Disability community worried about assisted dying expansion.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In his article published by the Epoch Times on March 10, 2021, Lee Harding interviews several disability rights activists to examine why the disability community opposes the expansion of euthanasia by Bill C-7.

Taylor Hyatt

Taylor Hyatt, a young woman with cerebral palsy tells Harding about a personal experience:

She recalls an occasion where acute breathing problems brought her to a hospital emergency room in Ottawa. When a doctor asked her if she wanted oxygen, she replied, “Of course I do.” The doctor then asked, “Are you sure?”

“I was floored,” Hyatt told The Epoch Times. “It was a real eye-opener for me about the way people trust doctors to be a guide to maybe frightening situations.”

Hyatt expressed her concern that the health care system is offering death as the preferred option for people with disabilities.

“If this bill goes through, and it probably will, I am thinking that I don’t want to be in the hospital alone ever again. Who knows what kind of judgments will be made? And unfortunately, what disabled people have to say about the value of their own minds and the support they need instead of the facilitation of their death—all of that is being pushed aside,”

Jonathan Marchand

Harding explains that during the Bill C-7 debate in Parliament and the Senate that several people with disabilities stated that they were pressured to ask for death.

Jonathan Marchand, who has muscular dystrophy, testified that “several doctors pressured me to adopt euthanasia, ‘comfort care’ as they called it,” after severe pneumonia put him in intensive care. “I never asked for this. I spent the next few weeks thinking and crying my eyes out. My life is really over? The thought had never crossed my mind.”

Disability leader, Gabrielle Peters, told Harding:

“Decades of dire warnings about how old and disabled people are going to burden our health care and society has been matched by marketing MAiD as a heroic, brave, self-sacrificing, and honourable death. You would be shocked at the number of times I have been called selfish by health-care professionals for wanting health care.”

Harding explains that there have been at least 15 media accounts of people being pressured to die by euthanasia. Roger Foley of London Ontario launched a lawsuit after being offered assisted death rather than assisted home care.

Senator Don Plett

Harding interviewed Senator Don Plett, who attempted to amend Bill C-7 to make it illegal for a physician to introduce the topic of assisted death with patients. Plett stated:

“I just think it is a sad, sad reflection on our society when we do not offer people the help that they need. … We should spend our time making living with dignity a higher priority than having dying with dignity the priority.”

Harding reports on how Senator Plett responded when the Senate passed the amendment allowing euthanasia for mental illness.

Plett called it a “brutal” amendment to “horrible legislation.”

“I believe that making mental illness as a sole reason for asking for assisted suicide is just, it’s just absolutely going way too far,”

Alex Schadenberg

Harding then interviewes Alex Schadenberg (myself) about the euthanasia for mental illness amendment to Bill C-7. I stated that in the Netherlands and Belgium euthanasia for mental illness requires one year of treatment whereas Bill C-7 would allow euthanasia for mental illness in 90 days without requiring treatment.

“In that one year, you must try all effective known treatments, Canada’s Bill C-7 does not require that you at least try effective treatments, so if you’re not terminally ill you can die within 90 days if you’ve been approved.”

I then explain to Harding how the Bill C-7 uses undefined terms which enables a wider use of the law. I said:

Bill C-7 says that if someone’s death is “reasonably foreseeable,” he or she can request MAiD and receive it the same day, whereas such a request would require a 90-day wait in other circumstances. Schadenberg says the bill leaves itself vulnerable to legal challenges to further expand euthanasia because the phrase “reasonably foreseeable” has never been defined, and some conditions require a wait while others don’t.

Except for its exclusion of minors, C-7 is the most liberal euthanasia legislation in the world, he said.

I told Harding about the many calls that EPC receives from family members who are distraught by the euthanasia death of a family member.

“It leaves a lot of people behind who have great, great pain related to the fact that a family member whom they dearly loved died in a way that they thought was absolutely wrong,”

“They’re not happy about it, but they’re also emotionally distraught by the situation, and they don’t want their stories told.”

Very few journalists have dug into the issues as Lee Harding has done. Thank you.

Canada’s claim to value seniors & disabled people rings false during COVID-19 pandemic

By Taylor Hyatt

Euthanasia Prevention Coalition board member & disability rights activist 

Canada's Maclean’s magazine has been running a series of articles on aspects of life turned upside down in the chaos of 2020. On their list of “14 things 2020 proved wrong” is the assumption that “Canada values its seniors” – not to mention younger disabled people who also live in congregate care settings.

Author Christina Frangiou’s piece begins on a jarring note, quoting a nurse in a Toronto-area hospital who called octogenarian Mary Wilton “a waste of space” while caring for her in the summer of 2019. Ms. Wilton’s daughter, Alison, says that her mother has been on the receiving end of many forms of age discrimination in the last decade as her needs changed. In addition to “callous comments, she condemns “unaffordable housing, insufficient home care, wait lists for long-term care and a lack of support for [caregivers].” As Alison Wilton notes, “[All of these problems] existed prior to the pandemic but worsened over 2020,” and it’s all dismissed as people in power say “Well, they’re old anyway.” In addition to the ageism the Wiltons observed, these problems stem from an apathy towards disability – both in younger people and as an effect of aging.

For nearly two decades, government officials have repeatedly promised to improve long-term care, and provide other services that older adults need to remain in their homes safely. Ms. Frangiou quotes former Ontario minister of health and long-term care George Smitherman; he said in 2004: “We need to change the culture of long-term care in this province…”.

Little has changed since then. The coronavirus pandemic has exposed authorities’ lack of action – and willpower – in this department. Ms. Frangiou quotes some sobering facts:

• “[By] the summer, over 80 per cent of all COVID-19 deaths in Canada occurred in nursing and retirement home settings – nearly twice the Organisation for Economic Co-operation and Development (OECD) average, even though Canada’s total COVID-19 mortality rate was comparatively lower.”
• “[The] military was called into long-term care homes in Quebec, [and] the Canadian Red Cross was summoned into some Ontario homes” when staff became overwhelmed with the number of sick residents, or homes faced staffing shortages when personnel themselves became ill. 
• Finally, provincial leaders are dismissing the deaths of elderly, ill, and disabled people as acceptable losses. “In Manitoba, Minister of Health Cameron Friesen [has said] that deaths in personal care homes are ‘tragic’ but ‘unavoidable.’ In Alberta, Premier Jason Kenney noted this spring that many people dying from COVID had already surpassed their life expectancy.” 

I find that last point particularly revolting. To rephrase it: because a long-term care resident has already lived longer than estimated, their preventable death – from an illness that has devastating effects even on younger people who contract it – is suddenly something we should shrug our shoulders at? Of course, we can't and shouldn't expect to prolong life, especially with the use of painful and extraordinary measures. Yet why should age, or associated disabilities, make someone less worthy of treatment? 

Healthcare systems in Quebec and Ontario have already faced criticism for ableist triage protocols implemented earlier in the pandemic, and these politicians’ remarks are rooted in the same attitude. Last but not least – as I've written before, not everyone who lives in an institution is an elder at the end of life.

Ms. Frangiou continues: 

“Even before the pandemic…430,000 [Canadians] reported having unmet home care needs, according to the National Institute on Aging. Many lack the funds to pay out of pocket for care: in 2016, 14.5 per cent of older Canadians lived in low-income households, according to census data from Statistics Canada.” 

The idea that aging in place depends on how much a person can afford to save is – as Toronto geriatrician Dr. Amina Jabbar says –  “grossly inequitable.”

Euthanasia Prevention Coalition executive director Alex Schadenberg calls attempts to reform long-term care facilities “band-aids.” He hopes that, if sufficient supports are provided that “more family and community support would develop over time.” Although he “applauds” provincial governments who fund renovations to make houses more accessible, these programs are “too little, too late” compared to the much greater cost and ease of keeping someone in an institution.

Dr. Vivian Stamatopoulos, a teaching professor at Ontario Tech University, sums up the truth at the heart of the situation. 

“People don’t want to think about the elderly because it’s sad, [or] because they just don’t see them.” 

This is largely true of younger disabled people as well. Initiatives to help them live in their own homes – outside of institutions – began in earnest with Ed Roberts and other disabled American students in the 1960s. Although Canada likes to present itself as a defender of equality, we must remember that this movement only reached Canada a few decades ago. (I'm at the end of my twenties, and my parents were young children then!) Even today, advocates such as Daniel Pilote, Jonathan Marchand, Tyson Sylvester and Amy Hampton work to make a truly dignified life in the wider community possible. Unfortunately, it seems decades will pass before more Canadians realize the importance of their efforts and the thanks they are due.

More than ever, isolation of institutions is no solution to COVID risks

By Taylor Hyatt
Euthanasia Prevention Coalition board member & disability rights activist

Taylor Hyatt

Much ink has been spilled over the state of Canada’s long-term care homes since the coronavirus pandemic arrived here. At first, it was understood that only the frail elderly, or those who had a “pre-existing condition” – in other words, an illness or disability – were at risk of becoming seriously ill. Therefore, it has become popular in some circles to suggest that these populations are safest in the facilities where they already live.

Unfortunately, this line of thinking is based on, at least, a few erroneous assumptions. 

First, “life” in an institution (or confined to one’s home for reasons of disability, while non-disabled people are encouraged to move freely) is not well-intended protection – it’s segregation. Besides being inhumane and a tremendous step backwards for disability rights, true segregation is impossible since disabled people rely on personal support staff. Like any other human being these staff also have social lives and needs that cannot be met within the facility; at some point, they must leave. There is still a chance, then, that they could contract the Coronavirus and carry it into the workplace. Second, extremely common conditions leave people of all ages at increased risk of complications. Finally, not everyone residing in an institution is an elder.

Chyanne

Chyanne, a resident of Midland Gardens Community Care in Scarborough, is the same age as me – 28. She moved into the facility in 2017, a year after acquiring her disability in a bus accident. Even before the pandemic, life in the facility left much to be desired. She has noticed “bruises and injuries on her fellow residents.” She has been documenting meals, which are “bland” and hardly filling. One morning’s breakfast consisted of “pre-packed fruit cups and muffins, with a single hard-boiled egg” – especially unappetizing for a woman who is hardly ever seen without a Starbucks cup in hand. She also sees a lot of death. In her words, it’s like watching her “grandmas and grandpas” pass away, and she remembers every one.

Midland Gardens breakfast

CBC Marketplace found that from 2015 to 2019, “her home (Midland Gardens) had 212 violations of the Long-Term Care Homes Act and Regulations. [That makes it the home with the most violations in Toronto [and] third-highest in Ontario.” Midland Gardens repeatedly violated the minimum standards for long-term care in Ontario. There were “infection control issues, injuries due to falls, medication errors or storage issues, abuse, and neglect.” Of the 632 homes for which there are records, 538 — or 85 per cent — had repeat violations…and faced no consequences from provincial authorities. Again, all of this took place before the pandemic began.

When the coronavirus reached her facility, Chyanne felt like “[she] was in a fishbowl, waiting…to get it.” At the beginning of May, she lost the ability to taste and smell. However, staff didn’t take her concern seriously, nor did they use proper protective equipment. They called an ambulance on May 17 after she had a dangerously high fever. Chyanne stayed in the hospital for a few weeks, relying on oxygen, until she returned to the institution on June 10th. Months later, she still has “breathing issues,” and struggles with being surrounded by death. She's “desperate” to reach the top of a waiting list for a proper home, but has a mission in the meantime: “accountability” for places like the one where she now lives.

Jonathan Marchand

Chyanne isn’t the only disabled Canadian fighting to leave institutional living. Earlier this year, Jonathan Marchand locked himself in a cage in front of Quebec’s National Assembly, symbolizing his “captivity” in a long-term care home. His goal was to meet with provincial government representatives to discuss the creation of a self-managed personal assistance program. (Government programs in Manitoba and Ontario – to name just two provinces – already offer financial help for people with disabilities to hire, train, pay, supervise, and fire their own support staff.) 

Daniel Pilote

In 2017, Daniel Pilote became the lead plaintiff in a class-action suit against the Quebec government, meant to compensate long-term care residents living in “shameful” conditions. (The text of Mr. Pilote's complaint is available online.) He’s compared his experience to living in a prison without being guilty of a crime. At times, the humiliation, depression, and abuse Mr. Pilote has faced has even “affected his desire to live.” Both have remained in the news as they cope with pandemic-related restrictions at their facilities.

As I write this, I'm cooking a huge pot of tomato soup. My spoiled cat is trying to climb in my lap to steal a piece of bacon. I'm thinking about what to write in a letter to a friend, which I’ll probably stay up late tonight to finish…and of course, all good writing requires a cup of tea in hand. I make all of these choices for myself, along with more fundamental ones – what to wear, and when to wake up, for example. None of this would be possible if I lived in an institution. No wonder it’s becoming increasingly common for people to say they would rather die than move into one.

None of the demands made by these advocates are new. Disability rights activists have been promoting self-directed home-based supports since the 1960s. The most popular reasons given for requesting euthanasia include ability “to participate in activities that made life enjoyable” or a loss of autonomy – and here’s a fix. Lives could be saved if only our society was willing to put as much work into allowing people to thrive in their own homes – on their own terms – as it does into permitting death.

Requests for euthanasia based on insufficient support for disabled Ontarians

By Taylor Hyatt
Euthanasia Prevention Coalition board member & disability rights activist

At the beginning of August, the Ottawa affiliate of the StopGap Foundation started a Twitter campaign using the hashtag #ODSPoverty. (For those readers who may not be familiar, the StopGap Foundation builds custom ramps for businesses with one-step entrances in cities across Canada, to improve access for people with disabilities. Local StopGap teams rely on donations of building materials from local stores and time from volunteers.) The goal of the campaign is to make the difficulties – more accurately, the impossibilities – of life on Ontario's disability assistance system more widely known.

On August 21, I saw that someone responded to the campaign with the news that they had “enrolled in MAID.” Given the meager financial supports available to them through the Ontario Disability Support Program, necessities of life such as food and medication are now unaffordable. My heart broke for the person on the other side of the screen.

Eleven days later, CityNews Toronto published an article on the matter. It includes some responses collected from Twitter, along with longer interviews of ODSP recipients. After rent is accounted for, some people reported having little more than a dollar a day for food. Others have less than $5 in their accounts after the month’s bills and essential medications are covered. One woman named Kim, who uses a feeding tube, told journalists that she feels “like I’m being punished for being born disabled, like I committed some kind of crime.”

The maximum amount of social assistance a single person can receive each month is $1169. The addition of a $250 food subsidy allows her to survive on just over $1400. All but a few hundred dollars goes towards rent for her RV. Kim notes that six of her friends have ended their lives since the COVID-19 pandemic began. She has considered applying for MAID as well. Kim’s landlord is evicting her in favour of making money through AirBnB, and she will be unable to meet her basic needs once her new – higher – rent is paid. She sums up her situation by saying: “I have no dignity left… I don’t feel like I’m worth anything to anyone anymore.”

No matter how much I want to be surprised by Kim’s conclusion, it’s old news. I’ve been in her place – twice. First, I depended on ODSP in university, so that I could keep up with a full course load when financial support from family wasn’t possible. Strange as it may seem, I was truly lucky in one sense. Most of my expenses – including housing, transit, utilities, and cafeteria food that lived up to the stereotypes – were part of a flat fee that I paid to my university over the course of the school year. (Now that I have my own apartment and multiple bills, this isn’t possible anymore!) Though I was able to work full-time during the summers, a significant chunk of my income went towards the upcoming year…and from September to May, the measly leftovers only allowed for survival. One luxury in particular still stands out: a $3 box of French fries from a little restaurant in the ByWard Market. Relying on the generosity of friends for more costly treats was an embarrassment. Sometimes I went without; as much as I loathed it, it was what I did in order to avoid the shame of being in anyone’s debt.

In my last year of university, I landed a well-paying contract – again, with the help of friends. I was able to pay off my student loans, continue working until the fall after graduation, and build up some sizable savings. Once my contract expired, however, the job search was harder than I anticipated. Those funds ran out after about six months. ODSP was all I had left. By then, I had moved off campus to a tiny bachelor apartment with utilities included in the rent – one of the few in the city that was both big enough for my mobility devices and affordable while on ODSP. After paying for rent, my bus pass, and my phone bill, about $130 remained. Let’s just say my diet at that time was…not ideal. Month after month of this scarcity began to wear on me. At times, I was in a dark place, and I’d be lying if I didn’t admit to clouds hanging over me. Whole weeks went by where my strongest thought was that I needed to – to put it gently – “put myself out of my misery.” I'm grateful for the support of friends and loved ones, the lists I made of reasons to keep going, and the mental health supports I was able to use. Life-sustaining services like these are often out of reach for many on ODSP.

Three years later, I'm in the middle of another job hunt after confronting the instability of the non-profit sector. This time around, I have much less to fear, and yet much more. If the worst happens once my employment insurance runs out, financial support is available to help cover the cost of rent for my now-accessible apartment. This would leave me with a few hundred dollars more than I’m used to. Still, I’m afraid that it may not be enough to do more than simply “exist” and I have now had a taste of life beyond “the bare minimum.” For example, my beloved cat Nibs has been a real lifeline for me in these months of limited socialization. There is no way I’d be able to afford her food, litter, vet appointments, grooming appointments and everything else needed to give her a fulfilling life while barely scraping by myself. Of course, I’d be willing to do what’s best for her…but could I cope with suddenly seeing her handed over to the care of friends, or a shelter? I doubt it!

Premier Doug Ford has recently, and rightly, come under fire for suggesting that ODSP recipients should “get a job” since “they’re healthy and they’re able to work.” For people like Kim, that might not be possible, and their survival should not depend on their ability to produce quantifiable output. Does the premier remember that someone on ODSP can only earn $200 per month before the province claws back their earnings? Who ever heard of rent that cheap? On top of this, supporters of (MAiD) euthanasia and assisted suicide say that the procedures allow people to exercise autonomy in the face of life-limiting medical conditions. They forget that a person cannot only be pressured into ending their life by another person; circumstances like living in poverty, lack of needed supports, or fear of institutionalization can have the same effect.

As disability rights activists often say, one cannot make a free choice to die if they do not also have a choice in where and how to live. A choice, by definition, includes more than one possible outcome. The provincial government, and the social services it controls, need to recognize that some Ontarians are now making false “choices” to escape unbearable circumstances. The latest provincial slogan, “Ontario: A Place to Grow,” does not apply to everyone unless Ontarians with disabilities are helped to thrive.

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?