Monday, July 18, 2016

Death by the numbers, eh? A Canadian euthanasia tally and small analysis.


Death by the numbers: the preliminary estimates of euthanasia numbers in Canada, as of July 17, 2016.

I.
I am a sociologist.  I have worked in the field since 1994 in small, community based organizations with very focused mission profiles and I have taken care to observe what happens in those groups to understand those dynamics.  In those positions, I have used what I learned at university to move forward the goals of whatever group I found myself involved with. 
Given that I am a sociologist in the field, I am also a bit of a numbers geek.  So I was interested when there was an article in the Toronto Star of Sunday, July 17, 2016 entitled, ‘Provinces vary on access to assisted dying.’  The article has a data box itself entitled, ‘Doctor assisted death cases in Canada’.  From that box we are given the following figures:
 
Table 1: raw data number killed/number of requests by province.
BC  Ab     Sask  Man   Ont   Que                Newf  NB   NS         
1     9/25  1/3    5/35   18      166/254 [1]  0/1      0      Won't
                                                                                             release
                                                                                             data

In two cases, we have provinces that have refused to reveal how many people have requested death or have been killed, and that is British Columbia and Nova Scotia.  That this information would be hidden from the Canadian public in those provinces should worry us because it removes the possibility of public comment or oversight from the view of the public.
The information can be misleading: in the case of Quebec, they have had medically imposed death since about halfway through December in 2015.  This means they do have a higher number than the Canadian average, so their numbers skew the overall average in Canada. 
Despite the supposed oversight, we have 200 deaths in Canada total since either December 2015 or June 6, 2016.  Another caution is that these are the deaths that we know about, or are allowed to know about.  By definition, therefore, we must assume the numbers are inaccurate, so we are taking estimates.
Whether they reflect actual deaths is another matter completely.[2]
What is worrisome is that some provinces refuse to release the data on how many deaths have happened.  For example, BC has had one death and one request where the person changed their mind.  Ontario was surprising: in my data, which I will admit is gleaned from the newspapers, 18 deaths was higher than I knew about.  Quebec’s number of 166 is much higher than was expected.
The problem is that we have provinces refusing to release their data, as in BC and Nova Scotia.  This is an issue of public health and so the public has a right to know what has happened to the money allocated to these examples of human experimentation.  If the procedure has not been tried before in a regime, by definition of its novelty, it is an experiment, and the context of medical care, which is the frame of reference for this issue, then we are looking at terminal human experimentation in action.

This works out to 200 people killed in a medical context in Canada.  If we assume that this is correct, then the following table shows the raw numbers and their expression of proportion:

Table 2. Number of days and resulting proportion of deaths per day in Canada.

Since December 2015                     Since June 6, 2016, including to date
Total number of days: 203            Total number of days: 41
Average deaths per day: 0.98     Average deaths per day: 4.8

These are the totals for all provinces, including Quebec, which as we have said, skews the numbers.  It increases the average deaths per day in Canada since June 6.  If we remove the 166 deaths in Quebec, then we see that we have 34 deaths total.  This means we have had 34 deaths in 41 days.  That works out to 0.8 deaths per day.
With Quebec numbers: 166 deaths over 203 days works out to 0.8 deaths per day.  Obviously this is not physically accurate, but it does show us the rate of death per day.[3]  Oddly, this works out to the same rate of deaths in one province as versus the rest of Canada.

II.
If the personal is political, and people are being killed in health contexts with public funds – I am not na├»ve enough to think that doctors who kill would refuse to get pay for their act of killing – then we need to understand personally how this might impact us.  We cannot assume we are told the total number of deaths; we cannot also assume the numbers are accurate.
It would be interesting to see if StatsCan provides the annual averages of death overall; somehow I am not optimistic that we, the Canadian public, will be allowed to know this information (for reasons of confidentiality).  I do not have information about what deaths happened in what hospitals in Quebec, although I understand that data is available.
There are some concerns with these numbers: they are not official, as said before.  We do not know their accuracy.  We also see that they are perhaps lower than the overall number of deaths, and this is worrisome because it gives the illusion that everything is under control and we cannot make that conclusion.  Remember, these numbers only reflect the deaths the Canadian public is allowed to know about.
It would be interesting to me, as a sociologist, to find out the gender proportions in these numbers; I would also be interested in learning the ages and the educational levels of these victims.  In addition, I would like to know the illnesses that led to the requests and resultant deaths.  Knowing this information would allow us to accurately know those who are being targeted for death – and perhaps if there were biases toward disability or definition. Knowing that information, however, depends upon knowing accurate numbers.
Yet, if the numbers are massaged and we as the Canadian public are not allowed to know how many people have died in a medical context, then we are at risk of euthanasia being used in Canada for either eugenic or political goals.  Recall that Denmark has made a policy decision they are to be Down Syndrome free in 2016.  What is to stop the government from making certain demands that result in emphasis on medically provided death versus the more costly medical care?  We have already seen patients in Ontario being refused care defined as expensive, remember Madi Vanstone and Kalydeco?
Information, in order to protect Canada's vulnerable citizens, must be accurately and clearly provided.  I am not convinced we have accurate information in this instance, and so I am suspicious – as we all should be of a government that permits the killing of its citizens, for whatever publicly stated reason.  Ontario has had its share of public corruption of late, and Ontario’s citizens are suffering as a result.  It’s too easy to hide an ulterior economic, political or eugenic motive inside a casket when its occupant cannot dispute what others say happened to place them there.
More research is obviously called for, and we must be on alert for new numbers if and as they become available.  I will write another piece linked to this analysing the implications as I think of them, but that is for another time.

Endnotes:
[1] There were 87 refused requests for death in Quebec and that is included in the total number of these requests.  One of those requests refused resulted in a death as the person starved himself into being eligible and was euthanized as a result.  We do not know why people were refused from the source article.
[2] For instance, there was one death in London, Ontario the week before Easter 2016 at a hospital in that city; it never made the papers.
[3] I am assuming here that the deaths started on December 10, 2015.

Appendix:
Raw data taken from Toronto Star as source, Sunday July 17, 2016, A3, ‘Provinces vary on access to assisted dying.’

Alberta   9/25
Ontario 18
BC refuses to release info: 1
Saskatchewan   1/3
Manitoba            5/35
Quebec                166 to June 30/254 requests/87 refused/changed mind
PEI                          0
Nova Scotia        refuses to release info
New Brunswick 0
Newfoundland 0/1 request but died before procedure
Nunavut/Yukon ‘N/A’
NWT                      0

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