Medical assistance in the event of death for prisoners: one of the few options

Nabil Anas

Global Courant

After more than four decades in a federal prison, Ed Speidel fights for a compassionate release so he can die outside, in a halfway house, instead of in his prison cell.

But after being denied parole and declining an appeal, he now fears he will die an agonizing death, struggling to breathe behind bars.

“My biggest fear is dying in prison. I don’t want to die in prison,” Speidel said in a telephone interview with CTV News from an office at the Matsqui Institution, a medium-security prison in Abbotsford, B.C.

The 62-year-old suffers from end-stage chronic obstructive pulmonary disease (COPD), chronic pain and rheumatoid arthritis. Tests show his lungs are only 19 percent functional compared to healthy adults.

“I have days where it’s really hard for me to breathe and it’s like I’m suffocating, like you’re starving for air,” Seidel said.

He needs oxygen 24 hours a day. But just before his phone interview with CTV, he said he was having trouble getting staff to give him a portable oxygen unit to make the journey to the room where the interview was to take place.

Speidel, who uses a walker and spends most of his time in his cell, says he poses no threat to the public in any way.

“I was the boss. (I did) robberies. But I didn’t hurt anyone,” he said. “I’ve done it for 41 years. I’ve served my time. Staying here won’t do you any good.”

At a parole hearing in July 2022, he exceptionally applied for parole – more commonly known as compassionate or geriatric parole – due to his ill health, age and time served. He was not represented by a lawyer and was rejected.

At the beginning of this year he received legal assistance. Lisa Crossley, who works at Prisoner Legal Services in Vancouver, says the case is supported by a note from a doctor at the facility, which recommended that the parole board consider a compassionate release for Speidel given his progressive health condition.

But the motion for an expedited hearing of his review on July 8 was denied. Speidel is now working on an application for a medically assisted death, although he says it’s not really his preference.

“For the vast majority of people, if you’re terminally ill, what risks are you really at? I think that should be asked and there should be more options for people for some sort of release,” Crossley told CTV News.

Still, Crossley says, she will continue to press for an expedited regular parole hearing and for another call for a compassionate release. She believes this is the first case of its kind in the country that will highlight the plight of elderly inmates who are sick.

“It’s a public interest issue that affects a lot of people in federal prison,” Crossley said.

AGED AND ILLNESS PRISONERS

Of the 6,886 inmates now in federal prisons as of 2023, more than 1,700 (25.6 percent) are age 50 and older and are classified as aging offenders.

Surveys show that prisoners age faster because of their former lifestylehigh rates of drug abuse and the stress of imprisonment.

There are higher rates of diseases associated with age, including cancer, diabetes, lung disease, and dementia.

Ivan Zinger, Canada’s criminal detective, says a 2019 review concerned him.

“We saw an inordinate number of inmates who were terminally ill or had dementia or Alzheimer’s disease, who had severe mobility limitations, who were bedridden. And all these individuals, you scratch your head and say, ‘What are they doing in a prison environment?'” he said in an interview from his office in Kingston, Ontario.

“Prisons and correctional facilities were never designed to be nursing homes, long-term care facilities or hospices. And they have become. And it’s just not acceptable,” Zinger added.

In a statement to CTV News, Canada Correctional Service officials said they could not comment on specific inmates or their cases, but wrote that the agency “recognizes there are challenges in addressing the many needs of aging offenders, but remains committed to continuing to develop strategies to meet those needs.”

The Parole Board of Canada, meanwhile, is responsible for making decisions about exceptional paroles and when offenders pose no risk to the public. In an email to CTV News, PBC officials wrote that between 2019 and early 2023, the board exceptionally granted 29 parolees to all age groups. Of these, 13 were inmates aged 60 and over.

That equates to about four compassionate releases per year and proves, Zinger says, that the corrections system is not providing enough compassionate medical releases.

“Each year, up to 40 inmates in Canadian penitentiaries die from ‘natural causes,’ mostly terminal illnesses,” he noted. “The fact is that none of these individuals benefited from a compassionate release, even though their deaths were expected or imminent.”

Meanwhile, studies show the cost to keep a geriatric offender in prison can be two to four times higher than to house him in a shelter with medical supervision.

Zinger points to other jurisdictions, such as in the US and Europe, building secure nursing homes for inmates where they can be transferred after they turn 65 or develop chronic or fatal illnesses.

In Canada, there are at least five secure halfway houses that are accepting or beginning to take in aging prisoners, with about four dozen beds. Haley House, in Peterborough, Ontario, has 10 beds and hopes to open a second house with an additional 10 beds this fall. Still, the case manager, Jeff Morgan, writes that the existing facilities “come even close to meeting the needs of aging offenders coming out of federal institutions or about to be released.”

COMPASSIVE parole or maid?

With no indication that he will be released soon, Speidel has applied for Medical Assistance to Die (MAID) and is awaiting a medical assessment. The process usually takes three months or less.

He says he would much rather die of natural causes in a guarded halfway house. But his next regular parole hearing could be in 2024.

“It seems like it’s easier here to commit suicide, with their (medical) help, than to try and convince them to let me go back. And I don’t understand why,” Speidel said.

CTV reported earlier in 2023 that there has been a small but notable increase in MAID prisoner deaths, at higher rates than most other countries that allow assisted death.

The Zinger’s 2019 report, too warned that without better planning for aging and sick inmates there would be a flurry of maid requests.

“The Correctional Authority of Canada should not be seen as involved in enabling or facilitating any form of death behind bars. It simply violates CSC’s obligation to protect and preserve lives,” he wrote.

Yet Speidel’s case suggests that this is exactly what is happening.

He wants his parole to die alone. But the path to approval for MAID may be easier — an issue his attorney says needs to be addressed.

“Are we comfortable with people being able to apply and get it within a month?” Crossly said. “If you qualify for MAID, you meet all those requirements, are you really such a risk to the community that you shouldn’t be eligible for some form of release?” she added.

For Speidel, it’s a simple, binary choice.

“I really hope I get out because if I don’t, I’ll take MAID. I’m not going to sit here, unable to breathe, until I’m on the floor choking,” he said.

Medical assistance in the event of death for prisoners: one of the few options

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