Webcast archive: Catching up on news briefs

In this episode of Euthanasia & Disability, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:

• Catching up on news briefs
  o Wettlaufer case: another homicide comes to light
  o Mobile palliative care units
  o Euthanasia by organ donation
  o Murder trial of Michel Cadotte

Please note that this text is only a script and that our webcast contains additional commentary.

CATCHING UP ON NEWS BRIEFS

• Now that we’ve finished with the Council of Canadian Academies reports, we can get back to some other important news stories from the past few weeks!

WETTLAUFER CASE: ANOTHER HOMICIDE COMES TO LIGHT

• Elizabeth Wettlaufer was a nurse from London, Ontario who was sentenced to life in prison in 2017 for killing eight people and injuring six others in nursing homes where she worked.  A recent CBC news report revealed that Wettlaufer confessed in 2018 to giving a lethal dose of insulin to a ninth person, Florence Beedall.  However Ms. Wettlaufer was not charged in this incident, nor was it included in the public portion of an inquiry last fall into how her crimes went undetected – until she confessed in 2016.
• Ontario Provincial Police Sergeant Carole Dionne told CBC News “there was no point” in laying an additional charge, “given that Wettlaufer is already serving a life sentence for her many other crimes against patients. We consulted with the attorney general and it was determined it was not in the public interest.”
• Hopefully no one else will get lost in the shuffle as the public commission drafts their recommendations and makes their final report due in July of 2019.

MOBILE PALLIATIVE CARE UNITS

• Paramedics in some parts of Saskatchewan, Manitoba, Newfoundland, British Columbia, New Brunswick, and Ontario will soon be offering palliative care services.  The Canadian Partnership Against Cancer and the Canadian Foundation for Healthcare Improvement will spend $5.5 million on the new project, which will train 5000 paramedics to administer pain medications, based on programs already running in Nova Scotia, P.E.I., and Alberta.
• The program coordinators believe the service will “reduce unnecessary hospital visits, and give those with cancer and other life-limiting conditions access to urgent end-of-life care ‘when they need it, and where they want it.’” Another story on the Nova Scotia service quotes one user: “Palliative care is wonderful if it’s done right. It gives you the option to stay in your own home and to have death with dignity. You’re not just a number, or a room number, or a disease.”
• Having palliative care available at home is important and desirable. Yet the line between care and killing is very thin, and it would be naïve to ignore the possibility that this service could evolve into the kind of mobile euthanasia units that have operated in the Netherlands since 2012.

EUTHANASIA THROUGH ORGAN DONATION

• Researchers in the Netherlands, several from Maastricht University, have written an opinion piece calling for further study of the possibility of allowing people who have asked for euthanasia to donate their hearts as part of the euthanasia procedure.  While other organs (lungs, liver, pancreas and kidneys) can be transplanted after euthanasia as it’s currently done, donating a heart would require that the organ be removed before brain death occurs. In other words, removing the heart “results in the death of the donor.”
• The authors note that “at least 70 [people] have donated organs after euthanasia in Belgium and the Netherlands,” though only about 10 percent of people who are euthanized will have organs suitable for donation.
• The authors cite a growing number of requests for a “living organ donation” procedure which they say “would maximally respect the patient’s autonomy but may give others the impression that patients are killed for their organs.”
• The researchers also challenge the policy that “only the patient should pose the question of organ donation, and only after a positive response to the euthanasia question.”
  • “…[I]t is our belief that a physician should always inform a patient who is medically suitable about the possibility of organ donation, even if this could disrupt the trust relationship, as many patients may choose not to ask about donation because they assume it is not possible in this context.“
• The authors describe four objections to “Organ Donation Euthanasia (ODE)” as questions for further study:
  • Living donation “goes against the dead donor rule, which states that vital organs should be taken only from persons who are dead. This rule is a safeguard against abusive exploitation.”  The authors argue the “spirit” of the rule is not violated when a person requests, and is deemed eligible for euthanasia.
  • Second the authors challenge the idea that living donation and euthanasia are “harmful” in the sense that they violate doctors’ Hippocratic oath to “first do no harm.”  The researchers assume that, euthanasia being acceptable, there is no difference between organ donation after death, and euthanasia by organ donation.
  • Third, the researchers point to the possibility that “people could be pressured to undergo euthanasia in order to donate, whereas the public may believe euthanasia was only granted to make organ donation possible.”
  • Finally, the authors worry that negative publicity may incite fear that people are being euthanized for their organs, which could, in turn cause distrust in the organ transplant system and scare away potential organ donors.

MURDER TRIAL OF MICHEL CADOTTE

• Finally, in Québec, the trial of Michel Cadotte in the homicide of his wife Jocelyne Lizotte two years ago is wrapping up.  Mr. Cadotte is accused of second degree murder after he admitted to smothering his wife who had dementia; he claims he wanted to end her suffering.
• Psychologist Gilles Chamberland testified that Cadotte’s actions were not related to depression. Nor was he overwhelmed with caring for his wife, since she was in a long-term care facility.  Mr. Cadotte had asked for euthanasia on his wife’s behalf but was refused.
• Evidence presented at trial showed that Ms. Lizotte’s condition was no better or worse than it had been in some time, but that Mr. Cadotte had been drinking heavily over the weekend leading up to the homicide.
• Mr. Cadotte claims he killed Ms. Lizotte “out of compassion,” but a report filed by Dr. Chamberland said Cadotte wanted “end her suffering,” to stop his own pain.
• Intimate partner violence among elders is neither rare nor new. A 2007 study of murder-suicides from the Clinical Interventions in Aging journal found that life-ending violence is often explained away as “altruistic,” especially in cases where one party is ill. This distortion prevents “proper investigation into the specifics of the case, especially with regard to victim consent.” In one incident, a husband “claimed his wife had terminal cancer, but the autopsy found she had no evidence of any illness.”
  • These murders may be inspired by the perpetrator’s “strong need to control [the spouse’s] fate.” Some even thought death was preferable over sending their partners to a nursing home.
  • The study rightly concludes that “[domestic] violence events should never be viewed as romantic or altruistic as it is often erroneously reported in the news media.”
• Disabled girls and women are also at a higher risk for abuse, including at the hands of their partners. In a 2017 submission to the United Nations, Women Enabled International explained that “women with disabilities worldwide experience domestic violence – including physical, sexual, emotional, psychological, and financial abuse – at twice the rate of other women.”
  • These women must also rely on the abuser “to meet personal needs; indeed, when the abuser is also a caregiver, it is frequently impossible for women with disabilities to get help.”
  • Women may be unable to leave a dangerous living situation because they don’t have transportation or can’t find an accessible shelter. The longer women stay in abusive environments, the higher the risk that violence will escalate to homicide.