Currently, the Senate of Canada is reviewing Bill C-7 as it seeks to understand the implications of further expanding medical assistance in dying, known as MAiD.
Some of the proposed amendments contained in Bill C-7 are in reply to the 2019 decision of the Quebec Superior Court in Truchon v. Procureur général du Canada. As a Canadian physician and anesthesiologist working in the United States, this debate is of interest to me. I was a witness in these Senate hearings because I am an expert in the opposition to lethal injection, the most common form of execution in the U.S. To be clear, my expertise is relevant to MAiD not because it is considered akin to the execution of prisoners in its essence, but because the pharmaceutical and medical methods used are quite similar.
Most often, death by lethal injection is a rather bloodless event. Witnesses can't see much. I speak from experience: I was witness to an execution at the request of the inmate since I had been an expert in his legal defense, and the death appeared peaceful.
My perception of this changed, however, when I was given a file of autopsy reports on inmates executed by lethal injection. Upon review, I noticed a striking and surprising finding: almost all autopsies revealed that the lungs had filled with frothy fluid. This occurred if the execution was by an injection of either pentobarbital or midazolam. I reviewed the autopsy of the execution that I had witnessed and found that, although I had seen no outward struggle, the inmate had developed the striking lung congestion I had noted in others.
Since then, I have reviewed a number of published MAiD protocols and found an additional striking factor: MAiD includes the use of a drug that paralyzes the body, making it impossible to breathe or to move. These drugs do not block the sensation of pain or the awareness of being paralyzed. Notably, the use of paralytics in execution by lethal injection generally has been abandoned because of its obvious cruelty.
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