A Canadian coroner has recorded more than 400 cases of failure to assist dying doctors since 2018.
Dirk Huyer, the chief coroner of Ontario, highlighted 428 cases of doctors and nurses violating medical guidelines for assisted suicide, and documented “practices of non-compliance with the law”, documents seen by The Telegraph show.
In many cases, doctors confessed that they did not wait a short time before using lethal drugs and did not record assisted dying as the cause of death of patients.
In one incident, described as “terrifying” by the investigator, a patient was forced to “suffer a lot” after a doctor gave him the wrong medication.
Last year, a quarter of all assisted living deaths in Ontario had at least one non-adherence issue.
‘Unregulated wild west’
The number of violations has prompted experts to warn of the “unorganized west” of assisted dying in Canada. Members of Parliament in the UK will vote on Friday on whether the practice is legal.
Much of the debate in the UK has focused on whether adequate safeguards can be put in place to prevent terminally ill people from being forced to choose assisted dying.
Under the law, a person who is expected to die within six months can be granted an assisted bereavement permit if they have the approval of two independent doctors and a high court judge.
However, Canadian medical experts have warned of a slippery slope when it comes to pressure conservation.
“The fact that Ontario’s violations remain unreported erodes public trust and shows that important safeguards are not easily implemented,” said Dr. Ramona Coelho, a family physician based in London, Ontario.
“UK policymakers should learn from Canada’s failure to ensure the safety and security of its citizens.”
‘No doctors have been charged’
Under Canadian law, assisted dying authorities are required to determine whether people requesting euthanasia are eligible, maintain protections against abuse and maintain records.
But even though the Ontario coroner uncovered hundreds of violations of these laws, no doctors have been charged, New Atlantis reported, although the coroner accused one of “blatant” wrongdoing in a secret conference of Ontario doctors.
Instead, the coroner’s office has deemed almost all cases as requiring only an “informal chat” with a doctor or an “educational” or “notification” email.
Until 2017, patients needed a 90-day screening period to qualify for death benefits, followed by a 10-day waiting period before the deadline. This has worked in all but the most extreme situations – as if they are at the point of losing the ability to accept when natural death is near.
However, the researchers’ documents first reported by The New Atlantis magazine show that the doctors died early because of “constant requests” and “unfavorable timing of death in relation to other family life events”.
‘Pattern of non-compliance’
In a 2017 case, a hospice assistant (Maid) brought the wrong medication to a patient’s home. “It was terrifying,” Dr Huyer said. “The family and the deceased suffered a lot.”
The College of Physicians and Surgeons regulator said it was “dismayed” by the doctor’s failure and said the doctor “continued to underestimate the growth of the provision of medically assisted death and the associated service”.
In response to these and other violations of the law by doctors, the Ontario coroner’s office in 2018 introduced a new five-step plan to address what Dr. Huyer called “an example” of Maid providers “not following the law”.
Speaking in a private webinar for Ontario nurses, he said: “We see patterns of non-compliance, we see patterns of non-compliance with the law, patterns of non-compliance with the law, and frankly we can’t just continue to do education for those people if they’re repeating the things that we’ve brought.”
Despite the introduction of the new system, compliance issues have rapidly increased from 73 in 2020 to 48 identified in total by 2024.
These include cases of patients without proper documentation, as well as doctors who did not provide documentation to review how the decision to provide assisted dying was reached and did not record the death as assisted, according to the coroner’s office.
Other violations include doctors failing to conduct a professional examination and not waiting for the 10-day deadline, which has been removed, to assist in dying.
In 2023 alone, the Ontario coroner revealed 178 hearing problems – an average of one every day.
In some cases where the patients were terminally ill, the doctors reported that they were not experts in the disease that afflicted the patient, but no outside expert was consulted.
Dr Huyer described these issues as a “learning opportunity” in a press conference, New Atlantis reported.
The number of deceased beneficiaries was not specified
Meanwhile, few doctors report their full number of assisted deaths despite a requirement to do so from the Office of the Chief Coroner for Ontario.
This comes after The Telegraph newspaper revealed last month that the aid is being used by Canadian patients because they are poor and homeless.
The first legal report on assisted dying in Ontario found vulnerable people faced “coercion” or “undue pressure” to seek the practice.
Dr Isabel Grant, a law professor at the District of Columbia University, said: “Protections are meaningless if they are ineffective and so far they have been ineffective in Canada due to a lack of oversight.
“If colleges and psychologists don’t do their part in controlling this practice, the consequences will be the injustice of the western way of ending the lives of disabled people who may see it as an emotional or financial burden for their loved ones or those who may be disabled. other reasons.”
Dr Coelho said: “With more than 400 violations recorded in Ontario alone – the province with the strongest governance – it’s clear that this problem could expand across the country.”
Rebecca Vachon, director of the Health program at Cardus, a Canadian Christian think tank, said: “The way the law is designed and the law has its inherent weaknesses. You are relying on self-reporting by doctors, and the ambiguity surrounding many eligibility criteria creates a situation where you may experience these types of abuse. “
Dr Huyer was contacted for comment.
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