Sign of growing discomfort with media exposure of serious problems w Canada's #MAID law/practice: @picardonhealth, MAID expansionist day 1, goes on all-out editorial defence MAID & government approach, with frankly extraordinary denial of any potential problem... 1/
2/ Some examples 1: Expert Panel on MAID Mental Illness, widely criticized for failing to impose any additional safeguards #mentalhealth (contrary to B & Nl, other liberal regimes), had 2 members resign in protest-- Picard: panel made “19 thoughtful recommendations”
3/ e.g. 2: Gov strongly criticized for not appealing lower court Quebec decision and caving in without defense of law broadly supported by parliament—Picard: law was “predictably struck down by court’
4/ e.g. 3: Picard "Most come at it from a point of 'compassion' (read: ‘all good people but some overly protective’). Other critics he refers to as ‘a few anti-choice zealots exploiting the vulnerable”. Of course no zealousness among MAID expansionists for Picard...
5/ e.g. 4: No other country treats MAID as just a standard medical procedure—nor did the Supreme Court – Picard: “assisted death is a medical procedure’
6/ e.g. 5: Disability & Indigenous advocates forcefully criticized Government & Parliament for recklessly moving ahead w-out adequate debate, study & hearings during pandemic,—Picard: gov "fashioned overcautious legislation, publishing thorough data, studying issue exhaustively”
7/ e.g. 6: parliamentary committee hearings strongly criticized for biased questioning & polarized ideological hearings. Picard calls them “excellent public hearings” (hint: check time allotted to MAID expansionists in #AMAD hearings & tone of questioning of gov critics)
8/ e.g. 7: Many point to agressive #MAID expansion as reflecting terribly impoverished concept of autonomy. Picard: "it's about autonomy vs protection". (even John Stuart Mill would likely cringe w such a simplification)
9/ e.g. 8: Specialists point to absence of scientific evidence to predict irremediability in mental illness. Picard: silence (so health care providers just need to find a solution to that one)
10/ This sums it up: Picard: “if we’re going to err, it has to be on the side of patient autonomy”. READ: if tens/hundreds of people who could've gotten better now die w state supported suicide, it's worth it if it helps to respect ‘autonomous choice’ of 1 (privileged) person
Two remarkable admissions David Lametti re #MAID: 1."suicide generally is available to people. 2. [MAID helps people] who, for physical reasons and possibly mental reasons, can’t make that choice themselves & do it themselves" @althiaraj@TorontoStarthestar.com/politics/polit…
2/ Let that sink it: fed justice minister recognizes that choice is always there. BUT: government wants to facilitate suicide of those who would otherwise be saved by the fact that, fortunately, they often doubt and there is often a barrier to end one's own life...
3/ if this isn't a glorification and problematic simplification of suicide and MAID as a terrific & much needed solution to 'intolerable suffering' of disabled persons, incl persons w mental illness, which needs to be facilitated by the state, what is?
Gov commissioned report shows serious challenges pandemic for p w #Disability "some people told her they were being encouraged to explore #MAID#euthanasia." And this was not going to happen w #BillC7, MPs & senators & DwD advocates claimed... 1/ kitchener.ctvnews.ca/it-makes-my-li…
L'association des medecins psychiatres de Quebec publishes paper “Access to medical assistance in dying for people with mental disorders”. Complex issue cannot be discussed fully. But timing no coincidence, so let's look at some deeply troubling issues (1) bit.ly/37Aqlxs
(2) Authors clearly know they feed into a process of Bill C-7 & endorse inclusion of MH; but Bill’s provisions DO NOT provide a reliable, safe basis for what even they recommend as minimal standards under which MAID for MD could be practiced
(3) 'in their view', as this is presuming that the reports’ recommendations are ethically sound/unproblematic, legally coherent, and evidence-based. Not so, imho. Let’s look at some components.
(2) "Should people with disabilities be penalized for impairments that may mean they require more resources to achieve the same result? Should hospitals be able to consider long-term survival? And if we accept short-term survival, do existing instruments need modifications...?"
(3) A public building is not just prohibited from posting a “No Wheelchair Users Allowed” sign–it is also required to ensure that a ramp is present. These are not acts of charity; rather, they are requirements to avoid discrimination under a civil rights law."
@CMA_Docs comes out with utilitarian "Framework for Ethical Decisionmaking During the Coronavirus Pandemic" embracing considerations of 'length of life' remaining, seemingly deprioritizing elderly & people w disabilities or chronic illness (1) policybase.cma.ca/en/viewer?file…
(2) As excuse for largely taking over recommendations & text NEJM article, @CMA_Docs suggests it looked at "documents, reports and policies produced by our Italian colleagues and ethicists and physicians from Canada & around the world, as well as provincial level frameworks"
(3) with its excuses for not holding any "deliberations and consultations with numerous stakeholders, including patients and the public". As if there is no other option than to consult for 'months' ...
(2) Call for attention to 'equity' & proper concern for already disadvantaged laudable: But there appears a troubling disconnect in this article between emphasis on 'equity' and attention for "people facing poverty, discrimination, language barriers and historical trauma" and ...
(3) suggestion that 'palliative care thus becomes the compassionate option to counterbalance this inequity". Palliative care should be available as matter of principle to all. Not as a token to substitute for care provided in priority to others when ...
(4) triage guidelines presented as 'value neutral' clinical decision making tools fail to address or account for these inequities & perhaps even enhance them by categorizing people w disabilities in category of lowest priority