Tuesday, April 5, 2022

Euthanasia instead of mental health and palliative care

Here is an excellent article (8 pages long) in the National Post last Saturday on Canada's legal euthanasia regime, and its proposed changes, where the mentally ill will be eligible. The article is well worth the read, I've only posted a very small number of points from it. It is written by an Ottawa doctor Dr. Ferrukh Faruqui. A lot of doctors who support MAID are having issues with the changes to the bill. 

I remember when the government introduced the legal killing of Canadians, they talked about all the safeguards the law would have. We knew of course that it was just a slippery slope. Now that slippery slope has become a landslide.

Slippery slope part 1 -- no promised review of underfunded palliative care:

"In 2015, the Supreme Court unanimously ruled that the prohibition of physician-assisted death was unconstitutional. Parliament responded by enacting 2016’s Bill C-14, which allowed doctors to euthanize competent adults with a severe, irremediable condition facing a reasonably foreseeable natural death (RFND). Parliament also promised to delay any new legislation until completion of a June 2020 review — not just of MAiD, but also of woefully underfunded mental health and palliative care — a review that never occurred."

 Slippery slope part 2 -- no more "reasonably foreseeable natural death":

"Instead, the Liberals introduced Bill C-7, which stakeholders say is a different beast altogether. It doesn’t just amend C-14. It redefines medical aid in dying to permit death for those who aren’t dying by eliminating the RFND clause. It also removes safeguards such as the 10-day reflection period. Instead of two independent witnesses to corroborate MAiD requests, only a single witness, be it a medical professional or paid caregiver, is needed. Critics warn such changes leave vulnerable patients open to coercion by the unscrupulous."

Less than 30 % of Canadians have access to palliative care, but legal euthanasia is available universally.
"Fewer than 30 per cent of Canadians have palliative care access, whereas 90 per cent could benefit from it, according to the McMaster Health Forum. In contrast, MAiD is enshrined as a health right, accounted for 2.5 per cent of deaths in 2020 and is universally available. The 2017 National Framework for Palliative Care in Canada notably tied zero funding to its action plan."
Slippery Slope Part 3 -- kill the mentally ill in March 2023:

In the article below from the NP Platformed, I have posted a few quotes from Colby Cosh's take on the bill. NP Platformed supports MAID. 

PANDORA’S BOX OF CYANIDE


"We favour legalized euthanasia in principle...but what astonished NP Platformed in Faruqui's essay is the appearance of the University of Toronto psychiatrist Dr. Sonu Gaind, who has seen the danger of equating mental illness with physical illness for the purposes of euthanasia law. In any newspaper you are bound to find someone — usually someone credentialed — arguing that mental illness is no different in principle from a bad tooth or a collapsed lung. Usually this is part of an argument for spending more public money on mental health, with the implicit premise that mental health treatments are just as effective as popping an Aspirin. 

 

In the hands of the courts, the “mental health is health” principle became part of an argument that sufferers from schizophrenia or obsessive-compulsive disorder have the same claims to assisted death as someone with ALS or an irreparable brain tumour. The result some doctors fear is that euthanasia will become a routine “treatment” for psychiatric disorders. Either way, it takes monumental courage for Gaind to insist — as he apparently has, in professional settings — upon the distinction between psychiatric illness and the physical kind. To deny it, he says, is “obfuscation.” In Faruqui's paraphrase: 

 

“Cardiologists know how heart disease works. But psychiatry hasn’t elucidated the pathophysiology of depression or schizophrenia. It’s impossible for clinicians to predict prognosis in individual cases, meaning that some who seek death would have gotten better.” 

 

Other psychiatrists have been making the same courageous point, which boils down to: “We, as a profession, don't totally know what we're doing.” This same point might be made when politicians make expensive promises to provide superior or even “universal” mental health care: somebody is going to have to invent it before you can buy it."


— Colby Cosh

One final point. What about the psychological effect on the doctors who do this killing? Does anyone know or care about that?

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