National Post Barbara Kay: Wider access to assisted dying in Canada will be catastrophic for the disabled

National Post - Saturday February 13th, 2021

Unless greater supports are provided for the disabled they will be pushed more towards assisted dying, writes Barbara Kay. Getty Images/iStockphoto

A bill to expand access to medical assistance in dying (MAiD) comes to a Senate vote no later than Feb 17. That leaves a bare working week for the House to consider what may be a number of Senate-approved amendments before a court-imposed deadline for final passage on Feb 26.

Bill C-7 is the Trudeau government’s response to the 2019 Quebec Superior Court Truchon ruling — named for Jean Truchon, one of its two disabled, but not dying, plaintiffs — which struck down the current euthanasia law’s “natural death is reasonably foreseeable” criterion as too narrow. It asserted the right to MAiD for any Canadian suffering what he or she considers irremediable mental or physical suffering. The government did not appeal the judgment, an indication of its willingness — in fact eagerness — to meet and, as evidenced in Bill C-7, go beyond Truchon’s request.

For example, C-7 eliminates the 10-day reflection period, and reduces the need for two witnesses to one (who may be part of the caretaking process). C-7 would therefore open the door to MAiD on demand for people struggling with chronic physical or mental disability — a total of about six million Canadians, according to government stats.

This feature is viewed as particularly catastrophic by many disabled Canadians, as well it should be. The obvious message to the disabled is that our society puts a higher value on “dying with dignity” than living with dignity, even with greatly diminished independence. Those disabled who require a great deal of costly care will be reminded far more overtly than they already are — and we know they are — that MAiD is available to them. As well, those who have just become disabled through calamitous injury will be encouraged to consider MAiD when they are most psychologically vulnerable to the temptation.

Nobody is more sensitive to this inevitable consequence than David Shannon, who became quadriplegic following a spinal cord injury in a rugby scrum at age 18. Despite multiple surgeries and close brushes with death, he leads what he considers a full life. An Order of Ontario and Order of Canada recipient, Shannon obtained a law degree, and has acted as a Human Rights Commissioner. Shannon writes, “I’ve loved and been loved. My proudest accomplishment is that I lived.” He asks, “Why is there not the promotion to pursue one’s autonomy?”

In a December speech to the House of Commons on C-7 Conservative MP Tamara Jansen said the disabled have to know that there is a “viable alternative” to death.

That’s the moral dilemma in a nutshell. Without a “viable alternative,” one cannot say euthanasia is a freely made choice. In reality, disabled people often choose MAiD because the only other options are not viable.

Roger Foley’s case, for example, continues to haunt me two years after I first wrote about him. Foley suffers from a neurodegenerative disease, cerebellar ataxia, that renders him unable to function independently. In his London hospital he has suffered food poisoning and substandard care serious enough to cause suicidal ideation. Foley has recorded being reminded that MAiD is an option. His only other choice is a forced discharge and dependence on contracted agencies that proved unreliable in the past. Foley wants a third option: “assisted life with self-directed funding,” which would cost 10-15 per cent of the daily $1,845 his London hospital charges him.

Why can’t he have that? It would allow him to live in the community with dignity, safety and continuity of care instead of in the soulless sterility of a hospital. Foley’s spirit and determination are indomitable, but one can see how easily others in his situation might request MAiD and, thanks to C-7, get it on the same day.

In 2016, Quebecer Archie Rolland, who suffered from advanced ALS and required specialized care chose MAiD when he was transferred against his will, for cost-saving reasons, to a facility with inadequately trained staff whose incompetence made his life a “living hell.” In the end, Rolland said, “It’s not the ALS that’s killing me; it’s my fight for better care, for decent care.”

Dr. Catherine Frazee gave heartbreaking testimony to the Senate hearings, citing Rolland’s case and that of Sean Tagert, also a prisoner of ALS. Tagert considered his quality of life good. He had shared custody of his adolescent son, while an elaborate technological system gave his days purpose. Denied the two additional daily hours of home care he required, Tagert was transferred to an institution far from his son, without the sophisticated technology that added critical value to his existence. So no “viable alternative” for Tagert. Is it any wonder he then chose MAiD?

A 2017 Journal of Ethics in Mental Health study of those who signed up for assisted suicide in Oregon concluded that pain and suffering were amongst the least cited reasons for choosing assisted death. Most significant were loss of autonomy, loss of self-control, feelings of being a burden, and, paramountly, fear of being alone. As anti-euthanasia physician Paul Saba writes in his eloquent new book, Made to Live, “The euthanasia and assisted suicide mindset has been marketed by attacking people’s failing courage and preying on their fear that they will end their lives as a worthless human burden or worse, alone.” Further, “It is irresponsible to promote the myth that euthanasia and assisted suicide are never the result of severe external pressures, and that they are pure rational choices freely arrived at by citizens of a civilized and caring country.”

Quebec Justice Christine Baudouin approved the right to MAiD (which he got) of the cerebral-palsy afflicted Jean Truchon, because “He can no longer live on his own … He says he has been dead since 2012.” Why couldn’t he live on his own? He couldn’t afford to. In an August 2017 email to Jonathan Marchand, who suffers from muscular dystrophy and is “trapped in my long-term care facility,” but has long fought for the right of the disabled, including Jean Truchon, to live with adequate assistance at home, Truchon confided (my translation), “I want to thank you for your interest in my cause. In response to your question concerning home care, I think that actually if there were services of 70 hours and more, I would have preferred to stay at home and possibly I would not have had the same wish to die.”

Two more care hours daily might have saved Sean Tagert’s and Jean Truchon’s lives. We should not be offering wider access to euthanasia until every Canadian that needs it has a truly viable option: access to excellent palliative care (only accessible to 30 per cent of us) or optimal life assistance for the disabled. But C-7 will, shamefully, make Canada one of the most MAiD-friendly countries in the world.