Advocates call for Disability-Rights Based Appeal of the Québec Superior Court's MAiD Decision in Truchon & Gladu.

 

October 4, 2019

Hon. David Lametti, MP. Attorney General

Dear Minister Lametti,

Re: Advocates Call for Disability-Rights Based Appeal of the Quebec Superior Court’s Decision in Truchon & Gladu

We, the undersigned members and supporters of the Canadian disability community, are deeply troubled by the Quebec Superior Court’s decision of Truchon c. Procureur général du Canada. As you are aware, the decision has struck down the “reasonable foreseeability of natural death” criterion of Canada’s medical assistance in dying legislation. As Attorney General of Canada, we urge you to file an appeal of the decision immediately.

We find this decision to be concerning for the following three reasons:

1) It fails to respect Parliament’s authority to balance the interests of individuals with the interests of society[1], effectively limiting Parliament’s capacity to pursue social targets such as substantive equality and inclusion.

Justice Christine Baudoin arrives at the conclusion that the end-of-life criterion violates section 7 and section 15 of the Charter by rejecting a key objective of Parliament, erasing any need for a section 1 analysis of reasonable limits. Parliament outlined the following societal objective in the preamble of the legislation:

It is important to affirm the inherent and equal value of every person’s life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled.

In fully rejecting this objective, the court has limited the authority of Parliament to govern toward an inclusive and equitable Canada. This is a dangerous precedent. Parliament intentionally included the end of life criterion in the legislation as a way of achieving the above objective. Is it reasonable for Parliament to limit the individual interests of Truchon and Gladu (autonomy) in order to promote the interests of society (equality and inclusion)? Without an appeal, we may never know. The Supreme Court must weigh in on this flawed analysis.

2) The decision will entrench stereotypes and exacerbate stigma for Canadians with disabilities, contributing to the adversity and oppression experienced by this vulnerable group.

Without the equalizing effect of the end-of-life criterion, which guarantees that the common thread between all persons who access an assisted death in Canada is that they are all dying, persons with disabilities will be able to gain access ultimately because they have a disability. A worse stereotype couldn’t be institutionalized in law - that disability-related suffering, largely caused by lack of support and inequality, justifies the termination of a person’s life.

Canada must avoid sending a message that having a disability is a fate worse than death. Canadians with disabilities are already bombarded daily with reminders that they are unwelcome and under-valued. We must not compound this harm by entrenching in law the message that others who share their condition will receive our full support if they choose to die prematurely. This message fits too neatly into the stereotype that a life featuring disability is a bad life, full only of suffering and pity. Such a narrative already exists. Canada must appeal the decision to prevent additional stereotyping and stigma, and to substantively protect the section 15 Charter rights of persons with disabilities.

3) Without the end-of-life criterion in place, Canada’s medical assistance in dying legislation will further violate article 10 of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD).

Article 10 of the CRPD reads as follows:

States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others.

By offering medical assistance in dying to persons with disabilities on the basis of disability, Canada would be further violating international law. If every Canadian who suffers cannot access a medically assisted death, and yet a Canadian who suffers and has a degenerative disability can, it is precisely their disability status that sets them apart.

Canada is already not taking necessary measures to ensure the effective enjoyment of life by persons with disabilities on an equal basis with others. There is case after case of Canadians whose medical and support needs are not being met, causing them to consider, if not seek out, death. [2]

Canada’s medical assistance in dying regime already concerns the UN’s Special Rapporteur on the rights of persons with disabilities, Catalina Devandas-Aguilar, who shared at the conclusion of her study visit to Canada that she is “extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective” and this is before the end of life criterion was struck down.

Minister Lametti, as Attorney General of Canada, we urge you to appeal this decision up through to the Supreme Court. Not to do so, we believe would be a failure on the part of your government to defend persons with disabilities from significant and tangible harm. After extensive consultation by Parliamentary Committees and public debate, your government crafted this legislation intentionally and purposefully. We trust that as Attorney General you will take the steps needed for its vigorous defence. Canadians’ human rights are at stake.

Link to the letter with signatures (Link).

[1] https://www.justice.gc.ca/eng/rp-pr/cp-pm/just/06.html

[2] Think of Sean Tagert, Archie Rolland, Natalie Jarvis, and Arleen Reinsborough as examples. Read more here:

https://www.cbc.ca/news/canada/british-columbia/als-bc-man-medically-assisted-death-1.5244731

https://montrealgazette.com/news/local-news/saying-goodbye-to-archie-rolland

https://www.cbc.ca/news/canada/nova-scotia/lung-transplants-atlantic-canada-toronto-financial-cost-1.5047818

https://www.thestar.com/news/canada/2019/01/20/hamilton-senior-in-unbearable-pain-wants-assisted-dying-to-save-her-from-nursing-home.html

Canada Goes Softly Authoritarian

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Wesley J Smith

Wesley Smith wrote a thought provoking article that was published in the The American Spectator on October 3, 2019.

The article concerns issues of freedom of speech, religion, thought and action. The article has a wider focus than euthanasia, but I will only publish his comments on euthanasia, which were well said, especially considering the pressure on St. Martha's hospital in Antigonish to provide euthanasia and the negation of physicians conscience rights in Ontario. Smith states:

Canada has become quietly authoritarian, its government and courts increasingly persecuting a cadre of its minority citizens. No, victims aren’t subject to arrest, nor are concentration camps being opened. Rather, this is a soft despotism — authorized by law — that compels victims to choose between their consciences and full participation in Canadian society.

Who are these wronged Canadians, you ask? Not racial minorities. Not refugees. Not sexual subgroups. Those vulnerable populations are amply protected and embraced in society. No, the victims of Canada’s soft authoritarianism are religious people who are being systematically and officially discriminated against because they refuse to violate their faith principles that conflict with reigning secularist dogmas.

Smith then writes about the imposing of euthanasia in Canada. He states:

The most explicit assaults on religious freedom have been mounted in the medical fields against Catholic (and other) religious professionals and institutions. The locus of the persecution has been the legalization of euthanasia. In 2015, the Canadian Supreme Court conjured a broadly defined right to be killed by doctors when diagnosed with a serious medical condition that causes “irremediable suffering.” Parliament soon passed a national law legalizing this form of homicide, subject to weak limitations. Since health care is administered at the provincial level, each of Canada’s provinces also passed euthanasia-enabling statutes.

That presented a significant problem for faithful medical professionals and church-affiliated institutions. Most notably, the Catholic Church forbids euthanasia. Thus, national legalization raised a crucial question of whether or not religiously dissenting doctors and Catholic medical facilities should be granted conscience exemptions from participation in doctor-administered death. The Supreme Court’s ruling left that issue for another day — as did the federal statute. Not so at the provincial level. After concentrated political pressure from religious organizations and citizens, most provinces crafted conscience exemptions allowing dissenting medical professionals to escape participation in euthanasia, while also publishing lists of M.D.s willing to administer “medical aid in dying” (MAID), the official euphemism for euthanasia in Canada.

... the province’s medical regulatory body, the College of Physicians and Surgeons of Ontario. This ethics rule requires all doctors approached by a legally qualified patient for euthanasia to either kill the patient (pursuant to the law’s procedures) or provide an “effective referral,” meaning to personally procure a doctor or certified nurse practitioner that the dissenting physician knows to be willing to do the deed. 

Perceiving such participation to be a grievous sin with eternal implications, some Catholic doctors sued, arguing that requiring them to be complicit in euthanasia violated the fundamental Charter right to “freedom of conscience and religion” — a protection more robust than the U.S. Constitution’s First Amendment’s guarantee of the “free exercise” of religion.

Considering the explicit guarantee in the Charter — and given the unoppressive “list” alternative crafted in other provinces — the case appeared strong. But with Canada secularizing at Mach speed, the Ontario courts were far more interested in forcing faithful doctors to yield to contemporary secular values than in protecting their Charter right to religious freedom. Accordingly, a trial court and court of appeals both ruled that the right to “equal and equitable access” to all legal health care paid for by Canada’s socialized medical system, including euthanasia, abortion, and interventions for gender dysphoria — a right not protected in the Charter — trumps doctors’ enumerated “freedom of conscience and religion.”

Think about what this means. Unless the national Supreme Court intervenes, Ontario doctors face legal compulsion to be complicit in the taking of innocent human life. The only alternatives are restricting their practice of medicine to fields like podiatry in which such requests are unlikely or leaving the profession altogether. If that isn’t oppression, I don’t know what else to call it.

Smith is correct. Slowly but methodically, the government is imposing secular demands upon the culture and abrogating the rights of those who disagree. A pluralistic society is one where everyone has a respected and equal voice, whereas the Canadian governments are imposing a common belief system upon a country and thus reducing pluralism to authoritarianism.

Canada's elections literally life-and-death issue.

This article was published by OneNewsNow on September 12, 2019.

By Charlie Butts

Canadians have another reason to pay attention to the upcoming federal election: making it easier to kill yourself with the government’s blessing.

Euthanasia has expanded rapidly in Canada, where the country's Supreme Court imposed it on its citizens and Parliament defined it with a liberal law that went into effect in 2016. It allows doctor-assisted suicide for terminal, incurable illnesses when one's death is "reasonably foreseeable."

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow the country’s laws changed greatly after a Quebec court struck down the portion of the euthanasia law over “reasonably foreseeable," which greatly loosened the legal requirements.

“Which was already a joke because it wasn't defined,” Schadenberg says of the law. “But what it did do was it tried to limit euthanasia to people who had a terminal illness.”

Now it is legally permissible for a Canadian citizen with chronic depression, for example, to qualify.

Schadenberg says what has occurred is judicial activism which should be appealed by the government. But that won’t happen, he predicts, because the liberal elected leaders who support the loosened euthanasia laws are up for re-election on Oct. 21.

“So if people will, during this upcoming election, put the liberals back into power,” he predicts, “I would expect that nothing positive will come of that when it comes to the issues of euthanasia and assisted suicide.”

Freedom of Conscience bill to be debated in Canada

David Anderson MP

Thank you again for your support of my Private Members Bill C-418: The Protection of Freedom of Conscience Act.

Two years ago, taking a patient’s life was culpable homicide. Although the law now permits physician assisted suicide, many doctors’ consciences will not. The Supreme Court of Canada has explicitly said that the legalization of euthanasia did not entail a duty of physicians to provide it.

However, regional associations have introduced regulations compelling conscientiously objecting physicians to provide effective referrals for physician assisted suicide, contravening this assurance. This happens, without any penalty.

I believe it’s time to stand up for doctors and health care providers who aren’t willing to leave their core ethics behind when they’re at a patient’s bedside. The protection of conscience rights for medical professionals is part of protecting the fundamental freedom of conscience and religion guaranteed to all Canadians in the Charter of Rights and Freedoms.

Bill C-418 amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or any other health care professional for compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or any other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.
I have enclosed a copy of my bill, a petition and an info sheet which includes a letter to Justice Minister David Lametti. We have received a large number of letters to the Minister from Manitoba, and from my own riding.

• Link to Bill C-418
• Link to the petition in english and french
• Draft letter to be sent to local MP. 
• Link to the info-sheet with letter to David Lametti.

I have also included a draft letter that can be sent to local MPs. I encourage you and your supporters to contact your Member of Parliament and MPs of all parties, to make them aware of the bill and to voice your support for this legislation.

The more people that know about C-418, the higher the likelihood that it will pass in the House of Commons.

Sincerely,

 

David Anderson, MP
Cypress Hills-Grasslands

Ontario court will issue decision in McKitty "Brain Death" case.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

Taquisha McKitty with daughter

Taquisha McKitty, of Brampton, who was declared brain dead in September 2017, after a cardiac arrest related to a drug overdose, died of natural causes on December 31, 2018.

On February 11, the Ontario Court of Appeal announced that they will issue a decision in the case, even though McKitty has died.

McKitty was declared brain dead on September 20, 2017, after having a cardiac arrest on September 14. On October 17, 2017, Hugh Scher, the lawyer for her family, asked the court for more time for medical tests to prove that Taquisha is alive.

On June 26, 2018 Ontario Superior Court Justice, Lucille Shaw, ordered that McKitty was to have the Life-Support withdrawn in a month.

McKitty's family appealed the decision preventing the removal of life-support and challenging the brain death designation.

In the lower court decision Justice Shaw stated that McKitty was dead and that the Charter of Rights and Freedoms did not apply to McKitty, because it only protects “persons,” and because McKitty is clinically brain dead, is not legally a “person.”

Hugh Scher

Scher argued in the court of appeal, last December, that McKitty’s Charter rights were breached in order to pronounce her dead. Scher stated:

"To say that she doesn't have Charter rights because she is dead is putting the cart before the horse."

“The Court’s predetermination of Taquisha’s death to justify non-application of the Charter of Rights and Freedoms ... dehumanizes Taquisha as a non-person from the outset,” 

“Taquisha is an individual under the law deserving of Charter protection.”

Scher told the Globe and Mail, that due to the extreme cost and complexity associated with court cases, like this one, that it is unlikely that this case, whatever the decision, will be appealed to the Supreme Court of Canada.

The McKitty case proves that Canada needs an organization that funds lawyers who take cases that are central to the public interest.

Canada's new Justice Minister is radically pro-euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

I am concerned about the expansion of euthanasia to children in Canada.

On January 16, Prime Minister Trudeau indicated his intention to expand Canada's euthanasia law when he appointed David Lametti as Justice Minister.

Jody Wilson-Raybould (left)
David Lametti (right)

After the release of the Council of Canadian Academies (CCA) reports on the expansion of euthanasia in Canada to include children, psychiatric conditions alone and incompetent people who previously requested euthanasia, Justice Minister Jody Wilson-Raybould stated that no changes to the law were coming. It seems likely that Lametti was appointed to expand the law.

Lametti voted against Bill C-14, the bill that legalized euthanasia in June 2016, because he thought that the law was too restrictive and thus unconstitutional.

● Article: Is Child Euthanasia Next in Canada?

I am concerned about the expansion of euthanasia to children. The CCA report on Child Euthanasia stated:

Denying MAID to mature minors would pose a potential future legal challenge if a case were to be brought forward in which a mature minor argued that their constitutional rights were being denied.

● Sign the online petition: I oppose Child Euthanasia.

The CCA reports were negative to the idea of expanding euthanasia to people with psychiatric conditions alone while the report on expanding euthanasia to incompetent people, who made a prior request, was mixed in its response. The euthanasia lobby is running a campaign to expand euthanasia to incompetent people who previously requested it.

I am also concerned about the conscience rights of medical professionals and institutions that refuse to participate in killing. 

Long-time euthanasia activist and "academic" Jocelyn Downie, is campaigning to force St. Martha's hospital to participate in euthanasia. Even though this is a provincial issue, the federal government could impact this debate.

Since the Liberals have a majority government, I hope that Lametti will wait until after the October 21 federal election, but it is possible that the Liberals will view euthanasia as a wedge issue and move to expand the law before summer.

Canadian media continue to promote expansion of euthanasia law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

For those who don't believe that legalizing euthanasia or assisted suicide will lead to incremental extensions (slippery slope) of the law, you only have to look to Canada.

In December the Euthanasia Prevention Coalition applied to intervene in the Lamb case in British Columbia. The Lamb case seeks to extend euthanasia to people who are not dying by striking the section of Canada's euthanasia law stating that a person's "natural death must be reasonably foreseeable." I note that the euthanasia law did not define the term "reasonably foreseeable."

Yesterday the Gladu case began to be heard in a Montreal court. Similar to the Lamb case, the plaintiffs in Gladu have degenerative disabilities but they are not terminally ill and they do not fulfill the requirement that their "natural death is reasonably foreseeable."

The CTV news article on the Gladu case interviews, as its expert, Jocelyn Downie, the long-time euthanasia activist and James Palmer chair in public policy and law at Dalhousie University. Downie, who has written books and articles and has made the promotion of euthanasia her life-time work, agrees that the law is somehow too restrictive. Downie tells  CTV news:

“The criteria should be about suffering and autonomy,” she told CTV’s Your Morning. 

“It has to be about your capacity for self-determination. So if you’re capable of making the decision and your experiencing and enduring intolerable suffering you should be allowed access assisted dying.” 

She argued that the current laws are paternalistic and patronizing.

Downie advocates for no restrictions on euthanasia.

Gordon Friesen, a disability activist from Montreal, is quoted by CTV as saying that changing the legislation would leave many Canadians vulnerable.

“Since the end of the Second World War, nobody has dared to bring up the idea (that) a sick man’s life isn’t worth as much as another man’s, but now, they are doing it again,”

Friesen seems to recognize the similarities between the German T4 euthanasia program and what is being considered by this court case? Many may consider Friesen's comments to be extreme but he could be right.

At the same time, Downie, with the help of the media, has orchestrated a campaign to force St. Martha's hospital in Antigonish NS to participate in euthanasia. 

A few days ago CBC news was busy promoting the expansion of euthanasia by focussing on the release of three reports from the Council of Canadian Academies (CCA) concerning: euthanasia for children, euthanasia for incompetent people who previously asked for euthanasia, and euthanasia for people with psychiatric conditions alone.

It is interesting how the media ignores the fact that the CCA report on extending euthanasia to people with psychiatric conditions alone stated:

MAID law in Canada explicitly defines intolerable suffering in subjective terms. While a healthcare practitioner must “be of the opinion that” these conditions are met, if a patient truly believes their suffering is intolerable, and believes that existing means to relieve their suffering are not acceptable to them, they thereby meet the criteria for intolerable suffering set out in the legislation. 

No other country permits MAID MD-SUMC where one of the eligibility criteria is based on an individual’s personal assessment of what conditions for relief of their intolerable suffering they consider acceptable. If Canada were to expand MAID MD-SUMC using this criterion, it could become the most permissive jurisdiction in the world with respect to how relief of suffering is evaluated.

The Gladu and Lamb cases will be decided, sometime in the future, by the Supreme Court of Canada. If the court strikes down the section of the euthanasia law requiring that a person's 'natural death must be reasonably foreseeable,' Canada would then have the most permissive euthanasia law in the world since it defines 'intolerable suffering' in a completely subjective manner.

Canada: Recent History of Euthanasia Legalisation

By Richard Egan (with the Australian Care Alliance)

On 21 April 2010 the Canadian House of Commons defeated Bill C-384 An Act to amend the Criminal Code (right to die with dignity) by 228-59.

The Quebec National Assembly passed an “An Act respecting end-of-life care” by a vote of 94-22. It came into effect on 10 December 2015. This Act permits euthanasia on the request of an adult who is “at the end of life; with a serious and incurable illness; and in an advanced state of irreversible decline in capability”.

On 6 February 2015 the Supreme Court of Canada in Carter v Canada (Attorney General) declared that provisions in the Canadian Criminal Code making it an offence to aid or abet suicide “unjustifiably infringe” section 7 [“Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”] of the Charter of Rights and Freedoms “and are of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” The declaration was suspended for a year, giving the opportunity for the Parliament to amend the offending laws by providing a scheme for physician assisted suicide.

The core paragraph in the judgement reads that: “The right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. Here, the prohibition deprives some individuals of life, as it has the effect of forcing some individuals to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable. The rights to liberty and security of the person, which deal with concerns about autonomy and quality of life, are also engaged. An individual’s response to a grievous and irremediable medical condition is a matter critical to their dignity and autonomy. The prohibition denies people in this situation the right to make decisions concerning their bodily integrity and medical care and thus trenches on their liberty. And by leaving them to endure intolerable suffering, it impinges on their security of the person.”

The argument based on the right to life is specious as it takes no account of the inevitability that a law permitting euthanasia will result in wrongful deaths based on medical errors, coercion, discrimination against or differential treatment of the disabled and mentally ill and suicide contagion.

The argument from liberty, if pressed to its logical conclusion, would require a law permitting assisted suicide or euthanasia on request by any person, including a minor, with capacity.

The argument from security is based on a false claim that pain and other physical symptoms cannot be relieved by best practice palliative care.

In response to the Supreme Court judgment, the Canadian parliament passed Bill C-14 which came into effect on 17 June 2016 and legalised euthanasia and assisted suicide on request for any adult who has “a serious and incurable illness, disease or disability”; is in “an advanced state of irreversible decline in capability”; and whose “natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining”.

Increase in numbers

There have been three interim reports providing national data on euthanasia as well as reports on the data from Quebec, the most recent of which covers 1 July 2017 to 31 March 2018.

First report.

Comparing the data for the three six month periods covered by the national data reports - 17 June 2016-31 December 2016; 1 January 2017-30 June 2017 and 1 July 2017-31 December 2017 – the number of deaths by euthanasia almost doubled (189%) between the first and third six month periods from 805 to 1525 increasing from 0.6% of all deaths in Canada to 1.07% of all deaths.

Similarly the data for Quebec shows that official reports of euthanasia almost doubled from an average of 46 per month for the six month period 1 July 2016-31 December 2016 to an average of 90 per month for the three month period 1 January 2018-31 March 2018.

Reported acts of euthanasia in Quebec accounted for 1.18% of all deaths in 2017.

Unreported cases

There is a discrepancy of 171 cases of euthanasia between the number of official reports received (1493) and the number of cases reported by institutions (1664) in Quebec suggesting a failure by physicians to report in 10.3% of euthanasia cases.

Failure to comply with the legal processes

Quebec euthanasia

Six per cent of all forms reporting euthanasia in Quebec are received late and 42% off all forms received have insufficient information and require follow up requests.

Even after repeated requests for further information there is insufficient information to conclude whether or not the act of euthanasia complies with the law in 5% of cases.

In a further 5% of cases (62 cases out of 1374 for which a final assessment has been made) there was a failure to comply with the law, including:

• 29 cases in which the consulting physician was not independent from the physician who carried out euthanasia. However, this has been addressed by officially slackening the interpretation of the requirements for independence! 
• 9 cases in which the physician who performed euthanasia did not ensure that the request for euthanasia was voluntary, informed and persistent  
• 6 cases in which the consulting physician examined the person before a request for euthanasia was formally made
•  5 cases in which the approval was countersigned by an unqualified person  
• 5 cases in which the person did not have a serious and incurable illness  
• 4 cases in which the person did not have the required Quebec health insurance  
• 2 cases in which the person was not at the end of life  
• 2 cases in which the physician failed to verify that all the conditions for euthanasia were met.
  

In summary of these 62 cases at least 23 could be characterised as possible wrongful deaths.

Underlying conditions

Very limited data is provided on the underlying condition for which euthanasia is performed. In the last reporting period 9% of cases involved either an unreported condition or a condition other than cancer related, neurodegenerative or circulatory/respiratory system.

Some of the “other” conditions have included osteoarthritis, rheumatoid arthritis and “age-related frailty”.

The Canadian law only requires that “death be reasonably foreseeable”. The decision of the Ontario Superior Court of Justice in AB v Attorney General of Canada delivered on 19 June 2017, in paragraph 81, interpreted this requirement as not requiring any connection whatsoever between the underlying conditions for which euthanasia is sought and the reasonable foreseeability of death – which can be based simply on advanced age. The woman in this case was 79 years old.

Additionally there are the 5 cases from Quebec in which the person did not have a serious and incurable illness and the 2 cases from Quebec in which the person was not at the end of life.

Short time between initial request and euthanasia being performed

Section 29 (c) of the Quebec law requires that before performing euthanasia the physician must verify “the persistence of suffering and that the wish to obtain medical aid in dying remains unchanged, by talking with the patient at reasonably spaced intervals given the progress of the patient’s condition”.

Section 241.2 (3) (g) of the Canadian Criminal Code requires a physician to “ensure that there are at least 10 clear days between the day on which the request was signed by or on behalf of the person and the day on which the medical assistance in dying is provided or — if they and the other medical practitioner or nurse practitioner referred to in paragraph (e) are both of the opinion that the person’s death, or the loss of their capacity to provide informed consent, is imminent — any shorter period that the first medical practitioner or nurse practitioner considers appropriate in the circumstance”.

Nonetheless according to a recent study of euthanasia at three institutions in Quebec the median number of days between the request for euthanasia and the patient’s death was just 6 days.

This study also found that in 32% of cases a palliative care consultation only took place less than 7 days before euthanasia was requested and in a further 25% of cases it took place on the same day or AFTER euthanasia was requested. This suggests that euthanasia is being routinely provided to people before they have had a chance to experience the full effect of palliative care to relieve their suffering and concerns.

Reasons for requesting euthanasia

A study from an Ontario hospital reported that those who received euthanasia tended to be white and relatively affluent and 95% of them indicated that loss of autonomy was the primary reason for their request. Other common reasons included the wish to avoid burdening others or losing dignity and the intolerability of not being able to enjoy one’s life. Few patients cited inadequate control of pain or other symptoms.

Disability – the story of Candice Lewis

Candice Lewis with her mother.

Candice Lewis is a 25 year old Canadian woman who happens to have been born with cerebral palsy.

In September 2016 Candice went to the emergency room at Charles S. Curtis Memorial Hospital in St. Anthony after having seizures.

Dr. Aaron Heroux told her she was very sick and likely to die soon. He offered her assisted suicide. The doctor also proposed assisted suicide for Candice to her mother Sheila Elson.

This offer was repeated despite both Candice and her mother making it clear that this was not an option Candice would consider. Dr Heroux told Sheila she was being selfish by not encouraging her daughter to choose assisted suicide.

Candice describes how bad it made her feel that a doctor was offering her assisted suicide.

More than twelve months later Candice has recovered well and her health was much improved. Candice hasn’t been having any seizures, is now able to feed herself, walk with assistance, use her iPad. She is more alert, energetic and communicative. She was able to "walk" down the aisle as a bridesmaid at her sister’s wedding in August 2017. She is doing what she loves most, painting and being with her family.

Candice and her mother Sheila have been interviewed by Kevin Dunn, who produced a film on euthanasia and assisted suicide called Fatal Flaws. The film of the interview can be viewed here.

There are several take home lessons from Candice’s experience:

• Doctors can get the prognosis wrong. Candice was told she was dying but was flourishing twelve months later. A wrong prognosis can lead to assisted suicide or euthanasia. A life can be thrown away needlessly;
• People with a disability already suffer discrimination in health care. When assisted suicide and euthanasia are legal, people with a disability are more at risk of being offered death as a solution because doctors and others consider that they would be better off dead; 
• Once doctors are authorised by the law to provide assisted suicide and euthanasia some of them will feel empowered to offer it to anyone they think would be better off dead. This undermines patients’ trust in doctors and can cause great distress.

Roger Foley

Financial issues: Denied assisted living but offered assisted suicide
Roger Foley, who has a crippling brain disease, has been seeking support to live at home. He is currently in an Ontario hospital that is threatening to start charging him $1,800 a day. The hospital has told Roger that his other option is euthanasia or assisted suicide under Canada’s medical assistance in dying law.

Canadian Report offers no clear direction on Child Euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The long-awaited reports from the Council of Canadian Academies (CCA) concerning the possible extension of euthanasia to children (mature minors), to incompetent people who made an "advanced request," and to people for psychological conditions alone was released on December 12.

• Link to the article: Is Child Euthanasia Next in Canada?
• Link to the pamphlet: Is Child Euthanasia Next in Canada?
• Sign the online petition: I oppose Child Euthanasia.

Canada legalized euthanasia in June 2016 in response to the Supreme Court of Canada Carter decision in February 2015 that struck down Canada's laws protecting people from euthanasia and assisted suicide. Canada's law limits euthanasia to persons 18 or older.

Euthanasia and assisted suicide are now referred to as Medical Aid in Dying (MAiD) in Canada.

The Euthanasia Prevention Coalition opposes euthanasia but for the purpose of this article we will only comment on the issue within the report.

• Link to the CCA summary of the three reports.
• Link to the CCA report: Medical Assistance in Dying for Mature Minors.

The CCA did not offer clear direction concerning the issue of Child euthanasia. The report concluded that:

Many in Canada are grappling with the question about whether to extend MAID to mature minors in a society already exposed to changing ideas about death and dying. Although the Working Group examined a wide range of evidence, it concludes that there are many gaps in knowledge that make it difficult to arrive at definitive answers.

The report leans toward the position that euthanasia is a medical act and it makes strong comparisons between end-of-life treatment decisions and euthanasia. These comparisons are contentious considering the fact that parliament legalized euthanasia (MAiD) by creating an exception in the criminal code and not by defining it as a medical act.

Sadly the report does lean towards the side of accepting child euthanasia. It states:

The view that minors are in need of heightened protection is a widely shared concern. Despite research demonstrating that some minors are capable of making critical healthcare decisions, including end-of-life choices, some argue that minors as a group are too vulnerable to be given the ability to request MAID. However, part of protecting potentially vulnerable patients is to ensure that they are listened to. Thus, it has been argued that, rather than denying healthcare choices to groups frequently labelled as vulnerable, society must provide the accommodations to ensure that everyone is protected not only from exploitation, but also from being ignored and excluded.

Canadians are restricted through the criminal code and regulations from participating in many activities based on age.  The driving age is 16, the voting age is 18 and in Ontario the drinking age is 19.

Thankfully, the report did not follow the direction of the Hospital for Sick Children (Toronto) report. The Sick Kids report stated that there is no difference between end-of-life medical treatment decisions and euthanasia. They then decided that based on their current end-of-life decisions policy, that if the euthanasia law is extended to children that a "mature minor" could die by euthanasia without requiring the consent of the parents.

The most recent data indicates that the number of euthanasia deaths is increasing quickly in Canada. Sadly, the recent Quebec report indicated that the number of euthanasia deaths increased by up to 75% between April 1 and March 31, 2018.