Police investigation, public outcry following B.C. woman's medically assisted death

An Abbotsford grandmother whose medically-assisted death was carried out while she suffered from complex medical and mental health issues has triggered a rare police investigation and become a rallying cry for advocates and analysts who fear vulnerable Canadians are seeing death as the only option.

The reaction comes in the wake of a CTV News investigation into the circumstances of Donna Duncan’s death last fall. Medical professionals from Fraser Health facilitated Duncan’s death despite the objections of the woman’s family physician and her daughters’ insistence that she wasn’t herself after a head injury in February of 2020.

Christie and Alicia Duncan say their mother went from a vivacious, energetic grandmother – who had retired from her psychiatric nursing position but was still working part-time – to an increasingly erratic and distraught woman who complained of intense sensitivity to light and touch, struggling to eat and ultimately weighing just 82 pounds.

"We believe she was actually starving herself," said Alicia, who described excellent care from the family’s long-time doctor, as well as mental health medications her mother refused to take for more than a few days.

“She wouldn't follow through with any of his recommended treatments. He was frustrated."

Medical records the family provided to CTV News outline a post-concussion syndrome diagnosis and mental health concerns, but no conclusive diagnosis for the physical issues. Duncan had been on a wait-list for a complex chronic disease clinic when she shocked her daughters by revealing she had applied to Fraser Health, been assessed, then approved for Medical Assistance in Dying (MAID) in the span of a few days.

“It’s unacceptable – it took a year to get treatment but it could only take four days to die," said Christie. “I just think she didn't want to be a burden. She'd been through the system (as a nurse). She knew what it would take to get better and she didn't have that optimism."

The 61-year-old was also isolated from many of her loved ones due to the pandemic, when scaled-back medical services were difficult or impossible to access.

One of the haunting questions when I was working on this story - would Donna Duncan have spiraled downward if #Covid_19 hadn't interfered with her post-concussion therapy?https://t.co/MbDTeCFvYA @CTVNews #assisteddeath #MAiD #conussion #mentalhealth #centralsensitivitysyndrome

— Avis Favaro (@Avis_Favaro) April 27, 2022

SCRUTINY ON MAID PROCESS

Fraser Health insists it followed all procedures and that it “abides by current federal legislation which states that Medical Assistance in Dying is provided only to legally eligible patients.” The health authority says it works “with eligible patients to ensure they fully understand the steps involved in Medical Assistance in Dying so that they can make an informed decision.” 

The family made a complaint to the College of Physicians and Surgeons of B.C., which replied that the matter was outside the Health Professions Act and therefore not in its jurisdiction. The college suggested it would be more appropriate for police to probe the situation under the Criminal Code of Canada.

Abbotsford police confirm their Major Crimes Unit is investigating, but would not provide a timeline for their work, asking that the public “please allow the investigative team some time to complete their work.”

EASIER TO CHOOSE DEATH?

Initially, Canada’s MAID legislation required that a patient who was physically suffering also be diagnosed with a terminal illness, known as the Reasonable Foreseeability Clause. Despite the objections of several groups, that’s no longer the case, and observers and advocates alike see Duncan’s case as an example of “slippery slope” concerns coming to fruition.

“Living with something like a brain injury and even other kinds of disabilities that can cause cognitive issues, you can find yourself in some really dark places and sometimes it's really, really hard not to give up,” said disability advocate Lucia Lorenzi, who is a brain injury survivor herself.

“It's really hard not to imagine not having to keep fighting with the medical system to get the care you need.” 

Lorenzi described the reaction to Duncan’s death among the disabled community as grief-stricken and fearful, particularly given the increasing strains on the health-care system. 

Analysts also point out that there are other examples of British Columbians who weren’t able to access adequate medical care through the public system, and the legislation does not require someone follow medical treatment to improve their condition before seeking MAID.

“They fight every day for an assisted life and they feel they're just now being offered an assisted death,” said UBC School of Social Work professor Tim Stainton.

“No province offers a disability benefit that comes even up to the poverty line, so being disabled probably means you're poor, probably means you're struggling every day to get the supports you need to live."

He adds that Canada is now one of the three most permissive countries when it comes to assisted suicide, with an anticipated further expansion of the legislation to those with mental illness (and no physical illness) next spring.

“We have known for a long time we have a mental health crisis in this country and we have inadequate supports," Stainton pointed out, urging all Canadians to pay attention to the discussion.

"This is not a far-out idea that happens to other people, this is and will affect every single person," added Alicia, who’s vowing to advocate for better safeguards to spare other families further heartache.

“We need to be treating people instead of ending their lives."