Introduction

Webcast archive: No free choice – Candice Lewis

This week, we take another look at the story of Candice Lewis, and examine a new statement from the Canadian Psychiatric Association.

Webcast archive: No free choice – Candice Lewis

During the COVID-19 pandemic, we will not present our webcast, due to technical problems caused by heavy internet usage. However we’re providing the text as a bulletin to offer up-to-date information about assisted suicide, euthanasia and ending-of-life practices for the disability community.

NO FREE CHOICE: CANDICE LEWIS

  • This week, we’re revisiting the story of a young Newfoundland woman whose doctor pressured her to end her life. Candice Lewis, who has physical and intellectual disabilities, was hospitalized in November of 2016. Her mother, Sheila Elson, accompanied her.
  • Ms. Elson says that at one point, a doctor approached the pair to tell them that “assisted suicide death was legal in Canada.” Upon hearing that neither were interested in pursuing it, the doctor called Ms. Elson “selfish.” Ms. Elson later discussed the incident with social workers, who said that any decision about life-ending measures would have to be made by Ms. Lewis herself since she was capable of communicating her wishes verbally.
  • Ms. Elson told the CBC “I didn’t want another family going through what we went through. People like her are being mistreated, and enough is enough.” The local healthcare authority offered to meet with Ms. Elson, and sent her a letter apologizing for the incident. Ms. Lewis’ story was featured in the Euthanasia Prevention Coalition’s 2018 documentary Fatal Flaws.
  • In an interview this week, Ms. Elson told us that the CEO of the health authority chose to step down instead of meeting with her. The nurse to whom Ms. Elson originally brought her complaint accused her of lying until the doctor who mentioned assisted suicide to Ms. Lewis retrieved his records of the conversation.  Ms. Elson then filed a complaint with the provincial physicians’ college, who found that the doctor did nothing wrong. Another doctor who treated Candice at the time has since apologized to Ms. Elson in person.
  • By September 2017, Ms. Lewis had recovered from her illness and was able to participate in her sister’s wedding. Since then, she has had several surgeries, including one last November with life-threatening complications, and another a few weeks ago. Ms. Elson says her daughter is currently having “a hard go of it” with “more bad days than good.”
  • Ms. Lewis now asks her mom “what [they’re] going to do to [her]” during every medical appointment; she still fears that her life is in danger. (In response, Ms. Elson says she will fight for Candice’s life “to the ends of the earth.”) Being treated by medical professionals they can trust has become even more important. It is clear to the family – and many other disabled Canadians – that some doctors believe “if you’re old and feeble or disabled, you have no right to live.”

CANADIAN PSYCHIATRIC ASSOCIATION PUBLISHES A POSITION STATEMENT ON MAID

  • On March 13, the Canadian Psychiatric Association (CPA)  released a position statement on providing assisted suicide and euthanasia to people with psychiatric conditions. The statement was written by the Professional Standards and Practice Committee and approved by the Board of Directors, so may not reflect the views of the CPA membership as a whole.
  • The statement says the CPA “does not take a position on the legality or morality of MAiD,” then lists several “principles and considerations regarding MAiD and psychiatry in Canada” it will “maintain even as the legislation and case law evolves.”
    • Canadian psychiatrists should “have a working knowledge” of MAiD legislation;
    • People “with a psychiatric illness should not be discriminated against solely on the basis of their disability  and should have available the same options regarding MAiD as available to all;”
    • “Psychiatrists will be mindful of the medical ethical principles as they relate to MAiD.  They should not allow personal opinion or bias to sway patients who wish to consider MAiD as an option for addressing irremediable conditions;”
    • “While psychiatrists may choose not to be involved with the provision of MAiD, patients requesting MAiD must be provided with information regarding available MAiD resources and the referral process.”
    • “Psychiatrists who assess eligibility for MAiD are expected to be rigorous in conducting capacity assessments and identifying symptoms of mental disorder that are likely to affect decision-making.”
  • Former CPA president and Council of Canadian Academies working group member Dr. Sonu Gaind responded to the position statement, citing a “lack of member engagement on this issue,” and calling the statement “damaging and dangerous.”  He says the Professional Standards and Practice committee failed to “provide any evidence-based guidance regarding MAiD and mental illness.” He further points out the confusion created by the CPA’s general statement that people with mental illness should not be discriminated against. “Does this mean that it would be discriminatory to not provide MAiD to patients with sole criterion mental illness? Or does this mean that it would be discriminatory to provide MAiD in such situations, since it would expose patients to arbitrary and unscientific determinations of irremediability that cannot be predicted?”