Canada is euthanizing its poor and disabled.

Euthanasia for poverty is horrifying, profane, the outcome of a failed social welfare system and it is indefensible. 

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

David Moscrop wrote an excellent article that was published by Jacobin Magazine on May 2, 2024. Jacobin is an ideologically left magazine, which is concerned about Canada killing people with disabilities and the poor by euthanasia, known as MAiD. The article begins with this quote:

Canada boasts one of the world’s highest assisted-death rates, supposedly enabling the terminally ill to die with dignity. However, this suicide program increasingly resembles a dystopian replacement for care services, exchanging social welfare for euthanasia.

Normand Meunier

Moscrop tells the story of Normand Meunier, the quadriplegic man in Québec who died by euthanasia after suffering from horrific neglect. Moscrop writes:

For want of a mattress, a man is dead. That’s the story, in sum, of a quadriplegic man who chose to end his life in January through medically assisted death. Normand Meunier’s story, as reported by the CBC, began with a visit to a Quebec hospital due to a respiratory virus. Meunier subsequently developed a painful bedsore after being left without access to a mattress to accommodate his needs. Thereafter, he applied to Canada’s Medical Assistance in Dying (MAiD) program.

As Rachel Watts writes in her report, Meunier spent ninety-five hours on a stretcher in the emergency room — just hours short of four days. The bedsore he developed “eventually worsened to the point where bone and muscle were exposed and visible — making his recovery and prognosis bleak.” The man who “didn’t want to be a burden” chose to die at home. An internal investigation into the matter is underway.

I find it interesting that the article states that Meunier chose to die by euthanasia when in fact he was put into an untenable situation. Moscrop then reinforces the concerns of the disability community:

Disability and other advocates have been warning us for years that MAiD puts people at risk. They warned that the risk of people choosing death — because it’s easier than fighting to survive in a system that impoverishes people, and disproportionately does so to those who are disabled — is real. Underinvestment in medical care will push people up to and beyond the brink, which means some will choose to die instead of “burden” their loved ones or society at large. They were right.

Moscrop comments on how euthanasia is the outcome of a failed social welfare state:

A libertarian ethos partially underwrote the fact that not many people blinked when MAiD was initially rolled out. Taking a more expansive view of rights, many of those not swayed by rote libertarianism were convinced that concerns over bodily autonomy and compassion were reason enough to adopt MAiD. However, in the absence of a robust welfare state, and in the face of structural poverty and discrimination, particularly toward disabled people, there is no world in which the MAiD program can be understood to be “progressive.”

Indeed, last year, Jeremy Appel argued that MAiD was “beginning to look like a dystopian end run around the cost of providing social welfare.” Initially supportive, he changed his mind on MAiD as he considered that the decisions people make are not strictly speaking individual but are instead collectively shaped and sometimes “the product of social circumstances, which are outside of their control.” When we don’t care for one another, what do we end up with?

“I’ve come to realize,” wrote Appel, “that euthanasia in Canada represents the cynical endgame of social provisioning with the brutal logic of late-stage capitalism — we’ll starve you of the funding you need to live a dignified life [. . .] and if you don’t like it, why don’t you just kill yourself?”

Moscrop then comments on that euthanasia for psychiatric reasons has been delayed in Canada based on the lack of mental health care. He refers to the reality as grotesque and writes that this is the stuff of nightmarish science fiction. Moscrop comments on the broken social welfare system in Canada.

In Canada’s most populous province, Ontario, a recipient of disability support receives about $1,300 a month — a pittance they’re meant to stretch to cover food, shelter, and other basic needs. Ontario Works — the province’s welfare program — pays a current maximum of $733 a month. Meanwhile, rental costs for a one bedroom apartment routinely push toward an average of $2,000 a month in many cities. In April, in Toronto, a one bedroom apartment averaged almost $2,500 a month.

Moscrop challenges a statement by euthanasia activists James Downer and Susan MacDonald who stated:

[d]espite fears that availability of MAiD for people with terminal illness would lead to requests for MAiD driven by socioeconomic deprivation or poor service availability (e.g., palliative care), available evidence consistently indicates that MAiD is most commonly received by people of high socioeconomic status and lower support needs, and those with high involvement of palliative care.

Moscrop replies:

By their own admission, the data on this matter is imperfect. But even if it were, the fact that “most” patients who choose MAiD are better off socioeconomically is beside the point. Some are not — and those “some” are important. That includes a man living with Amyotrophic Lateral Sclerosis who, in 2019, chose medically assisted death because he couldn’t find adequate medical care that would also allow him to be with his son. It also includes a man whose application listed only “hearing loss,” and whose brother says he was “basically put to death.” This story came a year after experts raised the concern that the country’s MAiD regime was in violation of the Universal Declaration of Human Rights.

In 2022, Global News said the quiet part out loud: poverty is driving disabled Canadians to consider MAiD. Those “some” who are driven to assisted death because of poverty or an inability to access adequate care deserve to live with dignity and with the resources they need to live as they wish. They should never, ever feel the pressure to choose to die because our social welfare institutions are starved and our health care system has been vandalized through years of austerity and poor management.

Moscrop then states that Canada has the resources to prevent endemic poverty and provide adequate care, that poor people being euthanized by the state is profane.

Trudo Lemmens

Moscrop then refers to a recent article by professor Trudo Lemmens who is a critic of Canada's euthanasia law.

In a February piece for the Globe and Mail, University of Toronto law professor Trudo Lemmens wrote, “The results of our MAiD regime’s promotion of access to death as a benefit, and the trivialization of death as a harm to be protected against, are increasingly clear.” In critiquing MAiD’s second track, which allows physician-assisted death for those who do not face “a reasonably foreseeable death,” Lemmens points out that within two years of its adoption, “‘track two’ MAiD providers had ended already the lives of close to seven hundred disabled people, most of whom likely had years of life left.”

In raising concerns about expanding MAiD to cover mental illness, Lemmens added that “there are growing concerns that inadequate social and mental health care, and a failure to provide housing supports, push people to request MAiD,” noting that “[a]dding mental illness as a basis for MAiD will only increase the number of people exposed to higher risks of premature death.”

Gabrielle Peters

Moscrop continues by referring to a commentary from disability leader Gabrielle Peters.

In 2021, Gabrielle Peters warned in Maclean’s that extending MAiD to cover those who weren’t facing an immediately foreseeable death was “dangerous, unsettling and deeply flawed.” She traced the various ways in which a broader MAiD law could lead to people choosing to die in the face of austerity, adding an intersectional lens that is often missing from our discussions and debates over the issue.

She warned that we were failing to consider “how poverty and racism intersect with disability to create greater risk of harm, more institutional bias and barriers, additional layers of othering and dehumanization, and fewer resources for addressing any of these.” And now here we are. We should have listened more carefully.

Moscrop ends his article by suggesting that euthanasia may be OK based on personal choice but it is indefensible when it is based on poverty.

While MAiD may be defensible as a means for individuals to exercise personal choice in how they live and how they die when facing illness and pain, it is plainly indefensible when state-induced austerity and mismanagement leads to people choosing to end their lives that have been made unnecessarily miserable. In short, we are killing people for being poor and disabled, which is horrifying.

It thus falls to proponents of MAiD to show how such deaths can be avoided, just as it falls to policymakers to build or rebuild institutions that ensure no one ever opts to end their life for lack of resources or support, which we could provide in abundance if we choose to.

I agree with most of Moscrop's comments but I disagree with his statement that euthanasia is possibly defensible as a means of individuals exercising personal choice. Even though people with disabilities experience social devaluation in Canada, they may be still exercising personal choice when they ask to be killed.

The problem with modern writers is that they miss the fact that euthanasia is about killing people. Even if Canada had a greater level of equality, there would be people who ask to be killed based on their poverty or their concerns about homelessness.

The real concern is that Canada has given medical professionals the right in law to kill their patients. This is about people killing people.

Nonetheless Moscrop is right that euthanasia based on poverty or disability is rarely based on personal choice and autonomy, it is horrifying, it is profane, it is the outcome of a failed social welfare system and it is indefensible.