TORONTO—A homeless man refusing long-term care, a woman with severe obesity, an injured worker given meager government assistance, and grieving new widows.
All of them requested to be killed under Canada’s euthanasia system, and each sparked private debate among doctors and nurses struggling with the ethics of one of the world’s most permissive laws on the practice, according to an Associated Press investigation.
When Canada legalized assisted dying in 2016, officials said they wanted to reduce suffering and support individual autonomy and freedom of choice—and polls have consistently shown public approval. Prime Minister Justin Trudeau promised then that safeguards would prevent vulnerable people from being euthanized “because you’re not getting the support and care you actually need.”
Unlike many other countries, Canada doesn’t require that patients exhaust all medical treatments before seeking death. Doctors and nurses “do not treat MAiD as an option of last resort,” said an August report published by the Christian think tank Cardus. The participant who shared some of the e-mail discussions with AP provided dozens of messages raising questions about the medical and ethical complexities of euthanasia requests from people nationwide who weren’t terminally ill.
“The question about who gets euthanasia is a societal question,” said Kasper Raus, a researcher at Ghent University’s Bioethics Institute in Belgium. “This is a procedure that ends people’s lives, so we need to be closely monitoring any changes in who is getting it.Critics have long warned that Canada’s policies have led to euthanasia among disadvantaged people whose deaths weren’t imminent.
Poverty doesn’t appear to disproportionately affect patients with terminal diseases who are euthanized, according to the leaked data. And experts say no other country that has legalized euthanasia has seen a marked number of deaths in impoverished people. The report cited three instances where legally mandated safeguards were not met. Among them: No assessor or expert versed in the nonterminal condition was involved, and efforts to discuss alternatives to death were “limited.”
Providers on the forum were divided over ending the lives of people in mourning. One case involved a woman in her 80s who required dialysis and lost her husband, sibling and cat in a six-week period. Her assessor said her suffering and request to die were tied to her husband’s death rather than any medical conditions.
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