Scheduled to Die: The Rise of Canada’s Assisted Suicide Program

Scheduled to Die: The Rise of Canada’s Assisted Suicide Program

Over the past few years, doctors have taken an increasingly liberal view when it comes to defining “reasonably foreseeable” death. Then, last year, the government amended the original legislation, stating that one could apply for MAiD even if one’s death were not reasonably foreseeable. This second track of applicants simply had to show that they had a condition that was “intolerable to them” and could not “be relieved under conditions that they consider acceptable.”

On September 7, Margaret Marsilla called Joshua Tepper, the doctor who planned to kill her son.

Marsilla is 46, and she lives outside Toronto with her husband and daughter, a nursing student. She had known that her 23-year-old son, Kiano Vafaeian, was depressed—he was diabetic and had lost his vision in one eye, and he didn’t have a job or girlfriend or much of a future—and Marsilla asked her daughter to log onto Kiano’s account. (Kiano had given his sister access so she could help him with his email.) He never shared anything with his mother—what he was thinking, where he was going—and Marsilla was scared.

That was when Marsilla learned that Kiano had applied and, in late July, been approved for “medical assistance in dying,” aka MAiD, aka assisted suicide.

His death was scheduled for September 22.

In a September 7 email from Tepper, the doctor, to Kiano and Tekla Hendrickson, the executive director of MAiDHouse, the Toronto facility where Kiano’s death would take place, Tepper mapped out the schedule:

“Hii,” he emailed. (Apparently, Tepper did not use spell check.) “I am confirming the following timing: Please arrive at 8:30 am. I will ask for the nurse at 8:45 am and I will start the procedure at around 9:00 am. Procedure will be completed a few minutes after it starts.”

The procedure entailed administering two drugs. First, a coma-inducing agent. Then, a neuromuscular blocker that would stop Kiano’s breathing. He would be dead in five to ten minutes.

Apparently, Kiano wanted to bring a dog with him. In an email to him that same day, Hendrickson said: “Dogs are welcome in the space as long as there is someone there who will be responsible for them during the time at MAiDHouse.”

Marsilla was terrified. She had tried to do everything for her son, but it had been rough for him. She and his dad had gotten divorced when Kiano was still a kid. On his sixteenth birthday, she had given him a BMW. When he was 17, he had been in a bad car accident. He wasn’t up to college. He smoked a ton of weed. He’d lived with his dad, then with his mom, and now with her sister, Kiano’s aunt.

Wherever he went, whatever he did—he was unhappy. Going blind in his left eye, this past April, was the tipping point.

The day after she discovered the email, Marsilla called Tepper. She pretended to be a MAiD applicant. She called herself Joann and said she “wanted to go through the whole process in general, from A to Zed, before the Christmas holidays—if you know what I mean.” Tepper indicated he understood.

Tepper, sounding matter of fact, ran through the list of requirements: “You have to be over 18. You have to have an OHIP card.” (He was referring to her Ontario Health Insurance Plan.) “You have to have suffering that cannot be remediated or treated in some way that’s acceptable to you.”

Marsilla, who recorded the conversation and shared the five-and-a-half-minute recording with Common Sense, told Tepper that she was diabetic and blind—more or less, her son’s condition. Tepper said he’d “had patients a lot similar to you.”

Then, the doctor said, “If you wanted, I could do a formal assessment with you.” Marsilla asked if she should come in. Tepper replied: “We do them remotely, often by video of some type: WhatsApp, Zoom, FaceTime, something like that.”

A few minutes later, Marsilla hung up. She had just over two weeks to stop her son from dying.

“Poised to Become the Most Permissive Euthanasia Regime in the World”

When we think of assisted suicide or euthanasia, we imagine a limited number of elderly people with late-stage cancer or advanced ALS in severe pain. The argument for helping them die is clear: Death is imminent. Why should they be forced to suffer?

In 2015, Canada’s Supreme Court ruled that assisted suicide was constitutional. In June 2016, Parliament passed Bill C-14, otherwise known as the Medical Assistance in Dying Act. MAiD was now the law of the land. Anyone who could show that their death was “reasonably foreseeable” was eligible. In this respect, Canada was hardly alone: The Netherlands, Switzerland, Belgium, Spain, Australia, and New Zealand, among others, allow assisted suicide. So do ten states in the U.S.

In 2017, the first full year in which MAiD, which is administered by provincial governments, was in operation, 2,838 people opted for assisted suicide, according to a government report. By 2021, that figure had jumped to 10,064—accounting for more than 3 percent of all deaths in Canada that year.

There have been a total of 31,664 MAiD deaths and the large majority of those people were 65 to 80 when they died.

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