Sunday, February 4, 2024

Progress in assisted suicide in Canada

Canada has delayed the extension of its assisted suicide program to people suffering solely from mental illness, health officials announced Monday.

Canada offers medically assisted death to terminally and chronically ill people, but the plan to extend the program to people with mental illnesses has divided Canadians, the New York Times reported. Some critics attribute the problem to a lack of adequate psychiatric care in the country.

The controversial policy would allow anyone in Canada with an incurable medical condition to apply for assisted suicide, even if the disease is not terminal, which makes the law one of the most liberal assisted suicide programs in the world.

Canada introduced medically assisted dying after its Supreme Court ruled in 2015 that requiring people to cope with intolerable suffering infringed on fundamental rights to liberty and security. The law was expanded in 2021 to include people experiencing "grievous and irremediable" conditions, such as depression and other mental health issues.

Over 13,000 Canadians were euthanized as part of the program in 2022, the Daily Mail reported.

When the program was announced last year, one conservative lawmaker "charged that the Liberal government of Prime Minister Justin Trudeau is promoting a ‘culture of death.’"

"Have we gone too far and too fast with Canada’s assisted suicide program?" Conservative MP Ed Fast said. "Will we evolve into a culture of death as the preferred option for those who suffer from mental illness or will we choose life?"

But now, health officials are slow-walking plans to expand the program, stating there are not enough doctors, specifically psychiatrists, in Canada to evaluate mentally ill people who wish to die, according to the announcement made by Health Minister Mark Holland and Justice Minister Arif Virani. This followed a meeting of the special parliamentary committee looking into the plan, the Times reported.

"The system needs to be ready, and we need to get it right," Holland told reporters. "It's clear from the conversations we've had that the system is not ready, and we need more time."

"Although the curriculum is present, although the guidelines are set, there has not been enough time for people to be trained on them, and provinces and territories are saying their systems are not ready and need more time," he added.

The officials did not provide a timeline for the changes, although the expansion had been previously scheduled to go into effect on March 17.

One group in favor of medical assistance in dying, "Dying with Dignity Canada," issued a statement in reaction to the news, urging the Canadian government to provide clarity on their plan of action.

"For the people across the country who live with treatment-resistant mental disorders who have patiently waited for this change in Canada’s MAID law, Dying With Dignity Canada is disheartened and shares the frustration of the continued exclusion, stigmatization and discrimination based on diagnosis," the group said.

Canada’s Special Joint Committee on Medical Assistance in Dying (MAID) recommended assisted suicide for minors without parental consent in mid-February.

A 138-page Canadian Parliament document was shared online called, "Medical Assistance In Dying In Canada: Choices or Canadians." One part of the report addressed assisted suicide options for "mature" minors in Canada. They considered two tracks, one for whom there is "reasonably foreseeable" death, the second track for those for whom "mental disorder is the sole underlying medical condition."

The government document explained the debate among government witnesses about expanding assisted suicide to those who are not yet legal adults.

"For MAID and mature minors, the committee heard a mix of views about whether MAID should be available to those under the age of 18. Many witnesses believed that age alone does not determine whether someone is capable of consenting to MAID," the document’s authors wrote. "At the same time, a cautious approach was recommended, especially since there is little evidence from youth themselves on this topic."

While the paper ultimately did not recommend MAID for children who are mentally ill, "The committee agrees with the many witnesses who opined that MAID for mature minors should be limited to track one [reasonably foreseeable natural death] at this stage, especially given the lack of youth perspectives on the topic."

Among a list of recommendations was a suggestion that "That the Government of Canada restrict MAID for mature minors to those whose natural death is reasonably foreseeable."

One critical aspect was that while the government committee supported the concept of consulting parents about administering euthanasia, children would have the final say: "The committee agrees with those witnesses who supported a requirement for parental consultation, but not consent, in the context of MAID for mature minors."

One recommendation the committee gave was to formalize this idea into law.

"That the Government of Canada establish a requirement that, where appropriate, the parents or guardians of a mature minor be consulted in the course of the assessment process for MAID, but that the will of a minor who is found to have the requisite decision-making capacity ultimately take priority," the committee advised.

The Daily Mail, after noting children would be "joining the roughly 10,000 adults who end their lives each year by state-sanctioned euthanasia in Canada, quoted multiple critics of the proposal.

"I think it's horrible," Amy Hasbrouck, of the anti-MAID group, Not Dead Yet, told the outlet. "Teenagers are not in a good position to judge whether to commit suicide or not. Any teenagers with a disability, who's constantly told their life is useless and pitiful, will be depressed, and of course they're going to want to die."

Executive director of the Euthanasia Prevention Coalition Alex Schadenberg told the Daily Mail, "We said we were going to have safeguards and guardrails, but the next government can simply open it up further by making a decision — and that's exactly what's happening."

More than a quarter of Canadians said in a new poll that homelessness and poverty are legitimate reasons to give people access to assisted suicide services.

Assisted suicide was legalized in Canada in 2021 for those with a "grievous and irremediable medical condition," but a sizable portion of Canadian respondents in a May poll conducted by Research Co. want expanded access for those with in less fortunate economic conditions. Homelessness, 28% of respondents said, is enough reason for assisted suicide access, and another 27% of respondents said poverty is a justifiable reason.

An inability to receive medical treatment in the country, which has a socialized system, should qualify those for assisted suicide, according to 51% of respondents. Half of respondents said those with disabilities should have access to assisted suicide. Another 43% said mental illness is reason for access.

Nearly three quarters of the Canadian respondents approved of their country's guidelines for assisted suicide, which requires the person to be at least 18-years-old, have a grievous and irremediable medical condition, make a voluntary request, and give informed consent.

Legalized assisted suicide and euthanasia has grown in popularity in recent decades, with the most notable countries with access being Canada, Australia, Belgium, Spain and the Netherlands.

Canada's Veterans Affairs office offered to assist a Paralympian and veteran to commit suicide when she sought to have a wheelchair lift installed in her home, the woman told lawmakers last week.

Christine Gauthier, a 52-year-old retired corporal who competed in the 2016 Paralympics at Rio De Janeiro, testified to lawmakers that a VA official had offered — in writing — to provide her with a medically-assisted suicide kit. The case officer remains unnamed but reportedly made similar offers to at least three other veterans, according to the Independent.

"I have a letter saying that if you’re so desperate, madam, we can offer you MAID, medical assistance in dying," Gauthier said in a hearing before the House of Commons veterans affairs committee.

Prime Minister Justin Trudeau condemned the incident in a public statement on Friday after Gauthier said she personally wrote him a letter on the issue.

"We are following up with investigations and we are changing protocols to ensure what should seem obvious to all of us: that it is not the place of Veterans Affairs Canada, who are supposed to be there to support those people who stepped up to serve their country, to offer them medical assistance in dying," Trudeau said.

Canada first approved medically-assisted suicide in 2016, and the parameters around allowing it have since loosened. The law originally legalized assisted suicide only for those facing imminent death, but it now also includes those who suffered severe pain or disabilities, according to the Independent.

Gauthier's story comes just weeks after a Canadian fashion company glorified assisted suicide in a commercial.

Canadian fashion company La Maison Simons promoted the "beauty" in voluntary euthanasia in a promotional video titled "All is Beauty." The ad includes a voiceover from Jennyfer Hatch, a 37-year-old Canadian woman who voluntarily euthanized herself after suffering from Ehlers-Danlos syndrome.

"Last breaths are sacred. Even though as I seek help to end my life, with all the pain and in these final moments, there is still so much beauty," Hatch says in the Simons video.

Simons says that the ad aimed to "help people to reconnect to each other and to this hope and optimism," which he says "is going to be needed if we're going to build the sort of communities and spaces where we want to live and that are enjoyable to live in."

"The ‘All is Beauty’ campaign has come to an end this week. Simons is now entering their annual holiday sprint," a spokesperson for Simons told Fox News Digital. "In this context, all of their teams' efforts are focused on in-store and web holiday activities."

A Canadian armed forces veteran suffering from post-traumatic stress disorder and a traumatic brain injury was offered medical assistance in dying by an employee of Veterans Affairs Canada.

The VAC released a statement last week admitting to an incident "where medical assistance in dying was discussed inappropriately" with the veteran. The department pledged that "appropriate administrative action will be taken" after the veteran expressed outrage at the suggestion, according to a report in Global News.

According to the report, the veteran called VAC seeking support for PTSD when the employee brought up medical assistance in dying, or euthanasia, unprompted. The veteran was reportedly shocked by the suggestion. His family told Global News that the soldier had been making positive progress in his physical and mental rehabilitation and that he felt betrayed by an agency that is tasked with assisting veterans.

The veteran's ordeal has since raised fears that the exchange may not have been an isolated incident, leading to questions about how often the agency has offered or discussed MAID with those suffering from PTSD.

The agency has since apologized to the veteran in follow-up call after the incident resulted in several complaints, with the VAC saying it "deeply regrets what transpired."

Canada legalized MAID in 2016, with 2021 amendments broadening eligibility for those requesting the procedure. People suffering from mental disorders will also be allowed access to MAID starting in 2023.

But discussing MAID with veterans is not within the scope of the VAC, an agency in charge of the care of a population already at higher risk of suicide.

In 2017, the Canadian government introduced a new suicide-prevention strategy for military personnel and veterans which promised improved care and services. The plan also provided training to medical staff on how to respond to the warning signs of suicide.

Reached for comment by Fox News, a VAC spokesperson said "advice pertaining to Medical assistance in dying is not a VAC service."

"VAC’s Case Managers, Veteran Service Agents, and Veteran Service Team Managers have no mandate or role to recommend medical assistance in dying to Veteran clients," the spokesperson said. "Considerations for medical assistance in dying are the subject of discussions between a patient and their primary care providers to determine appropriateness in each individual context. It is covered through the provincial and territorial health authorities and is administered by a physician or nurse practitioner directly to the individual.

"We are investigating what occurred. We have not found any other similar incidents," the spokesperson continued. "This isolated incident is not indicative of a pattern of behaviour or a systemic issue."


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