Safeguards in Medical Assistance in Dying

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:

• Click here to find you Member of Parliament
• Tip Sheet: Meeting with your Member of Parliment
• Life Worth Living, Life Worth Saving
• Email Example: Email your MP
• Survey: After you have spoken with your MP, please complete this brief Inclusion Canada survey. It is vitally important that we keep track of conversations to better understand the reach of this important work on MAiD legislation.

For more information, please contact us.