MAiD in Canada (plus a few personal notes)
People have been committing suicide when terminally ill or in terrible pain for a long long time, and it’s sad and troubling although understandable. But health care institutions and the state haven’t usually been involved until more recently. When they are, it seems that nightmare scenarios turn up with some frequency.
Consider the case of 83-year-old Brigitte Stegemann, whose assisted suicide under Canada’s MAiD program sounds more like it may have been a murder. It’s necessary to read the whole thing to understand the story, but the gist of it is that the elderly grandmother seemed to have lacked the ability to understand what MAiD was intending to do, and she was nowhere near the point of agreeing anyway:
… [A]ccording to [her granddaughter and primary caregiver] Kranendonk, her grandmother still had a good appetite even following a stomach cancer diagnosis, and rejected the idea of using MAiD when it was presented as an option.
Everything changed, however, in June when Kranendonk left to go on a 10-day road trip with her husband.
… [O]n July 3, near the end of her trip, Kranendonk said she received a call informing her that the home planned to arrange a MAiD assessment for Stegemann, despite her grandmother previously telling her that she did not want an assisted death.
Kranendonk said, according to The Daily Mail, that when she returned, she asked a nurse at The Pearl about who had initiated the MAiD conversation. …
When Kranendonk interjected and said, “She doesn’t understand what you’re saying,” the doctor allegedly looked at Stegemann and said, “We’re going to make sure you won’t have any more pain.”
According to a doctor, Stegemann was “deemed fit for MAID, and we’re going to proceed,” The Daily Mail reported.
It’s a chilling story, one of many under such programs. It has a special resonance for me at the moment because, although the details were very very different from that of Brigette Stegemann, I have recently experienced what it is like to feel that a hospital gave up on an older patient prematurely and to have nearly all my input and all my requests fall on deaf ears.
The distinct impression I got was that, once my ex-husband became very ill (at least in part because of what I consider to have been doctor negligence), many of the doctors seemed to ignore the fact that I kept telling them that his quality of life prior to this surgery had been pretty decent despite his Parkinson’s, and that he had been living completely independently.
I never got the impression they believed me. They didn’t seem to be able to adapt by changing interventions. Their concern seemed fake and unctuous, and it was combined with a condescension and early pessimism that were infuriating.
The hospital has a good reputation. Would another have been better? I’m not at all sure, and at any rate I didn’t know how to find that hospital or how to accomplish a transfer. The hospitalist system, in which doctors (some of whom don’t have particularly good English skills) rotate constantly, is extremely frustrating as well. The doctors didn’t take much time with my ex, and I’m virtually sure they didn’t read the bulk of the notes on his case. With a long hospital stay (three and a half weeks from relatively good health to death), the number of notes became enormous and would have taken hours to plow through.
No hospitalist was going to do that, and therefore in my opinion they missed what was really going on. Nor did they particularly care about a patient whom they barely saw – and would not be likely to see again after their days or week on that floor ended and they rotated out again. My distinct impression was that they wrote him off very early on and spent a great deal of time sending palliative care doctors to speak to me and try to convince me to write him off, too.
If I sound angry, it’s because I am.
When my dad died 20 years ago it was a four month ordeal that started with him still working full time and deteriorated to multiple hospital throughout western WA and being as meticulous as I am at some point I started keeping track of the number of doctors (hospitalists and a few specialists) that we knew actually saw him and it was like 25 or something and it was not uncommon for one to give completely opposite info from the one the day before or just offhandedly mention some other diagnosis that no one had ever mentioned before and would never mention again.
Would it have changed the end result in his case? Probably not but it sure didn’t help and it led to a lot of stress and confusion for all of the family because we honestly did not know what to do sometimes when they would ask us.
Neo, I had an experience similar to yours when my older sister was in the hospital. It left me angry also. It bothers me to even think about it.
As an old MD who was a recent hospital in-patient, my disgust with hospitalists was increased. Hospitalists are employed by hospitals, and their first duty is to their employer, NOT to the patient. And they are remarkably ignorant though in my case they were internists (as I was and am). The hospitalists defer to the nurses, and the nurses have illness-specific protocols created by them, laced with the medical ignorance only nurses can have.
The entire system is disgusting and dangerous.
Terribly sorry for that sort of experience Neo…and especially for your former husband. I’m in and out of hospitals regularly as a visitor…not always pleased with what I see.
Problem with hindsight is it’s often 20/20 but the moment never recoverable.
As I read your updates I feared that was what you were experiencing. My family experienced something like that as first my father and then years later my mother didn’t do well after serious but routine surgeries. They each survived because we were able to take them home and manage their care until they could each get back on their feet with the help of my RN sister, her friends and family – a luxury not everyone has. It seems to me the root cause is the de-personalization of medicine where care decisions are made by insurance rules, computer programs and finance offices not patients and doctors who know their patient. Until the medicare/medicaid/insurance model fails I don’t see it improving. Regardless it seems to me you did a wonderful job as the best patient advocate anyone could have. We should all be so lucky.
Had a similar enraging experience. Got the distinct and overwhelming impression that they wrote off a patient whose continued existence was only going to cost the hospital money.
As an old MD, my opinion of hospitalist is quite low barely a notch above PAs and APNs. Occasionally you’ll get a good one with the name Chuck but most you would not be comfortable on an airplane with. Frequently all they do is get unrequested consultations with proceduralists who do unnecessary billable procedures. Their notes on the electronic medical record are what is known as “ note bloat” and insider term of just copying a prior note by a different specialist and adding nothing to patient care.
Things were much better when the primary care physician came to the hospital and oversaw the care of their patients. But time and financial restraint has stopped that. And now we have third rate types like el sayed “ overseeing your care”
Planned Patienthood
Infuriating and depressing. I’m so sorry you had to experience that as an advocate and your ex had to experience that as a patient. That is not *care.*
First slowly, then suddenly
Wait until the future when people are put to death at 30yo,
oh wait that was a science fiction movie I saw.
Whats next in Canada, want yo get rid of your young children? The state will do it for you.
“Bring out your dead!”
Negative progress in the healing bureaucracy. By design. It once was medicine, a different thing.
We were fortunate here. My brother-in-law was in his community hospital, a really good one, where my sister had been a nurse supervisor. He apparently suffered a stroke, and had a no-code in place, so he was placed in hospice in the same hospital with only a morphine drip and died peacefully five days later. But there was no question of recovery, unlike your ex.
To be in some place impersonal would be so frustrating. Patients are people, not numbers.
I am sorry to hear of the hospital care problems of your ex. I am reminded of a family friend whom I last saw when she was a vigorous 86, still living alone. (That’s what happens when your husbands die.) Sometime in her 80’s she was hospitalized–was it an auto accident?—where the physicians were willing to let her slowly die. Her family very strongly objected and pointed out that she had been living a vigorous life up to that hospitalization. Fortunately, the physicians relented, and she lived 10 years longer.
My uncle (76) and then his son (79) died in the same hospital, three decades apart, for reasons different from why they were originally hospitalized. My uncle got knocked down by one of his cattle when he was delivering feed to them. Broke his hip, and used his cell phone to call for help. After several weeks in the hospital, he was ready to move to an assisted care facility and get going on his physical therapy. Before he could move, he died of a heart attack .
My cousin was hospitalized for a bowel obstruction. Years of smoking had given him emphysema, though he was still able to work his sizeable farm acreage. The breathing got worse when he was in the hospital. His son and wife decided to pull the plug.
I wonder if my cousin picked up some respiratory bug in the hospital. My uncle’s heart attack—probably luck of the draw. The broken hip probably put some stress on his heart.
Neo: “If I sound angry, it’s because I am.”
And, from my own experience with family members I call tell you, that even though I don’t know all the details of your experience, your anger is justifiable.
One family member who before going into the hospital was only on ONE drug; but, when released they gave me a plastic bag filled with half empty bottles of the medicines she was given by the doctors.
There were fourteen drugs that they had her on. 14! unbelievable! Reading the side effects of these drugs I realized almost all of them “may cause drowsiness.” Basically, they were doping patients up (the elderly as she was 90 years old) so that they sleep most of the time and therefore didn’t require much care.
The news media and those on the left mocked Sarah Palin when she said that there will be “death panels” deciding who would live and who would die – but she wasn’t wrong.
I know what you’re talking about. My mother was 85 when she died but prior to that she had a good quality of life, although she had a hiatal hernia that took YEARS to get diagnosed. It was while they were running tests on her to prepare her for surgery that, because of their neglect, she aspirated. They did’t even try — they just called my sister to get permission to not do anything. I’m still angry — angry that it took so long for her hiatal hernia to be diagnosed, that they put her in a position physically where she was likely to aspirate if she regurgitated, and pretty much made sure that she would regurgitate by feeding her starchy food right before.
When she was in her mid-60s, she had a doctor who really gave her no respect. I always got the sense that he just viewed her as some whiny old lady. It was hard to find another one. He finally retired and a new one took over his practice. She was great! But then she found a better job and left.
I’m getting old and the thing that stresses me out the most is that the medical professionals will treat me the way they treated my mother.
Reminds me of Kurt Vonnegut”s “Ethical Suicide Parlors” (from “Welcome to the Monkey House”).
I get it, neo. Boy do I ever. You know my story. Hospital/physician negligence resulting in permanent damage. The anger lingers.
Your anger is understandable and just. This last December we learned what the term “plateaued” means–but sadly were not informed until our wonderful 91 year old had suffered at the hands of the system. We all suffered and it should have never played out like it did. It was a perfect storm-her doctor’s upcoming retirement being one of the factors. The plethora of “notes” is no doubt an issue. Well–we did learn some valuable truth, the hard way.
The recitations here, about shxxty medicine practiced IN-HOSPITAL by useless MDs, brings back bad memories. I tried, long ago, to get an alcoholic (drinking on duty) MD kicked off my hospital staff, No go, I was told. The powers that be blah blah blah. Gotta wait til harm was done!
It’s a machine. Once you get on the conveyor belt, good luck getting off.
They are Doctors! How dare the peasantry question their decisions.
I am so sorry, Neo. My father, who also had Parkinson’s as well as other conditions, endured multiple hospitalizations over many years before he finally died of a complication not directly related to the Parkinson’s. Over and over we encountered doctors who didn’t listen, made assumptions, contradicted each other, looked down on us and gave no hint that they cared. Sometimes nurses were more helpful, sometimes not. I remember pleading with a neurologist to believe that my father, then suffering from a not-yet-diagnosed brain abscess and as a result behaving oddly and speaking incoherently, was NOT senile and had, two days before, been reading the New York Times as he did every day and, as he also did every day, discoursing at unreasonable length with clarity and perspicacity about every word he’d read. The doctor didn’t quite roll his eyes but clearly wanted to. All this happened on a Friday and over a weekend — never, ever get hospitalized on a weekend. It wasn’t until Monday came and we were able to get my father’s actual neurologist to call the hospital that they did anything to help him, starting with finding the abscess.
This changed in my father’s last few years when an old friend of ours became his family doctor, even though he was no longer accepting new patients — an act of kindness growing out of our long friendship. He stood up for us, listened to my dad, listened to us, spoke to us with honesty and concern, communicated with the various specialists, put up with us when the group of us siblings disagreed with one another and made things confusing, said wise and healing things when there was nothing medical left for him to do, and generally showed what a doctor can be. I suspect he was also praying for us, though he never said so. If only they were all like that, or at least a few more of them.
I’m so very sorry, Neo, that this happened to you and to your ex. Our medical system, like too many of our institutions, is an unbelievable, seemingly irretrievable mess.
There was a little girl
There was a little girl,
Who had a little curl,
Right in the middle of her forehead.
When she was good,
She was very good indeed,
But when she was bad she was horrid.
–Henry Wadsworth Longfellow
___________________________________
Kinda how I feel about American medicine.
Oh Neo, that is hearbreaking and infuriating. I am so sorry to hear this.
Long story short, my siblings and I rescued our 93-year-old father from the Cleveland Clinic, where he had acquired both flu and pneumonia in the course of what should have been a brief stay for another issue. As we were leaving, one of the nurses quietly told me that if my father had been suffering from a cardiac issue, he would have been in right place; otherwise, the nurse said, the world-renowned Cleveland Clinic is “just a hospital.”
The Cleveland Clnic literally left my father to die. He went on to live another 18 months with excellent quality of life, and in relatively good health for his age.
I suspect most Americans have a horror story or two about their experiences with the medical establishment.
Current advice is that all patients should have an advocate standing up for them in the process.
However, that is no guarantee, as the account of neo and her ex-husband demonstrates.
As a geriatric specialist I cared for my own hospital patients for 30 years and I was their advocate. The hospital pushed our group out for the hospitalists because they were more efficient. !! All about control. !! They answer to the hospital administrators lowered length of stay. I did not think the patients would put up with it but they had no choice!! The specialists love it because the hospitalists are the scut puppies they discharge the patients and talk to the families!!! My patients were mine even after discharge!! They were my total responsibility!! So sad !!!
A previous doc of mine since retired , said don’t go to hospital unless you got a broken bone or gsw. If you get trapped in one never stay unless you have someone there with you to fight for you.Avoid doctors as much as possible.make friends with the emts call them instead .
He was a retired AF flight surgeon , overweight cigar smoker , hard to replace .
Neo, you have had two losses within a short time. I pray that you will find consolation in the many kind words from your friends and regular readers.
Years ago I took a course in Jewish medical ethics. The first section, taught by Orthodox Rabbi David Bleich was about the absolute value of human life even when it comes with great suffering. The idea of “medical aid in dying” is absolutely abhorrent to me, partly because of what I learned but also because as we have seen in Canada there will always be mission creep.
In the past one could trust that a Catholic hospital would hold to the old values but now Catholic hospitals are often “founded by nuns but currently just part of the system”. Look at the lawsuits concerning Catholic orders which offer end of life care. Alas I have no idea where the old Jewish-founded hospitals stand. I’m guessing they are now constrained by the same economics as the formerly Catholic hospitals.
There have always been physicians who would quietly assist those who wanted a medical suicide. The awful and dangerous change was allowing it by law. It can only lead to an end point at which individuals will be required to register for a death when they reach a certain age. Didn’t one of obama’s advisors say 75?
Here’s a follow up question: as the U S Muslim community grows I wonder if we will see Muslim hospitals that follow sharia. I don’t know for sure but I think sharia would not allow maid. I can imagine that various state laws might just find a way to accommodate sharia hospitals.
I was married to a doctor. Omaha has two academic medical centers. I know a bit about the medical system and how it has changed.
It used to be the case that corporations couldn’t own medical practices. Doctors just had privileges to admit and treat at a hospital. That’s radically changed and many doctors are now hospital employees. We used to say that they were “owned” by the hospital.
My best friend from high school’s older brother is a doctor; Notre Dame undergrad and Creighton medical school. He was a hospitalist in KC. Some suit told him he had to work more hours and so he quit. Quit on the spot; two weeks’ notice.
And it is a complete scandal with the number of FMG’s in America. Part of the problem is that medical schools have failed at expanding their class size. Creighton doubled its class size by starting a new medical school in Phoenix. Just another reason why Creighton is the greatest enterprise in the world today. Santa Clara and Xavier are starting medical schools. All Jesuit schools. No urgency at the state schools. More interest in research than in teaching.
Notre Dame, on the other hand, is the richest Catholic university in America and they sit on their endowment.
I really don’t like the push to hospitalists especially with the also increasing number of RNs with extra training as primary care providers.
I liked having an actual doctor that knew me and my condition to come regularly into the hospital to see how my care was going. The more impersonal whoever wanders by to read the chart today, the less likely they will care if you die.
Additionally no doctor in the US should have limited English skills.
Nearly everything wrong with US hospitals and medical care is due to Obamacare. It was a horrible law in many more ways than just the insurance aspects.
Cardiologists take care of hearts.
Dermatologists take care of skin.
Pulmonologists take care of lungs.
Hospitalists take care of hospitals.
West TX Intermediate Crude:
That does seem to be the case.
martin:
They don’t know the patient and for the most part they don’t seem to care about the patient.
However, one of the hospitalists I encountered taking care of my ex did seem caring. Unfortunately, he’s the one who made a medication error.
Nearly everything wrong with US hospitals and medical care is due to Obamacare.
==
This is a perfectly antic remark.
Didn’t one of obama’s advisors say 75?
==
Ezekiel Emmanuel. It was pointed out by Mr. Sailer that Dr. Emmanuel had an elderly father who hung on a loooong time. Emmanuel is now 66. Mr. Sailer was predicting his opinion would ‘evolve’.
Fake, unctuous and condescending. Boy, does that sound familiar. My younger sister was hospitalized when she was about 60 years old. Mind you, with the exception of an older sister who was taken from us at 54 by cancer, the rest of the family made it to right around 80. So it took me a day to get to the hospital and by then she was heavily sedated. The head nurse told me several times they couldn’t have their bed tied up for a hopeless case, and her situation was hopeless. They wanted family permission to give her a heavy dose of drugs to suppress her breathing and let her pass. It all sounded so simple and clinical. Her children looked to me for advice, I told them they were more familiar with her situation since I hadn’t seen her in at least five years. The nurse kept saying there was no hope of her recovering and they needed the bed. The children agreed it was time for her to go if she was not going to regain consciousness. I did not participate in the decision, but did not object as I was so out of touch with her previous history. They each bade their farewells and the nurse shot a large dose of a heavy sedative into her IV and she was gone in minutes. And they had their damned bed available in another hour. It all felt terribly uncaring. She was a number, a box to be checked. And it was done.
I will admit she had not taken care of her health, so perhaps we were getting the most reasonable advice possible. But it sure didn’t feel like it at the time.
F:
What a sad and horrible story.
At least with my ex it wasn’t that bad. Nor did they ever talk about needing the bed, although it’s possible they did want it.
Neo, I am so so sorry that you experienced all that.
I suspect you are completely correct as to what happened with your son’s father.
This is the medical “system” created intentionally by Obamacare, which empowered insurers and systems to dictate “care.” (Which is now unaffordable too.)
We have seen clearly the dangers that having physician’s pay checks come from someone other than the patient with Covid. Pretending there was no effective outpatient care; recommending boosters that cause myocarditis, clots, strokes and MIs–
and now, you’ve experienced the lack of aggressive care for elders/disabled/impaired that is the inevitable result of a system committed to optimal financial outcome, not patient outcome.
The hospitalist system is a disaster; the electronic medical record is a disaster–it’s a billing tool, filled with information and untruths that have to be “documented” to bill; MASSIVE amount of words–templates and cut and paste– that yes, no one physician can EVER read.
When my ward was an inpatient, I found that I–a Harvard trained and former staff physician–had the most effective input to his care (which in hindsight was entirely managed by myself) through the social worker.
She was tasked with getting him out the door, so would get the consultants to do what needed to be done, so he could live–and ultimately leave.
She was infinitely more effective than the day’s hospitalist.
We live in the world our ignorant, immature, non-reality based friends, with their suicidal empathy and lack of understanding of basic economic principles (thus vote D) have created.
It can be remedied–but not likely in time for most of us. But hopefully for our kids and grands.
F-
I yield to no one in my cynicism about the American health care system, but your story beggars belief.
If a nurse told you they need the bed, and your sister was not in obvious distress and nurse gave her a med that suppressed breathing and she then died, that is First Degree Murder. Not manslaughter. Not a mercy killing. Capital murder- doing an act intentionally with the knowledge that it will cause death. Aggravating factor: it was done for financial gain (hospital had another customer who needed the bed).
I’m not saying that it did not happen. If it did, that nurse should be turned in to local law enforcement- there is no statute of limitations for murder.
Friends, we are not going to change the system.
But, we can learn to operate more effectively within it.
My experience is caring for my elderly father.
Things have gone better in the hospital when:
I’ve been there 22-23 hrs/day. The sleeper chairs are passable.
I’ve been up-to-date w/ his conditions, so I can quickly say yes to procedures.
I’ve made my focus keeping him calm and comfortable. Telling nurses how he likes things done. “Go a little slower and you’ll get a lot less resistance.”
.
More wisdom, please.
@ AppleBetty > “Things have gone better in the hospital when:
I’ve been there 22-23 hrs/day.”
We have done that with both our parents: my sisters-in-law did the bulk of care for my mother-in-law (frequent but short hospitalizations over a number of years), and my older sister and I rotated with our mother in her final illness That comprised 4 months mostly at home or in the local long-term-care facility, and then a week in the hospital with pneumonia. Someone was with her continually, and took care of the simple things (ice, water, conversation, lights, tv etc.) so the nurses only had to do the medical things. I did catch one aide about to give her the wrong pill – we made careful note of what the usual ones looked like.
She expired naturally, and no one offered to “help” her exit along; this was in 2010, so before the trend became so rampant.
BTW, despite being seen by her doctor, physician assistants, care facility staff, and cancer centers for radiation treatment of a recently discovered lung cancer, NO ONE suggested we get her a pneumonia immunization BEFORE she was hospitalized, despite that being a frequent side-effect of the radiation.
In retrospect, we should have omitted those treatments, as they were very uncomfortable for her, probably useless at her age, and probably the real cause of her death.
IOW, get your pneumovax promptly if not already done; it is not one of the “suspect” jabs AFAIK.
https://www.coffeeandcovid.com/p/last-ditch-friday-september-25-2026
“Your roundup includes: the New York Times watches the presidents of the two most powerful nations on Earth meet at the White House and files two thousand words about the press pool; the Boston Globe’s biggest story of the year, in which a KN-95-mandatory lesbian bar in Western Massachusetts tries one mask-optional night to make rent and gets denounced by its own regulars, a Zoom mob, and the Communist Party; 1,600 federal investigations, 32 federal charges in four weeks, and twenty more arrests in Florida as noncitizen voting finally becomes a “tier-one priority”; and the NIH’s new vaccine-injury research center, which could open by mid-October and which you probably heard about only here.“
“The MAID in the hospital with the crow bar”
Sarah Hoyt weighs in on whodunnit to her (almost).
https://accordingtohoyt.com/2026/09/24/the-problem-of-suffering/
A couple of corollaries for the above from Sarah’s commenters.
The first is truly frightening.
B. Durbin says:
September 25, 2026 at 5:22 pm
I found a substack read on Canada’s death loop, specifying how their implementation of MAID has set up a ratchet to ever-tighten down and increase the numbers. Kind of horrifying, especially as it’s worse than just the bare existence of MAID to begin with.
https://markatwood.substack.com/p/the-peculiar-institution
**********
Caroline Furlong says:
September 24, 2026 at 4:00 pm
My answer to euthanasia is the same one that Gandalf gave to Frodo about Gollum:
https://www.goodreads.com/quotes/7475611-i-am-sorry-said-frodo-but-i-am-frightened-and
“I am sorry,’ said Frodo. But I am frightened; and I do not feel any pity for Gollum.’
You have not seen him,’ Gandalf broke in.
‘No, and I don’t want to, said Frodo. ‘I can’t understand you. Do you mean to say that you, and the Elves, have let him live on after all those horrible deeds? Now at any rate he is as bad as an Orc, and just an enemy. He deserves death.’
‘Deserves it!’ I daresay he does. Many that live deserve death. And some that die deserve life. Can you give it to them? Then do not be too eager to deal out death in judgement. For even the very wise cannot see all end.” – The Fellowship of the Ring by J.R.R. Tolkien
If Gollum deserves Pity and Mercy to live, how much more does the bedridden grandmother or the grief-stricken husband? How much more the depressed teenager or anxiety-riddled mother? How very much more the innocent unborn child, or the one newly entered into the world?
Yet the same people who would clamor to give Pity and Mercy to multiple Gollums time after time would see death as the greater Pity and Mercy for the innocent relative to the guilty. NO. It’s good enough for everyone or it is good enough for no one. You don’t get it both ways! :raises sword: Forth Eorlingas!
First, I am deeply saddened by your story and by the stories I’m reading in the comments; I’m so sorry for what you all (and your loved ones) went through.
As an attorney in the medical malpractice defense field, I get more horrified by the week by the so-called healthcare system. I agree with all the comments about the need to have family members visit the patient and advocate for them in person every day.
At the same time, I have compassion for doctors. I think they’re caught up in a system that doesn’t really allow them to use their intelligence and think critically.