{"id":4539,"date":"2019-10-25T16:06:15","date_gmt":"2019-10-25T16:06:15","guid":{"rendered":"https:\/\/tvndy.ca\/?p=4539"},"modified":"2019-11-01T16:17:38","modified_gmt":"2019-11-01T16:17:38","slug":"webcast-archive-truchon-update-federal-election-expert-report-part-ii","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2019\/10\/webcast-archive-truchon-update-federal-election-expert-report-part-ii\/","title":{"rendered":"Webcast archive: Truchon update, federal election, &#038; Expert Report Part II"},"content":{"rendered":"<div class=\"fluid-width-video-wrapper\">\n<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/Grb57pF_OkA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<\/div>\n<div><\/div>\n<p>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck, Taylor Hyatt, &amp; Christian Debray discuss:<\/p>\n<ul>\n<li>No appeal of Truchon decision<\/li>\n<li>The federal election &#8211; what next?<\/li>\n<li>Excerpts from the Expert, Part II: Psychological conditions and Julia Lamb\u2019s case<\/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>NO APPEAL OF\u00a0<em>TRUCHON<\/em>\u00a0DECISION<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Despite a major social media campaign by disability rights activists, the caretaker government of Justin Trudeau did not appeal the\u00a0<em>Truchon<\/em>\u00a0decision.\u00a0 There was no public announcement of the decision last Friday, which was the deadline for an appeal.<\/li>\n<li>Under the constitutional rules for what a government can do during an election period, the attorney general could have taken action that was \u201c<a href=\"https:\/\/www.canada.ca\/en\/privy-council\/services\/publications\/guidelines-conduct-ministers-state-exempt-staff-public-servants-election.html\">urgent and in the public interest<\/a>.\u201d\u00a0 Since the appeal deadline fell before the election date, and the question of assisted suicide and euthanasia is definitely a matter of public interest, activists believed the Trudeau government should have filed the request in order to keep the option open for the next government to appeal the\u00a0<em>Truchon<\/em>\u00a0decision, if it chose to do so.<\/li>\n<\/ul>\n<p><strong>THE FEDERAL ELECTION: WHAT&#8217;S NEXT?<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Now that the Liberals lead a minority government, they will have to get support for any legislation they want to pass from one of the other political parties.\u00a0 An early test of their ability to work in coalition will be the changes to the Medical Aid in Dying or MAiD law. The Qu\u00e9bec superior court in the\u00a0Truchon case gave Parliament six months, or until March of 2020, to remove the eligibility requirement that the person\u2019s natural death has become reasonably foreseeable, which it declared unconstitutional.<\/li>\n<li>During the campaign, in the French-language debates, Mr. Trudeau said MAiD was a new and evolving law that required a balance between protecting the most vulnerable people and individual rights and choices.<\/li>\n<li>The Liberal party released two documents that mention disability; their\u00a0<a href=\"https:\/\/2019.liberal.ca\/wp-content\/uploads\/sites\/292\/2019\/09\/Forward-A-real-plan-for-the-middle-class.pdf\">party platform<\/a>, and a separate \u201c<a href=\"https:\/\/www.liberal.ca\/disability-equality-statement\/\">Disability Equality Statement<\/a>.\u201d Under the heading \u201cpublic health care,\u201d the Liberals pledge to \u201ccontinue to make home care and palliative care more available across the country.\u201d<\/li>\n<li>There are three disability-related points in the platform:\n<ul>\n<li>The Liberals announced a workplace accessibility fund to match contributions from employers and school boards, providing up to $5,000 to cover the cost of an accommodation. \u201cEmployers and schools will continue to be required to meet their accessibility obligations under provincial and federal law,\u201d even though most employers and schools are not covered under federal law and provincial accessibility legislation is uneven and difficult to enforce.<\/li>\n<li>The Liberal platform promised to double the monthly Child Disability Benefit payment made to families of some \u201cspecial needs kids.\u201d\u00a0 Eligibility is limited to children with certain diagnoses.<\/li>\n<li>Finally, veterans will receive \u201cup to $3,000 in free counselling services before a disability claim is required.\u201d The platform also promises \u201cwe will move forward with automatic approval for the most common disability applications, including depression, post-traumatic stress disorder.\u201d\u00a0 What \u201cmove forward\u201d and \u201cautomatic approval\u201d mean in practice is unclear from the text.<\/li>\n<\/ul>\n<\/li>\n<li>The Disability Equality Statement is mostly a bunch of platitudes. The Liberals praise themselves for holding \u201cthe first ever national summit for youth with disabilities, attended by the Prime Minister,\u201d creating the Accessible Canada Act, and signing on to the UNCRPD optional protocol. They claim to have moved beyond \u201cNothing About Us Without Us\u201d, to \u201cNothing Without Us.\u201d\u00a0 It says a lot about the Liberals that they (a bunch of non-disabled politicians) would co-opt and change a motto of the disability rights movement about disability control for their sales pitch.<\/li>\n<\/ul>\n<p><strong>EXCERPTS FROM THE EXPERT, PART II: PSYCHOLOGICAL CONDITIONS AND JULIA LAMB\u2019S CASE<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Finally, we return to the Expert Report for the\u00a0<em>Lamb<\/em>\u00a0case submitted by Dr. Madeline Li. We\u2019ll examine what Dr. Li has to say about providing assisted suicide and euthanasia (AS\/E) to people with psychiatric disabilities, as well as her findings concerning Julia Lamb\u2019s individual situation.<\/li>\n<li>Doctor Li expresses concern about whether AS\/E is the right response to mental suffering, given the poor record of doctors who don\u2019t have a mental health background to assess \u201ceven clearly irrational suicidal ideation,\u201d let alone \u201cmore complex suicidality, such as the undue internal influence of mild to moderate depressive symptoms.\u201d<\/li>\n<li>Dr. Li describes several factors that can lead doctors to wrongly decide someone is eligible for euthanasia:\n<ul>\n<li>\u201cIt is not clear in mental illness when a disorder is truly irremediable.\u201d Resistance to treatment is about what happened in the past, not what might happen in the future. When psychiatrists talk about \u201cTreatment resistant depression\u201d for example, they usually mean symptoms that don\u2019t respond to antidepressant drugs, without regard to other therapies or supports. Clinical trials can\u2019t predict each person\u2019s unique experience of the disorder, or their response to a treatment.<\/li>\n<li>\u201cUnlike cancer which can be either cured or not, response to treatment for mental illness falls on a spectrum \u2026 described as symptom reduction;\u201d a person might feel somewhat better, but still be suffering.\u00a0 Also, cancer can be measured and observed objectively, while emotional distress can only be described as a person\u2019s own experience.<\/li>\n<li>Psychiatric conditions do not always lead to \u201cirreversible decline.\u201d Even without treatment, some conditions get better or worse over time. The person\u2019s desires may change along with their symptoms. Dr. Li says the \u201creflection period\u201d should be longer than 10 days to account for these situations.<\/li>\n<li>In some cases, refusing treatment may even be harmful to the person. Dr. Li has seen people who know that AS\/E is an option \u201crefusing to even try treatments which may relieve their suffering, and in one case refuse\u201d a possible cure. She says some conditions, like depression, cause a \u201clack of insight, perceived stigma\u201d and reduce motivation. She cites a\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5530592\/\">2016 study<\/a>\u00a0of 66 completed Dutch psychiatric euthanasia where more than half of the people had refused at least some treatment.<\/li>\n<li>When a therapist evaluates a client\u2019s eligibility for euthanasia, it raises issues of caring, protection, abandonment, control and respect. This can harm the therapist-client relationship and make treatment less effective. By approving the request, the clinician agrees with the client\u2019s belief that they will never feel better, reinforcing their hopelessness.<\/li>\n<li>Equal numbers of men and women request euthanasia for non-psychiatric reasons. However, the ratio of women to men seeking euthanasia for a psychiatric condition in the Netherlands is more than 2 to 1. In Belgium, over 75% of euthanasia done for psychiatric reasons involve women. \u201cThis exceeds the known sex differences in mood disorders and personality disorders, and matches the sex ratio in suicide attempts in the general population.\u201d<\/li>\n<li>Finally, Dr. Li says allowing AS\/E for mental illness could make some doctors less vigilant in their suicide prevention efforts. She points to the advocacy of VSED (voluntarily stopping eating and drinking) by some AS\/E supporters as a \u201cblurring of what constitutes a suicidal act.\u201d She believes this contributes to the \u201csocial contagion effect on suicide rates from legalizing MAiD for mental disorders.\u201d<\/li>\n<\/ul>\n<\/li>\n<li>Here is what Dr. Li has to say about Julia Lamb\u2019s circumstances:\n<ul>\n<li>Dr. Li believes Julia Lamb would meet all MAiD eligibility criteria. Her condition is clearly \u201cprogressive [and] incurable.\u201d She believes Ms. Lamb\u2019s mobility impairment, swallowing and breathing problems, and need for help with everyday activities are signs of \u201can advanced state of irreversible decline.\u201d\u00a0 Dr. Li states that, since the definition of \u201cintolerable suffering\u201d is up to the person, \u201cwhen she says she is suffering enough to proceed with MAiD, that satisfies the criterion.\u201d<\/li>\n<li>Dr. Li said that, during the first year the MAiD program was in effect, when Ms. Lamb filed her lawsuit, practitioners used \u201cshorter prognoses for interpreting reasonably foreseeable natural death.\u201d However with the\u00a0<a href=\"https:\/\/tvndy.ca\/en\/2017\/06\/webcast-archive-ontario-superior-court-ruling\/\">AB decision<\/a>\u00a0in 2017 and the guidelines from the Canadian Association of MAiD Assessors and Providers (CAMAP), clinicians \u201cgained comfort with extending prognostic timeframes out to many years.\u201d She believes that Ms. Lamb\u2019s natural death would be considered \u201creasonably foreseeable.\u201d<\/li>\n<\/ul>\n<\/li>\n<li>She suggests that, if Ms. Lamb is unable or unwilling to undergo the \u201conerous\u201d MAiD evaluation process, palliative sedation \u2013 whether continuous or intermittent \u2013 would be an option, and could be \u201cspecified [in] an advance directive or authorized by a substitute decision maker.&#8221;<\/li>\n<\/ul>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nThis week, we discuss disability-related promises made by the new Liberal government, as well as Dr. Madeleine Li&#8217;s thoughts on euthanasia and psychiatric conditions.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2019\/10\/webcast-archive-truchon-update-federal-election-expert-report-part-ii\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Truchon update, federal election, &#038; Expert Report Part II&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2019\/10\/webcast-archive-truchon-update-federal-election-expert-report-part-ii\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: Truchon update, federal election, &#038; Expert Report Part II&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":[614,616,121,617,589,615,582,118],"class_list":["post-4539","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-dr-madeline-li","tag-election","tag-euthanasia-disability","tag-justin-trudeau","tag-lamb-en","tag-liberal","tag-truchon-en","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4539","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=4539"}],"version-history":[{"count":5,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4539\/revisions"}],"predecessor-version":[{"id":4556,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/4539\/revisions\/4556"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=4539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=4539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=4539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}