When Michael Fraser’s GP made a call on him at his Toronto home, both knew he had come not to cure him but to kill him.
Mr Fraser’s closest friends came too, gathering for a little party at which he enjoyed one last beer and urged the others not to waste the food in the fridge and take it home with them.
Then he and his wife Ann adjourned to the couple’s bedroom where Dr Navindra Persaud was waiting.
Mr Fraser, 55, lay on the bed with his wife as his doctor, after first asking for final approval, injected drugs into his arm.
Michael Fraser, 55, was euthanised by his GP after he pleaded poverty
Wheelchair-bound Les Landry, 65, an ex-lorry driver from Medicine Hat, Alberta, is one of those seeking assisted suicide primarily for financial reasons
First, a sedative that induces sleep in one to two minutes, followed by a local anaesthetic then another sedative that induces coma.
As Ann emerged from the room in tears, it was left only for the doctor to phone the coroner, report that he had been providing ‘palliative care’ to his now-dead patient and arrange for the body to be collected.
Mr Fraser had just joined the growing number of Canadians — more than 10,000 last year alone — who have availed themselves of the world’s most permissive government-assisted suicide programme.
That figure, equivalent to 3.3 per cent of the total number of Canadians who died, was up 32.4 per cent on the previous year.
So grimly generous are Canada’s euthanasia laws, in fact, that while he’d had a difficult existence that included liver disease, an inability to walk and depression, Mr Fraser was by no means dying.
Instead, he admitted that his poverty would prevent him from living a dignified life. Once regarded as completely taboo, euthanasia is becoming increasingly accepted around a world ever more keen to cater for the rights of the individual — including the right to decide when and how they die.
It’s a world that is also struggling to cope with the soaring cost of healthcare, making it more attractive than ever to encourage those who are a particularly heavy burden on the health system to consider cheaper alternatives.
Such as ending their lives. With Canada extending its MAiD, or Medical Assistance in Dying programme, to the mentally ill and potentially even to children — and the Quebec College of Physicians calling for it to be legal to kill severely ill or disabled newborns — experts have compared the country’s runaway euthanasia system to the Nazis’ mass murder of ‘undesirables’ such as the disabled who were ‘polluting’ their Aryan gene pool.
Christine Gauthier, a paraplegic army veteran who competed in the 2016 Paralympics, told MPs how, after five years of trying to obtain a stairlift for her home, a Veterans Affairs official told her that if she was ‘desperate’, they could offer her MAiD
Critics have coined a new trend — ‘poverty euthanasia’ — to describe those who fall through Canada’s over-stretched social welfare net and are deciding they have no better option than state-assisted suicide.
These ‘tired of life’ cases are people who have done their calculations and reluctantly concluded that they really are better off dead. And if the government can do it swiftly and painlessly for them, all the better.
From a Paralympian struggling to get a stairlift to those fearing homelessness, Canadians are being allowed — and often encouraged — to consider euthanasia when they’re very far from being a hopeless case.
And the drive to euthanise is spreading. In both Canada and the UK, euthanasia is defined as the act of deliberately ending a person’s life to relieve suffering.
It is often referred to as ‘physician-assisted dying’ or ‘assisted dying’ and is distinct from ‘assisted suicide’ which is helping someone to kill themselves by, say, obtaining lethal drugs for them.
Just months after the House of Lords halted an attempt to legalise euthanasia in the UK, the Commons last week launched a new inquiry into assisted dying with ‘a focus on the healthcare aspects’, including the role of doctors, access to palliative care, criteria for eligibility and ‘what protections would be needed to safeguard against coercion’.
Successive UK governments have refused to legalise euthanasia but inquiry chairman Steve Brine MP said there was now ‘real-world evidence’ to look at from those countries where it is legal.
What has also changed is that the British Medical Association, Britain’s biggest doctors’ union, took a landmark vote last year that ended its long- standing opposition to euthanasia.
To say that Canada offers Britain a cautionary tale is putting it mildly. Some of the cases that have come to light are horrifying.
And all this, ironically, in a country that not only has the world’s tenth richest economy, not to mention sharing many of the cultural and legal traditions of the UK, but which prides itself on its decency and humanitarian values.
Yet the progressive administration of Prime Minister Justin Trudeau now finds itself in the deeply embarrassing position of being attacked by human rights campaigners and the United Nations over MAiD.
Three UN experts last year concluded the law appeared to violate the Universal Declaration of Human Rights. Euthanasia — from the Greek for ‘good death’ — is a means of release to people in unimaginable and incurable pain, especially if expected to die soon.
For many people it’s the mark of a truly civilised society. But as soon as you allow it in principle, where do you draw the line? Canada’s Supreme Court dismissed as scaremongering fears of a ‘descent down a slippery slope into homicide’ when it overturned a ban on euthanasia in 2015, ruling that it was unconstitutional as it deprived people of dignity and autonomy.
The following year, Canada’s Parliament passed legislation allowing euthanasia, but only for people suffering from a terminal illness whose death was ‘reasonably foreseeable’.
Within five years, it became clear that Canada was, indeed, sliding down the slope when — again under pressure from the courts — MPs passed Bill C-7, which scrapped those criteria.
From 2021, anyone suffering from an illness or disability that ‘cannot be relieved under conditions’ that he or she ‘considers acceptable’ can, with the approval of two doctors or nurse practitioners, get MAiD free.
The patient must be found to be competent to make the decision and wait a minimum 90-day assessment period before death is provided.
If a doctor refuses to sign off the request, patients can shop around for one who is more amenable. And unlike other countries, including Belgium and the Netherlands, where euthanasia is legal, Canadian patients are not required to have exhausted all treatment alternatives first.
Last year, 96 per cent of MAiD applications were approved.
Seeking to understand why so many in government and healthcare appear to be pushing MAiD enthusiastically, critics point to a 2017 study by the University of Calgary that estimated medically-assisted dying could reduce national healthcare spending by $139million a year (£83 million).
The report noted that in some Canadian provinces, caring for patients in the last six months of life accounted for more than a fifth of healthcare costs.
Canada’s healthcare spending — which is entirely state-funded — is the second-highest in the developed world. This raises legitimate questions as to whether MAiD is ultimately a lot about money.
Wheelchair-bound Les Landry, an ex-lorry driver from Medicine Hat, Alberta, is one of those seeking assisted suicide primarily for financial reasons.
He suffers from ailments including epilepsy and diabetes but most of his disability benefits ended when he turned 65 in May as he was now classed as a senior citizen and different rules apply.
‘I don’t want to die but I don’t want to be homeless either,’ he told the Mail. Mr Landry said he was surprised how easy it was to request MAiD.
‘I just had to check off the boxes on the application form and sign the bottom.’ He was also struck by the speed of the response.
He cannot remember doctors making house calls since he was a child, but the first of two sent to assess him for assisted death came just 11 days later.
Poverty is not officially a criteria to receive MAiD, but he says he never hid his circumstances from the doctor.
‘He was honest with me. He basically said: ‘I can see why you’re doing this,’ and he told me he’d administered MAiD to people he knew were doing it because of poverty.’
Mr Landry, who is waiting for his assessment by a second doctor, says he sees himself and other poor and infirm people as victims of a government determined to cut costs albeit ‘under the guise of sympathy and compassion’.
Government officials have been accused of using the slightest pretext to encourage assisted dying.
Two weeks ago, Christine Gauthier, a paraplegic army veteran who competed in the 2016 Paralympics, told MPs how, after five years of trying to obtain a stairlift for her home, a Veterans Affairs official told her that if she was ‘desperate’, they could offer her MAiD.
Mr Trudeau admitted what happened was ‘absolutely unacceptable’, even as it emerged that at least another half-dozen veterans were told the same.
Ms Gauthier’s case is far from isolated. Roger Foley, 47, who suffers from a degenerative brain disorder, secretly recorded staff at his hospital in London, Ontario, mentioning euthanasia unprompted.
In one recording, the hospital’s director of ethics told Mr Foley it would cost ‘north of $1,500 a day’ to keep him in hospital, then asked ‘if you had an interest in assisted dying’.
The hospital said its staff were entitled to discuss MAiD without a patient having raised it.
Alan Nichols, a 61-year-old British Columbian was hospitalised in 2019 over concerns he might be suicidal.
Despite asking his brother, Gary, to ‘bust him out’ as soon as possible, within a month he’d submitted a MAiD request.
He listed only one health condition — hearing loss — but it was enough and he was euthanised. His family and a nurse practitioner made an official complaint, saying he had clearly not met the MAiD criteria because he lacked the capacity to understand the process and wasn’t suffering unbearably.
‘Alan was basically put to death,’ said brother Gary. Rod McNeill, 71, went to an Ontario hospital after a fall. A month later, he had been euthanised.
According to his daughter, Erin, the doctors responsible didn’t even retrieve his medical records and killed him, albeit with his consent, for end-stage chronic obstructive pulmonary disease — a condition that a post mortem showed he didn’t have.
According to her family, Nancy Russell, 90, persuaded doctors to let her be killed because she didn’t want to go through another Covid lockdown in her Toronto care home.
Friends and family were, at least, able to gather around her bed singing a song she’d chosen as a doctor gave the fatal injections.
The death of Jennyfer Hatch, 37, who had a debilitating tissue disease, was turned into an emotive and arty three-minute film entitled All Is Beauty celebrating her decision to end her life.
In October its maker, Canadian fashion giant La Maison Simons, (whose boss, Peter Simons, supports MAiD), was accused of glorifying suicide before recent revelations that Ms Hatch had complained of ‘falling through the cracks’ in attempts to get treatment and concluded it was ‘far easier to let go than keep fighting’.
Many are deeply concerned by next spring’s extension of MAiD to people with mental illnesses and — pending a parliamentary review — to ‘mature minors’ above the age of 12.
Amir Farhoud, 55, who suffers from myriad ailments including excruciating back pain and depression, applied for MAiD after fearing he was about to be made homeless but held off after an online appeal raised £36,000 for him.
He said: ‘Because it’s an irreversible decision, it needs to be thought out, not in a fit of despair but rationally.’
Neither the mentally ill nor teenagers fit that criteria, he adds. Most Canadian doctors refuse to euthanise people, leaving a small minority to take on the cases.
Dr Ellen Wiebe, a GP and clinical professor at the University of British Columbia, has performed more than 400 euthanisations and rejects claims that Canada’s policy has run out of control.
She admitted that ‘poverty was definitely involved’ in the cases of some of her MAiD patients, but believes many would want to die whether they had money or not.
Studies suggested that many applicants are afflicted by factors, such as loneliness, that had nothing to do with their economic status, she said.
She sees no problem with euthanising the mentally ill from next year, saying: ‘I have certainly met some of these people and I’m glad that their suffering is recognised as equal to people with physical illnesses and it is also recognised that we can’t fix that.’
Dr Wiebe may be satisfied but other experts are deeply worried.
Professor Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, described Canada’s law as ‘probably the biggest existential threat to disabled people since the Nazis’ programme in Germany in the 1930s’.
Madeline Li, a Toronto cancer psychiatrist and assisted dying adviser, said she was ‘comfortable’ with euthanising the dying, but not at the way Canada had pushed the boundaries, adding: ‘We’ve made MAiD so open you can request it for basically any reason.’
Senior Canadian psychiatrist John Maher said the country is about to offer ‘state-assisted suicide’ for the mentally ill: ‘You’re assisting someone in the completion of their suicide.
The doctor is the sanitised gun.’ He defied anyone to know if a patient’s mental illness was incurable, as is required under the current rules.
As British politicians look abroad for guidance, they will find in Canada a system that has borne out all the worst fears of euthanasia’s opponents and which — for many — is nothing less than a licence to kill.