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Assisted death framework to expand in Canada

Published

2 years ago

December 11, 2022

Toronto –

Canada is preparing to expand its medically assisted death framework to become one of the broadest in the world, a change some want to delay due to concerns vulnerable people have easier access to death than to a life without suffering.

Starting in March, people whose sole underlying condition is mental illness will be able to access assisted death. Mental illness was excluded when the most recent medical assistance in dying (MAID) law was passed in 2021.

That will make Canada one of six countries in the world where a person suffering from mental illness alone who is not near their natural death can get a doctor to help them die.

People will still need to apply and be deemed eligible by two clinicians who must determine whether they have an irremediable condition causing them intolerable suffering and whether they have capacity – whether they understand and appreciate their condition, the decision and its consequences.

“Tired-of-life cases in Canada are happening,” said Madeline Li, a cancer psychiatrist specializing in palliative care who put together an assisted death framework for her Toronto hospital network.

“I’ve become very comfortable with MAID for people who are dying. I am less comfortable for expanding indications. … We’ve made MAID so open you can request it for basically any reason.”

More than 30,000 Canadians have died with medical assistance since it became legal in 2016 – more than 10,000 of them in 2021, accounting for 3.3 per cent of Canadian deaths that year, according to official data. The vast majority were deemed close to their “natural” death. Last year 4.5 per cent of deaths in the Netherlands and 2.4 per cent of deaths in Belgium were medically assisted.

Clinicians and experts are working on a model MAID standard of care for mental illness for groups regulating clinicians.

But some are calling for the expansion to be delayed; others say the existing system is flawed because people suffering for lack of treatment or supports may access assisted death.

Some individuals have come forward in local news reports saying they are seeking assisted death because they lack appropriate housing or other supports.

The federal agency serving veterans says at least one employee suggested assisted death unprompted to at least four veterans between 2019 and 2022. It is investigating another such allegation, a spokesperson said in an email, adding advice on assisted death is not a department service. Some have pointed to this as an example of system misuse.

Some psychiatrists opposed to the expansion say it is impossible to determine whether a mental illness is “irremediable.”

A spokesperson for Health Minister Jean-Yves Duclos said the government is working with its counterparts to ensure “a strong framework is in place” when assisted death becomes available for mental illness.

A delay would mean “people who are currently suffering intolerably … would have to continue suffering,” said Toronto doctor Justine Dembo, who assesses patients for assisted death and was on an expert panel on the topic.

Dembo expects shortages of assessors and providers due to the stigma and demand attached to the job.

Jocelyn Downie, who is part of the group establishing practice standards, said while some people suffering intolerably might suffer less if they had timely access to treatment or supports, denying them assisted death does not solve the problem: It just means they keep suffering.

L.P., who suffers from anorexia and asked to be identified by her initials, hopes to access assisted death when it is available. Without it, she said, she will keep suffering until the illness or suicide kills her.

“This would just be more dignified.”

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Langford, Heim lead Rangers to wild 13-8 win over Blue Jays

Published

6 hours ago

September 17, 2024

Anne Joseph

ARLINGTON, Texas (AP) — Rookie Wyatt Langford homered, doubled twice and became the first Texas player this season to reach base five times, struggling Jonah Heim delivered a two-run single to break a sixth-inning tie and the Rangers beat the Toronto Blue Jays 13-8 on Tuesday night.

Leody Taveras also had a homer among his three hits for the Rangers.

Langford, who also walked twice, has 12 homers and 25 doubles this season. He is hitting .345 in September.

“I think it’s really important to finish on a strong note,” Langford said. “I’m just going to keep trying to do that.”

Heim was 1-for-34 in September before he lined a single to right field off Tommy Nance (0-2) to score Adolis García and Nathaniel Lowe, giving Texas a 9-7 lead. Heim went to the plate hitting .212 with 53 RBIs after being voted an All-Star starter last season with a career-best 95 RBIs. He added a double in the eighth ahead of Taveras’ homer during a three-run inning.

Texas had 13 hits and left 13 men on. It was the Rangers’ highest-scoring game since a 15-8 win at Oakland on May 7.

Matt Festa (5-1) pitched 1 1/3 scoreless innings to earn the win, giving him a 5-0 record in 13 appearances with the Rangers after being granted free agency by the New York Mets on July 7.

Nathan Eovaldi, a star of Texas’ 2023 run to the franchise’s first World Series championship, had his worst start of the year in what could have been his final home start with the Rangers. Eovaldi, who will be a free agent next season, allowed 11 hits (the most of his two seasons with Texas) and seven runs (tied for the most).

“I felt like early in the game they just had a few hits that found the holes, a few first-pitch base hits,” said Eovaldi, who is vested for a $20 million player option with Texas for 2025. “I think at the end of the day I just need to do a better job of executing my pitches.”

Eovaldi took a 7-3 lead into the fifth inning after the Rangers scored five unearned runs in the fourth. The Jays then scored four runs to knock out Eovaldi after 4 2/3 innings.

Six of the seven runs scored against Toronto starter Chris Bassitt in 3 2/3 innings were unearned. Bassitt had a throwing error during Texas’ two-run third inning.

“We didn’t help ourselves defensively, taking care of the ball to secure some outs,” Blue Jays manager John Schneider said.

The Blue Jays’ Vladimir Guerrero Jr. had a double and two singles, his most hits in a game since having four on Sept. 3. Guerrero is hitting .384 since the All-Star break.

TRAINER’S ROOM

Blue Jays: SS Bo Bichette (calf) was activated and played for the first time since July 19, going 2 for 5 with an RBI. … OF Daulton Varsho (shoulder) was placed on the 10-day injured list and will have rotator cuff surgery … INF Will Wagner (knee inflammation) was placed on the 60-day list.

UP NEXT

Rangers: LHP Chad Bradford (5-3, 3.97 ERA) will pitch Wednesday night’s game on extended five days’ rest after allowing career highs in hits (nine), runs (eight) and home runs (three) in 3 2/3 innings losing at Arizona on Sept. 14.

Blue Jays: RHP Bowden Francis (8-4, 3.50) has had two no-hitters get away in the ninth inning this season, including in his previous start against the New York Mets on Sept. 11. Francis is the first major-leaguer to have that happen since Rangers Hall of Famer Nolan Ryan in 1989.

—

AP MLB:

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Billie Jean King set to earn another honor with the Congressional Gold Medal

Published

7 hours ago

September 17, 2024

Anne Joseph

WASHINGTON (AP) — Billie Jean King will become the first individual female athlete to be awarded the Congressional Gold Medal.

Reps. Brian Fitzpatrick of Pennsylvania and Mikie Sherrill of New Jersey announced Tuesday that their bipartisan legislation had passed the House of Representatives and would be sent to President Joe Biden for his signature.

The bill to honor King, the tennis Hall of Famer and activist, had already passed unanimously in the Senate.

Sherrill, a Democrat, said in a statement that King’s “lifetime of advocacy and hard work changed the landscape for women and girls on the court, in the classroom, and the workplace.”

The bill was introduced last September on the 50th anniversary of King’s victory over Bobby Riggs in the “Battle of the Sexes,” still the most-watched tennis match of all-time. The medal, awarded by Congress for distinguished achievements and contributions to society, has previously been given to athletes including baseball players Jackie Robinson and Roberto Clemente, and golfers Jack Nicklaus, Byron Nelson and Arnold Palmer.

King had already been awarded the Presidential Medal of Freedom in 2009. Fitzpatrick, a Republican, says she has “broken barriers, led uncharted paths, and inspired countless people to stand proudly with courage and conviction in the fight for what is right.”

___

AP tennis:

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Account tweaks for young Instagram users ‘minimum’ expected by B.C., David Eby says

Published

7 hours ago

September 17, 2024

Anne Joseph

SURREY, B.C. – Premier David Eby says new account control measures for young Instagram users introduced Tuesday by social media giant Meta are the “minimum” expected of tech companies to keep kids safe online.

The parent company of Instagram says users in Canada and elsewhere under 18 will have their accounts set to private by default starting Tuesday, restricting who can send messages, among other parental controls and settings.

Speaking at an unrelated event Tuesday, Eby says the province began talks with social media companies after threatening legislation that would put big tech companies on the hook for “significant potential damages” if they were found negligent in failing to keep kids safe from online predators.

Eby says the case of Carson Cleland, a 12-year-old from Prince George, B.C., who took his own life last year after being targeted by a predator on Snapchat, was “horrific and totally preventable.”

He says social media apps are “nothing special,” and should be held to the same child safety standards as anyone who operates a place that invites young people, whether it’s an amusement park, a playground or an online platform.

In a progress report released Tuesday about the province’s engagement with big tech companies including Google, Meta, TikTok, Spapchat and X, formerly known as Twitter, the provincial government says the companies are implementing changes, including a “trusted flagger” option to quickly remove intimate images.

— With files from The Associated Press

This report by The Canadian Press was first published Sept. 17, 2024

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