Medicine

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Liz CarrLiz Carr, who is an actress, comedian and disability rights activist, produced a documentary that she titled Better off Dead? that will be airing on BBC1 on Tuesday May 14 at 9 pm (UK). Carr may be best known for her role as Clarissa Mullery on the BBC series Silent Witness.

John Pring interviewed Carr for Disability News Service for an article that was published on May 9, 2024. Pring begins with Carr telling him how frighting the concept of legalizing assisted suicide is for people with disabilities, within the concept of the failing National Health Service (UK):
Legalising assisted suicide, she said, would be even more dangerous at a time when “we are absolutely removing our welfare state, and we are dismantling our incredible NHS”.

Last week, at a protest outside the Houses of Parliament, she told DNS she was terrified by the government’s latest proposals to cut spending on personal independence payment.

She said: “I don’t even think the other side will make the connection over how terrifying that feels to disabled people yet again.

“We know disabled people have killed themselves because of DWP reforms in the past.Carr speaks about her experience with interviewing Amir Farsoud, a Canadian with disabilities who sought euthanasia based on fears of homelessness. Pring reports:
“That’s what terrifies me: the kind of thing happening in Canada where people for socio-economic reasons are choosing to end their lives through euthanasia.”

In Canada, she interviewed Amir Farsoud, a disabled man from Ontario, who requested an assisted suicide because his landlord was planning to sell off his apartment building, and he was terrified at the prospect of being left homeless on the freezing streets.

He eventually changed his mind about seeking an assisted suicide after a crowd-funding effort raised tens of thousands of dollars to support him.Farsoud told Carr that it was easier and quicker in Canada to apply for medical assistance in dying (assisted suicide) than disability benefits.

Carr comments on Keir Starmer, the leader of Britains Labour party, who is pro-euthanasia and currently leading in the polls, if an election were to happen:
She said: “I’ve always been a little bit worried about Starmer getting in power, because he introduced the guidelines [on prosecuting cases of assisted suicide, in 2010] when he was director of public prosecutions.

“I’ve known he’s been pro, we all have, for over 10 years.”

She said this was “quite frightening” and “makes it difficult for voters like me to know what to do for the next election”.

Asked if she had a message for Starmer, she said: “I would say, please watch the documentary.Carr, who is an athiest, said that people who are concerned about the legalization of assisted suicide shouldn't sideline the opposition because they are marginalized or religious because there are many people who are concerned about legalizing assisted suicide.

Pring then spoke to Carr about her meeting with Canadian euthanasia doctor Ellen Wiebe:
She also spoke of the “chilling” attitude of Canadian doctor Dr Ellen Wiebe – who is herself disabled – who has provided assisted suicide to hundreds of Canadians since it was legalised and is shown in the documentary telling Carr she was “so glad, so glad” that they had medical assistance in dying laws in Canada.

She told her: “I love my job. This is the very best work I have ever done.”

Wiebe is also shown saying that she had never had so many grateful patients, which Carr said was “one of the most terrifying things in the documentary”.

She said: “When she says that doctors like grateful patients, that is chilling to me.

“And as somebody that’s had a lot of involvement with, you know, medics, that really frightens me.”Pring then reported on Carr's message at a preview event for the documentary:
“If we ask the question, ‘Do you want to stop dying people’s suffering?’ everybody has to say yes to that, or you’re a psychopath.

“We all, I believe, want everyone to have a good death, so the answer is how we do that.

“And the only difference between me and [those supporting legalisation] is how you do that. That’s the only difference.

“I don’t want people to suffer. I want people to have a good death. I just think people will suffer more if we introduce assisted suicide.”Carr commented on the media reports that indicate that legalizing assisted suicide is inevitable. Pring reports:
she said there was “nothing inevitable about it, nothing at all… I still think it’s time for a conversation and it’s not inevitable.”

Carr said she did not understand why those fighting for legalisation did not put their resources into pushing for improved healthcare and palliative care, or “into giving people choice and control in their lives”.

She said: “Because choice isn’t choice when you’ve got no choice. It absolutely isn’t.

“And I meet people in my life who are suffering absolutely because they do not have choices in their life.”Pring reports that Carr produced the documentary to get people with disabilities prominent in the debate:
One of the things she wanted to do with the documentary, she said, was to ensure that the disabled activists who are “a big part of my life” and “who have waited for this voice for years… feel heard and seen”.

A series of disabled actors, artists and activists opposed to legalisation are either seen on film or interviewed in the documentary, including Lisa Hammond, Ellen Clifford, Jamie Hale, Paula Peters, Eleanor Lisney, Penny Pepper and disabled peers Baroness [Jane] Campbell and Baroness [Tanni] Grey-Thompson.Pring concludes the interview with Carr stating that her interview with Melanie Reid, who supports assisted suicide, primarily focused on the experiences of being two disabled women, living in contemporary society, and the struggles and the fights to get our care needs met”.

The documentary, Better off Dead? creates common ground for people with disabilities to oppose the legalization of assisted suicide. 

As the culture wars rage around us, it is easy to be consumed. Stories make the world go round, and the social media algorithms tend to keep us in a spiral of doom and gloom. Part of this is our own desire to know what is happening in the world, and tragedy is a part of the human experience. But there is also a concerted effort for people to deny natural and fundamental realities.

The CBC Network is a light on these fundamental truths, so anyone can see the reality and necessity of biomedical ethics. The simple axiom of “Do No Harm” helps us to hold the medical field accountable when they commodify the human body into simple pieces and parts to be purchased. To further the CBC’s mission, we also tell stories – true stories!

• Hopefully you have been following Gloria’s story, which details the harrowing reality of surrogacy. You can watch her story on our YouTube channel, or read about her surrogacy experience on our website.
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To hear these stories live, please join us for the Annual Paul Ramsey Award Dinner on June 15, 2024. We will celebrate Dr. Jeffrey Bishop, a widely recognized scholar in medical ethics and medical humanities. Our special guest speaker is the indomitable Riley Gaines, who has been a force in standing up for women’s safety, privacy, and equal opportunities.

With only 60 tickets left, DO NOT DELAY! Get your ticket on the CBC’s website. There are sponsorship opportunities that include complimentary tickets, signed books, and even a VIP cocktail gathering with Dr. Bishop and Riley Gaines. We hope to see you there!

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The post CBC Network Shines a Light on Truth — but We Couldn’t Do it without You appeared first on The Center for Bioethics & Culture Network.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Mark KomradPsychiatrists, Dr's Mark Komrad and Annette Hanson, Ronald Pies and Cynthia Gepert, wrote a commentary on the recent attempted expansion of California's assisted suicide law that was published by the Psychiatric Times.The article explains that Dr Jennifer Gaudiani assisted the suicides of three people with eating disorders. Komrad and Hanson explain:
The third patient—Alyssa B—was actually a coauthor of the paper with Dr Gaudiani. According to the published paper,18 “Dr. G prescribed the MAID medications about 6 weeks after Alyssa entered hospice care.”

The Gaudiani et al paper is notable in acknowledging that: “Alyssa had not completed a full residential eating disorder program; never fully restored weight; never tried newer psychedelic options such as ketamine, psilocybin, or MDMA; and hadn’t had a feeding tube. Dr. G acknowledged that all but the feeding tube might ordinarily be undertaken prior to someone’s seeking end of life care for AN. Yet, [Alyssa] had been suffering for so long, and despite many conversations about all these treatment possibilities, Alyssa would not consent to any of them. Therefore, given her clarity of understanding around these issues and her sense that she could not fight anymore, everyone had to accept that they weren’t meaningful options.”Not surprisingly, the published paper and its rationale were vociferously criticized by many in the psychiatric community. For example, Dr Angela Guarda—the director of the eating disorders program at Johns Hopkins—is quoted as saying that using aid-in-dying medication for anorexia patients is “alarming” and “fraught with problems.” This is partly because “…it is impossible to disentangle this request [for PAS] from the effects of the disorder on reasoning, and especially so in the chronically ill, demoralized patient who is likely to feel a failure.”

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Maggie Hroncich
Maggie Hroncich wrote an article on a proposed bill to permit federal funding for assisted suicide that was published in the New York Sun. Hroncich reported that Democrat Members of Congress have introduced a HR 8137 to reverse the 1997 Assisted Suicide Funding Restriction Act and replace it with the Patient Access to End of Life Care Act. The language of the bill is not yet available but the new act would permit federal funding for assisted suicide. Hroncich reports:

For nearly 30 years — since Oregon became the first state to legalize physician-assisted death — Congress has prevented federal funding such as Medicare from being used by patients to pay for the practice. A bill proposed by Democratic lawmakers seeks to change that.

In 1997, Congress passed the Assisted Suicide Funding Restriction Act, which prohibits using federal funds to provide for any health care services that assisted in someone’s death, including “assisting in the suicide, euthanasia, or mercy killing of any individual.”The sponsors of the bill, Democratic Representatives Brittany Pettersen and Scott Peters released a draft discussion which states:
“Medical aid-in-dying, an authorized medical practice, is not euthanasia, mercy killing, or assisted suicide,” a draft discussion of the new “Patient Access to End of Life Care Act’’ obtained by the Sun reads.In other words Petterson and Peters intend to get funding approved for assisted suicide by redefining assisted suicide as not being assisted suicide.

The Euthanasia Prevention Coalition is opposing the Patient Access to End of Life Care Act. Hroncich reports:
Yet, an online petition with hundreds of signatures is already forming against the proposal, noting that it “would force Americans to pay for assisted suicide (medically approved killing by poison) with their tax dollars.”

“I oppose assisted suicide and I vehemently oppose paying for medically approved killing,” the petition on Canada’s Euthanasia Prevention Coaltion writes of the American legislation. “Thank you in advance for upholding my conscience rights by not approving the use of tax dollars for killing.”

The Canadian group is outspoken in warning America not to follow its path, arguing that legalizing medically-assisted death opens a door that can’t be shut.Petition: I oppose US federal funding for assisted suicide (Link).

The post Report Cards for Embryos  appeared first on The Center for Bioethics & Culture Network.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dan Clark reported for the Times Union that assisted suicide remains on the docket in New York. Clark's article: A month left in NY's legislative session. Here's what Clark states is on deck states:
Legislation is also up for consideration that would allow terminally ill patients to be prescribed medication they could use to end their life before their illness takes them.

It’s a bill that’s struggled to gain support in the Legislature, but that may change because of a key endorsement of the legislation this year.

The Medical Society of the State of New York had opposed the bill, but reversed that position in April after an internal vote.

“(The Medical Society) supports legislation such as the Medical Aid in Dying Act and supports physicians’ choice to opt-in or decline to engage in the processes and procedures as outlined in any proposed medical aid in dying legislation,” the group said.

Advocates for the bill have been a consistent presence at the Capitol this year, usually on Tuesdays. They approach lawmakers and try to convince them to sign on to the bill.

Opponents of the legislation refer to the practice as “assisted suicide,” though some have different reasons for why they’re against it.

Some religious groups, for example, are morally against it. Some disability advocates, but not all, see it as a slippery slope that could lead to similar legislation aimed at people with chronic conditions.

The assisted suicide lobby has invested resources into getting the New York assisted suicide bill debated. We are ready to oppose the assisted suicide bill.

Contact New York representatives to oppose assisted suicide (Link).

More information on this topic:

• The assisted suicide lobby wants to legalize assisted suicide in your state and then expand the law later (Link).
• Disability leaders on New York's capital urge lawmakers to reject assisted suicide (Link).
  
• Vermont assisted suicide deaths more than quadruple (Link).

Euthanasia for poverty is horrifying, profane, the outcome of a failed social welfare system and it is indefensible. 

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

David Moscrop wrote an excellent article that was published by Jacobin Magazine on May 2, 2024. Jacobin is an ideologically left magazine, which is concerned about Canada killing people with disabilities and the poor by euthanasia, known as MAiD. The article begins with this quote:
Canada boasts one of the world’s highest assisted-death rates, supposedly enabling the terminally ill to die with dignity. However, this suicide program increasingly resembles a dystopian replacement for care services, exchanging social welfare for euthanasia.Normand Meunier
Moscrop tells the story of Normand Meunier, the quadriplegic man in Québec who died by euthanasia after suffering from horrific neglect. Moscrop writes:
For want of a mattress, a man is dead. That’s the story, in sum, of a quadriplegic man who chose to end his life in January through medically assisted death. Normand Meunier’s story, as reported by the CBC, began with a visit to a Quebec hospital due to a respiratory virus. Meunier subsequently developed a painful bedsore after being left without access to a mattress to accommodate his needs. Thereafter, he applied to Canada’s Medical Assistance in Dying (MAiD) program.

As Rachel Watts writes in her report, Meunier spent ninety-five hours on a stretcher in the emergency room — just hours short of four days. The bedsore he developed “eventually worsened to the point where bone and muscle were exposed and visible — making his recovery and prognosis bleak.” The man who “didn’t want to be a burden” chose to die at home. An internal investigation into the matter is underway.I find it interesting that the article states that Meunier chose to die by euthanasia when in fact he was put into an untenable situation. Moscrop then reinforces the concerns of the disability community:
Disability and other advocates have been warning us for years that MAiD puts people at risk. They warned that the risk of people choosing death — because it’s easier than fighting to survive in a system that impoverishes people, and disproportionately does so to those who are disabled — is real. Underinvestment in medical care will push people up to and beyond the brink, which means some will choose to die instead of “burden” their loved ones or society at large. They were right.Moscrop comments on how euthanasia is the outcome of a failed social welfare state:
A libertarian ethos partially underwrote the fact that not many people blinked when MAiD was initially rolled out. Taking a more expansive view of rights, many of those not swayed by rote libertarianism were convinced that concerns over bodily autonomy and compassion were reason enough to adopt MAiD. However, in the absence of a robust welfare state, and in the face of structural poverty and discrimination, particularly toward disabled people, there is no world in which the MAiD program can be understood to be “progressive.”

Indeed, last year, Jeremy Appel argued that MAiD was “beginning to look like a dystopian end run around the cost of providing social welfare.” Initially supportive, he changed his mind on MAiD as he considered that the decisions people make are not strictly speaking individual but are instead collectively shaped and sometimes “the product of social circumstances, which are outside of their control.” When we don’t care for one another, what do we end up with? “I’ve come to realize,” wrote Appel, “that euthanasia in Canada represents the cynical endgame of social provisioning with the brutal logic of late-stage capitalism — we’ll starve you of the funding you need to live a dignified life [. . .] and if you don’t like it, why don’t you just kill yourself?”

Moscrop then comments on that euthanasia for psychiatric reasons has been delayed in Canada based on the lack of mental health care. He refers to the reality as grotesque and writes that this is the stuff of nightmarish science fiction. Moscrop comments on the broken social welfare system in Canada.

In Canada’s most populous province, Ontario, a recipient of disability support receives about $1,300 a month — a pittance they’re meant to stretch to cover food, shelter, and other basic needs. Ontario Works — the province’s welfare program — pays a current maximum of $733 a month. Meanwhile, rental costs for a one bedroom apartment routinely push toward an average of $2,000 a month in many cities. In April, in Toronto, a one bedroom apartment averaged almost $2,500 a month.Moscrop challenges a statement by euthanasia activists James Downer and Susan MacDonald who stated:[d]espite fears that availability of MAiD for people with terminal illness would lead to requests for MAiD driven by socioeconomic deprivation or poor service availability (e.g., palliative care), available evidence consistently indicates that MAiD is most commonly received by people of high socioeconomic status and lower support needs, and those with high involvement of palliative care.Moscrop replies:
By their own admission, the data on this matter is imperfect. But even if it were, the fact that “most” patients who choose MAiD are better off socioeconomically is beside the point. Some are not — and those “some” are important. That includes a man living with Amyotrophic Lateral Sclerosis who, in 2019, chose medically assisted death because he couldn’t find adequate medical care that would also allow him to be with his son. It also includes a man whose application listed only “hearing loss,” and whose brother says he was “basically put to death.” This story came a year after experts raised the concern that the country’s MAiD regime was in violation of the Universal Declaration of Human Rights.

In 2022, Global News said the quiet part out loud: poverty is driving disabled Canadians to consider MAiD. Those “some” who are driven to assisted death because of poverty or an inability to access adequate care deserve to live with dignity and with the resources they need to live as they wish. They should never, ever feel the pressure to choose to die because our social welfare institutions are starved and our health care system has been vandalized through years of austerity and poor management.Moscrop then states that Canada has the resources to prevent endemic poverty and provide adequate care, that poor people being euthanized by the state is profane.

Trudo Lemmens
Moscrop then refers to a recent article by professor Trudo Lemmens who is a critic of Canada's euthanasia law.
In a February piece for the Globe and Mail, University of Toronto law professor Trudo Lemmens wrote, “The results of our MAiD regime’s promotion of access to death as a benefit, and the trivialization of death as a harm to be protected against, are increasingly clear.” In critiquing MAiD’s second track, which allows physician-assisted death for those who do not face “a reasonably foreseeable death,” Lemmens points out that within two years of its adoption, “‘track two’ MAiD providers had ended already the lives of close to seven hundred disabled people, most of whom likely had years of life left.”

In raising concerns about expanding MAiD to cover mental illness, Lemmens added that “there are growing concerns that inadequate social and mental health care, and a failure to provide housing supports, push people to request MAiD,” noting that “[a]dding mental illness as a basis for MAiD will only increase the number of people exposed to higher risks of premature death.”Gabrielle Peters
Moscrop continues by referring to a commentary from disability leader Gabrielle Peters.
In 2021, Gabrielle Peters warned in Maclean’s that extending MAiD to cover those who weren’t facing an immediately foreseeable death was “dangerous, unsettling and deeply flawed.” She traced the various ways in which a broader MAiD law could lead to people choosing to die in the face of austerity, adding an intersectional lens that is often missing from our discussions and debates over the issue.

She warned that we were failing to consider “how poverty and racism intersect with disability to create greater risk of harm, more institutional bias and barriers, additional layers of othering and dehumanization, and fewer resources for addressing any of these.” And now here we are. We should have listened more carefully.Moscrop ends his article by suggesting that euthanasia may be OK based on personal choice but it is indefensible when it is based on poverty.
While MAiD may be defensible as a means for individuals to exercise personal choice in how they live and how they die when facing illness and pain, it is plainly indefensible when state-induced austerity and mismanagement leads to people choosing to end their lives that have been made unnecessarily miserable. In short, we are killing people for being poor and disabled, which is horrifying.

It thus falls to proponents of MAiD to show how such deaths can be avoided, just as it falls to policymakers to build or rebuild institutions that ensure no one ever opts to end their life for lack of resources or support, which we could provide in abundance if we choose to.I agree with most of Moscrop's comments but I disagree with his statement that euthanasia is possibly defensible as a means of individuals exercising personal choice. Even though people with disabilities experience social devaluation in Canada, they may be still exercising personal choice when they ask to be killed.

The problem with modern writers is that they miss the fact that euthanasia is about killing people. Even if Canada had a greater level of equality, there would be people who ask to be killed based on their poverty or their concerns about homelessness.

The real concern is that Canada has given medical professionals the right in law to kill their patients. This is about people killing people.

Nonetheless Moscrop is right that euthanasia based on poverty or disability is rarely based on personal choice and autonomy, it is horrifying, it is profane, it is the outcome of a failed social welfare system and it is indefensible.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
Gabrielle PetersI was going through my emails and found this excellent article that was published on April 26 in Policy Options by Gabrielle Peters, a disabled writer, policy analyst and the co-founder of Disability Filibuster. X: @mssinenomine

Peters is writing from a disability perspective as to why we need MAiD free health care options in Canada. Peters explains:

Some health-care providers see MAiD-free spaces as working environments that allow them to respect their conscience and adhere to their professional understanding of doing no harm.

Disabled patients, however, have expressed different reasons for wanting MAiD-free health-care settings.

Peters continues:
To start with, we should have the right to receive medical care in places and from people who do not contemplate or participate in killing disabled people as part of a care plan.

Who wants to look up at a doctor from a hospital bed and wonder if they have just deliberately ended the life of someone with a similar condition? Or to overhear conversations in hallways, waiting rooms, nursing stations or on the other side of a curtain, about how a lethal injection preserved a relative’s dignity before she – gasp – became incontinent, like me.Peters explains that faith based facilities (for now) are the only MAiD-free spaces. She then comments on the reality of ableism:
Many disabled people can remember a time in their lives when they would or could have agreed to MAiD had it been suggested to them. The reason for this unfortunate common bond is ableism.

A brief and widely adopted definition of ableism Fiona Kumari Campbell explains it as “a network of beliefs, processes and practices that produces a particular kind of self and body…that is projected as perfect and species-typical, and therefore essential and fully human.”

As a result, disability “is cast as a diminished state of being human.” It is a short journey from believing disability makes you less human to thinking that it is better to be dead than disabled.

Ableism in Canada is structural, codified, and acts as the rebar in our economy, politics, and culture. It defines and designs access to resources, services, public space, education, housing, health and health care, employment, and fundamental human rights.

Ableism affects how others perceive and treat us and how we perceive ourselves and our experiences. In this way ableism informs how our suffering is interpreted, making causal links that are not supported by evidence.Peters then quotes from Professor Heidi Janz who commented on medical ableism:
Medical ableism is often presented as “common sense” instead of bias, University of Alberta professor Heidi Janz says. Part of what allows it to remain unexamined is it exists within a larger contested framework referred to as the medical model of disability. In this model, disability is defined as deficiency, tragedy, and the opposite of health. Suffering is assumed and, because disability is understood entirely as a problem with an individual’s body, knowledge, power, and authority are placed within the medical field.

The result of this is our entire humanity is compressed into our diagnoses. There is no examination of the inherent political oppression or the bias in treatment because the medical model assumes the inequity disabled people experience is a logical result of being disabled.

This also incidentally is one of the many reasons MAiD assessors are ill-equipped to identify social suffering and solutions.Peters writes about how health-care professionals have power over people with disabilities since the doctor are often the gate-keeper to the services and that people need. Peters continues:
That signature is shaped by their perception of us, which is shaped by how well we align with their judgment of us as a “good patient.” In recent years, medicine has moved away from the use of the word compliant to describe whether patients follow medical advice. Now they talk about adherence. But whichever word they use, the power imbalance remains, and patients and family are hesitant to ask questions or raise concerns. As well, in most interactions, patients have just 11 seconds to speak before a physician interrupts them, research has shown.

Physicians conflate disability with suffering. Some bioethicists have likened disabled people to “happy slaves” for daring to suggest that disability is not a synonym for misery. Physicians consistently rate disabled people’s quality of life lower than disabled people themselves do. This is called the disability paradox.Peters then explains why the euthanasia lobby have had such influence:
The deluge of emotionally charged MAiD coverage is driven primarily by stories crafted or at least aided by the public relations and lobby efforts by proponents. As part of its recent campaign, Dying with Dignity, a national organization that campaigns for the expansion and liberalization of MAiD, emailed supporters urging them to submit opinion pieces to media organizations and offered the help of its communications team.

The CEO of Dying with Dignity has met with senators and members of Parliament in official lobbying capacity 41 times in the last 12 months. The charity also employs lobbyists at Blackbird Communications.

In a public-relations war, money can create even more imbalance than it does in a courtroom.Peters explains her concerns with suicide contagion.
But much of the media coverage of MAiD runs counter to the World Health Organization’s guidelines for responsible reporting on suicide. The WHO warns against spreading suicide contagion through prominent placement of stories about suicide, by normalizing it or presenting it as a constructive solution to problems, and by explicitly describing the method used.

Perhaps a lot of the coverage of MAiD ignores contagion protocols because MAiD is a euphemism for assisted suicide or euthanasia.Peters then comments on the concept of the "forced transfer":
A former executive director of Dying with Dignity said in a 2019 statement of claim that it was her “creative-thinking” that is responsible for the “ground-breaking” term. The statement was part of an Ontario lawsuit in which the public-relations value of the term was highlighted, noting it has been adopted “nationally and internationally by academics, clinicians, lawyers, and others in the right to die movement.”

Patients are transferred every day to access care, equipment or expertise that is not available where they are.

And it is striking that the term “forced transfer” is selectively applied to MAiD and not, for example, patients forced to move to long-term care facilities not of their choosing, on threat of being billed $400/day by the government if they refuse.Peters comments on the reality of her deterioration of care.
In 2009, before MAiD was legalized, I was living in North Vancouver. Since the onset of my rare neuromuscular disease several years prior I had been seen by an assortment of specialists at three different hospitals. Approximately two years of that time was spent in search of diagnosis for the multiple and worsening symptoms. At first, I thought I was just run down following a virus, but a turning point was when I had to be helped out of the community centre pool by a lifeguard because I couldn’t catch my breath a quarter of the way into my first lap. Over time, I transitioned from trail runner to using a cane, then walker and eventually a wheelchair. Simultaneously I transformed from being perceived as normal but sick to disabled and “unfixable” – and fat because of the corticosteroids.

No longer able to work and unable to access benefits due to eligibility criteria that declared me a dependent of the boyfriend I had been living with, my economic situation deteriorated.

Soon, my care changed, too. Nurses stopped complimenting me on my shoes, asking about my work, and telling me not to give up. The new answer to every question was a shrug and “you’re disabled.” It took three trips to two different hospitals and a tense standoff to finally be diagnosed and treated for deep-vein thrombosis and a pulmonary embolism following an intravenous immunoglobulin treatment (IVIG).

Meanwhile my condition created a smorgasbord of symptoms and managing one would sometimes worsen or create another. There were complications, “atypical presentations,” systemic infections, superbugs, and an ever-growing list of prescriptions sometimes accompanied by allergic reactions and serious side effects. I was a “high-cost health-care user.” The term is used to describe the five per cent of health-care users who are said to account for nearly two-thirds of health-care costs.

I sensed a growing defeatism among those providing me with care. But I was certain that the danger was at least partially a result of the health-care system’s siloed and almost exclusive focus on the latest acute crisis made worse by under-funding and embedded bias.Peters explains her experience with treatment and care at St Paul's hospital in Vancouver that led to her improved health. There was a hospital employee who pressured her to accept non-treatment as a "treatment" proposal but after dealing with that employee she did find good care at St. Paul's. She then writes:
Many, if not most, disabled people would prefer the additional option of secular MAiD-free spaces. But Catherine Frazee, whose quote starts this article, has articulated the view of a great many disabled people who fervently want safety from MAiD.

Affirming support for the belief of “better dead than disabled” in health care is dangerous and cruel. Canada has made disabled people a killable class, and hardly anyone has considered the impact this would have on us. This country must maintain MAiD-free health-care spaces.

Hadamar May 5, 2024Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I spoke at a conference in Germany on May 4, 2024. Since I was going to Germany I decided to go for few days to visit some of the T-4 euthanasia killing centres.

On May 1, I first visited the Grafeneck euthanasia memorial since it was the first of the T-4 euthanasia euthanasia centres. Approximately 10,000 people were killed at Grafeneck. On May 2, I visited the Hartheim castle euthanasia memorial where 18,269 people were killed under the T-4 euthanasia program and at least 30,000 people in total were gassed to death.
On Sunday May 5 I visited the Hadamar euthanasia memorial where at least 10,000 people were killed under the T-4 euthanasia program and approximately 15,000 were killed in total. Canada had approximately 16,000 euthanasia deaths in 2023. I have been reading more about the T-4 euthanasia program because history seems to be repeating itself.

Hadamar May 5, 2024I will republish from the Hadamar killing centre website which states:

At the end of 1940, the building of the Hadamar State Sanatorium (Landesheilanstalt Hadamar) was converted into a killing centre. The contracting authority behind this was the organisation responsible for the centrally controlled “adult euthanasia” programme, which was later referred to as the “T4” programme (Aktion T4). The headquarters of this organization was located on the Berlin street address of Tiergartenstraße 4 – hence “T4”.

Adolf Hitler, Führer and Chancellor of the German Reich, had instructed Karl Brandt, his accompanying doctor, and Philipp Bouhler, head of the Führer’s Chancellery, to carry out the murders. Both men were at the forefront of the “T4” programme.

The psychiatric hospitals in the German Reich, often referred to as state sanatoriums or convalescent and care homes, first received registration forms, so-called “Meldebögen”, from the health administration of the Reich Ministry of the Interior, in which they had to report on patients.

On the basis of these registration forms, so-called “Gutachter”, often professors of psychiatry and heads of institutions, were called on as experts to assess the patients and then decided between life and death. Those who were no longer able to work or had been long-term institutional patients or had not heard from relatives in a long time had little chance of survival.

Bus at HadamarIt was in these killing centres, which had been set up for this specific purpose, that these persons were murdered at the beginning of 1940. The Hadamar killing centre was the sixth and last murder site that was set up during the “T4” programme. The 13th of January 1941 marks the beginning of these murders. These individuals were first moved to “intermediate institutions” where they awaited transport to the Hadamar killing centre.

The “intermediate institutions” leading to Hadamar were located in Herborn, Weilmünster, Idstein (Kalmenhof), Eltville (Eichberg) in what is today the state of Hesse, Galkhausen (now North Rhine-Westphalia), Andernach, Schauen (now Rhineland-Palatinate) as well as Wiesloch and Weinsberg (now Baden-Württemberg). It was from Düsseldorf-Grafenberg (now North Rhine-Westphalia) and Heppenheim (now Hesse) in particular that patients who were considered Jews according to Nazi racial policy were forcibly taken to Hadamar.

Hadamar gas chamber.As was done in the other killing centres, a gas chamber and cremation furnaces were set up in the former Hadamar State Sanatorium. The institution was managed by two doctors. During the year of 1941, the killing centre employed a total of about 100 people, including nurses, kitchen staff and administrative personnel.

Since January 1941, patients had regularly arrived at the Hadamar killing centre on buses operated by the transport company that was in itself a subdivision of the “T4” organisation. These persons then disembarked the bus inside the wooden bus garage that had been built specifically for this purpose. They were then led inside the main building and made to undress in a large hall. Afterwards, administrative staff members checked personal information and one of the killing doctors determined the cause of death that would later appear in the falsified documents.

Hadamar smoke.It was in the gas chamber in the basement that the persons were then murdered using carbon monoxide. Afterwards, special staff members of the institution incinerated the bodies in the crematorium. Rising above the killing centre, the smoke that ensued from the incineration process could be seen from afar; and, as people of that time reported, one could also smell it.

The relatives of those murdered received so called “comfort letters” typed by secretaries which included false information about the circumstances of death, the time of death and, sometimes, the place of death. If relatives so requested, they were sent urns. However, these urns did not contain the ashes of their murdered family member.

By the time the “T4” programme was halted on 24 August 1941, over 10,000 patients had been murdered in Hadamar.Wikipedia reports what happened at Hadamar in this manner:

The clinic in Hadamar, which housed a psychiatric facility, was the last of six facilities set up to implement the programme, with murders commencing in January 1941.  During the first phase of operations (January to August 1941), 10,072 men, women and children were murdered with carbon monoxide in a gas chamber as part of the Nazi "euthanasia" programme.  The gas was obtained in standard cylinders supplied by the chemicals company IG Farben.

Thick smoke from the hospital crematorium billowed over Hadamar in the summer of 1941, during which the staff celebrated the cremation of their 10,000th patient with beer and wine. Up to 100 victims arrived in post-buses every day. They were told to disrobe for a "medical examination". Sent before a physician, each was recorded as having one of 60 fatal diseases, as "incurables" were to be given a "mercy death". The doctor identified each person with different-coloured sticking plasters for one of three categories: murder; murder & remove brain for research; murder & extract gold teeth.

Families of the victims were sent "comfort letters" with falsified causes of death. Families could also request a funerary urn, but the ashes were not from their family member.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Hartheim May 2, 2024I will be speaking at a conference in Germany on Saturday, so I decided to go to Germany for few days to visit some of the T-4 euthanasia killing sites. I decided to first visit the euthanasia memorial at the Grafeneck psychiatric facility because it was the first of the T-4 euthanasia euthanasia sites.

Today I visited the Hartheim castle euthanasia memorial. 18,269 people were killed under the T-4 euthanasia program and at least 30,000 people in total were gassed to death at Hartheim. I have been reading more about the T-4 euthanasia program because history seems to be repeating itself.

The Hartheim castle is an historic property that became a home for people with mental disabilities after being donated by the Prince of Starhemberg to the Upper Austrian State Welfare Society in 1898. The German government took over the property in 1939 to convert it into a killing center.

I am republishing much of the wikipedia information about the Hartheim killing centre. Here is a link to great information about the Hartheim Castle (Link).

The Hartheim killing centre (German: NS-Tötungsanstalt Hartheim, ... was a killing facility involved in the Nazi programme known as Aktion T4, in which German citizens deemed mentally or physically unfit were systematically murdered with poison gas. Often, these patients were transferred from other killing facilities such as the Am Spiegelgrund clinic in Vienna. ... Other victims included Jews, Communists and those considered undesirable by the state. Concentration camp inmates who were unfit for work, or otherwise deemed troublesome, were also executed here. The facility was housed in Hartheim Castle in the municipality of Alkoven, near Linz, Austria, which now is a memorial site and documentation centre. (This paragraph was edited because wikipedia was wrong).

Hartheim and T-4 statistics

In June 1945, during investigations by US Forces into the former gassing facility at Hartheim, the American investigating officer Charles Dameron broke open a steel safe in which the Hartheim statistics were found. This was a 39-page document produced for the internal purposes of the Nazi "euthanasia" programme (Aktion T4), and contained monthly statistics of the gassing of mentally and physically handicapped patients (called "disinfection" in the document) carried out in the six killing centres on the territory of the Reich. In 1968 and 1970 an ex-employee of the establishment revealed, as a witness, that he had to compile the material at the end of 1942.  The Hartheim statistics included a page on which it was calculated that "disinfecting 70,273 people with a life expectation of 10 years" had saved food in the value of 141,775,573.80 Reichsmarks.

Victims of the first extermination phase in Hartheim

Hartheim gas chamberAccording to the Hartheim statistics, a total of 18,269 people were murdered in the gas chamber at Hartheim in the period of 16 months between May 1940 and September 1941:
1940: May, 633, June, 982, July, 1449, August, 1740, September, 1123, October, 1400, November, 1396, December, 947.
1941: January, 943, February, 1178, March, 974, April, 1123, May, 1106, June, 1364, July, 735, August, 1176.These statistics only cover the first extermination phase of the Nazi's euthanasia programme, Action T4, which was brought to an end by Hitler's order dated 24 August 1941 after protests by the Roman Catholic Church. (specifically Bishop von Galen)

In all it is estimated that a total of 30,000 people were murdered at Hartheim. Among those killed were sick and disabled persons as well as prisoners from concentration camps. The killings were carried out by carbon monoxide poisoning.

14f13 "Special Treatment"

Just three days after the formal end of Action T4, a lorry arrived at Hartheim with 70 Jewish inmates from Mauthausen concentration camp who were subsequently executed there.  The Hartheim killing centre achieved a special notoriety, not just because it was where the largest number of patients were gassed, but because as part of Action 14f13 Hartheim was also the institution in which the most concentration camp prisoners were executed. Their numbers are estimated at 12,000. 

Some of the prisoners at Mauthausen who were no longer capable of working, especially in the quarries, and politically undesirable prisoners were brought to Hartheim to be executed. In the papers these transfers were disguised with terms like "recreation leave". The entries under "sickness" included "German-haters", "communist" or "Polish fanatic". From 1944 on, the prisoners were no longer selected by T4 doctors; the objective was simply to gain space in the Mauthausen camp quickly.  Other transports came from the concentration camp of Gusen, and probably also from Ravensbrück during 1944, made up of women inmates who were predominantly tuberculosis sufferers and those deemed mentally infirm.

Execution Doctors

Rudolf LonauerThe Action T4 organisers, Viktor Brack and Karl Brandt, ordered that the execution of the sick had to be carried out by medical doctors because Hitler's memorandum of authorisation of 1 September 1939 only referred to doctors. The operation of the gas tap was thus the responsibility of doctors in the death centres. However, during the course of the programme, the gas valves were occasionally operated by others in the absence of the doctors or for other reasons. Also, many doctors used pseudonyms rather than their real names in the documents.

The following execution doctors worked in Hartheim: Head: Rudolf Lonauer: 1 April 1940 to April 1945. Deputy head: Georg Renno: May 1940 to February 1945

Move of headquarters from Berlin to Hartheim and Weissenbach am Attersee

Hartheim euthanasia staffIn August 1943, due to allied bombing of Berlin, the head office for the National Socialist Euthanasia Programme was moved from Tiergartenstrasse 4, Berlin, to the Ostmark region, which was then humorously described as the air raid shelter of the Reich. The statistic and documents by Paul Nitsche, correspondence, notices and reports were taken to Hartheim (office department, accounts office) and the Schoberstein Recreation Centre near Weißenbach am Attersee (medical department).

References can be found on wikipedia (Link)

Grafeneck gateAlex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I will be speaking at a conference in Germany on Saturday, so I decided to go to Germany for few days to visit a some of the T-4 euthanasia sites. Today I visited the euthanasia memorial at the Grafeneck psychiatric hospital where it is believed that 10,654 people were gassed to death. I have been reading more about the T-4 euthanasia program because history is repeating itself.

In September 2023, while I was in Berlin Germany to speak at a conference, I went to the Euthanasia Memorial located at Tiergartenstraße 4, which was the headquarters of the T-4 euthanasia program that killed approximately 70,000 people, beginning in January 1940 (Article).

I have reproduced the information from the United States Holocaust Memorial Museum about Grafeneck:

Grafeneck Castle (Link to information).

Grafeneck Castle (Schloss Grafeneck) was built near the city of Tübingen in southwestern Germany around 1560. It was originally a hunting lodge for the dukes of Württemberg. Later modernized, the complex was privatized in 1904. In 1928, it came into the possession of the Samaritan Foundation (Samariterstiftung), a charitable arm of the German Lutheran Church. The foundation established a care facility for male patients with disabilities at Grafeneck in 1929.

Establishing the Killing Center at Grafeneck

When T4 operatives began to identify sites to serve as killing centers for the adult euthanasia program, they first chose the Grafeneck complex. The isolated location of the castle in the hills of the Swabian Alb appealed to their need for secrecy. The surrounding forest shielded the site from public view and only two entrances led to the facility. On October 6, 1939, high ranking T4 officials confiscated Grafeneck “for the purposes of the Reich.” Soon thereafter, caretakers at Grafeneck, as well as the facility’s 110 male patients, were removed from the complex.

By late October, T4 operatives arrived to convert the care facility into a killing center. On the castle grounds they erected a wooden barracks with beds. A construction team transformed the old coach house behind the castle into a makeshift gas chamber.

The castle itself housed the facility’s administrative offices. It also included a special registry office which issued the victims’ death certificates without attracting the attention of local officials. The death certificates were issued with falsified causes and dates of death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby announced in their fundraising email on April 29, 2024 that they are spearheading a bill to force American to pay for assisted suicide (Medically approved killing by poison) with their tax dollars. The fundraising letter states:
The Patient Access to End-of-Life Care Act would end a ban on federal funding to help terminally ill people pay for medical aid in dying where it is currently authorized or will be authorized in the future.The Patient Access to End-of-Life Act is sponsored by Representatives Brittany Pettersen (D-CO) and Scott Peters (D-CA) and would essentially replace the Assisted Suicide Funding Restriction Act of 1997 which prohibited the use of appropriated funds for: 

1. causing or assisting in suicide, euthanasia, or mercy killing;
2. compelling any person or entity to provide or fund any item, benefit, program, or service for such purpose; or 
3. asserting or advocating a legal right to cause or assist such actions.

The act is titled: The Patient Access to End-of-Life Care Act because the assisted suicide lobby intends to promote the funding of medically approved killing in conjunction with other end-of-life care, such as palliative care.

Based on the current political configuration, it is unlikely that this bill will pass, but it indicates the direction of the assisted suicide lobby and it makes the issue of medically assisted killing, which has essentially been a state by state issue, into a federal issue.

Oppose the Patient Access to End-of-Life Care Act. Don't let your tax dollars be used to kill people.

The Euthanasia Prevention Coalition upholds that the Canadian federal budget announcement that people with disabilities, who qualify, can receive $200 more per month, is an insufficient amount to meet the basic needs of Canadians with disabilities. Alex Schadenberg

Meghan Schrader
Message from the Meghan Schrader

Instead of robustly funding the Disability Benefit that Canadian disability rights advocates had hoped would lift poor people with disabilities at least up to the poverty line, Justin Trudeau’s government allocated only $200 a month for the new benefit (twitter comment) and attached qualification for the benefit to the Disability Tax Credit, making it difficult to qualify for. (CTV news article).

The gutted sobbing of disabled people on disability benefits who were so hoping that they would finally be able to eat three times a day is an indictment of a government that prioritizes everything but disabled people. The fact that Canada’s government would give their starving and demoralized disabled citizens only an extra $6.18 a day is truly vile, and speaks to how much Canada, and the world, don't understand the needs of (Twitter comment) disabled people.

Moreover, the current Canadian government responded to the cries of disabled people with excuses and statements that Conservatives will simply cancel the benefit entirely. Every conservative voted for the benefit. The current government’s response is a hallmark of an abusive relationship: the government is telling the disabled people that they are killing and starving “no one will ever love you but me.” (Twitter comment).

One reason that I so strongly oppose assisted suicide is that there are too many in the United states who think like Justin Trudeau and the Canadian middle class (Article) and look longingly at Canada as a model (Article) for our country: “I want the free dental care, I want the $10 daycare, I want free lunches for my kids, I want the perfect autonomous death…” (Article) And those same people never consider the fact that they don’t actually need those entitlements in the same way that disabled people need accommodations and care; (Twitter comment) they don’t even think about the fact that disabled people exist. (Twitter comment) Others understand that their entitlements are coming at the expense of disabled people’s very lives, yet are willing to keep the people killing them in power because they want the free stuff.

Well, guess what, ableds: disabled people don’t owe you anything; we especially do not owe you our lives. You’re not entitled to anything at disabled people’s expense just because you want it.

All other Canadian political parties - the NDP, the Conservatives, the Greens - must roundly condemn the inadequate support for disabled people. (Twitter comment) And people in the United States need to stop looking at Canada as a model for how our society should function. All ethical people must join together and work hard to keep Canada’s degradation of the disabled people from oozing over our borders and making the already third class citizenship (Article) of disabled Americans (Meghan Schrader Twitter comment) even worse.

Meghan Schrader is an autistic person who is an instructor at E4 - University of Texas (Austin) and an EPC-USA board member.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

Help the Calgary father of the 27-year-old autistic woman stop his daughter from being killed by euthanasia by donating to his legal expenses. (Link to the GiveSendGo campaign).

Due to a publication ban, the media refers to the father as (WV) and his daughter as (MV). WV contends that MV does not qualify for euthanasia because she is physically healthy, even though she is experience suicidal ideation.

I reported on April 9, 2024 that the father was granted an injunction preventing the euthanasia death of his 27-year-old autistic daughter, at least until the Alberta Court of Appeal decides on his challenge to the decision approving his daughters's euthanasia death.

This case is particularly distressing for me since I have an autistic son.

The Calgary father has already accumulated more than $100,000 in legal expenses in his attempt to prevent the euthanasia death of his healthy autistic daughter.

The legal expenses will continue to climb as his lawyers prepare for the Alberta Court of Appeal hearing in October 2024.

Help the Calgary father of the 27-year-old autistic woman stop his daughter from being killed by euthanasia by donating to his legal expenses. (Link to the GiveSendGo campaign).

Articles on this topic:

• Great news: Judge prevents euthanasia death of Calgary autistic woman (Link). 
• Father of a 27-year-old autistic woman appeals court ruling in euthanasia decision (Link).
  

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ramona Coelho

An excellent interview of Dr Ramona Coelho by Jonathon Van Maren was published in the European Conservative on April 24, 2024. 

As stated by Van Maren, Dr Coelho is a family physician in London, Ontario, with a practice largely serving marginalized patients, she has testified before Parliament, laid out the dangers of legal euthanasia on TV and in print, and presciently warned policymakers of many of the scenarios we now see unfolding. Dr Coelho is a leading voice opposing Canada's euthanasia regime.

Van Maren begins the article by bringing up two of the most recent Canadian euthanasia stories and commenting on the issue of euthanasia for mental illness alone:

For the past several years, the euthanasia horror stories unfolding in Canada have captured the attention of the press on both sides of the Atlantic. I have detailed many of them in my reporting; as I write this, a desperate father is battling in court to prevent his healthy 27-year-old autistic daughter from dying by doctor-administered lethal injection; another Canadian has been approved for euthanasia after developing bedsores while waiting for necessary healthcare that is increasingly difficult to obtain.

At the end of January, the Trudeau government delayed, for the second time, their plan to expand euthanasia eligibility to Canadians struggling solely with mental illness. Initially, a strong majority of Canadians supported legal euthanasia in limited circumstances. The events of the past several years have begun to erode that support, and the Conservative Party is campaigning on a promise to pass legislation banning euthanasia for mental illness. It is an incredibly pressing issue: if suicide-by-doctor were to be made available to the mentally ill, Canada’s ever-rising euthanasia death rate would spike overnight.

Dr Coelho defines what is mean't by the term MAiD:

Medical Assistance in Dying (MAiD) is the Canadian term that refers to both euthanasia and assisted suicide, although up to this point 99.9% of cases have been euthanasia (physician administered lethal cocktail to induce death, usually by IV) so I think it’s accurate and clearer to refer to this as euthanasia. However, it is possible that there might be more cases of assisted suicide (patient self-administers the lethal cocktail of drugs) in coming years as both are permitted. I will refer to it as MAiD just for ease and as some very few cases do involve assisted suicide.

Van Maren then asks Dr Coelho to comment on euthanasia for mental illness:

MAiD really never should have been an option for those with mental illness. Canadians face major barriers to access mental health care and numerous Canadian psychiatrists have voiced serious reservations about this expansion. We do not even understand how clinically to distinguish between the overwhelming majority of those with mental illness, who recover with suicide prevention and services, and those very few who might not. Such an expansion would allow healthcare practitioners arbitrarily to decide who deserves suicide prevention and who is deemed eligible for MAiD, potentially placing many Canadians’ lives at risk.

The legislation permitting MAiD for mental illness should have been permanently abandoned. But despite recommendations from its most recent parliamentary committee and most Canadian provinces asking that the legislation be indefinitely paused, the government has chosen simply to delay its implementation once again, this time until 2027. Politically, the delay in implementation of this legislation, rather than stopping it altogether, seems imprudent for the current government, as it may become a significant election issue. I would say Canadians are increasingly recognizing the risks of expanding MAiD to include individuals whose sole medical condition is mental illness.

Dr Coelho then comments on possible further expansions of MAiD in Canada:

And besides this, we still have the 2023 parliamentary recommendations to include MAiD for “mature” children and advance directives for euthanasia next. MAiD was initially introduced as an exceptional procedure to be used only for those near death with intolerable suffering, but once society embraces the intentional ending of one’s life as a treatment for suffering, it becomes practically impossible to contain, with Canada being a case in point.

Dr Coelho then comments on the concerns with medical safety:

In February 2024, the Canadian Human Rights Commission expressed ongoing concern over reports indicating that individuals with disabilities opt for MAiD due to a lack of essential support services. The CHRC is joined by UN human rights experts, Canadian disability groups, Indigenous advocates, social justice groups, and numerous medical and legal professionals in these concerns.

I was interviewed for a documentary featuring the tragic MAiD death of Rosina Kamis, who, citing poverty and loneliness, chose MAiD due to insufficient support. Some Canadian bioethicists argue that MAiD under “unjust social circumstances” is a form of “harm reduction.” However, this is not a free autonomous choice, but death driven by desperation and structural inequalities.

Messages promoting suicide and easier access to lethal means heighten suicide risks. MAiD exacerbates these dangers, endangering vulnerable individuals by increasing the likelihood of being induced into a premature death. Additionally, healthcare providers’ often inaccurately rate the quality of life of individuals with disabilities as poor, which may lead to their biases leading to suggesting or approvals of MAiD, particularly when patients are experiencing transient low points in their lives.

Dr Coelho then comments on the model practise standard:

Health Canada’s “Model Practice Standard for Medical Assistance in Dying” suggests informing patients about MAiD if the practitioner suspects it aligns with patient values and preferences. In contrast, other jurisdictions discourage or prohibit raising death as a treatment option due to concerns about undue patient pressure. The model practice standard’s stance on “conscientious objection” supports “effective referral” of patients. This means that, if a physician is concerned that MAiD is not a patient’s best option, they must still refer the patient to ensure access to MAiD, instead of pausing or stopping the process.

Examples of these unsafe policies are evident in MAiD training videos. In one, an instructor recognizes that patients may choose MAiD for unmet psycho-social needs, suggesting referral for MAiD completion if discomfort arises. Another instructor in a separate video advises continuing the MAiD process even if a practitioner believes a patient doesn’t qualify for MAiD, suggesting doctor shopping is acceptable.

Certain regions in Canada have the highest MAiD death rates globally. By 2022, nearly 45,000 MAiD deaths occurred across Canada since its legalization—almost 13,000 in 2022 alone, with estimates for 2023 approaching 16,000. Canada’s MAiD regime has chosen to prioritize accessibility over patient safety.

Dr Coelho then comments on her experience with the disability community:

Realizing my political naivety while advocating for legislative change has been a profoundly sad and eye-opening experience. Despite the government’s repeated assurances of listening to the concerns of persons with disabilities and their advocates, the reality witnessed during parliamentary hearings has been disheartening, as their voices are frequently disregarded or dismissed.

Throughout these hearings, committee members have consistently challenged the credibility of accounts detailing abuses within the Medical Assistance in Dying (MAiD) system. They assert an unwavering trust in MAiD assessors, portraying them as professionals deserving of complete faith and trust to get it right every time. However, this confidence is inconsistently applied, as committee members often interrupt and question the integrity of medical and legal experts expressing caution or offering alternative perspectives.

Furthermore, the presence of physicians who are now part of the government on MAiD parliamentary committees has not resulted in the expected depth of medical expertise or unbiased guidance. Instead, their contributions have often been marked by bias, with loaded questions designed to limit responses and paint concerned witnesses as advocating for prolonged suffering. This portrayal is starkly at odds with the reality faced by patients who endure lengthy waits for treatment. This waiting for care and being neglected by our society and health care system wears people down and can lead to choosing MAiD as the only accessible option.

Dr Coelho then comments on the euthanasia lobby:

Behind the scenes, powerful lobby groups in Canada wield significant influence in shaping the debate surrounding the expansion of MAiD. These groups, backed by substantial funding for government relations, dictate the trajectory of discussions, often overshadowing the voices of the underfunded and marginalized disability community. Despite the government’s claims of inclusivity, the reality is that this debate has been primarily driven by powerful interests, rather than the voices of those directly affected.

In essence, the legislative process surrounding MAiD in Canada has exposed systemic flaws and power imbalances, highlighting the urgent need for genuine inclusivity and meaningful dialogue that centers on the experiences and concerns of the real stakeholders, the disability community, which is most directly impacted by these policies.

Coelho is then asked about what must be done to reduce MAiD:

Thomas Insel’s book Healing drives home the critical role community life, support networks, and purpose have in dictating mental health outcomes, thereby highlighting the need for proactive measures. Firstly, the government must fulfill its duty to ensure everyone gets timely care, counseling, and the community resources they need. It’s unfortunate that we’re offering death as an option without properly supporting people who are struggling. At the same time, establishing a national suicide prevention framework is imperative to mitigate the risk factors that could contribute to MAiD decisions.

Palliative care centers have to be prioritized, offering a range of services including pain management, emotional support, end-of-life planning, and counseling individuals facing terminal illness, alongside robust access to disability and mental health services. This entails a concerted effort to build expertise, expand medical care systems, and ensure widespread accessibility.

Investment in community systems is essential too, fostering relationships and a sense of purpose and belonging. By organizing regular community gatherings, support groups, and educational workshops, communities can forge stronger bonds, mitigating feelings of isolation and despair. On the ground level, everyone can be involved in making sure neighbours and family members feel they are needed and cared for.

Furthermore, Canada’s commitment to the UN Convention on the Rights of Persons with Disabilities must be upheld, ensuring the provision of essential services and support for those with disabilities and chronic illnesses. The government has to address the systemic lack of social, economic, and health supports in order to alleviate the suffering that may otherwise drive individuals towards MAiD. We know that suffering from social and economic deprivation actually increases overall suffering from disability as it becomes conflated.

In essence, reducing the number of victims under Canada’s MAiD regime requires a comprehensive approach. Only through concerted efforts across these fronts can Canada ensure the dignity and well-being of its citizens, particularly those facing vulnerability and suffering. We need to make people feel they can live with dignity.

Dr Coelho is then asked what a future government must do:

Sadly, many Canadians remain unaware of the risks of our MAiD regime. As I mentioned, once a society embraces ending life as a solution to suffering, containing this procedure becomes nearly impossible. Tragically, the victims of this system are dead and can be forgotten, silenced, unable to recount the injustices that may have influenced their “choosing” death.

Therefore, to start, completely repealing Bill C-7 is imperative. Anything less is unacceptable to the disability community and greatly perpetuates the risks that death is driven by unjust circumstances.

There is also an urgent need to redefine the terms used in legislation, particularly ambiguous terms like reasonably foreseeable natural death (RFND). Through broad interpretations, individuals with potentially years of life ahead of them are prematurely ending their lives through the RFND track—a practice that was intended only for those in the final stages of life. Moreover, we have people who are simply stating they will refuse care to make themselves sick enough to qualify for RFND; MAiD should only be available to those with a disease prognosis of six months or less, not to individuals deliberately inducing sickness to qualify.

It is necessary to stem the influence of powerful lobby groups and expansionist medical advocacy organizations like the Canadian Association of MAiD Assessors and Providers (CAMAP). CAMAP received 3.3 million Canadian dollars in funding from Health Canada to educate MAiD assessors and providers and has many problematic guidance policies. A balanced independent panel of experts, as urged by the Canadian Human Rights Commissioner, should be convened to review the MAiD regime. This panel should guide legislative amendments, Health Canada policies, and provincial regulatory bodies to increase patient safety.

Many existing policies clearly require revision, including raising MAiD unsolicited, enforced mandatory referrals, and the worrisome trend of integrating MAiD into all care facilities. Ideally, a civil board comprising a multidisciplinary team should evaluate each case before approval to mitigate choices to die that are driven by structural inequalities. We also need better, publicly available, data collection all around.

This is not merely a matter of individual autonomy; it is a public safety concern that is affecting marginalized and disabled individuals. When discussing autonomy, we must consider relational autonomy—what we owe to each other and society as a whole. MAiD is a public policy, so we must consider the well-being of all—not just those seeking to end their lives on their own terms.

Previous articles by or articles concerning Dr Ramona Coelho (Article links).

Dear Senator

EPC-USA's Fact Sheet is testimony regarding the social harms attached to assisted suicide legislation like HB1283. However, given that assisted suicide’s negative impact is going to fall primarily on the disabled community, the EPC felt that we should submit a more detailed analysis of how assisted suicide undermines disability rights, and whose advice on this matter ought to be heeded by members of the Assembly.

Members of the EPC board with training in the fields of disability studies and advocacy have noted that some assisted suicide advocates are trying to hijack disability rights for their own purposes. For instance, an able-bodied man named Christopher Riddle has done pro-assisted suicide advocacy in the Northeast while presenting himself as a “disability rights advocate.” Riddle is a colleague of Udo Schuklenk, one of the architects of Canada’s euthanasia program, and Riddle enthusiastically approves of that program.

Moreover, Riddle’s theories about disability rights have been reasonably criticized as lacking any empirical grounding in the experiences of disabled people. He has no experience or personal stake in the practical implications of his ideas.

Furthermore, Riddle’s scholarship dehumanizes disabled people who are harmed by assisted suicide; he frames anyone who might be harmed by assisted suicide as the equivalent of a car accident statistic. He asserts that harm that assisted suicide might cause for people with disabilities “ought not to be of special concern.” Hence, Riddle is willing to sacrifice people with disabilities for the right to die movement’s agenda; he is not the “disability rights advocate” he claims to be.

For a more accurate understanding of how the disabled community has approached the issue of assisted suicide, we encourage you to watch a video created by disability studies ethicist Harold Braswell about disability rights opposition to assisted suicide. Braswell has studied the right to die issue extensively.

There are other very important facts that legislators must take into account when considering how assisted suicide is impacting the disabled community:

The American Association of Suicidology made a 2017 statement saying that “MAiD” was not suicide. But in 2023 the AAS had to retract that statement because it was used in the 2019 Truchon decision that expanded assisted suicide to disabled Canadians, which was opposed by the Canadian Association for Suicide Prevention.The consequences of the AAS’s statement are an example of how green lighting assisted suicide for the terminally ill easily results in violence against people with disabilities.

In 2021, the United Nations Special Rapporteur on the Rights of People with Disabilities asserted that all assisted suicide laws violate its Convention On The Rights of People with Disabilities.

Peer-reviewed research establishes that people are more likely to view suicide as acceptable if the victim is disabled, and people with disabilities often lack access to comprehensive suicide prevention care. This bill exacerbates that problem by laying the scaffolding for “MAiD” to become a substitute for the suicides of persons with disabilities.

Well-known right to die leader Thaddeus Mason Pope has tweeted that it’s good for disabled people to die by suicide; the director of Compassion and Choices appeared on Dr. Phil with Pope in 2023. If you pass this bill, you empower and reward a contingent of people who want disabled people’s suicides to be a “medical procedure.”

We urge you to allow HB1283 to die this session because regardless of its content, it rewards a movement that is hostile to people with disabilities. Exacerbating the oppression that disabled people already face so that the proponents can plan their deaths is unwise and unjust.

Sincerely,

Meghan Schrader, Disability Rights EPC-USA
Josephine L.A. Glaser, MD.,FAAFP
Colleen E. Barry, Chairperson
Kenneth Stevens, MD
William Toffler, MD
Gordon Friesen
Alex Schadenberg
Epc_USA@yahoo.com

Endnotes

1. https://twitter.com/cariddlephd/status/1373071051631038470
2. http://www.lpbr.net/2014/08/disability-and-justice-capabilities.html?m=1
3. https://www.tandfonline.com/doi/full/10.1080/09687599.2014.984931
4. https://philpapers.org/rec/RIDAD
5. https://www.dropbox.com/scl/fi/vdpwdt26wwq42ak0eraee/Braswell_PAS-Statement_To-Send-1.mov?rlkey=05vve2sis2s4sy51hma27jx2u&dl=0
6. https://www.slu.edu/arts-and-sciences/bioethics/faculty/braswell-harold.php
7. https://suicidology.org/2023/03/08/aas-update-on-previous-statement/
8. https://twitter.com/TrudoLemmens/status/1666067817035190272
9. https://suicideprevention.ca/media/statement-on-recent-maid-developments/
10. https://www.ohchr.org/en/press-releases/2021/01/disability-not-reason-sanction-medically-assisted-dying-un-experts
11. https://pubmed.ncbi.nlm.nih.gov/26402344/
12. https://www.youtube.com/watch?v=XXVrgtTNN2Y&t=2108s
13. https://twitter.com/ThaddeusPope/status/1669450726831976449

Normal 0 false false false EN-CA X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-fareast-language:EN-US;} This letter was sent to elected representatives in the British Parliament and shared.

Ann Farmer
Dear ... 

As your constituent I am writing to draw your attention to the above debate, in the hope that you will be able to attend and speak against attempts to legalise assisted suicide/euthanasia, now going under the euphemism 'assisted dying'.

Given the appalling outcomes reported from those jurisdictions that have gone down this route, most notoriously Canada, where 'strict safeguards' have been swiftly dismantled to allow death for disability and also poverty, https://alexschadenberg.blogspot.com/2024/04/a-call-to-defeat-new-hampshire-assisted.html it is vital that we do not follow them down this slippery slope.

Significantly, advocates of 'assisted dying' neglect to mention that this issue has been thoroughly debated and decisively rejected by Parliament in the past few years, on the very valid ground that there is no safe way of killing.

I trust you will attend, or alternatively make the case for 'assisted living' for all, rather than the money-saving expedient of euthanomics.

With all best wishes,

Ann Farmer
Woodford Green
Essex

Recently, a colleague sent me a new report published in the journal Fertility and Sterility, which is the professional journal of the American Society of Reproductive Medicine. The report is a retrospective cohort study on all assisted reproductive technology cycles reported to the Society for Assisted Reproductive Technology via their Clinic Outcome Reporting Systems. Data was gathered on embryo transfers done to U.S. gestational surrogates from 2014 to 2020 and compared surrogacy between surrogates and commissioning parents in both domestic and international arrangements.

First, it struck me as strange, that the report referred to the patients who were in fact the intended parents. Seems to me the surrogate mother and by extension, the baby(s) she carried would be the patient. But this is just another example of diminishing the mother-child dyad and centering the moneyed interests as the focus of the report.
The actual results were striking too, in reporting not only the rise in international purchasing parents using American women, but also who these people are who are hiring American women.

Of 40,177 embryos transferred during 2014 to 2020, 32% of these arrangements were foreign contracts. In 2014, the figure was 22%. In 2019, it was 39.8%. And then in 2020, the figure decreased to 31.8%, which was probably due, in part, to the Covid travel bans. The profile of the international intended parent(s):

• More likely to be a male (41.3%)
  Largely from China (41.7%) then France (9.2%) and Spain (8.5%)
• U.S. gestational carriers for international arrangements were younger than 30 years (42.8%)
• Cycles for international arrangements more often used donor eggs (67.1%)
• More often used introcytoplasmic sperm injection (67.1%)
• Preimplantation genetic testing used (79.0%)

As many countries prohibit surrogacy, these restrictive (and good) laws only encourage the explosion in Big Fertility here in the U.S. I can see all sorts of ethical and legal risks in the role the U.S. plays in the international reproductive tourism landscape. First, it should be a red flag that many of these arrangements are with single men. My pedophile, baby trafficking radar is on high alert. Second, the high percentage of Chinese nationals hiring women to buy a baby that has the bonus of U.S. citizenship, what is commonly referred to as “anchor babies.” As we fight for the abolition of the baby trade, we would do well, to close our borders to these international nefarious arrangements that exploit women at home. What a big dent we could make in the multi-billion-dollar baby markets if we just closed our borders. Seems like something our State Department should investigate.

The post The Rise of International Gestational Surrogacy in the U.S. appeared first on The Center for Bioethics & Culture Network.

Alex Schadenberg

Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition

Amy SmithWhile cleaning up my emails I came across this excellent commentary by Amy Smith, who is a physician-assistant in Minnesota titled: Pledge to 'do no harm' and say No to physician-assisted suicide. Smith's commentary was published in the Minnesota Reformer on April 13, 2024. Smith begins her article by explaining why she opposes assisted suicide.
I’ve spent the past 20 years of my career as a physician assistant saving lives in the emergency department. On a daily basis, I pledge to “do no harm” to my patients as I care for them and render lifesaving aid.

As a medical provider, the greatest harm I can imagine is being responsible for ending my patient’s life. That is why I am deeply troubled by ongoing conversations at the Minnesota Legislature to legalize physician-assisted suicide.

This proposed legislation goes against the fact that a health care providers’ obligation is to care for their patients — not to assist in killing them — no matter the circumstance.Smith is also concerned with the inevitable future extensions to the legislation.
It is also evident that limits on assisted suicide erode over time. These laws often begin with eligibility limited to terminal illness and a six-month life expectancy; however, countries like Belgium, Netherlands and Canada have gradually expanded criteria to offer assisted suicide to people with depression, disability and chronic pain, as well as people with limited income. Patients often seek assisted suicide out of fear of becoming a burden. Legalizing it reinforces harmful misconceptions that people experiencing chronic illness are a burden and encourages people to end their lives prematurely. And euphemisms like “medical aid in dying” make it more palatable for people to accept this as okay, masking the fact that medical professionals are prescribing medication that results in suicide.Smith continues by sharing personal experience with death and dying:
Like many Minnesotans, suicide is also a deeply personal subject for me. My dad ended his own life when I was 12 years old. Most people would say that my dad’s death at age 35 was a tragedy. They’d say we should try our best to prevent suicide. I agree.

I also lost my mom to Amyotrophic Lateral Sclerosis when she was only 62. This proposed legislation tells us that it would not have been a tragedy for my mom, with the assistance of her medical provider, to end her own life prematurely. Instead, this legislation says it would have been the caring thing to do. I disagree.

Both situations are absolute tragedies. In both scenarios, a person should have access to supportive, person-centered care — not a legal path to suicide.Smith concludes by repeating why she opposes assisted suicide.
Is physician-assisted suicide really how we want to care for patients in Minnesota? As a physician assistant, wife, mother — and as an orphan daughter — my answer is a resounding ‘No’.