Canadian Senate sends Bill C-14 back to parliament with amendments, the worst parts of the bill remain intact

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Canada's Senate passed Bill C-14, with its amendments, by a 64 to 12 vote, and therefore sent the bill back to parliament for acceptance or amendments.

The Euthanasia Prevention Coalition argues that Bill C-14 must be amended or defeated.

Bill C-14 will now go back to parliament where they will either accept the Senate amendments or send the bill back to the Senate. 

The Senate made seven amendments to Bill C-14. The only amendment to receive media attention is the amendment that replaces that a person's "death must be reasonably foreseeable" with a person having a "grievous and irremediable medical condition and after the condition has begun to cause enduring suffering that is intolerable to the person"

CBC news reported that the six other amendments are:

1. requiring a person to give informed consent to receive MAiD after having had a palliative care consultation, and after having been informed of treatment, technology and support options available to relieve suffering.2. a provision that prohibits a beneficiary from assisting a persons assisted death or signing the request for assisted death.3. require the federal minister of health to make regulations on the provision and collection of information for the purpose of monitoring MAiD and on the use and disposal of that information, and the information on death certificates.4. requiring a two-year deadline for independent reports on assisted dying.5. An amendment to the language of the bill to make the French and English versions consistent.6. An amendment to fix a drafting error in the bill.

The amendment that prohibits beneficiaries from assisting a death underscores the most grievous problems with Bill C-14, that being the lack of effective oversight of the law and the fact that the bill enables anyone to participate in acts of euthanasia or assisted suicide.

The most grievous sections of the bill have not been amended:

1. Bill C-14 allows anyone to cause death by euthanasia or assisted suicide. 

• Bill C-14 - Section 227(2) states: No person is a party to culpable homicide if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2. 
• Bill C-14 - Section 241(3) states: No person is a party to an offence under paragraph (1)(b) if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2. 
• Bill C-14 - Section 241(5) states: No person commits an offence under paragraph (1)‍(b) if they do anything, at another person’s explicit request, for the purpose of aiding that other person to self-administer a substance that has been prescribed for that other person as part of the provision of medical assistance in dying in accordance with section 241.‍2.

No jurisdiction in the world offers legal immunity to anyone who does anything for the purposes of assisted dying. These sections must be struck from the bill.

2. Bill C-14 continues to provide medical practitioners or nurse practitioners total immunity for decisions or acts that contravene Bill C-14.

• Section 241.3 states: Before a medical practitioner or nurse practitioner provides a person with medical assistance in dying, the medical or nurse practitioner must: (a) be of the opinion that the person meets all of the criteria set out in subsection (1); 
• Section 227(3) states: For greater certainty, the exemption set out in subsection (1) or (2) applies even if the person invoking it has a reasonable but mistaken belief about any fact that is an element of the exemption.

I cannot understand why people remain so blind about the implications of the language of the bill. Bill C-14 remains the most wide-open bill in the world. It is even worse than the Belgian law. 

Recent studies from Belgium indicate that more than 1000 assisted deaths occur without request each year.

Bill C-14 must be amended or defeated.

Belgian Psychiatric euthanasia request based on sexual attraction

Alex Schadenberg, International Chair - Euthanasia Prevention Coalition

Sébastien

Sébastien

BBC News has reported that a Belgium man, known as Sébastien, is seeking euthanasia based on psychological suffering in order to end his struggle with his sexual attractions.

The BBC article by Jonathon Blake explains that in Belgium, euthanasia for psychological suffering requires three doctors to approve the act (one of the doctors should be a psychiatrist), The law says that they must be suffering incurable, constant and unbearable physical or psychological suffering. The article states:

Sébastien has undergone 17 years of therapy, counselling and medication and believes he has no other option. 
He claims to be attracted to young men and adolescent boys and is scarred from a difficult childhood; his mother was ill and there was a strict Catholic ethos. 
"My whole life has led me to this, really," 
"I have always thought about death. Looking back on my earliest memories, it's always been in my thoughts. It's a permanent suffering, like being a prisoner in my own body," 
"A constant sense of shame, feeling tired, being attracted to people you shouldn't be attracted to - as though everything were the opposite of what I would have wanted."

The article examines differing views on psychiatric euthanasia. Psychiatrist Caroline Depuydt, who works at a psychiatric hospital in Brussels, encourages her patients to try further treatment.

We always have something that could work. Time, medication, psychotherapy - something that we must try and keep going with that. And the psychiatrist must give hope to the patient that it's never finished,

Gilles Genicot, a lecturer in medical law at the University of Liege, and a member of the euthanasia review committee says that you can never rule out the option of euthanasia.

Sébastien's case does not fulfil the legal criteria for euthanasia. 
It's more likely he has psychological problems relating to his sexuality. I cannot find a trace of actual psychic illness here. 
But what you cannot do is purely rule out the option of euthanasia for such patients.
They can fall within the scope of the law once every reasonable treatment has been tried unsuccessfully and three doctors come to the conclusion that no other option remains. 
Sébastien's request for euthanasia has been accepted initially, he now faces further assessments to determine whether his case fits within the law.

When asked whether he would change his mind, Sébastien states:

"If someone could give me some kind of miracle cure, why not? But for now, I really don't believe it any more. And I'm too exhausted also, whatever may be out there." 
Although he is calm - almost matter of fact - about wanting to end his life deliberately, he acknowledges the effect this will have on the people around him. 
"The hardest thing now is telling my family. If I get a yes, that's what's going to be most delicate."

Belgian Psychiatrist, Lieve Thienpont, published a study, last year, on the first 100 requests she received for euthanasia for psychiatric reasons. The data states:

  • 77 euthanasia requests were made by woman, 23 were men,
  • of the 48 approved requests, 35 died by euthanasia, 
  • 1 died by palliative sedation (sedation with withdrawal of water),
  • the average age was 47,
  • 58 were depressed, 50 had a personality disorder,
  • 12 were autistic, 13 had post traumatic stress disorder, 11 had anxiety disorder, 10 had an eating disorder, etc.

Last year, there were 2021 reported euthanasia deaths in Belgium. Recent studies indicate that more than 40% of the euthanasia deaths are not reported.

Bill C-14 needs to be amended or defeated

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Alex Schadenberg

Alex Schadenberg

The House of Commons passed Bill C-14, the government bill to regulate euthanasia and assisted suicide in Canada, with a 186 to 137 vote. Canada's Senate will begin to debate Bill C-14. The Senate has the power to amend and/or defeat the bill.

For those who are concerned that Bill C-14 will not be passed by June 6, the date imposed by the Supreme Court of Canada, stop worrying, it will definitely not become law by June 6. Therefore the approach needs to be to amend Bill C-14 in the Senate and if it is not adequately amended, to defeat the bill.

I appreciate the amendments to Bill C-14, An act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying made by the House of Commons

I recognize that conscience protection language has improved and some of the language of the bill was improved, but the most grievous sections of Bill C-14 were not amended. 

If this bill passes, in its current form, the language of Bill C-14 will lead to significant growth of euthanasia. There will be many stories that people will refer to as a "slippery slope." Let me tell you now, these stories will not be the result of a "slippery slope" but rather they will be based on the fact that the language of Bill C-14 allowed these acts to occur.

When I stated that the most grievous sections of the bill have not been amended, here is what I meant:

1. Bill C-14 continues to allow anyone to cause death by euthanasia or assisted suicide. 

• Bill C-14 - Section 227(2) states: No person is a party to culpable homicide if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2
• Bill C-14 - Section 241(3) states: No person is a party to an offence under paragraph (1)(b) if they do anything for the purpose of aiding a medical practitioner or nurse practitioner to provide a person with medical assistance in dying in accordance with section 241.‍2
• Bill C-14 - Section 241(5) states: No person commits an offence under paragraph (1)‍(b) if they do anything, at another person’s explicit request, for the purpose of aiding that other person to self-administer a substance that has been prescribed for that other person as part of the provision of medical assistance in dying in accordance with section 241.‍2.

No jurisdiction in the world offers legal immunity to anyone who does anything for the purposes of assisted dying. These sections must be struck from the bill.

2. Bill C-14 continues to provide medical practitioners or nurse practitioners total immunity for decisions or acts that contravene Bill C-14.

• Section 241.3 states: Before a medical practitioner or nurse practitioner provides a person with medical assistance in dying, the medical or nurse practitioner must: (a)be of the opinion that the person meets all of the criteria set out in subsection (1)
• Section 227(3) states: For greater certainty, the exemption set out in subsection (1) or (2) applies even if the person invoking it has a reasonable but mistaken beliefabout any fact that is an element of the exemption.

Sections 241.3(a) and 227(3) make it impossible to penalize medical or nurse practitioners for approving or doing an assisted death that contravenes the law, since the bill only requires them to: “be of the opinion” that the person meets all of the criteria of the law. This is the lowest possible standard. Further to that, Bill C-14 provides no effective oversight of the law.

If the person who died was incompetent, the medical or nurse practitioner would only need to state that he/she was “of the opinion” that the person was competent.

The Supreme Court of Canada in Carter approved assisted death based on: “a competent adult person who clearly consents to the termination of life.” 

Section 241.3(a), does not assure that the person is competent or clearly consents to the termination of life.  Therefore Bill C-14 does not respect the language of Carter. Unless Section 241.3(a) is amended to ensure that the person meets all of the criteria set out in subsection (1), Bill C-14 will be struck down by a future court decision. 

Bill C-14, in its current form, must be defeated.

People with disabilities comment on Me Before You

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Me Before You has become one of the controversial films of the decade, with protests, boycotts and many articles about the film. Not Dead Yet organized protests outside movie theaters, EPC asked its supporters to boycott the film in order to not give the makers of this movie our hard earned cash, nonetheless, the clearest voices have been disability leaders.

John Kelly, the New England Regional Director for Not Dead Yet, who has read the book, was reported by the New Boston Post as saying:

“After a new injury, people are very vulnerable, because suddenly you become part of a marginalized group,” And in terms of the film, “Only a disabled character could have their suicide presented as noble. Imagine if another character in the movie had killed themselves based on their own internalized depression.” 
“People happily cry over people like me killing ourselves,” 
“Where are the films where he changes his mind and they live happily ever after?”

Link to the full article
 

Covenant Health in Alberta will not participate in euthanasia

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Last February, Archbishop Richard Smith of Edmonton stated clearly that Covenant Health will not participate in acts of euthanasia or assisted suicide.

A few days ago, CBC news reported that Alberta's Associate health minister stated that:

physicians and other health-care workers will not be forced to take part in this procedure if it goes against their beliefs. She said procedures are being set up to move patients, if necessary.

"We're working to set out a framework of protocols and processes to ensure that if a patient in a facility where medical assistance in dying is not available, that there will be a process in place for transfer of care likely through Alberta Health Services,"

Payne stated that this framework for transferring patients will be in place by June 6.

Covenant Health has proven that protecting Conscience rights requires a clear and united position by health care professionals and institutions. Thank you Covenant Health.

Bill C-14 needs to be amended or defeated

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

I appreciate the amendments to Bill C-14, An act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying made by the House of Commons

Alex Schadenberg

Alex Schadenberg

I recognize that conscience protection language has improved and some of the language of the bill was improved, but the most grievous sections of Bill C-14 were not amended. 

The House of Commons passed Bill C-14 with a 186 to 137 vote, now the Senate of Canada will begin to debate Bill C-14. The Senate has the power to amend the bill and/or defeat the bill.

For those who are concerned that Bill C-14 will not be passed by June 6, stop worrying, it will definitely not become law by June 6. Therefore the approach needs to be to amend Bill C-14 in the Senate and if it is not adequately amended, to defeat the bill.

If this bill passes, in its current form, the language of Bill C-14 will lead to significant growth of euthanasia. There will be many stories that people will refer to as a "slippery slope." Let me tell you now, these stories will not be the result of a "slippery slope" but rather they will be based on the fact that the language of Bill C-14 allowed these acts to occur.

Link to the full article

Euthanasia for Psychiatric reasons is complicated

Dr K Suno Gaind

Dr K Suno Gaind

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Doctor K Suno Gaind, who is a President of the Canadian Psychiatric Association and an associate professor at the University of Toronto wrote an article that was published in the Globe and Mail on Friday May 27, 2016; where he states that there are no known standards for approving euthanasia for psychiatric reasons.

Dr Gaind questions how euthanasia fits with  - Do No Harm - ethic:

Do no harm. How do we square this guiding tenet with medically assisted death? Which is the greater harm – helping a person to end his life, or allowing continued suffering when he seeks death? 
When it comes to mental illness, it is even more complicated. The 2015 Supreme Court decision emphasized the need to protect the vulnerable from seeking suicide at a time of weakness. Less clear is how we actually do that. 
Mental illness can affect how a person thinks. Depression fuels negative self-thoughts, self-blame, hopelessness and struggling with one’s place in the world. Negative events are dwelt upon and positive ones discounted, with emotional resilience lowered until mundane stresses seem overwhelming. 
This is not to deny the real pain and suffering of mental illness, nor to imply that it invariably compromises clarity of thought. However, in severe cases, teasing apart how illness-based cognitive distortions can influence decision making is a formidable challenge. Heart disease might produce suffering but not necessarily alter thought processes; with depression, people often say they no longer feel or think like themselves. 
This predicament could be moot if suffering continued indefinitely. The value of suicide prevention is not to stay alive with intolerable suffering, but to avoid ending life during a vulnerable period. Unfortunately, cognitive distortions can lead some to decline treatment and seek death, despite the prospect of a healthy future. 

Dr Gaind explains how difficult it is to assess irremediable suffering of psychiatric patients. 

Link to the full article