2020: Canada, having passed a law in 2016 permitting euthanasia for people with a terminal illness, now wants to expand the law to allow medical providers to end the lives of people, including mentally incompetent people. The UN Human Rights Council raised alarm bells about the potential for abuse of persons by health care providers in Canada. The expansion of the euthanasia law was drafted in response to a 2019 Superior Court of Quebec ruling that found it unconstitutional to deny medically assisted death to people who aren’t already dying.
In 2016, Elder Rights issued a submission to the Senate Committee deliberating the proposed euthanasia (Medical Assistance in Dying, aka MAID) law in which we warned that persons are at serious risk of abuse by health care providers as a result of a change in the law permitting medical practitioners to legally kill other people. The concerns identified in 2016 (below) still apply today, perhaps more so.
The Coalition of Elder Rights Defenders June 01, 2016
– Bill C-14 Medical Assistance in Dying, if passed, would give doctors, nurses and other unspecified “assistants” the legal right to end the life of another person. Health care providers would have immunity from prosecution in every death that they claimed was an assisted suicide death. Bill C-14 would grant enormous powers to doctors and nurses – essentially putting them above the law.
With such extraordinary power comes greatly increased opportunity for abuse of authority and maltreatment of persons. If Bill C-14 becomes law, Canada will open a Pandora’s Box from which our country’s reputation and quality of life may not recover for decades or generations.
Safeguards are not working now, and will not work under the framework of Bill C-14. Unlawful and criminal abuse of patients by doctors and nurses is not a theoretical fear – it is a common reality across Canada. Health care providers are endangering, harming, and killing people by administering drugs without obtaining the patient’s (or their substitute decision maker’s) consent, and by withholding basic medical care and the necessities of life such as food and water, often under the euphemism of “comfort care”.
These are people who are not suffering from an irremediable or unbearable ailment, and who do not want to die – yet their lives are being forcibly ended by doctors and nurses with impunity. Such abuse is rampant, unchecked and growing. Appended are five case summaries of evidence.
If Bill C-14 is passed, the Canadian government will be putting the public at far, far greater risk of malicious abuse, harm and death at the hands of doctors and other health care providers.
IN THE INTERESTS OF PUBLIC SAFETY, WE RECOMMEND:
- that NO legislation be passed that gives doctors, nurses or other health care providers immunity from prosecution for treatments they administer, approve or oversee;
- that NO legislation be passed giving doctors or nurses the right to kill other people until a system of effective safeguards has been implemented and proven to protect people from malicious harm by doctors and nurses such as is now occurring, unchecked; and,
- that public funding be made available for individual citizens to obtain legal representation in matters regarding abuse of authority and harm to persons by health care providers or government agencies and authorities, and that the funding for legal support for individual citizens be in amounts equal to or greater than the amount of public funds that are being provided by provinces and the federal government to the medical profession and other health care provider organizations for their legal protection.
There is an inherent conflict of interest in the safeguards (existing and proposed) that amounts to the fox guarding the henhouse. Bill C-14’s proposed “safeguards” would be in the hands of the doctors and medical colleges themselves to create, interpret, administer and adjudicate.
Medical colleges and other health industry organizations across the country are known to have covered up, excused and abetted many incidents of premeditated unlawful harm, including criminal acts, by doctors, nurses and other health care providers. Recent examples include:
- Doctors, nurses and hospital managers kept quiet for years about a Toronto doctor who frequently put his penis in the mouths of sedated female patients during surgery. The Ontario College of Physicians and Surgeons was “slow” to censure him http://bit.ly/281Dd9Y
- The BC College of Physicians and Surgeons supported a doctor who illegally usurped the decision-making authority of a family member in order to forcibly administer dangerous quantities of fentanyl and other opioids to a woman recovering from surgery, despite two other doctors and a pharmacist stating that the woman was being dangerously over-medicated (she died two weeks later). http://bit.ly/23kiVmQ
- The Alberta College of Physicians and Surgeons refused for years to sanction a Calgary psychiatrist despite multiple reports he tortured patients who were mandated by the court system to see this doctor. http://bit.ly/1RNjeA5
- A board member of the Ontario Medical Association (OMA) imprisoned his own family member in a nursing home through fraudulent means and without legal authority. This OMA board member was also on the board of the nursing home. http://on.thestar.com/1WwUIuV
- The B.C. Nurses’ Union successfully fought to reinstate a nurse who had been found guilty of repeatedly accessing over a dozen patients’ health information files which she had no authority to access (including records of her ex-husband’s family). http://bit.ly/1r2NalI
- Doctors and nurses at a Toronto hospital did not report to police allegations that a staff member sexually assaulted at least five elderly residents. The hospital quietly fired the man, who was soon hired by another health care facility. http://bit.ly/1RAp5ck
A culture of abuse, secrecy, intimidation, deceit and fear pervades the Canadian health care system, a fact that is an open secret among health care providers as well as patients and families. The results of a nation-wide Statistics Canada survey of 19,000 nurses released in 2009 revealed that 46 per cent of nurses reported being abused – by their own co-workers. Health care providers who observe wrongdoing are pressured to keep quiet by their managers, by their unions and by their self-regulating professional associations. The existing culture of secrecy intimidates good doctors and nurses, but most importantly it imperils the very lives of patients.
The dangerous and dysfunctional culture in the health care system today and the lack of repercussions for wrongdoing are the reasons that existing “safeguards” aren’t working now and will not protect people from abuses under the proposed Bill C-14. The public has lost trust in a health care system once revered. Safeguards are impossible in this environment.
Where do ordinary Canadians turn for help? The deck is impossibly stacked against individual citizens seeking protection or redress. Police, prosecutors and other authorities will not protect them from abusive health care providers, and most people cannot afford the tens (or hundreds) of thousands of dollars needed for legal representation against abuse of authority. Lawyers often refuse to take clients on the basis that they do not want to bankrupt families, such is the futility of trying to outlast the deep pockets of taxpayer funded lawyers who protect doctors and hospitals.
Until Canadians can be assured that doctors, nurses and other health care providers will not be able to so easily harm or kill patients who do not want to die, then we must not give doctors, nurses or anyone else the legal right to kill another person.
APPENDIX Senate submission: Opposing Bill C-14 – Medical Assistance in Dying
Case 1 – Nanaimo, British Columbia – March 2015:
A doctor at Nanaimo Regional General Hospital unlawfully revoked the decision-making authority of a patient’s son after the son asked that the patient’s pain medication be reviewed. The doctor was prescribing multiple opioids (e.g. morphine, fentanyl) to the patient recovering from leg amputation, an injury caused when she was struck by a nursing home food cart. The patient acquired bedsores due to inadequate care, and suffered severe drug side effects. Despite protests by the woman and her son, and warnings of over-medication by other doctors, opioids were prescribed in ever-increasing amounts. In one incident, 10 times the prescribed methadone dose was administered. Nurses withheld food and water. Two weeks later the patient died, heavily sedated and emaciated (i.e., “comfort care” program).
The decision by the BC College of Physicians and Surgeons http://bit.ly/23kiVmQ stated that they were “supportive of the care provided”, and “offered no criticism in regard to a medication error that occurred in the patient’s methadone dosing; the error was disclosed appropriately and documented.” The College said it was acceptable for Dr. Robin Love to revoke the son’s decision-maker’s authority if the doctor and the son disagreed about recommended treatment (ignoring the laws regarding autonomy and the right to informed consent).
Case 2 – Brantford, Ontario – December 2015
In July 2015, just the day before an 80-year-old woman was to return home after treatment for a hip fracture, Brantford General Hospital suddenly refused to discharge her. Instead, they banned her family from the hospital and imprisoned Pearl, allowing no contact with her family for six months. Despite repeated letters from the lawyer representing Pearl and her daughter (who is Pearl’s power of attorney for personal care), the hospital could not cite any legislation that allowed them to detain her. Still, they refused to free her.
A week before Christmas, Pearl’s lawyer sent the hospital a form stating that her daughter had instructed that her mother be “Discharged Against Medical Advice” within 24 hours. When that deadline came and passed without response, the daughter filed a complaint against Dr. Catherine L. Hanley, the hospital doctor responsible for Pearl’s care in hospital: http://bit.ly/1Z4P158 Two hours later, Pearl’s lawyer received a letter from the hospital, saying that Pearl would be ready to go home in 45 minutes. The family paid over $20,000 in legal fees to free their mother from unlawful confinement. See the daughter’s story here: http://bit.ly/1NQvAfN
Case 3 – Pickering, Ontario – October 2013:
Arthur Hippe, a 67-year-old man who suffered a stroke in 2010 was unlawfully detained by Ajax Pickering Hospital for three years and administered harmful drugs without consent. In June 2012 doctors wrongly declared him to be dying and forced him, over the objections of his wife (who was his power of attorney), into palliative care designation allowing only “comfort care” (i.e. opioids). In Oct 2013, after a year of legal system failures, a group of elder rights advocates freed Arthur from the hospital to return home where he now lives, happily cared for by his wife. Details and documents published at: http://rxisk.org/kidnapped-arthur-hippe/
Case 4 – Victoria, British Columbia – February 2011:
Broadmead Lodge staff and doctor were discovered to have administered lethal doses of morphine to an 87-year-old woman who had no pain or no terminal illness. Arriving for a visit, Kathleen’s daughter and son-in-law and a retired RN & elder rights advocate discovered her unresponsive and called 9-1-1. Nursing home staff tried to prevent paramedics from attending to Kathleen, but the paramedics persevered, reviving her in the ambulance by administering the narcotic antidote naloxone. The Emergency doctor wondered “why she qualified for ‘terminal sedation’ since she has no pain or illness requiring pain medication”. Kathleen recovered quickly, but died six weeks later under suspicious circumstances. When her daughter requested an investigation, the coroner agreed but later lied in an email saying that the law prevented the Coroner from giving her any information about her mother’s death. Read articles here: http://bit.ly/1SVsmGF and http://www.focusonline.ca/?q=node/249
Case 5 – Winnipeg, Manitoba – April 2016:
The family of a nursing home resident was heavily pressured on at least three occasions in the last several months to put their father on “comfort care” rather than receive medical treatment for minor, treatable ailments. Each time, the family insisted that he be hospitalized instead, where he quickly recovered. Repeatedly, the family discovered the doctors and staff had misled them: claiming that her father didn’t want to eat even though he had just devoured a hamburger the family brought him; and then discovering that he had been on two antidepressants for months without their knowledge or consent. Only when staff discovered that there were two doctors in the family, did the doctor and staff suddenly say that the man is “not ready for ‘comfort care’.” The irony is that the man is a retired judge, and the staff knew this. No one is safe from doctors and nurses who abuse their authority.
Lois J. Sampson, Executive Director, Advisory Board: Dr. David Healy, Angela Femia, Dr. Shiv Chopra, Dee Nicholson, Royce Hamer, Dr. Stephanie Seneff, Darwin Marquardt, Rose Stevens, John Papadakis, Eileen Dannemann and Patricia White.
The Coalition of ELDER RIGHTS Defenders