Doctors alarmed by Health Canada’s push for MAiD talks with patients

My latest BC Catholic story, generated by information I found in my ongoing investigation into MAiD

Canadian doctors who oppose euthanasia are sounding the alarm about governmental pressure on health professionals to initiate MAiD discussions with their ailing patients.

The doctors are reacting to a little-known 2023 Health Canada document urging health authorities and professional bodies to adopt a set of “practice standards” that would mandate doctors and nurse practitioners to raise the issue of medical assistance in dying with certain patients.

Vancouver family physician Will Johnston, head of B.C.’s Euthanasia Resistance Coalition, said implementing Health Canada’s Model Practice Standard for MAiD would “coerce” medical professionals and lead to a troubling rise in euthanasia deaths.

Johnston is one of several Canadian doctors who are publicly opposing any move, in Canada or abroad, to mandate initiation of MAiD discussions.

Health Canada’s model practice standard states that medical practitioners “must not” assume every patient knows about MAiD’s availability.

The model further states that, upon forming reasonable grounds to believe a person may be eligible, doctors and nurse practitioners — the only medical personnel legally permitted to perform MAiD — “must determine whether MAiD is consistent with the person’s values and goals of care.” If it is, they must then “advise the person of the potential for MAiD,” or, if they have a moral objection, transfer the patient’s care to another practitioner.

Those instructions alarm Johnston. “Whoever is in charge of ‘Death Canada,’ as I’ll call them, seems to have forgotten the promises that were made to the medical community when euthanasia was first proposed — that no one would be forced to become complicit in it,” Johnston said in an interview. “And now they’re simply reneging. They’re violating that promise by insisting on compelled speech.”

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said that despite Health Canada’s model not being law, he knows that many doctors commonly initiate MAiD discussions because they perceive euthanasia to be a medical treatment for the chronically ill and elderly.

“In fact,” he said, “because the intention of MAiD is to kill the patient, it is the very opposite of medical treatment.”

Schadenberg is also concerned a government-supported suggestion in Canada may become a government-mandated law in Australia. That country’s state of Victoria is planning an expansion of euthanasia eligibility that would let doctors initiate discussions about assisted death.

Schadenberg has produced a video highlighting the concerns of three Canadian doctors — Johnston, David D’Souza of Toronto, and Catherine Ferrier of Montreal — who describe problems associated with initiating MAiD discussions in Canada.

D’Souza said that if a physician suggests euthanasia as an option for a patient’s pain or suffering, “a patient is more likely to take this option given that a health professional has suggested it.”

Health Canada media relations officer Karine LeBlanc said in an email to The B.C. Catholic that the Model Practice Standard for MAiD was developed by a task group convened in September 2022. Members were chosen for their expertise in MAiD practice and professional regulation.

Health Canada cannot compel provinces or health authorities to adopt the guidelines, and a limited review by The B.C. Catholic found no evidence that any public agency or professional body in B.C. has done so.

Vancouver’s Catholic health authority, Providence Health Care, explicitly prohibits its employees from initiating a discussion about MAiD. “We don’t proactively mention MAiD as an option to consider,” Providence spokesman Shaf Hussain said in an email earlier this year. “We never initiate an offer of MAiD.”

On the other hand, there are widespread anecdotal reports from the public system that doctors and nurses do initiate such discussions.

After Canada legalized MAiD in 2016, and then expanded eligibility in 2020 to include people not dying but suffering from incurable diseases, numerous reports surfaced of patients being pressured about euthanasia options. The B.C. Catholic first exposed the problem in a 2021 investigation.

Not only is initiation of MAiD discussions ethically and practically problematic, but it also may be illegal, said Luke Chen, an associate professor of medicine at the University of B.C. In an interview, Chen said the Health Canada recommendation appears to contravene Section 241(a) of the Criminal Code of Canada, which makes it illegal to counsel a suicide.

The Canadian Association of MAiD Assessors and Providers rejects that notion, saying in a policy document that “so long as they do not have the aim of inducing, persuading, or convincing the patient to request MAiD, any health-care professional can legally provide information ... about MAiD.”

It may be legal, but initiating a MAiD discussion sends a powerfully negative message, says Deacon Tim Kostamo, a surgeon who is a member of Christ the Redeemer Parish in West Vancouver. “Fundamentally the problem with it is that as soon as you offer MAiD to someone — or, as it really is, ‘medical killing’ — the message you are telling them is that you think their life is not worth living,” he said in an interview.

Deacon Kostamo said the Health Canada document is yet another indication that there’s something fundamentally wrong with the medical system in Canada. As a surgeon, he sees patients wait up to three years for needed hip replacement surgery. On the other hand, “two clicks [on your computer] and you’re connected to someone who will coordinate your death,” he said.

Johnston said he is troubled by the fact the model even exists. “The very process of a doctor notifyi

ng ... potentially suggestible people of suicide-by-doctor validates it and is an inducement to consider it,” he said, calling the practice an “outrage against decency.” Schadenberg said he is “saddened, shocked, and angered” by Health Canada’s guidelines, which he has known about since their publication.

He believes every major hospital in Canada now has a MAiD team tasked with informing patients about euthanasia’s availability. “That’s why I’m getting so many phone calls from patients complaining they are being ‘pestered and pestered’ to succumb to MAiD.

“Some of the MAiD teams are very sales-oriented,” Schadenberg said. “They can’t understand why you don’t want it.”

The issue is serious enough to warrant legislation making it an offence for any medical practitioner to initiate a discussion of MAiD, he said.

“We’re simply seeing too many people who feel pressured and coerced to agree to MAiD.”

Sacred music is good for the brain as well as the soul, neuroscientist says

My story, published recently in the BC Catholic

Sixteen hundred years ago, St. Augustine is credited with saying, “He who sings, prays twice.”

Today, scientific research shows that he who sings, performs, or listens to music also enriches and strengthens his brain, says Catholic neuroscientist Kathlyn Gan.

Not only that, but sacred music may produce even more beneficial effects.

Gan, who leads a research laboratory at the University of Toronto, delivered the uplifting news to about 50 people at an Oct. 30 talk at St. Francis de Sales in Burnaby.

In her hour-long presentation The Neuroscience of Sacred Music, Gan, a former choir director and accompanist at St. Joseph’s Parish in Port Moody, described how research showing that music can be part of a healthy lifestyle that helps counter the mental decline that accompanies aging.

Music can also help prevent the onset of Alzheimer’s disease, which, in up to 95 per cent of cases, can be driven by non-genetic factors, including obesity, high blood pressure, smoking, deafness, brain injury, and social isolation.

Not only does music stimulate the brain in special ways, it also fosters healthy social connections when performed in a group setting, said Gan, currently a liturgical musician in the Archdiocese of Toronto.

Speaking with The B.C. Catholic, she said music is encoded and integrated by multiple brain regions, stimulating neural pathways that regulate memory, movement, reward, emotion, and empathy.

“Based on those effects, music can help us keep our minds active and foster social connections, which in turn can help us mitigate the risk of Alzheimer’s disease,” she said.

Gan, who earned her doctorate at Simon Fraser University in Burnaby and did postdoctoral studies at Stanford University in California, said music therapy is widely used as part of a holistic treatment approach to improve behavioural issues and encourage social connections during mid- to late-stage Alzheimer’s.

Gan noted that the CBC recently reported that doctors in Montreal have partnered with the city’s symphony orchestra to prescribe music as medicine.

“Physicians will get prescriptions that they will give to patients,” said Mélanie La Couture, CEO of the Montreal Symphony Orchestra. “The patients will call us, and we will give each patient that calls us two tickets for free.”

Even more benefits could conceivably come from listening to or singing sacred music, which Gan defines as any music — from chant and classical to jazz and gospel — that contributes to the solemnity and beauty of the Mass, promotes deeper reflection on the scriptural readings and homily, and glorifies God.

Music activates different parts of the brain, strengthening pathways for memory, movement, emotion, and empathy, said Kathlyn Gan at St. Francis de Sales. That said, it will be challenging for scientists to prove sacred music’s special benefits because of listeners’ or musicians’ subjective perceptions of music and their varying depth of spiritual formation and understanding, Gan said.

At the very least, however, listening to or performing sacred music helps a person grow in faith and to love God, she said in her presentation.

Along with the three degrees she earned at SFU, Gan also holds an associate diploma from the Royal Conservatory of Music and is an accomplished classical pianist who shares her talent and faith in churches and the wider community. These outings include performances with her piano students at retirement homes and long-term care facilities, as well as playing piano in music-therapy and spiritual-care programs.

She views her music ministry as a form of prayer that challenges her not only to recognize scriptural themes and imagery but also to communicate them “in a manner that honours the historical context of the hymns and shares my own spirituality and lived experience.”

Her studies and ministry have not only deepened her appreciation for the human mind’s complexity and capacity for mirroring Christ’s humility, compassion, forgiveness, and love, but they’ve also “encouraged my spiritual growth and enriched my faith.”

‘Coercion wearing a polite face’: Anti-euthanasia voices warn against MAiD expansion for mental illness

I contributed to this BC Catholic story with my coverage of MP Jansen's community meeting.

Combat veteran Kelsi Sheren told an Ottawa news conference she joined the Canadian Armed Forces at 18 knowing she might die for her country, but she never imagined her own government would one day offer to help her do it.

“Behind closed doors, in quiet conversations, veterans are being offered medical assistance in dying not therapy, not recovery, not support, but death,” Sheren said. “When somebody’s drowning in trauma and desperation, that’s not a choice. That’s coercion wearing a polite face.”

The former artillery gunner and mental-health advocate spoke at a Euthanasia Prevention Coalition news conference with other anti-euthanasia voices calling on MPs to support legislation blocking the expansion of medical assistance in dying (MAiD) to people suffering solely from mental illness.

Bill C-218 is a private member’s bill introduced in June by Conservative MP Tamara Jansen (Cloverdale–Langley City). The bill would permanently exclude mental illness as a sole qualifying condition for MAiD.

Sheren, who served in Afghanistan and lives with post-traumatic stress disorder, traumatic brain injury, and major depressive disorder, pointed out several incidents of veterans seeking help instead being “offered medical assistance in dying not therapy, not recovery, not support, but death.”

MP Tamara Jansen at her Langley constituency office for a roundtable about her private member’s bill to exclude expanding MAiD for mental illness. (Terry O’Neill photo) “This isn’t compassion,” she said. “It’s a moral rot disguised as mercy. Veterans are being told their lives cost too much money. That’s not health care, it’s surrender.” Gordon Friesen, EPC’s president, said the coalition’s message was simple: “No euthanasia for mental illness.”

The government plans to expand MAiD to make it available to individuals whose only medical condition is a mental disorder. Friesen said that would violate the original safeguards promised when Parliament legalized assisted dying in 2016.

“MAiD was only to be for people who are dying, only for adults, and only for people able to truly choose,” Friesen said. “Unfortunately, all of those promises have been broken.”

Friesen warned that allowing MAiD for people with psychiatric disorders “destroys all notion of MAiD as an authentic patient choice,” since mental illness can directly impair judgment and decision-making. He cautioned that “once the door is opened,” other vulnerable groups such as children or people with dementia could follow. EPC executive director Alex Schadenberg said the coming change “should never even be considered.”

He said Bill C-7, passed in 2021, removed the requirement that a person’s death be “reasonably foreseeable” and laid the groundwork for extending MAiD eligibility to non-terminal illnesses. Although Parliament has twice delayed the mental-illness provision, now set to take effect in March 2027, the expansion remains law.

“This undermines the whole concept of whether someone can properly consent,” Schadenberg said. “Whether they are truly consenting, whether they are of their right mind, whether there are alternatives for them.”

Schadenberg shared a letter from a woman named Andrea, who had attempted suicide multiple times and might have qualified for MAiD under the pending criteria. If MAiD had been available, “she would have wanted it and she would have been dead,” Schadenberg said. “Today she’s married, expecting her first child, and well. That’s why we can’t allow this.”

Montreal family physician Dr. Paul Saba, who has long opposed euthanasia, said people requesting MAiD because of mental illness “cannot make a free and informed consent.” “The desire to die, in most cases, is a symptom of a mental illness such as depression,” he said. “This is not compassion; it’s a failure of care.” Dr. Saba called on MPs “who truly value life” to support Bill C-218 and reject any future expansions. According to the federal government’s 2023 MAiD annual report, 15,343 Canadians died through MAiD that year, up nearly 16 per cent from 2022, accounting for 4.7 per cent of all deaths nationwide. Federal data and academic reviews show that loneliness or social isolation were cited as contributing factors in nearly half of all non-terminal MAiD requests.

Schadenberg said those figures reflect a deeper problem. “When we start offering death instead of care, we stop being a compassionate country,” he said. The Ottawa news conference followed a local roundtable Oct. 18 at Jansen’s Langley, B.C., constituency office, where about 50 people, including pastors, priests, and lay leaders from Orthodox, Catholic, Mennonite, Baptist, and Calvinist churches, as well as a Sikh representative, met to discuss the bill. One participant called it a show of unity across faith traditions.

“This is about loving our neighbour,” Jansen told the gathering. “Our neighbour is at risk.” She called the pending expansion of MAiD for mental illness “a freight train coming,” and urged churches to circulate petitions and write letters to MPs. “The bigger the support, the better.”

Jansen also rejected claims that mental illness is irremediable. “You can flourish with the right treatment,” she said. Among clergy present were Rev. Dr. Yuriy Sakvuk, chancellor of the Ukrainian Catholic Eparchy of New Westminster, and Deacon Steve Potusek of St. Matthew’s Parish in Surrey.

Father Augustine Obiwumma, pastor of Star of the Sea Parish in Surrey, said afterward the meeting was valuable. “It was good to see Christians and pastors of all denominations speak with one clear voice about the dignity of every human being,” he said. “As Christians, we are called to be agents of truth, compassion, love, and hope not agents of death. The sick, the suffering, the terminally ill, and the dying need our love and support.”

In a follow-up email to attendees, Jansen thanked participants for their leadership and support of the bill, attaching background materials and a petition for signatures. She said endorsement letters from faith and community leaders “will play an important role in showing other Members of Parliament ... that this issue unites people across many backgrounds.”