Where some choices (imitating George Orwell) are “more equal” than others.
Recent Developments
[For further information about the original court decision and subsequent legislation that legalized euthanasia and assisted suicide in Canada in 2016, under the euphemism Medical Assistance in Dying (MAID), see Leiva R, Cottle MM, Ferrier C, Harding SR, Lau T, McQuiston T, Scott JF. Euthanasia in Canada: a cautionary tale. WMJ [Internet]. 2018 Sep [cited 2019 Oct 20];64(3):17-23. Available from https://www.wma.net/wp-content/uploads/2018/10/WMJ_3_2018-1.pdf]
A) Hastening Death: Government actions, court rulings, health authority decisions and some practitioners’ practices have shown a clear bias in support of hastening death –
Case I, March 2018 – Manipulation of elastic criteria is the equivalent of no criteria: A patient with no threat to life starves self to become eligible for euthanasia in conformance with “end of life” criterion. Doctor performs procedure. College [regulatory authority] finds no wrongdoing. https://www.theglobeandmail.com/canada/article-bc-doctor-cleared-of-wrongdoing-for-providing-assisted-death-to/
Case II, Aug 2019 – Euthanasia everywhere (and even by stealth): Nursing home in British Columbia bans on-site euthanasia for religious reasons. Doctor enters facility during evening hours and euthanizes patient. College finding: no wrongdoing. https://www.cjnews.com/news/canada/b-c-doctor-cleared-of-assisted-death-in-jewish-home
Case III, Sept 2019 – Conditions can be created: A chronically depressed man with no serious physical condition, admitted in a dehydrated and confused state, was euthanized one month later (against the wishes of family). Criteria of “intolerable suffering” and “reasonably foreseeable” death were deemed to have been fulfilled at that time, but medical records were not released (even to grieving family). https://www.ctvnews.ca/health/family-says-b-c-man-with-history-of-depression-wasn-t-fit-for-assisted-death-1.4609016
Case IV, Sept 2019 – Moving the goalposts: Quebec Superior court Strikes down “end of life” and “death reasonably foreseeable” provisions. Euthanasia will now be available (in the absence of appeal) to all ill and handicapped individuals (physical or mental, including purely psychiatric) subject only to “intolerable suffering” (to be judged subjectively by patient). https://montreal.ctvnews.ca/a-quebec-court-has-invalidated-parts-of-the-medical-aid-in-dying-laws-1.4588622
Case V, Oct 2019 – Prime Minister Justin Trudeau surrenders to the “slippery slope”: Promises not to appeal Quebec court decision which has invalidated that law for which his own government is responsible, and which is only three years old. https://www.huffingtonpost.ca/entry/five-moments-french-leaders-debate-tva_ca_5d956d5fe4b02911e115a7ac (see section 4)
Case VI, Oct 2019 – The next step: Ongoing discussions regarding euthanasia of the incapable, through advance directive. Veronique Hivon (architect of legal euthanasia in Quebec/Canada) fully reveals “slippery slope” strategy in her own words: “The reason we did not (initially) take this extra step was because we would have lost our consensus amongst the legislators and it was necessary to get over that first big step of voluntary euthanasia (MAID). And that allowed us to reassure everybody…” She now believes that Quebec society is “ready” for such a policy.
(And how long before we are “ready” for euthanasia of incapable individuals without any consent? – Ed.) https://www.ledevoir.com/politique/quebec/564250/sante-des-medecins-plus-a-l-aise
Note: As Canadian physicians, we strongly encourage our colleagues to avoid the initial step our country took, of allowing euthanasia to be legalized in Canada. Please, do not accept official assurances that euthanasia can be carefully restricted to exceptional cases. Our experience, as detailed above, clearly shows otherwise.
B) Failure to support life: Government actions, court rulings, health authority decisions and some practitioners’ practices have shown a clear bias against supporting life:
Case VII, July 2017 – Mother of adult disabled daughter (who has a normal desire to live) bullied by doctor, is told she is “selfish” (for not pressuring her daughter to die). https://www.cbc.ca/news/canada/newfoundland-labrador/doctor-suggested-assisted-suicide-daughter-mother-elson-1.4218669
Case VIII, Aug 2018 – Ontario man refused home care, offered euthanasia as a solution. https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
Case IX, May 2019 – Dissenting Canadian doctors bullied by Ontario Court; must provide “effective referrals” for MAID, on demand. (Never before, for any other procedure, including abortion, has such a requirement been imposed. – Ed.) https://torontosun.com/news/provincial/ruling-expected-on-doctors-giving-referrals-for-services-they-oppose
Case X, Aug 2019 – Man in BC chooses MAID because he cannot get adequate home care. https://www.cbc.ca/news/canada/british-columbia/als-bc-man-medically-assisted-death-1.5244731
Case XI, Oct 2019 – Two severely handicapped Canadians feel personally threatened by extension of MAID criteria to include those who are not at the “end of life”. They petition Prime Minister Justin Trudeau to appeal Quebec Superior Court ruling to the Supreme Court of Canada. https://www.ctvnews.ca/health/two-canadians-want-next-prime-minister-to-push-for-assistance-in-living-not-assisted-dying-1.4619767?fbclid=IwAR1_Bg34gT7yjZ6lrepcVJeBD2EZwOq-aNhI_fwEAeifp81eRsaYrjsN3rA
Case XII, Oct 2019 – Advocates call for disability-rights based appeal of the Quebec Superior Court’s Decision in Truchon-Gladu: Sixty-eight (68) different national and regional organizations supporting the lives and rights of disabled Canadians join in submitting a detailed plan to appeal the Quebec Superior Court decision extending the criteria for voluntary euthanasia to include people who are not actually dying. They claim the ruling limits the role of Parliament to fairly balance individual and collective rights; stigmatizes and stereotypes the disabled, threatening both their social status and physical security; and is in contravention of article 10 of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD). https://cacl.ca/2019/10/04/advocates-call-for-disability-rights-based-appeal-of-the-quebec-superior-courts-decision-in-truchon-gladu/
Note: Unfortunately, as noted on page one, Prime Minister Justin Trudeau’s government did not appeal the invalidation of this law that his own government crafted in 2016 (including the repeated assurances of “effective safeguards” that will now be removed). Therefore, the motives of Canadian jurists and legislators (which remain unclear) appear to be more closely aligned with the sensationalized suicidal desires of a tiny minority of disabled individuals, and not with the virtually unanimous fears expressed by the organizations organically formed to promote the interests of this community.
Failure of monitoring: The 2016 law directed the federal Minister of Health to make regulations for MAID monitoring. These regulations were not put into place until November 2018, more than 2 years after people started to receive MAID, and there is no report as yet on the outcome of this monitoring. It is of grave concern that this federal monitoring aimed only at gathering data from a “societal perspective”. The monitoring of compliance with eligibility criteria and procedural safeguards is “under the purview of local law enforcement,” which would be provincial and territorial governments. To date, no such government has released a comprehensive report on the performance of the MAID program within its jurisdiction.
Government of Canada. Regulations for Monitoring of Medical Assistance in Dying: SOR/2018-166. Canada Gazette. 2018 Part ii:Vol.152. Accessed October 17, 2019 http://www.gazette.gc.ca/rp-pr/p2/2018/2018-08-08/html/sor-dors166-eng.html
As detailed in our examples: In opposition to the wishes of most doctors and patients, Canada is apparently transitioning to an aggressively universal program of euthanasia, having the objective effect of diminishing/alleviating/ government financial responsibility for maintaining the lives – and life quality – of the mentally and physically ill or disabled. Please do not allow the WMA or other authorities to follow in this path.