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If you die from MAID in Canada, will you die by drowning in your own lung fluid (waterboarding) and will you be able to feel that you are drowning? Will you suffer the conscious trauma (panic, desperation, agony) of death by drowning? Or is this an invalid concern, and the MAID drugs actually provide a peaceful, pain-free death?

Medical assistance in death (MAID) is a legal way to have a doctor help you kill yourself. My father is 86 with advanced heart disease, diabetes (his feet are rotting and legs in tremendous pain), and he has smoked and imbibed alcohol for 64 years. He had to completely quit the booze a few years ago, and my mum has kept him alive with organic homecooked food, along with a lot of natural supplements to boost his health.

My Mum and Dad 5 months ago

But the strongest factor in his favor is his mental discipline and will to live. He had triple bypass surgery 24 years ago and multiple procedures since then. His heart function is at 30% and his pulse can drop to 37 beats per minute (normal is 60-100 bpm). He is now on continual pain meds and sleeping pills and has asked for MAID. In a recent call, when he had switched pain meds and therefore had a bad night and intense pain all day, he said:

“And now let me go. Don’t hang onto me. Enjoy yourself. Just let me go. Just let me go. I’ve had enough life. I don’t want to have pain. Just switch off. Just switch off the lights. Unplug it. Unplug my heart.”

My Dad last week

And what criteria do you have to meet to qualify for MAID?

• have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2027)
• be in an advanced state of irreversible decline in capability
• have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable

My father has received approval for MAID from the homecare nurse and from a doctor. He needs approval from one more doctor and then the procedure can be scheduled.

Does MAID Cause Death by Drowning in Lung Fluid?

My father is a doctor and my brother (who has medical power of attorney for my parents) is also a doctor. So both of them are capable of understanding the drugs used in MAID. However, I had already been alerted to a possible unknown and poorly researched issue with MAID in this video with Canadian war veteran, Kelsi Sheren, and Dr. Jordan Peterson.

I then found this article, written by Joel Zivot MD, that details the core concern:

“As an anesthesiologist, I have injected propofol into thousands of patients. Very commonly, patients complain of a burning sensation. I learned to block this painful sensation with a prior injection of a local anesthetic. MAiD uses a dose 10 times greater than what I would use in the operating room.

Like pentobarbital execution, propofol will very likely burn its way through the lungs and cause the frothy fluid accumulations seen in lethal injection. The experience of this will be akin to death by drowning. Waterboarding, widely understood as torture, creates the same effect. The injection of a paralytic after the propofol will make every death appear outwardly unremarkable — and according to MAiD proponents, even beautiful in its peacefulness.

Canadians who choose to die by MAiD must be informed of the real possibility that the death they experience may be very different from that which is described by MAiD advocates. It is time to perform autopsies on everyone that dies by MAiD, so we can determine if MAiD protocols produce frothy fluid in the lungs. It is time to cease the use of paralytics in MAiD, so we can be certain we are not covering the potential for a painful death akin to drowning. It is time to accept what the evidence available to date shows: MAiD may very likely provide a torturous death.”

I posted both these references in our family group chat to give everyone a heads-up that perhaps we should take a deeper look at this method of killing.

One of my family members then texted back:

“I asked palliative care about the concern that MAID is a paralytic and they said the first drug you get is a sedative that is the same one you get when you get surgery. Then you get another one that puts you in a deep coma. Only then you get a paralytic that is basically for the comfort of your family as it keeps you from death jerking. And then you get a muscle relaxant that stops your heart.”

And the palliative care nurse provided us with this article by Dying with Dignity that is the standard description of MAID used by those involved with administering it in Canada.

My family member went on to say, “I’d be 100% with you except for one question – isn’t the patient unconscious? Same way they are as during surgery? If so they’re feeling nothing, no?”

And therein lies the issue. Try to find data on that – I’ve looked but I can’t find it.

Does Propofol Prevent Conscious Awareness or Feeling Trauma?

Does the person FEEL that they are drowning in their own lung fluid? Are they aware, and therefore suffering the trauma this would induce? In the comments section underneath Dr. Zivot’s article, a fellow physician posted this:

I also don’t understand what drug or combination is causing the lungs to fill with fluid? My research showed that Propofol is used in prolonged sedation/coma-induction with ‘minimal’ after-effects. Rocuronium causes broncho-bronchiolar constriction – is this somehow involved?

So why are autopsy results on MAID showing the cause of death as drowning from lung fluid? Why wouldn’t the autopsy show death from cardiac arrest?

Instead, I’ve found a few papers like this that admit, “There has been little to no research into their parameters at such high doses as seen with MAiD … There is no peer-reviewed literature to guide best practice in compounding these medications.”

And then, in the same Senate hearing that Dying with Dignity references to support the MAID drugs, I found this clarification from Dr. Zivot, who was also present at the hearing:

“These drugs that are used for lethal injection, let’s be clear that they are designed to treat people and to be used as medicine. Here in the setting of medical assistance in dying and lethal injection, they are now repurposed as poisons. The kind of dosage that you’re talking about here are not the way that we would normally give these drugs at all in a therapeutic sense. What is done here is really rather speculative. I think it’s clear that if these drugs are given in very, very large quantities, that things can happen to the body, all the way up, including death.

Midazolam in the United States was used as a replacement for pentobarbital. If it would be used the same way in Canada, it would be used as a replacement for propofol. That’s not exactly how it’s used here. It’s used as a method of creating some kind of extra component of unresponsiveness.

Let me also be clear, though, that the way a person would die with medical assistance in dying is going to be with a combination of the propofol but mostly the paralytic. The propofol is given in a very large quantity, 10 times what I would give in the operating room.

Let me be clear that when propofol is injected in one tenth of the concentration that is given in medical assistance in dying, it frequently causes a burning sensation. Dr. Holland talked about using a localized injection prior to the propofol so the person would not experience the burning. But let’s be clear, that burning is occurring in the lungs.

Now you’re using a very large quantity of a chemical as it races toward the lungs and very likely tears up the lung with the chemical effects of the propofol. On top of that, you add this paralyzing drug. This paralyzing drug is difficult for me to get my head around because what you are doing now — I think medical assistance in dying becomes theatre, because now a person is not able to move in any way or to indicate that they are uncomfortable.

To state that the death that the person experiences is peaceful, this is unknowable or false. To say that it outwardly appears to be peaceful, I suppose that would be true. But that is a chemical myth put in place. That is a trick of what is actually happening here.”

So Dr. Zivot believes the Propofol is causing the excess lung fluid, that then causes death by drowning. And as he points out, we don’t know whether this is causing the person discomfort or trauma because they have also been given a full-body paralytic. They can’t open their eyes, speak, or lift a finger. There is no way the person can signal distress.

However, Dr. Holland believes that Propofol does indeed prevent the person from experiencing any suffering or trauma:

“The autopsies he [Dr. Zivot] had done were using a barbiturate medication, which is not used anywhere in our regimen at all. That medication from those autopsies is not involved in any way in our medical assistance in dying regimen.

Midazolam, the very first agent we use, has been used in capital punishment in the United States, but in a very crude and inefficient way. They’re using it to try to stop someone from breathing, but midazolam isn’t very good at that. They are using it in huge doses on its own. We don’t use it for that purpose in this regimen. In this regimen, it is solely to create a sense of relaxation at the very start. The purpose is not to cause the person to stop breathing, nothing to that effect. You could take that medication out of this regimen and it would work just as effectively in terms of ending someone’s life. The propofol and the rocuronium are not medications that Dr. Zivot has mentioned, and these are the ones that are the effective ones in terms of ending a person’s life.

The propofol induces the deep, deep coma. We have experience with this extensively in operating theatres and emergency departments in inducing these comas to be able to cause incredible distress to a body in a necessary fashion, like taking out an appendix or setting a bone. The patient wakes up and they haven’t felt anything. They don’t remember. Their mind was not there. While their body was there, their mind is completely unconscious. Most people at those doses will die because their brain is so unconscious that it doesn’t want to breathe anymore. It’s not distressed by not breathing because it doesn’t feel the drive to have to do so.

With the rocuronium, we add it just to be sure that it paralyzes the lungs to ensure the person is no longer breathing so that the body has definitely died. Theoretically, the propofol might induce such a deep coma that you are unconscious but somehow still able to breathe just a little bit. You would not be distressed by it because, likewise, when we put people in an operating theatre at a tenth of the dose that we are using in medical assistance in dying, when we give them rocuronium they can’t breathe, they have a tube down their throat — all of these terrible things happen to their body, physically distressing things and they wake up.

Of the medications that Dr. Zivot describes, the main one is not used in our regimen at all. The second one, midazolam, is not being used in high doses and not being used to end lives. It is being used as a relaxation medication in a much smaller dose for a completely different intention. The ones we use to end life, neither of those medications have highlighted any research on causing drowning of lungs. These are things that we have used extensively in other aspects, and people go under and wake up.

It’s trying to liken two things that are not the same at all. The medications we’re using are extensively used throughout many countries and there are many experts on this who would back me up on it.”

Where are the Autopsies on Canadian MAID Patients?

Thankfully, The Chair of the Senate Hearing asked Dr. Zivot to respond to Dr. Holland’s assertion, and Dr. Zivot replied:

“Here are the facts. Autopsies for individuals who have died by MAID, to my knowledge, have not been done. I would ask Dr. Holland and others to perform these autopsies, and then we can put to rest the question of whether or not propofol will produce the same effect in the lungs as I speculate they would.

I see nothing elegant about this in any way. I see this as death by anesthesia and death with a paralytic. The paralytic serves no purpose other than to make it appear outwardly to witnesses that it’s peaceful. I think the interior experience of the people dying is not known and only speculative. To say that the operating room and the emergency department are the same as medical assistance in dying is false and that doses are not at all similar. I accept that Midazolam is used in a different fashion for execution than it’s used in MAID. I did read in the protocol that pentobarbital is the second drug that is available if propofol is not available or cannot be given for whatever reason. I imagine that perhaps pentobarbital has been used for MAID at some point somewhere. I’m not sure.”

So there you have it, two experienced and reputable doctors on opposite sides of this issue. However, Dr. Zivot asserts that the rocuronium paralytic drug serves no purpose, whereas Dr. Holland says it’s given to paralyze the lungs to ensure the person is no longer breathing.

Dying with Dignity also provides a link to a study on successful lung transplants from people who have died from MAID. Unfortunately, the donor lungs were not just from Canada, but also from Belgium, Spain and the Netherlands. And each country uses a different drug regimen, some countries like Belgium don’t have a standardized protocol. So we can’t use this study to provide any evidence for whether the Canadian MAID protocol causes lung damage, or not.

Will my Father choose MAID?

For me, in the real-time experience of a father who wants to have this procedure, the bottom line to this argument is as Dr. Zivot states towards the end of the hearing, “Of course, you’re right that in Canada it’s different, and also there is no information like the information that I have, having reviewed autopsies of executed individuals. There are no autopsies to review of people who have died by medical assistance in dying. I would think it would be valuable and important to determine exactly what death really looks like from the inside.”

Canada needs to conduct autopsies on people dying from MAID. Until this is done, we will not know for sure how people are dying, nor can we extrapolate how much suffering/trauma is involved.

For my situation, I just want to be sure my father understands that there is a possibility he might die from drowning in his lung fluid, and also that he might be conscious of that fact and experience that trauma. Then it is his choice whether he still wishes to undergo this experience.

Personally, I wish my father had listened to my suggestions over the years that he learn how to meditate. If he was skilled at putting himself into meditative state, then he most likely would be able to release his soul from his body – as long as his soul agreed that it was his time to die.

I hope this research helps others that are in a similar position. And please feel free to share your stories below. This is a safe space; people are welcome to share their opposing thoughts and opinions, but not to attack or shame others. Namaste.