New organ transplant procedure violates the dead donor rule

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Sharon Kirkey wrote an indepth article for the National Post that was published on October 19 concerning the new organ transplant procedure that is challenging ethical guidelines. Kirkey explains:

The procedure, known as normothermic regional perfusion (NRP) is already legal in some jurisdictions, outlawed in others and has medical ethicists split over whether it invalidates the declaration of death and violates the dead donor rule, which holds that organs should only be taken from dead patients.

Kirkey states that the Canadian transplant community is getting ready to adopt the new procedure. Kirkey explains the development of organ donation.

Organs were once only ever removed from donors declared brain dead, which is defined as the complete and irreversible loss of all brain function. They’re medically and legally dead, but their hearts are still beating. A ventilator keeps oxygen flowing to the heart and other organs until they can be retrieved for transplant.

In 2006, doctors began removing organs from “controlled circulatory death” donors, people who aren’t brain dead but whose prospects for recovery are so grim a decision is made to withdraw life support.

Life support is removed and, after the heart stops and surgeons wait an obligatory five-minute “no touch” period to ensure the heart has permanently ceased beating, organ procurement can begin.

Kirkey explains how traditional organ donation procedures cause the organs to start dying, Kirkey explains:

The difficulty is that the heart and other organs are starved of oxygen and nutrients during the dying process and the mandated waiting period. The heart is especially sensitive to warm ischemia time, time without blood flow and oxygen. Organs can become unsuitable for transplant or take longer to recover once put inside the recipient than they would have “if they’d been getting blood flow the whole time,” said Toronto nephrologist Dr. Jeffrey Schiff, president of the Canadian Society of Transplantation.

Dr Schiff explains, that the same problem does not exist for NPR because the blood continues to flow to the vital organs. Kirkey writes:

With NRP, once death is declared, the major arteries supplying blood to the brain are clamped and tied off. The donor is quickly connected, via cannulas placed inside large blood vessels, to a machine that funnels their blood into a device that adds oxygen and removes carbon dioxide before pumping it back into the body. The goal is to reverse damage to the organs and improve their function.

The obvious problem with NRP is that it may violate the dead donor rule because the person is intentionally allowed to die, then declared dead, and then the body is revived but the blood supply is clamped off from the brain.

When you revive the body for the purpose of organ donation but deny blood to the brain to ensure brain death, then you are intentionally not permitting a person to live, who may have continued to live.

Kirkey explains how the American College of Physicians have asked that NPR be stopped. She writes:

The American College of Physicians, which wants the use of NRP to be paused, argues that by restarting circulation, even artificially, NRP undermines the validity of the definition of circulatory death because “the patient is, in fact, successfully resuscitated.”

Critics also say NRP challenges the dead donor rule, which holds that donors can’t be made dead to obtain their organs and that organ retrieval can’t cause death. By cutting off blood flow to the brain, the doctors’ college argues, “the patient is now dead by brain death criteria — due to actions taken by the physicians procuring the organs.”

Kirkey also interviews Dr Charles Weijer, a professor of medicine and philosophy at Western University who does not oppose NPR but has concerns about whether the technique blocks off all blood to the brain, meaning that it may be possible that the person's brain reanimates while the organ retrieval process is occuring.

An article written by Bioethicist Wesley Smith and published in the Epoch Times on October 17 stated:

This is a terrible mistake. If a patient is resuscitated after cardiac arrest, the person is not dead! Cutting off blood flow to the brain to cause brain death thereafter seems awfully close to reviving the patient and then killing him. This is not only immoral—and arguably illegal as a violation of the DDR—but it also represents another in a long series of violations that have bred so much public distrust in institutions.

I wrote an article on this topic on September 29 which stated:

The new organ donation method ignores the "dead donor rule." What this means is that people who are possibly dying or nearly dead could be essentially killed for their organs. Several factors that are driving this change are that living donors provide healthier organs for transplant; the medical community is rejecting the concept of "do no harm;" and the demand for healthier organs for donation are fulfilled by this procedure.

People who oppose killing will not be able to trust the ethics of organ donation. It is not that I oppose donating organs after death, it is that I cannot be assured that I am dead when the organs are removed.

This technique ignores the dead donor rule and paves the way for euthanasia by organ donation.

Canada's euthanasia (MAiD) regime will be the most permissive in the world.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

61 per cent of Canadians -- are unsure or don’t support MAiD for those waiting for care.

Canada's euthanasia (MAiD) regime is the most permissive in the world, with the exception of child euthanasia. The recent W5 investigative report by Avis Favaro focuses on people who want to die by euthanasia for mental illness; the doctors who are willing to kill patients with mental illness; and those who recognize the serious problem with killing people by euthanasia for mental illness.

When Canada's parliament passed Bill C-7 in March 2021 one of the expansions to the euthanasia law was it allowed euthanasia for mental illness alone, but the government established a two-year moratorium on euthanasia for mental illness in order to establish protocols around the killing.

On the pro-euthanasia side of the equation, Favaro interviews John Scully (81) who is a retired journalist who has struggled with depression for 35 years. Scully wants to die by euthanasia for mental illness after the two year moratorium is lifted in March 2023.

Favaro also interviewed Dr Ellen Wiebe, one of Canada's most outspoken euthanasia doctors, who operates a euthanasia clinic in Vancouver. Wiebe who says that she had killed 400 people by euthanasia told Favaro that:

"Mental illness and Physical illness both can cause unbearable suffering."

Favaro interviewed Mitchell Tremblay (40) who has been living with depression for many years. Favaro reports:

...he was diagnosed with severe depression as a teen and he also deals with anxiety, alcoholism, personality disorders and continual thoughts of suicide. He can’t work and lives in poverty on a disability payment of just under $1,200 a month.

"You know what your life is worth to you. And mine is worthless,"

Mitchell is seeking euthanasia because of depression but he is also living in poverty.

Dr John Maher

"But some experts warn Canada is about to offer what they say will amount to "state sanctioned suicide" for the mentally ill.

Favaro interviewed psychiatrist, Dr John Maher, who focuses on suicide prevention. Maher said:

"I had a patient who talked to me recently about MAiD who wants to die because of his belief no one will ever love him,"

He says colleagues have shared similar stories of patients in their care, enquiring about how to stop therapy and qualify for assisted death.

Maher told Favaro that patients may wait up to five years for treatment. Maher says:

"There are cycles of illness... Some of it's up and down. It might be years. And then there's a burst of illness and suffering that we then take care of,”

“You're assisting someone in the completion of their suicide. The doctor is the sanitized gun,"

"I'm not at all disagreeing that there are people who have an irremediable illness. What I defy you or any other person in the universe to prove to me is that it's this person in front of you.”

Serena Bains

Favaro interviews Serena Bains, who lives with severe depression, anxiety and borderline personality disorder. Bains is afraid that she will die by euthanasia when she is at a low time in her life. Favaro reports:

Her worry is that if she spirals downward and hits a rough patch she might be suicidal enough to ask for MAiD and qualify.

"A lot of the conditions I have ... they're perceived as being severe. They've been consistent. I've had them since I was a teenager," she says.

Serena’s been on a waitlist to see psychiatrists multiple times. "This year it took, like, a year and three months,"

Bains told Favaro that the mental health system in Canada is broken. Dr Wiebe achnowledged that there are problems with Canada's mental health system but she said that it doesn’t mean patients shouldn’t be eligible for assisted death.

Favaro then refered to a CTV news Nanos poll that indicated that 61 per cent -- almost two-thirds of Canadians -- are unsure or don’t support MAiD for those waiting for care.

Dr Scott Kim

Favaro completes her investigative report by interviewing bioethicist and Washington based psychiatrist Dr. Scott Kim who says that Canada is about to become the most liberal country in the world in allowing those with mental disorders to access assisted death. Favaro reports:

Dr. Kim has been studying psychiatric euthanasia and its use in countries such as Belgium and the Netherlands, where it’s been practised for two decades.

Both countries have more stringent requirements for proving an illness is irremediable, says Dr. Kim, by requiring psychiatric input and putting more emphasis on trying additional therapies than is recommended in Canada.

Belgium also has a two-track system in which patients and doctors look for potential therapy and treatments, while another team assesses the patient for MAiD.

The rates of approval for psychiatric illnesses in Belgium and the Netherlands are low, says Dr. Kim, ranging from just one to three per cent.

“The large majority are rejected,” he says. "Overwhelmingly, the main reason is there are other alternatives."

Dr Wiebe told Favaro that assessors will review what treatments patients have received but treatments can't be forced on anyone.

Wiebe is correct that treatment is voluntary, but the protocols in the Netherlands and Belgium indicate that if a person rejects effective treatment then they will not be considered for MAiD.

The Euthanasia Preventino Coalition opposes all forms of euthanasia and assisted suicide because we reject the concept that medical practitioners should have the right in law to kill their patients. Nonetheless we thank Favaro and W5 for covering the issue of euthanasia for mental illness.

23-year-old Belgian woman with PTSD dies by euthanasia creating a global scandal

Alex Schadenberg

Executive Director,
Euthanasia Prevention Coalition

Shanti De Corte

Sue Reid, wrote an article in the Daily Mail on October 16 about the world-wide reaction to the euthanasia death of Shanti De Corte, the 23-year-old who died by euthanasia in Belgium in May because she was living with PTSD after a ISIS bombing attack 7 years earlier.

• Belgium euthanasia for 23-year-old PTSD ISIS Terrorist Victim (Link). 
• Belgian Neurologist challenges euthanasia death of 23-year-old with PTSD (Link).
  

Reid, reporting for the Daily Mail explains:

Yet the small country is embroiled in a huge controversy, after it emerged that a 23-year-old woman called Shanti De Corte had chosen to end her life in May this year, with the support of her middle-class parents Peter and Marielle. She was suffering from depression and ‘unbearable’ mental distress. She had never recovered from being caught up in the Isis terror bombing of Brussels airport in 2016 as she waited to board a plane to Rome on a school trip.

Shanti, who was then 17, escaped the explosion in the departure hall physically unscathed but many others were less fortunate. No fewer than 32 innocent people were killed and hundreds injured.

Shanti escaped physical injury from the terrorist attack but she continued to live with PTSD. Shanti received treatment but never recovered from the trauma. But when Shanti sought a death by euthanasia, her parents were supportive of the decision.

De Corte's death has had international ramifications. Reid explains:

The revelation that Shanti chose death because of a mental health problem, rather than as a result of suffering a painful or terminal physical disease, has now provoked Belgian prosecutors to investigate her case.

They acted after a Brussels neurologist, Paul Deltenre, complained that she was euthanised ‘prematurely’. The neurologist said there were treatments and care options that had not been tried or explored.

Whatever the truth of this, the case has led anti-euthanasia campaigners to renew claims that, if a young woman who has everything ahead of her can so easily opt to end her life by a doctor’s injection, the country’s assisted-dying law is too liberal.

Godelieve de Troyer

The article explains the state of euthanasia in several jurisdictions. Reid comments on the recent Human Rights decision concerning the euthanasia death of Godelieve de Troyer, who died by euthanasia in 2011 because she had experienced chronic depression.

The European Court of Human Rights (ECHR) slammed the country earlier this month after a 64-year-old woman called Godelieve de Troyer, who suffered from chronic depression, persuaded doctors to euthanise her without the knowledge of her family.

In a damning judgment, the ECHR ruled that the country’s federal euthanasia commission had violated Godelieve’s right to life by failing to examine her case properly after her son, Tom Mortier, complained to the ruling body about the manner of his mother’s death.

His lawyers say she was physically healthy and her own doctor of more than 20 years had denied her request to be euthanised. But she had made a €2,500 donation to an end-of-life organisation which helped organise the procedure in 2012, according to ECHR documents.

Mr Mortier, who is still distressed about the case, has said: ‘My mother was treated for years by psychiatrists and, sadly, she and I lost contact for some time. It was during this period that she died. Never could I have imagined that we would be parted for ever.’

He has revealed that the first he knew of his mother’s death was 24 hours after it had happened, when his wife received a phone call from the hospital telling the family to collect his mother’s belongings and make funeral arrangements. ‘Euthanasia inflicts immense harm on people in vulnerable situations contemplating ending their lives, but also their families,’ he said in a series of European TV interviews and media statements.

Tine Nys with her sisters

Reid writes of Tine Nys, who died by euthanasia because she was autistic, but her family claims that Nys wanted euthanasia after a broken relationship.

        Another high-profile civil case is under way in                        Belgium over the euthanasia of a 38-year-old woman         called Tine Nys who, according to her three doctors,            was suffering ‘unbearable psychological pain’ when she died.

The medics, who argued that they acted in good faith, were each cleared of murder in 2020 despite poisoning Ms Nys when she asked them to kill her in the aftermath of a broken relationship.

Her two sisters, Sophie and Lotte, argue that her condition fell short of an ‘incurable’ mental disorder. They want the key doctor who administered an injection to Tine to pay compensation to their family for what they have told Flemish TV was a botched procedure ‘carried out in an amateurish way’ on someone who had not had psychiatric treatment for 15 years’.

In a Flemish TV interview, the sisters said: ‘He [the doctor] also asked our father to hold the needle in her arm because he had forgotten to bring plasters. When she had died, he asked our parents if they wanted to listen through the stethoscope to check her heart had stopped beating.’

Reid writes of Maria De Laet (81) who requested euthanasia after caring for her husband with dementia for 10 years before he died. 

Killing by euthanasia is promoted and approved based on the "hard" cases. Once killing becomes an acceptable solution to human suffering, there will be many more reasons to kill.

We need a caring society not a society that kills.

Don’t Let Doctors Kill Sick Patients for Their Organs

This article was published by the Epoch Times on October 17, 2022

By Wesley Smith

Because of long transplant waiting lists, the bioethics and medical establishments are bent on increasing the source of organs. It has gotten so bad that some of the most influential policy advocates in bioethics now urge that doctors be allowed to do what was once considered unthinkable—kill would-be donors for their organs.

Harvesting vital organs from living patients is illegal under what is known as the “dead donor rule.” The DDR not only prevents removing livers, lungs, hearts, both kidneys, and the like from living people, but its corollary forbids killing patients for the purpose of obtaining them—even if they consent. Thus, the DDR ensures that every prospective organ donor remains a fully equal member of the human community with the right to life until their natural death.

The Dead Donor Rule Under Attack

In recent years, the commitment of organized medicine to the DDR has become so badly frayed that many influential voices are calling for the rule to be repealed altogether. The most recent example was just published in the influential Journal of Medical Ethics. Authored by University of Utah bioethicist Anthony P. Smith (no relation), it urges that doctors be allowed to harvest the vital organs of cognitively disabled people like the late Terri Schiavo—while they are still alive.

Here’s the gist of the argument: What matters most in organ donation isn’t the death of the donor, but consent to harvesting, particularly if the living patient has been diagnosed as permanently unconscious. In such cases, killing is not morally wrong because it doesn’t harm the patient, who Smith says, no longer has “ultimate interests.” He writes, “Without consciousness, a person can have no wants or desires” such as choosing to “buy a house or get married.” This means, Smith argues, that “one cannot be harmed because one has no interests to be thwarted or impeded.”

Really? Taken at face value, Smith’s argument would dehumanize people thought to be unconscious and strip their lives of all meaning. Indeed, it would mean that their beings would not have to be protected—even though there are many cases of the supposedly permanently unconscious unexpectedly awakening or proving to have been misdiagnosed. (One recent study found that one in five patients thought to be unconscious were actually awake. An earlier study pegged that number as up to 40 percent.)

Claiming that unconscious patients could not be harmed would also mean that they would not be wronged by, say, being raped, since they would have no continuing interest in their body’s integrity. And since under Smith’s value system we should be able to kill them for their organs, why not also experiment upon their bodies? After all, their moral value would be reduced to that of yeast.  

Why Bioethics Journals Matter

What’s that you say? Who cares what bioethicists write in their arcane professional journals?

We all should. Bioethical discourse is not akin to bar stool philosophizing. What starts in the Journal of Medical Ethics, the New England Journal of Medicine, the Hastings Center Report, the Journal of the American Medical Association, and other such publications often has real-world impact.

Indeed, such argumentation is often an early step in the creation of public health law. First, “the experts” argue back and forth about policies they would like to see enacted. Once a rough consensus is reached, many of these proposals are legislated into law or imposed bureaucratically via regulation. Sometimes, they become official policy by way of litigation in which bioethicists testify about what “the experts” believe and a judge enacts their ideas in court rulings. As a clear example, this is precisely the process that unleashed the headlong rush to allow transgendered children to have their puberties blocked or be subjected to “gender-affirming” surgeries.

Killing for Organs May Already be Happening

Killing for organs may have already leaped from advocacy to implementation by blurring the line between what is called “brain death” and “heart death.” Dead is dead, we might say, but there are two approaches to declaring that a life has ended. The first is commonly known as “brain death,” which involves the irreversible cessation of the whole brain and each of its functions. The second method is sometimes called “heart death,” meaning irreversible cardiac arrest.

Notice that the key word in declaring death in either case is “irreversible.” If the heart stops but can be started again—as happens routinely in open heart surgery—the patient is not dead. If the seemingly inert brain can still recover function, the patient remains alive. In this way, the dead can be declared deceased, but the still-living won’t be pushed out of the lifeboat until all hope for survival is lost.

Alas, some transplant surgeons have been blurring these crucial moral boundaries by restarting donors’ hearts after a planned cardiac arrest (when life-sustaining treatment is withdrawn) and clamping off blood flow to the brain to cause brain death so that beating hearts can be harvested.

Known as “normothermic regional perfusion with controlled donation after circulatory death” (NRP-cDCD), the procedure is quietly being tested or implemented across the country.

This is a terrible mistake. If a patient is resuscitated after cardiac arrest, the person is not dead! Cutting off blood flow to the brain to cause brain death thereafter seems awfully close to reviving the patient and then killing him. This is not only immoral—and arguably illegal as a violation of the DDR—but it also represents another in a long series of violations that have bred so much public distrust in institutions.

You know what I mean: A controversial policy is instituted with the assurance by “the experts” that “strict guidelines” will protect against abuse—only for those boundaries to be violated or stretched beyond recognition once the policies are firmly in place. Such public policy promise-breaking has become so ubiquitous that one is tempted to believe that all such assurances are merely ruses to allow “the experts” to do whatever they want. Allowing doctors to restart hearts in order to induce brain death calls into question the sincerity of transplant medical ethics.

Thankfully, some in organized medicine—such as the American College of Physicians—are resisting this new approach to organ gathering. But the process seems to be expanding with new hospitals instituting NRP-cDCD protocols on an ongoing basis. That means it’s time for the general public to weigh in and say, “This must stop!”

Some lines should never be crossed. Allowing doctors to kill patients during organ harvesting would not only be an acute threat to the sanctity of life, but I can think of no better way to sow mistrust in our health care system generally—and the lifesaving field of organ transplant medicine specifically. Reducing living patients into so many organ farms ripe for the harvest is not only blatantly immoral, it’s also profoundly unwise.

Ontario man seeks euthanasia to avoid homelessness.

Alex Schadenberg
Executive Director

Euthanasia Prevention Coalition

Cynthia Mulligan and Meredith Bond reported for  CityNews  Toronto on October 14 that Amir Farsoud (54) who lives in St Catharines Ontario is applying for (MAiD) euthanasia because social supports are failing him and he thinks that he has no other choice.

According to the report Farsoud has constant pain from a back injury and he takes medication for depression and anxiety and his quality of life is awful but he is applying for euthanasia because of his fear of becoming homeless. The report states:

But Farsoud said his quality of life is not the reason he is applying for MAiD. He applied because he is currently in danger of losing his housing and fears being homeless over dying. “It’s not my first choice.”

Farsoud lives in a rooming house he shares with two other people, and it is currently up for sale. He is on social assistance and says he can’t find anywhere else to live that he can afford.

“I don’t want to die but I don’t want to be homeless more than I don’t want to die,” shared Farsoud.

When asked what he would decide if he had stable housing, Farsoud states:

“It would be on my radar because my physical condition is only going to get worse,” added Farsoud. “At that point, I would be probably availing myself of the option, but that would be presumably years down the road.”

Mulligan and Bond report:

UN experts released a report in Jan of 2021 that said when “life-ending interventions are normalized for people who are not terminally ill or suffering at the end of their lives, such legislative provisions tend to rest on – or draw strength from – ableist assumptions about the inherent ‘quality of life’ or ‘worth’ of the life of a person with a disability.”

In a letter sent directly to the Government of Canada ahead of the change in MAiD legislation, the UN said it was concerned with the expanded access, specifically citing concern with a circumstance like the one Farsoud faces.

“It is not beyond possibility that, if offered an expanded right as per Bill C-7, persons with disabilities may decide to end their lives because of broader social factors such as loneliness, social isolation and lack of access to quality social services,” read the note.

Farsoud is one of many Canadians with disabilities who are seeking euthanasia based on a lack of medical treatment, poverty or based on a feeling that they have no choice.

Links to more stories of the euthanasia experience in Canada:

• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Manitoba woman died by euthanasia based on inadequate home care (Link).
• Quebec man seeks euthanasia based on changes to home care (Link). 
• Alberta man requests euthanasia based on poverty (Link).
• Ontario man approved for euthanasia because he can't get medical treatment (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

World Medical Association upholds Conscience Protections.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Recently the World Medical Association (WMA) upheld, after much debate, a position respecting conscience rights. Physicians from Canada and other jurisdictions proposed that the World Medical Association change their position to require that physicians provide an effective referral, where euthanasia is legal. An effective referral would require physicians to be complicit in the Act.

Several committed physicians spoke out in support of conscience rights and lobbied national medical associations to uphold conscience rights. These physicians took the time to organize a strong response and to travel to the WMA meetings to support conscience rights. Thank you.

Canada's parliament recently defeated Conscience Rights Bill C-230 based on a party line vote with most of the Conservatives, including Pierre Poilievre, supporting the conscience rights and nearly every Liberal, NDP and Bloc Québécois MP voting against it. How your MP voted on C-230 (Link), the battle for conscience rights is far from over.

The WMA victory underlines the importance of continuing the fight to protect the conscience rights of medical professionals. If conscience rights cannot be protected, at this time, federally, then we will renew our commitment at the provincial or state level.

Conscience rights protect medical professionals from being forced to be complicit in acts that they consider wrong, but conscience rights are also important for patients.

All of us need to be assured, in our time of need, that our doctor will respect our opposition to being killed. You need a physician who respects your values. If you are experiencing a difficult medical condition you may become very depressed and ask for something that you would never otherwise request. You need a physician who is free to protect you at the lowest time of your life.

Conscience rights protect medical professionals and conscience rights protect you.

British nurse charged with serial killing of newborns

This article was published by Bioedge on October 12, 2022

Lucy Letby

By Michael Cook, the editor of Mercatornet.

A 32-year-old nurse is on trial for murdering five new-born babies and attempting to murder 10 others at a hospital in the west of England. 

Lucy Letby, who is now 32, allegedly gave babies extra insulin doses or injected them with air in 2015 and 2016 at the Countess of Chester Hospital. An investigation by hospital staff and police found that the common factor in all the incidents was Ms Letby.

“Prior to January 2015, the statistics for the mortality of babies in the neo-natal unit at the Countess of Chester were comparable to other like units,” the prosecutor told the jury at the beginning of her trial at Manchester Crown Court. “However, over the next 18 months or so, there was a significant rise in the number of babies who were dying and in the number of serious catastrophic collapses.”

Ms. Letby has pleaded not guilty; her trial is expected to last for up to six months.

 

Belgian Neurologist challenges euthanasia death of 23-year-old with PTSD.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Wesley Smith wrote an excellent article that was published on October 7 by National Review online concerning a 23-year-old Belgian woman with PTSD caused by an ISIS Terrorist attack, who died by euthanasia.

An article by Steve Warren that was published by CBNNews on October 10 further examines the story. Warren reported:

A young Belgian woman who survived the Islamic State terror attack in the Brussels airport in 2016 chose to end her own life after suffering from severe depression and PTSD for years following the incident.

Now Belgian prosecutors are investigating the case after receiving complaints from a local neurologist who told them the decision to euthanize Shanti De Corte, 23, "was made prematurely."

Warren explains that De Corte was a 17-year-old high school student when on March 22, 2016 she was traveling with a group of classmates to Italy. The teenagers were walking through the departure lounge of the Belgian airport in Zaventem when Islamic State terrorists detonated a bomb.

Warren states that De Corte had escaped the explosion without any physical wounds. However, the mental toll on the teenager left her with constant panic attacks and periods of dark depression. De Corte was under the care of a psychiatric hospital in her hometown of Antwerp and she was taking anti-depressants, but she tried to kill herself on two separate occasions in 2018 and 2020. De Corte died in May 2022 after two psychiatrists approved her death by euthanasia.

I hope that the Belgian authorities truly investigate this death. The Belgian euthanasia commission lacks effective independence since the chair of the committee also operates a euthanasia clinic. Living with PTSD is a difficult decision but De Corte was very young to be determined to have an "unremittant" condition.

How poverty, not pain, is driving Canadians with disabilities to consider euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Brennan Leffler and Marianne Dimain wrote an indepth research article that was published by Global News on October 8, 2022 titled: How poverty, not pain, is driving Canadians with disabilities to consider medically-assisted death.

Leffler and Dimain (writers) interview people with disabilities who are seeking a death by (MAiD) euthanasia and they examine the wider issue of why people with disabilities are requesting death by euthanasia.

The first person interviewed is Joannie Cowie (52) who lives in Windsor with her daughter, who is a University student who also has a disability. The writers state:

It’s an unmistakable message from the government: if you want to end your life, we’ll help you.

“If you call the number on the government website, they will provide doctors that will sign off for you,” says the 52-year-old resident of Windsor, Ont.

“They can have me dead in 90 days. That’s what I was told.”

Cowie certainly meets the medical criteria.

“I have severe, severe asthma. And that’s turned into COPD, and Guillain-Barré syndrome as well as cancer. And I also just recently fractured my back,” she says.

“I’m tired a lot. The pain is excruciating.”

Joannie Cowie

The writers explain that Cowie, like many people with disabilities, is trapped in a cycle of poverty. The writers state:

“I get angry at people who say you need to budget better because I just want to say to them, go to hell,” she says.

Cowie developed epilepsy when she was six years old, but still managed to pursue education and work — for a time.

“I have my criminology degree. I also have a couple of college degrees, and I taught at a local college here,” she says.

But as her disabilities and pain piled up over the years, her employment options narrowed. That is also a common experience. According to Statistics Canada, only 31 per cent of people who are severely disabled are employed.

Today, Cowie is unable to work, and has no family support. She lives with her daughter, a university student who is also disabled. Together, they must find a way to scrape by on $1,228 from Ontario’s disability support program, and a few hundred more for her daughter. It isn’t nearly enough, and going without is especially hard during Thanksgiving, as Canadians sit down to enjoy a holiday meal.

Cowie explains that after paying her bills, she is left with about $59 per month to buy food.

The writers then interview Dr Naheed Dosani, a palliative care physician in Toronto who is concerned because people are now asking for MAiD because they have no money to live. The writers quote Dr Dosani who said:

“People are living in abject poverty when they’re on social assistance, in almost every province and territory across Canada.”

The numbers are grim. Looking across the country, provincial disability support rates vary from a low of $705 per month in New Brunswick, to a high of $1,685 in Alberta. Try getting by on $1,228 per month in Toronto, or $1,358 in Vancouver, where the average rent on a one-bedroom apartment is about $2,500.

The writers refer to the case of Sophia, a 51-year-old woman with MCS (multiple chemical sensitivies) who died by euthanasia in February 2022 because she couldn't find an affordable clean place to live.

Trudo Lemmens

The writers then interview Trudo Lemmens, professor of health law and policy at the University of Toronto who is concerned that Canada's euthanasia system is rife with problems. The writers state:

Lemmens cites the Netherlands and Belgium, the first countries in the world to legalize doctor-assisted death. It became legal in those countries in 2002. But he says there are important differences between their systems and Canada’s.

“You combine how in Belgium and the Netherlands people don’t put medical assistance in dying on the table. And doctors have to basically explore with the patient other options.”

He says those missing safeguards, and no review system for difficult cases, make Canada’s laws the most permissive in the world.

“In the context of medical assistance in dying, we’re getting rid of this idea that we will first try the least interventionist measures. There is no jurisdiction in the world other than Canada that frames this as just a medical intervention. It means a life-ending action.”

Lemmens explained that it has become a source of discrimination to approve euthanasia based on disability. Lemmens said:

Lemmens says the rapid expansion of eligibility criteria for MAiD, particularly during the pandemic, sent the wrong message to the disabled community.

“To say that we, that persons with disabilities, urgently need a life-ending procedure in that kind of period, I think, was disturbing, was really insensitive and reckless.”

Alan Nichols (left)

The writers then explain the story of Alan Nichols who died by euthanasia in 2019. They write:

The world has noticed. In August, the Associated Press extensively chronicled the case of Alan Nichols, a B.C. man who was admitted to hospital as a result of a mental health check, and was granted a doctor-assisted death in hospital only weeks later, over the objections of his family. His brother, Gary, insists Alan didn’t meet the medical criteria for MAiD. Alan’s family members have been unable to get an explanation that satisfied them, and maintain Nichols should still be alive.

The writers then tell the story of the Veterans Affairs employee who urged a Veteran with PTSD to consider a death by euthanasia.

The UN Special Rapporteur on the rights of persons with disabilities have written two cautionary reports. The writers state:

In 2019, she reported that during a visit to Canada, seniors told her they were offered a choice “between a nursing home and medical assistance in dying.”

And in 2021, in a letter to the federal government, the Special Rapporteur expressed “grave concerns” that Canada’s expanded eligibility criteria would violate “Canada’s international obligations to respect, protect and fulfil the core rights of equality and non-discrimination of persons with disabilities.”

Lemmens told the writers that the massive expansion in the numbers of people and the reasons for dying by euthanasia are sending the wrong message to the disability community.

The writers report that there were 10,064 reported euthanasia deaths in 2021 which was a 32% increase from 2020. Lemmens is concerned that, in a very short time, Canada has surpassed the number of euthanasia deaths in the Netherlands and Belgium, even though those jurisdictions legalized euthanasia 20 years ago.

Les Landry

Les Landry is seeking euthanasia in Alberta based on poverty. The writers state:

Just over a decade ago, Landry was working as a truck driver. Then, disaster struck.

“I developed a hernia. And that’s when the surgery happened. That’s when the blood pressure went out of control. That’s when I developed epilepsy, and three mini strokes, and things just fell apart.”

Today, the Medicine Hat, Alta., man is in a wheelchair and has severe chronic pain. But that’s not why he’s planning to apply for MAiD.

Landry got by for years — just barely — on disability payments of $1,685 and timely donations solicited on Twitter. He also received a few extra benefits available under Alberta’s disability program — only a few hundred dollars extra, but it allowed him to budget and get ahead on his bills.

Then, he turned 65, and through a bureaucratic loophole, actually lost benefits.

“What I lost is the disability benefits — service dog allowance, special diet allowance, transportation allowance,” he says. “I am no longer a person with a disability. I’m a senior citizen in poverty.”

He worries that with the loss of income and rising prices, he may soon be homeless.

Landry says that he will die by MAiD rather then become homeless. Landry who is not opposed to euthanasia says that the reality is lopsided. Landry told the writers:

“How do you target a segment of society with basically death as their only option to get out of their situation? And you don’t do anything by helping them out of that situation. I mean, how do you explain that?”

Landry said:

“I don’t want to die. I don’t want to die. I just can’t see me living like this for the rest of my life.”

Links to more stories of the euthanasia experience in Canada:

• Veterans affairs worker advocates euthanasia for PTSD (Link).
• Alberta man requests euthanasia based on poverty (Link).
• Shopping for doctor death in Canada (Link).
• Gwen is seeking euthanasia because she can't access medical treatment (Link).
• Euthanasia for disability and poverty (Link).
• Euthanasia for Long Covid and poverty (Link).
• Canada's MAiD law is the most permissive in the world. (Link).

Netherlands death group launches court case to allow anyone to participate in suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The Netherlands euthanasia group - Cooperative Last Will - launched a court case challenging the Dutch euthanasia law because it allows doctors to kill by euthanasia but it forbids people who are not doctors from participating in suicide.

The Cooperative Last Will case was launched to expand the Netherlands euthanasia law. A Reuters article written by Stephanie van den Berg and published on October 10 reported:

A lawyer for the cooperative said the case is strategic litigation aimed at forcing the Netherlands to change the laws.

They argue that the current ban on assisting suicide not overseen by medical professionals violated the right to self-determination and respect for private life enshrined in the European convention on human rights.

Lawyers for the Dutch state argued that the euthanasia laws strike good balance between the duty of the state to protect citizens, even from themselves, and individual autonomy.

The article also explains that - Cooperative Last Will - is also involved in another court case concerning Substance X. van den Berg reported:

Cooperative Last Will has been promoting a suicide powder it calls "Substance X" since 2018. There is a separate ongoing case before the Dutch courts against a member of the cooperative who is suspected of illegally assisting suicide by selling "Substance X" to at least 33 people.

A ruling is expected on Dec. 14, the judges said.

On September 30th I published an article by Randy Knol, concerning the arrest of Jos van Wijk, the chairman of the Coöperatie Laatste Wil, euthanasia group. van Wijk was arrested for allegedly participating in a criminal organization. Randy is the father of Ximena, a 19-year-old who died in February 2018 by ingesting the suicide powder known as "Substance X."

More articles on this topic:

• Netherlands man arrested for selling suicide powder resulting in at least 4 suicide deaths (Link).
• Netherlands assisted suicide group member admits to breaking the law in at least 100 suicides (Link).
• Dutch assisted suicide group leader arrested for participating in an alleged criminal organization (Link). 

Canada's Euthanasia Program.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A few weeks ago, Rupa Subramanya called the Euthanasia Prevention Coalition and asked many questions about what is happening with (MAiD) euthanasia in Canada. We had a challenging conversation but I found Rupa to be wanting to report the truth about Canada's (MAiD) law.

Today I received a link to Rupa's article - Scheduled to Die: The Rise of Canada's Assisted Suicide Program that was published on October 11 by Common Sense news. 

The Euthanasia Prevention Coalition helped Margaret with her petition and her letters that she sent to groups and individuals. We are happy that Kiano remains alive.

Rupa sets up her article by telling the story of Kiano Vafaeian, a 23-year-old with Type 1 diabetes who was approved for MAiD by Dr Joshua Tepper and his mother Margaret Marsilla, who did everything that she could to prevent her son's death. Rupa writes:

Image from Margaret's petition

On September 7, Margaret Marsilla called Joshua Tepper, the doctor who planned to kill her son.

Marsilla is 46, and she lives outside Toronto with her husband and daughter, a nursing student. She had known that her 23-year-old son, Kiano Vafaeian, was depressed—he was diabetic and had lost his vision in one eye, and he didn’t have a job or girlfriend or much of a future—and Marsilla asked her daughter to log onto Kiano’s account. (Kiano had given his sister access so she could help him with his email.) He never shared anything with his mother—what he was thinking, where he was going—and Marsilla was scared.

That was when Marsilla learned that Kiano had applied and, in late July, been approved for “medical assistance in dying,” aka MAiD, aka assisted suicide.

His death was scheduled for September 22.

In a September 7 email from Tepper, the doctor, to Kiano and Tekla Hendrickson, the executive director of MAiDHouse, the Toronto facility where Kiano’s death would take place, Tepper mapped out the schedule:

“Hii,” he emailed. (Apparently, Tepper did not use spell check.) “I am confirming the following timing: Please arrive at 8:30 am. I will ask for the nurse at 8:45 am and I will start the procedure at around 9:00 am. Procedure will be completed a few minutes after it starts.”

The procedure entailed administering two drugs. First, a coma-inducing agent. Then, a neuromuscular blocker that would stop Kiano’s breathing. He would be dead in five to ten minutes.

Margaret, Kiano's mother wanted to stop her son from being killed. Rupa reports:

The day after she discovered the email, Marsilla called Tepper. She pretended to be a MAiD applicant. She called herself Joann and said she “wanted to go through the whole process in general, from A to Zed, before the Christmas holidays—if you know what I mean.” Tepper indicated he understood.

Tepper, sounding matter of fact, ran through the list of requirements: “You have to be over 18. You have to have an OHIP card.” (He was referring to her Ontario Health Insurance Plan.) “You have to have suffering that cannot be remediated or treated in some way that’s acceptable to you.”

Marsilla, who recorded the conversation and shared the five-and-a-half-minute recording with Common Sense, told Tepper that she was diabetic and blind—more or less, her son’s condition. Tepper said he’d “had patients a lot similar to you.”

Then, the doctor said, “If you wanted, I could do a formal assessment with you.” Marsilla asked if she should come in. Tepper replied: “We do them remotely, often by video of some type: WhatsApp, Zoom, FaceTime, something like that.”

A few minutes later, Marsilla hung up. She had just over two weeks to stop her son from dying.

Rupa continues her article by telling the history of MAiD in Canada and then interviewing several people who are seeking death by euthanasia and several people who oppose killing by MAiD. Rupa then returns to the story of Marsilla and Kiano. Rupa reports:

Dr. Kristen Creek, in Winnipeg, messaged her (Marsilla). As it turned out, Creek was a family physician, and she provided MAiD. She was surprised to hear that a young man with diabetes had been approved for it. She urged Marsilla to call Tepper back and be up front about who she was.

Marsilla did just that. Soon after, Marsilla, Kiano, Kiano’s aunt, and Tepper spoke on the phone. That call led nowhere, Marsilla said. By now, a right-wing, Canadian Catholic news site had picked up on Marsilla’s post, which mentioned Tepper by name, and the doctor was getting pummeled by outraged readers.

On September 16, Tepper texted Marsilla to say that he’d postponed Kiano’s death until September 28. Five days later, the doctor texted her again to say that, actually, he wasn’t going through with it. He apparently wanted nothing more to do with Kiano Vafaeian. 

Rupa explains that she tried to interview Kiano and then finally arranged to do a facetime interview. Rupa writes:

Kiano told me he was “baffled” by everything that had happened the past three weeks: his mother’s social-media campaign, Tepper’s decision not to help him die. “I didn’t know what to say,” Kiano said. “It’s how she knows how to love me.”

Still, he was furious with her. He didn’t know what came next, whether he’d find another doctor. The MAiD people didn’t want to touch his case.

Dr Ramona Coelho

The other key interviews include Rupa's interview with Dr Ramona Coelho who emphasized her concerns for people seeking death based on a lack of resources. Rupa wrote:

“I do worry MAiD is an easy solution to bed shortages and the terrible lack of resources patients are facing,”

 “the perverse disincentive that exists for administrators and governments with providing MAiD rather than care and resources to live can present a real danger to the lives of vulnerable or marginalized persons.”

Coelho’s comments jibed with a 2021 letter, from three UN officials to the Canadian government, about MAiD having “a potentially discriminatory impact on persons with disabilities and older persons who are not at the end of their life or nearing death from natural causes.” The letter added that “there is a real risk” that those “who may be further marginalized by their racialized, indigenous, gender identity or other status, will be more vulnerable to being induced to access MAiD.”

Dr Sonu Gaind

Dr. Sonu Gaind, a professor of psychiatry at the University of Toronto and a former president of the Canadian Psychiatric Association, told Rupa that the expansion of MAiD was “built on a house of cards.” Rupa reported:

“While pretending to provide MAiD for an irremediable condition, we actually end up taking the lives of non-dying people—who could get better—for all sorts of other psychosocial suffering,” Gaind told me. “That’s not compassion.”

He added: “When we have people who are genuinely suffering, and we don’t provide them options for dignified living, but we provide them with what we label as a painless death, it provides these people with the enticement of a means to escape their suffering, when we could have helped them escape otherwise—by overcoming their problems and moving on and living.”

Nor, Gaind said, is expanding MAiD about personal autonomy—at least, not for everyone. In a recent article, he wrote: “It is a myth that expanded MAiD is just about autonomy. Expansion may increase privileged autonomy for some to die with dignity, but it does so by sacrificing other marginalized Canadians to premature deaths for escaping painful lives that we failed to allow them to live with dignity.”

From its inception, Canada's MAiD law was designed to expand. The law employed undefined terminology and it was clearly written to protect the doctors and nurses who were willing to kill their patients. Bill C-7, in March 2021, clearly expanded euthanasia to include people with disabilities. Bill C-7 created a dichotomy whereby a person who is having difficulty receiving the necessary treatment or care is not having the same difficulty obtaining MAiD (euthanasia).

The fears of the disability community were correct. Extending euthanasia to people who are not dying but are living with chronic or disabling conditions would lead to euthanasia based on social conditions because many people with disabilities are living in poverty and/or unable to access the treatment or care that they require.