Raymond J. de Souza: Canadians need more palliative care, not same-day death on demand

Bill C-7 kills off the modest safeguards that were supposedly in place. It will now be possible to be get the lethal injection the same day it is requested

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It’s more than strange during a global pandemic to expand the capacity of the health professions to administer death, but the federal government is hell bent on getting Bill C-7 on expanding medically-administered death passed on an accelerated schedule.

The official acronym/euphemism is “medical assistance in dying”: MAiD. But the new law does not require the candidate for lethal injection to be dying, or at least not any more than everyone is dying. The 2016 MAiD law required that death had to be “reasonably foreseeable.” The new bill, in response to a Quebec court judgment which the federal government declined to appeal, removes that requirement.

A coalition of physicians and vulnerable Canadians rightly calls this “MAD”: “medically administered death.” If the candidate no longer has to be dying, it is no longer a question of “assistance” in dying. This is straight up death for those who do not want to live.

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This is straight up death for those who do not want to live

Yet it is more ominous than that. Those suffering from a chronic illness or disability — but who are not dying — would be eligible. And some of those sick and disabled who are eligible will, as certainly as death comes for us all, be pressured into doing just that.

Taylor Hyatt recently testified that her doctor suggested that she might look into the possibility of medically assisted death. She was then in her twenties and had pneumonia, so this would not be the customary indicated therapy. But Taylor was disabled and in a wheelchair. She would eventually recover from her pneumonia, as most twentysomethings do.

“All the doctor seemed to see, though, was a disabled woman alone, sick, tired and probably tired of living,” said Hyatt. A quick injection could take care of all that, especially the “living” part.

When MAiD, now “MAD,” was introduced in 2016, the government loudly trumpeted the “safeguards” that would ensure that no one would be pressured into requesting a lethal injection, that the decision would be carefully considered, that alternatives would be assiduously offered.

Whether that was ever true in practice, it will no longer be true in law. C-7 kills off the modest safeguards that were supposedly in place. It will now be possible to be get the lethal injection the same day that it is requested. In a country where you can wait weeks or longer for diagnostic imaging, it is perverse that lethal injections are the one “medical” option that has no wait time.

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Gone, too, is the requirement for two independent witnesses. Thus a vulnerable person, perhaps mentally disabled with a chronic health condition — perhaps incarcerated — could be given a medically administered death with no waiting period, no contemporaneous request and no witnesses. And if Dr. Smith is asked why he gave John Doe a lethal injection in the afternoon, all he has to say is that he was asked for it that morning. With John Doe now dead, who can say that it was not his will, that he was eliminated contrary to his wishes?

Gone, too, is the requirement for two independent witnesses

We would like to think that Canadian doctors would never do such a thing. Consider those, like Taylor Hyatt, who were advised to consider the possibility of death when they sought out simple medical treatment. Is it so hard to imagine that with all safeguards removed, some doctors might offer more than just advice, especially now that no one is looking? And if encouraged to do so by others who consider this particular life no longer worth living?

The health system overall, whether unwittingly or be design, does provide exactly that encouragement. Palliative care at the end of life is what the vast majority of Canadians want, as survey after survey reports. Palliative care removes the burden of intrusive and debilitating treatments, reduces or removes pain, provides comfort and the company of loved ones. Yet it is woefully underfunded, with some small cities having palliative care beds that can be numbered in single digits. Lacking meaningful access to palliative care, patients are offered instead help to die, rather than to live.

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Particularly perverse are those health-care systems that count the costs of medically administered death as part of palliative care, diverting already too few resources. Palliative care is much cheaper than overly-medicalized hospital deaths, but there is nothing cheaper than a single hypodermic.

Decades of studies have confirmed two facts of about end-of-life care in Canada. It consumes a vast amount of resources; many people will consume more “health care” in the last year before death than in the entirety of their life before that. And most Canadians do not want to spend large parts of that last year in hospital.

Palliative care, hospice care and home care are what is needed and what is desired. Yet these remain chronically underfunded and delayed while the option for a quick and cheap death is full speed ahead.

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