An elderly woman was euthanized just hours after her husband reported that she had expressed a desire to continue living, despite previously expressing a wish to die.

Under Canada’s Medical Assistance in Dying (MAiD) laws, individuals with terminal conditions can request assistance in dying, provided that an assessor determines their situation meets the stipulated criteria.

While many patients experience a waiting period of several weeks, euthanasia can be expedited to the same day of application if a MAiD provider assesses the situation as medically urgent.

However, a report by the Ontario MAiD Death Review Committee has surfaced concerns about the potential erosion of safeguards, leading to questionable instances of euthanasia.

One highlighted case involves a woman in her 80s, referred to as ‘Mrs. B’. She experienced complications following coronary artery bypass graft surgery.

She faced severe health decline and initially chose palliative care. Subsequently, she was discharged from the hospital, receiving palliative support at home, with her husband acting as her primary caregiver.

But as her condition got worse, her elderly husband struggled to care for her even with the help of visits by nurses.

‘Mrs B reportedly expressed her desire for MAiD to her family. In response, and on the same day, her spouse contacted a referral service on her behalf,’ the report read.

Doctor-assisted deaths are widely available in Canada, though heavily restricted in the US  

However, she told the assessor she ‘wanted to withdraw her request, citing personal and religious values and beliefs’ and instead wanted inpatient hospice care.

Her husband took her to hospital the next morning where doctors found she was stable but her husband was ‘experiencing caregiver burnout’. 

Mrs B’s palliative care doctor applied for in-patient hospice care due to her husband’s burnout, but it was quickly denied.

Her husband asked for an urgent second MAiD assessment later that day and a different assessor showed up. 

This one judged her to be eligible, but the original one, who was contacted as per protocol, objected.

‘This MAiD practitioner expressed concerns regarding the necessity for “urgency” and shared belief for the need for more comprehensive evaluation, the seemingly drastic change in perspective of end-of-life goals, and the possibility of coercion or undue influence (i.e., due to caregiver burnout),’ the report explained.

Their request to meet Mrs B the next day was declined by the MAiD provider as ‘the clinical circumstances necessitated an urgent provision’.

Instead, a third assessor was sent who agreed with the second one, and Mrs B was euthanized that evening.

Nearly two-thirds of Canada’s recipients of assisted suicides are sufferers of cancer 

Ontario MAiD Death Review Committee members raised concerns about how Mrs B’s case was handled, in the report released by the Office of the Chief Coroner.

Many members ‘believed the short timeline did not allow all aspects of Mrs B’s social and end-of-life circumstances and care needs to be explored’.

These included ‘the impact of being denied hospice care, additional care options, caregiver burden, consistency of the MAiD request, and divergent MAiD practitioner perspectives’.

‘Many members brought forward concerns of possible external coercion arising from the caregiver’s experience of burnout and lack of access to palliative care in an in-patient or hospice setting,’ the report noted.

Members were also concerned that Mrs B’s spouse was the main person advocating and navigating access to MAiD, and there was little documentation that she actually asked for it herself. 

The MAiD assessments were completed with her husband present, which raised additional concerns that she felt pressured to go along with it.

Dr Ramona Coelho, a family physician and member of the committee, wrote a review of the report that was extremely critical of Mrs B’s case.

‘The focus should have been on ensuring adequate palliative care and support for Mrs B and her spouse,’ she wrote for conservative thinktank the Macdonald-Laurier Institute.

‘Hospice and palliative care teams should have been urgently re-engaged, given the severity of the situation. 

‘Additionally, the MAiD provider expedited the process despite the first assessor’s and Mrs B’s concerns without fully considering the impact of her spouse’s burnout.’

Dr Ramona Coelho, a family physician and member of the committee who is relentlessly critical of MAiD and assisted dying in general, wrote a highly critical review of Mrs B’s case

Coelho is relentlessly critical of MAiD and assisted dying in general and savaged the Hollywood film In Love last year.

The film, based on Amy Bloom’s 2022 memoir In Love: A Memoir of Love and Loss, follows a man with early-onset Alzheimer’s who travels to Switzerland for an assisted suicide.

George Clooney starred as Bloom’s husband Brian Ameche, an architect diagnosed with early-onset Alzheimer’s in his mid-60s.

Coelho cared for her father Kevin Coelho, a businessman and teacher from Dorchester, Ontario, until his death from dementia in March last year.

She called the film ‘dangerous’ and ‘irresponsible’ and claimed it risked encouraging vulnerable people to end their lives.

‘Turning assisted suicide into a Hollywood love story is dangerous,’ Coelho told the Daily Mail in October.

‘It romanticizes death for people who are vulnerable and afraid.

‘If George Clooney makes death look beautiful, sexy and noble, what message does that send to people who are sick, elderly or disabled?’ she said.

‘When death is presented as an answer to suffering, it encourages suicide contagion – the opposite of what we teach in suicide prevention.’

Coelho savaged the Hollywood film In Love last year, which is based on the real-life Connecticut couple Brian Ameche and Amy Bloom (pictured together)

Canada legalized assisted dying in 2016, initially limited to terminally ill adults whose deaths were reasonably foreseeable.

But the law has since expanded to include people with chronic illness, disability, and soon – pending a parliamentary review – those with certain mental health conditions.

Dementia cases remain controversial because of questions about capacity and consent.

In the US, only a dozen states and Washington, DC, allow physician-assisted death under strict conditions.

Other cases highlighted by the committee’s report included an elderly woman known as Mrs 6F who was approved for MAiD after a single meeting in which a family member relayed her supposed wish to die.

Her consent on the day of her death was interpreted through hand squeezes.

In another, a man known as Mr A with early Alzheimer’s signed a waiver years earlier.

After being hospitalized with delirium, he was deemed ‘capable’ for a brief moment – and euthanized.