A warning from Canada

Daniel Harkins discovers the disturbing truth about assisted suicide in Canada.

Last week a final proposal was lodged at the Scottish Parliament for a member’s bill that seeks to make assisted suicide legal in Scotland. It is the second attempt in seven years after a previous bill was rejected by MSPs in 2015.

If successful, Scotland would become only the eighth country in the world to allow for medically assisted suicide at a national level. While most of these countries have increasingly liberalised their laws after initial implementation, Canada has arguably gone furthest.

There, anyone over 18 with a serious illness, disease or disability can end their life. Many of the safeguards present in other countries are not in place.

From next year, assisted suicide will be extended further to people with mental ill- nesses. Disability campaigners have been outspoken in their opposition as several worrying cases emerge.

Alan Nichols, 61, was euthanised in Canada in 2019. He had a history of mental illness and depression. In June of that year a neighbour, concerned that Alan had stopped opening his curtains, called police, who found him dehydrated and confused and rushed him to hospital.

Alan told his family he wanted to leave, but they felt it best he stay at the hospital to recuperate.

Just over a month later, has family were shocked to receive a phone call from a doctor telling them that in four days time Alan would be euthanised.

Alan’s sister-in-law, Trish Nichols, told CTV News: “I was appalled by all of it and I said we want this stopped, this can’t happen. Our family doesn’t agree with this.

“(The doctor) said, ‘Well, you can’t stop this. Alan is the only person who can stop this.” On July 26, the family watched as medical staff gave Alan three injections that ended his life.

The Associated Press (AP) reported that Alan’s application for euthanasia listed hear- ing loss as the reason for his request to die. “Alan was basically put to death,” his brother Gary Nichols told AP.

Assisted dying in Canada now accounts for 2.5% of all deaths, and the figure is growing, with an increase of 34% in 2020 on the previous year.

The country records the nature of suffering of those who received assisted dying. In 18.6% of cases, patients cited ‘isolation or loneliness’. In 35.9% they cited being a ‘perceived burden’ on others. Concerns have even reached the UN. A 2019 report from its special rapporteur on the rights

of disabled people said it was ‘extremely concerned’ about the implementation of assisted dying. It added that there is ‘no protocol’ to offer ‘viable alternatives’ to assisted dying to disabled people and that ‘worrisome information’ had been received ‘about persons with disabilities in institutions being pressured to seek medical assistance in dying.’

Scotland’s proposed legislation is in its infancy. Its proponents say it is narrow in scope and will include safeguards. But in every country where euthanasia has been introduced, access has increased over time. In Canada’s case, it followed court challenges, a situation that could be replicated here.

“What was originally conceived as an exceptional practice in medicine has quickly become normalised,” Trudo Lemmens, a health law specialist at the University of Toronto, told The Lancet last week.

The results of a consultation on the new Scottish legislation were published earlier this month. Media reports focused on the fact that, as the BBC describes, “three quarters of respondents supported the proposals for assisted dying.”

But a qualitative reading of the submissions gives a more comprehensive understanding.

Many doctors who responded were overwhelmingly opposed to assisted dying. In my own – admittedly incomplete – reading of 20 submissions from doctors, all but one doctor was opposed.

Almost all raised the issue of palliative care. They said it is insufficient, arguing that what is truly needed, what is the real solution to the problem, is funding and support to ensure people have access to a good death.

Stanley L Bukowski, a retired doctor from the United States, made a particularly good case.

“The public demand for assisted dying exists only because we in the medical profession have not adequately relieved our patients’ suffering… If adequate relief and care were given, there would be no demand for assisted dying,” he wrote.

“Too often… we doctors and our institutions have so failed to adequately treat, and often to personally accompany, our dying patients that there is now a public demand for assisted suicide and even euthanasia, led in almost every instance by people who have witnessed their loved ones dying with suffering that was not adequately addressed.”

“The bill,” he added, “misses what is truly desired by Western peoples: a truly good death, which means effective pain/ symptom control plus personal engagement and emotional/psychological/existential support.”

All of the above is costly. It will take time and effort and require an overhaul of our healthcare system. But there are many medical professionals who are full of ideas on how to do it – you can read them in the responses to the Scottish bill consultation.

It is a solution which will provide many more happy years for the ill and disabled who would otherwise seek assisted dying, and for their families.

And it is a solution that will not further persecute the already discriminated- against disabled minority in Scotland, or result in people being coerced into ending their lives prematurely.

Daniel Harkins is a journalist, former editor of the Scottish Catholic Observer and contributing editor to The Scottish Catholic.

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