Health Canada report shows euthanasia deaths on rapid rise

OTTAWA (CCN)—Euthanasia deaths in Canada could soon exceed the rates of such deaths in Belgium and the Netherlands, warns the Euthanasia Prevention Coalition.

Reported euthanasia deaths rose by 46.8 per cent in the second half of Canada’s first year of legalized euthanasia and assisted suicide, according to an interim report released by Health Canada Oct. 6.

The report said 1,179 “medically assisted deaths” occurred between Jan. 1 2017 and June 30, 2017, rising to 0.9 per cent of all deaths in Canada during that time period.

As of June 17, 2017, the first anniversary of the law legalizing so-called Medical Aid in Dying (MAiD) in Canada, Canada has seen a total of 2,149 MAiD deaths. That figure includes euthanasia that took place in Quebec since Dec. 10, 2015, when Quebec’s separate law came into effect.

Health Canada reported the euthanasia and assisted suicide figures are in line with those of other jurisdictions where MAiD is legal, with rates varying between 0.3 per cent and 4.6 per cent of all deaths.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said on his blog, however, the number “is high when compared to Belgium where there was 235 reported assisted deaths in the first year (2003); 349 in the second year, and 393 in its third year after legalization.” Belgium’s population is about one third of Canada’s.

“Based on the number of reported assisted deaths, it is possible that Canada will quickly surpass the Netherlands and Belgium,” he said.

Also, the Canadian figures could be much higher than those reported, he warned. “Canadian governments have established a self-reporting system, meaning the doctor who carries out the death is the same doctor who reports the death” without oversight of the law. “Therefore it is possible that under-reporting and abuse of the law occurs,” Schadenberg wrote.

The vast majority of Canada’s MAiD deaths involved euthanasia, the deliberate killing of a patient by a health professional, usually a physician. Only an estimated five cases of assisted suicide were reported, where the lethal drugs were self-administered. Quebec’s law does not permit assisted-suicide; other jurisdictions are uncomfortable with patients self-administering without medical supervision; and some smaller jurisdictions declined to report for privacy reasons, the Health Canada interim report said.

Though “assisted deaths” occurred across the legal age-of-consent spectrum (from 18 to 91+) the average age of those euthanized was approximately 73, the Health Canada study reported. The most common underlying condition prompting the request for MAiD was cancer-related (63 per cent), and that is consistent with findings in other jurisdictions, it said.

Other underlying conditions included neuro-degenerative illness and circulatory/respiratory illnesses.

Health Canada reported a slight increase (eight per cent) in assisted deaths taking place outside a hospital setting, from 50 per cent in hospital for the first six months, to 42 per cent in the second six months.

“It is still too early to determine whether this is the beginning of a longer-term shift attributable to improved system integration and policies designed to facilitate home-based assisted death, which international research suggests many individuals prefer, or may be due to other factors such as barriers to providing medical assistance in dying in hospitals in some jurisdictions or lack of infrastructure for providing this service in institutions in some smaller communities,” Health Canada’s report said.

Canada is the only jurisdiction in the world that allows nurse practitioners to administer euthanasia drugs. The Health Canada report shows there were fewer than seven cases of nurse practitioners involved in assisted dying in the first six-month period, but the number rose to 38, or 4.3 per cent of cases, in the second six-month reporting period. The increase may have been helped by Ontario’s passage of legislation allowing nurse practitioners to prescribe controlled substances, the report said.

Health Canada also reported that in jurisdictions where information on requests was available, about one third of those who requested MAiD had their requests declined, with the most common reasons being “loss of competency (51 per cent) and that death was not reasonably foreseeable.”

The report also shows about 24 per cent of those requesting MAiD died before the request could be carried out.

The federal government left open to further study whether to allow MAiD for those with dementia through advanced directives; for mature minors under the age of 18; and for those with mental illness whose death is not foreseeable.