CV NEWS FEED // Canada is “rushing to death” through quick approvals for its euthanasia program Medical Aid in Dying (MAiD), according to a member of Ontario’s MAiD Death Review Committee.
Dr. Ramona Coehlo, a committee member and a family physician, made the warning after the committee released two reports, “Waivers of Final Consent,” and “Navigating Complex Issues within Same Day and Next Day MAiD Provisions,” that share case studies of people who have died by euthanasia through the MAiD regime.
“These cases highlight how vulnerable individuals, having lost the capacity to consent, may be coerced or unduly influenced to die — whether through financial abuse, caregiver burnout, or other pressures — reminding us that the stakes are high — life and death, no less,” Coelho wrote for the Macdonald-Laurier Institute.
One of the cases is of a woman in her 80s, “Mrs. B,” who was receiving palliative care after surgery complications. She underwent a MAiD assessment because she reportedly requested it, but the first MAiD assessor did not end up “prescribing” euthanasia because Mrs. B later said she wanted to withdraw that request.
The next day, her spouse, experiencing caregiver burnout, brought her to the emergency room while she was in stable condition. She was discharged again.
The report states that Mrs. B’s palliative care physician requested in-patient care because of her social circumstances, namely, caregiver burnout. This request was denied because she did not meet hospice criteria for end-of-life. Instead, long-term palliative care was offered.
The same day, Mrs. B’s spouse requested an urgent MAiD assessment, and a new MAiD assessor came. This second assessor determined that Mrs. B was “eligible” for euthanasia but contacted the first assessor.
Concerned over the apparent change in desire for MAiD, the first assessor asked to revisit Mrs. B to re-assess her — but the second MAiD provider’s “clinical opinion that the clinical circumstances necessitated an urgent provision” prevented that, according to the report. A third assessment was conducted virtually that day, and the third assessor agreed that Mrs. B was “eligible” for MAiD.
Mrs. B was euthanized that night.
According to the report, most committee members believed the time and evaluation taken before Mrs. B’s euthanasia were insufficient, given her circumstances.
Writing for the Macdonald-Laurier Institute, Coelho noted that the report indicates that local medical environments may also contribute to rushed euthanasia.
“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,” Coelho wrote. “This highlights a worrying trend where the speed of the MAiD provision is prioritized over patient-centered care and ethical safeguards.”
Coelho also wrote about two other cases brought up in the reports that document people being euthanized without their consent. In one instance, a man with Alzheimer’s had been scheduled for euthanasia six months out, through a “Waiver of Final Consent” that permits a practitioner to euthanize the patient on a certain day even if the person has lost capacity to consent. On the day of the scheduled euthanasia, he was not capable of providing final consent, according to the report. The MAiD assessor did not try to verbally confirm his current wishes or capacity. Invoking the Waiver of Final Consent, the practitioner euthanized him.
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Coelho urged that comprehensive care must be the proper response to these situations, not “guesswork,” for example, on what the person would have wanted if they had the ability to consent.
“If we truly value dignity,” Coelho wrote, “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.”