TAKE NOTE DR SHIPMAN-DETTERLING
She is not terminally ill, but the 39-year-old performance and burlesque artist has been approved for assisted dying under Canada's increasingly liberal laws.
Warning: This article contains details and descriptions some readers may find disturbing
She is speaking to BBC News from the Bus Stop Theatre, an intimate auditorium with a little under 100 seats, in the eastern city of Halifax, Nova Scotia.
Illuminated by a single spotlight on a stage she has performed on many times before, she tells me she plans to die here "within months" of her imminent 40th birthday. She'll be joined by a small group of her family and friends.
April plans to be in a "big comfy bed" for what she calls a "celebratory" moment when a medical professional will inject a lethal dose into her bloodstream.
"I want to be surrounded by the people I love and just have everybody hold me in a giant cuddle puddle and get to take my last breath, surrounded by love and support," she says.
April was born with spina bifida and was later diagnosed with tumours at the base of her spine which she says have left her in constant, debilitating pain.
BBC's Fergus Walsh meets people in Canada on both sides of the assisted dying debate
She's been taking strong opioid painkillers for more than 20 years and applied for Medical Assistance in Dying (Maid) in March 2023. While she could yet live for decades with her condition, she qualified to end her life early seven months after applying. For those who are terminally ill it is possible to get approval within 24 hours.
"My suffering and pain are increasing and I don't have the quality of life anymore that makes me happy and fulfilled," April says. Every time she moves or breathes, she says it feels like the tissues from the base of her spine "are being pulled like a rubber band that stretches too far", and that her lower limbs leave her in agony.
We meet April as, almost 3,000 miles away, MPs are scrutinising proposals to legalise assisted dying in England and Wales. They voted in principle in support of those plans in November 2024, but months of detailed scrutiny have followed - and further votes in the Commons and Lords are required before the bill could possibly become law.
This week, the BBC witnessed a man's death in California, where assisted dying laws are far more similar to those being considered in Westminster.
Critics say Canada is an example of the "slippery slope", meaning that once you pass an assisted dying law it will inevitably widen its scope and have fewer safeguards.
Canada now has one of the most liberal systems of assisted dying in the world, similar to that operating in the Netherlands and Belgium. It introduced Maid in 2016, initially for terminally ill adults with a serious and incurable physical illness, which causes intolerable suffering. In 2021, the need to be terminally ill was removed, and in two years' time, the Canadian government plans to open Maid to adults solely with a mental illness and no physical ailment.
Opponents of Maid tell us that death is coming to be seen as a standard treatment option for those with disabilities and complex medical problems.
"It is easier in Canada to get medical assistance in dying than it is to get government support to live," says Andrew Gurza, a disability awareness consultant and friend of April's.
Andrew, who has cerebral palsy and uses a wheelchair, says he respects April's decision, but tells us: "If my disability declines and my care needs got higher, I'd still want to be here. To know there's a law that's saying you could easily end your life - it's just really scary."
Andrew Gurza is worried that getting support to live is too hard in Canada
Before she was approved for Maid, April was assessed by two independent physicians who were required to inform her of ways to alleviate her suffering and offer alternative treatments.
"The safeguards are there," she says, when we press her about disabled people who feel threatened by assisted dying, or whether Maid is being used as a shortcut to better quality care. "If it's not right for you and you're not leading the charge and choosing Maid, you're not going to be able to access it unless it's for the right reasons," she adds.
There were 15,343 Maid deaths in 2023, representing around one in 20 of all deaths in Canada - a proportion that has increased dramatically since 2016 and is one of the highest in the world. The average age of recipients was 77.
In all but a handful of cases, the lethal dose was delivered by a doctor or nurse, which is also known as voluntary euthanasia. One doctor we spoke to, Eric Thomas, said he had helped 577 patients to die.
Assisted Dying: The Final Choice
Meet patients legally choosing assisted dying. And hear from those who feel it puts the most vulnerable at risk
Dr Konia Trouton, president of the Canadian Association of Maid Assessors and Providers, has also helped hundreds of patients to die since the law was introduced.
The procedure is the same each time - she arrives at the home of the person who has been given approval for Maid and asks if they wish to go ahead with it that day. She says the patients always direct the process and then give her the "heads up and ready to go".
"That gives me an honour and a duty and a privilege to be able to help them in those last moments with their family around them, with those who love them around them and to know that they've made that decision thoughtfully, carefully and thoroughly," she adds. If the answer is yes, she opens her medical bag.
Demonstrating to the BBC what happens next, Dr Trouton briefly puts a tourniquet on my arm. She shows me where the needle would be inserted into a vein in the back of my hand to allow an intravenous infusion of lethal drugs.
In her medical bag she also has a stethoscope. "Strangely, these days I use it more to determine if someone has no heartbeat rather than if they do," she tells me.
A list of organisations in the UK offering support and information with some of the issues in this story is available at BBC Action Line
Some 96% of Maid provisions are under "track one" where death is "reasonably foreseeable". Dr Trouton says that means patients are on a "trajectory toward death", which might range from someone who has rapidly spreading cancer and only weeks to live or another with Alzheimer's "who might have five to seven years".
The other 4% of Maid deaths come under "track two". These are adults, like April, who are not dying but have suffering which is intolerable to them from a "grievous and irremediable medical condition".
That is in stark contrast to Labour MP Kim Leadbeater's bill to legalise assisted dying in England and Wales, which says patients must be expected to die within six months. The Westminster bill would not allow doctors to give a lethal dose – rather patients would have to self-administer the drugs, usually by swallowing them.
Death via intravenous infusion normally takes just a few minutes, as the lethal drugs go straight into the bloodstream, whereas swallowing the drugs means patients usually take around an hour or two to die, but can take considerably longer, although they are usually unconscious after a few minutes.
Dr Trouton told me she regarded the Canadian system as quicker and more effective, as do other Maid providers. "I'm concerned that if some people can't swallow because of their disease process, and if they're not able to take the entire quantity of medication because of breathing difficulties or swallowing difficulties, what will happen?"
'Canada has fallen off a cliff'
But opponents argue it's being used as a cheaper alternative to providing adequate social or medical support.
One of them is Dr Ramona Coelho, a GP in London, Ontario, whose practice serves many marginalised groups and those struggling to get medical and social support. She's part of a Maid Death Review Committee, alongside Dr Trouton, which examines cases in the province.
Dr Coelho told me that Maid was "out of control". "I wouldn't even call it a slippery slope," she says "Canada has fallen off a cliff."
Dr Ramona Coelho says she wants to help patients to live
"When people have suicidal ideations, we used to meet them with counselling and care, and for people with terminal illness and other diseases we could mitigate that suffering and help them have a better life," she says. "Yet now we are seeing that as an appropriate request to die and ending their lives very quickly."
While at Dr Coelho's surgery I was introduced to Vicki Whelan, a retired nurse whose mum Sharon Scribner died in April 2023 of lung cancer, aged 81. Vicki told me that in her mum's final days in hospital she was repeatedly offered the option of Maid by medical staff, describing it as like a "sales pitch".
The family, who are Catholic, discharged their mother so she could die at home, where Vicki says her mum had a "beautiful, peaceful death". "It makes us think that we can't endure, and we can't suffer a little bit, and that somehow now they've decided that dying needs to be assisted, where we've been dying for years.
"All of a sudden now we're telling people that this is a better option. This is an easy way out and I think it's just robbing people of hope."
'Not a way I want to live'
So is Canada an example of the so-called slippery slope? It's certainly true that the eligibility criteria has broadened dramatically since the law was introduced nine years ago, so for critics the answer would be an emphatic yes and serve as a warning to Britain.
Canada's assisted dying laws were driven by court rulings. Its Supreme Court instructed Parliament that a prohibition on assisted dying breached the country's Charter of Rights and Freedoms. The extension of eligibility for those who were not terminally ill was in part a response to another court decision.
In Britain, judges in the most senior courts have repeatedly said any potential change to the law around assisted dying is a matter for Parliament, after the likes of Tony Nicklinson, Diane Pretty and Noel Conway brought cases arguing the blanket ban on assisted suicide breached their human rights.
April knows some people may look at her, a young woman, and wonder why she would die.
"We're the masters of masking and not letting people see that we're suffering," she says. "But in reality, there's days that I just can't hide it, and there's many days where I can't lift my head off the pillow and I can't eat anymore.
"It's not a way I want to live for another 10 or 20 or 30 years."
Gene, why do you keep printing this ridiculous nonsense?
ReplyNot a single news medium - print, broadcast or social - has picked up on this story in TWO YEARS.
Are we expected to believe that a story as sensational as this would not have been all over the news media round the world had the media been able to verify it from the medical evidence? It hasn't, and the only possible conclusion is that there is no reliable evidence to produce.
It would be very simple to do, and I suggest that you set about this task straight away - it would after all validate the bogus bollocks about Medjugorje with which you have stunk up the internet for years.
[a] produce the scans, clinical notes and testimony from Ms Fitzgerald's general practitioner, consultants and hospital records from March - July 2022. This would show that Ms Fitzgerald had been diagnosed with a terminal liver cancer which had metastasised to her spine, blindness in one eye and congestive heart failure. It would also record the medical verdict that she had weeks to live and the diagnosis that her husband should seek hospice care for her.
[b] produce the scans, clinical notes and testimony from Ms Fitzgerald's general practitioner, consultants and hospital records from September 2022 - March 2023. This would record the complete disappearance of the liver and spinal tumours, as well as the restoration of sight in one eye and the recovery from congestive heart failure.
Simple - so why won't you do it?
This post is not only stupid, it is offensively stupid. My first wife died of liver cancer, and the memory of her diminution from being a vital, intelligent, gracious and feisty woman to a scarecrow who could not bear to see her own face in the mirror is something I will carry to the grave. In publishing this kind of bogus, sentimental CRAP you are pissing on her grave. I would LOVE to kick you in the balls for publishing this piffle.
Fr. Leon Pereira, mentioned here and chaplain resident in Medjugorje, is a former medical doctor. Better placed than you Detters to comment here.
ReplyGene, why do you keep printing this ridiculous nonsense?
Not a single news medium - print, broadcast or social - has picked up on this story in TWO YEARS.
Are we expected to believe that a story as sensational as this would not have been all over the news media round the world had the media been able to verify it from the medical evidence? It hasn't, and the only possible conclusion is that there is no reliable evidence to produce.
It would be very simple to do, and I suggest that you set about this task straight away - it would after all validate the bogus bollocks about Medjugorje with which you have stunk up the internet for years.
[a] produce the scans, clinical notes and testimony from Ms Fitzgerald's general practitioner, consultants and hospital records from March - July 2022. This would show that Ms Fitzgerald had been diagnosed with a terminal liver cancer which had metastasised to her spine, blindness in one eye and congestive heart failure. It would also record the medical verdict that she had weeks to live and the diagnosis that her husband should seek hospice care for her.
[b] produce the scans, clinical notes and testimony from Ms Fitzgerald's general practitioner, consultants and hospital records from September 2022 - March 2023. This would record the complete disappearance of the liver and spinal tumours, as well as the restoration of sight in one eye and the recovery from congestive heart failure.
Simple - so why won't you do it?
So sorry to learn about what happened to your first wife Detters.
ReplyNo you are not, Gene. You haven't an atom of compassion in you.
ReplyMaybe you should contact Fr Dr Leon Periera OP about this case. He was formerly a medical doctor in the UK and he is now chaplain to the English-speaking pilgrims in Medjugorje.
Reply"I would LOVE to kick you in the balls for publishing this piffle."
Now I know you don't mean a word of this. But, I understand your anger and frustration. Most likely you are thinking: "If only my first wife would have had the opportunity to make a pilgrimage to Medjugorje."
And yes, I am saddened about your first wife's suffering and death from liver cancer. Was she a smoker Detters?
GENE
Take my first wife's name out of your grubby mouth, and mind your own fucking business.
And yes, I would love to kick you in the balls for publishing this pernicious rubbish whereby religion takes on the quality of fairground fortune telling and sympathetic magic - to traffic in this crap is to blaspheme the mercy of God.
"A few months later, I got an email from Fr. Dan Powell, saying, "Do you remember this lady, Maureen?" And, of course, I did. He told me that she was well, she was cured, that her blood results were normal, and the tumors had shrunk or disappeared. And then shortly after, I had an e-mail from Maureen herself, with a lot more details. And I encouraged her to send all this medical data to the Bishop here, the Apostolic Visitator, Archbishop Aldo Cavalli. So she told me this morning that she did that yesterday. I think she had a meeting with the Bishop and handed over all the medical documentation to him and told him the story as well."
ReplyFr Leon Periera
Sounds pretty convincing to me.
GENE
Nonsense.
Let us have the before and after medical data - scans, treatments prescribed, progress, prognoses and case resolution notes - from the doctors and hospitals who [a] pronounced Ms Fitzgerald terminally ill and [b] pronounced her cured.
Nothing else can confirm the truth of this yarn: and until it is confirmed by medical data it must be seen for what it is - a pack of lies, no matter how well meant.
"Sounds pretty convincing to me."
Only because you are pathologically incapable of admitting that you are wrong, you contemptible little turd.
"And I encouraged her to send all this medical data to the Bishop here, the Apostolic Visitator, Archbishop Aldo Cavalli. So she told me this morning that she did that yesterday. I think she had a meeting with the Bishop and handed over all the medical documentation to him and told him the story as well."
ReplyFr Leon Pereira
Sounds pretty convincing to me.
GENE