'Dark side': Canada's euthanasia law is a threat to disabled people, expert says

Alan Nichols had a history of depression and other medical problems, but none were life-threatening. When his 61-year-old Canadian was hospitalized with suicidal thoughts in June 2019, he asked his brother to "kick him out" as soon as possible.

Within a month, Nichols filed a request for euthanasia, and despite the concerns of his family and nurses, he was killed.

On his euthanasia application, he listed only one medical condition as the reason for requesting his death. I'm hard of hearing.

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Nichols' family reported the incident to police and health officials, claiming he was incapable of understanding the process and suffering unbearably amid euthanasia requirements. did. They say he wasn't taking the medication he needed, wasn't using a cochlear implant to help him hear, and that hospital staff improperly assisted him with his request for euthanasia.

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

The story is not unique to Canada, which has perhaps the most permissive euthanasia regulations in the world, allowing people with severe disabilities to live without other medical problems, according to disability experts. It is permissible to choose to kill in some cases.

Many Canadians support euthanasia, and advocacy groups say that euthanasia is "driven by a desire for compassion, an end to suffering and discrimination, and a desire for individual autonomy." “It is being done.” But human rights advocates say that national regulation lacks the necessary safeguards, disregards the lives of people with disabilities, and warns doctors and health care workers to enforce this procedure on people they might otherwise not consider. I encourage you to make suggestions.

People who were about to be killed because they did not receive adequate livelihood support from the government.

Canada plans to expand access to euthanasia next year, but supporters say the system will It now says it needs more scrutiny.

Human Rights Commission Director Marie-Claude Landry said euthanasia "cannot be a breach of Canada's human rights obligations."

Landry wrote that Canada's euthanasia law appeared to violate the agency's Universal Declaration of Human Rights, a "serious concern" expressed last year by his three UN human rights experts. said to share. They said the law had a "discriminatory effect" on persons with disabilities and was inconsistent with Canada's obligation to uphold international human rights standards.

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Tim Stainton, director of the Canadian Inclusion and Civil Rights Institute at the University of British Columbia, described Canadian law as "probably the greatest threat to persons with disabilities since the Nazi programs in Germany in the 1930s." Stated.

During a recent visit to Canada, Pope Francis condemned the labeling of a waste culture that sees the elderly and disabled as disposable. Francis said he "needs to learn how to listen to the pain" of the poor and most marginalized, and he lamented "patients who were given death instead of love."

Canada prides itself on being liberal and inclusive, says David Jones, director of the UK's Anscombe Center for Bioethics.

Euthanasia, in which doctors use drugs to kill patients, is practiced in Belgium, Canada, Colombia, Luxembourg, the Netherlands, It's legal in 7 countries, New Zealand, Spain, and some states in Australia.

Other jurisdictions, including some states in the United States, allow assisted suicide, in which the patient voluntarily ingests a lethal drug, usually contained in a drink prescribed by a doctor.

Death assistance, even though more than 99.9% of deaths are euthanasia. More than 10,000 people were euthanized last year, about a third more than the previous year.

Canada's journey to legalize euthanasia began in 2015. The Supreme Court declared that outlawing assisted suicide robs people of their dignity and autonomy. It gave the country's leaders a year to draft legislation.

The resulting 2016 law allows people over the age of 18 to legalized both euthanasia and assisted suicide. A condition, disease or disorder that is in advanced irreversible decline and endures "intolerable physical or mental distress that cannot be alleviated under circumstances the patient deems acceptable". Their deaths also had to be "reasonably foreseeable" and euthanasia requests had to be approved by at least two doctors.

The law was later amended to allow non-terminally ill people to choose death, greatly expanding the number of eligible people. Critics say the change removes important safeguards intended to protect people who may have years or decades to live.

Seek help when dying.

Canada's Health Minister Jean-Yves Duclos said the country's euthanasia law "recognises the rights of all people and the inherent equal worth of all life."

Countries that allow euthanasia and assisted suicide differ in how they manage and regulate the practice. , Canada has some policies that make it stand out. others. Example:

_ Unlike Belgium and the Netherlands, where euthanasia has been legalized for 20 years, Canada publishes an annual report on euthanasia trends, but there are potentially problematic ones. There is no monthly committee to review potential cases.

_ Canada is the only country that allows nurses, not just doctors, to end patients' lives. Medical authorities in Ontario and Quebec, the two largest states, have explicitly instructed doctors not to list deaths from euthanasia on death certificates.

_ Belgian doctors are advised not to mention euthanasia to their patients as it can be misconstrued as medical advice. The state of Victoria, Australia, prohibits doctors from euthanizing patients. Canada has no such restrictions. The Canadian Association of Medical Professionals Providing Euthanasia has instructed doctors and nurses to let patients know if they are eligible to be killed as one of the possible "clinical treatment options." increase.

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_ Canadian patients do not have to exhaust all alternative treatments before seeking euthanasia . Netherlands.

Still, Duclos said appropriate safeguards were in place, including "strict eligibility criteria" to ensure that persons with disabilities were not encouraged or forced to commit suicide. Government statistics show that more than 65% of people are euthanized because of cancer, followed by heart problems, respiratory problems and neurological conditions.

Theresia Degener, professor of law and disability studies at the Protestant University of Applied Sciences in northwestern Germany, believes that disability alone It was a clear violation of human rights, stating that euthanasia would be permitted based on

"The (Canadian) law means that a life with a disability is automatically less worth living, and in some cases death is preferable," she said Degener. Stated.

Alan Nichols lost. He underwent brain surgery at age 12 and recently suffered a stroke, but lived mostly alone. "He needed our help, but he wasn't handicapped enough to deserve euthanasia," said Gary Nichols.

In one of his evaluations submitted by nurse practitioners before Nichols was killed, Nichols noted his history of seizures, weakness, and "growth failure." She also wrote that Nichols lost hearing and sight.

The Nichols family believes that his death appeared to have been approved in part based on Alan's deafness. and had other concerns about how Alan was euthanized. They lodged a complaint with the British Columbia Agency Regulating Physicians and the Royal Canadian Mounted Police, seeking criminal charges. They also wrote to the Canadian Minister of Justice.

READ MORE: Group opposes forced transfer of BC. Patients Seeking Medical Assisted Death

"Somebody has to take responsibility so that it doesn't happen to another family," said Trish Nichols, Gary's wife. rice field. "I fear my husband or other relatives will be hospitalized and somehow get these (euthanasia) forms into their hands." He said he had justified the death and, in line with the patient's privacy, had no obligation to inform the relatives or involve them in treatment discussions.

The state regulator, the College of Physicians and Surgeons of British Columbia, told the family that it could not proceed without a police investigation. In March, the Royal Canadian Mounted Police Cpl. Patrick Maisonneuve emailed his relatives, said they reviewed the documents and concluded that Alan Nichols "meets the criteria" for euthanasia.

Family member of parliament, Laurie Sloness, has asked his Columbia health minister to conduct a public inquiry, calling the death "extremely disturbing".

Health Minister Adrian Dix said the state's oversight department had reviewed the case and had "not referred it for further investigation." He pointed out that the Euthanasia Act does not allow families to consider euthanasia requests or participate in hospital decisions.

Trude Lemmens, director of health law and policy at the University of Toronto, concludes that authorities justified Nichols' death. He said it was "amazing".

"This case shows that the rules are so lax that doctors and hospitals can hardly be held accountable for the deaths of people who should not have died," he said. rice field.

Some Canadians with disabilities decided to kill in the face of rising bills.

Sean Taggart struggled to get the around-the-clock care she needed until she was euthanized in August 2019 at the age of 41. The government provided Taggart, 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 for his remaining eight hours of insurance.

Health officials suggested Tagert be moved to an institution, but Tagert was too far from his young son and refused. He called the proposal a "death sentence" in an interview with the Canadian Broadcasting Corporation.

READ MORE: No 'euthanasia' in Quebec nursing homes during COVID-19, expert says told the coroner's hearing

Before his death, Tagert spent CA$16,000 to purchase the specialized medical equipment he needed to live at home with his caregivers. ($12,400) or more. But even that wasn't enough.

"I know I want change," Taggart posted on Facebook before his death. "I just didn't realize it was unacceptable."

British He is a professor at Columbia University, where his Stainton provides disability benefits income above the poverty line. I pointed out that there are no states or territories. In some areas, it's as low as 850 Canadian dollars ($662) a month, less than half what the government has provided for those unable to work during the COVID-19 pandemic, he said.

Heidi Janz, assistant professor of disability ethics at the University of Alberta, said: She” and leads them to euthanasia.

The Minister of Health, Duclos, told the Associated Press that she could not comment on specific cases, but that all jurisdictions have broad policies to support persons with disabilities. said there is. He acknowledged "disparities in access to services and support across the country."

Others with disabilities find euthanasia readily available to be a source of anxiety-provoking and sometimes frightening debates. I say connected.

Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so surprised that staff members mentioned euthanasia that he secretly shared some of their conversations. started recording.

In one of his records obtained by the AP, the hospital's director of ethics said it would cost Foley "more than $1,500 per day for him" to stay at the hospital. Foley responded that mentioning fees felt like an extortion and asked what plans he had for his long-term care.

"Roger, this is not my show," replied the ethicist. "My part of this was to talk to you [to see] if you were interested in dying assistance."

Read more: Prime Minister Trudeau calls for relaxation of restrictions on assisted death

Foley , said he had never mentioned euthanasia before. The hospital says it has not barred staff from raising concerns.

Catherine Frazee, professor emeritus at Ryerson University in Toronto, said cases like Foley's are probably just the tip of the iceberg.

"There is no easy way to track these cases, so it is difficult to quantify, but I and other advocates report weekly reports from persons with disabilities considering [euthanasia]. I listen regularly," she said.

Frazee cited the case of her 25-year-old woman, Candice Lewis, who had cerebral palsy and spina bifida. Lewis' mother, Sheila Elson, took her to a Newfoundland emergency room five years before her. During her hospitalization, Elson told the Canadian Broadcasting Corporation that her doctor said Lewis was a candidate for euthanasia and that it would be "selfish" if her mother chose not to pursue it.

Canada has made tweaks to its euthanasia rules since they were first enacted six years before her, but critics say Canada in particular has further expanded access to euthanasia. He said more needs to be done as time goes on.

Next year the country will allow people to be killed for mental health reasons only. We are also considering extending euthanasia to "mature" minors, i.e. children under her 18 who meet the same requirements as adults.

Chantal Aubertin, spokeswoman for Canadian Justice Minister David Rametti, said in an email that the government When it added safeguards to euthanasia regulations last year it said it took into account concerns raised by the community. These changes included people being notified of all services such as mental health support and palliative care before they seek to die.

Aubertin argues that these and other measures "will ensure that some Canadians continue to suffer on their own terms while ensuring important safeguards to protect vulnerable populations." It helps us to respect the difficult and personal decision to end."

Dr. Jean Marmoreo, a family physician who provides regular euthanasia services in Ontario, has sought an expert panel to provide second opinions in difficult cases.

"I don't think this is something you want to rush into, but at the same time, if the person makes a considered request for this and meets the eligibility criteria, they may exercise that right. It should not be denied. Death with dignity," she said.

Canada's Human Rights Commissioner Landry said leaders should listen to the concerns of those facing hardships believing that euthanasia was the only option. She called for social and economic rights to be incorporated into Canadian law to ensure that people have adequate housing, medical care and support.

"In an era when the right to die with dignity has been recognized, more must be done to ensure the right to live with dignity," she said.

Nicole Winfield of Edmonton, Alberta contributed to this report.

© 2022 The Canadian Press