00:00:00.000Alberta is pumping the brakes on the expansion of medical assistance in dying and today I'm
00:00:05.200talking to one of the activists who helped get that done. I'm Sheila Gunn-Reed and you're watching
00:00:10.580the gun show. A couple of years ago, I made a documentary called MADE, as in medical assistance
00:00:34.380in dying the dark side of Canadian compassion and one of the things that I learned along the way
00:00:41.400making that documentary was that people are choosing to euthanize themselves not out of
00:00:51.580a sense of pain or that their deaths are right around the corner but because they have lost a
00:01:03.980sense of usefulness in society. And I learned that from today's guest, Amanda Aktman. She is an
00:01:16.900activist who is working behind the scenes and in front of the camera to tell the stories of
00:01:25.080people who have been offered medical assistance in dying instead of help. But she's also a person
00:01:32.380who is telling us what we can do as a society, as members of our community,
00:01:38.060to make sure that people don't lose hope, don't lose that sense of purpose that is driving them
00:01:46.620into despair. We have the ability to help people who are struggling with pain and illness and
00:01:56.040depression from feeling like a burden to their families and to society. And so I wanted to have
00:02:05.940Amanda on the show in light of Alberta, the province of Alberta, pumping the brakes on the
00:02:12.360expansion of medical assistance in dying to tell us some of the stories that she's heard from people
00:02:19.740who have been offered MAID and also what we can do to make sure that this is not something that
00:02:27.200people are choosing in their darkest hours. Here's the interview we recorded earlier today. Take a
00:02:33.860listen. So joining me now is Amanda Achtman. Amanda is one of the people featured in our
00:02:47.540documentary made the dark side of Canadian compassion. And she's the person who taught me
00:02:52.440that imminent death and suffering is really not the reason that people choose to euthanize
00:03:00.300themselves at the hands of the state. But Amanda, I wanted to have you introduce yourself and your
00:03:07.340role in your activism in this country to prevent people from making the irreversible choice
00:03:17.460of choosing medical assistance in dying. Thanks so much. Well, I am the founder of a cultural
00:03:24.560initiative called Dying to Meet You, through which I work to humanize our cultural conversations
00:03:29.840around suffering, death, meaning, and hope. And I also serve as the ethics director for Canadian
00:03:36.400Physicians for Life, an association of life-affirming medical professionals committed to
00:03:42.140the Hippocratic tradition of do no harm. And you're right to point out what you mentioned
00:03:49.000at the beginning, because euthanasia represents not so much a medical crisis in this country,
00:03:55.060though it is very, very much tied to a whole host of medical crises. But from those requesting it,
00:04:02.060it really is an existential crisis. It's a crisis of meaning. It's a crisis of self-worth in the
00:04:08.380face of certain losses and grief. And so I look forward to discussing the real underlying reasons
00:04:16.700why Canadians are requesting euthanasia, because I insist that it really comes down to disappointments,
00:04:22.800sometimes disappointments with the healthcare system, but very often disappointments in life
00:04:27.440in general. Now, I think you probably wouldn't toot your own horn, but I know that your
00:04:38.080advocacy, especially, um, with the doctors that you work with was instrumental in getting the
00:04:45.420province of Alberta to pump the brakes on the expansion of track to made. And just before we
00:04:51.360get into that, um, and what Alberta is doing, tell us what track to made really is because, um,
00:05:00.100it, it already is very vague and worrisome. And we're seeing people choose euthanasia under that
00:05:06.980track for things that are completely treatable and transient. Yeah, labeling path to deaths as
00:05:18.360tracks is already very sinister and very sad, in my view. And in 2016, Canada legalized euthanasia
00:05:25.800nationwide. And fewer than five years later, the government was already talking about expanding it.
00:05:31.300And the reason is because once legalized, euthanasia cannot remain limited, but will always be expanded on the grounds of equality.
00:05:40.380That's because if it's seen as a reasonable and compassionate means to address suffering by killing the one who suffers,
00:05:47.560then why wouldn't this means, why wouldn't this approach be expanded more and more on the grounds of equality?
00:05:54.940So that's exactly what happened, because the rationale was there are people who suffer more throughout life,
00:06:01.300maybe with a chronic illness or a disability or a neurological condition and so those became the
00:06:07.540criteria for the expansion so-called track two made and that was legalized in 2021 at the same
00:06:15.380time euthanasia was expanded on the basis of mental illness as a sole underlying condition
00:06:21.140for this very reason of equality the senate thought that bill c-7 didn't go far enough
00:06:26.260by expanding euthanasia to persons with disabilities, and insisted that it be amended to also include an expansion on the basis of mental illness as a sole condition.
00:06:36.500That law passed in March, on March 17th, 2021, with a sunset clause that simply delayed the implementation of the mental illness as a sole condition.
00:06:47.900First of all, for two years, and then by another year, and then until 2027.
00:06:52.940but it's very important for viewers to know that Canada already legalized euthanasia on the basis
00:06:59.480of mental illness alone. It simply hasn't taken effect yet. And unless there's an active
00:07:05.040legislation to change it, this becomes a risk on March 17th, 2027, that people could actually
00:07:12.420be euthanized in our country whose sole medical diagnosis is a mental illness.
00:07:18.560Thank you, Chair, and thank you, Witnesses, for being here.
00:07:24.040You were clear in your comments that you don't think it's reasonable to deny people with only a mental illness access to MAID if it's permitted for people with a physical condition.
00:07:34.340Do you believe that all mental health diagnoses could lead to someone being eligible for MAID?
00:07:44.760Mr. Chair, it's an excellent question, and I think the Canadian legislation is quite clear.
00:07:51.460If I may reclaim my time, it was a yes or no question, Doctor.
00:07:55.380I would allow her briefly, Dr. Gupta, to finish your response.
00:07:59.900The legislation is clear that it's trying to capture people in certain kinds of clinical circumstances
00:08:05.500rather than point to specific diagnoses.
00:08:08.400So I would say that what's important is the circumstances of the person, not the medical category, we classify them with.
00:08:16.580But just for clarity, do you believe that there are certain diagnoses that could never rise to that level of being grievous and irremediable and justify medical assistance in dying as far as diagnostic mental illnesses are concerned?
00:08:30.640Well, there are, excuse me, Mr. Chair, there are certainly diagnoses that, by definition, are intended to be time-limited or reactive to certain kinds of circumstances, and I think we can safely assume that those would not meet the legislated criteria as they are currently written.
00:08:48.420Do you believe in eating disorder? Could qualify someone for MAID?
00:08:52.020Again, I think the legislation is clear that it really depends on the circumstances of the person.
00:08:59.520And depression as well, major depressive disorder?
00:09:02.440Again, it depends on the clinical circumstances of the person.
00:09:05.260Is there a consensus among psychiatrists on how many treatments one needs to try
00:09:10.620or for how long one needs to seek treatment for it to be classed as treatment resistant?
00:09:16.280The use of the term treatment resistance in the clinical research literature
00:09:22.120is meant to capture different populations depending on the goal of the study being undertaken.
00:09:28.120So there are a range of different definitions. But of course, as we know, treatment resistant is not the term that's used in the legislation. It is a different term that describes a different set of circumstances than what researchers are interested in when they want to identify a population they consider treatment resistant.
00:09:47.100One of the things that Alberta has done is to regulate euthanasia providers. I had no idea that it was the Wild West out there. I did know that it's a very small subset of doctors doing the majority of euthanization in this country.
00:10:05.400But I had no idea that you could just sort of dub yourself a maid provider and then get at her. It's frightening because it seems that there are really no breaks to this system.
00:10:19.660euthanasia directly ending the lives of patients is not what people go to school for years and
00:10:26.360years to learn how to do it is very devastating that there was actually a euthanasia doctor
00:10:32.300in the media who said i find myself using the stethoscope to check that the heart has stopped
00:10:39.140rather than that it is beating what is going on with the medical profession when there's a complete
00:10:45.020inversion of the entire vocation of being a doctor, being to accompany patients in moments
00:10:52.640of vulnerability and distress. And so you're right to point out that most doctors want nothing to do
00:11:00.340with this. And yet we're seeing increasingly, even within the medical association with which
00:11:05.600I'm involved, that medical students, residents, early practice physicians are facing it like
00:11:11.500they've never faced it before. It's causing very complex ethical dilemmas for people who are
00:11:18.440looking to begin entering the healing profession and who want nothing to do with directly ending
00:11:24.740patients' lives. Now, before we talk about your work with dying to meet you, are there
00:11:33.140professional pressures being put on these doctors who, for example, with Physicians for Life or
00:11:41.480just any doctor out there who enters the profession of medicine to treat people to
00:11:49.240heal them as opposed to kill them are they facing profession or professional pressures from their
00:11:55.400professional organizations or even their peers yes and we are losing doctors who are moving to
00:12:00.960the states because they don't want to practice in this climate i even know uh physicians who
00:12:06.180have moved between provinces in order to find a province that has better conscience protections
00:12:11.240for physicians. And so doctors are actually voting with their feet and choosing where to
00:12:16.620live and practice based on the euthanasia policies there. So that's very important to note. And yes,
00:12:24.160there's a lot of pressure from the College of Physicians to basically make referrals for
00:12:32.440euthanasia, even if against a person's medical judgment, a person should not be recommended
00:12:37.900to die. And who could refer their patient for death? Really, if a patient, if a physician is
00:12:44.680really looking out for their patient's good, they will never make a suggestion that they would be
00:12:48.540better off dead. Now, I want to talk about your work with dying to meet you because through your
00:12:56.100work, we're seeing the stories of people who have been offered euthanasia when they go to the
00:13:03.980hospital for routine treatment or to receive treatment for something that is completely
00:13:09.720treatable. And in so many cases, they went, they go on to live fruitful lives post-treatment.
00:13:19.720And, you know, it frightens me because if that person were in a moment of vulnerable,
00:13:26.560vulnerable bill oh my goodness sheila if that person were in a moment of vulnerableness
00:13:33.260what what sort of irreversible choice could have been made um and you know at the end of the day
00:13:43.060and through my work on our documentary the stories of the families left behind
00:13:49.940the helplessness of the families left behind and the grief um and the trauma of what happened
00:13:57.260i just think it's a cascade of events um but you show us the other side of that that there is hope
00:14:04.680there is healing and uh there's i i think to a large extent happiness on the other side
00:14:11.220yeah i was recently on vancouver island and that really is uh the euthanasia capital
00:14:17.920very high rates of euthanasia there everyone seems to know someone who has died by euthanasia
00:14:25.760and so while I was there I met a woman who after one of my talks shared that she was offered
00:14:32.020made practically upon arrival to the hospital this was shocking to hear she had gone in she
00:14:38.920had been in excruciating pain her daughter called an ambulance and basically she says this young
00:14:44.340doctor came over and said we would like to offer you made and she said I didn't even know what was
00:14:50.480wrong with me at the time and she took a month to recuperate from this back pain that she had
00:14:57.540and then she went on to go to Mexico Cuba and Guatemala shortly after all of that and so
00:15:04.820she shared this with me just one-to-one after a talk and I said would you be willing to say that
00:15:11.160on camera and she said yeah I don't see why not and so I recorded a short clip I posted it on X
00:15:18.580and it quickly amassed more than 300,000 views and finally some media started to pay attention
00:15:26.060it was picked up by the New York Post, People, Daily Mail, several other outlets in Canada
00:15:32.940and City News Vancouver and then interestingly City News Vancouver received word from another
00:15:39.700family who came forward because of Miriam's story and said, even though this happened to our family
00:15:45.600a while ago, and we had never thought to bring it to the media, Miriam's decision to go to the media
00:15:51.300made us come forward as well. And that's why I say that there's going to be a bit of a Me Too
00:15:56.140moment with Made in Canada, where seniors start to become emboldened. And rather than the
00:16:02.320embarrassment at having been mistreated, they become courageous ambassadors for life, telling
00:16:08.860us about coming out on the other side full of life and hope and resilience you know and
00:16:14.980I know that a lot of of the advocacy done around this issue is frequently done by the families
00:16:24.720closest to the seniors and so for me this is just uh an just another reason why frankly we
00:16:34.940shouldn't warehouse our old people and we should stay as close to our loved ones as they enter
00:16:41.780their golden years as possible we have to act as advocates for them as they try to navigate the
00:16:47.480medical system because you know when when our our seniors our elderly our vulnerable are in the
00:16:56.980medical system alone, uh, there can be a moment of weakness where you feel like a burden on society
00:17:05.580and that becomes a bit of an earworm that can lead to catastrophic results.
00:17:12.220Yeah. And in a position of vulnerability, especially you expect that the doctor is on
00:17:15.940your side and that, and that whatever they suggest would be for your good. And so when
00:17:20.760something is suggested and it actually is for your death, it's so shattering. It really breaks
00:17:25.680that doctor-patient trusting relationship. And I think that these offers, these unsolicited
00:17:32.080offers of euthanasia are really, really detrimental to the self-esteem of seniors and also to the
00:17:40.340confidence of families in our healthcare system. And you're right, there are so many family members
00:17:46.000who are speaking out. And I think this is important, especially for those who, I think,
00:17:53.140well i'll just say that we have a tendency of addressing the euthanasia topic as it pertains
00:17:59.660to individuals individuals choices and it's really important that we attend to the social reality
00:18:07.660and the way that this choice reverberates throughout all of society because it's not
00:18:14.080a victimless choice the way that people are left behind the complex grief the intergenerational
00:18:20.380trauma. So I've heard from many people, adult children, adult grandchildren, two of my latest
00:18:26.440short films feature the adult grandchildren speaking out. And similarly, there was a
00:18:31.600hesitancy, there was a resistance. And this is why we don't hear a lot of stories from the adult
00:18:36.740children and adult grandchildren is because, sadly, devastatingly, family members are met
00:18:42.480with the accusation of selfishness for wanting their loved one to be with them as long as
00:18:48.200possible until their last natural breath they're accused of selfishness for not wanting a doctor
00:18:55.000to give them a lethal injection and and an overdose of medications that will end their life
00:19:01.400it's the complete inversion because euthanasia is what's the opposite of love and it's the loving
00:19:09.180response to mount resistance to this particular form of suicidal ideation and to this particular
00:19:16.060form of abandonment and so we have to resist this and I think more as more and more family members
00:19:22.220come forward and say we are not made for this this is not natural this is not healthy this is not
00:19:30.160good for us I don't think it's going to last as well so I think it's very important that seniors
00:19:36.000think about their legacy because I don't think this is going to last very long and if you go
00:19:42.200through with this unfortunately I think you will be part of an anomaly historically speaking and
00:19:49.420your family will know that you at this particular moment fell for something that was sold as a good
00:19:58.740but that was recognized not long after to be gravely evil and dehumanizing. Yeah you know
00:20:05.980the families left behind when you speak to them it's almost like you're speaking to the survivors
00:20:13.020of a violent crime that happened to them they're just they have this grief and trauma and sense of
00:20:19.480helplessness that uh that in another circumstance they would be met with compassion but instead
00:20:29.460they're met with accusations of selfishness or lack of understanding or lack of care it's the
00:20:37.500most bizarre inversion that these people have to be traumatized not once by the act but the second
00:20:44.780time by the system that perpetrates it and and then to some extent uh depending on where you
00:20:51.900consume your media, the media that sort of celebrates the act of euthanasia. I want to
00:20:59.860ask you about the best thing that we can do as a society to make this an unthinkable choice
00:21:15.240for our elderly and our suffering and our sad
00:21:19.140because there are things that we can do
00:21:22.020while things are being sorted out in the political realm
00:22:33.060and the last one bears similar data to all the previous years and the last one for which we have
00:22:41.160data is 2024 and there's a chart in there that says the main kinds of suffering leading people
00:22:47.460to request euthanasia and the number one kind of suffering by people's own admission driving
00:22:53.740their request is an inability to engage in meaningful life activities inability to engage
00:23:00.660in meaningful life activities. So the first question is, how do we make sure that there
00:23:05.040are meaningful activities in our lives that can withstand the loss, the circumstances,
00:23:11.380and the conditions in which we are bound to find ourselves as we age, as we develop certain
00:23:18.140illnesses, as we suffer certain losses? That's really the heart, is the search for meaning.
00:23:26.060now the next reason why people say they're they're motivated for euthanasia is an inability to do the
00:23:33.140daily activities of personal care and daily living and so this too requires some work ahead of time
00:23:40.360and this is where people with disabilities have a lot of I think insight and contributions to make
00:23:46.560because unfortunately sometimes when you go through life with a lot of health and independence
00:23:50.780and wealth you think if this or that happens to me then I wouldn't want to live anymore
00:23:55.600but what that attitude does is it actually dehumanizes and devalues everyone who might
00:24:01.640be in that situation already or throughout their lives of having less than you of having certain
00:24:08.300disabilities and most people with disabilities will say I love my life and this is the only life
00:24:16.560I know and so if you just kind of live your way into the next step you'll find you're capable of
00:24:22.000bearing much more than you thought possible. There's a lot of projection. And so it's addressing
00:24:27.040those feelings of projection and also preparing ourselves to receive the love and care of others
00:24:32.880after probably years of giving and being generous and providing for others. Somehow we have to work
00:24:39.180our way into being able to lovingly receive that attention. Then the next kinds of suffering by
00:24:46.180people's own admission are a loss of independence and a loss of dignity. So again, very interesting.
00:24:52.360These are very first world problems in terms of driving the euthanasia crisis. And again,
00:24:57.860this is from the government data of those specifically going for euthanasia. These are
00:25:03.280the reasons they're giving. And then there's existential distress and a kind of general fear.
00:25:07.620But only after all of those reasons I've just been discussing, does pain slash the fear of pain
00:25:14.780even enter in and so we do know that there are gaps in palliative care and that not everyone
00:25:21.100has adequate access to proper medical care and timely medical care that's first and foremost
00:25:26.840that's the basic we must make sure that we're providing adequate health care palliative care
00:25:35.660to people but again the driver of euthanasia is not so much that as it is all of the adjacent
00:25:44.020existential psychological social factors i know that people are asking for euthanasia because
00:25:50.480they are bereaved i read the obituaries of people who are opting for made and it's there's basically
00:25:57.000a genre of uh euthanasia obituaries of of uh bereaved spouses and nobody's talking about this
00:26:07.040we have to take seriously the loneliness the alienation the abandonment because this is a
00:26:13.840social crisis more than a medical one. Amanda, how do people find the very important work that
00:26:22.820you're doing to address those issues of loneliness, isolation, and abandonment?
00:26:30.660You can go to dyingtomeatyou.com and see the short films I've released. There are going to
00:26:35.900be more resources coming soon. I was recently hearing from someone who said, oh, this person
00:26:40.840is planning on dying by maid? Do you have talking points? And my heart just kind of sank because
00:26:47.500it's very inadequate. You can't just do a one pager or cue cards to save lives. It takes
00:26:54.480the engagement. And so I gave her a call and I said, why does this person want to die? And she
00:27:00.240said, well, she's terrified of being a burden to her adult sons. And I said, well, please tell her
00:27:06.660that nothing would burden her sons more than her suicide and that she is a gift for them as long
00:27:13.220as she lives but you can't script all of this ahead of time it takes coming alongside and so
00:27:19.000that's why I travel all across Canada all the time engaging people every day in the uniqueness of
00:27:25.200their circumstances and I hope that the videos the podcasts the short films give a bit of a flavor of
00:27:31.180those discussions I do a lot of workshops all across the country so we can engage these themes
00:27:36.240of meaning dignity dependence together in community through actual workshop exercises
00:27:42.840and if people are looking to learn more about life-affirming health care in Canada you can
00:27:48.740check out physiciansforlife.ca join the email list there get a weekly digest of
00:27:54.140about of news from a life-affirming health care perspective about the latest developments
00:28:00.200legislatively and within the professional domain concerning this. So stay engaged in the issue,
00:28:07.280have conversations every day about these topics, because what I find without exception is that
00:28:14.260people want to talk about suffering, death, meaning, and hope. And you can be the occasion
00:28:19.780to create that opening. It might seem uncomfortable or awkward at first, but you'll see that it
00:28:24.680becomes a basis for intimacy, communion, and depth that you would not have wanted to miss.
00:28:31.040Amanda, thank you so much for the work that you do to help the vulnerable, help their families navigate these challenges in our bizarre, death-focused society.
00:28:46.440I've seen the work that you do firsthand.