{"id":3981,"date":"2018-11-30T15:12:11","date_gmt":"2018-11-30T15:12:11","guid":{"rendered":"https:\/\/tvndy.ca\/?p=3981"},"modified":"2018-11-30T15:42:11","modified_gmt":"2018-11-30T15:42:11","slug":"webcast-archive-the-federal-reporting-form","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-the-federal-reporting-form\/","title":{"rendered":"Webcast archive: The federal reporting form"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/BqZj7xKSyl0?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><strong>\u00a0<\/strong>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:<\/p>\n<ul>\n<li>The federal AS\/E reporting form<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>THE ASSISTED SUICIDE AND EUTHANASIA REPORTING FORM<\/strong><\/p>\n<ul>\n<li>As promised in our webcast of\u00a0<a href=\"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-first-euthanasia-prosecution-in-the-netherlands\/\">November 16<sup>th<\/sup><\/a>, we\u2019re looking at the federal assisted suicide reporting form today. We\u2019ve already discussed\u00a0<a href=\"https:\/\/www.canada.ca\/content\/dam\/hc-sc\/documents\/services\/medical-assistance-dying\/guidance-reporting-summary\/document\/MAID%20Guidance%20Document%20October%2015-full.pdf\">the guidance document<\/a>, which allows \u201c[a] patient&#8217;s written request [to] take any form,\u201d including text, email, or other informal means, and the likelihood that this \u201cshort-cut\u201d will replace the formal application that is protected by safeguards.<\/li>\n<li>The reporting form states that information about whether the request is voluntary can come from family members, friends, or health care and social service professionals.\n<ul>\n<li>All of these could potentially be sources of \u201cexternal pressure\u201d or coercion, and are therefore not reliable sources of whether the person\u2019s request is voluntary.<\/li>\n<li>\u201cExternal pressure\u201d is not defined in the statute or the regulations.\u00a0 The definitions we did find apply to abuse or coercion, not discrimination, or social and economic stresses.<\/li>\n<\/ul>\n<\/li>\n<li>For each eligibility criterion, the practitioner may check \u201cyes\u201d \u201cno\u201d or \u201cdid not assess.\u201d How can \u201cdid not assess\u201d be an option? This would make it possible for a form to be submitted where no eligibility assessments were done.<\/li>\n<li>No information is given about whether the person submitted a second application after being declared ineligible.<\/li>\n<li>There is no space for practitioners to describe how decision-making capacity was determined \u2013 in other words, what criteria, procedures or tests were used. Some psychiatric conditions can affect decision-making, so evaluation of the person\u2019s mental health is essential.<\/li>\n<li>Following section 3 (eligibility criteria), the form asks practitioners if they \u201c[consulted] other health care professionals, such as a psychiatrist or the patient\u2019s primary care provider\u2026\u201d Two problems leap to mind:\n<ul>\n<li>This is not mandatory.\u00a0 Health Canada does not\u00a0<strong>require<\/strong>\u00a0that the practitioner consult with, or report having consulted with, another health care professional<\/li>\n<li>There is no mention of how these other professionals would be informed about the person making the AS\/E request.\u00a0 If the consultant does not speak to the person directly, the information on which they base their opinion will be filtered through the lens of the practitioner\u2019s biases and prejudices.<\/li>\n<\/ul>\n<\/li>\n<li>As well, no space is given for practitioners to discuss what evidence led them to decide the person\u2019s condition was in an \u201cadvanced state of irreversible decline\u201d, or why they believe death has become \u201creasonably foreseeable.\u201d<\/li>\n<li>In our last webcast, we pointed out that the effect of the \u201csecond assessment\u201d was still unclear.\n<ul>\n<li>If the second practitioner believes the person is\u00a0<strong>in<\/strong>eligible, does that stop the application process in its tracks?\u00a0 Or is the second practitioner\u2019s assessment just a rubber stamp, where their opinion that the person is ineligible simply causes the first medical professional to seek another second opinion until they find someone who agrees the person is eligible.<\/li>\n<li>The monitoring form seems to clear up this question, stating that the second medical practitioner must have \u201cprovided a written opinion (second assessment)\u00a0<strong>confirming<\/strong>\u00a0that the patient met all of the criteria.\u201d The second practitioner is expected to go along with the decision of the first. If they disagree, their opinion doesn\u2019t count.<\/li>\n<\/ul>\n<\/li>\n<li>The person\u2019s description of their suffering is reduced to a \u201ccheck all that apply\u201d list, which is mostly borrowed from Oregon\u2019s reports.\u00a0 Practitioners are not required to solve these problems before killing the person.\u00a0 They are:\n<ul>\n<li>Loss of ability to engage in activities making life meaningful;<\/li>\n<li>Loss of dignity;<\/li>\n<li>Loss of control of bodily functions;<\/li>\n<li>[Perceiving oneself as a] burden on family, friends or caregivers;<\/li>\n<li>Inadequate pain control, or concern about it;<\/li>\n<li>Inadequate control of other symptoms, or concern about it;*<\/li>\n<li>Isolation or loneliness;*<\/li>\n<li>Loss of ability to perform activities of daily living (e.g. bathing, food preparation, finances);*<\/li>\n<li>Or \u201cother,\u201d with room for more information. (Finally!)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>The three items marked with an asterisk are not in the Oregon or Washington reports.<\/p>\n<ul>\n<li>As we\u2019ve often noted, most of these are disability issues, unrelated to approaching death.\u00a0 In the \u201cOther information\u201d section, the form asks about palliative care and whether \u201cdisability support services\u201d were needed, available, received, and used.\n<ul>\n<li>\u201cDisability support services\u201d are described in footnote 3. They include \u201cassistive technologies, adaptive equipment, rehabilitation services, personal care services and disability-based income supplements.\u201d Notably, \u201cpeer support\u201d is missing.\u00a0 Peer support is crucial to adapting to a new disability.<\/li>\n<li>It is possible for the medical professional to declare that they \u201cdidn\u2019t know\u201d whether \u201cdisability support services\u201d were required, or available.<\/li>\n<li>The form asks how long disability supports were used, and includes the option \u201cless than six months.\u201d That is nowhere near enough time to come to terms with a new disability, obtain equipment and services, and adjust to their everyday use.<\/li>\n<\/ul>\n<\/li>\n<li>The federal form continues the tradition of mixing up\u00a0<strong>actual pain<\/strong>\u00a0or symptoms, with\u00a0<strong>the fear of<\/strong>\u00a0pain or symptoms. The goal of improving palliative care will not be served by allowing this confusion to continue.\u00a0 People are choosing assisted suicide because they fear what\u00a0<strong>may\u00a0<\/strong>happen to them in the future. The reports should record what\u00a0<strong>does\u00a0<\/strong>happen to people.<\/li>\n<li>The reporting form does nothing to lessen our fears about inadequate monitoring of the AS\/E process. Adding one question about disability support services amounts to the government throwing a bone to disability rights activists. How many people will die unnecessarily before authorities decide that killing ineligible people is a problem?<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we discuss the information that needs to be reported to the federal government about each euthanasia death.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-the-federal-reporting-form\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: The federal reporting form&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/11\/webcast-archive-the-federal-reporting-form\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: The federal reporting form&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[258,121,127,188,118],"class_list":["post-3981","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-eligibility","tag-euthanasia-disability","tag-health-canada","tag-monitoring","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=3981"}],"version-history":[{"count":5,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3981\/revisions"}],"predecessor-version":[{"id":3988,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3981\/revisions\/3988"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=3981"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=3981"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=3981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}