By Alex Schadenberg<\/p>\n\n\n\n The Ontario Death Review Committee (MDRC) published two new reviews of Ontario MAiD (euthanasia) data between 2018 \u2013 2023. The two MDRC reports focus on (Waivers of Final Consent<\/a>), (Navigating Complex Issues Within Same Day and Next Day MAiD Provisions<\/a>).<\/p>\n\n\n\n The first three MDRC reports (Report 3<\/a>) (Report 2<\/a>) (Report 1<\/a>) were released in October 2024. I have included three articles about these reports.<\/p>\n\n\n\n Dr Ramona Coelho, who is a member of the MDRC Committee wrote an article concerning the recent two reports that was published by the Macdonald-Laurier Institute on April 7, 2025<\/a>. Coehlo writes:<\/p>\n\n\n\n Canada legalized Medical Assistance in Dying (MAiD) in 2016<\/a>, encompassing both euthanasia and assisted suicide. Initially limited to those nearing their natural death, eligibility expanded in 2021<\/a> to individuals with physical disabilities, with eligibility for individuals with mental illness in 2027<\/a>. Parliamentary recommendations include MAiD for children<\/a>. A recent federal consultation<\/a> explored extending MAiD to those who lack capacity via advance directives, an approach Quebec has already adopted<\/a>, despite its criminal status under federal law.<\/p>\n\n\n\n Despite its compassionate framing, investigative journalists<\/a> and government reports<\/a> reveal troubling patterns<\/a> where inadequate exploration of reversible suffering \u2013 such as lack of access to medical treatments, poverty, loneliness, and feelings of being a burden \u2013 have driven Canadians to choose death. As described<\/a> by our former Disability Inclusion Minister, Canada\u2019s system at times makes it easier to access MAiD than to receive basic care like a wheelchair. With over 60,000<\/a> MAiD cases by the end of 2023, the evidence raises grave concerns about Canada\u2019s MAiD regime.<\/p>\n<\/blockquote>\n\n\n\n Coelho writes about the scope of the MDRC reports:<\/p>\n\n\n\n I am a member of Ontario\u2019s MAiD Death Review Committee (MDRC). Last year, the Chief Coroner released MDRC reports<\/a>, and a new set of reports has just been published. The first report released by the Office of the Chief Coroner, Waivers of Final Consent<\/em><\/a>, examines how individuals in Track 1 (reasonably foreseeable natural death) can sign waivers to have their lives ended even if they lose the capacity to consent by the scheduled date of MAiD. The second, Navigating Complex Issues within Same Day and Next Day MAiD Provisions<\/em><\/a>, includes cases where MAiD was provided on the same day or the day after it was requested. These reports raise questions about whether proper assessments, thorough exploration of suffering, and informed consent were consistently practised by MAiD clinicians. While MDRC members hold diverse views, here is my take.<\/p>\n<\/blockquote>\n\n\n\n Coelho then writes about the topic: Rushing to death, Ignoring Reversible Causes of Suffering<\/strong>:<\/p>\n\n\n\n In the same-day or next-day MAiD report, Mrs. B, in her 80s, after complications from surgery, opted for palliative care, leading to discharge home. She later requested a MAiD assessment, but her assessor noted she preferred palliative care based on personal and religious values. The next day, her spouse, struggling with caregiver burnout, took her to the emergency department, but she was discharged home. When a request for hospice palliative care was denied, her spouse contacted the provincial MAiD coordination service for an urgent assessment. A new assessor deemed her eligible for MAiD, despite concerns from the first practitioner, who questioned the new assessor on the urgency, the sudden shift in patient perspective, and the influence of caregiver burnout. The initial assessor requested an opportunity for re-evaluation, but this was denied, with the second assessor deeming it urgent. That evening, a third MAiD practitioner was brought in, and Mrs. B underwent MAiD that night.<\/p>\n\n\n\n The focus should have been on ensuring adequate palliative care and support for Mrs. B and her spouse. Hospice and palliative care teams should have been urgently re-engaged, given the severity of the situation. Additionally, the MAiD provider expedited the process despite the first assessor\u2019s and Mrs. B\u2019s concerns without fully considering the impact of her spouse\u2019s burnout.<\/p>\n<\/blockquote>\n\n\n\n The lack of adequate palliative care and the pressure from the spouse led to Mrs B\u2019s euthanasia death. Even though the first assessor indicated that Mrs B wanted palliative care, which reflected her personal values, she not only died by euthanasia, but her death was expedited.<\/p>\n\n\n\n Coelho assesses other factors.<\/p>\n\n\n\n The report also has worrying trends suggesting that local medical cultures\u2014rather than patient choice\u2014could be influencing rushed MAiD. Geographic clustering, particularly in Western Ontario, where same-day and next-day MAiD deaths occur most frequently, raises concerns that some MAiD providers may be predisposed to rapidly approve patients for quick death rather than ensuring patients have access to adequate care or exploring if suffering is remediable. This highlights a worrying trend where the speed of the MAiD provision is prioritized over patient-centered care and ethical safeguards.<\/p>\n\n\n\n Coelho points out how same-day or next-day deaths are more prominent in Western Ontario, she also suggests that the speed of death is being prioritized over the care of the patient.<\/p>\n\n\n\n Coelho then examines the issue of consent. Euthanasia was sold to Canadians as being for: Competent adults who freely choose and consent to the act. The Waivers of Final Consent report creates concern as to whether people [did].<\/p>\n<\/blockquote>\n\n\n\n Coehlo focuses on two stories to outline her concerns about MAiD without Free and Informed Choice<\/strong><\/p>\n\n\n\n Consent has been central to Canadians\u2019 acceptance of the legalization of euthanasia and assisted suicide. However, some cases in these reports point to concerns already raised by clinicians: the lack of thorough capacity assessments and concerns that individuals may not have freely chosen MAiD.<\/p>\n\n\n\n In the waiver of final consent report, Mr. B, a man with Alzheimer\u2019s, had been approved for MAiD with such a waiver. However, by the scheduled provision date, his spouse reported increased confusion. Upon arrival, the MAiD provider noted that Mr. B no longer recognized them and so chose not to engage him in discussion at all. Without any verbal interaction to determine his current wishes or understanding, Mr. B\u2019s life was ended.<\/p>\n\n\n\n In the same-day or next-day MAiD report, Mr. C, diagnosed with metastatic cancer, initially expressed interest in MAiD but then experienced cognitive decline and became delirious. He was sedated for pain management. Despite the treating team confirming that capacity was no longer present, a MAiD practitioner arrived and withheld sedation, attempting to rouse him. It was documented that the patient mouthed \u201cyes\u201d and nodded and blinked in response to questions. Based on this interaction, the MAiD provider deemed the patient to have capacity. The MAiD practitioner then facilitated a virtual second assessment, and MAiD was administered.<\/p>\n<\/blockquote>\n\n\n\n Coehlo outlines how these cases do not ensure free choice and informed consent<\/strong>.<\/p>\n\n\n\n These individuals were not given genuine opportunities to confirm whether they wished to die. Instead, their past wishes or inquiries were prioritized, raising concerns about ensuring free and informed consent for MAiD. As early as 2020<\/a>, the Chief Coroner of Ontario identified cases where patients received MAiD without well-documented capacity assessments, even though their medical records suggested they lacked capacity. Further, when Dr. Leonie Herx, past president of the Canadian Society of Palliative Medicine, testified before Parliament<\/a> about MAiD frequently occurring without capacity, an MP dismissed her, advising<\/a> Parliament to be cautious about considering seriously evidence under parliamentary immunities that amounted to malpractice allegations, which should be handled by the appropriate regulatory bodies or police. These dismissive comments stand in stark contrast with the gravity of assessing financial capacity, and yet the magnitude is greater when ending life. By way of comparison, for my father, an Ontario-approved capacity expert<\/a> conducted a rigorous evaluation before declaring him incapable of managing his finances. This included a lengthy interview, collateral history, and review of financial documents\u2014yet no such rigorous capacity assessment is mandated for MAiD.<\/p>\n<\/blockquote>\n\n\n\n Coehlo completes her article by asking \u2013 What is Compassion?<\/p>\n\n\n\n While the federal government has finished its consultation on advance directives for MAiD, experts <\/a>warn against overlooking the complexities of choosing death based on hypothetical suffering and no lived experience to inform those choices. A substitute decision-maker has to interpret prior wishes, leading to guesswork and ethical dilemmas. These cases highlight how vulnerable individuals, having lost the capacity to consent, may be coerced or unduly influenced to die\u2014whether through financial abuse, caregiver burnout, or other pressures\u2014reminding us that the stakes are high \u2013 life and death, no less.<\/p>\n\n\n\n The fundamental expectation of health care should be to rush to care for the patient, providing support through a system that embraces them\u2014not rush them toward death without efforts to mitigate suffering or ensure free and informed consent. If we truly value dignity, we must invest in comprehensive care to prevent patients from being administered speedy death in their most vulnerable moment, turning their worst day into potentially their last.<\/p>\n<\/blockquote>\n\n\n\n LifeNews.com Note: Alex Schadenberg is the executive director of the Euthanasia Prevention Coalition<\/a> and you can read his blog<\/a> here.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" The whole MAiD system in Canada is a way for the OCGFC to get you to off yourself so you’re not a drain on the system or the tax dollars they want for themselves, and there are some cases where consent is precarious. And nationalized healthcare can’t efficiently service populations, so killing off the really […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,7],"tags":[],"class_list":["post-11425","post","type-post","status-publish","format-standard","hentry","category-health","category-world"],"blocksy_meta":[],"featured_image_src":null,"author_info":{"display_name":"Jason","author_link":"https:\/\/jasonsblog.ddns.net\/index.php\/author\/jturning\/"},"_links":{"self":[{"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/posts\/11425","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/comments?post=11425"}],"version-history":[{"count":1,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/posts\/11425\/revisions"}],"predecessor-version":[{"id":11426,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/posts\/11425\/revisions\/11426"}],"wp:attachment":[{"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/media?parent=11425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/categories?post=11425"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jasonsblog.ddns.net\/index.php\/wp-json\/wp\/v2\/tags?post=11425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"\/](\"https:\/\/www.lifenews.com\/wp-content\/uploads\/2016\/05\/picassistedsuicide41.jpg\")
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