We must ensure revised assisted dying law will not threaten lives of people with disabilities.

This article was published by the Calgary Herald on October 26, 2020.

Heidi Janz

By Professor Heidi Janz

In recent months, horrific acts of violence and abuse against racialized people who were in distress have forced Canadians to begin to wake up to the reality of systemic racism in Canada. While the need to address systemic racism remains urgent, the fact that our country is on the verge of expanding eligibility for Medical Aid in Dying to include people with disabilities who are not at end-of-life creates an equally urgent need for Canadians to wake up to another form of systemic discrimination that is just as widespread and just as deadly. It’s called ableism.

Ableism is discrimination and social prejudice against people with disabilities based on the belief that typical abilities are superior. Like racism and sexism, ableism classifies entire groups of people as “less than,” and perpetuates harmful stereotypes. Clear, yet unacknowledged, evidence of ableism can be seen in everything from the way in which buildings are built to exclude people who do not walk or see, to the way in which terms associated with disability are used as insults in common parlance. Unlike racism or sexism, however, ableism remains, in the words of Canadian disability scholar Gregor Wolbring, “one of the most societally entrenched and accepted isms.”

The COVID-19 pandemic has laid bare the systemic ableism that relegates people with disabilities to the margins of society. Running contrary to the oft-repeated public health mantra of “We’re all in this together” have been stories of COVID-19 outbreaks in long-term care facilities and group homes causing personal support workers to fall ill themselves, and prompting those who remained to abandon their elderly and disabled clients. We’ve also seen elderly and disabled people who fall ill being left to die in nursing homes and never sent for medical care in hospitals. We are promised better facilities for warehousing elderly and disabled people, rather than in-home supports where the risk of contagion is lower.

COVID-19 coupled with systemic ableism has also exacerbated the financial challenges that people with disabilities face. Increasing numbers of disabled people are in extreme financial distress as the pandemic drives up costs while already-meagre provincial income support remains stagnant. What’s more, some provinces have recently been publicly musing about reducing, or altogether scrapping, their income support programs for people with disabilities. Recent news reports from Ontario indicate that some people with disabilities living in poverty are being driven to end their lives through MAID, because they lack the means to survive.

Systemic ableism creates a disparity in societal reactions to suicidal behaviour. When a non-disabled person is suicidal, they are directed towards suicide prevention resources. But suicide is assumed to be a “rational” choice for a person with a disability — solely because a disability is present. People with disabilities are at a higher risk of suicide, yet they face substantial barriers when trying to access suicide prevention services. Medical professionals overlook typical sources of stress; problems arising from relationship breakdowns, depression and isolation are wrongly attributed to disability.

It is stunning that federal legislators are attempting to expand the eligibility criteria for MAID in the middle of a pandemic, which is not only exacerbating existing barriers for disabled Canadians but also creating new ones. Bill C-7 will legally entrench systemic ableism by enshrining assisted death as an alternative to assistance in living. Policymakers need to wake up to the lethal realities of systemic ableism, and ensure that Canada’s MAID law has adequate safeguards to prevent MAID from weaponizing ableism.

Heidi Janz is an adjunct professor with the University of Alberta’s John Dossetor Health Ethics Centre. She is chair of the Council of Canadians with Disabilities’ ending-of-life ethics committee and is a member of a disability advisory group for the federal minister of disability inclusion. Her interest in disability ethics grew out of her lived experience with disabilities.