The 2023 MAiD numbers are out, just in time for Christmas, when people are distracted by shopping and partying and decorating, baking and otherwise “getting ready”. Nobody wants to be thinking about these issues in the lead-up to Christmas, so most people will not, and the report will slip by with very little attention to the way Canada has leapt into the international lead on government-sanctioned doctor-assisted death. Remember, these numbers are a year old already — the 2024 numbers will be even higher.
On December 13th, The National Post published a sobering and sad article, pointing out the number of people who cited loneliness as one of their main sources of death-worthy suffering. I can’t help remembering The Beatles song, Eleanor Rigby, from 1966.
I don’t like getting tied up in statistics — I think they flatten, dehumanize and chill responses to human realities and tragedies. But here are a couple for you:
Total MAID provisions in 2023: 15,343 (Gasp! The report notes this very high number only represents a 15% increase over the previous years, which increased at 30+% per year. So there’s a “slowdown” in the “uptake”. Yay.)
Track 1 (People whose death was reasonably foreseeable) – 14,721.
Track 2 (People with disabilities who were not otherwise dying) – 622.
Lonely people:
Track 1 – 3091. (21.1%)
Track 2 – 292. (47.1%)
People with emotional distress, fear, anxiety or “existential suffering”:
Track 1 – 5667. (38.5%)
Track 2 – 218. (35%)
There is overlap in these numbers, but what’s clear is that there are not enough people who are willing to just BE with people. People who are suffering from loneliness need to laugh and chat and cry and hold hands and remember together what a joy life can be when other people share it. They need their symptoms dealt with — pain, breathlessness, constipation and so on. But just as surely, they need their “after-life” anxieties dealt with. They need their fears and anticipatory worries dealt with. They need their belief that they’re doomed to die in pain-wracked agony dealt with. They need answers, but mostly they need company.
Now the report claims, in the introduction to section 5, that pretty much everyone (75%) who wanted or needed palliative care had access to it. But as I understand palliative care*, the issues highlighted in the statistics above are exactly the areas of concern that palliative specialists deal with, along with bringing pain and other physical symptoms under control. So, I have questions. If the report is being truthful when it reports that MOST people had access to palliative care, how can it be that so many did NOT get their emotional/psychological/spiritual needs met by people claiming to practice palliative medicine? Are there rogue practitioners? Is palliative care, as practiced in Canada, not living up to international care standards? Which medical authorities are querying and enforcing the standards of palliative care? Perhaps more to the point, which medical authorities will question and challenge the blurring of the bright line between palliative care (neither hastening nor postponing death) and MAID (administration of drugs to cause death)?
* The Canadian Medical Association policy paper from 2016 states that palliative care is distinct from medical assistance in dying. https://policybase.cma.ca/viewer?file=%2Fmedia%2FPolicyPDF%2FPD16-01.pdf#page=1
The Canadian Association of Palliative Medicine (CAPM) agrees. https://www.pallmed.ca
CAPM made a clear and compelling statement to the AMAD committee after their recommendations were released in February 2023. You can read it here: https://www.pallmed.ca/wp-content/uploads/2023/03/CSPCP-response-to-AMAD-report_final-Mar-2023.pdf
Please consider this a gentle reminder to reach out to people in your life who you know to be lonely, especially at this time of year.
Wishing you all the best of the season, however you choose to spend it.
Very disheartening statistics and heard to comprehend.
In my experience, trying to access palliative care for those close to me was fraught with roadblocks, disagreements with the “professionals”, limited access and available spaces, differing definitions of “palliative” and criteria needing to be met, having to “shop around” and often relying on word of mouth from others who had also been through similar experiences. The emotions, physical and medical needs and struggles of those needing palliative care and their loved ones were never met.
There most surely is a huge gap between theory and practice! I just find it so scary and wrong that the “answer to the problem” could ever be the termination of the life of the person needing care!!
Thanks Patricia. Christmas can bring hope and cheer and we need a lot of both!
We do indeed need both, Laurel, thank you!