Friday, November 13, 2020

The federal government should rethink its new medical assistance in dying law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Trudo Lemmens
An excellent article by Trudo Lemmens and Leah Krakowitz-Broker on Bill C-7 was published by CBC news on November 10 with the title: Why the federal government should rethink its new medical assistance in dying law. The article begins by explaining the government response to the Truchon court decision which found that requiring people to be "terminally ill" to die by euthanasia was unconstitutional. The article states:

The main goal of the new bill is to allow people with chronic illness or disabilities to request MAID even when their death is not imminent. The bill also lifts some existing safeguards for people who are close to death, even though the Truchon decision doesn't require this.

The bill would transform MAID from a procedure to facilitate dying into a terminal therapy for life's suffering – but only for some.

The article challenges Bill C-7 by stating:

Indeed, only people with chronic illness and disability will be given privileged access to MAID, with token safeguards against premature death for those who may otherwise have had years or even decades to live. While reflecting understandable empathy for often-severe suffering, the bill conforms to an ableist presumption that a life with disability or chronic illness is less worth living. As the UN Rapporteur on the Rights of Persons with Disabilities warns, MAID for reasons of disability violates the right to life of persons with disabilities.
The article comments on the 90 day waiting period for people who want do be killed, but are not terminally ill.
For people whose death is not "reasonably foreseeable," the bill introduces an assessment period of 90 days, combined with an evaluation of eligibility by a practitioner with expertise in the patient's condition. These measures are meant to ensure that people with disabilities and chronic illness are informed of other available treatments or support options outside of medically assisted dying. But unlike any other country in the world, the new bill fails to explicitly require that all reasonable options be made available and tried first, before allowing physicians to end a patient's life.

In other words, the bill makes their dying easier than living. Rather than instilling hope and helping to build resilience by focusing on options for living, health care providers will now be asked to discuss an early death.

Promoting the medical system's involvement in ending the life of persons with disabilities and chronic illness in this way amounts to a deadly form of discrimination.
The article further examines the 90 day waiting period for people with disabilities and chronic conditions.
Some critics consider the three-month period too long, but in fact 90 days is a grossly inadequate time-frame. When people are faced with a life-changing illness or disability, it tends to take much more than three months to develop a renewed perspective on life – and just as long, or longer, to access necessary medical and financial supports.

Recovery from spinal cord injuries may not even begin within the first three months, for example. Yet a person who experiences such a life-altering injury, often accompanied by depression, could obtain MAID under the proposed legislation before crucial life-adjustments and supports start to provide hope.
The article examines healthcare waiting periods in comparison to the 90 waiting period.
Many people with chronic illness or disability may need specialized long-term care, but people waited 126 days on average in Ontario in 2019 to have access to it. Adequate home care or supported living are not sufficiently available in several provinces, which is precisely why Sean Tagert said he opted for MAID after years of pushing for changes to the health care system.

The median wait time for access to specialized pain clinics was around 5.5 months in 2018, making it faster to obtain MAID than to receive treatment.
The article explains how Bill C-7 makes euthanasia appear to be a better option than treatment:

When faced with debilitating pain, financial hardship, or the prospect of lingering in institutions without proper care, many may welcome MAID as a solution. But it seems unconscionable for governments to prioritize state-financed MAID, rather than putting resources into ensuring access to proper care and offering people a reasonable quality of life. In fact, expanding MAID is giving our health care system an all-too-easy way out.
The article concludes that parliament needs to consider the risks related to passing Bill C-7:

Introducing a social experiment by expanding MAID when people are more vulnerable than ever is not progressive policy making — it is reckless. In its desire to accommodate some who want to control the timing and manner of their death, it puts others at risk of premature death.

Members of Parliament need to take seriously the discriminatory risks associated with expanding MAID. The pandemic context confirms how we need to strengthen safeguards for persons with disabilities and chronic conditions, rather than diminish them. At a minimum, Parliament should insist on an explicit requirement that all reasonable options are made available and tried first.
Previous articles by Trudo Lemmens:

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