Delaying MAID changes is a mistake

Opinion

Hey there, time traveller!
This article was published 05/02/2024 (607 days ago), so information in it may no longer be current.

Death is a difficult subject for many people. As writer Isaac Asimov explained many years ago, “Life is pleasant. Death is peaceful. It’s the transition that’s troublesome.”

Fortunately for many Canadians that transition was made easier and more humane as a result of the original MAID legislation, Bill C-14, passed by parliament in 2016. The legislation offered individuals whose death was foreseeable a chance to end their life with dignity, on their own terms. To date some 45,000 Canadians have chosen to exit the world this way. And the number of Canadians accessing MAID has grown steadily, with applications increasing more than 25 per cent last year.

Supporting legislation passed in 2021, Bill C-7, had the effect of extending MAID eligibility to individuals with medical conditions or chronic pain whose natural death was not reasonably foreseeable. As a precaution, the legislation imposed a two-year delay in implementation until March 2023.

Just prior to the two-year delay expiring in March 2023, the federal government postponed implementation of the full scope of MAID a further year, to March 2024. The delay was characterized as an effort to ensure that health care and support services were in place to manage the full implementation of MAID. Federal Health Minister Mark Holland’s recent decision to further delay expanding the MAID criteria is perplexing. That’s because the question of whether the government needed to wait a further year to implement Bill C-7 had already been examined by the government’s own expert panel in 2022.

The Final Report of the Expert Panel on MAID and Mental Illness examined two important questions, whether mental illness was a legitimate reason for requesting MAID and whether trying to include mental disorders was justification for deferring full implementation of the legislation.

In May 2022, after extensive review and after considering MAID criteria and guidelines used in many other countries, the panel released its report. In the report submitted to the minister of justice, the dozen panelists, experts in medicine, law, mental illness and mental health, unanimously concluded that, “further delay would not be necessary.”

In the panel’s transmittal letter to then-justice minister David Lametti, the expert panel explained the reasons why they were convinced that delay would not serve Canadians with overwhelming medical or mental health issues.

The panel concluded that delaying the implementation of the full scope of the MAID legislation was unnecessary.

They noted, “No system of safeguards, protocols and guidance will satisfy everyone because people differ in terms of how they make the compromises between the competing values at the heart of this practice.”

In coming to that conclusion, the expert panel also noted that for many mental disorders, “it is difficult, if not impossible, for clinicians to make accurate predictions about the future for an individual patient.”

The fact that an all party parliamentary committee recently concluded that a delay was warranted is not surprising. It is certainly possible that their considerations were tainted with conflicting personal and political agendas, rather than the simple goal of offering people in various states of physical and mental agony a way out on their own terms.

Neither the justice minister or those politicians supporting a further delay are listening to the majority of Canadians.

They are certainly not listening to the professionals who work with those who have chosen MAID. A 2020 IPSOS poll found that most MAID professionals were not only in support of the current legislation, but would also include the right to an advanced request for MAID. According to the poll, “regulated health professionals (such as doctors, nurses and physiotherapists) are 82 per cent in support of allowing advance consent for assisted dying where individuals are diagnosed with a serious capacity-eroding condition.”

Perhaps the minister needed to talk with loved ones who have been a part of the thousands of MAID experiences across Canada or those who have watched as loved ones waste away in pain or disappear in the fog of dementia.

Why would the government hesitate on this issue when the same IPSOS poll found that the very people the government has expressed concerns about feel differently? The poll found that, “Individuals with chronic physical or mental conditions or disability (those who report being unable to carry out the basic activities of daily living without assistance) are 84 per cent in support of allowing Canadians with a grievous and irremediable illness to consent in advance to assisted dying.” Overall, 82 per cent of Canadians believe that “people diagnosed with a grievous and irremediable medical condition, including those with dementia, should be allowed to make advance requests for medical assistance in dying (MAID).”

There are undoubtedly many reasons to feel uneasy about allowing someone to end their own life, but our uneasiness is not preventing many from choosing that option, even without MAID.

The fear that MAID may lead to preventable deaths implies that someone else’s choice has no merit.

MAID is a choice, a very personal choice that for many is, ironically, an affirming one. For those crippled by mental or physical pain or those facing the indignity of a slow, agonizing terminal illness, choosing MAID says I have agency over my life and how it ends. In 2023 more than 4,400 Canadians committed suicide.

Maybe embracing MAID more fully can help end the tragedy of our friends and neighbours dying alone, by their own hand, without the benefit of loved ones around them.

Jerry Storie is a former politician and educator living in Winnipeg.