A Canadian man who was hospitalised due to repeated alcohol-related falls had his life ended by assisted dying the day after having virtual eligibility assessments, despite no clinical investigations and no terminal diagnosis.
An official report by the Chief Coroner of Ontario’s Medical Assistance in Dying Death Review Committee (MDRC) highlighted that the man, known as Mr A, had previously been found ineligible to end his life under Canada’s euthanasia and assisted suicide regime because he did not have a “grievous and irremediable condition”.
The report states that Mr A developed covid approximately a month after his prior assisted death assessment, but was showing “no significant impact to his function or ability to live independently”. During this period, Mr A was suffering from alcohol use disorder.
Just over a month later, Mr A was admitted to the hospital due to what the attending practitioner referred to as falls that were “precipitated by alcohol use and decreased oral intake of other fluids”. Shortly afterwards, he was voluntarily admitted to a psychiatric unit in a care institution; following a psychiatric assessment, this status became an involuntary admission.
During his psychiatric admission, Mr A experienced a functional decline and repeatedly expressed a wish to die, expressing significant pain in his upper arm.
Mr A asked to be provided with state assistance in ending his own life. He received two virtual eligibility assessments by phone, one after the other, which the inpatient treatment team was not made aware of, and was found to be eligible due to a presumptive diagnosis of complications following covid and possible heart failure, though no additional clinical investigations took place.
Immediately following the assessments, Mr A was transferred to a hospital, where he was found to have a dislocated shoulder, which was subsequently stabilised.
The next day, Mr A was discharged from the hospital and ended his life with the assistance of the state.
Many people are dying in same-day and next-day suicides in Canada
The MDRC report outlined that, in 2023, 65 people in Ontario had their lives ended by Canada’s assisted suicide and euthanasia programme on the same day that they made their requests to do so. A further 154 people had their lives ended the day after their request was made.
According to the report, most members of the MDRC agreed that the short turnaround time between Mr A’s virtual eligibility assessments and an assisted death “did not promote a quality approach” to assisted dying. They argued that a short timeline like this does not allow for adequate investigation of an individual’s conditions or collaboration with a treatment team, evidenced by the fact Mr A’s treatment team were not aware of his over-the-phone assessments. They also argued that this does not allow for alternative care options to be offered.
Canada’s original assisted suicide and euthanasia law, known as Medical Assistance in Dying (MAiD), passed in 2016, required a 10-day waiting period between requesting assisted dying and being given the assistance to end one’s life.
The Canadian Parliament removed this requirement for individuals whose deaths were “reasonably foreseeable” in 2021. There are no specific criteria used to discern whether a same-day or next-day suicide should be applicable or not.
Fears shared of assisted suicide becoming an alternative to high-quality care in the UK
As Peers continue to scrutinise the England and Wales assisted suicide Bill in the House of Lords, these cases of same-day and next-day suicides and an absence of care availability add to the concerns of the Bill’s opponents.
In the assisted suicide Bill, as it stands in England and Wales, individuals could end their lives in as little as nine days following an initial request. Like with the law in Canada, nothing prevents this “period for reflection” from being reduced or removed entirely through an amendment to the law.
Critics warn that, if legalised, assisted suicide would become an alternative to high-quality palliative and end-of-life care. Palliative care services in the UK are already in crisis, with Marie Curie reporting that 170,000 people are dying each year in England needing palliative care but not receiving it. The report also estimates that, in the next 25 years, unmet palliative care needs are expected to rise by 23%, meaning an additional 40,000 people are expected to die with unmet palliative care needs in 2050 compared to 2025.
Spokesperson for Right To Life UK, Catherine Robinson, said “The deeply sad case of Mr A’s next-day assisted death is yet another example of how dangerous assisted suicide and euthanasia can be. Providing an individual with assistance to end their own life following back-to-back remote consultations, with no in-person medical evaluation, no consultation with inpatient medical teams, and no period for reflection can only be described as a tragic farce”.
“People with end-of-life care needs should receive that care and support, rather than be given promptly administered assistance in suicide or euthanasia simply because it is easier or more cost-effective”.
“These examples should serve as warnings of what may happen in the future in England and Wales if the dreadful assisted suicide Bill is made law and starts down the path towards a progressively more expansive assisted suicide regime. It cannot be allowed to happen”.
