Introduction

Webcast archive: No free choice to die – Bob Blackwood’s story

This week, we look at the story of Bob Blackwood, and a new study in the Canadian Medical Association Journal.

Webcast archive: No free choice to die – Bob Blackwood’s story

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

  • No free choice to die: Bob Blackwood
  • Study of early Ontario MAiD cases doesn’t allay fears

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

NO FREE CHOICE TO DIE: BOB BLACKWOOD

  • Bob Blackwood was euthanized in Sherbrooke, Québec on August 18, 2017.  He was first diagnosed with Parkinson’s disease in 2010, but his diagnosis was changed in 2016 to Multiple Systems Atrophy because of the rapid progression and severe symptoms he had.  For Mr. Blackwood, MSA caused severe pain, cramping, circulation and balance problems, nausea and sleeplessness.
  • After outpatient treatment was unsuccessful at managing his pain, Mr. Blackwood went into the hospital for palliative care In July of 2017.  The medical team got his pain under control so he could sleep, but the medications also suppressed his breathing, so the doctors cut the dosage. The return of pain and sleep deprivation, described in a CBC article as “torture,” lead Mr. Blackwood to consider suicide. Or, as the CBC put it: “With the palliative care no longer providing relief from his suffering, Blackwood applied for a medically assisted death.”
  • His application under Québec’s euthanasia law was denied because the second doctor didn’t believe he was at the “end of life.” Mr. Blackwood’s wife, Heather Ross, had problems in advocating on his behalf, because of summer vacation schedules.
  • When she finally arranged a team meeting, Ms. Ross was informed she could ask a different clinician (“doctor shop”) for an opinion on her husband’s eligibility for euthanasia. She soon found a physician to sign off on her husband’s medical assistance in dying (MAiD) request.
  • After Mr. Blackwood’s death, Heather Ross joined with Dying with Dignity to advocate for changes to Québec’s euthanasia law to clarify and relax the “end-of-life” eligibility requirement.
  • The reporter’s focus on death as a solution to suffering, while downplaying palliative care, is typical of media coverage of assisted suicide and euthanasia (AS/E), as we discussed last week.  Rather than investigating why his pain medications were decreased, whether Mr. Blackwood might have been eligible for palliative sedation, or what alternative measures were tried, the CBC reporter makes the denial of MAiD the central issue of the report.
    • The CBC report uses emotional language to describe Mr. Blackwood’s symptoms. Phrases such as “stumble in a woozy daze,” and “Committed to palliative care,” are designed to provoke an emotional response in the reader, and the word “suffer” is used nine times in the article.
    • Suicide is presented as something to be avoided at all costs, even though, like euthanasia, it results in the person’s death.
    • The article quotes a palliative care specialist about whether Mr. Blackwood was at the end of life, rather than on the type and amount of palliative care he received.  The reporter also quotes a spokesperson from Dying with Dignity, with no opposing view to provide balance.
  • second article from the CBC focuses on the difference between the “end of life” criterion in the Québec statute and “reasonably foreseeable” natural death requirement in the federal law.  The piece quotes National Assembly Member Véronique Hivon defending the provisions of the bill she sponsored.
  • The proposal that would have changed the Québec criterion from “end of life” to “on a trajectory toward the end of life for which the doctor can reasonably foresee their death” became obsolete with the ruling in the Truchon decision that declared the “end of life” eligibility criterion unconstitutional.

STUDY OF ONTARIO MAID CASES DOESN’T ALLAY FEARS

  • new study came out on Tuesday comparing demographic information about people who received medical assistance in dying between June, 2016 and October, 2018 and those who died from other causes.  In statements to the press, the researchers claim that the study shows that concerns about vulnerability and isolation of people who request MAiD and access to palliative care are unfounded.
  • In the Globe and Mail Dr. James Downar is quoted as saying “It was very unusual to see anything but well-educated [patients] who were well aware of their rights and options and definitely had access to good palliative care.” However on page 8 of the study itself, the authors state that “A number of important patient characteristics were not routinely recorded — for instance, religion, ethnicity or education.”
  • The study says “Palliative care providers were involved at any point in the care of 77.2% of patients, and at the time of the request for MAiD in 74.4%,” without defining what “involved” means.  Other data in the study offer a clearer idea of the effectiveness of supports people received. The fact that 99.5% of people who requested MAiD reported physical suffering would seem to indicate that whatever palliative care they received, it was inadequate.  Also, psychological consults were performed in only 6.2% of MAiD requests, though 96% of people reported psychological suffering.
  • The researchers said that they did not have any information about disability status, but offered the percentage of people who lived in institutions as a substitute count of disabled people, without regard to the many disabled people who don’t live in institutions.
  • The way this study is being presented to the public seems like a propaganda exercise: “experts agree, everything is fine.” But you only need to scratch the surface of the data to find that all is not well.