Seeking doctor who won't end my life then harvest my organs
Seeking doctor who won't end my life then harvest my organs
Thoughts on physicians playing God in Canada and the alarming MAID stats
Research for my new work REMNANT took an unexpected turn this week as I read and studied survival stories from ancient history.
A few contemporary news headlines pushed me down a surprising path: exploring the upcoming changes to medical assisted dying laws in Canada.
What follows are a few thoughts; the piece may become an opening anecdote to a chapter in the future or an entire chapter on its own.
~ AK
I can’t shake an unsettling feeling as I learn more about how medically assisted dying (known as MAID in Canada) morphs. It’s been quite an evolution since it became a medical option in the Great North after a federal amendment to the Criminal Code in 2016.
With each headline I read about MAID, and with each subsequent conversation I have with friends and family, I’m increasingly concerned.
Quick facts about Medically Assisted Dying in Canada
Since a March 2021 government amendment, an individual’s death need not be reasonably foreseeable as a condition for MAID.
“In 2021, 2.2% of the total number of MAID provisions (219 individuals), were individuals whose natural deaths were not reasonably foreseeable (non-RFND). The most commonly cited underlying medical condition for this population was neurological (45.7%), followed by other condition (37.9%), and multiple comorbidities (21.0%). The average age of individuals receiving MAID who were non-RFND was 70.1.” ~MAID annual report
In March 2023, mental health will be a qualifier for medically assisted dying.
A Parliamentary Review committee is currently reviewing eligibility for “mature minors"—16 and 17 year olds, which has clear support from assisted-dying advocates.
Primary care physicians, the Canadian government reports, are the principal MAID providers.
What could go wrong?
A lot has happened in 7 short years. Look how MAID has evolved!
Canada made headlines this week for performing more organ transplants from medically-assisted deaths than any other country in the world. Cue my provocative headline.
It takes very little stretch of the imagination to see a MAID referral turn quickly into an organ donor solicitation.
An ICU doctor and medical adviser assured CTV this week that, “[Doctors] would never say, ‘Hey, do you want MAID?’ and, ‘Hey, do you want to be an organ donor?’" because such a twofer is “not ethical.” He also made it clear that any MAID candidate and organ donor also has the right to change their minds at any point before the life-ending, organ-donor-making procedure.
If a care worker offered MAID as an option for a Paralympian seeking resources like a wheelchair ramp, it’s not unreasonable to have other concerns. Such as MAID candidates being pressured to become organ donors or that death will be offered for a whole range of non-life-threatening conditions, major and minor, as
in The Free Press has reported. A too-porous, failed safety net rather than health prognoses seems to be driving some to MAID.Trending toward dying
Death may be inevitable, but year-over-year increases in MAID deaths need not be so.
As I’ve learned and thought about medically assisted dying this week, my mind has turned to thoughts about survival.
That thing we’ve all been trying to do over these last few years–stay alive–and more generally over the centuries of human existence, however far back you trace it, faces yet another challenge.
The stats should give us caution. There’s a 32.4% growth rate of MAID deaths in Canada from 2020 to 2021. Over 31,000 Canadians have died with the assistance of a doctor and in 2021 alone, MAID accounted for 3.3% of all deaths in Canada.
Canada is embracing MAID as a normal health procedure. And in March 2023 doctors will be able to offer the option to people suffering from mental illness, including those with suicidal thoughts. In a system where 1 in 10 Canadians wait more than 4 months for access to care, this should be sounding some critical alarm within the system. In light of scientific evidence that 9 in 10 people who attempt suicide and survive will not go on to die by suicide at a later date because suicidal crises are, typically, short-lived, more alarms should ring.
Are institutions and communities meant to serve and support Canadians compensating for their shortfalls and failures by offering assisted dying?
It’s an important question to consider.
What about dignity in dying?
I think everyone should die with dignity. But I'd rather everybody live with dignity (for as long as possible) first.
From what I've read, the main argument for MAID is that this is all about dignity in death for people truly suffering. I don't doubt the sincerity of the claim. But it's an argument hard to hear right now amidst all the alarm bells. An argument made convincingly, to federal gatekeepers in 2016.
Look how widely the gate has now opened with the 2021 amendment and now the upcoming March 2023 change!
Forgive me for being alarmed. Something doesn't add up.
If, like me, you haven’t paid much attention to federal legislation around MAID, decisions to change the Criminal Code so that medical assisted dying can be normalized seems, at a minimum, strange.
Does it seem to threaten what you’d once thought about the dignity of life? Does the “medical intervention” seem suddenly too accessible and too irreversible for people thrown into desperate times who could be better supported by other options? Does learning that a doctor can schedule a patient’s death after a ten minute Zoom assessment nearly stop your heart?
It's worth asking questions like these. It's important to discuss. It warrants calling your MP, your MLA, your doctor, your Pastor, Rabbi, Iman or Priest and raising your voice. Perhaps even a holy ruckus.
If we've been quiet or inattentive, perhaps it's time to wake from our deadly asleep.
What’s your take?
Reading subject matter like this can be difficult.
If you need help right now because you are considering ending your life, you can call 1-833-456-4566. If you need immediate help, please call 9-1-1 or go to your nearby emergency room. There is help and hope for you.
Thanks for the article. Keep digging, cousin! You will find even more disturbing scenarios that people need to know about...
-Quebec and BC rates of assisted suicide are approaching 5% of all their deaths (closer to 9% on the island);
-The Ontario College of Physicians and Surgeons requires doctors to participate even against their conscience, by writing an “effective referral” to a doc who will do the deed if they won’t, and following up to make sure it was done;
-Many people requested, and received, assisted suicide rather than go through another Covid lockdown;
-many specialist referrals (chronic pain clinic, psychiatry, neurology, etc) take 6-12 months to get into, or more, but current legislation for non-terminal assisted suicide requires that candidates only wait 90days, and that can be shortened by the physician;
-and for a suicidal patient, to whom do we offer suicide prevention and whom do we give suicide assistance?
It is truly a shocking situation. Ethical doctors following the Hippocratic Oath are being forced out. Most docs just make a referral and try to avoid the issue. And patients can shop around for doctors until they get 2 that agree to sign off.
We need more people standing up to sound the alarm, and helping with assisted living, reestablishing meaning in life for those on the brink... even those with only weeks to live can still teach others about caring and bearing each others burdens and sharing life lessons. There is always hope, and always meaning through suffering that brings dignity (Victor Frankl). Dignity does not come at the end of a needle.
Ok. I’ll be done for now. Lots more could be said. Thanks again for raising the issue.
Andrew, my dad was a family physician long before there was much talk of MAID. He used to tell his potentially suicidal patients to wait until morning. Some of them later told him that this advice saved their lives. He would certainly have been dead against MAID except possibly for people who were living in agony with a foreseeably imminent death - but I am not even sure of that.
Interestingly, however, when diagnosed with acute myelogenous leukemia (AML) he was asked if he wished to prolong life with blood transfusions. He said "No" and died a month after diagnosis. The wife of a friend of his got the same diagnosis and went for the transfusions. She lived another 3 years.
I had told my dad about my 300+ blood donations and reminded him of his significant number. I also mentioned the case of a young woman who spoke at a donor awards dinner. She had Thalassemia major. She could not make her own blood cells and depended entirely on blood transfusions. He thanked me for the support - but let himself die nonetheless. Ever uncomplaining, none of us will ever know to what level his quality of life had descended.
I retain a mind in a whorl on the subject. I lack the courage to do anything but "Rage, rage against the dying of the light!" if faced with the kind of misery some people experience. I do, however, fear that some experience depression out of all proportion to the triggering issue. All I can do is hope that doctors who gauge these things are aware of this.