Canada’s permissive euthanasia laws

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ASPartOfMe
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18 Aug 2022, 8:34 am

Disturbing’: Experts troubled by Canada’s euthanasia laws

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Alan Nichols had a history of depression and other medical issues, but none were life-threatening. When the 61-year-old Canadian was hospitalized in June 2019 over fears he might be suicidal, he asked his brother to “bust him out” as soon as possible.

Within a month, Nichols submitted a request to be euthanized and he was killed, despite concerns raised by his family and a nurse practitioner.

His application for euthanasia listed only one health condition as the reason for his request to die: hearing loss.

Nichols’ family reported the case to police and health authorities, arguing that he lacked the capacity to understand the process and was not suffering unbearably — among the requirements for euthanasia. They say he was not taking needed medication, wasn’t using the cochlear implant that helped him hear, and that hospital staffers improperly helped him request euthanasia.

“Alan was basically put to death,” his brother Gary Nichols said.

Disability experts say the story is not unique in Canada, which arguably has the world’s most permissive euthanasia rules — allowing people with serious disabilities to choose to be killed in the absence of any other medical issue.

Many Canadians support euthanasia and the advocacy group Dying With Dignity says the procedure is “driven by compassion, an end to suffering and discrimination and desire for personal autonomy.” But human rights advocates say the country’s regulations lack necessary safeguards, devalue the lives of disabled people and are prompting doctors and health workers to suggest the procedure to those who might not otherwise consider it.

Equally troubling, advocates say, are instances in which people have sought to be killed because they weren’t getting adequate government support to live.

Canada is set to expand euthanasia access next year, but these advocates say the system warrants further scrutiny now.

Euthanasia “cannot be a default for Canada’s failure to fulfill its human rights obligations,” said Marie-Claude Landry, the head of its Human Rights Commission.

Landry said she shares the “grave concern” voiced last year by three U.N. human rights experts, who wrote that Canada’s euthanasia law appeared to violate the agency’s Universal Declaration of Human Rights. They said the law had a “discriminatory impact” on disabled people and was inconsistent with Canada’s obligations to uphold international human rights standards.

Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, described Canada’s law as “probably the biggest existential threat to disabled people since the Nazis’ program in Germany in the 1930s.”

During his recent trip to Canada, Pope Francis blasted what he has labeled the culture of waste that considers elderly and disabled people disposable. “We need to learn how to listen to the pain” of the poor and most marginalized, Francis said, lamenting the “patients who, in place of affection, are administered death.”

Canada prides itself on being liberal and accepting, said David Jones, director of the Anscombe Bioethics Centre in Britain, “but what’s happening with euthanasia suggests there may be a darker side.”

Euthanasia, where doctors use drugs to kill patients, is legal in seven countries — Belgium, Canada, Colombia, Luxembourg, Netherlands, New Zealand and Spain — plus several states in Australia.

Other jurisdictions, including several U.S. states, permit assisted suicide — in which patients take the lethal drug themselves, typically in a drink prescribed by a doctor.

In Canada, the two options are referred to as medical assistance in dying, though more than 99.9% of such deaths are euthanasia. There were more than 10,000 deaths by euthanasia last year, an increase of about a third from the previous year.

Canada’s road to allowing euthanasia began in 2015, when its highest court declared that outlawing assisted suicide deprived people of their dignity and autonomy. It gave national leaders a year to draft legislation.

The resulting 2016 law legalized both euthanasia and assisted suicide for people aged 18 and over provided they met certain conditions: They had to have a serious condition, disease or disability that was in an advanced, irreversible state of decline and enduring “unbearable physical or mental suffering that cannot be relieved under conditions that patients consider acceptable.” Their death also had to be “reasonably foreseeable,” and the request for euthanasia had to be approved by at least two physicians.

The law was later amended to allow people who are not terminally ill to choose death, significantly broadening the number of eligible people. Critics say that change removed a key safeguard aimed at protecting people with potentially years or decades of life left.

Today, any adult with a serious illness, disease or disability can seek help in dying.

The countries that allow euthanasia and assisted suicide vary in how they administer and regulate the practices, but Canada has several policies that set it apart from others. For example:

— Unlike Belgium and the Netherlands, where euthanasia has been legal for two decades, Canada doesn’t have monthly commissions to review potentially troubling cases, although it does publish yearly reports of euthanasia trends.

— Canada is the only country that allows nurse practitioners, not just doctors, to end patients’ lives. Medical authorities in its two largest provinces, Ontario and Quebec, explicitly instruct doctors not to indicate on death certificates if people died from euthanasia.

— Belgian doctors are advised to avoid mentioning euthanasia to patients since it could be misinterpreted as medical advice. The Australian state of Victoria forbids doctors from raising euthanasia with patients. There are no such restrictions in Canada. The association of Canadian health professionals who provide euthanasia tells physicians and nurses to inform patients if they might qualify to be killed, as one of their possible “clinical care options.”

— Canadian patients are not required to have exhausted all treatment alternatives before seeking euthanasia, as is the case in Belgium and the Netherlands.

Still, Duclos said there were adequate safeguards in place, including “stringent eligibility criteria” to ensure no disabled people were being encouraged or coerced into ending their lives. Government figures show more than 65% of people are being euthanized due to cancer, followed by heart problems, respiratory issues and neurological conditions.

Theresia Degener, a professor of law and disability studies at the Protestant University for Applied Sciences in northwestern Germany, said allowing euthanasia based exclusively on disability was a clear human rights violation.

“The implication of (Canada’s) law is that a life with disability is automatically less worth living and that in some cases, death is preferable,” said Degener.

Alan Nichols lost his hearing after brain surgery at age 12 and suffered a stroke in recent years, but he lived mostly on his own. “He needed some help from us, but he was not so disabled that he qualified for euthanasia,” said Gary Nichols.

In one of the assessments filed by a nurse practitioner before Nichols was killed, she noted his history of seizures, frailty and “a failure to thrive.” She also wrote that Nichols had hearing and vision loss.

The Nichols family were horrified that his death appeared to be approved based partly on Alan’s hearing loss and had other concerns about how Alan was euthanized. They lodged complaints with the British Columbia agency that regulates doctors and the Royal Canadian Mounted Police, asking for criminal charges. They also wrote to Canada’s minister of justice.

Some disabled Canadians have decided to be killed in the face of mounting bills.

Before being euthanized in August 2019 at age 41, Sean Tagert struggled to get the 24-hour-a-day care he needed. The government provided Tagert, who had Lou Gehrig’s disease, with 16 hours of daily care at his home in Powell River, British Columbia. He spent about 264 Canadian dollars ($206) a day to pay coverage during the other eight hours.

Health authorities proposed that Tagert move to an institution, but he refused, saying he would be too far from his young son. He called the suggestion “a death sentence” in an interview with the Canadian Broadcasting Corporation.

Before his death, Tagert had raised more than CA$16,000 ($12,400) to buy specialized medical equipment he needed to live at home with caretakers. But it still wasn’t enough.

“I know I’m asking for change,” Tagert wrote in a Facebook post before his death. “I just didn’t realize that was an unacceptable thing to do.”

Stainton, the University of British Columbia professor, pointed out that no province or territory provides a disability benefit income above the poverty line. In some regions, he said, it is as low as CA$850 ($662) a month — less than half the amount the government provided to people unable to work during the COVID-19 pandemic.

Heidi Janz, an assistant adjunct professor in Disability Ethics at the University of Alberta, said “a person with disabilities in Canada has to jump through so many hoops to get support that it can often be enough to tip the scales” and lead them to euthanasia.

Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations.

In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost “north of $1,500 a day.” Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care.

“Roger, this is not my show,” the ethicist responded. “My piece of this was to talk to you, (to see) if you had an interest in assisted dying.”

Foley said he had never previously mentioned euthanasia. The hospital says there is no prohibition on staff raising the issue.

Catherine Frazee, a professor emerita at Toronto’s Ryerson University, said cases like Foley’s were likely just the tip of the iceberg.

“It’s difficult to quantify it, because there is no easy way to track these cases, but I and other advocates are hearing regularly from disabled people every week who are considering (euthanasia),” she said.

Canada has tweaked its euthanasia rules since they were first enacted six years ago, but critics say more needs to be done — especially as Canada expands access further.

Next year, the country is set to allow people to be killed exclusively for mental health reasons. It is also considering extending euthanasia to “mature” minors — children under 18 who meet the same requirements as adults.

Chantalle Aubertin, spokeswoman for Canadian Justice Minister David Lametti, said in an email that the government had taken into account concerns raised by the disabled community when it added safeguards to its euthanasia regulations last year. Those changes included that people were to be informed of all services, such as mental health support and palliative care, before asking to die.

Landry, Canada’s human rights commissioner, said leaders should listen to the concerns of those facing hardships who believe euthanasia is their only option. She called for social and economic rights to be enshrined in Canadian law to ensure people can get adequate housing, health care and support.

“In an era where we recognize the right to die with dignity, we must do more to guarantee the right to live with dignity,” she said.


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CockneyRebel
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19 Aug 2022, 12:36 am

I feel very troubled by Canada's euthanasia laws. Living in modern day Canada is like living in Nazi Germany. A hateful parent can say to a doctor, "Kill my autistic child. He's got handicapped germs and he's not normal."


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19 Aug 2022, 12:38 am

I want to move to Germany. At least their government respects all human life.


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19 Aug 2022, 2:02 pm

CockneyRebel wrote:
A hateful parent can say to a doctor, "Kill my autistic child. He's got handicapped germs and he's not normal."


That doesn't appear true:

Quote:
Federal legislation creates a framework for medical assistance in dying across Canada, including establishing eligibility criteria. The eligibility requirements are that the patient must:

be eligible for publicly funded health care services in Canada (or in the applicable waiting period),
be 18 years of age or older,
be capable of making health care decisions


https://www.health.gov.on.ca/en/pro/programs/maid/

Read the guidelines yourself.


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19 Aug 2022, 8:05 pm

I hate Justin Trudeau. I wish that he would drop dead.


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19 Aug 2022, 8:09 pm

No country is safe for disabled people anymore.


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aspiemike
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20 Aug 2022, 2:02 pm

When it comes to disability and euthanasia, I do agree with the article that states that elderly are likely to be the victims in all of this. I wouldn't necessarily agree that autism would qualify or at least not yet.

I am more inclined to believe that those who are disabled and want to work, but can't will likely fall into this trap since both disabilities and not being able to find work can tie into depression. Homelessness can lead there as well if there is no support group. Also consider third party insurance companies in the workplace trying to manage disabilities and attendance. if an employer refuses to accommodate a disability based on company job requirements, where does that employee go if they can't find other work?

Just trying to look at the big picture here. Loosening euthanasia laws can save governments lots of money in Old Age Security and Canada Pension Plan payments. Not sure if that would be an intended consequence though.


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20 Aug 2022, 9:53 pm

CockneyRebel wrote:
I feel very troubled by Canada's euthanasia laws. Living in modern day Canada is like living in Nazi Germany. A hateful parent can say to a doctor, "Kill my autistic child. He's got handicapped germs and he's not normal."

Do you know of a specific actual case in which a parent successfully requested that their child be euthanized?


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20 Aug 2022, 11:05 pm

I fear for the day that a nurse comes running after me with the needle.


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21 Aug 2022, 12:58 am

I generally support right to die type laws, but some of the recent stories have been disturbing, I can easily see the conflict when you have something like public healthcare where aging patients can draw a lot of resources, and administrators penciling out whether or not it's worth it to spend the money to prolong their lives.


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23 Aug 2022, 10:53 pm

Canadian soldier suffering with PTSD offered euthanasia by Veterans Affairs

I know it's Fox News but...


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23 Aug 2022, 11:27 pm

And a special, little cross for Justin Trudeau.


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