Only Going To Get Worse

Robyn Urback writes:

When the Canadian government passed legislation nearly a decade ago to approve medical assistance in dying (MAID), it was an exercise in compassion. A competent Canadian adult suffering from an “irremediable medical condition,” whose death was “reasonably foreseeable,” would no longer have to suffer; MAID would offer a way to avoid the unnecessary pain, the loss of dignity and the loss of autonomy that often comes with natural death. In narrow circumstances and with strict safeguards, MAID could expedite a process that was already occurring.

Since then, MAID has morphed from being a last resort to an option among many: a path for those suffering from chronic illnesses or disabilities, a suggestion for those experiencing suicidality, and even a choice offered to veterans seeking assistance from the federal government.

In 2019, Quebec’s Superior Court struck down the part of the law that limits MAID access to those whose death is “reasonably foreseeable,” and with that move it inadvertently changed the concept of state-assisted death as a matter not simply of personal autonomy in how one chooses to die, but a matter of how and if one chooses to die. Along with its failure to establish clear and stringent safeguards, and clear and stringent guidelines, Canada is seeing a worrying trend whereby the poor, the vulnerable and those with disabilities are disproportionally accessing MAID.

A recent report released by Ontario’s chief coroner into MAID deaths involving dementia patients offers stark examples. One case reviewed by the MAID Death Review Committee (MDRC) is that of a woman in her late 80s with “cognitive impairment” whose “wish to die” was brought forward by a family member.

This woman, who is referred to as Mrs. 6F, experienced multiple falls and was admitted to hospital where she was diagnosed with “moderately advanced dementia.” It was during that admission that a family member told her care team about her desire to access MAID, and though a referral was made and a discussion had with a MAID practitioner, she opted to transition to long-term care at that time instead.

Approximately four months later, a family member again made a referral for MAID on her behalf. A MAID practitioner assessed her eligibility – with a family member present – and determined that Mrs. 6F “met the criteria for an incurable condition, citing advanced dementia, chronic comorbidities, and terminal frailty.” The practitioner only made “limited evaluation of Mrs. 6F’s cognitive impairments,” and facilitated a third-party signer, since Mrs. 6F attempted to sign the form but was unable. As is required, a secondary assessor evaluated the woman and approved MAID for the following week.

On the day of the procedure, Mrs. 6F became “overwhelmed” by the number of visitors in her room and several were asked to leave. The report noted that “final express consent was determined based on Mrs. 6F’s ability to repeat the consent question and via squeezing the provider’s hand.”

This is an edge case, obviously. We know that the vast majority of MAID provisions in Canada are carried out for those whose death is “reasonably foreseeable” (95.9 per cent in 2023), with the majority suffering from cancer. But those trends are irrelevant if even one person is being effectively euthanized under laws created by the state. Did that happen to Mrs. 6F? We don’t know. But we do know that her MAID referrals were made by a family member and that she was assessed with a family member present, which would lead reasonable people to wonder if pressure from family played a role.

It’s also reasonable to wonder about the extent to which Mrs. 6F had capacity to consent to a life-ending procedure; her ability to repeat the consent question could have been an expression of understanding, or simply a symptom of echolalia, which some dementia patients experience.

We don’t have answers, but the point is that when someone’s life is being ended for them, these lingering questions should not exist. According to the MDRC report, 103 MAID deaths were reported between 2023 and 2024 where dementia was the primary condition. Among those cases was one where a man in his 80s with an Alzheimer’s diagnosis was evaluated by both MAID assessors on a day when, according to the report, he was experiencing delirium. It’s impossible to say how many more MAID provisions have been carried out on individuals experiencing some form of cognitive impairment.

It’s clear that Canada has lost the plot on MAID. What started out as a compassionate option for those in advanced stages of dying has morphed into a state-sanctioned death apparatus for anyone – and/or their family members – who knows how to navigate the loose safeguards that are supposed to ensure that this life-ending procedure is carried out with the utmost caution. There is a word for ending someone’s life without their informed, lucid consent, and it’s not “compassion.”

Those who want that over here are already doing as Rachel Charlton-Dailey describes:

The Department for Work and Pensions (DWP) has had to admit that delays on one of its benefits helplines could be contributing to a rise in claimants harming themselves. Mind you, they’ve only done it because they’ve had to, and of course, they haven’t admitted this publicly. 

DWP begging for help with a problem they cause

In the last few weeks, the DWP has sent out an urgent appeal to stakeholder groups, including advice agencies and charities, asking for their help to solve “pain points” experienced by Employment Support Allowance (ESA) Claimants who have to deal with distressing delays and waits when they call the DWP for help.

The email to stakeholders, shared by Benefits and Work, said:

We are interested in identifying the pain points faced by ESA customers communicating with DWP, particularly issues surrounding telephony and the pain points our customers face when contacting DWP by phone.

The department reports that the number of calls they are receiving, particularly from worried ESA claimants, is increasing rapidly, creating “unresolved backlogs”. However, they can’t seem to put two and two together at that place because they also say:

the link between backlog management, operational decisions, and customer behaviour isn’t fully understood.

I dunno man, mentally and physically disabled people having to suffer through agonising waits to speak to someone who’s supposed to help, while every single day they’re told by the media and politicians that they’re all useless scroungers? Nah, I can’t figure it out either.

Claimants in danger while the DWP lies about customer satisfaction

The DWP also scarily admitted that far more calls require an intervention, and that it’s their fault:

Additionally, 6 Point plan intervention during these phone calls are rising across all service lines, potentially due to delays impacting the customer experience.

The six point plan is a series of steps DWP staff are required to follow if a claimant tells the operator that they intend to harm or kill themselves. The plan includes grabbing a colleague to support them in the call, finding out information from the caller to gauge the level of risk they are in and then providing referral advice or calling the emergency services.

However, as Benefits and Work points out, this appeal to stakeholders is in direct opposition to the DWP customer experience survey results, which the department posted on 25 September.

The findings of the survey were, as ever, wholly positive bordering on delusional – with an astounding 80% of customers (apparently) saying that it was easy to use DWP services. 80% also said they were satisfied with the time it took DWP to tell them the outcome of their new claim or change of circumstances. With an incredible amount of backlogs, this seems absolutely ridiculous.

Begging stakeholders for (unpaid) help

The survey, of course, makes no mention of distress and especially nothing about how many claimants want to kill themselves after the way they’re treated on the phone, but would a public survey mention that? Instead, they’re pretending the DWP is hunky-dory while they’re begging stakeholders for help.

The email continues:

We believe that our shared clients’ experiences are crucial to shaping a better system. Their stories of dealing with DWP processes will help us identify not only practical pain points but also the emotional toll that service delays can have on their lives. We are especially interested in capturing their feelings, anxieties, and any challenges they’ve faced when interacting with these systems.

The department has asked stakeholders for an incredible amount of unpaid labour here. They want to know what claimants are telling the advice lines and charities about:

• Experiences of contacting ESA/New Style ESA telephony service lines.
• Any difficulties or frustrations they’ve had when interacting with ESA.
• Any barriers or challenges faced when liaising with ESA.
• Their feelings, anxieties, or positive experiences with these systems and services.
• Suggestions on how these processes could be made more accessible, user-friendly, and emotionally supportive.

The scale of this problem is even worse than the DWP cares about

While, seemingly, this is a positive thing that the DWP are trying to find new ways of supporting claimants, the fact that they’re keeping it so secretive whilst pushing out bullshit about how satisfied customers are is troubling. There’s also the fact that at every turn the DWP is against claimants and does not work in their best interests.

We don’t yet know the scale at which delays are causing ESA claimants to harm themselves, but if it’s bad for claimants who are still on ESA, imagine what it must be like for those having to deal with the disastrous and cruel DWP whilst they’re being forced to migrate over to Universal Credit. You can also guarantee that with the increase in media-fueled benefits hate, the scale at which it’s unreported will be even higher. 

One thing’s for certain, it must be fucking bad if the DWP are actually seeking help for it, because the department is responsible for an untold number of deaths that they have for many years tried to cover up.

And, if you set aside the unfortunate opening sentence:

Not content with ruining trans people’s lives, Wes Streeting has turned his attention to disabled people, too. The Secretary of State for Health and Social Care has ordered a review into the increase in mental health and neurodivergent conditions, to decide whether they are over-diagnosed.

Streeting played a significant part in getting the current welfare cuts pushed through in government. Back in March, he said “there’s too many people being written off” and that there was an “overdiagnosis” of mental health conditions. He also fully backed the cuts to PIP, which were squashed due to a backbencher rebellion.

Streeting appoints dangerous professor to lead bullsh*t mental health review

Benefits and Work reported that the review was announced in the Health Service Journal, and that even more worryingly, a highly controversial figure will play a huge part in it. The review will be vice chaired by the professor The Times dubbed “the most hated doctor in Britain”, Sir Simon Wessely.

The Professor of Psychological Medicine at the Institute of Psychiatry, Psychology & Neuroscience at King’s College is widely disliked due to his research, which led to the societal belief that ME/CFS is primarily a psychological condition. This work and his subsequent media appearances, during which he spouted this rubbish, meant it became harder for people with ME/CFS to be believed and have their pain taken seriously.

It also made it much more difficult for them to advocate for their own care and put many in danger. On top of this, the shift in attitudes it caused meant it was harder for people with ME/CFS to gain support at work and claim benefits.

Last year The Canary’s Hannah Sharland reported that Wessely was one of the reasons that ME campaigners were denied an inquiry into the treatment of people with ME who are left to die in hospitals. Wessley had managed to weasel his way onto the Judicial Appointments Board, the body which appoints tribunals and inquiries.

Wessely also played a part in the PACE trials and was a big force behind CBT and entrenched GET becoming the main treatments for ME/CFS. he also holds an astonishing amount of power within the medical world. As Sharland points out, he was president of the Royal College of Psychiatry and the Royal College of Medicine. The Queen and King’s College London (KCL) awarded Simon Wessely the first Regius Professor in psychiatry, a special title bestowed by a monarch. In 2017, Theresa May asked him especially to reshape the Mental Health Act, he now also sits on the NHS board.

Not a surprise from a government that wants disabled people dead

However, his appointment hasn’t come as a surprise to disabled people. For a long time now the government have been working hard to sow distrust of benefits claimants into the public consciousness – the latest line being that it’s too easy to claim for mental health and neurodivergent conditions.

Just last Wednesday, as The Canary reported, Keir Starmer ramped up the hatred of benefit claimants with mental health conditions. Starmer told Radio 4 last week that “there is a moral case” for changing who is eligible for out-of-work disability benefits and that in particular he was “concerned” about how many young people were out of work with mental health conditions. 

He said:

I have to say I’m particularly concerned about young people. In this regard, there are about a million young people who are on benefits, not all for mental health issues, but quite a number for mental health issues.

I think that is wrong and I don’t just say that because of the spending implications, I say it because if you are on benefits in your 20s, it is going to be extremely difficult to get off benefits for the rest of your life, it is not good and there’s a million young people in that position so there is a moral case for changing that.

As Benefits and Work pointed out, one of the main criticisms made after Labour failed to push through benefit cuts at the beginning of the year was that ministers had failed to create well-researched arguments for reducing PIP eligibility. It’s clear that reports like this will lay the groundwork for doing just that.

At a time when Labour are more focused on savings than actually providing support for disabled people, it’s clear that any research into over-diagnosis is already a foregone conclusion. With someone like Wessley on board, it’s only going to get worse for disabled people.