Delta Hospice Society responds to campaign urging premier to steal their assets.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Recently I wrote about the Mayor of Delta BC pressuring the BC Premier to expropriate the remaining assets of the Delta Hospice Society  (Link).

In that article I wrote that Delta BC Mayor George Harvey urged BC Premier John Horgan to:

“take whatever steps you can to ensure that thrift store assets and revenue are restored to the Irene Thomas Hospice as originally intended by the Delta community.”

The Irene Thomas Hospice was taken from the Delta Hospice Society (DHS) by the BC Ministry of Health in March 2021 because the DHS refused to participate in (MAiD) euthanasia. The Irene Thomas Hospice is now operated by the Fraser Health Authority who permit MAiD.

Angelina Ireland

Angelina Ireland, the President of the Delta Hospice Society provided a strong response that was referred to in an article by James Smith writing for the Surrey Now Leader. She called the letter by Harvey "chilling." Smith quoted Ireland as stating:

“One wonders why the democratically elected Mayor Harvie will not recognize our private organization’s democratic process and the overwhelming results of our annual general meeting, which saw a super-majority of 76 per cent of members vote for traditional palliative care,”

“Further, the mayor urging Premier Horgan to take ‘whatever steps you can’ is chilling and should cause concern for all private organizations and businesses.”

The DHS established the Delta Cares Helpline to help people experiencing end-of-life medical issues and concerns at: 1-800-232-1589. 

The Delta Cares Helpline was established for people in the Delta BC region and beyond. Smith reported Ireland as stating:

Ireland said proceeds from the thrift shop support the society’s operations and the local community’s need for “traditional palliative guidance,” which the DHS also makes available to people across the country.

“Traditional palliative care knows no boundaries,”

Revenue from the store has also supported the launch and operation of the Delta Cares Helpline, which provides free 60-minute counselling sessions and practical advice for individuals and families struggling with difficult end-of-life circumstances or bereavement, according to the society’s website.

The euthanasia lobby continues to attack the DHS because they continue to oppose MAiD and they publicly refuse to kill their patients.

The DHS has expertise in providing end-of-life care. The Delta Cares Helpline is instrumental for helping people live with dignity until they die a natural death.

The Delta BC mayor urges the BC Premier to expropriate the remaining Delta Hospice Society property.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In February 2021, the Delta Hospice Society (DHS) was defunded by the British Columbia Ministry of Health because they refused to kill their patients by euthanasia. The battle over the existence of the DHS has continued since that time.

The DHS held an online Annual General Meeting on March 26/April 2 in which they elected 10 board members and passed resolutions ensuring their continued opposition to euthanasia and assisted suicide, referred to as MAiD in Canada. 76% of the membership voted to remain opposed to MAiD.

Disclosure: Alex Schadenberg was elected to the DHS board.

The mayor of Delta BC, George Harvie, has now asked BC Premier John Horgan to expropriate the remaining property of the DHS.

James Smith, reporting for the Surrey Now Leader reported:

Delta Mayor George Harvie is asking Premier John Horgan to “take whatever steps” he can to make sure money raised at the Delta Hospice Society (DHS)’s Hospice Cottage Charity Shoppe is used to support hospice care in the community.

Harvie’s request, made in a letter dated April 13, comes after members of the society voted in support of constitutional and bylaw amendments formally rejecting medical assistance in dying.

Smith further reports that the Charity Shoppe building is what they want expropriated. He writes:

In his letter, Harvie urged the premier “take whatever steps you can to ensure that thrift store assets and revenue are restored to the Irene Thomas Hospice as originally intended by the Delta community.”

Harvie stated the thrift store, valued at nearly $3 million, was created using community funds for the purpose of generating income to support services at the hospice. Instead, under the current board, revenue generated by the shop is being used by the society to support a national “1-800” palliative care help line.

The DHS did not stop providing care in the Delta BC region, the BC government defunded them and expropriated their 10 bed hospice bed building.

As the DHS reorganizes its focus in providing hospice care it established a 1-800 help line.

The DHS has expertise in providing end-of-life care. They will not permit the killing of any future clients by MAiD.

Disability rights group opposes expanding California's assisted suicide law to permit euthanasia for people with disabilities.

This article was published by the Disability rights group DREDF (Link).

DREDF Opposes Elimination of Fundamental Protections in California’s End of Life Options Act

In a pending legal case, Shavelson v. California Department of Health Care Services, a terminally ill plaintiff contends the self-administration requirement of California’s End of Life Options Act (ELOA) violates existing anti-discrimination laws on the basis of disability. While the plaintiff is eligible for physician assisted suicide and has the ability to self-administer lethal medication at present, they’d prefer to utilize the option later in the dying process, when self-administration is no longer possible.

The lawsuit seeks to pressure California into eliminating the state’s most essential safeguard and, in doing do, sanction a dangerous practice not allowed in any of the state’s where assisted suicide is legal. Today, District Judge Vince Chhabria heard arguments in the case, which the State of California has moved to dismiss. DREDF supports the motion and is actively monitoring the case.

Here’s why disability rights advocates strongly oppose granting the waiver requested by the plaintiff.

Assisted suicide doesn’t exist in a vacuum. It must be considered against the backdrop of the United States’ tragic history of state-sanctioned discrimination against people with disabilities and chronic illnesses in health care settings. This sordid history includes nonconsensual experimentation, forced sterilization, the denial of essential medical care based on biased and/or inaccurate quality of their life assessments, issuing of “Do Not Resuscitate” orders without patient consent, and most recently, employing COVID crisis standards of care and health care rationing systems that explicitly, openly devalue disabled lives.

This long, violent history of discrimination is the result of common, largely unspoken biases in society and in the medical profession that assume (without evidence) that the quality of life and inherent worth of people with disabilities is beneath that of their non-disabled peers. Countless studies have consistently revealed the disturbing revelation that health care providers hold negative views of people with disabilities that too frequently translates in failures to equitably protect, serve, or support disabled people.

In 2019, the National Council on Disability – an independent federal agency – released a series of reports exploring how people with disabilities are harmed by these biases in several critical areas of health care delivery including organ transplantation, assisted suicide and determinations of medical futility. The report details a deadly double standard in providing suicide prevention services or support where disability communities are concerned. Under grave circumstances like these, existing safeguards in California’s law must be preserved, especially when other key safeguards in ELOA have already been rolled back.

When it enacted ELOA in 2016, California’s legislature rightfully drew a clear line between assisted suicide and euthanasia in an attempt to preserve the integrity of unqualified consent inherent in the self-administration requirement. Or so they claimed at the time.

Yet in October 2021, California enacted Senate Bill 380, eliminating the very protections the Legislature championed only a few years before, including (1) reducing mandatory 15-day waiting periods between requests for assisted suicide drugs to 48 hours; and (2) eliminating the requirement that an individual affirm their decision before lethal drugs are administered. These requirements were critical guardrails against erroneous or coerced requests for assisted suicide; without them, the risks of abuse and coercion to people with disabilities increase exponentially.

Requiring California to cross that line as the plaintiff in Shavelson seeks to do would compromise the essential nature of the end-of-life program the state created and increases existing threats to the civil rights, and the very lives, of profoundly oppressed and already marginalized communities.

In short, the state’s self-administration requirement reflects a sound legislative judgment that no person’s life should be ended unless they are fully committed to ending it – something that can never be truly clear unless they perform the act themselves. While not ideal, this affirms and secures an essential moral and legislative line between assisted suicide and euthanasia. California’s requirement that individuals must self-administer a lethal prescription remains a necessary barrier to coercion and abuse that must, in good conscience, remain.

Netherlands 2021 euthanasia deaths increase by 10.5% to 7666. 115 euthanasia deaths for mental illness.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Dutchnews.NL reported that the number of euthanasia deaths in the Netherlands increased by 10.5% in 2021 to 7666. Last year's Netherlands euthanasia report indicated that there were 6938 reported euthanasia deaths in 2020 which was up by 9% from 6361 in 2019.

There may be many unreported euthanasia deaths. Research indicates that 20% - 23% of the Netherlands euthanasia deaths are not reported.

The Dutchnews report indicated that there were 206 reported euthanasia deaths for early stage dementia and 6 reported euthanasia deaths for late stage dementia and 115 reported euthanasia deaths for severe mental illness.

The Dutchnews report also stated that 7 reported euthanasia deaths did not fit the legal criteria of the law and yet none of these doctors lost their medical license or were censured in some other manner.

In December 2021 the Dutch Medical Association approved euthanasia for incompetent people who had made an advanced request.

In February 2022, a member of the euthanasia lobby was arrested in the Netherlands for selling a suicide powder that resulted in at least 4 deaths.

In 2021, a further 206 patients with earlier stage dementia were helped to die, as were 115 people with severe psychiatric illness. The vast majority of people had terminal cancer.

Read more at DutchNews.nl:

Winnipeg Church hosts (MAiD) euthanasia death

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Jesse T Jackson that was published by the publication, Church Leaders on April 18 explains that Churchill Park United Church in Winnipeg Manitoba hosted the euthanasia death of Betty Sanguin (86) on March 9, 2022.

Sanguin, who was living with Amyotrophic Lateral Sclerosis (ALS) died by lethal injection in the sanctuary of the Church. According Jackson:

Sanguin visited with her family and friends during the ceremony hosted at the church. The lethal injection started at 1PM. An hour later, she was no longer present on earth. At 4PM, the funeral home arrived to take her body.

The MAiD death was referred to as a “simple Crossing Over Ceremony”

A CBC article in October 2021 reported that some funeral homes were permitting MAiD on their premises nonetheless, MAiD, which is done by lethal injection, is a form of homicide. In fact, Canada legalized MAiD (euthanasia) in 2016 by creating an exception in the criminal code to homicide. Therefore Churchill Park United Church permitted a homicide on its premises.

Significant non-compliance with Colorado assisted suicide law.

This article was published by the Australian Care Alliance.

Colorado’s experiment in providing a safe regime for assisted suicide is a failure because it lacks any possibility of identifying problems and, five years in, authorities remain lackadaisical about significant non-compliance even with the minimal reporting requirements.

In more than one in five cases the physician failed to lodge a copy – as required by law - of the person’s written request. In more than one in four cases the physician failed to lodge the mandatory written report from the consulting physician. 

In 2021 nearly one in seven cases even the basic form from the attending/prescribing physician has not been lodged and for which even the supposed assurance given by all the boxes being ticked is not provided.

Assisted suicide has been legal in Colorado since 16 December 2016 following the passing of a ballot initiative.

Minimal  data

Five annual reports have been published with the latest covering 2021.

Even compared to the limited data reported annually in Oregon and Washington the annual reports are sparse and uninformative.

In 2021 prescriptions for a lethal substance were written for 222 people – an 18% increase from 2021 and more than three times (308%) the number of prescriptions written in 2017.

For 2021 records of the lethal substance actually being dispensed were lodged for 156 (70.3%) of these cases.

A range of experimental lethal cocktails were dispensed, including combinations of diazepam, digoxin, morphine sulfate, and propranolol (DDMP or DDMP2 – 32 cases, 20.5%), with amitriptyline instead of propranolol (DDMA – 67 cases, 42.9%), and DDMA with the addition of phenobarbital (DDMAPh – 57 cases, 36.5%).

It is not known whether the prescription was not dispensed in the other 66 cases or if the mandatory paperwork was simply not lodged. 

Death certificates for 189 people for whom a lethal prescription had been written were received. However, as the death certificates, by law, only record the underlying illness and make no mention of whether death was caused by ingesting a lethal substance, it remains unknown how many of these 189 people actually died from the lethal substance or even collected it.

The youngest person who has been prescribed a lethal substance was reported as aged in the “upper 20s”.

There is no requirement (or even any process) for reporting complications for people from taking the lethal substance despite the mandated written declaration under the law requiring a person to acknowledge “although most deaths occur within three hours, my death may take longer”. The record length of time from ingestion to death reported from Oregon is 104 hours (4 days 8 hours).[3]

Although the law requires a referral to a psychiatrist or psychologist “if the attending physician believes that the individual may not be mentally capable of making an informed decision” only 5 out of 777 (0.64%) of those people for whom a lethal prescription was written (2017-2021) were first referred for an assessment., with no referrals reported for 2021.

Although eligibility is supposedly limited to a “terminally-ill individual with a prognosis of six months or less to live” the maximum duration of time between the date of prescription and date of death was “approximately 11 months”, with once case of “approximately eight months” in 2021.

“Other”, unspecified conditions

The 2021 report includes 8 cases of a lethal prescription written for “other illnesses/conditions” with no indication of what these were. This is double the 4 reported each year in 2019 and 2020.

A Colorado medical practitioner, Dr Jennifer Gaudiani, has reported acting as a consultant in two out-of-state cases of the prescription of a lethal substance for two 36 year old women with anorexia.[4]

With no details given in the Colorado reports on “other illnesses/conditions” we may never know when cases of a prescribing a lethal substance for anorexia or other non-terminal illnesses, including mental illnesses, occurs.

Significant non-compliance by physicians

What is most concerning is the level of non-compliance by physicians who prescribe lethal substances with even the very minimal reporting requirements.

In more than one in five cases (22.4%) from 2017-2021 the physician failed to lodge a copy – as required by law - of the person’s written request.

In more than one in four cases (25.5%) the physician failed to lodge the mandatory written report from the consulting physician. 

But the Colorado Board of Health is relaxed about this massive rate of non-compliance:

While reporting of the required documentation (including prescribing forms, patients’ written requests, consulting physicians’ written confirmations, and mental health provider confirmation) may be incomplete, all attending/prescribing forms received contained physicians’ signed attestations that all requirements of the Colorado End-of-Life Options Act have been met, and that required documentation is complete and contained in patients’ records. Efforts continue to educate physicians and other health care providers about reporting requirements.

This lay back approach glosses over the  13-15% of cases in each year from 2017 to 2021 where even the basic form from the attending/prescribing physician has not been lodged and for which even the supposed assurance given by all the boxes being ticked is not provided. There was 14.9% non-compliance with this legal requirement in 2021 – up from the lowest level of non-compliance of 12.9% in 2018.

Conclusion

Colorado’s experiment in providing a safe regime for assisted suicide is a failure because it lacks any possibility of identifying problems and five years in authorities remain lackadaisical about significant non-compliance even with the minimal reporting requirements.

Download a fact sheet on Colorado (PDF Link).

66 New Zealanders die by euthanasia in 5 months after legalization.

The following New Zealand update was published by the Australian Care Alliance.

Euthanasia and assistance to suicide became legal in New Zealand from 7 November 2021 under the End of Life Choices Act which passed the Parliament by 69 votes to 51 in December 2019 and was endorsed at a referendum in 2020 by 65.1% of voters.

Numbers

66 people were euthanased or assisted to suicide between 7 November 2021 and 31 March 2022 – approximately 0.48% of all deaths in New Zealand in that period.

More women than men applied for euthanasia or assistance to suicide - 114 women and 92 men. No breakdown by sex is given for the 66 applicants who had their lives actively ended. However, if the proportion was the same then this would give a rate of 0.53% of all deaths of women in the period, compared to 0.42% for men – more than a quarter (26%) higher rate for women than men.Eligibility criteria

The key eligibility criteria are that the person is an adult New Zealand citizen or permanent resident who, according to two assessing medical practitioners, “suffers from a terminal illness that is likely to end the person’s life within 6 months”.

Neither medical practitioner needs to have any specialist qualification in a field relevant to the particular terminal illness.

If either or both assessing practitioners are uncertain of the person’s competence to make an informed decision then the person must be examined by a psychiatrist to determine this matter.

Not even one of the 168 people assessed by a first medical practitioner or the 128 people assessed by a second medical practitioner for eligibility between 7 Nov 2021 and 31 March 2022 was referred to a psychiatrist.

Health practitioner

Health practitioners are not permitted to initiate a discussion with or make a suggestion to a patient about accessing euthanasia or assistance to suicide under the Act.

A medical practitioner with a conscientious objection can refuse to participate but must advise a person who requests access of the person’s right to ask the SCENZ Group for the name and contact details of a replacement medical practitioner. The SCENZ (Support and Consultation for End of Life in New Zealand) Group maintains a register of health practitioners willing to provide access to people seeking euthanasia or assistance to suicide.

Administration

If the person chooses to self-administer the prescribed lethal poison it is only supplied to them shortly before a time specified by the person for self-administration (suicide).

Regardless of whether the lethal poison is self-administered or administered by an attending medical or nurse practitioner, the attending medical or nurse practitioner (or a substitute practitioner) must be in “close proximity to the person”, but not necessarily in the same room or area, until the person’s death.
Annual report

The only elements required by the Act to be in the annual report are the total number of deaths and the number of deaths occurring through each of the four methods described in the Act and the number of complaints received about breaches of this Act and how those complaints were dealt with.

The first annual report is not due to be tabled in Parliament until after 30 June 2022.

Download as a (PDF Link)

EPC-USA makes U.S. Life Protecting Power of Attorney for Health Care available

You are only a car accident away from needing medical care while you are unable to express your wishes. April 16th was National Health Care Decisions Day—a good time to legally appoint someone you trust, called an Agent, to make those decisions for you. You do this by completing a Power of Attorney for Health Care. We offer documents that meet the requirements for all 50 states. One document for 46 states and then one for New Hampshire, Ohio, Texas and Wisconsin at: https://epc-usa.org/resources/

You can protect your life by empowering your agent to make important decisions. Instead of answering “YES” or “NO” to certain treatments, the documents empower your Agent who you appoint to make those decisions to protect your life. 

Have you ever thought about being on a ventilator to help you breathe? If you say NO and then you need it, you may die. Maybe you don’t want to be on a ventilator forever, so you don’t want to say YES either. Remember Christopher Reeve who played Superman? After an accident, he lived on a ventilator for 8 more years. Probably, you would like to be on a ventilator until your lungs recover. Maybe it needs to be tried to find out if that is the case.

Our documents empower your Agent with flexibility. Your Agent is directed to request and consent to treatment that is appropriate and beneficial and authorized to reject treatment that is not. The words “appropriate” and “beneficial” mean what you told your Agent they mean. So, only your Agent decides what is appropriate and beneficial. If you told your Agent you would like to be on a ventilator for a short time until you recover and not need it permanently, your Agent can do that.

What if you need care and a doctor disagrees with your family or your family disagrees among themselves? If you have a Power of Attorney for Health Care, then the Agent, who you appoint, is the final decision maker.

We advise you to appoint a Health Care Agent who shares your values.

EPC-USA asks for a free-will donation of $15 for the Life Protecting Power of Attorney for Health Care. You can give more or less, it’s up to you.

Find the document for your state at: https://epc-usa.org/resources/

Canadians can purchase the Life-Protecting Power of Attorney for Personal Care from Euthanasia Prevention Coalition to protect your life and assure that you will receive beneficial treatment or care. (Link).

MAiD euthanasia for chemical sensitivities and housing.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

CTV National News Medical Correspondent, Avis Favaro, reported on April 13 of a (MAiD) euthanasia death in February of a 51-year-old Ontario woman who had severe chemical sensitivities. According to Favaro, the woman was not terminally ill but living with a chronic condition that makes her highly sensitive to chemical sensitivities and environmental allergies.

This story represents the ultimate form of abandonment whereby this woman died by MAiD, not because of "unremittant suffering" but because the government wouldn't help her find appropriate housing. Favaro wrote:

She died after a frantic effort by friends, supporters and even her doctors to get her safe and affordable housing in Toronto. She also left behind letters showing a desperate two-year search for help, in which she begs local, provincial and federal officials for assistance in finding a home away from the smoke and chemicals wafting through her apartment.

“This person begged for help for years, two years, wrote everywhere, called everywhere, asking for healthy housing,” said Rohini Peris, President of the Environmental Health Association of Québec (ASEQ-EHAQ).

“It’s not that she didn’t want to live,” Peris said from her home in Saint Sauveur, Que. “She couldn’t live that way.”

Her chemical sensitives seemed to be worsened by the Covid crisis, as Favaro writes:

Research shows that many symptoms of MCS dissipate when chemicals are removed from a person’s environment. But, like Canadians across the country, Sophia had to spend a lot of time at home because of the COVID-19 pandemic and related restrictions.

Letters she wrote said that indoor cigarette and pot smoking increased, sending fumes through her Scarborough apartment building’s ventilation system. More chemical cleaners were used in the hallways that worsened her symptoms. She confined herself to her bedroom -- or “dungeon,” as she called it -- for most of the pandemic, sealing the vents to keep cigarette and pot smoke from wafting into her unit.

Her doctors tried to help her. As Favaro wrote:

Four Toronto doctors were aware of Sophia’s case and they also wrote to federal housing and disability government officials on her behalf. In that letter the doctors confirmed that her symptoms improved in cleaner air environments and asked for help to find or build a chemical-free residence.

“We physicians find it UNCONSCIONABLE that no other solution is proposed to this situation other than medical assistance in dying,” they wrote.

The letter was signed by Dr. Lynn Marshall, an environmental physician, Dr. Chantal Perrot, a family physician and MAiD provider, Dr. Justine Dembo, a psychiatrist, and Dr. James Whyte, a family doctor and psychotherapist. The physicians who wrote the letter all declined to speak to CTV News.

“It was an easy fix,” said Dr. Riina Bray, a Toronto physician who treats those with environmental sensitivities. “She just needed to be helped to find a suitable place to live, where there wasn't smoke wafting and through the vents.”

“If people have to go and kill themselves, that would be a very pathetic thing and it will be heard by the rest of the world because it's not acceptable,” said Bray.

Friends set up a go-fund me page that was promoted by the Euthanasia Prevention Coalition to raise money for a suitable place to live:

Friends set up a fundraiser and collected approximately $12,000 to try to help Sophia get better housing, away from chemicals and smoke. But by then Sophia had an appointment to have a medically-assisted death.

“If nothing turns up before FEB 22 please know that it is ok,” wrote Sophia in an email in early 2022. " I already have a way out. I don’t have the energy to fight anymore.”

Dr. Claudia Miller, a professor emerita in the department of allergy/immunology and environmental health at the University of Texas, said this death was unbelievable. Favaro reports:

The solutions, she said, are cleaning up the environments to prevent new cases, and making homes and apartments smoke and chemical free. She’s never heard of a patient being granted an assisted death instead of proper housing.

“It's a sad statement. …people are so desperate they do want to die,” Miller said from her home in San Antonio in an interview with CTV News. “I think that's completely an indication of a huge failure…a societal failure. It’s …..such a bad statement about not just Canadian government, but any government that allows that to occur,” she said.

Since Sophia's death more Canadians with chemical sensitivies have applied for MAiD. Favaro reports that Rohini Peris is concerned:

“I’m terrified,” said Peris. “I don’t believe this is the answer. I think the answer is to get together and fight the government that they will do the right thing,” said Peris, who is advocating for a national program to build chemical-free homes.

Why did two medical authorities approve her death? Clearly this is the ultimate case of abandonment to death.

Danish doctor assisted suicide conviction upheld.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Danish physician who was convicted in 2018 of assisting the suicide of two people and assisting another attempted suicide lost his attempt to overturn his conviction at the European Court of Human Rights.

An article by Molly Quell published by the Courthouse News Service on April 12, 2022 stated that the European Court of Human Rights found that Svend Lings’ 2018 conviction for medically assisted suicide didn’t violate the European Convention on Human Rights. Quell reported:

Lings, the former chief physician at Odense University Hospital in southern Denmark, was given a 40-day prison sentence in 2018, later increased to 60 days, for helping two people die and a third person attempt suicide. The 81-year-old, now-retired physician founded Læger for Aktiv Dødshjælp, or Physicians in Favour of Euthanasia, in 2015, which advocates for legalizing assisted suicide in Denmark.

Following a 2017 radio interview, in which he described how his organization had helped at least 10 people take their own lives, his medical license was revoked and, after further investigation, he was ultimately charged for his involvement in three suicides or attempted suicides.

Quell explains that Lings appealed to the European Convention on Human Rights after losing at the Denmark Supreme Court.

Lings argued before the court in Denmark, as well as before the ECHR, that he had merely been disseminating information about suicide. After his final appeal failed before the Danish Supreme Court, he complained to the ECHR, arguing that under the right to expression, guaranteed by the convention which created the court in 1959, what he did should not be considered illegal.

The seven-judge panel disagreed, writing that Lings “had not only provided guidance, but had also, by specific acts, procured medications for the persons concerned, in the knowledge that it was intended for their suicide.” It was clear, the court wrote, that he had gone beyond simply providing general information about suicide.

Similar to other euthanasia activists, Ling openly challenged the law. He likely hoped that his actions would result in an acquittal, thus striking down the law, instead the Denmark and European courts have upheld his conviction.

Belgium reported euthanasia deaths rise. At least 50 people die by euthanasia for mental illness in 2021.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On March 31, the Belgian Commission for the Control and Evaluation of Euthanasia published their 2021 euthanasia data.

 

In reporting on the euthanasia commission's date, the European Institute of Bioethics (EIB) stated that the number of reported euthanasia deaths increased to 2699 from 2444 in 2020.

The EIB reported that at least 50 people died by euthanasia for mental illness which was more than double from the 2020 report  where there were 21 euthanasia deaths for mental illness.

The EIB reported that studies indicate that at least 25 - 35% of the euthanasia deaths are not reported and therefore illegal. Previous studies also indicate that approximately 2% of all euthanasia deaths are done without request or consent.

In 2019 Europe's top human rights court, agreed to hear the case of a depressed Belgian woman who died by euthanasia and in 2018 three Belgian doctors were charged in a euthanasia death for psychiatric reasons.

The three doctors were acquitted in the euthanasia death, but in September 2020 a retrial was ordered for one of the doctors in the case. The retrial was heard in May 2021.

In May 2021, Belgium's euthanasia law was criticized at the UN Human Rights Council.

In November 2021 a Belgian doctor was accused of doing an unlawful euthanasia death.

Euthanasia for mental illness. Killing people without a certain prognosis.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Canada expanded its (MAiD) euthanasia law by passing Bill C-7 in March 2021, Many people are unaware that one of the bill's provisions legalized euthanasia for people with mental illness alone. This means that a person who is not physically ill or dying but is living with mental illness can be killed by euthanasia.

At that time the federal government put a 2-year moratorium on euthanasia for mental illness to enable the government to establish protocols for this catagory of killing. I have stated that the two-year moratorium is unenforceable making euthanasia for mental illness legal already. 

Recently an acquaintance told me that her friend's mother (a person who I do not know) recently died by MAiD after living with chronic depression for more than twenty years. I certainly understand the suffering related to chronic depression but when did killing become a treatment for chronic depression?

A recent article by Sharon Kirkey titled: Canada will soon offer doctor-assisted death to the mentally ill. Who should be eligible? examines the issue by first interviewing Dutch research Psychiatrist Dr Sisco van Veen who says that mental illness cannot be identified like other diseases. van Veen states:

You can’t see depression on a scan. With the exception of dementia, where imaging can show structural brain changes, “in psychiatry, really all you have is the patient’s story, and what you see with your eyes and what you hear and what the family tells you,” van Veen says. Most mental disorders lack “prognostic predictability,” which makes determining when psychiatric suffering has become “irremediable,” essentially incurable, particularly challenging. Some say practically impossible...

... In the Netherlands, MAID for irremediable psychiatric suffering has been regulated by law since 2002, and a new study by van Veen and colleagues underscores just how complicated it can be. How do you define “grievous and irremediable” in psychiatry? Is it possible to conclude, with any certainty or confidence, that a mental illness has no prospect of ever improving? What has been done, what has been tried, and is it enough?

Kirkey outlines the government time-table on euthanasia for mental illness:

Sometime in April, an expert panel struck by the Liberal government to propose recommended protocols for MAID for mental illness will present its report to the government. A joint parliamentary committee studying the new MAID law has been given a mandate to report back by June 23. The expert panel’s chair declined an interview request, but her 12-member assembly has been tasked with setting out proposed parameters for how people with mental illness should be assessed for and — if found eligible — provided with MAID, not whether they should be eligible.

Kirkey speaks to Dr Sonu Gaind, a critic of euthanasia for mental illness.

For Dr. Sonu Gaind, a past president of the Canadian Psychiatric Association, the most fundamental safeguard has already been bypassed, because there is no scientific evidence, he says, that doctors can predict when a mental illness will be irremediable. Everything else goes out the window.

Gaind isn’t a conscientious objector to MAID. He’s the physician chair of the MAID team at Humber River Hospital in Toronto, where he’s chief of psychiatry. He works with cancer patients. He’s seen the positive, the value that MAID can bring. But unlike cancer, or progressive, neurodegenerative diseases like ALS, “we don’t understand the fundamental underlying biology causing most major mental illnesses.”

“We identify them through the clustering of various symptoms. We try to target treatments as best we can. But the reality is, we don’t understand what’s going on, on a fundamental biological level, unlike with the vast majority of these other predicable conditions.” Without understanding the biological underpinnings, what do you base your predictions on, he asks. He’s heard the argument that it’s difficult to make firm predictions about anything in medicine. But there’s a world of difference between the degree of uncertainty between advanced cancers and mental illnesses like depression, he argues.

“There’s no doubt that mental illnesses lead to grievous suffering, as grievous, even more grievous in some cases than other illnesses,” Gaind says. “It’s the irremediability part that our framework also requires and that scientifically cannot be met. That we cannot do. That’s the problem.”

Kirkey then reports, as I previously reported, that euthanasia for mental illness has already been happening in Canada. Kirkey writes:

Euthanasia for mental illness has, in fact, already occurred in Canada. Testifying before a Senate committee studying Bill C-7 last year, Vancouver psychiatrist Derryck Smith told the story of “E.F.”, a 58-year-old woman who suffered from severe conversion disorder, where a person’s paralysis, or blindness or other bizarre nervous system symptoms can’t be explained by any physical findings. She suffered from involuntary muscle spasms. Her eyelid muscles had spasmed shut, leaving her effectively blind. Her digestive system was a mess, she was in constant pain and needed to be carried or use a wheelchair. In May 2016, Alberta’s Court of Queen’s Bench allowed her an assisted death.

Smith took part in another case involving a 45-year-old Vancouver woman who had suffered from anorexia nervosa since she was 17. She’d endured a “gauntlet” of treatments, he said, had been certified several times under the Mental Health Act, involuntarily hospitalized and force fed by a tube in a manner that left her feeling “violated.” “At the time I assessed her, she had virtually no social life … no joy in her life.” Smyth determined the woman had capacity to agree to assisted death.

Gaind also explains how euthanasia for mental illness is far more prevalent for women than men.

“But when you expand it to sole mental illness conditions, the entire demographic shifts, and it’s people who have unresolved life suffering that also fuels their request,” Gaind says. A stark gender gap also emerges: when MAID is provided to the imminently dying, it’s a 50-50 gender split. As many men as women seek and get it. Experience in the Netherlands and other countries shows that twice as many women seek and receive MAID for mental illness.

Kirkey points out that, unlike the Netherlands, Canada's (MAiD) euthanasia law does not require people to try effective treatment before being approved for death. We don't know if Canada will require people who request euthanasia for mental illness alone to try effective treatment first.

Jocelyn Downie, Dalhousie University professor of law and medicine and Canada's leading pro-euthanasia academic as saying that, based on autonomy, we don't require Canadians to try effective treatments for other conditions. But Downie wants to ignore that fact that death by lethal injection is an irreversible decision with an immediate effect, whereas refusing treatment for cancer will result in a natural death. Downie also wants MAiD to be seen as a medical treatment decision that is equal to all other medical treatment decisions. Even if Downie accomplishes her goal, people in general will never and should never consider death by lethal injection as a medical treatment.

Sadly, Canada rushed into passing Bill C-7 in March 2021. Most Canadians have no idea that euthanasia for mental illness is permitted and previous opinion polls showed that most Canadians opposed euthanasia for mental illness alone.

I am expecting a report from the one-sided federal government appointed committee that was established to create rules for MAiD for mental illness alone. I am very concerned.

Connecticut assisted suicide bill is defeated again.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Cathy Ludlum, Second Thoughts Connecticut

I have great news.

Connecticut assisted suicide bill SB 88 was defeated again. This represents the 10th assisted suicide bill to be defeated in Connecticut.

But the battle in Connecticut may return next year.

In March, SB 88 passed in the Connecticut Public Health Committee. The assisted suicide lobby tried to prevent the bill from going to the Judiciary Committee since this committee defeated previous assisted suicide bills.

The Judiciary Committee once again defeated the bill.

There are many groups and individuals who, year after year, have worked to defeat assisted suicide bills in Connecticut. Notably, disability rights group Second Thoughts Connecticut has maintained a focussed and consistent opposition to assisted suicide.

Cathy Ludlum (above) with Second Thoughts Connecticut testified that based on her health and Covid, she has been fighting for her life. Assisted suicide threatens her life.

SB 88 was different than previous assisted suicide bills. It changed the language to hide the reality of the bill and to cover up that it still required falsification of the death certificate.

Stephen Mendolsohn

Stephen Mendolsohn from Second Thoughts Connecticut stated in his testimony:

No amount of change in bill language can change the fact that some people will suffer  prolonged and agonizing deaths from the experimental lethal drug cocktails, with some even regaining consciousness only to die of their terminal illness. Nothing can change the fact that the currently most widely used lethal compound, DDMA / DDMA-Ph, contains amitriptyline, which burns the throat. Medical science cannot guarantee the peaceful death proponents claim. If lethal injections administered for capital punishment have resulted in inhumane deaths, oral ingestion of lethal drug compounds is far more likely to do so. We may put our pets down without their consent and for bad reasons—because they are unwanted or have behavior problems—but at least we do not make them ingest these experimental lethal compounds and make them suffer even more in the process.

No change in language can change the deadly mix between assisted suicide and a broken health care and home care system. As the cheapest “treatment,” assisted suicide diminishes choice, and especially so for people of color, disabled people, and others who have been historically marginalized in our health care system.

No change in language can change the problem of misdiagnosis or the unreliability of terminal prognosis. Jeanette Hall, John Norton, and Rahamim Melamed-Cohen have outlived ostensibly terminal prognoses by decades. All three became staunch opponents of assisted suicide.

No change in language alters the fact that offering suicide prevention to most people while offering suicide assistance (redefined as “aid in dying”) to an ever-widening subset of disabled people is lethal disability discrimination.

The changes that have been made in the bill from previous years are ineffective and do nothing to protect against mistakes, coercion, and abuse.

The EPC-USA testimony against SB 88 stated:

• The Bill allows Assisted Suicide with elastic and meaningless “safeguards.”
• Assisted Suicide is not about pain or receiving a peaceful death; both are myths.
• Assisted Suicide spawns more suicides and attempted suicides.
• Insurance companies use Assisted Suicide to deny coverage for curative life-saving treatments, offering to pay for Assisted Suicide instead. This raises equity concerns.

Thank you to everyone who helped to once again defeat assisted suicide in Connecticut.

Swiss Assisted Suicide Clinic facing lawsuit and questions concerning foreign suicides

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The shocking news that two healthy American sisters died by assisted suicide in Switzerland is opening new questions about assisted suicide and the Pegasos suicide clinic.

On March 23 I wrote about the deaths of Lila Ammouri (54) and Susan Frazier (49) were sisters who traveled from Phoenix Arizona to Basel, Switzerland on February 3, and died by assisted suicide on February 11 at the Pegasos suicide clinic.

Article: Swiss assisted suicide clinic provides death for $11,000.

An article by Barbie Latza Nadeau that was published by the Daily Beast on April 4 further investigates into the Pegasos suicide clinic and uncovers a lawsuit that was launched by the family of Krista Atkins who died by assisted suicide at the Pegasos clinic in June 2020.

Nadeau wrote in her article:

The story of the Arizona sisters has started a global conversation about the ethics of high-dollar assisted suicide for those who are not terminally ill. Harry Nelson, a health lawyer in the United States, and author of The United States of Opioids: A Prescription for Liberating A Nation in Pain, told The Daily Beast that he hopes media attention given to the Arizona sisters will shame Switzerland into changing its rules, which allow foreigners to engage in what he calls “suicide tourism.”

Nadeau then outlines several inconsistencies with the deaths of Ammouri and Frazier including inconsistent messages from the sisters and continues with information about the lawsuit that has been filed by the family of Krista Atkins.

Pegasos is currently embroiled in a legal suit with family members of another client, Krista Atkins, an American who Nitschke confirms hired the clinic in June of 2020. A family member told The Daily Beast her bank records show that she paid $15,000 to Pegasos between November 2019 and May 2020, and an additional $2,500 to Flemming Schollaart, founder of the Right to Die Society in Denmark, who they say drove from Denmark to Zurich airport to meet her and served as the witness—a requirement by Pegasos. The Daily Beast sent emails and left messages with the Right to Die Society but did not receive a response.

Atkins’ scheduled death happened at a time when international travel was restricted by COVID-19, which raises questions about how she was able to get permission to travel to Switzerland. In the legal action Atkins’ brother is filing against the company, it is claimed that Pegasos advised her to use a Red Cross loophole to enter the country for health reasons. The family says that Atkins, who was 40, was physically healthy but suffered from alcoholism and severe mental illness with suicidal ideation, which she did not disclose to Ruedi Habegger of Pegasos.

Shortly before her death, the family claims to have reached out to Pegasos and informed them of Atkins’ history with mental illness—complete with a letter stating there were medical records of her hospitalizations in the U.S. Nitschke, who also helped facilitate Atkins’ death, confirmed that the family was angry. “She has an unhappy brother who is a professor of medicine, and he did not take it well,” Nitschke told The Daily Beast, adding that he regretted the legal entanglement the parties were in.

It is important to note the involvement of Philip Nitschke with the Pegasos suicide clinic in Switzerland. Nitschke is a long time promoter of suicide including troubed teens. Nadeau continues:

Atkins’ family members are livid after alleging that their mental health warnings were ignored. “While I understand Pegasos’ service may seem altruistic, I believe their vetting process is too loose and needs to be tightened, especially in cases involving those suffering from mental illness. While Krista may have mentioned her depression to Ruedi in her application, she did not fully disclose to Pegasos the severity of her mental illness diagnosis which resulted in her hospitalization in a psychiatric hospital in early 2020,” the family told The Daily Beast. Pegasus and Exit International do not dispute that Atkins paid for their services, but say she passed all their requirements–and confirm that she paid her fee in full.

It is true that Switzerland has never had a residency requirement for people who die by assisted suicide. The deaths at Swiss assisted suicide clinics are particularly concerning now that Oregon has decided to remove its residency requirement. Many states have, year after year, rejected bills to legalize assisted suicide and now Oregon will make it possible for people to fly to Oregon, like Switzerland, to die by assisted suicide. 

Article: Oregon extends assisted suicide nationally by eliminating residency requirement.

It is my hope that people will realize how assisted suicide undermines protection in law for vulnerable people and it is a form of abandonment of people at their greatest time of need.

Great news: Delta Hospice Society elects Board of Directors who oppose euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Great news: More than 75% of the members of the Delta Hospice Society voted to elect a new board that oppose euthanasia (MAiD) and they also supported the amendment to the constitution and bylaws for the group. Many supporters of the Euthanasia Prevention Coalition are also members of the Delta Hospice Society.

In February 2021, the BC Ministry of Health defunded the Delta Hospice Society (DHS) and expropriated it's 10 bed hospice building because the DHS refused to participate in euthanasia (Link).

On Saturday, March 26, an online meeting was held for the Delta Hospice Society members to vote on a new board of directors and a revised constitution and bylaws to ensure that Delta Hospice Society provides palliative care that affirms life to its natural end. The March 26 meeting was not finished and was completed on April 2.

There were issues with the online platform but everyone who joined the meeting were able to vote online or by phone.

I was elected to the DHS Board of Directors. The Euthanasia Prevention Coalition supports the direction and goals of the Delta Hospice Society.

The Delta Hospice Society will soon initiate its plans to create an independent hospice that is privately funded and does not provide euthanasia (MAiD). The DHS is committed to creating safe places for people to die.

Euthanasia (MAiD): Nothing about this felt OK.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ferrukh Faruqui is a Ottawa physician and freelance writer who wrote an essay examining how expanding eligibility for medical assistance in dying (MAiD) to those with non-terminal conditions is throwing the medical community into civil war. Faruqui's article was published by the National Post on April 1, 2022.

Dr Faruqui begins her essay by writing about the death of Alan Nichols, who died by MAiD in July 2019. Faruqui interviews Alan's brother Gary and sister-in-law Trish who maintain that Alan was not of sound mind and not terminally ill, nonetheless he died by MAiD.

Faruqui writes:

Alan was once “a bloody great goalie,” says Gary. But he faced a lifetime of challenges after his first brain surgery for a benign tumour at age 12 left him with a weak right side and hearing loss. Step by step, he learned to grasp a pencil and write with his left hand before completing high school.

Alan gave up hockey and picked up a Pentax camera instead. He became a loner who shot film, including beautiful prints for his parents’ silver wedding anniversary. He worked for years as a janitor before things got bad.

As an adult, he depended on his family for emotional as well as practical support. Once, when he didn’t show up for dinner and refused to open his door, they called a locksmith. When they rushed inside, they found him waiting in bed. “I knew someone would show up,” he said.

He was suspicious of authorities, refusing to accept his disability cheques. The family tried unsuccessfully to obtain guardianship over his affairs. His brother, Wayne, picked him up weekly to buy groceries and do his banking.

In June, alerted by his neighbour, Sharon, RCMP officers found Alan dehydrated and delirious. They quickly transported him to the hospital, where he was admitted under the Mental Health Act. Gary flew out to Chilliwack immediately. He was concerned but figured things would play out as usual — it wasn’t the first time Alan’s baseline depression plummeted and landed him in hospital. But he always got better, returning to his small, sparsely furnished condo, where Sharon kept an eye on him.

Alan & Gary Nichols

Faruqui explains that after entering the hospital, Alan stayed in the psychiatric unit for 5 days and was then released to the regular ward but uncharacteristically, this time Alan refused to speak to his family.

After five days in the psychiatric unit, Alan was discharged to the regular ward. Uncharacteristically, he refused to see or speak with his family. When reached by phone, staff assured them he was improving. On July 22, a doctor called Gary to say that Alan was scheduled to die in four days by medical assistance in dying.

Gary started to cry. How could a suicidal man who’d been involuntarily admitted be eligible for MAiD? He wasn’t facing imminent death. Despite the family’s pleas, the hospital insisted this was Alan’s decision, that his medical records were confidential, and they were lucky that Alan had grudgingly agreed to let them know.

A few days later, Gary and Trish, who’d spent decades helping Alan live, watched him die.

Faruqui explains that the family were not provided with answers to the decision to approve Alan's death.

A year later, despite getting legal advice and pressing the hospital and coroner for answers, they’re no further ahead. The Fraser Valley Health Authority told them the law doesn’t require patients to be actively dying to be eligible for MAiD.

Gary’s not a rich man and lawyers are expensive. He says he’s haunted by how families are shut out of these crucial decisions. He says Alan could have lived longer, that the system erred terribly. When he called Wayne to tell him what happened, Wayne was stunned.

“They killed our brother.”

Faruqui writes:

Gary Nichols’ grief demonstrates the heartache medical assistance in dying can inflict on family members. For many doctors like myself who’ve sworn to uphold life, decriminalizing the deliberate act of ending a patient’s life is an ethical turning point that’s transformed the very nature of the profession.

Faruqui explains how Canada's euthanasia (MAiD) law came to be. How the Supreme Court struck down the prohibition on euthanasia and assisted suicide. How the government passed Bill C-14 in June 2016. How the Truchon case, challenging the "terminal illness" requirement in the law was heard and decided in Québec, and how the current government expanded euthanasia (MAiD) by passing Bill C-7 in March 2021, a bill that removed the "terminal illness" requirement, eliminated the 10-day waiting period for terminally ill people and approved euthanasia for mental illness alone. She continues:

For millennia, it’s been taboo for doctors to kill their patients. In many places it still is. As western societies hurled off the shackles of religious authoritarianism, an ethical void was created. This gap’s been filled by humanist creeds that teach that the greatest good flows from personal independence. This libertarian ideal posits the individual as the master of his universe, however lonely that universe may be.

Dr Sonu Gaind

Faruqui writes that many physicians who oppose MAiD are silent for fear of repercussions, but now the issue has moved to euthanasia for mental illness putting psychiatrists on the line. She interviews Dr Sonu Gaind, a psychiatrist who doesn't oppose euthanasia in general but opposes euthanasia for mental illness. She writes:

Dr. Sonu Gaind is troubled, too. A professor at the University of Toronto, he’s not a conscientious objector. In fact, at the Humber River Hospital where he’s head of psychiatry, he’s the physician chair of the MAiD committee. He emphasizes that he’s speaking on his own behalf as an individual psychiatrist.

Pretending there’s no difference between physical as opposed to mental illness for the purposes of MAiD borders on “delusional,” he says. He can’t fathom why the statement of the Canadian Psychiatric Association, which declares that excluding access to MAiD for mental illness is discriminatory, makes no mention of the troubling suicidality that characterizes untreated psychiatric illness.

Language crystallizes key concepts of sweeping movements that reshape societies. But it can also mislead and flatten knotty issues such as euthanasia. Terms like discrimination and autonomy become missiles, annihilating debate. Offering death to the mentally ill, whose unique symptomatology includes pathological despair, is both illogical and unjust.

Faruqui further explains why Gaind opposes euthanasia for mental illness.

Gaind’s Senate testimony emphasized psychiatry’s essential incompatibility with the “irremediable” element of the MAiD framework. Society should recognize and address this contradiction, he insists. Doing otherwise is an exercise in obfuscation. Cardiologists know how heart disease works. But psychiatry hasn’t elucidated the pathophysiology of depression or schizophrenia. It’s impossible for clinicians to predict prognosis in individual cases, meaning that some who seek death would have gotten better.

He cites metrics that show a demographic divide. Those terminal patients who’ve lived a good life and have the privileged autonomy to choose a “good” death are overwhelmingly white and affluent. Unfortunately, their rights magnify the vulnerability of those who’ve never had a good shot at life. In the Netherlands, those marginalized by poverty and trauma are the ones seeking psychiatric euthanasia. Of these, 70 per cent are women. Gaind says these sad, lonely individuals need suicide prevention, which costs time and money and is mostly unavailable. Instead of the “right to die,” he wants to legislate the “right to live.” As for personal choice, he calls it a cruel fallacy. Guaranteed access to death in the setting of absent mental health treatment is no choice at all.

“You shift to MAiD to avoid a painful death — then you shift to MAiD to avoid a painful life. It’s like a Jenga tower — when you pull out one block, the tower comes tumbling down. It’s all connected.”

Faruqui writes that Gaind has now been suspended from the Canadian Psychiatric Association, a group the he is a past President, based on his opposition to their support for euthanasia for mental illness.

Faruqui then writes about the euthanasia death of Arthur Cole.

Jayde Curts’s long hair frames her sombre face. One November afternoon in 2020, she sat alone in her London, Ont., living room, cut off from the rest of her family. She heard the clock strike one. She remembers thinking, “I guess my grandpa’s dead now.”

She refused to attend his scheduled death by MAiD. She says her mother wouldn’t discuss it afterwards, while her grandmother isolated herself and refused to talk about it. Jayde says it didn’t feel right.

“Nothing about this felt OK,” she says. “It felt like putting a dog down.”

Her grandfather, Arthur Cole, was in his 80s. During surgery for thyroid cancer, doctors discovered it had spread. After being discharged home with a tracheostomy and without home care, his elderly wife had trouble managing the breathing tube. When the cancer spread to his brain, he requested home palliative care but was told it wasn’t available. Instead, a doctor offered to make a house call to administer MAiD.

Jayde says that her grand father did not receive the care that he needed and the decision has divided her family.

His granddaughter says Arthur worried aloud about burdening his family. Post-surgery, breathing through a tube, Jayde questions his psychological competence to make the critical decision to end his life.

“You read about this in the news. But it’s shocking when it happens to your family,” she says. She’s paid a heavy price for her outspokenness. She no longer speaks to her mother or her grandmother. She regrets the estrangement but stands by her conviction that the medical system blundered badly.

“They played on his emotions … He was vulnerable and it feels like they took advantage of him,” she says. She wonders why the health system offered death instead of help. She wants people to hear Arthur’s story so other families can speak up, too.

Faruqui then interviews Dr Balfour Mount the father of palliative care in Canada, who trained under Cicily Saunders, who developed modern palliative care. Faruqui writes:

Dr. Balfour Mount is the retired father of Canadian palliative care...

“Total pain” encompasses suffering across dimensions, especially the spiritual, where conventional medicine falters. Palliation supports patients through the arc of incurable conditions such as multiple sclerosis and heart failure. Mount believes the simple act of being present soothes existential pain and chases dread away, that once we slow down to appreciate each moment, the end of life holds infinite potential for joy. He once explained, “When pain and other symptoms are controlled, there really is limitless potential for quality of life at the end of life. … It’s not about ending things; it’s about the present moment. That’s all that any of us have — is just now. And, it turns out, that there’s endless potential in the present moment.”

Mount does not support (MAiD) euthanasia.

He calls MAiD a euphemism that confuses the public and muddies both the benefits of palliative care and the reality of euthanasia. He’s endorsed a joint statement by the Canadian Society of Palliative Care Physicians and the Canadian Hospice Palliative Care Association that rejects conflation of the respective practices, which are distinct in philosophy and intent. The latter exists purely to hasten death, while the former focuses on enhancing life.

Faruqui then speaks to Dr Leonie Herx, the past President of Canadian Society of Palliative Care Physicians, who lives in Kingston. Farququi writes:

“We’ve come so far in palliative care,” she says, adding that many patients either fear palliation will accelerate their deaths, don’t realize MAiD is a lethal injection, or both. She laments that even colleagues don’t appreciate how effective early palliation can be. Because of its absence from the conversation, too many patients opt for MAiD instead.

Herx has presented before parliamentary committee's and laments the quick expansion of MAiD. But not without a cost. Faruqui writes:

She’s withstood relentless attacks on her professional integrity by other physicians. She’s weary, despairing even as she wades into dangerous waters, citing hospital colleagues who complain they’re pressured, even bullied into going along with policies that trouble them. Doctors across the country call her to report that some MAiD providers refuse to assume transfer of care as the “most responsible physician,” thereby implicating them in a practice they are philosophically opposed to. Some institutions, perhaps lacking sufficient MAiD providers, even expect the MRP-conscientious objectors to conduct the initial MAiD assessment. All worry about professional ramifications. Some who’ve voiced doubts about MAiD in certain clinical scenarios have been called obstructionist, of trying to block access to a legal service. There’s no protection for whistleblowers. She knows of many doctors who’ve left the specialty or retired early. Her colleagues know of more. Some have left medicine for good. But they’re not talking. Few were willing to speak to me.

Herx is concerned that the pressure to participate in MAiD may cause her to leave medicine.

Herx warns that the implications of C-7, which expands MAiD from terminal to chronic conditions, will fan out to involve doctors across specialties. This tightening of the moral screw will likely precipitate more departures from the profession. With effective referral, mandated in only two provinces — Ontario and Nova Scotia — the pressure on these doctors to participate may become unbearable.

She describes the loss of moral integrity, “which is how we keep our resilience in medicine.” Dispensing with medical care to offer MAiD amps up moral distress. Herx speaks almost dispassionately about how she might have to quit medicine to avoid complicity.

Faruqui then interviews Dr. Karen Ethans who directs the Spinal Cord Unit at Winnipeg’s Health Sciences Centre, who says that she has seen patients being counselled to die by MAiD.

“My biggest concern,” she says, “is that people can’t initially see what their quality of life will be once they’ve adapted to their injury.”

It takes six months just to get out of the hospital, to go through denial and grief. Then comes vocational rehabilitation. Patients on ventilators within a week of injury are sometimes told their quality of life as quadriplegics will be poor, to turn off their breathing machines. One young man’s weeping mother followed Ethans outside the intensive care unit, looking for hope. Four months later, her son walked out of the hospital.

“Why does it have to be doctors involved in giving death serums?” she asks. Many of her colleagues are angry. They believe doctors should not be doing this work.

Faruqui continues her essay by speaking to the Nichols family again about the death of their brother Alan.

After the numbness wore off, the hurt set in, uneasy layers roiled by a gathering rage. Gary says that Alan wasn’t of sound mind, that his case warrants a thorough review. He’s bewildered by how patient confidentiality can trump common sense, bypassing grieving families in life-and-death scenarios such as MAiD.

Each institution they’ve appealed to for a review of Alan’s case denies jurisdiction. That includes the RCMP, the coroner’s office, the provincial and federal ministries of health and B.C.’s College of Physicians and Surgeons. Doors keep slamming shut. “They Ping-Pong you” back and forth, he says.

Faruqui then interviews Dr Stefanie Green, the President of the Canadian Association of MAiD Assessors and Providers (CAMAP) who clearly supports euthanasia and all the changes associated with the law.

Faruqui then tells the story of Elizabeth (71) a retired teacher in the United States who has lives with chronic pain for 30 years. Faruqui explains:

Elizabeth lays it out for me. She confesses that although she’s a devout Catholic, she plans to seek MAiD once her pain becomes unbearable, or she loses her independence. It’s not that she wants a doctor to put her to death. It’s that she has no other choice. She can’t move to the U.S. because, among other things, she’ll lose her pain specialist. And she can’t ask her son to upend his life for her. She says she’s a member of the growing ranks of the forgotten elderly, dismissed because they’re no longer productive.

“Rights don’t apply to us,” she says. “Our lives are cheap because we’re non-contributors.”

The inequalities in society scare her. She won’t use her real name because she hasn’t told her son yet. He’s an only child. She doesn’t want him to feel abandoned.

Faruqui then interviews Dr Sandy Buchman, a past President of the Canadian Medical Association, a palliative care physician and a (MAiD) provider. Buchman explains that with the passing of Bill C-7 he will limit his euthanasia practise to people who are terminally ill.

Faruqui continues her essay by speaking with Dr Natalia Novosedlik who opposes euthanasia but did refer a patient against her conscience. Faruqui writes:

“I oppose euthanasia in any case.” She says there’s a human need for contemplation, that this bill has been “rushed.”

She pauses. “Sometimes a picture is painted of MAiD being beautiful. The cases I saw — one involved pronounced social isolation — these deaths were not beautiful.”

She felt cornered by a patient who refused symptom management and insisted on a MAiD referral. Although he ultimately died naturally, she was terrified that every new patient would request MAiD. The anxiety was unrelenting.

“I knew I couldn’t do this again, it was so emotionally draining,” she says, so after the birth of her second child, she didn’t return to work.

When care coordination came up, many doctors asked to be taken off the list of providers and assessors. She feels guilty about pulling back, leaving patients to suffer. She hopes to eventually resume practice in a different field.

Faruqui then interviews Dr Mark D'Souza, who stopped being a palliative care doctor after euthanasia was legalized because of the pressure to participate in MAiD.

He couldn’t square his conscience with MAiD, a term he pronounces “Orwellian,” a form of “doublespeak” that’s critical to what he describes as the marketing of death. He calls such terms euphemisms for what’s really going on, which is “killing our patients,” so he settles for euthanasia, a less inflammatory term. He’s convinced that doctors have lost their way, that the radical left has taken over the profession. There’s an embargo on debating, much less opposing MAiD. He’s not sanguine about the profession, saying we “aren’t leaders anymore.

Dr. Viren Naik, the medical lead for Ottawa's Hospital's MAiD team admitted that only 5 of the 30 euthanasia providers are willing to participate in MAiD for people who are not terminally ill.

He describes how medically and ethically complex these patients are, and how emotionally taxing for clinicians, who question whether their MAiD requests are driven by underlying illness or vulnerability. He predicts that this exquisite challenge, what he terms “a grey area of practice,” will become more fraught once psychiatric MAiD is factored into the mix.

One MAiD providing doctor, who wished to remain anonymous, told Faruqui that research needs to be done on the effect of MAiD on the providers.

As Faruqui is closing her essay she states:

The doctors I spoke to are driven by altruism. Their compassion is compelling. But a number of MAiD providers refuse to offer death to those who aren’t dying. Personal autonomy as the overriding principle in this discourse overlooks the reality that state-sanctioned MAiD is not an autonomous act; involving doctors sanitizes it, makes it more palatable for everyone: lawmakers, patients, and society.

Faruqui quotes from Dr Herx who sees the changes in law as causing a schism in healthcare.

In the headlong rush to satisfy the individualistic need for control, we’ve glossed over MAiD’s practical, philosophical and moral harms. We’re on the cusp of sanctioning the deaths of the most helpless members of society — the mentally ill, children and the elderly — instead of caring for them. That existential nadir, when we’ve outlived our usefulness, is exactly when we should not, cannot abandon each other.

Faruqui ends her essay as she began it, with the Nichols family. Gary Nichols, Alan's brother states:

His family’s faced roadblock after roadblock. But they’re pushing on. The RCMP have opened a new case file. The Nichols family is angry at the way Alan — in equal measures volatile and vulnerable — was dispatched to death. They’re furious at the doctors who approved MAiD and the politicians who enacted the legislation that permits it. He says a lot of people care about this issue, but “so far, there’s been no accountability.” They’re fighting for safeguards to prevent the abuse of patient confidentiality by the profession.

If all else fails, Gary’s considering posting a YouTube video to warn complacent Canadians what can happen to them or their families under Bill C-7.

“We can’t save Alan now, Alan’s gone,” he concedes. “We’re trying to make some noise here to prevent other families going through this.”

Thank you Dr Ferrukh Faruqui.