Canada the Cruel

Euthanasia is the slope off of which the post-civilised world careens.

Cases in point:

By authorizing its doctors to carry out “advance directives” for MAID starting Wednesday, the Government of Quebec has effectively told its health-care system to start committing murder.

(Sidebar: because Quebec is special.)

Last year, the Quebec legislature adopted Bill 11, which aimed to allow physicians to administer MAID to unresponsive or mentally incompetent patients, provided that the patient had given “advance” authorization to do so.

This is considered murder under federal law, so Quebec announced this week it will simply be instructing its prosecutors to ignore the relevant sections of the Criminal Code governing culpable homicide.

In a Monday statement, the federal Ministry of Health said they wouldn’t be challenging the decision – but warned Canada’s non-Quebec doctors not to get any ideas.

“As the Criminal Code applies uniformly across Canada and does not permit the provision of MAID based on an advance request, providing MAID pursuant to an advance request remains an offence under the Criminal Code,” it read.

 

And who is going to stop these murder-happy doctors? :

On private forums, doctors and nurses have expressed deep discomfort with ending the lives of vulnerable people whose deaths were avoidable, according to messages provided to AP by a participant on condition of anonymity due to their confidentiality.  

Some of the requests from the forums were approved and acted upon. Others were denied. But the discourse about patients who are poor, disabled or lonely shows a fraught process where medical professionals test the limits of what conditions warrant euthanasia. The controversial cases in the forums have never been disclosed through Canada’s oversight system, even in an anonymized manner. 

 **

Remember - euthanasia, like abortion, was supposed to be for the hard cases:

Coval said there is an “arguable case” about whether the MAID criteria were properly applied to the woman.

“As I’ve said, the evidence suggests (her) situation appears to be a mental health condition or illness without a link to any physical condition and it may not only be remediable, but remediable relatively quickly,” he said.

The woman and her partner have been granted anonymity by the court.

The application says the woman was diagnosed with bipolar disorder and later became convinced she had akathisia — an inability to sit still that is linked to certain types of medication — and began exploring medical assistance in dying.

“At the same time, (she) continued to express her desire to die. She did not want to do it herself, and regularly begged the plaintiff to end her life,” the application said.

It said two practitioners with expertise in the condition told her it was treatable, transitory and manageable, and if she followed their recommendations, “her akathisia could resolve within two to six months.”

The document claims she did not exhaust all medical treatments and was unable to obtain approval for assistance to die in Alberta.

 **

Fast forward to today. In less than a decade, the “slippery slope” has arrived, with Canada arguably having the world’s most permissive assisted dying regime – or medical assistance in dying (MAiD) as it is referred to in Canada. According to the latest Health Canada data, Canada will soon have the highest per capita MAiD death rate in the world. Year-on-year MAiD deaths have increased at a staggering rate of approximately 30 per cent. 

The “stringent and well-enforced safeguards” envisioned by the Supreme Court largely do not exist. What few safeguards there are have been ineffective. There are well-documented and shocking cases of vulnerable persons receiving MAiD due to poverty and social isolation. 

The discourse around MAiD in Canada has become perverse. During a parliamentary committee hearing, a physician representing the Québec Medical Association disturbingly recommended euthanising infants with severe deformities.

How did MAiD go off the rails so quickly in Canada? It didn’t happen in a vacuum. It happened because Justin Trudeau’s government has approached MAiD almost exclusively through the ideological lens of individual autonomy without appropriate regard for negative impacts to vulnerable persons. 

The Trudeau government, after being elected in 2015, was effectively forced by the Supreme Court’s decision to craft a legislative framework for MAiD, including eligibility criteria and safeguards. 

Initially, the Trudeau government took a somewhat cautious approach. The government’s original MAiD legislation required patients to meet certain criteria, including that their natural death be “reasonably foreseeable.”

It did not take long, however, for the Trudeau government to throw caution to the wind. 

In 2019, a Québec lower court judge ruled that the eligibility requirement that death be reasonably foreseeable was unconstitutional. Instead of defending a law passed by Parliament only three years earlier, Trudeau’s Attorney General opted against appealing the decision, and introduced legislation to remove the criteria.

The Trudeau government did this despite near universal opposition from the disability advocacy community. These groups warned that MAiD would lead to ableism and discrimination against persons with disabilities. 

Now persons with disabilities qualify for state-administered death on the basis that they are disabled – stigmatising and devaluing the lives of persons with disabilities. As Canadian disability advocate Gabrielle Peters aptly put it, “Canada has made disabled people a killable class.” 

By removing any connection to the foreseeability of natural death, eligibility has become significantly more subjective. This has widened the door for potential abuse. And it has devalued life, with persons who could potentially live for decades becoming eligible. 

The Trudeau government has proceeded to push the expansion of MAiD even further. Persons suffering solely from an underlying mental health disorder will soon be eligible. According to the Chair of the Trudeau-appointed Expert Panel on the implementation of MAiD for mental illness, anyone with a mental disorder listed in the American Psychiatric Association’s DSM5-TR could qualify. That includes persons suffering from depression, anxiety, schizophrenia, and personality disorders. This should horrify anyone of decency and demonstrates how depraved Canada’s MAiD regime has become under Trudeau’s watch.

While eligibility criteria have significantly widened, from the start, the so-called legislative safeguards have proven inadequate.  

To qualify, a patient needs only the sign-off of any two physicians or nurse practitioners. There is nothing to stop a patient from doctor-shopping until they are approved.

 
Under the law, there is no mechanism to review MAiD assessments. Accordingly, once approved by any two clinicians, there is no practicable means to stop a patient from receiving MAiD – even where there is evidence that the patient is not eligible.

There is no legal requirement that a patient undergo standard treatment options – only that they be advised of such options. Accordingly, a patient could qualify after declining treatments that would have ameliorated their condition.

There is a real risk of coercion when healthcare professionals proactively raise MAiD as a treatment option, given the power imbalance between physician and patient. Yet Health Canada’s practice standard, incredibly, encourages this practice. This is in contrast to other jurisdictions, such as the Australian State of Victoria, where this is prohibited.

Meanwhile, there is no comprehensive system in place to monitor and enforce the less-than-robust safeguards and compliance with the law. While the Trudeau government and Health Canada insist that instances of non-compliance are rare, this is almost certainly due to a lack of proper monitoring and oversight. Indeed, so permissive are the eligibility criteria, and so lacking are the safeguards, Canada’s MAiD regime is rife for abuse even if such abuse occurs in technical compliance with the law. 

This is evidenced by a growing list of disturbing cases of vulnerable persons who received MAiD under apparently questionable circumstances. Take the case of Rosina Kamis. In her last days alive, she documented that her MAiD request was motivated primarily by poverty, loneliness, and a lack of support. In another case, an Ontario woman with severe chemical sensitivities received MAiD after she was unable to find adequate subsidised housing free of cigarette smoke.

 

And, as again with abortion, the alleged safeguards meant to prevent this life-ending pursuit will never be pondered or questioned lest one swallow one's pride and admit that this practice is a cruel one and does not address any underlying problem.