Medical Assisted Suicide Is Disability Discrimination

This article was written by Mark Pickup and published on his blog on April 2, 2017.

Mark Pickup

In 2015, Canada’s Supreme Court struck down the nation’s laws against assisted suicide. It sent shock waves across the country: People opposed to legalization of assisted suicide were appalled the high court would do such a thing; advocates of assisted suicide were shocked that the court went so far – even beyond their fondest dreams. The foundation beneath the high court’s ruling was the new high ideal of personal autonomy. Apparently, in Canada, people now have a right to assisted suicide if they have a “grievous and irremediable medical condition (including an illness, disease or disability that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

The Supreme Court said that self-defined grievous and irremediable medical condition ”does not require the patient to undertake treatments that are not acceptable to the individual.” Everything hinges on the patient’s perceptions and feelings -- and they need not take treatments they don’t like.

Something significant happened to shake the historical taboo of killing the sick and disabled. More than 700 years of Common Law, that discouraged, prohibited or otherwise punished assisting someone’s suicide was brushed aside by one judicial decree.[1] How did this happen?

If the Supreme Court was to rule in favour of assisted suicide they had to confront a problem: The Canada’s Charter of Rights and Freedoms – which acts as a constitution in Canada – states in Section 7 that “everyone has the right to life, liberty and security of the person …”. The judges’ had to suppress the ‘right to life’ and accentuate a false notion of liberty and emphasise ‘security of the person’. The problem with trying to suppress the right to life is that all other rights depend upon it. Liberty and security of the person become tenuous if the right to life is not guaranteed. Self-destruction eliminates liberty and assisting in a suicide is license, not liberty.

The Supremes paid obligatory but shallow homage to the concept of the sanctity of human life, then discounted the right to life in one paragraph. They wrote:

“…[W]e do not agree that the existential formulation of the right to life requires an absolute prohibition on assistance in dying, or that individuals cannot “waive” their right to life. This would create a “duty to live”, rather than a “right to life”, . . . The sanctity of life is one of our most fundamental societal values. Section 7 [of the Charter of Rights and Freedoms] is rooted in a profound respect for the value of human life. But Section 7 also encompasses life, liberty and security of the person during the passage to death. It is for this reason that the sanctity of life “is no longer seen to require all human life be preserved at all costs.”

Continuing in their cleaver distortion, the judges wrote: 

“Underlying both these rights [liberty and security of the person] is a concern for the protection of individual autonomy and dignity.” 

I do not believe the architects of the Canadian Charter envisioned a vehicle to autonomy and dignity included a right to suicide. The right to death is not mentioned in the Charter – the right to life is. Do you see how they were twisting things? They went on to say:

“The law has long protected patient autonomy in medical decision making.” 

Granted, but Canadian law has only recently sanctioned medical killing by assisted suicide or euthanasia.

The dramatic departure from legal and moral traditions went from the court to the Canadian Parliament and assisted suicide became legal in June 2016. The legislation (bill C-14) was enacted under the euphemistic and deceptive title “medical assistance in dying”. I used the words 'deceptive' because those who are eligible for ‘medical assistance in dying’ do not have to be dying. The odious new law defines grievous and irremediable medical conditions eligible for medical killing:

“A person has a grievous and irremediable medical condition only if they meet all of the following criteria:

(a) they have a serious and incurable illness, disease or disability;
(b) they are in an advanced state of irreversible decline in capacity;
(c) that illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and cannot be relieved under circumstances they consider acceptable; and
(d) their natural death has become reasonably foreseeable, taking into account all their medical circumstances, without a prognosis having been made as to the specific length of time that they have remaining.”

In the first 6 months after the law passed, at least 744 Canadians received “medical assistance in dying”. There’s that deceptive euphemism again! Not all recipients were dying. According to Canadian reporter, Graham Slaughter, (what an apt name!) most of the patients have cancer, ALS or multiple sclerosis.[2] Multiple sclerosis is rarely terminal. Life expectancy for people with MS is only 7 years shorter than normal life expectancy. I have had MS for over 32 years. I use an electric wheelchair but I’m hardly dying. Medical assistance in dying becomes medical killing.

It should be noted that in 2012 Canada’s Parliament gave UNANIMOUS support to the idea of developing a National Suicide Prevention Strategy. In 2016 they legalised assisted suicide for people who are sick or disabled. So let me get this straight: Healthy and abled-bodied Canadians who become suicidal get suicide prevention support, sick and disabled suicidal Canadians get help killing themselves? Yup.

Disability advocates have fought to advance equality and inclusion for over 40 years. Canada’s assisted suicide legislation caused a severe setback to those goals. This did not go unnoticed in America. Many American disability groups oppose legalization of assisted suicide, including the American Association of People with Disabilities, the National Spinal Cord Injury Association, and Not Dead Yet, just to mention a few. Diane Coleman and Stephen Drake of Not Dead Yet commented on the Canada’s Supreme Court Decision:

“The Canadian Supreme Court ruling openly targets people with non-terminal disabilities … The Canadian high court’s holding is a shockingly blatant mandate of lethal discrimination based on disability and should be rejected outright by any human society.” [4]

Is the Canadian situation Supreme Court decision a harbinger of things to come across America? Medically assisted suicide (MAS) has been legalised in 6 states under various parameters. Someone may say that the disabled are not eligible for MAS in most states. Proponents of MAS refuse to acknowledge almost all the people dying under these laws are disabled.

Not Dead Yet asserts 

“assisted suicide violates the Americans with Disabilities Act by establishing a system of unlawful discrimination whereby most suicidal people, those who reveal their intentions, receive suicide prevention services, while old, ill and disabled people receive suicide assistance instead.” 

They’re right.

Old prejudices against the disabled have appeared again under the guise of death with dignity. Can you hear a chorus calling out from a multitude of disabled people, “Must we die to find dignity?” I hope not.

If there is dignity to be found, it is found in life.

Mark Pickup
____________________________________
[1] Paraphrase of Chief Justice William Rehnquist on assisted suicide, Washington v. Glucksberg, 521 U.S.702(1997). http://www1.law.umkc.edu/academic/Spring2011/assignments/Washington%20v%20Glucksberg.pdf . Canadian and American law and legal traditions have deep roots in British Common Law, which dates back to the Middle Ages.

[2] Graham Slaughter, “At least 744 assisted deaths in Canada since law passed: CTV News analysis,” CTVNews.ca, 28 December 2016 (http://www.ctvnews.ca/health/at-least-744-assisted-deaths-in-canada-since-law-passed-ctv-news-analysis-1.3220382)

]3] See National Multiple Sclerosis Society website (http://www.nationalmssociety.org/About-the-Society/News/Study-Shows-Life-Expectancy-for-People-with-MS-Inc)

[4] Diane Coleman and Stephen Drake, “Statement of Not Dead Yet (USA) to Canadian Panel on Carter Case Decision”, 14 October 2015, (http://notdeadyet.org/statement-of-not-dead-yet-usa-to-canadian-panel-on-carter-case-decision)