Euthanasia Prevention Coalition Euthanasia Prevention Coalition: Candice Lewis

Showing posts with label Candice Lewis. Show all posts

Friday, November 10, 2023

Canada: Women, the lonely, and people with disabilities, at risk to euthanasia

This article was recently published by the Australian Care Alliance.

Article: Health Canada reports 13,241 assisted deaths in 2022 representing 4.1% of all deaths (Link).

In October 2023 the Fourth Annual Report on Medical Assistance in Dying in Canada was published. It stated that there had been 13,241 reported cases of euthanasia and assisted suicide in 2022, bringing the total of such deaths since legalisation to 44,958.

The number of cases each year has more than quadrupled (466%) in 6 years from 2,838 in 2017, the first full year of legalisation, to 13,241 in 2022 with annual increases of 57.8% (2018); 26.4% (2019) 34.2% (2020); 32.4% (2021) and 31.2% (2022).

“Fewer than seven” cases of assisted suicide have occurred each year since 2019. Canadian practice overwhelming uses euthanasia. The 2019 report stated that: “providers are less comfortable with self-administration [assisted suicide] due to concerns around the ability of the patient to effectively self-administer the series of medications, and the complications that may ensue”.

In 2022 euthanasia and assisted suicide accounted for 4.1% of all deaths in Canada. Provincial rates of euthanasia are highest in Quebec - 6.6% in 2022 and British Columbia - 5.5% in 2022.

Underlying conditions

Very limited data is provided on the “main condition” for which euthanasia is performed.

In 2022, for 8.3% of cases the “main condition” is reported as “multiple comorbidities” and a further 14.9% as “other conditions” - that is other than cancer, cardiovascular, respiratory, neurological or organ failure. For these two categories combined, 25% of cases involved “frailty” and 11.9% involved diabetes. Other conditions cited included vision or hearing loss, tendency to falls; and difficulty swallowing. For women these two categories now account for nearly one out of three (29.1%) deaths by euthanasia.

The 2021 report comments “Multiple comorbidities and other conditions encompassed a wide range of diseases or conditions, including frailty, diabetes, arthritis, and osteoporosis”. Note that these are not terminal conditions.

In only 161 cases in 2022 did the clinician administering euthanasia give their specialty as oncology. Additionally, 806 cases involved some consultation with an oncologist. This means that in 2022, at least 7,649 Canadians were euthanized on the basis that they had cancer with no discussion with an oncologist about this course of action. This represents 90.6 % of cases of euthanasia for cancer.

The majority (67.7%) of those administering euthanasia were primarily engaged in family medicine.

The 2022 report notes that the second opinion on eligibility was given by a nurse practitioner in 7.3% of cases.

“Death be reasonably foreseeable” - no longer required

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

On 11 September 2019, the Quebec Superior Court, in the case of Truchon c. Procureur général du Canada, invalidated the relevant provisions in the Canadian law which limited euthanasia to cases where “natural death has become reasonably foreseeable” and the Quebec law which required that the person be “at the end of life”. The effect of this decision was suspended for six months.

The Canadian Government introduced Bill C-7 into the House of Commons in February 2020 to give statutory effect to the decision. The Bill became law from 21 March 2021 opening the way for euthanasia to be given to people with chronic, non-terminal conditions, including people with a disability.

463 such cases were reported for 2022. -59% of these involving the euthanasia of a woman whose death was not reasonably foreseeable.

In Ontario in 2022, 121 out of 3934 (3.1%) euthanasia cases involved a person whose natural death was not reasonably foreseeable.

Short time between initial request and euthanasia being performed

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

Of the 7,384 people killed by euthanasia in Canada in 2020 for whom data is available on the length of time between first request and when euthanasia was administered some 34.3% or 2,532 people were euthanased in less than 10 days of first requesting it.

For 905 of these people the only justification given for the haste with which euthanasia was performed was that loss of capacity to consent was imminent. This raises real questions about the validity of the original request. If a person is on the verge of losing capacity what degree of certainty can there be that the person currently has full capacity?

In the period April 2021 to March 2022 in Quebec, 50% of people were euthanized less than 10 days after making a request. However, only 13% of people had a prognosis of less than 2 weeks to live.

Under the revised law from 21 March 2021 there is no longer any required waiting period for any person whose death is said to be “reasonably foreseeable”. Same day request and lethal injection is acceptable.

In other cases, a 90 day waiting period is specified but if the two assessing practitioners think that loss of decision making capacity is imminent this can be waived entirely.

Advanced directive

Euthanasia can now (since 21 March 2021) be provided on the basis of an advanced directive to persons who have lost decision making capacity. This is not supposed to be done if the person resists or refuses by "words, sounds or gestures".

However, this requirement is undermined by a provision that "involuntary words, sounds or gestures made in response to contact do not constitute a demonstration of refusal or resistance". How do we know they are "involuntary"?

In Ontario in 2022, 190 out of 3934 (4.83%) involved euthanasia of a person who at the time they were killed was incapable of giving consent.

Reasons for requesting euthanasia

The 2022 annual report states that loss of ability to engage in meaningful life activities (86.3%) followed closely by loss of ability to perform activities of daily living (81.9%) were the most common reasons for a euthanasia request.

Inadequate control of pain, or concern about it (59.2%) ranked much lower.

Disturbingly 35.3% reported as a reason for their euthanasia request “Perceived burden on family, friends or caregivers” and 17.1% reported “Isolation or loneliness”.

So in 2022 some 2,294 Canadians were given a lethal injection because they were lonely: Why didn't the doctor or nurse practitioner just have a cup of tea and a chat with them instead of giving them a lethal injection?

For Quebec, between April 2021 and March 2022, 1700 (47%) of people euthanased gave a reason as “Perceived burden on family, friends or caregivers” and 824 (23%) of people reported “isolation or loneliness” as a reason.

Needed disability services and palliative care not provided

In 2022 there were 328 cases where palliative care was not accessible if needed – an increase of 63% from 2021 when cases had already increased by 60% from the 126 cases in 2020.

The 2021 report notes even where palliative care was being accessed or was available “this result does not offer insight into the adequacy or quality of the palliative care services that were available or provided”.

In 2022 there were 568 cases where disability support services were needed but NOT received (up from 332 in 2020 – an increase of 71%). In 2021 this included 12 of the 219 people whose deaths were “not reasonably foreseeable”.

The 2020 report stated that “Disability support services could include but are not limited to assistive technologies, adaptive equipment, rehabilitation services, personal care services and disability based income supplements.” The 2021 report admits that, even for those who were reported as having received disability support services, the data “does not provide insight into the adequacy of the services offered”.

Denied assisted living but offered assisted suicide

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

Candice Lewis: pressure for euthanasia based on disability

Candice Lewis (right)

Candice Lewis was a 25 year old Canadian woman who happened to have cerebral palsy.

In September 2016 Candice went to the emergency room at in Newfoundland after having seizures.

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

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

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

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

Candice and her mother Sheila were interviewed by Kevin Dunn, who is produced a film on euthanasia and assisted suicide called Fatal Flaws for the Euthanasia Prevention Coalition. The film of the interview can be viewed here.

Candice has since passed away from natural causes.

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

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

A taste for killing?

Of the 1746 physicians and 91 nurse practitioners who euthanased people in 2022, some 336 of them did so 10 times or more – up 29.2% from 260 in 2021. The 91 nurse practitioners killed an average of nearly 14 people each – twice the average for medical practitioners of 7 people each.

Conclusion

Canada's court ordered experiment with euthanasia is already out of control with significant rates of failure to comply with the legal requirements and processes. No action appears to have been taken in response to identified cases in which euthanasia is performed contrary to the law. People with disabilities are being harassed to choose assisted suicide against their will.

Thursday, November 25, 2021

Swiss assisted suicide doctor does not support euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Erika Preisig

Erika Preisig is a doctor and president of assisted suicide organisation Lifecircle. She was recently asked in an interview, with Swissinfo, if Switzerland should allow euthanasia rather than assisted suicide?

She answered NO and stated:

I don't want to kill anybody.

Preisig correctly differentiates assisted suicide, which is a self-administered suicide death from euthanasia, which is done by lethal injection, done by someone else.

Preisig explains how assisted suicide is possible in all medical conditions, except locked-in syndrome.

To be clear, I don't support euthanasia or assisted suicide but Preisig's comments are contrary to the comments made by Dr Shavelson in a California court case. Shavelson argues that the California assisted suicide law discriminates against people with certain conditions because they are unable to "self-administer." The California court case, is attempting to permit euthanasia within the assisted suicide law.

Preisig didn't stop there. When asked if the Swiss system is better than the Netherlands system, she responds Yes and stated:

In my opinion, the Swiss model is the best option. Here, the patient has the final say on his/her life.

Doctors should not decide whether a life is not worth living. If doctors can give the injection, how can you be sure that this was really the patient’s wish?

Preisig is not consistent in her message. Concerning euthanasia (death by lethal injection) - how can you be sure that this was really the patient's wish? She also states:

People always talk about the slippery slope this could lead to and potential abuse. But this has never happened in Switzerland, nor in Canada, where euthanasia is legal.

Preisig's statement about the slippery slope or potential abuse not happening in Switzerland or Canada is clearly a false statement. Canada and Switzerland have expanded their reasons for allowing assisted suicide and euthanasia.

Abuse of the law

In October 2019, a Geneva court gave a suspended sentence to the regional vice-president of EXIT, Pierre Beck, for assisting the suicide of an 86-year-old woman who was not sick. According to Swissinfo, Beck admitted to acting beyond the criteria of the law but he said that he didn't regret his action and faced with a similar situation he would likely do it again.

Candice Lewis

In August 2016, Candice Lewis (25) while receiving treatment at a Newfoundland hospital was pressured to "request" an assisted death.

No one questions that Candice was very sick, but as Candice's mother told CBC news, the doctor pressured her to request physician-assisted death, Candice never asked for it.

Preisig then appears to contradict herself. She states:

Five years ago, I was charged with murder of a very old Swiss lady. She had been at a psychiatric ward for three months and was diagnosed with depression. I had a talk with her son, the chief of the nursing home where she was staying and her caretaker. But I couldn't find a psychiatrist for the assessment.

When you face a court case for murder, and you think you have done everything perfectly right…. you ask yourself, why am I putting myself through this? And you think, why don't I quit (laughter)? But there are so many people who trust me and need my help. This is why I keep going.

It is interesting that she does not recognize that it is impossible to confirm the elderly depressed lady with questionable competency and ability to consent was freely deciding to die. She then says people trust her to provide them the lethal drug cocktail for suicide and that is why she continues.

Monday, December 28, 2020

Tuesday, December 22, 2020

Stop telling people with disabilities they might be better off dead

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Toronto Star published an excellent article on December 21, 2020 by Lisa Bendall, a disability leader and former editor of Abilities Magazine.

Lisa Bendall

Bendall's article concerns Bill C-7, the bill to expand euthanasia in Canada, and its effect on people with disabilities. Bill C-7 is currently being debated by Canada's Senate. Bendall explains:

Senators are currently deliberating Bill C-7, which would allow assisted suicide for people who aren’t near death. Not all people, mind you; just people who happen to have disabilities. While many of us fear that this bill might steer vulnerable people toward an untimely death, others argue that that’s a paternalistic viewpoint, and that the law would have built-in protections.

But think on this. People with disabilities are constantly bombarded with the subtle and not-so-subtle message that it’s better to be dead than disabled. We know from experience that this has an impact on the way people are treated in public, in private and in health care.

Bendall writes about her friend, Audrey King:

Toronto’s Audrey King, who lives with the effects of polio, was hospitalized with pneumonia in 2018. While she was fighting for her life, her PSW overheard two nurses talking: “This is cruel. Why can’t they just let her go?” King, an artist and retired psychologist, is convinced no one would speak that way of a patient without a disability. “My life has been rich and full,” she says. “I’ve achieved far more than most ‘upright’ people, thanks to all the support I’ve had.”

She then tells a personal story about her husband:

When my husband Ian was hospitalized in 2018 for a fairly benign problem, he unexpectedly had complications that led to cardiac arrest and ventilation. Because of his weak muscles — he’s quadriplegic from a decades-old spinal cord injury — he needed a tracheotomy in order to come off the ventilator gradually, building back his stamina.

A doctor new to his case came to meet us — and to tell Ian that even with the surgery, he might never get off the ventilator. We knew that already. To our horror, the doctor then matter-of-factly suggested another option: Ian could skip the tracheotomy, have the ventilator removed instead, and be kept comfortable as he died.

We were stunned that a doctor charged with my husband’s care could so blatantly disregard his life, even one in which he potentially used a ventilator (as a couple of our friends did). It hadn’t crossed Ian’s mind to give up; he had a loving family and was starting his retirement. “From that moment on, I was afraid of having this man as my doctor,” he says. Incidentally, Ian was back home, healthy, within weeks.

Candice Lewis

Bendall continues with the story of Candice Lewis:

Candice Lewis of Newfoundland had a similarly traumatic experience in 2016, according to CBC News. While the young woman with disabilities was sick in hospital, she overheard a doctor telling her mother that assisted suicide was an option. Mother and daughter were shocked.

Bendall gets to the crux of the issue:

Why single out people with disabilities as the only nondying Canadians who can choose assisted suicide, as Bill C-7 proposes to do? Most people with suicidal feelings are given treatment, not MAID, even if they feel that their situation — poverty, loneliness, depression — makes life unbearable.

Furthermore, until people with disabilities have proper access to supports, it’s unconscionable to provide them with a direct path to death. Anyone who is housebound because of a lack of transportation, in pain because they can’t afford therapies, lonely because their housing is far from loved ones, or suffering from PSW shortages is more likely to feel suicidal.

Here’s another consideration: Some people who are new to having a disability may believe their emotional turmoil will never ease. Yet they may later go on to live a full, rewarding life. Liberal MP Marcus Powlowski, a physician, voted against C-7 for this reason, saying, “Morally, it’s incumbent upon me to stand up when it comes to issues of health and life and death.”

If this legislation passes, there is a strong chance it will result in needless deaths and great losses to society. That makes it a dangerous bill indeed.

Links to other articles concerning Bill C-7

Canada sees it as merciful to let me die, instead of providing me with what I need to live (Link).
Cheryl Lowen and Alan Nichols died by MAiD (euthanasia), even though they didn't qualify to be killed (Link).
Parliament passed Bill C-7 without amendments. Contact the Senators (Link).

Friday, October 9, 2020

Proposed changes to MAID (Bill C-7) are pure madness

An important article by Dr's Ramona Coelho, Leonie Herx, Timothy Lau and John F. Scott was published in the National Post on October 8, 2020.

The article begins by explaining how Bill C-7 almost allows anyone to be killed by MAiD:

On Monday, the federal government reintroduced Bill C-7. Under the proposed legislation, medical assistance in dying (MAID) would no longer be offered only to people who are dying, but would include those who are chronically ill and disabled, as well. This bill effectively allows medical death on demand for almost anyone who wants it.

The COVID-19 pandemic has brought us together as a nation to protect our most vulnerable. Canadians supported putting safeguards in place for the sake of the common good. Against this backdrop, it is shocking that our federal government is proposing to remove almost all the safeguards that were previously put in place to protect the vulnerable under MAID.

Dr Ramona Coelho

The authors continue by commenting on the state of palliative care in Canada.

Less than 30 per cent of Canadians have access to palliative care, and access to disability supports is limited in many areas. We know that depression and anxiety are common in those facing challenging health situations, but psychiatric care can take months or even years to access.

The July 2020 Health Canada report on MAID detailed the percentages of those accessing palliative care and disability supports, but contained no description of the adequacy of these services, which is necessary to make any meaningful conclusions. Meanwhile, many palliative care and disability experts have been raising their anguished voices over the lack of access to care, which the COVID-19 pandemic has amplified.

The fact is that our medical system is not able to adequately serve our patients. Expanding MAID to all chronically ill and disabled people is not the solution to the scandalous lack of adequate funding, skilled health-care professionals and public services in this country. This bill will throw real options for care out the window for those who need them.

Leonie Herx

They comment on several stories of how MAiD has affected people with disabilities

Already, there have been several reported cases of people being pressured to seek MAID. For example, in 2017, Roger Foley, who suffers from a neurological condition, made a recording of his health-care team suggesting that he should seek MAID due to the expense of living in hospital, given that his care needs could not be met at home. There was also the case of Candice Lewis, a 25-year-old with a developmental disability and chronic medical problems whose doctor suggested to her mom that she should receive MAID.

Instead of using our resources to increase health-care personnel, improve our quality of care, enhance our palliative care options and ensure quicker access to psychiatric care, our federal government seems more interested in fast-tracking death on demand and dismantling the MAID safeguards that were put in place to protect the vulnerable.

Tim Lau

They end the article by commenting on how changing the law changes reality.

Under this bill, you no longer have to be dying to receive medical assistance in dying, therefore the acronym no longer fits. The procedure more accurately becomes medically administered death (MAD).

The message that C-7 sends to those with chronic illnesses or disabilities is that their lives are not worth living and that they would be better off dead. As physicians, we fear that this system would quickly change from one that gives people a choice to die, to one that coerces people to die. It’s pure MADness!

Thank you Dr's Ramona Coelho, Leonie Herx, Timothy Lau & John F. Scott.

Dr. Ramona Coelho is a London, ON.-based family physician who cares for disabled and marginalized people. Dr. Leonie Herx is an associate professor and chair of the division of palliative medicine at Queen’s University. Dr. Timothy Lau is an associate professor of psychiatry at the University of Ottawa. Dr. John F. Scott is an associate professor in the division of palliative care at the University of Ottawa.

Monday, August 10, 2020

New Zealand End of Life Choice Act would lead to many, not a few assisted deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New Zealand is having a referendum on euthanasia as part of its October 17 federal election.

New Zealand's parliament passed a euthanasia bill in November 2019 by a vote of 69 to 51. To obtain the votes to pass the Act the government agreed to a referendum.

Some proponents of the End-of-Life Choices Act (Act) refer to the Oregon assisted suicide model to suggest that legalizing assisted death will not result in many deaths. This argument is false.

The New Zealand Act legalizes Canadian style (MAiD) euthanasia which means that there will be many deaths, not a few.

The New Zealand Act uses the following definition of assisted dying:

(a) the administration by an attending medical practitioner or an attending nurse practitioner of medication to the person to relieve the person’s suffering by hastening death; or

(b) the self-administration by the person of medication to relieve their suffering by hastening death.

This means that the New Zealand Act is similar to the Canadian MAiD (euthanasia and assisted suicide) model and not the Oregon model. Canada legalized death by (a) administration by an attending medical or nurse practitioner (done by lethal injection) and (b) self-administration (you take the lethal drugs yourself, whereas the Oregon model is limited to (b) self-administration.

Why is this important:

Canada, Belgium, Luxembourg and the Netherlands have legalized assisted death by euthanasia (lethal injection) and assisted suicide (self-administration of lethal drugs).

Canada legalized assisted death by lethal injection in 2016. In 2019 there were 5631 reported euthanasia deaths represented 2% of all deaths in Canada.

The Oregon assisted suicide law came into effect in 1998, In 2019 there were 188 reported assisted suicide deaths represented about 0.5% of all deaths in Oregon.

The Netherlands euthanasia law which came into effect in 2002. In 2017 there were 6585 reported euthanasia (lethal injection) deaths representing almost 4.5% of all deaths.

Legalizing euthanasia and assisted suicide (a) administration by an attending medical or nurse practitioner (done by lethal injection) and (b) self-administration (taking the lethal drugs yourself) there will be exponentially more deaths than when the law is limited to assisted suicide, as in Oregon.

What is the difference?

Based on human experience, people are less likely to seek death by self administration (taking the lethal drugs) than by administration (lethal injection by another person). In other words, it is easier to have someone lethally inject you, than for you to take those same drugs yourself.

Euthanasia (lethal injection by another person) in most countries is a form of homicide because someone else causes the death, whereas death by self-administration is a form of assisting a suicide.

Abuse of the law.

Legalizing euthanasia will also lead to more abuse of the law. It is possible for someone to feel pressure and ask for assisted suicide, and it is possible that someone, who has the lethal drugs for assisted suicide, will be administered those drugs rather than self-administer. In the case of euthanasia physicians and nurse practitioners become part of the mode of pressure.

For instance, in August 2016, Candice Lewis (25) while receiving treatment at a Newfoundland hospital was pressured to "request" an assisted death.

No one questions that Candice was very sick, but as Candice's mother told CBC news, the doctor pressured her to request physician-assisted death, Candice never asked for it.

In August 2019, Alan Nichols died by euthanasia, even after his family insisted that Alan was not competent to make this decision and that he was living with chronic depression.

In August 2017, a 5 year study sponsored by the Netherlands government showed significant increases in assisted deaths and continued abuse of the law.

In March 2018, we learned that the public prosecutor was investigating several controversial euthanasia deaths. The public prosecutor was also investigating a euthanasia group in the Netherlands after the death of a 19-year-old woman.

Margreet in the Netherlands was interviewed for the Fatal Flaws Film explaining how her mother died by euthanasia without request.

Then there is the case that Tom Mortier has brought to the European court of Human Rights, after the Belgian courts refused to hear it. The Belgian law appears to have been violated in the euthanasia death of Mortier's depressed mother. How many other euthanasia deaths have violated the law?

Euthanasia laws, whether or not they are called assisted death or Medical Aid in Dying, are designed to provide legal protection for the medical practitioner who is willing to kill another person.

The New Zealand End of Life Choices Act tightly protects medical or nurse practitioners who are given the right in law to kill while providing no effective oversight of the law.

Kiwi's will reject the End-of-Life Choices Act if they examine the experience with euthanasia in other jurisdictions.

Saturday, July 25, 2020

Canada's MAiD report: 26% increase in 2019 euthanasia deaths. The hidden story of abuse.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Health Canada released the first annual report on (MAiD) euthanasia and assisted suicide. The data was gathered from the reports submitted by the medical or nurse practitioners who caused the death. There is no requirement that a third party or neutral person submit the euthanasia reports to insure their accuracy.

Unlike the most recent Québec euthanasia report (October 2019), the data in this report does not attempt to uncover potential abuse of the law. The data in the Québec report indicated that at least 13 assisted deaths did not comply with the law.

The report concerns the 2019 Canadian MAiD deaths indicates that the number of assisted deaths is increasing:

In 2019, there were 5,631 MAID deaths reported in Canada, up from 4467 in 2018, accounting for 2.0% of all deaths.
The number of cases of MAID in 2019 represented an increase of 26.1% over 2018 with every province experiencing a steady growth in the number of cases of MAID since its introduction into law in 2016.
When all data sources are considered, the total of number of medically assisted deaths reported in Canada from legalization until December 31, 2019 is 13,946.

MAID is most often administered in a home or hospital setting.

The primary settings for the administration of MAID are hospitals (36.3%) (excluding palliative care beds/units) and patients’ private residences (35.2%). The remaining cases of MAID occurred in palliative care units (20.6%) and residential care (6.9%) or other settings (1.0%).
There were 1,271 unique practitioners who provided MAID in 2019. MAID was provided most frequently by a family medicine physician (65.0%), followed by palliative medicine specialist (9.1%) and anesthesiologists (5.0%).

Nature of suffering among MAID recipients

Practitioners reported that suffering among MAID recipients was closely tied to a loss of autonomy.
The most frequently reported reason for the patient's intolerable suffering was loss of ability to engage in meaningful life activities (82.1%) followed closely by loss of ability to perform activities of daily living (78.1%), and inadequate control of symptoms other than pain, or concern about it (56.4%).

One-quarter of written requests for MAID did not result in an assisted death

there were 7,336 written requests for MAID reported through the MAID in 2019. Of these requests, 26.5% (or 1,947) did not result in a MAID death, because the patients died before receiving MAID (57.2% or 1,113 cases), were deemed ineligible (29.3% or 571 cases), or they withdrew their request (13.5% or 263).
The most frequently reported reasons why a person was deemed ineligible for MAID (7.8% of written requests) were: lack of capacity to make health care decisions (32.2%); the individual’s natural death was not reasonably foreseeable (27.8%); and the individual was not in an advanced state of irreversible decline in capability (23.5%).
Of those persons who were assessed as eligible for MAID, but did not receive it, the majority died of another cause prior to administration (15.2%), while a small number (3.6%) of persons withdrew their request after having been deemed eligible.

The report acknowledges that many people start the MAiD process with an oral request, but the law only requires tracking once a written request has been made. Therefore some requests for MAiD are not reported.

The report indicates that 20.6% of the assisted deaths were done in a palliative care setting and 9.1% were done by a palliative care specialist.

Palliative care and hospice professionals and organizations opposed the legalization of MAiD and are now being forced to participate. The Delta Hospice Society, which is an independent hospice charity, has is being forced by the British Columbia Health Minister to provide euthanasia or lose their funding.

The report indicates that the federal law does not force physicians or nurse practitioners to participate in MAiD, and yet some provinces are pressuring medical practitioners to participate.

In May 2019, the Ontario Court of Appeal ruled that doctors, who oppose euthanasia, had to participate in the act by doing an effective referral. In March 2020, the Physicians Alliance Against Euthanasia reported that a growing number of physicians are being bullied to participate in MAiD.

Roger Foley

The report indicates that 41.2% of those who died by MAiD, in 2019, required disability support services, and 89.8% were receiving those services. The data doesn't provide information as to the level of services. There are people with disabilities who have been denied the level of support that they needed but instead offered MAiD. For instance, Roger Foley of London Ontario was turned down for self-directed home-care but offered euthanasia.

Candice Lewis

The report does not attempt to uncover abuse of the law and it didn't track stories that were negative to euthanasia. For instance, in August 2016, Candice Lewis (25) while receiving treatment at a Newfoundland hospital was pressured to "request" an assisted death.

No one questions that Candice was very sick, but as Candice's mother told CBC news, the doctor pressured her to request physician-assisted death, Candice never asked for it.

Alan Nichols (Center)

In August 2019, Alan Nichols died by euthanasia, even after his family insisted that Alan was not competent to make this decision and that he was living with chronic depression.

Do you have a story about euthanasia or assisted suicide (Link).

In September 2019, Justice Baudouin, struck down the requirement in Canada's euthanasia law that a person be terminally ill. The federal government did not appeal the decision.

I reported that striking down the "terminal illness" requirement in the law opened the door to euthanasia for psychiatric conditions (Link).

On February 24, Canada's federal government introduced Bill C-7 to expand the euthanasia law.

What does Bill C-7 do?

1. Bill C-7 removes the requirement in the law that a person’s natural death be reasonably foreseeable in order to qualify for assisted death. Therefore, people who are not terminally ill can die by euthanasia. The Quebec court decision only required this amendment to the law, but Bill C-7 went further.

2. Bill C-7 permits a doctor or nurse practitioner to lethally inject a person who is incapable of consenting, if that person was previously approved for assisted death. This contravenes the Supreme Court of Canada Carter decision which stated that only competent people could die by euthanasia.

3. Bill C-7 waives the ten-day waiting period if a person's natural death is deemed to be reasonably foreseeable. Thus a person could request death by euthanasia on a "bad day" and die the same day. Studies prove that the “will to live” fluctuates.

The report indicates that in 65.7% of MAID deaths, MAID was provided following the 10-day reflection period. In the 34.3% of MAID deaths where this period was shortened, most practitioners (84.4%) cited imminent loss of the patient’s capacity to consent as the primary reason, with imminent death cited in 45.4% of these cases.

Bill C-7 does not need to eliminate the 10 day waiting period because more than one-third of the deaths, the waiting period is already waved.

For instance, in November 2016 EPC reported the case of a woman who may only have had a bladder infection who died by euthanasia. Even in this case, soon after legalization, the doctor waved the 10 day waiting period.

4. Bill C-7 creates a two track law. A person whose natural death is deemed to be reasonably foreseeable has no waiting period while a person whose natural death is not deemed to be reasonably foreseeable would have a 90 day waiting period before being killed by lethal injection.

5. As stated earlier, Bill C-7 falsely claims to prevent euthanasia for people with mental illness. The euthanasia law permits MAiD for people who are physically or psychologically suffering that is intolerable to the person and that cannot be relieved in a way that the person considers acceptable. However, mental illness, which is not defined in the law, is considered a form of psychological suffering.

Bill C-7 goes much further than the Quebec Superior Court Truchon decision.

Sign the Petition: Reject euthanasia Bill C-7 (Link).

The Canadian government must reject Bill C-7 and begin the promised 5-year review of the euthanasia law with an open view to what is actually happening rather than continuing to expand euthanasia, making Canada the most permissive euthanasia regime in the world.

Five reasons to oppose euthanasia and assisted suicide (Link).

Wednesday, June 24, 2020

Australian man loses appeal in his conviction for assisting the suicide of his wife for $1.4 million.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Jennifer Morant

In a unanimous decision, the Queensland Australia Court of Appeal upheld the conviction of Graham Morant who assisted the suicide of his wife, Jennifer Morant (56) for her $1.4 million in life insurance.

Morant was convicted in October, 2018 and sentenced to 10 years in prison.

Commentary by Richard Egan on the Court of Appeal decision (Link).

In an article published by the Brisbane Times by Lidia Lynch, Lynch explains why Morant's conviction appeal failed. Lynch reports:

Morant was the sole beneficiary of his wife's three life insurance policies, totalling $1.4 million.

Ms Morant lived with chronic back pain and found even the most simple everyday tasks difficult.

But Morant persuaded her over the months before her death by telling her the funds would go towards building a religious commune.

Morant claimed to police his wife wanted to die, but two witnesses close to her testified she did not want to kill herself and was scared by his pressure on her to do so.

Morant's lawyers appealed his conviction on four grounds and argued for a retrial based on emails between Ms Morant and Dr Nitschke came to light after the initial conviction. Lynch explains why the Court of Appeal didn't view these emails as effecting the conviction:

In the emails sent months before her death, Ms Morant told Dr Nitschke about her suffering and sought his help.

She told him of her anguish and pain and asked for his help about "how to end my life in a peaceful manner".

In his reasons, Court of Appeal President Walter Sofronoff acknowledged the emails were not available to Morant's lawyers at trial.

"However, it is impossible to see how they could have helped the appellant to secure an acquittal," he wrote.

"It would, instead, have reinforced Ms Morant’s vulnerability to the appellant’s inducements."

At his sentencing in November 2018, ABC News Australia reported Justice Peter Davis stating:

"You took advantage of her vulnerability as a sick and depressed woman.

You counselled your wife to kill herself because you wanted to get your hands on the $1.4 million.

Your general financial position was such that $1.4 million was a very significant sum, as it would be to most people.

You have not shown any remorse for the offences you have committed.

You did not plead guilty and you did not cooperate with the administration of justice."

Candice Lewis

The coercion used by Graham Morant that led to the assisted suicide death of his wife Jennifer is not indicative of most assisted suicide deaths, but it is also not uncommon.

In Canada, Candice Lewis, among others, was pressured by her doctors to ask for an assisted death. We will never know how many assisted deaths occurred after the person was pressured by doctors, nurses, family members or friends because the victim is dead and the victimizer thinks that it was the right thing to do.