Canada’s leading euthanasia opponent is questioning the latest assisted-suicide statistics, saying they may not come close to accurately counting the actual numbers of Canadians dying at the hands of caregivers.
A new federal government report shows the number of Canadians killed by euthanasia rose 26 per cent in two years. The First Annual Report on Medical Assistance in Dying in Canada 2019 was published in July following a series of interim reports that were published over the last year.
But Alex Schadenberg of the Euthanasia Prevention Coalition is skeptical about the reliability of the figures, noting “the data was gathered from reports submitted by the medical or nurse practitioners who caused the death. There is no requirement that a third party or neutral person submit the euthanasia reports to ensure their accuracy.”
In addition, the report does not attempt to uncover possible abuse of the law, unlike the most recent Quebec euthanasia report (October 2019) which “indicated that at least 13 assisted deaths did not comply with the law,” Schadenberg said.
Schadenberg said the report notes that many people start the assisted suicide process with an oral request, but the law only requires tracking once a written request has been made. “Therefore some requests for MAiD are not reported.”
The report says more than a third of those who opted for “medical assistance in dying” cited concerns of being a burden to family or carers.
In 2019, there were 5,631 assisted deaths reported in Canada, up from 4467 in 2018, accounting for two per cent of all Canadian deaths, said Schadenberg. That represents an increase of 26.1 per cent over 2018 with every province experiencing a steady growth in the number of cases of assisted suicide since its introduction into law in 2016.
When all data sources are considered, the total of number of medically assisted deaths reported in Canada from legalization until December 31, 2019 is 13,946.
The report found that cancer was the most common condition among those who ended their lives with MAiD, followed by respiratory conditions and neurological ailments. Slightly over two thirds of those who used MAiD had cancer as an underlying condition.
Along with having a “reasonably foreseeable” natural death, a person who wished to receive MAiD also had to show that their condition was causing them “enduring physical or psychological suffering that is intolerable to them and cannot be relieved in a manner that they find acceptable.”
In just over a third of 2019’s MAiD deaths, a “perceived burden on family, friends or caregivers” was one of the reasons cited, and in 13.7 per cent of cases, “isolation or loneliness” was a factor.
“When asked to describe the nature of the suffering prompting their request, patients most often reported ‘a loss of ability to engage in meaningful life activities’ followed by ‘loss of ability to perform activities of daily living’ reported in 82.1 per cent and 78.1 per cent of cases, respectively,” says the report.
“Inadequate control of pain” was cited in 53.9 per cent of cases, followed by “loss of dignity” in 53.3 per cent of cases.
In U.S. states with legal physician-assisted suicide, less than one half of one percent of deaths are due to euthanasia, the lowest rate in the world. If Canada’s numbers were extrapolated to the United States, approximately 50,000 people each year would end their lives with MAiD. This would put euthanasia in the top 10 causes of death for the United States, just above “intentional self-harm (suicide)” and just below kidney disease.
Countries that permit physicians to administer euthanasia and do not mandate self-administration have higher percentages of deaths from euthanasia. Similar to countries such as Belgium and the Netherlands, Canadian law permits doctors to administer the lethal dose of medication to the patients. In the United States, the drugs must be self-administered.
While Canadians have the option to self-administer the drugs, the number of people who chose to do so last year was “fewer than seven.”
In 2019, the average age of a person who received MAiD in Canada was 75.2 years, but 103 people between the ages of 18 and 45 received MAID.
Last year, 92.2 per cent of requests for MAiD were approved, out of a total of 7,336 applications.
Only 3.6 per cent of people who were deemed eligible for MAiD withdrew their request.
Of those who were deemed ineligible for MAiD in 2019, about a quarter were denied because death was “reasonably foreseeable,” and an additional quarter were denied due to not being “in an advanced state of irreversible decline in capability.” Those requirements are likely to change for future years.
The report says 41.2 per cent of those who died by assisted suicide in 2019 required disability support services, yet “there are people with disabilities who have been denied the level of support that they needed but instead offered MAiD,” said Schadenberg, listing several examples:
- In August 2016, a Newfoundland woman named Candice Lewis receiving treatment at a hospital was pressured to “request” an assisted death, said Schadenberg. “As Candice’s mother told CBC News, the doctor pressured her to request physician-assisted death” without Lewis asking for it.
- In 2018, Roger Foley of London, Ont., was turned down for self-directed home-care but offered euthanasia.
- In August 2019, Alan Nichols died by euthanasia in Chilliwack, even though he was living with chronic depression and his family insisted he was not competent to make the decision.
In September 2019, the requirement that a person be terminally ill to access euthanasia was struck down. The federal government did not appeal the decision.
Striking down the “terminal illness” requirement has opened the door to euthanasia for psychiatric conditions, said Schadenberg.
In February, Ottawa introduced Bill C-7 to expand the euthanasia law by removing the requirement natural death be reasonably foreseeable, permitting a doctor or nurse practitioner to lethally inject a person who is incapable of consenting if they were previously approved, and waiving the 10-day waiting period if a person's natural death is deemed to be reasonably foreseeable.
“Studies prove that the will to live fluctuates,” said Schadenberg. Under Bill C-7, “a person could request death by euthanasia ‘on a bad day’ and die the same day.”
In January, the B.C. and Yukon bishops expressed concern about efforts to broaden the criteria for assisted suicide. They asked Catholics to press members of Parliament to vote against any expansion and to call on the federal government to expand palliative care. They also urged health professionals to assert their right to refuse to participate in euthanasia and assisted suicide.
Health Minister Patty Hajdu said in a message released with the report that while she has “heard many heart-warming stories from Canadians describing how MAiD granted their loved ones a calm, compassionate and peaceful ending,” the federal government acknowledges that there are critics of the system and legal euthanasia.
“I have also heard voices of concern from other Canadians, worried there are insufficient protections for those who may be vulnerable to coercion or abuse, or who may request MAiD out of a sense of hopelessness associated with their personal situation,” Hajdu said.
“Supporting individual autonomy to choose how one wishes to address intolerable pain and suffering, while ensuring the decision is made freely and not the result of external pressures or a temporary period of despair, underpins MAiD legislation in Canada,” she said.
The Health Canada report claims that “the majority of persons who received MAiD in 2019 were reported to have received palliative care services (82.1%) and that the majority (60.8%) received these services for one month or more.”
The federal report says that indicates “requests for MAiD are not necessarily being driven by a lack of access to palliative care services.”
But Schadenberg said the report does not indicate what kind of palliative care is being accessed and that citing registration for palliative care is a “smokescreen.”
“The reality is the report does not give any understanding of what that palliative care was,” Schadenberg told Canadian Catholic News in a phone interview.
“The (federal) report just gives numbers as reported by MAiD practioners,” he said. “It doesn’t have any independent analysis of what is actually being provided.”
The report acknowledges more information is needed about what the palliative care numbers in relation to MAiD actually mean.
“It is important to note that while the data provide insight into whether palliative care has been received, it does not speak to the adequacy of the services offered,” the federal report into MAiD in 2019 said. “This may be an area for future study.”
Catholic News Agency with B.C. Catholic and Canadian Catholic News files