Introduction

Webcast Archive: No Free Choice – Ms. S.

This week: we ask whether a person should be relieved of the duty to try to improve their quality of life, given the social costs of MAiD.

Webcast Archive: No Free Choice – Ms. S.

During the COVID-19 pandemic, we will not present our webcast, due to technical problems caused by heavy internet usage. However we are 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: MS. S.

  • In June of 2016, just as medical aid in dying (MAiD) was adopted in Canada, a British Columbia woman known as Ms. S. who had Multiple Sclerosis was evaluated for MAiD by Dr. Ellen Wiebe. According to Jocelyn Downie, Dr. Wiebe concluded that Ms. S. met most of the eligibility criteria (incurable condition, advanced state of decline in capability, and enduring and intolerable suffering) but the doctor did not believe Ms. S. would die “in the foreseeable future,” so she was determined ineligible.  
  • As we reported in March of 2018, the Final Disposition Report of the Inquiry Committee of the College of Physicians and Surgeons of British Columbia, found that Ms. S. was “suffering from … trigeminal neuralgia and gastrin [sic] intestinal symptoms for which treatment had been only minimal [sic] effective.” Elsewhere in the report, another physician said Ms. S. had declined “potentially effective” treatment.  
  • Dr. Wiebe exchanged correspondence with Ms. S. in December of 2016 and January of 2017, to the effect “that the patient’s life expectancy was not short enough to qualify for medical aid in dying.” Then in mid-February of 2017, “Ms. S decided to starve herself to death at home, with the support of palliative-care nursing.” 
  • Her husband called Dr. Wiebe two weeks later, and Dr. Wiebe visited Ms. S. on March 3. At that time, Dr. Wiebe determined that she met all eligibility criteria, and she was euthanized on March 6, 2017.
  • The Inquiry Committee, in its final disposition report of February 13, 2018, found that: 
    • “MAiD is intended to be restricted to those individuals who are declining toward death, allowing them to choose a peaceful death, as opposed to a prolonged, painful or difficult one.”
    • “In view of the foregoing standard, a patient cannot be forced to take treatment they do not consider acceptable.”
    • “Ms. S. met the requisite criteria and was indeed eligible for medical assistance in dying despite the fact that her refusal of medical treatment, food, and water undoubtedly hastened her death and contributed to its ‘reasonable foreseeability’.”
  • Ms. S.’ suicidal act highlights a basic flaw of assisted dying: governments have put their efforts toward the goal of ending lives, rather than ending suffering.  From the information provided, we don’t know what symptoms Ms. S. had, how her family and friends reacted to her disability, whether she had peer support, whether she’d received specialist care for her multiple sclerosis, what treatment(s) had been tried, and whether she had received effective palliative care and mental health services. But when the government, in the person of a euthanasia provider, puts its thumb on the scale in favour of death, it makes the struggle to live well with a disability just that much harder.
  • At the same time, the public policy conclusion drawn by this case is that the person asking to die should not be burdened with the obligation of first trying to improve their quality of life. This might make sense there were no social costs from assisted suicide and euthanasia (AS & E). But there are very significant social costs, not just to those who choose to die, their families and medical practitioners, but to all people whose lives are devalued and put in danger by the practice.