Safeguards in Medical Assistance in Dying

UPDATE: January 26, 2024

Canadians with disabilities are currently the only group who can seek Medical Assistance in Dying (MAiD) on the basis of having a disability alone, without being near end-of-life. This further stigmatizes people with disabilities and institutionalizes systemic violence against them. Inclusion Alberta continues to advocate to have this reversed.

On March 17, 2024, individuals in Canada whose sole underlying medical condition is a mental illness will also become eligible for MAiD, unless the federal government decides not to go forward as planned. Doctors can’t predict when a mental illness will or will not improve. While people with mental illness can benefit from supports and can get better, they will soon have assisted suicide legally available to them.

Many people with a mental illness cannot access the supports and services they require to improve their mental health – it’s morally abhorrent to offer them assisted suicide. When we consider the intersections of disability, mental illness, and even being 2SLGBTQ+ and/or Indigenous, it magnifies the fact that some of our most vulnerable community members are being provided assisted suicide as an option rather than the supports they need to live a good life.

Our national federation organization, Inclusion Canada, has provided an infographic that helps spell out the high rates of mental illness among marginalized populations and the dangers of offering MAiD to those with disabilities and/or mental illness alone. Contact your Member of Parliament today and tell them to reverse allowing MAiD on the basis of disability alone and to stop the planned expansion to include mental illness.

An infographic by Inclusion Canada on Medical Assistance in Dying. A readable PDF version is linked below.

A PDF version of the above infographic can be found here on Inclusion Canada’s website.

 

With court challenges already in place on Canada’s Medical Assistance in Dying laws, the Canadian Government has drafted and reintroduced new legislation (Bill C-7) that makes having a disability reason enough to request to die.

Inclusion Alberta calls upon families to urge their Member of Parliament to ensure that current legislation is rewritten to maintain and strengthen end-of life requirements and safeguards for vulnerable persons.

Removing vulnerable persons safeguards and end-of-life requirement would allow people with disabilities who are not nearing death to access Medical Assistance in Dying (MAiD) because of their disability.

Click through the sections below to learn more about Medical Assistance in Dying and what you can do to help protect vulnerable Canadians, including those with intellectual disabilities.

UPDATE: January 26, 2021 

The World is Watching: UN Human Rights Experts Speak Out Against Disability as a Reason for MAiD

The United Nations has now spoken out, confirming what Inclusion Alberta and over 60 national disability rights organizations have said about Bill C-7: that allowing access to medically assisted suicide on the basis of disability alone is discriminatory, dangerous and morally wrong. 

Having passed in the House of Commons, the Bill now sits with the Senate who has the power to stop it when they reconvene starting February 1st. Inclusion Alberta urges you to contact your Senator today to explain the risks the Bill poses to individuals with developmental disabilities, and to the moral framework of our society.

To learn more and to contact your Senator, please click here.

In 2016, Canada legalized Medical Assistance in Dying (MAiD). Since that time, disability advocates have been encouraging government to restrict access to MAiD to people who are dying. This is because we want to prevent Canada from authorizing death on the basis of disability. This advocacy was successful and the law included a requirement that to access MAiD, a person’s death must be “reasonably foreseeable”.

The Quebec Superior Court struck down this requirement in a 2019 decision known as the Truchon Decision. The decision stated that the “reasonable foreseeability of natural death” requirement was too limiting and prevented some people (including people with disabilities) who were suffering from being able to choose when and how they die, even without a terminal illness. Canada chose not to appeal the decision.

On October 6,2020 the Canadian Government re-introduced Bill C-7 which seeks to address these issues, and could potentially make having a disability reason enough to request to die. In short, legislation without proper vulnerable person safeguards and an end-of-life requirement would allow people with disabilities who are not nearing death to access MAiD because of their disability.

Like race, gender, sexual orientation and age, disability is a protected status as outlined by the Charter of Rights & Freedoms. Like other historically marginalized groups, persons with disabilities experience suffering as a result of societal and cultural barriers, systemic inequities, lack of adequate access to resources, as well as prejudice and discrimination.

Despite the fact that marginalized groups all experience suffering as a result of their marginalization, allowing medically assisted death on the sole basis of disability targets only persons with disabilities. By way of analogy, it would be morally abhorrent to offer MAiD to residential school survivors as a way to address their suffering. It would be unthinkable to offer MAiD to LGBTQ2+ Canadians who experience discrimination and violence.

In the words of Catherine Frazee:

“To reinvent MAiD so that it is no longer an alternative to a painful death, but for some instead, an alternative to a painful life, to do that is to embrace uncritically the dangerous notion that suffering associated with disability is a burden greater than death and that termination of such a life is a benefit worth of protection in law.”

Such legislation would be discriminatory, posing a threat to the lives of persons with disabilities by further dehumanizing them and devaluing their lives. It would reinforce the notion that living with a disability is a fate worse than death. We have seen how this way of thinking already informs policy and practice in Canada, for example during the COVID-19 pandemic when triage protocols in some jurisdictions are put in place that limit access to potentially life-saving treatments for persons with disabilities.

Conversation around MAiD tend to centre upon the concept of autonomy. We are asking that Canadian society weighs autonomy in death against the right to live without discrimination. We tolerate the restriction of our autonomy for purposes of, for example, public health as seen during the COVID-19 pandemic (travel restrictions, school and business closures, mandatory mask-wearing) and for reasons of public safety (seat belt laws, helmet laws, registering cars and firearms, etc). In order to coexist, our autonomy is necessarily restricted, specifically when our autonomy poses a threat to others. Our society is full of competing rights. It’s Parliament’s job to balance those rights for the greater good.

The bottom line is that end-of-life criteria for accessing MAiD safeguards persons with disabilities while ensuring access to all Canadians whose death is reasonably foreseeable.

*UPDATE as of December 17, 2020: The House of Commons has now passed Bill-C7, which will make it possible for someone NOT near the end of life to receive assisted death on the basis of having a disability. The bill is now sitting with Senators for consideration, and we urgently need your help in reaching out to explain the risks and dangers this bill presents to people with developmental disabilities. To learn more and to contact your Senator, please click here.

 

Inclusion Alberta calls upon families to meet with their Member of Parliament in order to explain the risks and encourage them to ensure that newly written legislation must contain clearly defined end-of-life requirements to safeguard people with disabilities. This legislation must be sent to the Supreme Court of Canada to determine its constitutionality. Only then will we have a law that treats all Canadians fairly and protects the rights of Canadians under the Charter of Rights and Freedoms. Maintaining this crucial safeguard requires the sustained advocacy and strong voice of individuals and families at risk and their allies.

Resources for contacting your Member of Parliament:

For more information, please contact us.

Learn More About Safeguards in Medical Assistance in Dying

Inclusion Canada - Safeguards in Medical Assistance in Dying

Read more about what Inclusion Canada is doing to advocate for safeguard in medical assistance in dying.

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The Vulnerable Persons Standard

The Vulnerable Persons Standard (VPS) is a vital policy instrument for protecting vulnerable Canadians — especially those with disabilities — from direct and indirect forms of coercion, abuse and inducement to suicide.

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Kory Earle Presentation

Hear Kory Earle, President of People First of Canada, speak about safeguards in MAiD at the End of Life, Equality, and Disability Forum.

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Nicolas Rouleau Presentation

Hear Nicolas Rouleau, a Constitutional Lawyer, speak at speak at the End of Life, Equality, and Disability Forum.

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