No Free Choice To Die for Archie Rolland

Toujours Vivant - Not Dead Yet (TVNDY) is a non-religious organization by and for disabled people. (Link).

By Amy Hasbrouck and Taylor Hyatt
Toujours Vivant - Not Dead Yet.

Since last summer, TVNDY has been gathering stories of people who have been caught in the gears of the medical aid in dying (MAiD) machinery. Most were people who asked to die, but really needed help to live. Many were euthanized, or had life-sustaining care withdrawn or withheld, or simply pled their case via the media in the court of public opinion.

Over the next few months, we’re going to tell these stories of how and why the system has failed people who needed help to live, not to die, in preparation for the five-year review of the MAiD law that is supposed to begin this summer.

Archie Rolland was a landscape architect who lived with Amyotrophic Lateral Sclerosis for 15 years. From 2007 to 2015 he was treated at the McGill University Health Centre’s Chest Institute. In 2013 he wrote an opinion piece in the Montréal Gazette about his experience of “incarceration” in long-term care, and his fears about upcoming changes in his living situation.

In January of 2015 Mr. Rolland was among 17 people, most of whom used respirators, who were transferred to Lachine Hospital’s Camille-Lefebvre long-term care wing, in advance of Montreal Chest’s move to the newly-built “super hospital.” According to a report in the Montreal Gazette, “only 70 per cent of the nursing staff made the transfer, and fewer than half the hospital attendants.” As well, attendants were put on a rotating schedule, which disrupted continuity of care.

According to the Gazette, problems arose as soon as residents moved to the Lachine facility, and Mr. Rolland documented them in emails to the head nurse, the ombudsman, hospital officials and a patient’s committee representative. He reported long delays after pressing the call button, not being provided water, poor positioning causing bed sores, and more dangerous problems. In one incident, staff failed to remove mucus from his throat, then ignored the respirator alarm until his mother ran to get help. On another occasion, attendants leaned on his bed rail, jamming the call button against his head and “laughed at me in my distress.”

Other families also contacted the media about problems caused by staff shortages and rotating schedules, and multiple reports appeared in the Gazette detailing the problems at the Lachine facility. In the summer of 2016, three doctors resigned because their “pleas for additional support led nowhere.”

By July of 2016, Mr. Rolland had had enough. In emails to the Gazette reporter he emphasized that it wasn’t his illness that was killing him; he was tired and discouraged from having to fight for necessary and compassionate care. On July 4 he left the Lachine facility and made the 10-hour trip to the family’s country home in Métis-sur-Mer. Three days later he ordered that his respirator be turned off.

Though transfer to another facility was mentioned as a potential solution, in none of the reports was the possibility raised that Mr. Rolland could have lived at home with attendant services. The residents of the long-term care facility (referred to as “patients” rather than “people”) and were described as “hooked up to” respirators and feeding tubes, rather than “using” such equipment. 

Where is the choice in that?

More than 5400 Canadians died by euthanasia in 2019 more than 13,000 since legalization

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The media was reporting that there have been more than 6700 MAID deaths in Canada since it was legalized. I estimate that there have been at least 13,000 euthanasia deaths and here is how I defend this estimate.

The 6700 deaths was based on the Fourth Interim Report on Medical Assistance in Dying released by Health Canada on April 25, 2019 which stated that there were 6700 assisted deaths up to October 31, 2018. The data in the report from Quebec and the three Territories was incomplete. The Quebec data in the Health Canada report was up until March 31, 2018. (Link to my commentary on the report)

The Health Canada report was sloppy by stating that the number assisted deaths represented 1.12% of all deaths. The Health Canada report divided the number of reported assisted deaths into the total deaths, but they did not remove the total Quebec deaths from March 31 - October 31 from the equation.

The number of assisted deaths as of December 31, 2018, was approximately 7949.

(The government of Canada estimated that there were 5444 assisted deaths in 2019 and 4438 assisted deaths in 2018 in Canada on February 24, 2020)

On March 21, 2019 I reported that there were 7949 assisted deaths in Canada as of December 31, 2018 representing 4235 assisted deaths in 2018, an increase of 50% over 2017, representing almost 1.5% all deaths in 2018. The data from my report was obtained from a presentation by Jocelyn Downie, an academic euthanasia activist, who spoke on March 15, 2019 to a Royal Society of Canada luncheon in Ottawa. 

Similar to the Netherlands and Belgium, nearly all of the assisted deaths are euthanasia (lethal injection) rather than assisted suicide.

We don't have national assisted death statistics for 2019 but we do have accurate data from Ontario and Alberta. 

According to the data from the Ontario Office of the Chief Coroner there were 1789 reported assisted deaths in 2019, 1499 in 2018, 841 in 2017 representing nearly a 20% increase in Ontario assisted deaths in 2019. 

What is more striking about the data is the increase in the second half of 2019 where there were 1015 assisted deaths in the second half of 2019 up from 774 in the first six months of 2019, meaning that Ontario will likely have more than 2000 assisted deaths in 2020.

Alberta Health Services updates there assisted death data regularly. The Alberta data indicates that there were 377 assisted deaths in 2019 up from 307 in 2018, and 206 in 2017. The data indicates a 23% increase in Alberta assisted deaths in 2019.

A report by Marney Blunt for Global News stated that the number of assisted deaths are increasing quickly in Manitoba. Blunt reported that the number of Manitobans dying by euthanasia skyrocketed. The report stated:

When medically-assisted death first became legal in 2016, 42 people requested the service and 24 received it. That number rose in 2017, when 142 people requested MAiD and 63 people received it. 

Those numbers almost doubled in 2018, when 239 requested and 138 received. Last year, 313 people asked for a medically-assisted death, and 177 people received it.

The data indicates a 28% increase in Manitoba reported assisted deaths in 2019.

Since Ontario, Alberta and Manitoba had approximately a 20% increase in 2019, I would assume that there was a similar increases nationally. Therefore there approximately 5000  (4235 + 20%) assisted deaths in Canada in 2019 and 13,000  assisted deaths since legalization. Even if the numbers were slightly lower than 5000 in 2019, today is January 20, so it is safe to say that there has been 13,000 assisted deaths since legalization.

But that is not the whole story.

Canada's data collection system does not account for under-reporting of assisted deaths, but Quebec's data collection system can account for under-reporting. Quebec employs a multi report system making it possible to uncover the number of times a physician didn't report the assisted death.

Based on an analysis by Amy Hasbrouck and Taylor Hyatt, the Quebec interim report indicated that between April 1, 2017 – March 31, 2018 there were 142 unaccounted assisted deaths in the data representing 17% of all assisted deaths. The Quebec Interim report also indicated that 7 assisted deaths did not fit the criteria of the law, 22 assisted deaths did not follow procedural safeguards and in 67 assisted deaths, the physician did not provide the necessary information to determine if the patient fit the criteria of the law.

Based on the Quebec Interim report, if we extrapolate the data to all of Canada, it would suggest that there may have been more than 2000 (17%) unreported assisted deaths in Canada and approximately 60 assisted deaths that did not fit the criteria of the law.

This article is based on hard facts and conservative estimates. The fact is that Canada's assisted death law is quickly going out of control. The recent federal government consultation, that employs biased questions, is not concerned about Canadians whose lives are taken without due process.

Ontario Doctor experiences abuse with MAiD (euthanasia) law.

By Taylor Hyatt and Amy Hasbrouck
Tourjours Vivant - Not Dead Yet

Taylor Hyatt

Recently, Taylor Hyatt attended a conference for medical students, where a few lectures on euthanasia were presented. 

Taylor was moved by the talk given by Dr. David D’Souza, a chronic pain specialist in Toronto. His talk focused on eligibility for euthanasia, and he included the stories of three people considering euthanasia whom he had seen in his practice. Dr. D’Souza expressed concern that the safeguards around euthanasia eligibility were being flouted in all three cases.

The first case happened when visiting a nursing home where Dr. D’Souza met an elderly lady with dementia. Her condition had progressed “to the point where she [couldn’t] recognize her own family and [had limited] communication abilities.” Her family asked to meet with the doctor, and requested that she be euthanized. They brought a will that she had written 10 years before, while in the early stages of her dementia, which stated that she would want to be euthanized. Dr. D’Souza told the family that she was not a candidate for euthanasia. According to the eligibility criteria, the person must request MAiD themselves; no one can do it on their behalf. He also told them the law requires the person be able to give consent at the time of the procedure, which she was not competent to do. Dr. D’Souza also pointed out that, “she may have sufficient quality of life that she still enjoys.”

The second incident took place “shortly after euthanasia was legalized” in 2016. A middle-aged man who spent two months on a waiting list for palliative care, came to Dr. D’Souza. He was a wheelchair user and amputee, and he was on dialysis. The man only had his wife for support, and had “[decided] to discontinue dialysis completely.” By the time the man saw Dr. D’Souza, he hadn’t had dialysis for over three weeks, and so had “nausea, fatigue…uncontrolled pain, [and] shortness of breath.” He also reported a “low mood” along with feelings of hopelessness. The man had submitted a request for euthanasia.

His first words to the doctor were “Are you here to relieve my pain? Are you here to relieve my suffering?” Dr. D’Souza said yes. Then the man asked him whether he was “here to end my life.” Upon hearing “no,” he asked “Why not? Isn’t that part of your job? I heard about this MAID thing on TV … isn’t that what you do?” Dr. D’Souza provided palliative care for him, who then withdrew his MAiD request. Dr. D’Souza reported that “although he chose to decline further dialysis sessions, he later died peacefully and comfortably, and of natural causes, with the assistance of genuine palliative care.”

The last case is about a man in his 70's who was concerned about hardness in his abdomen. Early tests suggested gastrointestinal cancer as a possible cause. The first thing he said after receiving these test results was “I want to be euthanized.” Dr. D’Souza “tried to steer the conversation in a different direction and said to him ‘you don't qualify for that. You don’t even have a diagnosis. Let’s first figure out the diagnosis and we can talk about all that later.’” He was then sent for the scan. 

A few weeks later, Dr. D’Souza received a report from the hospital: the patient had gone there the day after his initial appointment and “demanded to be euthanized.” He was admitted to the hospital, but “refused further testing;” he also turned down meetings with a surgeon, oncologist, and psychiatrist. Instead, he met with the euthanasia team, including a nurse practitioner and a physician. They determined that he met the eligibility requirements for MAiD. 

Dr. D’Souza visited him on the day he was euthanized. Dr. D’Souza recalled that “he was in no apparent pain [or] distress. He was smiling. He was excited for the big event, and so was his family. His family was surrounding him and they had dressed him up in a very nice suit, and they were very, very excited. He told me he wanted to have a dignified death” not caused by unknown and unpredictable factors.

Dr. D’Souza pointed out eligibiity criteria that were were disregarded and safeguards that were overlooked when the request for euthanasia was approved:

• First, the person must “have a serious and incurable illness, disease, or disability.” He did not have a definitive diagnosis. “He refused investigations and specialist assessments; therefore, he did not know if he had an incurable illness.”
• Next, the person must “be in an advanced state of irreversible decline.” Not knowing his condition, it was impossible to know whether it was in decline. Even if further tests confirmed that he had cancer, his prognosis “would depend on a number of [factors, including] the primary source of cancer, presence of metastases, [and] type of tumour. These factors would then [suggest treatment] options, such as chemotherapy and/or surgery.”
• The person must also have “physical or psychological suffering that is intolerable to them.” The MAID team reported “that he was in no pain, but he was deemed to be in intolerable suffering.”

Dr. D’Souza also mentioned that he did not see a psychiatrist, so it is impossible to know whether emotional issues may have played a role in his decision to request euthanasia. Asking to die while refusing to obtain an accurate diagnosis suggests an impulsive and emotional choice, or that he was already prone to suicidal feelings. The doctor also believed the 10-day waiting period is arbitrary and inadequate. He doesn’t know “any physician who has been able to completely cure anxiety or depression in 10 days.”

These potential violations were discovered by someone with extensive experience in the medical field and knowledge of the Canadian euthanasia program, who took the time to share his insights. These case histories give us a glimpse into how the MAiD program works on the ground. Multiply Dr. D’Souza’s experience by the number of practitioners performing MAiD, and a frightening picture emerges. It also raises troubling questions: 

• Was man's euthanasia seen as compliant with the law upon review by the designated authorities? 
• How many ineligible people are being euthanized when MAiD evaluation teams don’t completely grasp or strictly apply the eligibility criteria and safeguards?

If this isn’t a slippery slope, what is?

Québec - 1331 reported euthanasia deaths (April 1, 2018 - March 31, 2019) At least 13 deaths did not comply with the law.

Fourth report from Québec's Commission on end-of-life care

By Amy Hasbrouck and Taylor Hyatt 

Toujours Vivant - Not Dead Yet.

On October 2, Québec’s Commission on end-of-life care released its fourth report for the period April 1, 2018 to March 31, 2019. The Commission reported a substantial increase in the number of euthanasia over the previous years. They reported:

Link to the analysis by Amy Hasbrouck and Taylor Hyatt on the previous Third Québec report (Link).

• There were 1,331 euthanasia were reportedly performed this year April 1, 2018 - March 31, 2019). Added to the 1,630* for the 28 months from December 10, 2015 to March 31, 2018, bringing the total to 2,909 euthanasia in Québec since the program began. We’ll talk in a few minutes about why those numbers don’t add up.
• Continuous palliative sedation (CPS) was performed on 1,243 people during the reporting period. Added to the 1,704 CPS performed during the 28 months from December 10, 2015 to March 31, 2018, this brings the total to 2,947. 
• Euthanasia and CPS each accounted for 1.9% of deaths in Québec during the reporting period, for a total of nearly 4% of all deaths in the province. 
• *As explained in footnote 19 on page 27, 1,630 euthanasia deaths is a corrected total from the Commission’s summary report issued last spring. Apparently “two MAiD reported by an institution as having been administered were not administered.” 

The exact number of euthanasia deaths is hard to pin down from the report.

• On pages iii, 12, 27 (footnote 19), 37 and 38, the report says “1,279 people received MAiD between April 1, 2018 and March 31, 2019.” This figure, when added to the 1,630 from previous years, gives the reported total of 2,909.
• But on page 23, the report says “according to reports from institutions, 1,937 requests for MAiD were made between April 1, 2018 and March 31, 2019; of these, 1,271 were administered and 672 were not administered.” 
• The 1,271 figure, added to the 60 euthanasia performed by doctors outside of institutional settings and reported by the Collège des médecins du Québec (CMQ), gives a total of 1,331 euthanasia. 
• Maybe you’ve noticed that 1,937 minus 672 does not equal 1,271, but rather 1,265. The six missing people are accounted for in a note in figure 3.17 which does not show the outcome of the six euthanasia requests in region 10. The Commission explains: 
• “In order to respect the rules of confidentiality, and because of the risk of identification related to the disclosure of a small number of individuals, the exact distribution of the euthanasia administered and not administered could not be provided.” 
• As for the 1,279 figure used elsewhere in the report, we don’t know where it comes from, or if it includes the 60 euthanasia reported by the CMQ. And if you think we’re being nit-picky, just remember that euthanasia laws are supposed to impose “stringent limits” that are “scrupulously monitored and enforced.” 

This year, the Commission received 1,400 euthanasia reports, some of which document euthanasia performed before the reporting period. 

“The Commission notes that 86 forms were received more than six months after the administration of MAiD and some of them more than one year later.” 

A few things to note about the Commission’s process:

• The Commission can only evaluate compliance with the law; it has no influence over other aspects of the medical practice, even if they could affect euthanasia. So, for example, if the doctor makes a mistake in diagnosis or the cause of a decline in capacity, that would probably fall outside the Commission’s area of responsibility.
• Two-thirds of the commissioners must agree that a violation has occurred for a finding of non-compliance to be made. Such cases are referred to the institution’s Council of Physicians, Dentists and Pharmacists (CPDP) and the Collège des médecins du Québec. There is no remedy for the loved ones of ineligible people who are euthanized, or where safeguards are ignored. 
• This year the Commission introduced a new procedure for evaluating reports, in response to the growing number of euthanasia. Declarations are examined by a sub-group including at least three commissioners; if all group members agree that the eligibility criteria were met and the safeguards complied with, the case is recommended for approval by the whole commission. If there is disagreement in the small group, the case is referred to the full commission for further discussion. 

The commission took a first look at 1,384 reports, and needed more information or had questions on 31%, or 430 of them. The Commission found that 96% of the 1,354 cases it ruled on complied with the law, but it could not reach a decision in 41 cases (3%) because they didn’t get the information they requested from the doctor. The commission found that 13 euthanasia (1%) did not comply with the law.

• Four people were not eligible: 
• Three people did not have a serious and incurable illness (they all had broken hips); 
• One person’s medical insurance card had expired. 

• In nine cases, safeguards were violated. 
• The second doctor examined the person before the euthanasia request was signed in five cases. 
• The doctor did not conduct the interviews to ensure that the request was informed, that the person’s suffering persisted and they still wanted euthanasia. “In two cases, the physician who administered the MAiD met the person only on the day of the [euthanasia].” 
• One request form was witnessed by a non-qualified person. 
• “In one case, the second doctor consulted had a family connection with the doctor who asked for the opinion.” 

Of those who asked for MAiD, 65% received it.
The three most common reasons euthanasia was not administered were:

• The person was not eligible (246 people, or 37%)
• The person died before the evaluation process was completed or before MAiD could be administered (224 people, or 33%) 
• The person withdrew their request (127 people, or 19%). 

Forty percent of those approved were euthanized within ten days of making the request.

The Régie d’assurance maladie du Québec (RAMQ) reports that 682 doctors billed for services related to MAiD. According to the CMQ, of 23,478 doctors registered, 480 say they performed euthanasia in 2018.

If there’s a take-away message from this report, it would probably be that the number of euthanasia deaths is increasing rapidly, and procedures are still handled in a slip-shod manner. We still wouldn’t get on an airplane with a 1% chance of crashing, and a 3% uncertainty factor.

Marieke Vervoort: an athlete’s influence used for harm?

This article was published by the disability rights group Toujours Vivant - Not Dead Yet on October 28.

Taylor Hyatt

By Taylor Hyatt 
Policy Analyst & Outreach Coordinator,
Toujours Vivant-Not Dead Yet

After the 2016 Paralympic Games in Rio de Janeiro, Brazil, Belgian wheelchair sprinter Marieke Vervoort made two startling announcements. First, she was retiring; the Rio Paralympics would be her last sporting event. Second, she was considering euthanasia due to the progression of her neuromuscular condition.

Ms. Vervoort was an accomplished athlete. She won the gold medal in the 100-metre, and silver in the 200-metre sprints at the 2012 London Games, as well as the silver medal in the 400m and bronze in the 100m in Rio. Until that point, sport had given her “a reason to keep living.” Sadly, Ms. Vervoort has followed through with her plan; according to a statement posted on the website of her hometown of Diest, she was euthanized on October 22.

Since her desire to die became public knowledge, Ms. Vervoort made many public statements in favour of euthanasia. She told CNN that she “regained control” of her life when she was approved for the procedure in 2008. She considered euthanasia to be “going to sleep … something peaceful” and a way out of unbearable suffering. Ms. Vervoort enjoyed the feeling of “rest” that her “papers” gave her, and was relieved that she did not have to end her life in a more traditional, painful way.

Ms. Vervoort lived with severe pain and a lack of sleep because of her disability. She did not have support to manage these aspects of her condition. This raises questions, such as:

• What palliative care measures did Ms. Vervoort receive to help manage her changing condition? We already know that palliative care is often unavailable and underfunded. As well, most doctors don’t know about advanced pain management techniques.
• Was she supported by a peer counselor as she grappled with the drastic changes associated with retirement and a progressive condition? The “better dead than disabled” message was probably harder to counter because her identity had been tied to sports for so long. After devoting so much time to her career, the question “Who is Marieke Vervoort, if not an athlete?” would prove difficult to answer. However, like all of us, Ms. Vervoort’s worth is not tied to her supposed usefulness in a particular domain. Human beings are not cartons of milk – they do not have a “best before” date! Nor would retirement take away from her accomplishments.
• Did anyone one match her interest in death with encouragement to live, or present her with other options?
• If Vervoort was immersed in pro-suicide messages, did she eventually feel like she had no choice but to act on them?

Ms. Vervoort made her suicide a public matter. She used her influence to convince others that ending one’s life is an acceptable response to difficult circumstances. I imagine a young admirer of Ms. Vervoort hearing her say that death is both a valid and accessible way to cope with distress, and it breaks my heart. I’ve never been particularly interested in sports, but I have been let down by a famous person I looked up to.

Steven Fletcher and Taylor Hyatt

By high school, politics – and the underlying ethical debates – had become my passion. A teacher noticed my growing interest and pointed out that MP Steven Fletcher, a disabled man, served in the House of Commons. Mr. Fletcher and I eventually met – not on a class tour of Parliament, as I had initially hoped, but on opposite sides of the euthanasia debate in the Supreme Court. Thankfully, I was well into my university studies at that time. Although I was disappointed, I was well aware of the risks of putting famous people on pedestals.

Public figures are human and fallible, and sometimes don’t live up to our expectations. On the other hand, these same figures must remember that many people, especially youth, look to them as examples. Combined with the lack of role models for disabled people to identify with, and the effects of suicide contagion, one woman’s untimely death could have a disturbing ripple effect.

May Marieke Vervoort rest in peace. I hope all who failed her by allowing her wish for death to go unchallenged have a change of heart. If not, more young fans could be motivated to follow in her footsteps, and more lives could be lost.

Vincent Lambert: Death by discrimination

This article was published by Toujours Vivant - Not Dead Yet on July 16, 2019.

Taylor Hyatt

By Taylor Hyatt - Policy Analyst & Outreach Coordinator, Toujours Vivant-Not Dead Yet

Vincent Lambert died recently.

For the past few weeks, all eyes have been on the French courts as they determined his fate. Mr. Lambert was severely injured in a car accident in 2008. Various news reports described him as “quadriplegic” with a brain injury, in a “vegetative state,” in a minimally conscious state, or used multiple terms to describe his condition. The phrase used most consistently throughout the media coverage, “right to die,” does not capture what the case was really about: disability rights.

Vincent Lambert

After the accident, Mr. Lambert used a feeding tube, but could still breathe without assistance. He could not speak, nor did he appear to respond to questions or commands. He had cycles of sleeping and waking, where he opened his eyes, moved his limbs and sometimes smiled or cried. In 2011 he was evaluated by the Coma Science Group at the Liège University Hospital in Belgium, which determined that he was in a “minimally conscious, plus” state and recommended that attempts be made to find a way to communicate with him. He subsequently received physiotherapy for one year, and 87 sessions with a speech/language therapist, which were deemed “unsuccessful.” Evaluations done in 2014 and 2018 by a team of doctors affiliated with the hospital in Rehms where Mr. Lambert was treated described his condition as “vegetative,” a view that was still contested at the time of his death.

Mr. Lambert had no directive in place expressing what he wished to happen if he ever became incapacitated. A bitter family feud arose as a result. Mr. Lambert’s wife Rachel, and six of his eight siblings, maintained that he would not want to live with a severe cognitive disability. The two remaining siblings joined their Catholic parents, Pierre and Viviane Lambert, in fighting to continue the tube feeding. Since 2013, Mr. Lambert’s parents have appealed to various authorities on multiple occasions using different legal arguments, including the European Court of Human Rights (under Article 2 of its convention, the Right to Life) and the United Nations Committee on the Rights of Persons with Disabilities. Article 25 of the Convention on the Rights of Persons with Disabilities calls on states to “prevent discriminatory denial of…food and fluids on the basis of disability.”

The Court of Cassation – the highest applicable appeals court in France – finally ordered that his feeding tube be removed on July 2 of this year. Anyone familiar with Terri Schiavo’s story will see multiple parallels between the two cases, and the questions raised therein.

The campaign to withdraw food and fluids was prompted by Mr. Lambert’s supposed “resistance” to care he was receiving. As Kevin Yuill pointed out, this points to an inconsistency in the position of those advocating the withdrawal of food and fluids; was Mr. Lambert capable of having and expressing an opinion about his care through his behaviour, and therefore possessing the right to refuse care? Or was he in a vegetative state, in which case his movements should be interpreted as reflexive and meaningless?

Another crucial issue raised by the Lambert case is the idea that disabled people must meet a certain threshold of functioning, or potential for improvement, in order to justify their existence and to receive the necessities of life (food and fluids). The view that death is preferable to severe disability led to a modification of France’s Public Health Code in February of 2016 to allow for the passive euthanasia of people like Mr. Lambert who were receiving “artificial life support” (tube feeding). The law allows treatments that are “unnecessary” or “disproportionate” to be stopped; in Mr. Lambert’s case food and fluids were deemed to be “unnecessary” and “disproportionate” because he was unlikely to achieve a certain level of functioning.

As well, the record is unclear as to what kind of ongoing rehabilitative care Mr. Lambert received, aside from the physiotherapy and speech/language sessions recommended by the Coma Science group three years after his injury. The team who evaluated Mr. Lambert in 2014 and 2018 noted that his condition had deteriorated; can that be linked to the kind of care he was (or was not) receiving?

Finally, the question of whether a feeding tube constitutes “artificial” life support was not sufficiently addressed. Not Dead Yet raised this question in the California Supreme Court in the Wendland case in 2000; if a person receives nutrition through a tube taken by mouth, that is not medical treatment; why should that same tube be considered “medical treatment” because it goes into the person’s stomach?

If nothing else, courts should have given more weight to the fact that death is permanent. Mr. Lambert’s life changed drastically after the accident. Requiring the support of family and professionals does not make a person’s life “pointless” or “a waste of resources.” When Mr. Lambert’s wife no longer wished to care for him, calling for his death was not a humane response – especially when his parents were willing to take over. We only get one chance at life.

Another disabled person starved and dehydrated to death while the world watched. I take some solace in the fact that he was sedated when his feeding tube came out, though this does not make his fate right or less unnerving. May Vincent Lambert rest in peace.

• We mourn the death of Vincent Lambert while thankful that an agreement will protect the life of Hannah Cement.

Free Online Conference celebrating 20 years of protecting people from euthanasia and assisted suicide.

Alex Schadenberg

Join EPC on Saturday July 20 to celebrate the 20^th anniversary for Alex Schadenberg as the Executive Director of the Euthanasia Prevention Coalition.

EPC is celebrating the occasion with a free live online conference from (1 pm to 3:00 pm eastern time) featuring key presenters.

You need to go to the EPC youtube page and press subscribe (Link).

The conference will include: 

• Amy Hasbrouck, (EPC - President), 
• Taylor Hyatt (Toujours Vivant – Not Dead Yet researcher),
• Maxime Huot Couture - Vivre dans la Dignite Quebec)
• Kristina Hodgetts - Compassionate Community Care.
• Catherine Glenn Foster (AUL - President), 
• and Alex Schadenberg.

EPC is focusing on the International campaign to prevent euthanasia and assisted suicide and Canada's five year review of its euthanasia legislation that is scheduled for June 2020.