I fully agree that the laws are far too strict and make it difficult to provide service. My ex-wife is having trouble getting her medical assistance in dying. Yet she is suffering considerably. Her diagnosis is not yet terminal enough to be accepted. She suffers from overactive bladder, diabetes, polycystic ovary, uterine cancer, hypothyroidism, eczema, generalized anxiety and depression.
I feel that the current rules give too much weight to the final decision by doctors. I would like him to demedicalize medical aid in dying in Canada.
I'd like to make a request for my mental health disorder, except that it won't work until 2027, or if the law is invalidated soon by John Scully's and Dying with dignity Canada's challenge.
I am impressed with the level of detail you have brought to your understanding of MAID. You are quite right that there are differences from one Province to another. The Federal legislation is criminal only, whereas the Health competency is Provincial. To my knowledge, only Quebec has passed a real law outlining policy. Manitoba did do something on consciences protection and religious hospitals but only specific to that subject. Most tellingly, the Federal law takes the term MAID, of which the only definition comes from QC. Also, in the whereas section, the goal of universality is mentioned. Hence precedent and passivity have made the Quebec interpretation a de facto standard. Nonetheless, it would be possible for individual Provinces to dissent (subject to retribution in transfers).
In practice, BC is very agressive. The Delta Hospice situation was quite extraordinary. It was built with donated private money. It was a non-religious entity. It was a model cooperation of non-profit and government. After extended discussion of the MAID issue. Delta announced their intention to operate with no public funds (that was the first official threat) In the end, the lease on the land was withdrawn, and the building effectively seized (stealing several million private dollars with which it was built), even though there was a hospital right on the other side of the street to which patients might be transferred.
Another interesting BC example involves St. Paul Hospital in Vancouver, which claimed the religious exemption. In that case, the govt expropriated land adjacent to the hospital and built a MAID centre connected with a corridor.
The most relevant distinction however, is public/private. In BC, all public institutions provide MAID. (Subsidized religious institutions are still exempt, but the writing is on the wall.) After that private only (Delta was willing to go that route, but got caught anyway because they had built on govt land). But private health facilities have other limitations. (hint: there is no private general hospital in Canada). And I do not think there are any entirely private non-religious PC homes in BC. operating without MAID. If you have a counter example, please let me know.
Also In Ontario: if you are aware of a non-religious public institution that does not allow MAID, or a private one for that matter, I would be interested to learn about it. Anywhere in Canada, actually.
Returning to QC, several PC homes originally gave up govt funds to continue without MAID. But as of now, all of that has been rolled up, (and even the religious ones including one that was only built a couple of years ago --with donated private funds--on the specific govt promise that MAID would never be provided there).
So I believe your statement should be very strongly qualified. There is certainly no climate of tolerance in the big three (QC ON BC)
With regards to your call to refuse conscience rights: As I mentioned in my first comment, the people punished by universal penetration of euthanasia are the non-suicidal majority of patients. By simple economic market fairness, this large majority deserves access to institutions full of professionals who whole-heartedly respect their will to live. Simply put, it is not possible to "add" meat to a vegetarian diet. The two models are mutually exclusive.
I personally agree with your contention that the medical model is the wrong way to go, whether one likes euthanasia or not. My reason for saying this, as someone opposing euthanasia in Canada, is that the medical footprint is so much (hugely) larger than the non-medical alternative. Just think Switzerland (erstwhile assisted-suicide capital of the world) which has no eligibility criteria and a pourcentage of all deaths only a quarter or a fifth of that in the Province of Quebec.
The difference, of course, lies in the mandates.
When you say there is no "right" to euthanasia, it is a very misleading statement. The World Health Organization constitution requires that States provide "medical care" as required. The original QC law which set the Canadian definition for "medical aid in dying" calls euthanasia "end of life care", and specifically states that all eligible citizens have a right to that care. (the right is for those who "require" it and the only existing guidance on who that is lies in the eligibility criteria). The most recent QC update requires that all "establishments" under the QC administrative model, including hospitals, long-term care, palliative care and homecare, have maid policies "in harmony with ministerial policy", and which are communicated to patients and their entourage. In other words, euthanasia practice (and its promotion) is now mandated in all corners of public healthcare.
You might, perhaps, argue that professionals may refuse participation by "right of conscience" . Hence if everybody were to refuse, a given patient might not be able to access maid. But that would be a little silly from a practical viewpoint, considering that maid providers will actually be flown --literally to the ends of the earth-- to make sure that does not happen.
But the really sick thing about the medical model and the resulting mandates, is that typical, non-suicidal patients, now have nowhere to go, where they are safe from the influence of doctors and care teams who believe their deaths to be the optimal clinical outcome. In other words, very sick people already agitated by the force of events and their condition, are further stressed by the worry that they can not trust their doctors' commitment to keeping them alive..
I will spare you the economic arguments which demonstrate their fears are objectively rational.
Best Regards,
Gordon Friesen, President, Euthanasia Prevention Coalition, epcc.ca
Outside of Quebéc, it isn't true that hospitals are required to offer MAID. That's exactly the cause of the controversy over forced transfers. Catholic hospitals don't want to provide MAID and currently don't have to. Non-religious hospitals can offer MAID, but also aren't required to. They can just say "we don't do that here," which is what happened post-legalization, and continues to happen in some places.
I fully agree that the laws are far too strict and make it difficult to provide service. My ex-wife is having trouble getting her medical assistance in dying. Yet she is suffering considerably. Her diagnosis is not yet terminal enough to be accepted. She suffers from overactive bladder, diabetes, polycystic ovary, uterine cancer, hypothyroidism, eczema, generalized anxiety and depression.
I feel that the current rules give too much weight to the final decision by doctors. I would like him to demedicalize medical aid in dying in Canada.
I'd like to make a request for my mental health disorder, except that it won't work until 2027, or if the law is invalidated soon by John Scully's and Dying with dignity Canada's challenge.
I cannot locate part two....
Part II is here: https://valuejudgments.substack.com/p/what-does-it-mean-to-have-a-right
Part III is here: https://valuejudgments.substack.com/p/safeguards-for-non-medical-assisted
I am impressed with the level of detail you have brought to your understanding of MAID. You are quite right that there are differences from one Province to another. The Federal legislation is criminal only, whereas the Health competency is Provincial. To my knowledge, only Quebec has passed a real law outlining policy. Manitoba did do something on consciences protection and religious hospitals but only specific to that subject. Most tellingly, the Federal law takes the term MAID, of which the only definition comes from QC. Also, in the whereas section, the goal of universality is mentioned. Hence precedent and passivity have made the Quebec interpretation a de facto standard. Nonetheless, it would be possible for individual Provinces to dissent (subject to retribution in transfers).
In practice, BC is very agressive. The Delta Hospice situation was quite extraordinary. It was built with donated private money. It was a non-religious entity. It was a model cooperation of non-profit and government. After extended discussion of the MAID issue. Delta announced their intention to operate with no public funds (that was the first official threat) In the end, the lease on the land was withdrawn, and the building effectively seized (stealing several million private dollars with which it was built), even though there was a hospital right on the other side of the street to which patients might be transferred.
Another interesting BC example involves St. Paul Hospital in Vancouver, which claimed the religious exemption. In that case, the govt expropriated land adjacent to the hospital and built a MAID centre connected with a corridor.
The most relevant distinction however, is public/private. In BC, all public institutions provide MAID. (Subsidized religious institutions are still exempt, but the writing is on the wall.) After that private only (Delta was willing to go that route, but got caught anyway because they had built on govt land). But private health facilities have other limitations. (hint: there is no private general hospital in Canada). And I do not think there are any entirely private non-religious PC homes in BC. operating without MAID. If you have a counter example, please let me know.
Also In Ontario: if you are aware of a non-religious public institution that does not allow MAID, or a private one for that matter, I would be interested to learn about it. Anywhere in Canada, actually.
Returning to QC, several PC homes originally gave up govt funds to continue without MAID. But as of now, all of that has been rolled up, (and even the religious ones including one that was only built a couple of years ago --with donated private funds--on the specific govt promise that MAID would never be provided there).
So I believe your statement should be very strongly qualified. There is certainly no climate of tolerance in the big three (QC ON BC)
With regards to your call to refuse conscience rights: As I mentioned in my first comment, the people punished by universal penetration of euthanasia are the non-suicidal majority of patients. By simple economic market fairness, this large majority deserves access to institutions full of professionals who whole-heartedly respect their will to live. Simply put, it is not possible to "add" meat to a vegetarian diet. The two models are mutually exclusive.
Best Regards,
Gordon Friesen euthanasiadiscussion.com
I personally agree with your contention that the medical model is the wrong way to go, whether one likes euthanasia or not. My reason for saying this, as someone opposing euthanasia in Canada, is that the medical footprint is so much (hugely) larger than the non-medical alternative. Just think Switzerland (erstwhile assisted-suicide capital of the world) which has no eligibility criteria and a pourcentage of all deaths only a quarter or a fifth of that in the Province of Quebec.
The difference, of course, lies in the mandates.
When you say there is no "right" to euthanasia, it is a very misleading statement. The World Health Organization constitution requires that States provide "medical care" as required. The original QC law which set the Canadian definition for "medical aid in dying" calls euthanasia "end of life care", and specifically states that all eligible citizens have a right to that care. (the right is for those who "require" it and the only existing guidance on who that is lies in the eligibility criteria). The most recent QC update requires that all "establishments" under the QC administrative model, including hospitals, long-term care, palliative care and homecare, have maid policies "in harmony with ministerial policy", and which are communicated to patients and their entourage. In other words, euthanasia practice (and its promotion) is now mandated in all corners of public healthcare.
You might, perhaps, argue that professionals may refuse participation by "right of conscience" . Hence if everybody were to refuse, a given patient might not be able to access maid. But that would be a little silly from a practical viewpoint, considering that maid providers will actually be flown --literally to the ends of the earth-- to make sure that does not happen.
But the really sick thing about the medical model and the resulting mandates, is that typical, non-suicidal patients, now have nowhere to go, where they are safe from the influence of doctors and care teams who believe their deaths to be the optimal clinical outcome. In other words, very sick people already agitated by the force of events and their condition, are further stressed by the worry that they can not trust their doctors' commitment to keeping them alive..
I will spare you the economic arguments which demonstrate their fears are objectively rational.
Best Regards,
Gordon Friesen, President, Euthanasia Prevention Coalition, epcc.ca
Outside of Quebéc, it isn't true that hospitals are required to offer MAID. That's exactly the cause of the controversy over forced transfers. Catholic hospitals don't want to provide MAID and currently don't have to. Non-religious hospitals can offer MAID, but also aren't required to. They can just say "we don't do that here," which is what happened post-legalization, and continues to happen in some places.
Since conscientious objection is incompatible with patient-centred care, I've argued that we shouldn't allow it: https://valuejudgments.substack.com/p/conscientious-objection-is-incompatible