Report: Patients being offered assisted suicide in apparent policy violation

CNA Staff, Feb 28, 2021 / 04:01 am

An investigation by a Vancouver, Canada Catholic newspaper has uncovered evidence that at least one of the region’s publicly funded health authorities has been offering patients euthanasia or assisted suicide without the patient requesting it. 

Though euthanasia and assisted suicide are legal in Canada, the health authority guidelines state that the patient must be the one to raise the issue, BC Catholic reported Feb. 25. 

Officially known in Canada as MAID (medical aid in dying), euthanasia and physician-assisted suicide were legalized in the country during June 2016. 

Since then, nearly 14,000 people have ended their lives through MAID in Canada as of 2019. 

BC Catholic filed a freedom of information request in March 2020 to get information about the health authority’s implementation of MAID after a woman told the paper that she felt “pestered [and] pressured” by staff to avail herself of assisted suicide while she was fighting a serious illness.

The documents BC Catholic obtained state that MAID is supposed to be an “entirely patient-driven” process, but do not detail the regulations or standards barring a physician or other medical professional’s introduction of the subject of assisted suicide without first being asked for information.

Eligibility for assisted suicide is restricted to mentally competent Canadian adults who have a serious, irreversible illness, disease, or disability. 

While to be eligible a patient does not have to have a fatal condition, they must meet a criterion variously expressed as they “can expect to die in the near future”, that natural death is “reasonably foreseeable” in the “not too distant” future, or that they are “declining towards death.”

The national health ministry of Canada claims there are safeguards to ensure that those requesting euthanasia or assisted suicide “are able to make health care decisions for themselves” and “request the service of their own free will.”

However, a registered nurse who works at a hospice in the Fraser Health region spoke to BC Catholic on condition of anonymity, and said that in her experience, doctors assessing incoming patients inform them of the possibility of assisted suicide but, as a matter of course, do not describe alternatives, such as palliative care.

Pro-life advocates, such as the Canadian Conference of Catholic Bishops, have repeatedly challenged the government to upgrade and promote palliative care options instead of assisted suicide laws.

Dr. Williard Johnston of Vancouver, a family physician who is also the head of the B.C. branch of the Euthanasia Prevention Coalition, told BC Catholic that he believes medical staffs’ mere introduction of the possibility of assisted suicide puts undue pressure on patients when they are the most vulnerable.

Fraser Health’s communications office did not respond to BC Catholic’s request for immediate comment. 

(Story continues below)

Fraser Health earlier this year revoked $1.5 million in funding from Delta Hospice Society, as well as its permission to operate as a hospice, because of the organization’s opposition to euthanasia.

Founded in 1991, Delta Hospice Society ran a 10-bed hospice and in February 2021 had to lay off its entire staff.  

Religious hospitals in Canada are not forced to provide euthanasia, but no such conscience rights exist for secular institutions like the Delta Hospice Society. Delta Hospice shut down on Feb. 24. 

In a high-profile case involving Fraser Health last year, a 61-year-old mentally ill man named Alan Nichols died by voluntary euthanasia at a British Columbia hospital in 2019. His family did not support the decision, and were unable to stop it from being carried out. They doubt Nichols was able to give informed consent to his euthanization, and maintain his natural death was not reasonably foreseeable.

The number of Canadians killed by physician-assisted suicide nearly doubled between 2017 and 2019, according to a 2020 report released by the Canadian government.

In 2019, a total of 5,631 Canadians ended their lives through MAID. This amounts for 2% of the total deaths in Canada, an increase from 2018, when MAID deaths accounted for 1.12% of the total deaths in Canada.

In U.S. states with legal physician-assisted suicide, less than 0.5% of deaths are due to euthanasia, the lowest rate in the world. If Canada’s numbers were extrapolated to the United States, approximately 50,000 people each year would end their lives with MAID. This would put euthanasia in the top 10 causes of death for the United States, just above “intentional self-harm (suicide)” and just below kidney disease. 

The report found that cancer was the most common condition among those who ended their lives with MAID, followed by respiratory conditions and neurological ailments. Slightly over two thirds of those who used MAID had cancer as an underlying condition.

In 2019, Quebec’s Supreme Court ruled that requiring death to be “reasonably foreseeable” in assisted suicide cases was unconstitutional. The court said the government must update its laws to reflect this ruling by Feb. 26, 2021.

In response, the federal government introduced Bill C-7, which would remove a reasonably foreseeable death from the criteria necessary to qualify for legal assisted suicide. The law would still prohibit assisted suicide for patients who have only mental illnesses and not physical illnesses.

The bill passed through the House of Commons by a two-to-one margin on December 10. It still needs the approval of the Senate, however the government is required by Feb. 26 to bring federal law on assisted suicide in line with the Quebec Superior Court’s 2019 ruling that requiring death to be “reasonably foreseeable” for assisted suicide is unconstitutional.