On March 17, 2021, the lives of people with disabilities in Canada changed forever, when Canada made it legal to receive Medical Assistance in Dying (MAiD) based on disability.
MAiD on the basis of disability continues to be a leading topic for debate in Canada as the Special Joint Committee on MAiD reviews the recent changes to the law. The Committee is considering three areas of potential expansion of MAiD:
- to mature minors;
- by advanced request; and
- based on mental illness.
In response, we presented the Committee with several briefs, about our positions and concerns. Our goal is to influence the work of the Committee and to defend your rights.
Protection of People with Disabilities
Disability is a protected category under the Charter of Rights and Freedoms. Making it legal to end someone’s life based on disability directly targets people with disabilities. It devalues their lives and worth. It’s discriminatory, and it goes against section 15 of the Charter.
The disability rights community has been clear about how to protect people with disabilities. Stop trying to create the impression that their suffering is different. Bring back the end-of-life requirement for MAiD. Change the systems and conditions that make life hard for so many people with disabilities.
MAiD for Mature Minors
Under the current laws, you must be 18 years or older to apply for MAiD. The Committee is considering getting rid of this rule. This could be especially harmful for youth with disabilities. Youth with disabilities are uniquely dependent on adults for social and financial support. They experience increased rates of depression, anxiety, loneliness, and low self-esteem. They’re also more affected by suicidal thoughts because they face more poverty, lack of belonging, and abuse.
The Courts provide special protections to mature minors. Courts consider, on a case-by-case basis, whether a mature minor will be allowed to make their own healthcare decisions. This vital protection would be removed if the MAiD laws are expanded.
MAiD by Advanced Request
MAiD by advanced request is a request from a person who is not looking to have MAiD now. Instead, they want to plan ahead in case they lose their capacity to consent. People without disabilities sometimes have mistaken beliefs about the quality of life with a disability. This makes it hard for them to imagine and assess future pain. People with disabilities often see their quality of life as similar to those without disabilities. Non-disabled people tend to see the quality of life of people with disabilities as lower than their own. MAiD by advanced request should not be expanded to allow one person to consent to MAiD for someone else because these decisions would be based on stereotypes and stigmas about life with a disability.
Mental Illness and MAiD
Canada’s law will allow people with a mental illness to access MAiD starting in March 2023. People with mental illness have unique vulnerabilities connected to their illness. For example: the social conditions that surround mental illness and the fact that suicidal thoughts tend to be a symptom of mental illness itself. Because of these vulnerabilities, mental illness should be excluded as an allowable category for MAiD.
These vulnerabilities are greater for people with intellectual disabilities who also have a mental illness. They have a harder time finding support and being diagnosed. They’re at risk of being over-medicated and institutionalized. This increases the risk that a person might ask for MAiD, even though their condition is treatable. We’ve asked the Committee to discuss this issue more. We want them to focus on fixing the gaps in mental health care for all people in Canada, including people with intellectual disabilities.
Palliative Care versus MAiD
Palliative care supports in Canada are inadequate, underfunded, and not widely available – unlike MAiD. The Committee needs to understand that state of palliative care in Canada and its effects on people with disabilities.
Canada’s MAiD monitoring system needs significant improvements. We believe that the government should do a study of palliative care and other supports for people with disabilities. This should be a priority. They should gather reports from patients with disabilities on the care they’re receiving and its effects. This would help to figure out whether people with disabilities are being pressured, coerced, or persuaded to turn to MAiD.
Inclusion Canada is extremely concerned with the current MAiD legislation and the negative potential outcomes for people with disabilities if the legislation is expanded. Our battle against MAiD will continue.