Alberta, British Columbia, budget cuts, Canada, cause of death, COVID-19, deaths, Ethics, euthanasia, health care, Labrador, lifeboat ethics, living with disabilities, loneliness, maid, Medical Assistance in Dying, medical ethics, Medically assisted suicide, medically assisted suicide for the mentally ill, Newfoundland, Ontario, Pierre Poilievre, Quebec, Right to Life, Roman Catholic Church, suffering, suicide
“Tim Stainton director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia said the country’s uniquely permissive euthanasia laws were, “probably the biggest existential threat to disabled people since the Nazis’ program in Germany in the 1930s.” https://www.forbes.com/sites/gusalexiou/2022/08/15/canadas-new-euthanasia-laws-carry-upsetting-nazi-era-echoes-warns-expert/
(2021 is the most recent report.)
In 2021, in Canada, 54% of assisted suicide took place in institutional settings: hospitals (28.6%), palliative care facilities (19.6%), residential care facilities (6.1%), compared to 44.2% in private residences. Other settings is 1.5%. The combination of institutional settings and high rates in Quebec, where discussions of limiting treatment of the terminally ill, to save the Province money, were already taking place decades ago, raises concern that people may be pressured into assisted suicide for financial reasons. Compare to the much lower rate of assisted suicide in Alberta, which has oil wealth to help support its medical system: https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html. Furthermore, the fact that, shockingly, most cases are approved by “family physician” generalists suggests a lack of adequate consideration and expertise.
This is in Ontario: “Canadian man claims assisted suicide is being pushed on him by hospital” By Michael Kaplan November 8, 2022 https://nypost.com/2022/11/08/canadian-man-assisted-suicide-being-pushed-on-me-by-hospital/
“Another ethicist, Tom Koch, says he found the recordings sad and shocking: ‘The larger concern is when the issue of the care of the fragile becomes simply a matter of financial expediency,” he says. “When we are given the option for a rapid death rather than a complex life then we are all at risk.” “I have heard from other friends of mine elsewhere in palliative care that they are all facing this enormous pressure towards the rapid, cost-effective ending rather than the complex and perhaps more expensive but skilled homecare that we all deserve.” https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
“3.2 MAID Deaths as a Proportion of Overall Deaths in Canada
MAID deaths accounted for 3.3% of all deaths in Canada in 2021, an increase from 2.5% in 2020 and 2.0% in 2019. In 2021, all provinces continued to experience increases in the number of MAID provisions as a percentage of total deaths, ranging from a low of 1.2% (Newfoundland & Labrador) to a high of 4.8% (British Columbia), with the exception of Alberta, which remained steady in 2021 at 1.9%. Québec and British Columbia experienced the highest percentage increase of MAID as a proportion of all deaths within their jurisdiction in 2021 (4.7% and 4.8% respectively), a trend consistent with 2019 and 2020, and reflective of the socio-political dynamics of individual provinces COVID-19 did cause some variation in the overall numbers of deaths in 2020. Footnote 8 The increase in total deaths in 2020 due to Covid 19 did not have any impact on the percentage of MAID deaths as a proportion of all deaths in Canada given the relatively small number of MAID provisions relative to total deaths in Canada.” See: “3.2: Percentage of Total Deaths Attributed to MAID by Jurisdiction, 2019 – 2021 Third annual report on Medical Assistance in Dying in Canada 2021” https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html
Quebec is the only majority Roman Catholic Province, yet shockingly has much higher rates (per capita) than Ontario or Alberta. Where’s the Quebec Roman Catholic Church? Notably, Roman Catholics in Alberta have made a web site explaining the problems with euthanasia from the vantage of theology and ethics: https://www.catholicyyc.ca/blog/maid-a-catholic-response The Roman Catholic Church has served as a bulwark against euthanasia, and appears to be the only major bulwark.
This apparent failure to involve experts in decision-making is surprising, shocking, and concerning:
“5.4 Specialty of Practitioner Delivering MAID
The majority of MAID practitioners work within the specialties of family medicine (68.2% of procedures), palliative medicine (8.6% of procedures), nurse practitioners (8.4% of procedures), and anesthesiology (4.5%) comprising 89.7% of all MAID provisions. This has remained consistent with results from 2019 and 2020, when these four specialties provided 86.2% and 89.4% of all procedures in those years respectively.
While family physicians continue to provide the majority of MAID provisions, 10.3% of procedures are provided by a range of other medical specialties, including: internal medicine (3.0%); critical care and emergency medicine (2.1%); oncology (1.3%); and other (3.9%) such as psychiatry, MAID specialists, Footnote 18 geriatric medicine, neurology, and respiratory medicine. A breakdown by jurisdiction is found in Appendix A.” See: “5.4: Specialty of MAID Practitioner, 2021, Third annual report on Medical Assistance in Dying in Canada 2021” https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html
Canada’s revised medical assistance in dying (MAID) came into effect on March 17, 2021. Details on the changes may be found here: https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html
“Third annual report on Medical Assistance in Dying in Canada 2021” https://www.canada.ca/content/dam/hc-sc/documents/services/medical-assistance-dying/annual-report-2021/annual-report-2021.pdf
Pierre Poilievre, who represents Alberta, has raised concerns that people who are depressed may be allowed to have medically assisted suicide: “Eliminate them?” https://youtu.be/5yjQDW8zI0U
“Chronically ill man releases audio of hospital staff offering assisted death” CTVNews.ca Staff Published Thursday, August 2, 2018 10:00PM EDT https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
Apparently this is supposed to be in conjunction with other conditions such as cancer or neurological symptoms, but it’s still alarming:
“4.3 Nature of Suffering of Those Who Received MAID
In order to be eligible for MAID, an individual must experience intolerable physical or psychological suffering that is caused by their medical condition or their state of decline and that cannot be relieved under conditions that the individual finds acceptable. In 2021, the most commonly cited source of suffering by individuals requesting MAID was the loss of ability to engage in meaningful activities (86.3%), followed by loss of ability to perform activities of daily living (83.4%), and inadequate control of pain, or concern about controlling pain (57.6%). These results are very similar to the 2019 and 2020 results, indicating the nature of suffering that leads a person to request MAID has remained consistent over the last three years. George was diagnosed with invasive cancer in 2019. He lived for a year at home, but began to experience a loss of independence, loss of ability to care for himself, loss of dignity, total loss of capacity, and pain. The disease had become severe, serious and incurable. He refused all treatments for his cancer, as nothing gave him back his ability to do the activities he loved and his dignity. He is fit for MAID.
– Practitioner Report “ Excerpted from:
“Nature of Suffering, Third annual report on Medical Assistance in Dying in Canada 2021” https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html
Summary excerpts from: “Third annual report on Medical Assistance in Dying in Canada 2021“:
“Growth in the number of medically assisted deaths in Canada continues in 2021
* In 2021, there were 10,064 MAID provisions reported in Canada, accounting for 3.3% of all deaths in Canada.
* The number of cases of MAID in 2021 represents a growth rate of 32.4% over 2020. All provinces continue to experience a steady year over year growth.
* When all data sources are considered, the total number of medically assisted deaths reported in Canada since the Parliament of Canada passed federal legislation that allows eligible Canadian adults to request medical assistance in dying in 2016 is 31,664.
Profile of MAID recipients
* In 2021, across Canada, a slightly larger proportion of men (52.3%) than women (47.7%) received MAID. This result is consistent with 2020 (51.9% men vs 48.1% of women) and 2019 (50.9% men vs 49.1% women).
* The average age at the time MAID was provided in 2021 was 76.3 years, slightly higher than the averages in 2019 and 2020 (75.2 and 75.3 respectively). The average age of women during 2021 was 77.0, compared to men at 75.6.
* Cancer (65.6%) is the most commonly cited underlying medical condition in the majority of MAID provisions during 2021, slightly down from 69.1% in 2020. This is followed by cardiovascular conditions (18.7%), chronic respiratory conditions (12.4%), and neurological conditions (12.4%). Three-quarters of MAID recipients had one main condition, while one-quarter had two or more main underlying medical conditions.
* In 2021, 2.2% of the total number of MAID provisions (219 individuals), were individuals whose natural deaths were not reasonably foreseeable (non-RFND) (in Quebec since 2019 and the rest of Canada after the passage of the new legislation on March 17, 2021). The most commonly cited underlying medical condition for this population was neurological (45.7%), followed by other condition (37.9%), and multiple comorbidities (21.0%). The average age of individuals receiving MAID who were non-RFND was 70.1.
The majority of MAID recipients received palliative care and disability support services
* During 2021, the majority of MAID recipients (80.7%) received palliative care. This compares similarly to 2019 and 2020 (82.1% and 82.8% respectively). Of the MAID recipients who did not receive palliative care, 88.0% had access to these services if they required them.
* In 2021, 43.0% of individuals who received MAID required disability support services. Of these, the majority, 87.4%, received disability support services. These results are similar to 2019 and 2020 findings.
* The use of palliative care and disability support services is similar amongst all main conditions except for neurological conditions where the use of palliative care is lower (56.0%) and the requirement for disability support services is higher (66.8%)
Nature of suffering among MAID recipients
* The most commonly cited intolerable physical or psychological suffering reported by individuals receiving MAID in 2021 was the loss of ability to engage in meaningful activities (86.3%), followed closely by the loss of ability to perform activities of daily living (83.4%).
* These results are very similar to 2019 and 2020 results, indicating that the nature of suffering that leads a person to request MAID has remained consistent over the last three years.
The total number of practitioners providing MAID continues to grow, and primary care physicians remain as the principal MAID providers
* The total number of unique practitioners providing MAID increased to 1,577 in 2021, up 17.2% from 1,345 in 2020. Similar to 2020, 94.4% of all practitioners administering MAID were physicians, while 5.6% were nurse practitioners. Physicians provided 91.6% of MAID procedures during 2021, while nurse practitioners took on an increasing share, performing 8.4% of MAID provisions.
* Family physicians continue to provide the majority of MAID provisions (68.2%), consistent with 2019 and 2020 results.
Private residences continue to be the primary setting for the administration of MAID in Canada
* In 2021, 44.2% of MAID provisions took place in private residences, continuing to be the primary setting for the administration of MAID in Canada. This is only a slight decrease from 2020 (47.6%) and continues the trend during that year of MAID provisions shifting away from hospitals towards other more familiar settings. The remainder of 2021 MAID provisions took place in hospitals (28.6%), palliative care facilities (19.6%), residential care facilities (6.1%), and other settings (1.5%). These levels are similar with 2020 results.
* The Atlantic provinces had a higher proportion than other jurisdictions of MAID provisions for individuals living in rural areas, ranging from 42.1% in Nova Scotia to 46.2% in Prince Edward Island. By contrast, Alberta (84.1%), British Columbia (83.6%), Ontario (81.6%), Manitoba (80.7%), and Québec (79.1%) had the highest proportion of MAID recipients living in urban areas. This is consistent with 2020 and roughly representative of each jurisdiction’s general pattern of population distribution.
Requests not resulting in a medically assisted death
* There were 12,286 written requests for MAID in 2021.This represents an increase of 27.7% over the number of written requests in 2020. The majority of written requests (9,950 or 81.0%) resulted in the administration of MAID.
* The remaining 2,336 requests (19.0%) resulted in an outcome other than MAID: 231 individuals withdrew their request (1.9% of written requests); 487 individuals were deemed ineligible (4.0% of written requests); and 1,618 individuals died prior to receiving MAID (13.2% of written requests).
* The main reasons for the withdrawal of a MAID request was the individual changed their mind (62.3%) or that palliative care was sufficient (38.5%). For 12.1% of withdrawals (28 individuals), withdrawal occurred just prior to the MAID procedure when asked to provide their final consent.
* In 2021, 487 individuals were deemed ineligible for MAID, representing 4.0% of all written requests. This represents a decrease from 2020 (6.1% of all written requests) and 2019 (7.9% of all written requests). The most common reason for a determination of ineligibility was due to the individual not being capable of making decisions with respect to their health (33.1%), consistent with 2020 results.
* The average age of individuals who died of another cause prior to receiving MAID in 2021 was 73.7 with 55.1% men and 44.9% women. Approximately 70% had cancer. The median days to death from another cause from the time of the submitted request was nine days.” https://www.canada.ca/en/health-canada/services/medical-assistance-dying/annual-report-2021.html
From their Information page:
“Medical assistance in dying
This webpage deals with topics that may cause distress. If you or someone close to you needs support, we encourage you to reach out. Resources are available at canada.ca/mental-health.
February 2, 2023 – The Government of Canada introduced legislation proposing to extend the temporary exclusion of eligibility for MAID in circumstances where a person’s sole underlying medical condition is a mental illness until March 17, 2024. Learn more: News Release https://www.canada.ca/en/department-justice/news/2023/02/delay-of-eligibility-for-medical-assistance-in-dying-for-persons-suffering-solely-from-mental-illness-proposed-by-ministers-of-justice-and-health.html
Canada’s revised medical assistance in dying (MAID) came into force on March 17, 2021. The new law includes changes to eligibility criteria, procedural safeguards, and the framework for the federal government’s data collection and reporting regime.
* Read the Canada’s revised MAID law https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html
The information provided in the sections below reflect Canada’s current MAID regime. On this page, you can also read reports published about MAID in Canada…” Read the rest here: https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html
Pierre Poilievre of Alberta raises the alarm in the Canadian parliament: “Eliminate them?” https://youtu.be/5yjQDW8zI0U MAiD
“Chronically ill man releases audio of hospital staff offering assisted death” CTV News.ca Staff Published Thursday, August 2, 2018 10:00PM EDT https://www.ctvnews.ca/health/chronically-ill-man-releases-audio-of-hospital-staff-offering-assisted-death-1.4038841
“During the Second World War, the Roman Catholic Church protested against Aktion T4, the Nazi involuntary euthanasia programme under which the mentally ill, physically deformed, and incurably sick were to be killed. The protests formed one of the most significant public acts of Catholic resistance to Nazism undertaken within Germany. The euthanasia programme began in 1939, and ultimately resulted in the murder of more than 70,000 people who were senile, mentally handicapped, mentally ill, epileptics, cripples, children with Down’s Syndrome, or people with similar afflictions. The murders involved interference in Church welfare institutions, and awareness of the murderous programme became widespread. Church leaders who opposed it – chiefly the Catholic Bishop Clemens August von Galen of Münster and Protestant Bishop Theophil Wurm – were therefore able to rouse widespread public opposition…”. https://en.wikipedia.org/wiki/Nazi_euthanasia_and_the_Catholic_Church
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