What's going on with medically assisted dying in Canada?
Disabled advocates say Bill C-7's proposed expansion to medical assistance in dying is a huge mistake.
Hey there, and welcome to the 20th issue of The Supplement, a newsletter that fills in the gaps of your other news intake. This is Alex, one-third of The Supplement team!
Each week, we pick a question submitted by you, our readers. If you’d like to submit a question for a future week — it can seriously be about anything — then email us at thesupplementnewsletter@gmail.com.
This week, we’re tackling this question: What's going on with medically assisted dying in Canada?
TL;DR: Since early 2020, the federal government has been working on Bill C-7, which would expand access to medical assistance in dying (MAiD) by removing a number of existing restrictions. But Bill C-7 has faced major pushback from disabled people. Given underwhelming government support programs, they said this expansion could push disabled people into choosing MAiD because it’s easier and cheaper than receiving adequate care.
Note: We chose to use the phrasing “disabled people” for this edition because this is the preferred term for many in the community. But some may prefer people-first language like “people with disabilities” — read more about that here.
You may have seen this abbreviation: MAiD, which stands for medical assistance in dying. MAiD first became legal in Canada in 2016, which includes eligibility criteria like requiring the individual’s natural death to be “reasonably foreseeable.” (In a Dalhousie Law Journal article, authors Jocelyn Downie and Kate Scallion said this means “in the professional opinion of the medical or nurse practitioner … how or when the patient’s natural death will occur is reasonably predictable.”) Since then, there have been 13,000 assisted deaths, and cancer is the main medical condition cited for pursuing the procedure.
But a lot has happened since 2016, so let’s catch you up.
In September 2019, Quebec Superior Court Justice Christine Baudouin set off the current chain of events by striking down the “reasonable foreseeability of natural death” requirement and mandating the federal government to pass a new law within six months.
In February 2020, Ottawa introduced Bill C-7.
Besides removing the restriction mentioned above, the bill would allow the final consent requirement to be waived in some situations and cancel the required 10-day reflection period. Altogether, these changes would expand access to MAiD.
In December, the House of Commons passed Bill C-7, pushing it to the Senate for debate. The same month, the court granted the federal government its third extension to pass the legislation, moving the deadline to February 26, 2021.
But disabled people and advocates, including the UN, have raised alarm throughout this process.
Because disabled people already experience a higher risk of poverty and underwhelming government financial support — gaps that have been highlighted by the pandemic — they said Bill C-7 could create a coercive system that pushes disabled people into choosing MAiD because it’s easier and cheaper than for them to receive adequate care.
They added that systemic racism — particularly as it acts in relation to poverty and the healthcare system — also heightens the potential harm for disabled people of colour, especially those who are Black and Indigenous.
"Bill C-7 is anti-working class, racist and ableist," said Sarah Jama, a Black disability justice advocate with cerebral palsy. "(The bill) makes it more accessible for people with mental health disabilities to kill themselves as a form of treatment without making mental health supports free.”
Want more analysis on this? In Passage, writer and activist Nora Loreto pulled together voices of disabled people and advocates to show how “the right to die is coercive without giving support to live.” Andray Domise, a contributing editor for Maclean’s, also wrote a deeply personal opinion piece for The Globe and Mail. He calls MAiD’s proposed expansion “anything but merciful.”
What’s happening now?
The Senate approved Bill C-7 earlier this month, but with additional amendments that would expand access to MAiD further. The bill is now back to the House for debate.
Notably, the bill originally disqualified any person suffering from only mental illness. But with senators calling this exclusion unconstitutional and voting for a 18-month time limit on it, the federal government has recently opted to put a two-year limit on the proposed ban. It said the delay would be used to study and recommend safeguards for MAiD requests from people with mental illnesses.
The government also agreed to collect race-based data as well as data on the number of disabled people seeking MAiD to track “the presence of any inequality.”
But while federal Justice Minister David Lametti tweeted on February 22 that it’s “vitally important that we move this critical legislation to Royal Assent before the Feb 26th deadline,” there is still opposition from the Conservatives. One day before this deadline, Lametti tweeted again, saying that the government’s request for a fourth extension to March 26 has been granted and that “this will be the last extension.”
So there’s more to come on this discussion!
Here’s someone to follow: To learn more about disability justice, listen and learn directly from disabled people like Alice Wong, who is a leading activist based in San Francisco. She is also the editor of Disability Visibility — a collection of first-person stories that highlights the complexity of disabled people’s experiences in the 21st century.
Here’s a story to check out: A big study about solitary confinement in Canada dropped this week, as reported in this detailed piece for VICE World News by investigative journalist Justin Ling. The research finds that around 10 per cent of inmates placed in structural intervention units are essentially being tortured, which means Canada is allegedly breaking its own laws and the UN convention on torture.