Dialysis one way, MAiD the other? Critics sound alarm about Vancouver clinics offering life or death

My latest, as published in the B.C. Catholic weekly newspaper:

The head of one of Canada’s leading anti-euthanasia organizations is accusing the B.C. government of deliberately placing a non-descript MAiD facility beside a Vancouver dialysis clinic as a quiet reminder to patients that ending their lives is an available option.

“I don’t think I’m being too extreme about it,” Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said in an interview. “I think putting [the MAiD clinic] beside a dialysis clinic is intentional.”

The Vancouver Coast Health Authority won’t say what the facility is. Insiders say it’s a euthanasia clinic, conveniently situated beside a dialysis clinic.

Both Schadenberg and The B.C. Catholic received a tip about the existence of a standalone MAiD clinic at a building that houses a dialysis clinic and offices of the provincial-government-directed Vancouver Coastal Health authority.

What the location of a euthanasia facility so close to a dialysis clinic would mean, Schadenberg said, is that “if you’re very down” about the thrice-weekly routine of undergoing dialysis, “here’s another option.”

He said the apparent opening of a MAiD clinic that is not associated with a hospital or hospice setting is consistent with the B.C. government’s record of strong support for medical assistance in dying.

“Unlike in Ontario, for example, the government in B.C. is leading the way,” Schadenberg said. “This clinic shows they are intentionally in the business of killing people, not just providing a legally mandated service. It’s a big concern. The government is directly involved in promoting death.”

The B.C. Catholic emailed and phoned Vancouver Coastal, which operates 120 facilities serving 1.25 million people, in an attempt to confirm the existence of the facility, but the health authority did not provide answers to questions about the purported clinic’s origins, cost, or even whether it actually existed.

However, a B.C. Catholic visit to the location at 520 West 6th Ave. in Vancouver found evidence to support the tip.

The building is a five-storey structure primarily housing offices and facilities of Vancouver Coastal. The main entrance opens into a lobby area. To the right is a dialysis clinic operated by Providence Health Care. To the left is a clinic-like area behind frosted glass.

That clinic’s entrance door is labelled “Vancouver Coastal Health, Horizon Space.” No one answered a reporter’s repeated knocking at the locked door.

The building directory shows a dialysis clinic but no mention of Horizon Space.

Vancouver Coastal does not have any record of Horizon Space on its website. The building’s directory, next to its elevators, does not list the space.

In response to B.C. Catholic questions about Horizon and other locations at which Vancouver Coastal offers MAiD, a spokesman for Vancouver Coastal provided only a vague answer.

“There is no designated location for patients requesting MAiD,” he said in part. “Patients will have their requests addressed, assessments performed and, if eligible, receive an assisted death in the care location consistent with their care needs and wishes.”

After he failed to answer follow-up questions about Horizon Space, The B.C. Catholic filed a freedom-of-information application with Vancouver Coastal seeking confirmation of Horizon’s existence and intended use.

Schadenberg said Vancouver Coastal’s silence on Horizon’s existence serves only to confirm the insider’s tip that the government had opened a secret MAiD facility.

If so, Vancouver family doctor Will Johnston, a member of Physicians for Life, said in an interview that such a clinic might have its uses.

Johnston, who also heads the Euthanasia Resistance Coalition of B.C., said that any move to take euthanasia out of medical settings such as palliative care wards and hospices “shows that this shameful behaviour can be separated from the hospital system.”

A “death space” does not need to be part of actual health care, Dr. Johnston said. “And, in fact, it doesn’t even have to be staffed by doctors and nurses. It’s really simple to kill people.”

He said anyone can be trained to administer the drug cocktail used to kill euthanasia patients.

“I’m just saying that, as a long-term, aspirational project, having this free-standing facility separate from the health-care system, per se, means that maybe we can work towards making sure the staff are separate from the health-care system as well,” he said.

The B.C. government reported that the province recorded exactly 3,000 MAiD deaths in 2024, 633 (21.1 per cent) of which were in the Vancouver Coastal region.

According to government data, the most common location for MAiD to be performed in B.C. was in a private residence (40.2 per cent), followed by hospital, excluding palliative care beds (26.9 per cent), hospice (12.9 per cent), and palliative care facility (8.9 per cent). Other locations included community care facility, residential care facility, and medical clinic or ambulatory setting.

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.”