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This photo provided through Gary Nichols shows him, right, with his brother, Alan, on the eve of his euthanasia in Chilliwack, British Columbia, Canada, in July 2019. (Photo: Associated Press)
TORONTO (AP) — Alan Nichols had a history of depression and other medical problems, but none were life-threatening. When the 61-year-old Canadian was hospitalized in June 2019 for fear he was suicidal, he asked his brother to “get him out” as soon as possible.
In less than a month, Nichols filed a request for euthanasia and killed, despite considerations raised through his circle of relatives and a nurse practitioner.
Her request for euthanasia indicated a physical challenge as the explanation for why her request to die: hearing loss.
Nichols’ circle of relatives reported the case to police and health authorities, arguing that he did not have the ability to perceive the procedure and that he did not suffer unbearably – among the situations required for euthanasia. They say he wasn’t taking the mandatory medication, that it wasn’t the cochlear implant that helped him hear, and that hospital staff improperly helped him request euthanasia.
“Alan necessarily sentenced to death,” said his brother Gary Nichols.
Disability experts say the story is not unique to Canada, which arguably has the most permissive euthanasia standards in the world, allowing other people with severe disabilities to die in the absence of any other medical problem.
Many Canadians support euthanasia and the advocacy organization Dying With Dignity says the procedure is “motivated by compassion, an end to suffering and discrimination, and a preference for non-public autonomy. “But human rights advocates say the country’s regulations lack the mandatory guarantees, devalue the lives of other people with disabilities, and urge doctors and fitness staff to recommend the procedure to those who wouldn’t do it otherwise.
Equally troubling, according to advocates, are the cases in which other people tried to be killed because they did not have a government good enough to live in.
Canada is about to expand to euthanasia next year, but advocates say the formula now deserves additional scrutiny.
Euthanasia “cannot be a flaw in Canada’s failure to comply with its human rights obligations,” said Marie-Claude Landry, chairwoman of its Human Rights Commission.
Landry said he shared the “grave concern” expressed last year through 3 United Nations human rights experts, who wrote that Canada’s euthanasia law gave the impression of violating the agency’s Universal Declaration of Human Rights. They said the law had a “discriminatory impact” on other people with disabilities and incompatible with Canada’s obligations to comply with foreign human rights standards.
Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, described the Canadian law as “probably the greatest existential risk to other people with disabilities since the Nazi program in Germany in the 1930s. “
During his recent visit to Canada, Pope Francis criticized what he called the culture of waste that regards the elderly and disabled as disposable. “We will have to be informed to pay attention to the pain” of the deficient and maximum marginalized, Francis said, lamenting the “patients who, instead of affection, are administered death. “
Canada prides itself on being liberal and tolerant, said David Jones, director of the Anscombe Bioethics Centre in Britain, “but what’s going on with euthanasia suggests there’s a darker side. “
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Euthanasia, in which doctors use drugs to kill patients, is legal in seven countries (Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand and Spain) and in several states in Australia.
Other jurisdictions, in addition to several U. S. states, allow assisted suicide, in which patients take the lethal drug themselves, in a drink prescribed by a doctor.
In Canada, any of these functions is called medical assistance to die, more than 99. 9% of these deaths are performed by euthanasia. There were more than 10,000 deaths from euthanasia last year, an increase of about a third over the past year.
Canada’s path to authorizing euthanasia began in 2015, when its supreme court ruled that banning assisted suicide harmed others in terms of their dignity and autonomy. He gave national leaders a year to draft a law.
The resulting law of 2016 legalized both euthanasia and assisted suicide for other people over the age of 18, provided that certain situations occurred: that they had a serious condition, illness or disability that was in a state of complex and irreversible deterioration and was subjected to “unbearable physical conditions or intellectual disorders. “suffering that cannot be alleviated in situations that are considered appropriate through patients. “Their deaths also had to be “reasonably foreseeable” and the request for euthanasia had to be approved by at least two doctors.
Subsequently, the law was amended to allow other people who are not terminally ill to decide on death, greatly expanding the number of other eligible people. Critics say the update removed key protection to protect other people who have years or decades to live.
Today, any adult with a serious illness, ailment, or disability can seek help to die.
Canadian Health Minister Jean-Yves Duclos said the country’s euthanasia law “recognizes the rights of all other people . . . as well as the inherent and equivalent price of each life. “
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Countries that allow euthanasia and assisted suicide vary in the way they administer and practice, however, Canada has several policies that set it apart from others. Like what:
Unlike Belgium and the Netherlands, where euthanasia has been legal for two decades, Canada does not have monthly fees to review potentially problematic cases, but it does publish annual reports on euthanasia trends.
Canada is the only country that allows nurse practitioners, not just doctors, to end patients’ lives. The medical government in its two largest provinces, Ontario and Quebec, explicitly asks doctors not to hint on the death certificate if other people have died by euthanasia.
— Belgian doctors are requested to avoid mentioning euthanasia to patients, as this may be misinterpreted as medical advice. The Australian state of Victoria prohibits doctors from talking about euthanasia with patients. whether they might be eligible for death, as one of their imaginable “clinical care options. “
— Canadian patients are not required to have exhausted all remedies before applying for euthanasia, as is the case in Belgium and the Netherlands.
Still, Duclos said good enough safeguards existed, adding “strict eligibility criteria” to make sure no user with a disability encourages or forces them to end their lives. Government figures show that more than 65% of other people are euthanized due to cancer, followed by center disorders, respiratory disorders and neurological disorders.
Theresia Degener, a professor of law and disability studies at the Protestant University of Applied Sciences in northwestern Germany, said allowing euthanasia based solely on disability is a transparent violation of human rights.
“The implication of (Canadian) law is that a life with a disability has less value and, in some cases, death is preferable,” Degener said.
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Alan Nichols lost his hearing after brain surgery at age 12 and suffered a stroke in recent years, but usually lived alone. “He needed our help, but he wasn’t so disabled as to be eligible for euthanasia,” Nichols said.
In one of the tests presented through a nurse practitioner before Nichols’ death, she noted her history of seizures, frailty and “stunted growth. “He wrote that Nichols had hearing and visual loss.
Nichols’ circle of relatives was horrified that his death appears to have been approved in part on the basis of Alan’s hearing loss and had other considerations about how Alan was sacrificed. They filed court cases with the B. C. , which regulates doctors and the Royal Canadian Mounted Police, seeking fraud charges. They also wrote to Canada’s Minister of Justice.
“Someone has to take up the duty so that this never happens to another family,” said Trish Nichols, Gary’s wife. “I’m terrified that my husband or another parent will be hospitalized and get those (euthanasia) forms. “
The hospital claims that Alan Nichols made a valid request for euthanasia and that, in accordance with the patient’s privacy, he was not required to tell family members or accompany them in discussions about treatment.
The provincial regulator, the College of Physicians and Surgeons of British Columbia, told the circle of relatives it could not continue without a police investigation. In March, Cape Town. Patrick Maisonneuve sent an email to relatives to tell them he had reviewed the documentation and concluded that Alan Nichols “met the criteria” for euthanasia.
The family’s parliamentary representative, Laurie Throness, has called B. C. ‘s fitness minister. for a public inquiry, calling the death “deeply disturbing. “
Health Minister Adrian Dix said the province’s surveillance unit had reviewed the case and “referred it for further investigation. “He noted that the euthanasia law allows families to review euthanasia requests or be aware of hospital decisions.
Trudo Lemmens, a professor of fitness law and policy at the University of Toronto, said it was “surprising” that the government had concluded that Nichols’ death was justified.
“This case shows that regulations are too lax and that even when other people die when they haven’t died, there is almost no way to hold doctors and hospitals accountable,” he said.
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Some Canadians with disabilities have to be killed in the face of emerging bills.
Before being euthanized in August 2019 at age 41, Sean Tagert struggled to get the 24-hour care he needed. The government provided Tagert, who has Lou Gehrig’s disease, with 16 hours of care at his home in Powell River, British Columbia. he spent about 264 Canadian dollars ($206) per day to pay for the policy for the other 8 hours.
The health government proposed that Tagert be transferred to an institution, but he refused, saying he would be too far away from his young son. He called the suggestion a “death sentence” in an interview with canadian broadcasting corporation.
Before his death, Tagert had raised more than 16,000 Canadian dollars ($12,400) to purchase the specialized medical devices he needed at home with caregivers. But it still wasn’t enough.
“I know I’m asking for change,” Tagert wrote in a Facebook post before his death. “I just didn’t realize it was unacceptable. “
Stainton, a professor at the University of British Columbia, noted that no province or territory provides benefits for people with disabilities who cross the poverty line. In some areas, he said, it’s as low as C$850 ($662) a month. less than a portion of the amount the government has provided to others who are unable to cope with the COVID-19 pandemic.
Heidi Janz, an assistant assistant professor of disability ethics at the University of Alberta, said that “a user with a disability in Canada has to overcome so many barriers to get help that it may be enough to tip the scales” and get euthanized.
Duclos, the national fitness minister, told The Associated Press he may not comment on the snap cases, but said all jurisdictions have a wide variety of policies for other people with disabilities. He said there are “disparities in access to facilities and services across the country. “”
Other people with disabilities say ease of access to euthanasia has led to troubling and frightening discussions.
Roger Foley, who suffers from a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed when staff members mentioned euthanasia that he began secretly recording some of their conversations.
In a recording received through the AP, the hospital’s chief ethics officer told Foley that for him, staying at the hospital would cost him “more than $1,500 a day. “Foley replied that mentioning the payment sounded like coercion and asked what the plan was for her long term care.
“Understood, this is not my program,” the ethicist replied. “My part of this by talking to you, (to see) if you had an interest in medical assistance to die. “
Foley said he had never discussed euthanasia before. The hospital says it is not forbidden to raise the issue.
Catherine Frazee, professor emerita at Ryerson University in Toronto, said cases like Foley’s are just the tip of the iceberg.
“It’s hard to quantify because there’s no simple way to track those cases, yet I and other advocates listen to other people with disabilities every week that they’re contemplating (euthanasia),” he said.
Frazee cited the case of Candice Lewis, a 25-year-old woman with cerebral palsy and spina bifida. Lewis’ mother, Sheila Elson, took her to an emergency room in Newfoundland five years ago. During her hospital stay, a doctor said Lewis was a candidate for euthanasia and that if her mother decided not to pursue her, she would be “selfish,” Elson told the Canadian Broadcasting Corporation.
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Canada has replaced its euthanasia regulations since they were first enacted six years ago, but critics say much remains to be done, especially as Canada further expands access.
Next year, the country is preparing to allow the killing of other people solely for reasons of intellectual aptitude. It also plans to do more euthanasia for “mature” minors: young people under the age of 18 who find themselves in the same situations as adults.
Chantalle Aubertin, a spokeswoman for Canadian Justice Minister David Lametti, said in an email that the government had taken into account considerations raised through the disability network when it added safeguards to its euthanasia regulations last year. These adjustments included that other people had to be told about all services, such as intellectual fitness and palliative care, before asking for death.
Aubertin said those and other measures would “help honour the difficult and unpublic decisions of some Canadians to end their suffering on their own terms, while enshrining vital safeguards for the vulnerable. “
Dr. Jean Marmoreo, a family physician who provides euthanasia services in Ontario, has asked specialized committees to provide immediate input on difficult cases.
“I think it’s not something that should be rushed, but at the same time, if the user has made a considered request about it and meets the eligibility criteria, then they should not be denied their right to a dignified death. “she said. said.
Landry, Canada’s human rights commissioner, said leaders deserve to pay attention to the considerations of those facing hardship and that euthanasia is their only option. He called for social and economic rights to be enshrined in Canadian law to make sure others can get good enough housing, health care and support.
“At a time when we recognize the right to die with dignity, we will have to do more to ensure the right to live with dignity,” he said.
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Nicole Winfield of Edmonton, Alberta contributed to this report.
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The Associated Press Department of Health and Science receives information from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely to blame for all the content.
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This article was originally published on HuffPost and updated.