VANCOUVER -- Beware entering a B.C. hospital if you are gravely wounded, elderly or suffering from dementia, warns Richard Leskun.
He tells this from personal experience, and has recently told his story of how staff at Abbotsford Regional Hospital badgered him in 2018 to approve a do-not-resuscitate (DNR) notice for his ailing wife Marilynn. When Leskun refused five times, a doctor then offered to euthanize her, until someone placed the DNR order on her file anyway. She died hours later.
Leskun, a 75-year-old resident of Secret Cove, sounded the new warning earlier this month after reviewing the contents of an email sent to The B.C. Catholic by Fraser Health, B.C.’s largest health authority, in answer to questions about the case.
“The letter from Fraser Health chills my soul,” Leskun said. “After Marilynn died I realized that this hospital had seized complete control of her life. Though I tried, I was not able to regain control of her life.”
Marilynn, who was suffering from dementia and a broken neck, died Dec. 9, 2018, at the age of 71. She and her husband were parishioners at St. James in Abbotsford at the time of her passing.
The health authority’s email, sent Feb. 14, does not comment on the Leskun case specifically but only outlines general policy surrounding Medical Assistance in Dying and end-of-life medical orders.
The email, signed by Dixon Tam, a senior public-affairs consultant, asserts that MAiD is always a patient-led process — a protocol that Leskun has repeatedly charged was not followed.
Tam also said medical staff have the right in some circumstances to issue end-of-life orders that do not align with a family’s wishes.
“It is within the scope of practice for physicians or nurse practitioners to select a designation, which includes or does not include cardio-pulmonary resuscitation (CPR), based on their clinical judgment of the client’s current health status,” Tam stated. Such decisions are usually reached in consultation with patients or their families but, “On rare occasions, consensus is not reached.“
The Leskun case was apparently one of those occasions.
“I was preparing to take her home again to heal from the broken neck,” Leskun said. “I had a team of friends and caregivers in place to help me. But the day after I demanded her release she took a bad turn. Her legs developed large purple blotches. She was struggling to breathe. That night I was offered MAiD by her primary physician. She died a few hours later.”
Leskun says he was pressured repeatedly to put a do-not-resuscitate order on his wife before staff offered to euthanize her.
Leskun had a formal meeting with staff to review the case but did not file a complaint. Nevertheless, the experience shook him and the recent Fraser Health email has done nothing to assuage his concerns.
“My message is this: gravely wounded, demented or elderly people are at risk of euthanasia in this B.C. health system,” he said. “Marilynn had all three of those conditions, so it is no wonder she ended up dead.”
Although Leskun did not assert that staff deliberately killed his wife, he said the constant pressure on him to approve a DNR, combined with a doctor’s shocking suggestion that she be euthanized, sent a strong message that medical staff had concluded her life was not worth saving.
The unnamed doctor’s offer to provide MAiD, if true, would not only have been in breach of Fraser Health protocols but would also have led to an illegal act — a homicide, said Alex Schadenberg, executive director of the Ontario-based Euthanasia Prevention Coalition.
“There’s nothing in law that allows anyone but patients themselves to request an assisted suicide,” Schadenberg said. “And, even if Mrs. Leskun had said before she was incapacitated that she would like an assisted suicide, the law currently does not allow advance directives for MAiD either.”
Ironically one of Schadenberg’s most vocal opponents, Dying with Dignity Canada, has come to the same conclusion. Sarah Dobec, a communications specialist with the pro-euthanasia lobby group, said in a letter to The B.C. Catholic that “a request for medical assistance in dying (MAiD) must be initiated by the individual” and that “the person must have capacity to make that request.”
“To be clear, a clinician cannot order an assisted death ... There are rigorous criteria and safeguards in place regarding MAiD in Canada and the request must be initiated by the patient.”
Dobec’s letter did not mention the fact that Dying with Dignity has launched a campaign to persuade parliamentarians to allow persons to issue formal advance directives permitting themselves to be euthanized.
That campaign appears to be bearing fruit. On Feb. 15, Parliament’s Special Joint Committee on Medical Assistance in Dying recommended in its final report that the government amend the Criminal Code to allow for advance requests for MAiD “following a diagnosis of a serious and incurable medical condition, disease or disorder leading to incapacity.”
Schadenberg said he is disappointed but not surprised by the recommendation.
“I predicted that this would be the case, based on the make-up of the committee,” he said.
The Liberal government did not immediately say if it was prepared to enact the recommendation. It may decide to move cautiously, given that in the face of widespread public and professional opposition it recently delayed by a year, to March 2024, its plan to allow persons to qualify for MAiD if their sole underlying condition is a mental disorder.
Schadenberg welcomed that delay and also commended Abbotsford MP Ed Fast’s introduction of a private member’s bill this month calling for the scrapping of the mental-disorder provision, which was introduced by the Senate in 2021 and accepted by the government, which put a two-year delay on its implementation.