Are vulnerable citizens at risk?
Concerns about where medical assistance in dying might be going
Is the option of medical assistance in dying leaving some citizens more vulnerable? We should carefully examine this question as a society.
I am worried that, despite stated limits in law, a medical option to die might be leaping in front of a right to quality care and support.
In 2016, Parliament passed “An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).” This law followed a decision of the Supreme Court of Canada (Carter v. Canada) in which a complete prohibition on medically assisted death was deemed unconstitutional.
In the 2016 statute, federal lawmakers laid out a process to enable some adults to choose medical assistance in dying. The law states that a person must be able to give full and informed consent. He or she must have a serious illness, disease or disability, be in an advanced and irreversible state of decline, and be experiencing unbearable mental or physical suffering.
However, the condition does not have to be fatal or terminal.
Roger Foley, 42, is living with a neurodegenerative disease cerebellar ataxia. He needs help with things like sitting upright and eating.
He is now in Victoria Hospital in London, Ont. He says he’s there because inadequate or incompetent agency homecare left him at risk. He wants to selfdirect his homecare; he wants to be allowed to use the allotted resources to hire qualified people who would be responsible to him and not fall asleep on the job.
His appeals and requests have been declined.
In a legal action for better care, Foley alleges that he was given only two options: go home and take the homecare the agencies provide or consider medical assistance in dying.
Although this case is still before the courts, advocates for people with disabilities have pointed out that it exposes poor safeguards.
“This is the problem: medical assistance in dying is come to be seen as another health care intervention when that was never the vision for this,” Michael Bach told CTV News. He is the managing director for the Institute for Research and Development on Inclusion and Society (IRIS), which advocates for disability rights.
Meanwhile, Foley’s lawyer said that his client was not interested in assisted death but in “assisted life.”
Last year, Newfoundland and Labrador’s minister responsible for persons with disabilities expressed concerns about reports that medical assistance in dying was offered as an option by Candice Lewis’s doctor. Lewis is a 25-yearold woman living with spina bifida, cerebral palsy and chronic seizure disorder. By all indications, Lewis was simply hoping for better care.
Even in some cases where medical assistance in dying is the purported choice of a person, we need to be concerned about subtle familial or social pressures. No one should consider herself or himself a burden on family or society.
Already, for instance, there is lobbying to make it easier for people living with mental illness to access medical assistance in dying.
And people who feel weighed down by grief or advanced age, or think it would be impossible to go on without a cherished spouse, should know that we would cherish them and support them as a community.
On March 27, Shirley and George Brickenden, ages 94 and 95 respectively, received medical assistance in dying at the same time at a Toronto retirement home. They had been married for 73 years. They did not want to be apart.
They had started to contemplate dying together when Shirley’s health took a turn for the worse. Both felt that their quality of life was declining, but their deaths were not imminent by any means.
Two days before they passed away, as part of a kind of ritual of preparation for their appointed hour, the Brickendens went out for a pleasant supper at their favourite restaurant.
If the Brickendens’ case becomes common, it could mean undue pressure on others who are elderly, frail or vulnerable to chart a ritual while they still can. That worries me.
There is still great dignity in passing away at an hour that we have not chosen. And there is always dignity in “assisted life.” We should do much better on assuring overall care for each other. We should keep the focus there.
“No one should consider herself or himself a burden on family or society.”