The hidden story of abuse
By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition
Editor’s note. This is excerpted from a post that appeared here.
Health Canada released the first annual report on Medical Assistance in Dying (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 latest most recent report from the eastern province of Québec (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.
This report concerns the 2019 Canadian MAiD deaths and it indicates that the number of assisted deaths is increasing:
In 2019, there were 5,631 cases of MAID reported in Canada, accounting for 2.0% of all deaths in Canada.
The number of cases of MAID in 2019 represented an increase of 26.1% over 2018 numbers, 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 since the legalization of assisted death 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 descriptions of the patient’s intolerable suffering were 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 monitoring system 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% of all assisted deaths were done by 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.
The 2019 report indicates that 41.2% of those who died by MAiD required disability support services, and 89.8% were receiving those services. The problem with the data is that it 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.
The report does not attempt to uncover abuse of the law and it certainly didn’t track stories that were negative about euthanasia. For instance, in August 2016, Candice Lewis (25) was pressured to “request” an assisted death while receiving treatment at a Newfoundland hospital.
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 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.
On February 24, Canada’s federal government introduced Bill C-7 to expand the euthanasia law. …
Bill C-7 goes much further than the Quebec Superior Court Truchon decision.
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.