THE federal government’s Medical Assistance in Dying (MAiD) legislation has been a simmering political issue for some time, but has not featured prominently in coverage of Canadian politics. Recent news, however, should give rise to grave concerns about the government’s recent reforms and the lack of effective safeguards against misuse of MAiD.
MAID, as originally formulated by the government in 2016 in response to a 2015 Supreme Court ruling, was available only to Canadians whose death was "reasonably foreseeable," allowing primarily cancer patients to choose death with dignity rather than enduring suffering prior to death.
This was a reasonable compromise and limit on who could access medically assisted death, which ensured the interests of the elderly, ill and disabled were protected from overly broad availability and misuse of MAiD.
But, in 2019, a single Quebec judge ruled in Truchon v Canada that the requirement that death be reasonably foreseeable violated Canadians’ charter rights.
There were compelling reasons why the federal government should have appealed this ruling. But the government failed to do so, instead deferring to the ruling of a single judge, and introduced amendments to MAiD creating a new track for disabled and ill Canadians whose deaths were not "reasonably foreseeable."
The Liberal government went even further, reversing its previous opposition to the use of MAiD by Canadians suffering solely from mental illness. This new practice will commence in March 2023.
Since the 2015 Carter decision, disability rights advocates have both spoken out against and urged caution regarding the use of medically assisted death. The core of the argument is that MAiD, if clear limits are not imposed, will be seen by disabled Canadians as the only alternative to end their suffering given a lack of government-provided medical, housing and income supports.
Without such supports, disabled Canadians may feel pressured into an openness to assisted suicide. Academics Trudo Lemmens and Leah Krakowitz-Broker, for example, argue that the government’s revised law transforms MAiD into "a terminal therapy for life’s suffering."
That prediction appears to be coming to pass for Canada’s most vulnerable people. Earlier this month, a 51-year-old woman in Ontario ended her life using MAiD following a lengthy struggle to find public housing that would not aggravate her chronic multiple chemical sensitivities condition.
The woman, anonymous but referred to as "Sophia," left records dating back over two years detailing her efforts to find proper government support to help her live a life of dignity in light of her illness. Facing obstacle after obstacle, Sophia eventually, reluctantly, turned to assisted death.
"This person begged for help for years, two years, wrote everywhere, called everyone, asked for healthy housing," argues Rohini Paris, an advocate who was in regular contact with Sophia prior to her death. "It’s not that she didn’t want to live. She couldn’t live that way."
"The government sees me as expendable trash, a complainer, useless," said Sophia in a heartbreaking recording made eight days prior to her MAiD-facilitated death. But no Canadian, lest of all our most vulnerable countrymen, should be left to fend for themselves in the face of disability and illness. The use of the new more permissive MAiD regime to substitute for government supports that would allow people to live with dignity is enraging to disability-rights activists. It should be to everyone.
Just this week, it was revealed that police were investigating the circumstances of a medically assisted suicide conducted under MAiD in Abbotsford B.C. Nurse Donna Duncan, following a series of inconclusive diagnoses after a concussion, was approved for a medically assisted death just 48 hours after receiving approval from two MAiD practitioners. Duncan’s daughters were shocked to learn this, and obtained an injunction delaying their mother’s death, but were subsequently informed over the phone that she had received a medically assisted death.
These stories are sure to arise more often under the new, more permissive MAiD law, and even more so next year when mental illness will be allowed as a rationale to receive an assisted death.
In October 2020, Canada’s Parliamentary Budget Officer published a document entitled "Cost Estimate for Bill C-7 ‘Medical Assistance in Dying’," which provides a cost breakdown of the government’s revised MAiD law. The report compares the "net reduction in health care costs" associated with providing medically assisted suicide under the old and new MAiD legislation.
The report concludes that "Expanding access to MAiD will result in a net reduction in health care costs for the provincial governments."
Try to wrap your mind around that last paragraph. A bland government report summarizing the financial advantages of expanding access to death rather than the supports vulnerable Canadians need is the stuff of dystopian novels.
But is it really surprising? It’s clear that some of the direst predictions about what could result from this formulation of MAiD in Canada have already been realized. Things will only get worse.
Royce Koop is a professor of political studies at the University of Manitoba and academic director of the Centre for Social Science Research and Policy.