Expanded euthanasia will save money but increase deaths: report 

Canada’s Parliamentary Budget Office says expanding access to euthanasia will save millions of dollars in health-care costs, but could also lead to nearly 1,200 more assisted suicides next year.

The report, released Oct. 20, acknowledged the cost savings of assisted suicide, but said “this report should in no way be interpreted as suggesting that (euthanasia) be used to reduce health-care costs.”

At the same time, the report acknowledged the “disproportionately high” health-care costs to care for people in their last year of life, especially in their last month. Such patients represent one per cent of the population and 10 to 20 per cent of total health-care costs.

Access to assisted suicide, the report said, reduces health-care costs for provincial governments, the primary health-care providers. Since the legalization of assisted suicide in June 2016, the report estimated some $87 million have been saved by not providing individuals with health care or palliative care.

Alex Schadenberg of the Euthanasia Prevention Coalition said he predicted that social pressure to save money would become the ultimate form of social responsibility. “People will be socially pressured to die.”

Schadenberg said despite the report stating it wasn’t recommending euthanasia to reduce health-care spending, “Sadly, some people will point to the cost savings as a positive reason to promote euthanasia.”

A Quebec Superior Court last year ruled that it was unconstitutional to limit medically assisted suicide only to those whose natural death is “reasonably foreseeable.” The Liberal government decided not to appeal the decision, a decision lamented by Canada’s Catholic bishops.

The Canadian Conference of Catholic Bishops joined more than 50 religious leaders across Canada in an open letter earlier this month opposing the Trudeau government’s efforts to expand euthanasia by removing the safeguard of foreseeable natural death.

The court ruling required the government to introduce legislation to comply. That legislation would no longer require natural death to be “reasonably foreseeable” for a patient to be eligible for assisted suicide.

Rather, Bill C-7 provides easier eligibility rules for people near death and stricter eligibility rules for people who are not near death. It removes a 10-day waiting period for those whose natural death is “reasonably foreseeable.”

For persons whose natural death is not reasonably foreseeable, eligibility assessments must take at least 90 days unless loss of capacity to consent is imminent. According to a summary of the bill on the Justice Department website, two independent doctors or nurse practitioners must provide an assessment and confirm the patient is eligible. At least one doctor or practitioner assessing the person’s eligibility must have expertise in the medical condition causing his or her suffering.

The bill allows the possibility to waive final consent for assisted suicide for patients whose death is reasonably foreseeable and who are at risk of losing the ability to consent. It would also reduce the number of required witnesses for patient consent from two to one. Under the legislation, the patient must be informed of options to relieve suffering, including counselling, mental health and disability support, community services, and palliative care. Mental illness as a sole underlying condition would not be sufficient to access legal assisted suicide.

The new legislation to expand access to assisted suicide will result in another 1,164 assisted suicide deaths in Canada in 2021, the report predicted, in addition to the 6,465 deaths expected under existing law. Provincial health budgets would save $149 million next year as spending on end-of-life care declines.

“While this amount may appear significant, it only represents 0.08 per cent of total provincial health care,” said the report. The cost reduction “represents a negligible portion of the health-care budgets of provinces.”

Justice Minister David Lametti introduced the latest assisted suicide bill in February but its progress was halted when the House of Commons adjourned in mid-March because of the coronavirus epidemic.

Bill C-7, characterized as a “medical assistance in dying” bill, would modify Bill C-14, passed in 2016 to legalize and regulate doctor-assisted suicide.

In February the Canadian Conference of Catholic Bishops voiced “the greatest concern and dismay” about efforts to expand assisted suicide. They condemned “the lamentable legislative aim” of broadening access to assisted dying, and insisted “that every opportunity for due diligence be taken during the parliamentary process.” They have said better palliative care is needed.

“We unequivocally affirm and maintain the fundamental belief in the sacredness of all human life, a value that we share with many others in our country, including persons of different faiths and no faith at all,” Archbishop of Winnipeg Richard Gagnon, president of the CCCB, said in an October letter to Prime Minister Justin Trudeau.

“Despite the misleading euphemism, ‘Medical Assistance in Dying’ remains simply euthanasia and assisted suicide – that is, the direct taking of human life or the participation in his/her suicide, which can never be justified,” Gagnon added.

The First Annual Report on Medical Assistance in Dying in Canada 2019 said more than a third of those who opted for “medical assistance in dying” cited concerns of being a burden to family or carers.

Assisted suicide opponents have warned that legalizing such killings helps increase social or financial pressure on a person to kill him or herself, whether this pressure comes from insurance companies, private or government health-care administrations, or relatives. They question how society can campaign against suicide for the healthy or in favor of better palliative care for the ill while justifying assisted suicide at the same time.

They say there is a danger that assisted suicide further marginalizes the disabled, the elderly and the terminally ill and undermines the duty to respect and care for them. People facing treatable conditions could be presented assisted suicide as a better option, they warn.

With B.C. Catholic files