Anorexic woman, 47, who weighs just 92 pounds candidly lays bare her plan to DIE under Canada's new assisted death laws: 'Every day is hell. I'm done'
A woman who has wrestled with anorexia for decades has opened up about her decision to die as soon as Canada expands its criteria for medically assisted death.
Lisa Pauli, 47, shared that she has had a warped relationship with her body since she was eight years old and has been struggling with an eating disorder for nearly 40 years.
She now weighs 92 pounds and may go days without eating solid foods. She explained she is too weak to carry groceries home without stopping for breaks, describing her life as a living 'hell'.
'Every day is hell,' she told Reuters. 'I'm so tired. I'm done. I've tried everything. I feel like I've lived my life.'
Lisa Pauli, 47, from Canada, has been struggling with anorexia for nearly 40 years and plans to die as soon as Canada expands its criteria for medically assisted death
Pauli has had a warped relationship with her body since she was eight years old
Pauli cannot legally get medical help to die - yet.
An expansion of the criteria for medically assisted death that comes into force in March 2024 will allow Canadians like Pauli, whose sole underlying condition is mental illness, to choose medically assisted death.
Canada legalized assisted death in 2016 for people with terminal illnesses and expanded it in 2021 to people with incurable, but not terminal, conditions.
The legal changes were precipitated by court rulings that struck down prohibitions on helping people to die.
The new mental health provision will make Canada one of the most expansive countries in the world when it comes to medical assistance in dying (MAID), according to an expert panel report to Canada's parliament.
Pauli first raised the idea of assisted death with psychiatrist Justine Dembo in April 2021.
Dembo served on an expert panel on assisted death and mental illness that presented a report to Canada's parliament last year. She assesses people for MAID, although on that visit Pauli was seeing her for body dysmorphic disorder.
Pauli has tried a multitude of treatments and has been hospitalized twice, but she said she still thinks constantly about what she has eaten and what she will eat.
Pauli weighs 92 pounds and may go days without eating solid foods. She explained she is too weak to carry groceries home without stopping for breaks
Last month, DailyMail.com exclusively revealed that Canada had seen a 35 per cent rise in euthanasia deaths in 2022
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Dembo told Pauli she could be eligible for assisted death once Canada's law changes.
'She's undergone very high-quality treatments and they just have not made an impact,' she said.
When Dembo assesses people for MAID, she said, she treats it as 'a last resort,' and tries to determine whether they have received all available medical and social supports.
Pauli said she plans to apply for MAID once she is eligible - however when she first broached the possibility of getting help dying, her mother Mary Heatley could not accept it.
'The wind knocked out of me... I just couldn't imagine her not being in this world,' she said in an interview.
But Heatley talked to her daughter and realized what she was going through.
'She just could not foresee another 10, 20, whatever years of this, living with this eating disorder,' she said.
'I say to myself, "You have to try and remember. This is what she wanted. It's her life." And I would just have to go on without her.'
Canada has one of the world's most permissive assisted suicide programs.
Proponents of assisted death - which is still a novel concept in many parts of the world - say it is an issue of personal autonomy, however critics insist the country is on a perilous road to mass euthanasia and ever-more pressure on the sick, disabled and poor to end their lives prematurely.
Alex Schadenberg, director of the Euthanasia Prevention Coalition, said euthanasia rates were 'skyrocketing' because a 'heavy promotion of MAID within our medical system' had 'normalized' lethal injections.
'Every major healthcare institution has a MAID team which will literally approach everyone who may qualify for MAID and ask them if they want to die,' Schadenberg told DailyMail.com in June.
Six disability rights and religious advocates told Reuters that the pace of the planned changes to the assisted death framework in Canada brings additional risks of people opting for MAID because they are unable to access social services - the lack of which could exacerbate their suffering.
'Every day is hell,' Pauli told Reuters. 'I'm so tired. I'm done. I've tried everything. I feel like I've lived my life'
Pauli has tried a multitude of treatments and has been hospitalized twice, but she said she still thinks constantly about what she has eaten and what she will eat
The number of MAID deaths in Canada has risen steadily by about a third each year from the previous year
Last month, DailyMail.com exclusively revealed that Canada had seen another record-busting year of euthanasia deaths, with a 35 per cent rise to some 13,500 state-sanctioned suicides in 2022, according to an analysis of official data.
However Canada's Justice Minister David Lametti has dismissed criticism that the country was moving too fast or opening up the system to abuse.
'We have gotten where we are through a number of very prudent steps,' Lametti said in an interview with Reuters in June. 'It's been a slow and careful evolution. And I'm proud of that.'
In 2021, the most recent year available, 10,064 people died through medically assisted death, about 3.3 percent of deaths in Canada that year.
That is compared to 4.5 percent in the Netherlands and 2.4 percent in Belgium, where assisted dying has been legal since 2002, according to each country's official data.
The vast majority of assisted deaths in Canada conformed to the legal rules but provincial authorities deemed a small number worthy of investigation, according to previously unreported provincial government data. Provinces and territories are responsible for health care in Canada.
In 2021-2022, Quebec found 15 assisted deaths, 0.4 percent of the total, did not follow the rules. The province referred the cases to Quebec's self-governing medical body and medical facilities, provincial spokesperson Marie-Claude Lacasse said.
In six of those cases, the person did not have a serious and incurable condition, according to a provincial commission.
Government officials in British Columbia have referred 19 assisted death cases to regulatory bodies and a further two to law enforcement since 2018, according to a provincial spokesperson who did not provide further details.
Pauli first raised the idea of assisted death with psychiatrist Justine Dembo in April 2021. Dembo told Pauli she could be eligible for assisted death once Canada's law changes
'She's undergone very high-quality treatments and they just have not made an impact,' Dembo said of Pauli
None of the referrals in the two provinces resulted in disciplinary action for doctors, regulatory bodies said, declining to provide further details.
Four other provinces reported no problematic cases of medically assisted death. Other provinces and territories including Ontario, Canada's most populous province, did not respond.
More than 30,000 people have died with medical assistance in Canada since 2016, more than 10,000 of them in 2021 when the law was expanded to people whose deaths were not 'reasonably foreseeable.'
Even after the change in the legislation, about 98 percent of the assisted deaths in 2021 were people deemed near their natural death, according to Health Canada data.
'So far nothing I see would suggest that we need to worry about having gone too far,' Lametti said.
The procedure is only available to people covered by a Canadian healthcare program. It requires a written application and assessments from two independent medical practitioners, including at least one specialized in their condition if the applicant is not near their natural death.
The procedure frequently involves an injection administered at home.
Lametti said the federal government is considering recommendations from a parliamentary committee to allow advance requests and 'mature minors' - people under 18 deemed capable of making this decision - to access assisted death.
Quebec passed a law on June 7 that would allow people to make advance requests for assisted death that would go into effect when they reach a predetermined point of incapacity due to Alzheimer's or similar conditions.
But Georges L'Esperance, president of the Quebec Association for the Right to Die with Dignity, said it could take up to two years for the provision to go into effect.
Dying With Dignity Canada has organized nearly 10,000 letters this year to government officials seeking to legalize advance requests across Canada, spokesperson Sarah Dobec said.
An expansion of the criteria that comes into force next year will allow Canadians like Pauli, whose sole underlying condition is mental illness, to choose medically assisted death
The new mental health provision will make Canada one of the most expansive countries in the world when it comes to medical assistance in dying (MAID)
Lametti did not say whether the federal government - which is responsible for administering the criminal code - would challenge Quebec's law in the courts. When it comes to minors and advance requests, he said: 'We need more time' to gauge public opinion and address policy questions.
Some medical experts say mental illness alone should not be a criterion for assisted death. It can be difficult to determine whether a mental illness is truly irremediable, as the law requires, and to differentiate between pathological suicidality and a rational desire to die, said Sonu Gaind, chief psychiatrist at Toronto's Sunnybrook Health Sciences Centre.
'We don't even understand the biology of most mental illnesses,' he explained.
Six activists said Canada's expansion of assisted death puts people with intellectual and physical disabilities, low incomes or other vulnerabilities at risk.
'My biggest fear is that we go to this absolute terminal end and people die but we haven't invested time, money, people in putting the things in place that would mean that people don't want to consider' assisted death, Michelle Hewitt, co-chair of the advocacy group Disability Without Poverty, said in an interview.
Hewitt pointed to a widely reported case of a British Columbia man, Sean Tagert, with amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease who opted for medically assisted death in 2019 after he struggled to get 24-hour care.
'He was very clear on what he wanted - more care hours at home - and when he was told he would have to move to a care facility a distance from his family, particularly his young son, he used MAID,' Hewitt wrote in an email.
Social media posts by Tagert's family said that finding care was 'a constant struggle and source of stress for Sean'.
The reported cases of people resorting to medically assisted death in part due to lack of support are 'tragic,' Lametti said.
But 'you can't get MAID simply because you're having some social challenges or economic challenges... Unless they fall into the medical criteria, they can't access.'
While the reported numbers of problematic assisted deaths in Canada are low, some opponents of assisted death in other jurisdictions are using the country's experience as a cautionary tale, three people involved in the debate in Britain told Reuters.
When Pauli first broached the possibility of getting help dying, her mother Mary Heatley was stunned, but she has come to accept her daughter's decision
Pauli said she plans to apply for MAID once she is eligible
'Canada is being used primarily as an argument against us, not an argument in favor,' said Charles Falconer, a British Labour peer who supports assisted death for people with a terminal illness in Britain, where it is not legal.
'It does in one sense [represent a slippery slope], doesn't it, because it started off with terminal illness and it's ended up with non-terminal illness and mental illness.'
Canada's politicians are currently weighing whether to expand access to MAID to include children and the mentally ill.
Canadians are largely behind euthanasia policy, polls show. A survey released in May showed that more than a quarter of voters said the poor and homeless should be allowed to end their lives with MAID.
Canada's road to allowing euthanasia began in 2015, when its top court declared that outlawing assisted suicide deprived people of their dignity and autonomy. It gave national leaders a year to draft legislation.
The resulting 2016 law legalized both euthanasia and assisted suicide for people aged 18 and over, provided they met certain conditions: They had to have a serious, advanced condition, disease, or disability that was causing suffering and their death was looming.
The law was later amended to allow people who are not terminally ill to choose death, significantly broadening the number of eligible people.
Critics say that change removed a key safeguard aimed at protecting people with potentially decades of life left.
Today, any adult with a serious illness, disease, or disability can seek help in dying.
Euthanasia is legal in seven countries — Belgium, Canada, Colombia, Luxembourg, Netherlands, New Zealand and Spain — plus several states in Australia. It's only available to children in the Netherlands and Belgium.
Other jurisdictions, including a growing number of US states, allow doctor-assisted suicide — in which patients take the drug themselves, typically crushing up and drinking a lethal dose of pills prescribed by a physician.
In Canada, both options are referred to as MAID, though more than 99.9 percent of such procedures are carried out by a doctor. The number of MAID deaths in Canada has risen steadily by about a third each year from the previous year.
Source: Daily Mail
