An Open Letter to Quebec Commissioner of Health, Joanne Castonguay
Quebec Commissioner of Health, Joanne Castonguay (Photo : Twitter)
By email and mail
November 18, 2020, +JMJ+
Commissioner
Joanne Castonguay
880, chemin Sainte-Foy, suite 4.40
Quebec, Quebec
G1S 4X4
Madam Commissioner,
I am writing to you as President of the Campagne Québec-Vie / Quebec Life Coalition, a non-profit association that aims to make its contribution so that Quebec can once again become a Christian society that protects faith, family, and life, from conception to natural death.[1]
I learned from an article in La Presse that the Minister of Health, Christian Dubé, had mandated you “to examine the performance of the health network, especially elder care, during the first wave of the COVID-19 pandemic” and that this study would be similar to a commission of inquiry, less punitive powers.[2]
Your mandate as defined by Mr. Dubé suggests that this spring’s fatalities are all caused by the coronavirus, and that your work will consist solely of identifying gaps in the health care system that would explain why our seniors and other vulnerable people have not been sufficiently protected from a deadly virus. However, we believe that this assumption of a very lethal virus from which we would not have been sufficiently protected is not the only one, nor even the most probable one. We are therefore writing to encourage you to consider, in your report, other scenarios that would better account for the increase in “all-cause mortality” observed in Quebec this spring[3].
In our opinion, the vulnerable people who died in Quebec this spring in unusually high numbers are not only, or even for the most part, dead from a virus with a case-fatality rate close to that of a strong seasonal flu[4]; they mostly died for other reasons[5], including the following:
- Gross neglect caused in part by an acute labour shortage in long-term care facilities, which was in large part the result of a media scare campaign that created panic among long-term care employees; [6]
- A stressful situation caused by isolation and other health measures, weakening the immune system of people who are already very fragile, and making them more likely to succumb to what in normal times amount to relatively benign illnesses; [7]
- A triage policy for seniors, denying them, during the crisis, access to hospital services that were normally available to them; [8]
- Contamination of senior care facilities by sick elderly people who have been evacuated from hospitals (to “free up” 7,000 beds, including those of 1,400 patients who were still sick), in anticipation of a “wave” of “higher priority” patients that never materialized; [9]
- A suspension of several surgeries and other interventions, again in order to “free up” beds to deal with the crisis; a pause in care that may have indirectly caused several deaths this spring; and [10]
- The establishment of euthanasia-like protocols. [11]
Commissioner, you will be required to table a report on how the crisis was managed by the end of summer 2021. We believe that the credibility of your report can only be strengthened if you do not stick to the implicit assumption imposed by government authorities that the emergency measures put in place this spring including the lockdown have “saved lives”. It is our earnest hope that your report will take into account the aforementioned hypothesis, which we believe is more plausible, that health measures, far from having protected the population, actually contributed to the hecatomb : by stressing our seniors, resulting in a fall of their immune systems; by exposing them to patients expelled from hospitals and laden with nosocomial viral loads; by isolating them and making them lose their will to live; by causing their famine and dehydration in care homes from which a large number of long-term care center employees fled in panic because of the fear-mongering campaign by government authorities and the media, and finally by euthanizing them under the guise of “palliative care” made necessary by lack of access to hospital care.
Commissioner, a huge task lies ahead of you. We wish you all the courage and strength you need to successfully complete it. It goes without saying that in addition to offering you our logistical support in your endeavours, we are committed to praying for you and your team, hoping that your work will bear fruit, not only for the sake of the Quebec health care system, but also so that justice will be done for elderly and vulnerable people for whom the deaths this spring were in many cases perfectly preventable.
Yours sincerely,
Georges Buscemi, president
Quebec Life Coalition
This letter has been published on the Campagne Québec-Vie / Quebec Life Coalition website (https://en.cqv.qc.ca) and sent to various organizations and media.
Electronic copies of this letter were also sent to the following individuals:
- Marguerite Blais, Minister responsible for Seniors and Informal Caregivers (blais.prev@assnat.qc.ca)
- Pascale Descary, Chief Coroner (descary@coroner.gouv.qc.ca)
- Christian Dubé, Minister of Health (Dube.LAPR@assnat.qc.ca)
- Christian Lépine, Archbishop of Montreal
- Alex Schadenberg, President of the Euthanasia Prevention Coalition
- Dr. Patrick Vinay, President of Living with Dignity
[1] For more information about our organization, please visit https://en.cqv.qc.ca/ who_we_are
[2] Source: https://www.lapresse.ca/ actualites/2020-08-19/ covid-19-la-commissaire-a-la-sante-fera-enquete.php, consulted on November 18, 2020.
[3] According to the data from the Institut de la statistique du Québec (see https://www.stat.gouv.qc.ca /statistiques/population-demographie/ deces-mortalite/nombre-hebdomadaire-deces_an.html, consulted on November 18, 2020), there was indeed excess mortality in spring 2020 in Quebec. In fact, from year to year we observe a seasonal cycle of death rates, with the rate increasing in winter (with the flu season and other respiratory diseases) and decreasing in summer. In Quebec, approximately 1300 people die each week (186 per day). In 2020 this fluctuating and seasonal mortality rate drastically increased in April, which coincides with the Covid 19 crisis in the province. It is therefore tempting to conclude that these deaths were caused by the coronavirus. However, in our opinion, this is an erroneous conclusion, as we will explain later.
[4] The mortality rate from seasonal influenza is estimated to be 1 in 1000 affected people (see: Fauci, Lane and Redfield [2020], online at: https://www.nejm.org /doi/full/10.1056/ NEJMe2002387, accessed Nov. 18, 2020) while the median covid 19 infection fatality rate is between 2 and 3 in a thousand, according to Ioannidis, John PA (2020), online at : https://www.who.int/bulletin/ online_first/ BLT.20.265892.pdf; accessed November 18, 2020 (Back-up link, here).
[5] There are good reasons to believe that the official figure of 6,710 deaths “due” to Covid 19 as of November 18, 2020, is significantly inflated. For more information on this “statistical inflation”, read the comments of Dr. Sucharit Bhakdi, Dr. Horacio Arruda, etc., quoted in the following article, from the section entitled Gonflage statistique des décès dus au covid ?: https://www.cqv.qc.ca/ libre_opinion_sur_la_pandemie_2020 - gonflage, consulted on November 18, 2020.
[6] Among many examples, there is the situation at the Herron and Sainte-Dorothée residences, as described in this article from the Journal de Montréal: https://www.journaldemontreal.com/ 2020/09/23/ les-problemes-de-personnel-ont-engendre-lhecatombe, consulted on November 18, 2020. Another example from the documentary Mourir dans l’angle mort produced by Radio-Canada, which described the situation in the Herron residence as follows: “31 deaths, but, above all, residents found lying in their feces, without care, dehydrated and starved due to a lack of staff. (This quote ends at 9 minutes 42 seconds in the documentary available at the following address: https://www.youtube.com/ watch?v=S8dhFPfTWP4, consulted on November 18, 2020.)
[7] On the significant impacts of stress on mortality observed during spring 2020 in different communities, see Rancourt, Denis (June 2020) : https://www.researchgate.net/publication/ 341832637_All-cause_mortality_during_COVID-19_ No_plague_and_a_likely_signature_of_mass_ homicide_by_government_response, consulted on November 18, 2020. This article has been translated in French here: https://lesakerfrancophone.fr/ mortalite-toutes-causes-confondues- pendant-la-covid-19, consulted on November 18, 2020.
[8] An example of such a protocol can be found here: https://www.lapresse.ca/ covid-19/2020-04-18/ un-plan-de-triage-pour-faire-les-choix-dechirants, consulted on November 18, 2020.
[9] At the beginning of the crisis, Health Minister Danielle McCann announced having “freed up” 7,000 beds, including 1,400 patients sent to CHSLDs and other institutions, thereby exposing thousands of vulnerable people to contagious, nosocomial and other diseases. See Mourir dans l’angle mort at 1:49 : https://www.youtube.com/ watch?v=S8dhFPfTWP4, consulted on November 18, 2020)
[10] Ibid.
[11] Many Western jurisdictions, in Canada, Sweden, and France, have implemented long-term care facility protocols in times of pandemic that are, in reality, disguised forms of euthanasia. See the following articles for Canada: https://www.cqv.qc.ca/ mort_de_faim_et_de_soif_a_cause_des_mesures_ anticoronavirus, Sweden: https://www.cqv.qc.ca/suede_euthanasie_ dans_les_maisons_pour_personnes_agees_protocoles_eugeniques, and France: https://www.medias- presse.info/gouvernement-et-coronavirus-ouverture-a-leuthanasie-deguisee-en- recommandant-des-usages-letaux-du-rivotril/119441/, each consulted on November 18, 2020.
Questions to Ponder about End-of-Life Care Legislation
Isabelle and Ward O'Connor of the Vivere Group offer questions to ponder about Quebec's new Euthanasia legislation.
1. Do euthanasia and palliative care go together?
The palliative care philosophy is based on respect for the natural process of death. Matching induced death by euthanasia ("medical aid in dying") with palliative care in a "continuum of end of life care" is it logical? Doing so risks creating conflict and confusion. This is the view of, among others, le Réseau de soins palliatifs du Québec (RSPQ), as recorded in its deposition regarding the subject legislation. The RSPQ affirms that "Euthanasia is not a treatment." Further, it is important to know that the Fédération du Mouvement Albatros of Québec (FMAQ) adopted unanimously a resolution in support of the RSPQ position.
2. Is End of Life Care Legislation valid?
It is important to know that induced death, either by euthanasia or assisted suicide, is a crime in Canada, although the authors and promoters of the legislation on end-of-life care categorically deny that "medical aid in dying" means "euthanasia", hoping that their semantic game will evade Canada’s Criminal Code. You should know that Canada’s Attorney General announced that he will challenge the
validity of this legislation, pending the Supreme Court of Canada ruling in the case Carter-Taylor case heard October 5, 2014, with a decision expected within six months – i.e., no later than April 2015. The Carter-Taylor case challenges the validity of criminalizing death induced by euthanasia or assisted suicide.
3. Would government induced death jeopardize the right to personal security?
Consent and intent are difficult to prove, and the weak, vulnerable, disabled, elderly, depressed, illiterate or otherwise physically or mentally vulnerable are very easy to manipulate. Their consent can also be difficult to interpret. Substituted consent is another important issue, appearing in the Quebec law (Articles 47, 48, 55) as does presumed consent (Articles 57 and 58 ). The mistreatment of these large segments of the population, especially from relatives and institutions, being widely and well documented, as are discrimination and other social exclusionary pressures of exclusion, is such a precarious secure environment in our health care facilities acceptable?
The Quebec legislation in no way restricts euthanasia for people diagnosed with terminal illness. It is applicable to anyone with a chronic degenerative disease, whether that person is dying or not.
In addition, each year in Quebec, more than 350,000 medical errors are reported, the vast majority of which are injection errors (Ménard report). As euthanasia is done via an injection, do not the number of medical errors argue against the practice of euthanasia?
Finally, the end-of-life care legislation leaves it to the physician to ensure that consent to euthanasia is not the result of undue pressures arising from different sources. What training in psychology and police detection methods will the doctor receive for this purpose? What budget he will have to conduct the needed investigation? Abuse is both pernicious and very clever thing to detect for he seeks to detect it.
Talk on Palliative Care and Euthanasia in Montreal
A highly interesting lecture on Bill 52 and palliative care (vs. Euthanasia) will be given by Dr. Manuel Borod on November 18, 2014 @ 7:00 pm.
Where:
Segal Centre
5170 Chemin de la Côte-Sainte-Catherine
Montreal, QC H3W 1L5
Canada
Dr. Manuel Borod is vehementlt opposed to Bill 52, the bill which has passed earlier this year and proposes to legalize euthanasia in Quebec.
Dr. Manuel Borod practiced family medicine for 20 years prior to embarking on a career in palliative medicine.
He developed the home care program at Mount Sinai Hospital prior to coming to the MUHC on a full-time basis. He served as Clinical Director of Palliative Care there from 2003-2009 and since then has been the Division Director.
He has been very active in improving and developing different programs such as out-patient services which include a palliative care day hospital, cancer rehabilitation and a multidisciplinary program on cancer pain. He has long been a dedicated teacher and mentor to medical students, residents, and colleagues.
Dr. Borod has given many presentations at local, national and international conferences on a number of subjects including cancer pain, ethics, palliative sedation and euthanasia as well as the role of humour in palliative care.
The event is $12, payable at the door.
Calgary Herald Poll
Dear Friends of Life,
Please respond negatively to the The Calgary Herald survey on assisted suicide.
You will find the the poll under the heading "The Question of the Day," on the right hand side of the page, mid-way down.
The question reads: Are you in favour of Canada legalizing assisted dying?
Please VOTE NO. The NOs were ahead but only marginally.
Case Against Euthaniasia for Children In Belgium
Dr Paul Saba shares a personal story of diagnosed illness and a success against the odds.
//www.youtube.com/embed/n1Ib4NHOims
This video provides a counter argument to those advocating the euthanising of children, as Belgium has enacted earlier today; click here for this story.
Gazette Opinion: Finding meaning at the end of life
The following letter came to my attention from one of our faithful QLC readers. The author, David Benrimoha, a McGill medical student, (pictured left) argues against the proposed legislation permitting the practice of euthanasia in the province - bill 52. He argues that our ability to form meaning is central to human beings and to deny this is not right. Euthanasia denies this right and an important time of one's life.
I have never experienced what it is like to see a terminally ill family member in pain, and so I do not for one moment pretend to judge or criticize the choices or beliefs of patients or their families. Instead, I want to offer a philosophical argument against euthanasia and in favour of alternative practices, such as expanded access to palliative care.
There is a character in Harper Lee’s classic novel To Kill a Mockingbird called Mrs. Dubose, an old woman who is terminally ill and addicted to the morphine that she takes for her terrible, fitful pain. As a punishment for misbehaving, Jem (the narrator’s brother and the son of lawyer Atticus Finch) is made to read to her every day. At the end of every reading session a bell is rung and Mrs. Dubose receives her dose of morphine. But every day the bell is rung a little later, and in this way, even though she faces the return of her pain, Mrs. Dubose weans herself off the morphine and dies free of the mind-clouding painkillers.
It has taken me a long time, but I now realize why I find this story so powerful. It is because it is an expression of what I consider to be the most human of all desires: the desire to create and hold onto meaning in one’s life. Mrs. Dubose could probably have convinced her servants to give her a lethal dose of morphine — a common practice in assisted suicide — but instead chose a course of suffering that led to her final, though short-lived, victory over her addiction. Outwardly this may seem pointless: Why, if she was going to die anyway, should she have suffered so much?
In my opinion, our society has become preoccupied with pain and suffering and preventing it at all costs. It is of course logical and just to prevent and ease pain and suffering when we can, and to develop and use medications and technologies that can do this. But is death preferable to pain? In a video that was shown to us in class (not directly related to euthanasia) Viktor Frankl — philosopher, neurologist, psychiatrist and Auschwitz survivor — speaks of the extreme suffering he and his fellow inmates were subject to in the concentration camp, and of how, even in the midst of all that suffering, he was able to find meaning in choosing his own attitude to his situation, and in thinking of his love for his wife, who had been sent to another camp. He is far from the only example of a person who, through extreme suffering such as that caused by the Holocaust, has been able to create and find meaning.
In Quebec, euthanasia is being considered for persons suffering from a terminal illness who are still able to make competent decisions. Yet these are the very people who are most likely to be able, with the right support, to find or create meaning at the end of their lives. This is why I am against euthanasia: because allowing it is saying that we are willing to sacrifice our potential to find meaning in order to end suffering; that we have allowed pain to conquer the pursuit that most defines our humanity.
The best counter-argument to all this is that we as a society have no right to demand that people keep on living in terrible pain when they, as competent adults, would prefer a quick death. My response is that this choice is not the one we are faced with. We have, as has been pointed out by many doctors, technologies and medications that can allow us to manage pain; we have psychologists, chaplains and other guides who can help people find and create meaning in their final days. All of this is brought together in the discipline of palliative care, which aims to help patients find the peace and dignity they want at the end of life, on their own terms. These technologies and approaches are not perfect, of course; they cannot prevent all suffering. But I have seen them work, seen that despite their suffering patients continue to love, to reconcile with estranged family members, to play music, to eat favourite foods, to reflect, and to find meaning in life.
As a society we should be putting our efforts into improving end-of-life care. Palliative care in situations where an illness cannot be cured has proven to be less resource-intensive compared to aggressive treatment, or repeated stays in an intensive-care unit — both of which entail expensive medications and procedures, and the time of large numbers of specialized staff. As such, palliative care is a sustainable option, a responsible use of our health-care resources that ensures patients are able to die with dignity. Even though the process may be painful and draining for patients, families, doctors, nurses and other health professionals, I believe that the beauty and power of the human experience of creating, finding and holding onto meaning is worth it.
David Benrimoh is a first-year medical student at McGill University. He lives in Côte-St-Luc.
Bill 52: Gazette columnist's lack of professionalism
The war aimed at swaying Quebecers to favour bill 52 turned its rhetorical canons today at the anglophone community.
The Gazette Quebec Bureau Chief, Kevin Dougherty hands a bouquet to the bill's proponents in a complimentary article - "Bill 52: Veronique Hivon's long battle," about the legislation that will permit the practice of euthanasia of our fellow citizens.
(Above: Quebec minister Veronique Hivon waves as she is applauded by members of the legislature after she tabled Bill 52. Photo by Jacques Boissinot, CP)
Dougherty (pictured below) argues that the inter-party concord that has prevailed over the process leading up to the tabling of the proposed law is a sign of the merit of this legislation.
Unfortunately Mr. Dougherty's professionalism is lacking on three fronts.
- His logic. It does not follow that if political parties agree on a particular law, then that law is a good one. History is rife with examples: apartheid, segregation, ...
- His objectivity. He subordinates his journalistic duty to that of being a mouth-piece for the government as he spouts the bill's objectives of solidarity, compassion, and respect. Is one really being compassionate when killing a patient to end his pain? Is this really respectful of their dignity?
- His ethics. Finally, through his copious references to anglophone MNA Geoffrey Kelley who endorses the bill, our columnist wishes to sway readers by appealing to a kindred authority figure.
Dear Mr. Dougherty, no institution or government agency should be given the right or power to take the life of an innocent human person.
(Bill 52, entitled "An Act respecting end-of-life care," was tabled this past June 12, 2013, and will be debated when the provincial legislature reopens this Fall, at the conclusion of the Summer recess. You may consult the 20-page proposed legislation by clicking here as well as leave your comments about it.)
A rose by any other name would still smell like a rose
The title for this blog is taken from Shakespeare's tragedy Romeo and Juliet. Juliet, the speaker, is saying that names of things do not matter, only what these things "are."
This is pertinent to the current discussion about Bill 52 - "An Act respecting end-of-life care" tabled by the Quebec government this past June 12, 2013.
Bill 52 is not about the sweet smell of roses but rather euthanasia or as the Quebec government prefers to call it, "medical aid in dying," or MAD to use an acronym coined by Margaret Somerville.
Ambiguity in language is one example that Somerville, founding director of the Centre for Medicine, Ethics, and Law at McGill Univeristy, noted in her commentary on Bill 52 which appeared in The Globe and Mail this past June 19, 2013.
Somerville's commentary about this dangerous bill (her descriptor) is "intended simply to identify some of the arguments, reasoning and strategies that it manifests and issues it raises."
Why Quebec's Bill 52 should not become law
Bill 52 - "An Act respecting end-of-life care," was tabled this past June 12, 2013, in the National Assembly, days prior to the end of the legislative session.
In today's opinion section of the Gazette, two professionals speak out against this legislation, arguing that its goal is nothing other than active euthanasia.
A couple points which Dr. Marc Beauchamp and Me. Michel Racicot make about the bill include:
1. its use of misleading language
[T]he government terminology is not based on any semantic recognition in known literature, or in our country's case law. (...)
Bill 52 introduces the concept of "terminal palliative sedation" a concept not defined in the bill, and one that causes a lot of confusion. Inasmuch as the goal of such sedation is to cause death, not to relive pain, it is also another form of active euthanasia.
It therefore appears clear that the bill essentially aims, using this newly invented terminology, to eliminate a prohibition ... on a physician voluntarily ending a patient's life.
2. mistaken notion of compassionate
[The government argues that not permitting] euthanasia would be a sign of a lack of compassion on the part of medical staff. Such an affirmation, false and otherwise improper, undermines the recognition of all those who provide care, with humanity and dedication, to suffering patients in Quebec, and who believe the medical staff should not offer euthanasia to end-of-life patients, or cause their death.
The writers, one representing the Physicians' Alliance for Total Refusal of Euthanasia and the other a board member of Living with Dignity Citizens' Network, make several more points before urging elected officials to "share the responsibility for protecting the population" and vote against this law.
Emphasing the Value of Human Life: Dr. Frank Humphrey
Dr. Frank Humphrey may play an important role in discussions about Bill 52 - "An Act respecting end-of-life care."
In a previous blog, I noted that on Wednesday, June 12, 2013, days prior to the Summer recess, the Quebec provincial government introduced Bill 52, a bill if passed will permit euthanasia.
Section 26 of the 20-page bill presents four criteria authorizing euthanasia. These are:
- be of full age, be capable of giving consent to care and be an insured person within themeaning of the Health Insurance Act;
- suffer from an incurable serious illness;
- suffer from an advanced state of irreversible decline n capability; and
- suffer from constant and unbearable physical or pyschological pain which cannot be relieved in a manner the person deems tolerable.
Dr. Humphrey, a quadriplegic, may play an important part in the discussions because he fulfills all four of these criteria.
Dr. Humphrey has amyotrophic lateral sclerosis (ALS or Lou Gerig's disease).
ALS is a neurodegenerative disease, akin to muscular dystrophy. In Dr. Humphrey's case it has progressed over the past eight years.
Further after a recent six-month stay in a hospital dealing with pneumonia, his wife Daria was told by a number of physicans that maybe it was time for her husband to die.
Yet, Dr. Humphrey, until recently pastor with the Peoples Church of Montreal, is an accomplished author. He has recently published a text on origins of the universe, melding science with faith.
Bill 52 is a failure for it ignores the giftedness of the person as manifested not only by those who have published works of science but also by simply being a member of the human family.
For a couple of stories about Dr. Humphrey and issues related to the proposed legislation, see Coalition of Physicians for Social Justice and the Suburban newspaper.