False Claim: Dr. Zivot is back claiming people are “drowned to death”

Dr. Joel Zivot is back again with his claim that people who receive MAiD in Canada are drowning to death. Most recently, he made this claim in a segment on the Bridge City News YouTube channel.

That video has since been reposted on multiple platforms, including in a May 11 blog post by the Euthanasia Prevention Coalition, and a May 2 article on LifeNews.com

We are working on a fuller breakdown of why Dr. Zivot’s claims are not supported by the science or evidence. For now, here are the basics.

The basics of Dr. Zivot’s claim

Dr. Zivot examined autopsy reports from 43 prisoners in the United States who were executed by lethal injection. Those autopsies found a high rate of fluid in the lungs and airways (pulmonary edema).

From there, Dr. Zivot argues that “it is intuitive” that pulmonary edema in these capital punishment cases was caused by midazolam. One of the reasons he gives is that “intravenous acid is known to cause diffuse lung injury in animal models.”

He then extends that concern to MAiD in Canada because midazolam is commonly used in Canadian MAiD protocols.

The problem with that reasoning

First:

The lethal injection protocol he is discussing used “a large intravenous dose of midazolam,” usually 500 mg.

To call that a large dose is an understatement! Canadian MAiD protocols typically use 10 mg to 20mg of midazolam. While 20 mg is on the higher end, it is not outside recommended dosing for other conditions. For refractory status epilepticus 5 to 20mg is given IV over 2-3mins with a ability to repeat in 3-5 minutes. In palliative care, midazolam is used for palliative sedation, commonly administered via infusion at 0.5mg - 20mg/hr depending on the depth of sedation desired. In addition, midazolam 5 to 10 mg IV can be given every 10 to 15 minutes for catastrophic hemorrhage or severe respiratory distress.

If 10–20 mg of midazolam caused fluid to fill the lungs, we would expect to see that in other clinical settings where similar doses are used. And we do not.

Second:

The paper Dr. Zivot cites does not support his claim that “intravenous acid is known to cause diffuse lung injury in animal models.”

In that 1965 study, the researchers did not inject an acidic drug and then observe acid damage to the lungs. They created pulmonary edema in anaesthetized dogs by rapidly infusing a large amount of dextran in saline. Dextran is a volume expander used to increase the amount of fluid in the bloodstream. The researchers infused it continuously, at about 4 mL per kilogram per minute, until foam came out of the animals’ trachea.

The authors themselves did not blame acidity. They wrote that the way dextran was infused caused a marked rise in left atrial pressure, “which, alone, could account for pulmonary edema.”

In plain language, this paper shows that rapidly forcing enough fluid into the bloodstream can cause pulmonary edema — fluid entering the lungs — but it does not show that the acidity of an IV medication causes lung damage or makes people “drown.”

Third:

Actual lung-transplant evidence does not support Dr. Zivot’s assumptions. A North American study found that 33 patients received lungs from MAiD donors, with outcomes comparable to — and in some measures better than — lungs from non-MAiD donors. These are not lungs being accepted casually; donor lungs undergo extensive assessment before transplant., including weighing the lungs, x-rays, bronchoscopies, among other assessments. During these assessments, the authors note that "the airway was evaluated with bronchoscopy with special attention to evaluate for airway abnormalities and aspiration" (emphasis added). If MAiD medications were routinely causing severe pulmonary edema, that should show up in the evaluation of those lungs. But it does not.

Other claims by Dr. Zivot

Dr. Zivot makes other assumptions to support his claim that MAiD recipients are experiencing fluid-filled lungs, but this is already enough to show the problem: he is taking evidence from American executions, involving very different drugs, doses, protocols, and circumstances, and applying it to MAiD in Canada.

We will publish a fuller breakdown in the coming weeks, including the other ways Dr. Zivot misrepresents the science of the medications used in MAiD. Subscribe to receive notification of new Substack posts.