Does anyone have the right to ask questions?

Katherine and her husband have been married for 48 years.  He is 83 years old, and so they have been married for more than half their lives. 

Katherine’s husband, given the name Mr X by a court, was diagnosed with chronic obstructive pulmonary disease (COPD) in 2003.  In April 2020, after a series of falls, Mr X applied for euthanasia.

His wife opposed his request and has sought to challenge it through the courts.  It appears she has failed in her bid, with the court ruling she did not raise a legally arguable issue.

Notwithstanding the legal issues, the judgment of the court revealed the wide range of reasoning used by medical professionals.  The detailing of Mr X’s assessment process was particularly concerning:

  • Schelene Swinemar, Nurse Practitioner – a nurse who was the primary care provider to Mr X determined he met all euthanasia eligibility criteria;
  • Lorri Griffin, Nurse Practitioner – a second nurse practitioner said that Mr X was not capable of making decisions regarding euthanasia because of dementia, and also concluded that his death was not foreseeable;
  • Drs Terry Chisholm and Kathleen Singh, Psychiatrists – opined that Mr X has mild cognitive impairment, but not dementia, and that his cognitive status did not impair his ability to consent to euthanasia. They also opined that he had a grievous and irremediable medical condition;
  • Dr Du Toit, Respirologist – Did not see that Mr X would die from his lungs in the next year, but noted this was not sure with COVID-19;
  • Dr David Martell, Addiction Medication specialist – Opined that while COPD did not create a reasonably foreseeable death for Mr X, opined that cerebrovascular disease was the foremost condition making his death reasonably foreseeable;
  • Dr Ashley Miller, General Internist – opined that Mr X’s death was reasonably foreseeable as a result of progressive frailty driven by COPD; and
  • Dr Holland, specialisation not specified – opined that Mr X would not be surprised if Dr X died within the next month.

So, here’s the summary: one nurse declared Mr X eligible for euthanasia, another nurse said he was not, and could not consent.

  • Two psychiatrists, obviously not specialists in lung disease, deemed his death reasonably foreseeable. A respirologist, a doctor more familiar with lung diseases, said it wasn’t.
  • An addiction medicine specialist decided that Mr X was terminal, but not from COPD, but from cerebrovascular disease.
  • Then it was the sixth and seventh doctors who agreed on a reasonably foreseeable COPD death.

So many medical practitioners, so many contradictions. 

But somehow, the greatest weight was placed on the decisions of those medical professionals who deemed Mr X to be eligible for euthanasia.  The other medical professionals were ignored, as was his wife of 48 years.

This leads us to ask a question: if not a medical professional and not the person who knows him best in the world, is there anyone who is allowed to question the approval of euthanasia once two doctors have signed off, even if they did so after some serious doctor-shopping?