Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
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| Dr Ivan Zinger |
The Annual Report of the Office of the Correctional Investigator is calling on the federal government to enact a moratorium on MAiD (euthanasia) in prisons.
Dr Ivan Zinger, the Correctional Investigator for the federal government outlined his concerns in his annual report concerning the known MAiD deaths in the prison system. The report states:
There are three known cases of MAiD in federal corrections, two carried out in the community, and each raises fundamental questions around consent, choice, and dignity. In the two cases reviewed in the reporting period, my Office found a series of errors, omissions, inaccuracies, delays and misapplications of law and policy.
As I have discussed numerous times before,
questions of autonomy and free choice in the
context of incarceration are difficult to square.
In this case, the “wishes of competent patients”
must be seen in context of the seemingly
inflexible system of sentence administration and
lack of viable release alternatives for non-violent
offenders, including medical parole. It would seem
that this man “chose” MAiD not because that
was his “wish,” but rather because every other
option had been denied, extinguished or not even
contemplated. This is a practical demonstration
of how individual choice and autonomy, even
consent, work in corrections.
The report states that the second case concerned both mental and physical illness issues: The other case of MAiD investigated this past
year revolves on the intersection of mental
and physical illness and the capacity to provide
informed and voluntary consent for assisted
death. In that case, the inmate was suicidal and
suffering from mental illness. He was terminally ill
and a designated Dangerous Offender. He would
threaten suicide if he was not provided MAiD.
His prospects for release, even considering the
advanced stages of his illness, were minimal.
Once again, these are circumstances that
would never be confronted by free citizens
in the community when choosing to end life.
Hopelessness, despair, lack of choice and
alternatives, conditions imposed by the fact
and consequence of incarceration, are issues
magnified in the correctional setting. As the
Government considers extending MAiD beyond
physical illness to intolerable psychic pain,
there must be careful deliberation of the mental
health profile of Canada’s prison population.
The report challenges the status quo: My review of these cases suggests that the
decision to extend MAiD to federally sentenced
individuals was made without adequate
deliberation by the legislature. ...two aspects of how MAiD
was legislated and later applied in the correctional
context seem to make little sense from an
accountability and public transparency point
of view.
The first is the decision to exempt CSC
from reviewing or investigating MAiD deaths. This
exemption is untenable given that CSC is, de-facto,
the state agent that enables or facilitates assisted
death to people under federal sentence. There
just has to be some degree of internal scrutiny,
transparency and accountability that goes with
the exercise of such ultimate and extreme
expressions of state power, even if MAiD is
provided for compassionate reasons. By removing
the legislative requirement for CSC to investigate,
this measure also removes the obligation for the
Service to provide notice “forthwith” of an inmate
death involving MAiD to my Office. In effect,
there is no legal or administrative mechanism for
ensuring accountability or transparency for MAiD
in federal corrections. Surely, this exemption was
an oversight that demands correction.
Secondly, that MAiD is allowed to be carried
out in a penitentiary setting, under so-called
“exceptional circumstances,” seems inconsistent
with the legislation’s intent to provide Canadians
with a legal option to end their life with dignity
at a time and place of their choosing. It is simply
not possible or desirable to provide or meet
those intents in context of incarceration.
Dr Zinger is right. The government simply reacted to a request for MAiD by a prisoner by approving the death.
Dr Zinger may not be aware that there is no effective oversight of Canada's MAiD (euthanasia) law throughout Canada. Zinger questions how there can be no legal or administrative mechanism for ensuring accountability.
I would suggest that a similar reality exists for people with disabilities and elderly people who live in institutions. Similar to the prison population, these people lack the same level of freedom and autonomy as the rest of the population.
All Canadian MAiD deaths are approved by two doctors or nurse practitioners and then, after the death, are reported by the doctor or nurse practitioner who carried out the death. Even in circumstances, such as the Sorenson case, where there were euthanasia assessments stating that Jack didn't qualify for MAiD and other assessments saying he did. The law is only concerned that two doctors or nurse practitioner approved his death. There is no oversight to determine why some assessments said he didn't qualify and some assessments said he did.
Dr Zinger has made some important points. He questions the oversight of the law, as it pertains to the prison population while emphasizing that prisoners do not share the level of freedom and autonomy as the rest of the population.
