, disease or disability leading to the request for MAiD as the cause of death, rather than the medications administered, the actual cause.

Kay argues that if euthanasia is a public good, then why the deflection?

Kay concludes:

This deliberate obfuscation is consistent, however, with the honed tactics of boundary-pushing activists whose Dignity-R-Us rhetoric captured the nabobs. Liberals settled on a winning strategy. Don’t make euthanasia a political plank; do use the courts to keep the expansion ball rolling. The fix was always in for expansion of the death as “reasonably foreseeable” guardrails established by the 2015 Carter decision. Thus, the 2019 Quebec Truchon decision that found Carter’s limits to MAiD access unconstitutional went unchallenged by Quebec and Ottawa, in spite of a flawed trial process.

• Canada's Healthcare Savings attributed to euthanasia (Link).
• Study: Legalizing euthanasia saves money (Link).

Has Canada finally realized that its euthanasia law is a human rights disaster?

This article was published by Mercatornet on January 23, 2023.

By Michael Cook

Finally, after 40,000 or so deaths, Canadians are having second thoughts about legalised euthanasia.

Euthanasia deaths in Canada have shot upwards like a skyrocket. In 2015 there were none; in 2021, the last full year for which there are statistics, there were 10,064. On current trends, more than 10,000 died in 2022, bringing the total to more than 40,000.

But Justin Trudeau’s government believed that it was being too restrictive. It announced that it would permit patients with mental illness to request “medical assistance in dying”. This was due to begin on March 17.

Canada’s media, politicians and voters have been firmly behind MAiD. But as this deadline approached, a number of cases emerged of people who applied for MAiD simply because they didn’t have housing, or because they couldn’t access mental health care, or because they were lonely. At least four military veterans were pressured by a caseworker to accept MaiD, including a paralympian.

People began to realise that something was wrong — very wrong. A Toronto psychiatrist who had helped hundreds of people to die, Madeleine Li, told the BBC that Canada had gone too far. “Making death too ready a solution disadvantages the most vulnerable people, and actually lets society off the hook,” Dr Li said. “I don’t think death should be society’s solution for its own failures.”

In this astonishing documentary from Canada’s premier investigative journalism program, The Fifth Estate, journalist Gillian Findlay interviews several critics of the MAiD. Despite reassurances from the Minister for Justice, David Lametti, it shows that Canada is about to fall off a cliff.  

It’s well worth watching.

Letter from Canada's Disability groups opposing (MAiD) euthanasia for mental illness.

The following letter was signed by more than 50 organizations and sent to Justice Minister David Lametti, Prime Minister Justin Trudeau, Opposition Leader Pierre Poilievre, Leader of the NDP Jasmeet Singh, Leader of the Bloc Québécois Yves-Francois Blanchet, and Elizabeth May, Leader of the Green Party.

Dear Minister David Lametti,

We, the undersigned disability and human rights organizations are writing to express our concern and opposition to the legalization of Medical Assistance in Dying (MAiD) for mental illness and to the already-legal practise of euthanizing people with disabilities who are not terminally ill.

The legalization of MAiD for mental illness is a discriminatory process that is made worse by systematic poverty, a national housing crisis, and inadequate access to support in the community. We know, as do you, that the existing law is not working and has not worked, and that people with disabilities have been dying by MAiD due to their life circumstances and oppression. To legalize MAiD for mental illness would pour gas on a fire that is already out of control.

Over two million Canadians over the age of 15 have a mental health-related disability. The majority are women, non binary, and gender non-conforming people. Four out of five have at least one other type of disability. The majority have experienced assault. Persons living in poverty and those who are homeless are over-represented, as are indigenous people who, as noted in both Expert Panel's reports, have not been meaningfully consulted or engaged in relation to MAiD.

As a country we cannot provide state-assisted death to people who are not terminally ill, without ensuring a legislated right to a decent life for all. The current MAiD law has chipped away at the constitutional protections of Canadians. The very existence of the current law is a threat to the lives of people with disabilities and their families.

We call on the government to take the necessary steps to not just delay MAiD for mental illness but to fully roll back the sunset clause and to repeal track two MAiD (for persons not terminally ill) as introduced under Bill C-7. We cannot allow systematic discrimination of this magnitude and risk to continue. The government's ill-considered, trial-and-error experiment on the lives of persons with disabilities is failing. It is time to ensure protection for all, including people with disabilities.

Thank you for considering our concerns, and we expect to see meaningful action taken on this critical issue.

Sincerely,

Signed by 53 disability and human rights organizations.

No Other Options. An exposé on euthanasia in Canada.

"euthanasia seems like the only way out"

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Alexander Raikin wrote an exposé on the experience with Canada's (MAiD) euthanasia exposé titled No Other Options . His exposé was published in The New Atlantis on December 16. Raikin provides important insights into Canada's experience with euthanasia that should be read by everyone concerned with the issue (Link to the article).

Raikin writes his article as an investigative reporter into Canada's Medical Assistance in Dying (MAiD) law. He begins the article by speaking with Dr Stefanie Green one of Canada's leading euthanasia doctors. Green tells Raikin that:

The procedure, she assures me on our call, is “100 percent effective.” If her patient asks to die, and if her schedule, her ethics, and the law permits it, she will administer a lethal injection.

To create context, Raikin quotes David Lametti, Canada's Justice Minister, who stated:

Supporters insist that this is not state-sanctioned suicide. Rather, it’s a dignified solution for those who no longer wish to suffer from terminal or chronic illness. MAID allows “for compassionate action, while also protecting those who are particularly vulnerable,” claimed David Lametti, the attorney general and minister of justice, in 2021.

Raikin then quotes from Prime Minister Justin Trudeau: 

Prime Minister Justin Trudeau has long promised to strike just this balance. In 2019, while pressing the need to expand access to euthanasia, he assured that people will be able to choose assisted death “in a way that isn’t because you’re not getting the supports and cares that you actually need.”

This is the promise of medical assistance in dying: that vulnerable people who want to die for the wrong reasons will be encouraged to live, as they always have been — while people who want to die for the right reasons will have their autonomous decision upheld. If even a single vulnerable person were pushed into assisted death, it would be a scandal to the system. That is why safeguards were put into place.

Raikin states:

As this article will show, in internal meetings, those close to the system have long talked openly about red flags that many people are choosing euthanasia because they’re not getting the “supports and cares” they need. The physicians in charge of the process not only know that this is happening, but they have discussed it in seminars, collected evidence, and then kept it quiet in public.

The safeguards promised by Trudeau and others to prevent vulnerable people from heading down the road to euthanasia turn out to be vague, pro forma, and easy to get around by doctor-shopping.

The quotes from Lametti and Trudeau are important considering the scandal of euthanasia for people with disabilities because of poverty, an inability to obtain needed medical treatment or care, homelessness, neglect and abandonment.

Raikin then comments on the number of people who have died by euthanasia.

One of the greatest reasons for concern is the sheer scale of Canada’s euthanasia regime. California provides a useful point of comparison: It legalized medically assisted death the same year as Canada, 2016, and it has about the same population, just under forty million. In 2021 in California, 486 people died using the state’s assisted suicide program. In Canada in the same year, 10,064 people used MAID to die.

...But the picture that emerges is not a new flowering of autonomy but the hum of an efficient engine of death.

Raikin's interview with euthanasia provider Stefanie Green continues:

Asked on a call about stories of abuse, she raises her voice and says, “you cannot access MAID in this country because you can’t get housing. That is clickbait. These stories have not been reported fully.”

Raikin reminds us that the Supreme Court of Canada, in the Carter decision that legalized euthanasia wrote that:

“a permissive regime with properly designed and administered safeguards” would be “capable of protecting vulnerable people from abuse and error.”

To add context, Raikin quotes from former Senator James Cowan who said:

“We have four or five years of experience now, and absolutely no indications, that I’m aware of, of alleged misuse or poor decisions,”

Helen Long, the CEO of Dying with Dignity told MacLeans magazine:

arguing that the stories that people “who are not able to access supports like safe and affordable housing are opting to have MAID instead” are “simply not true and there is no evidence that I’m aware of to support those claims.”

Raikin then points out that Green, Cowan and Long are denying what they know to be true. Raikin quotes euthanasia provider Madeline Li who testified to a parliamentary committee that:

...legislated safeguards are “impotent.”

“I believe the Canadian populace and maybe even the legislators are not aware of who has been qualifying for MAID.”

Raikin then proves that the euthanasia lobby are aware that people are dying by euthanasia because of poverty, access to medical treatment and housing. He writes:

The Canadian Association of MAID Assessors and Providers, the leading organization of Canadian euthanasia providers, has sat on credible evidence by its own members that people are being driven to euthanasia by credit card debt, poor housing, and difficulties getting medical care. These are people who do have some sort of medical condition but in many cases are using these conditions to check a box in the approval process, when the relief they are mainly seeking is from other forms of suffering. And the system is doing much more to help them down the path toward death than to protect them as the public was promised.

Raikin uncovers a presentation by Althea Gibb-Carsley, a retired care coordinator and social worker of the Vancouver Coastal Health’s assisted dying program. The title of her presentation asked, “What is the role of the MAID assessor when resources are inadequate?”

Gibb-Carsley describes several people who qualified for euthanasia. Mary (55) with fibromyalgia and chronic fatigue who can't afford the food and supplements that would lessen her health issues and identified poverty as driving her to MAiD. Nancy (68) a physician with chronic pain following a car accident who didn't save any money. Greg, 57, a writer who has diabetes, cardiac problems, anxiety and depression, and a history of trauma. Lucy, a 38-year-old trans woman, is an immigrant who has pain, osteoarthritis, depression, and anxiety.

Raikin reports that Gibb-Carsley concludes her presentation by stating:

these patients have “no other options” because of their poverty, their housing situations, their difficulty getting medical care. “I think you will find, and you know already,” she says to her audience of euthanasia providers, that if you want to offer your patients some alternative to MAID, “this will often mean a referral to not very much, and certainly not very fast.” It’s not that they are terminally ill or truly beyond help, but that they can’t get the help they need in the system right now, so euthanasia seems like the only way out.

Raikin then states that it is important what Gibb-Carsley didn't say:

Of Mary, the patient who identified “poverty as the driver of her MAID request,” we do not hear that the system discouraged and denied her application. Of Greg, who the slides say “identified housing as [a] driver” of his euthanasia request, we hear that he is “getting very close to needing to set a date” to be euthanized — and again, not that any effort is being made to stop him. Of Nancy, for whom “uncertain housing is the driver,” we hear of no effort to stop her.

Raikin then explains that people must be protected from abuse.

If the MAID system were working as promised, the presenters should be warning attendees that they must be vigilantly on the lookout for just the kinds of cases described in the seminar, scrupulously ensuring that they are not approved for euthanasia.

Raikin points out that the presenter and the audience understood that these were serious problems, in fact Gibb-Carsley states:

“Our silence is our complicity,”

Raikin shows how they were examining the problem from the wrong point of view. Rather than viewing these issues within the context of changing the implementation of euthanasia they were viewing it within the context of:

an opportunity to highlight the real problem: the inadequacy of the welfare state.

Gibbs-Carsley states that these assessments can be used to leverage the government for improved welfare. She then states:

Your Assessments provide a rare opportunity to hear from the typically disenfranchised patients about their experiences.” The subtext of this sunny euphemism is that giving a voice to the voiceless will, for many, ultimately mean killing them.

The euthanasia assessors are then told that they can withdraw from these cases but they will be obligated to refer those patients to assessors who will be willing.
 

Earlier in the interviews Stefanie Green referred to these stories of abuse as:

“clickbait” that “have not been reported fully.”

Raikin then examines why these deaths are happening in Canada. He writes:

A core reason that Canada’s assisted dying program has grown so much faster than any other program in the world is that it is the most permissive. Eligibility criteria began loose and are rapidly getting looser. You do not need to be terminally ill, only to have a “grievous and irremediable” condition, a standard that is open to significant differences in interpretation. In March 2023, mental illness alone will qualify as an acceptable medical reason to die. And the Quebec College of Physicians now suggests that Parliament expand euthanasia eligibility to minors and even newborns. (Euthanasia for mental illness alone will be delayed).

Raikin then states that the safeguards are clearly not working.

Raikin then interviews Dr Paul Appelbaum, a professor of psychiatry for 40 years, who developed the test to determine mental competency for medical decision making. Appelbaum commented about the test used to assess competency for euthanasia:

“it doesn’t strike me as a particularly well-thought-through evaluation process.” Among other things, “it’s not clear from these forms how an evaluator would decide that a condition is ‘grievous and irremediable,’” he says, quoting one of the key legal criteria.

Moreover, the initial screening questions for depression and anxiety “are not detailed enough to result in a diagnosis, and even if they did, the impact the answers to these questions are supposed to have on the final decision about authorizing MAID is unspoken.”

Dr Mark Komrad, a clinical psychiatrist and ethicist who helped craft the American Psychiatric Association’s statement against euthanasia for patients who are not terminally ill called the evaluation process as: 

“Death by checklist!”

Raikin continues by writing:

when I asked Stefanie Green how she decides whether a patient with a mental health condition has the competence to choose euthanasia, she said that she makes a judgment call about whether a patient has an “active” or “stable” case of mental illness. For “active” cases, she will consult a specialist; for “stable” cases, she proceeds on her own. Green is not a psychiatrist, so I asked Appelbaum about her framework. “It’s not a distinction that makes any sense to me,” he says.

Raikin points out that the law allows any doctor or nurse practitioner to assess someone for euthanasia without requiring further training.

Raikin then writes about how easy it is to die by euthanasia in Canada. He begins by pointing out that if an assessor rejects someone for euthanasia that all they need to do is go to another assessor. Raikin explains:

In another CAMAP seminar recording, we learn of a man who was rejected for MAID because, as assessors found, he did not have a serious illness or the “capacity to make informed decisions about his own personal health.” One assessor concluded “it is very clear that he does not qualify.” But Dying with Dignity Canada connected him with Ellen Wiebe, a prominent euthanasia provider and advocate in Vancouver. She assessed him virtually, found him eligible, and found a second assessor to agree. “And he flew all by himself to Vancouver,” she said. “I picked him up at the airport, um, brought him to my clinic and provided for him,” meaning she euthanized him.

Jocelyn Downie states in a seminar that you can ask as many assessors as you want or need disagreement doesn't mean you must stop.

Jocelyn Downie

Downie stated in euthanasia seminars that:

“There is no certainty or unanimity required. There is not perfection required,” says Downie. The result: There are many paths available to reach the end, and you only need to find one. The system makes it easy to die.

When asked by email how these statements reconcile with safeguard reassurances that have been offered to the public, Downie responded:

“This is an inaccurate characterization of what I said and did at the two seminars.” She did not specify the nature of the inaccuracy.)

The fact is that the rules surrounding euthanasia are subjective and enforcement of the procedure is lax. Nancy Hansen, the Director of the Disability Studies program at the University of Manitoba, told Raikin that in effect:

“there’s no consequences for non-compliance” with the law.

When asked for her response to her earlier comment, Weibe said:

“It is rare for assessors to have patients who have unmet needs, but it does happen. Usually these unmet needs are around loneliness and poverty. As all Canadians have rights to an assisted death, people who are lonely or poor also have those rights.”

Raikin continues his exposé by writing about Les Landry and Rosina Kamis.

Landry, was a truck driver who had a reaction to anesthesia in 2009, which led to his disability. When Landry was turning 65 he requested euthanasia based on poverty. Landry told Raikin:

“I turned 65 [and] lost all m[y] disabilities benefits and now a senior in poverty. I am not going to live my life like this.” On December 2, Les received his first approval for euthanasia. He is now waiting for the second and final approval. And he says he will doctor-shop until he gets it.

Rosina Kamis (41) requested euthanasia because she was in constant pain from her fibromyalgia, had chronic leukemia and a myriad of other mental and physical illnesses. But there was much more to her story. Raikin did an investigation and learned:

Oftentimes, Rosina was hungry. The artificial light in her room would make her migraines worse. It was loneliness driving her to MAID, that she “must suffer alone” with her service dog — which she could “easily lose,” as her landlord was trying to evict her and she had nowhere else to go. It was that she didn’t want her physicians to harm her by changing her pain medication, as they sometimes did. It was that she was “scared” of being institutionalized; that what she needed to live was not what she could reasonably expect to get; and that others would benefit from her death because MAID “is the best solution for all.” Her choices seemed slim. When her fingers hurt, she couldn’t make food. She would post a video of herself going to bed, in her dark room, hungry and crying.

Rankin then states:

Rosina showed one face of her suffering to the MAID system, and another to her confidants. To the latter, the reasons she gave for really wanting to die were not physical suffering. “Please keep all this secret while I am still alive because … the suffering I experience is mental suffering, not physical,” Rosina wrote in a message apparently intended for her powers of attorney. “I think if more people cared about me, I might be able to handle the suffering caused by my physical illnesses alone.” To her two dozen subscribers on YouTube, she said, “Sometimes all the pain will go away just by having another human being here.”

Raikin explains:

Rosina was approved, and specifically asked to die on the date of her ex-husband’s birthday. Rosina died in her shared basement apartment on September 26, 2021, after a doctor gave her a lethal injection.

Raikin further assesses the reality of euthanasia in Canada. He writes:

Whatever your view on euthanasia, stories like Les’s and Rosina’s are not entirely straightforward. In many cases it is hard to sort out the tangle of internal and external reasons someone might make a voluntary request to die. But that is precisely the problem. Canadians were promised a system that would distinguish a rational choice to die from a desperate cry for help. But in stories like Les’s, Rosina’s, and so many others, that distinction breaks down.

This is particularly true in cases where a patient seeking euthanasia has a history of depression. As the psychiatrist Paul Appelbaum told me: “People with depression can be extremely rational in explaining the reasons for the decisions that they’re making. And what is most difficult is to separate the effect of the depression on that decision from what their underlying non-depressed motivations might be.”

Raikin explains that the law requires that a person have an “incurable” and “irremediable” medical condition. Even the euthanasia lobby knows that this is often not the case. Raikin states:

According to an internal study of MAID assessments, presented to CAMAP in 2022, of 54 patients who were not terminally ill, two-thirds had concurrent mental illness. A fifth of the patients had difficulty finding “appropriate” treatment. And, most disturbingly, over a third of patients were “not offered appropriate / available treatments.”

Raikin refers to euthanasia doctor, Ellen Wiebe as an example.

Ellen Wiebe, the poster child for Canadian medical death — in 2016 Maclean’s covered her as a visionary. She has since become one of the most prolific MAID providers, having personally euthanized over 400 patients. In testimony to a parliamentary committee, Wiebe said that she would consider a patient on a five-year waitlist for an effective treatment to have “irremediable suffering.”

Elsewhere, in a public talk, Wiebe described a recent procedure she performed, saying, “It was a beautiful death.” And she admitted that the real difficulty is not protecting the vulnerable from abuse: “Angry family members are our greatest risk,” she says, and laughs.

Even the Simons euthanasia commercial, All Is Beauty, featured a woman who didn't want to die. Raikin explains:

an ad video by the Canadian fashion company La Maison Simons, titled “All Is Beauty,” went viral online. It told the story of Jennyfer Hatch, a 37-year-old-woman with Ehlers-Danlos syndrome who had chosen euthanasia. Slickly produced, the video showed slow-motion images of people gathered on beaches. At one point it describes “the most beautiful exit,” apparently referring to MAID. Hatch was euthanized the day before the campaign launched. She had told friends and interviewers that she wanted to live, but couldn’t afford it.

Raikin suggests that the tide is turning with relation to euthanasia and quotes from disability scholar Catherine Frazee who says:

has observed patients who become fixated on MAID, who under different circumstances, before MAID was a part of our culture, would have carried on living through difficult times, or who would have pursued treatment options with a reasonable chance of success even though doing so would be temporarily unpleasant or uncomfortable. Many people who are not at risk of suicide are nevertheless at risk of MAID, especially so because it has been so quickly embraced as an honourable, “dignified,” idyllic form of death.

Amy Hasbrouck, a disability advocate told Raikin:

MAID is a way to “get rid of disabled people.” It’s an extreme view. Yet it is possible to imagine a euthanasia system that is set up without that intention, even one that is nominally set up to protect the vulnerable — and yet that, step by step, becomes indistinguishable from a system deliberately designed to usher them to their deaths.

Euthanasia doctor Madeline Li told a Parliamentary Committee that:

“I’ve certainly had cases where I felt compelled to provide MAID against my better clinical judgment because the law did not adequately protect.”

While psychiatrist John Maher, editor of the Journal of Ethics in Mental Health, who told a Parliament committee that:

he has patients who could get better but “are now refusing effective treatment to make themselves eligible for MAID.”

Raikin ends his exposé by stating:

From Rosina, Les, Mary, Nancy, Greg, Lucy, and so many others across Canada, what we hear are the cries of people in despair asking for help. Just a few years ago they would have been textbook candidates for what a just society would say: Your life has value. In Canada today they hear something else: Your death will be beautiful.

Links to more stories of the euthanasia experience in Canada:

• Toronto Star: We need to put the brakes on euthanasia (Link).
• Globe and Mail: No to euthanasia for mental disorders (Link).
  
• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Canadian man claims that he was pressured to request euthanasia (Link).
  
• Why did they kill my brother (Link).
  
• Manitoba woman died by euthanasia based on inadequate home care (Link).
• Quebec man seeks euthanasia based on changes to home care (Link). 
• Alberta man requests euthanasia based on poverty (Link).
• Ontario man approved for euthanasia because he can't get medical treatment (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

Canada's new assisted dying law threatens vulnerable citizens

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Sonu Gaind, a professor of psychiatry at the University of Toronto, a former president of the Canadian Psychiatric Association and honorary member of the World Psychiatric Association, leads his hospital MAID team and sat on the Council of Canadian Academies Expert Panel on MAID and Mental Illness wrote a scathing article opposing Bill C-7, that the Liberals passed in March 2021.

In his article - New assisted dying law threatens vulnerable citizens - that was published in the Hamilton Spectator on August 17, 

Gaind states that he came from an immigrant family who came to Canada when Pierre Trudeau was Prime Minister. He states that he finds it painful to watch Justin Trudeau enact legislation that endangers the lives of vulnerable citizens. Gaind wrote:

MAID has been sold as an issue of autonomy and the right to “die with dignity.” But is it true autonomy for the marginalized who will seek death to escape a life they never had the right to live with dignity?

As physician lead of our hospital MAID team, I am keenly aware that suffering does not compartmentalize into neat little boxes. Cumulative life distress fuels MAID requests. Introduced to help avoid painful deaths, MAID in Canada now risks enticing nondying disabled who are marginalized by sexism, racism, ageism or ableism with state-sanctioned death to escape painful lives.

Canada’s reckless MAID expansion has been abetted by disconcerting failures of due diligence. Through consultations on mental illness and dying, Canadian Psychiatric Association leadership never once raised concerns about mental illness related suicide risk or discussed suicide prevention. After giving assurances for a year that C-7 would safeguard against MAID for mental illness, the Liberal government reversed its commitment in February and less than a month later pushed C-7 through parliament.

Gaind continues by writing about the struggles that Margaret Trudeau had with mental illness and explaines how the United Nations High Commissioner for Human Rights cautioned that Canada’s MAID expansion is grounded in prejudiced ableism assumptions, a clear concern for the disability community. 

He concludes by stating:

To provide increased autonomy to privileged voters who have lived well and want to die well, it seems our current Prime Minister Trudeau is willing to sacrifice marginalized lives of those who never had the chance to live well, and are suffering from life distress during periods of resolvable despair.

... It is not Justin Trudeau’s mother who is at risk, but all of ours.

Thank you Dr Gaind for sharing your concern for the lives of people who live with mental illness.

Euthanasia law is a matter of life and death for people with disabilities.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Bill C-7 passed into law on March 17, thereby expanding Canada's euthanasia (MAiD) law to include people with disabilities or chronic conditions who are not dying, and people with mental illness alone. It's important to remind people of how Bill C-7 undermines Canada's global human rights commitments.

Dulcie McCallum and Steve Estey who were members of Canada’s delegation to the United Nations when negotiating the Convention on the Rights of Persons with Disabilities, explain in an article published by iPolitics how Bill C-7 is counter to Canada's Human Rights Commitments. McCallum and Estey wrote:

The value of Canada’s stock on the global human rights market is about to plummet. In what could be considered a perverse sense of timing, the House moved for closure on Bill C-7 – which proposes fundamental changes to criteria for medical aid in dying (MAiD) – on the very week that marks the eleven-year anniversary of Canada ratifying the Convention on the Rights of Persons with Disabilities.

As the special advisers to, and members of, Canada’s delegation to the United Nations when negotiating the Convention on the Rights of Persons with Disabilities, we feel compelled to speak out because Canada is on the threshold of committing a serious legal breach.

They then explain why Bill C-7 represented a human rights violation:

Bill C-7 will, if passed, make it entirely legal to end a person’s life simply because they have a disability. The fact that Parliamentarians cannot see that Bill C-7 turns the right to equality and non-discrimination on its head is of grave concern.

This legislative initiative reinforces negative stereotypes and perceptions about people who live with a disability or who are aging, giving us a law that is predicated on discriminatory and harmful ableist and ageist criteria. The legislative drafters have penned a cruel twist into the Criminal Code by deeming ease of access to medical assistance for people with a disability as a benefit.

McCallum and Estey explain that others have warned the government about the violation.

We are not the first to warn the Prime Minister that this legislation is in direct contravention with international law. A cohort of UN Special Rapporteurs and experts have issued a global expression of alarm. Their statement, issued early this year, said in part; “Disability should never be a ground or justification to end someone’s life directly or indirectly.”

The international experts went on to make the specific point that if the law allows this differential treatment, it would “institutionalize and legally authorize ableism” in direct contravention of the Convention.

McCallum and Estey point out that Prime Minister Trudeau considers himself a staunch supporter of human rights and yet his euthanasia (MAiD) law is in direct contravention of the Convention on the Rights of Persons with Disabilities.

Dulcie McCallum is a human rights lawyer and was special adviser to Canada’s Delegation to the UN Ad Hoc Committee to negotiate the Convention on the Rights of Persons with Disabilities. Steve Estey is a longtime human rights advocate and activist and was a member of Canada’s delegation to the United Nations Ad Hoc Committee which drafted the CRPD between 2002 and 2006.

Further articles on this topic:

• Disability is not a reason to sanction euthanasia (Link). 
• UN disability expert concerned about euthanasia, assisted suicide and the new eugenics (Link).
• UN disability rights envoy urges changes to Canada's euthanasia law (Link).
  

MAiD (euthanasia) for mental illness ignores safeguards for vulnerable people

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr K. Sonu Gaind

Dr. K. Sonu Gaind who is an associate professor of psychiatry at the University of Toronto, a past president of the Canadian Psychiatric Association (CPA) and a member of the Council of Canadian Academies expert advisory group on MAiD was published yesterday by the Conversation concerning the approval of euthanasia for people with mental illness alone.

Gaind explains why this topic is being considered:

People whose suffering is caused by mental illness alone do not currently have access to MAID. However, the Senate recommended Bill C-7 contain a “sunset clause” that would lift this exclusion in 18 months. The Trudeau government has extended the clause to 24 months but has otherwise accepted it, meaning that in 18 to 24 months, MAID will be provided to those suffering solely from a mental illness.

Gaind examines the known evidence on this topic:

The fundamental underpinning of all MAID requests is supposed to be the presence of “a grievous and irremediable medical condition.” The blunt and indisputable reality is that, unlike for much more predictable medical conditions with better understood biologies, it remains currently impossible to predict whether mental illness is irremediable.

The Centre for Addiction and Mental Health has concluded: “There is simply not enough evidence available in the mental health field … to ascertain whether a particular individual has an irremediable mental illness.”

After 15 months of studying global evidence, the Council of Canadian Academies came to the same conclusion, as did the Expert Advisory Group on MAID. Both the American Psychiatric Association (APA) and Royal Australian and New Zealand College of Psychiatrists (RANZCP) have also concluded that there’s no evidence to support providing MAID solely for mental illness.

Sign the petition: No to euthanasia for mental illness and incompetent people! (Link)

Gaind explains why safeguards are not effective for people with mental illness:

Those who advocate expanding access to MAID propose mitigating this reality with “safeguards.” This ignores the fact that irremediability is itself the primary safeguard built into the MAID framework, and bypassing it renders all other supposed “safeguards” meaningless.

Because we cannot predict irremediability, there is 100 per cent certainty that MAID will be provided to some people who could recover — there is no safeguard against that. Suggesting otherwise is akin to a society that declines to use the death penalty over concerns of potentially executing the innocent, but then implements the death penalty anyway with false “safeguards” to reassure the public even as the wrongly convicted are executed.

Gaind challenges the Canadian Psychiatric Associations for focusing on opinion and ignoring evidence:

Regrettably, while the APA and RANZCP have provided meaningful evidence-based guidance in their societies’ debates on MAID and mental illness, Canadian psychiatric associations have not. After failing to consult members for two years, the Canadian Psychiatric Association released its position statement in 2020 that “patients with a psychiatric illness … should have available the same options regarding MAID as available to all patients.” Remarkably, the association also said that its statement was “never intended to … examine whether psychiatric conditions are irremediable and if so, how this should be assessed.”

Equally remarkably, the president of the Québec Psychiatric Association (AMPQ) responded to concerns about the lack of supporting evidence by saying in recent Senate hearings: “This is not a data-driven question, this is an ethical question.” That sentiment is reflected in an AMPQ document offering guidance on developing a MAID framework for mental illness.

Gaind continues by presenting his position based on the evidence:

Other evidence highlights the risks of providing access to easy death to suicidal, vulnerable and marginalized people who are not dying but suffering from psychosocial life stress. Even the Office of the United Nations High Commissioner for Human Rights has raised the alarm that Canada’s pending MAID policy will prematurely end vulnerable lives.

These concerns simply serve as icing on the cake to the indisputable, evidence-based reality that there is no predictably irremediable mental illness for which MAID can be provided. And the government’s 24-month sunset clause is as meaningful as a decree telling coronavirus to disappear — non-existent evidence cannot simply be commanded to appear.

Gaind continues with his concerns based on how common mental illness is:

We are poised to provide death for mental illness to potentially suicidal, non-dying marginalized people suffering from life distress who have the potential to recover — all based on less evidence than is required for the approval of any sleeping pill. Given the ubiquity of mental illness, no family needs to look very far to appreciate the implications.

Years ago, I had the pleasure of meeting our prime minister’s mother, Margaret Trudeau, to present her a mental health advocate award from the Ontario Psychiatric Association. I recall her vibrancy as she spoke of her life experiences and graciously mingled with my colleagues and me after dinner. I also recall the poignancy of her descriptions of despair during her periods of deep depression, including hopeless times she wished to die.

Gaind finishes his article by calling for honesty in the debate:

If Canada wants to provide MAID to people who are suffering but whose illness might get better, we should have an honest debate and our MAID framework should reflect that. But if MAID is meant for irremediable conditions, evidence shows it would be a dishonest and hypocritical deception to offer it for mental illness.

Unfortunately, in Canada’s debate about medical assistance in dying, evidence has already been provided a medically assisted death.

More articles on this topic:

• Article: Canadian Psychiatric Association position on euthanasia for psychiatric reasons is an embarrassment (Link).
• Article: Canadian Psychiatric Association approves euthanasia (Link). 
• Article: Is euthanasia psychiatric treatment? (Link).
• Article: Why legalizing medical assistance in dying for people with mental illness is misguided (Link).
• Article: Canada's Justice Minister says that euthanasia may be extended to people with mental illness (Link). 
• Article: Quebec court expands euthanasia by striking the terminal illness requirement. Euthanasia for psychiatric reasons is next (Link).  
• Article: Psychiatrists must prevent suicide, not provide it (Link).
•  Article: Physically healthy depressed man died by euthanasia in BC (Link). 
• Article: Dr Mark Komrad: Why psychiatrists should oppose euthanasia (Link).