The scope of euthanasia in Canada | It will also be allowed to people with mental illnesses

In 2016, Canada legalized medically assisted dying for adults suffering from a “serious and irremediable” terminal illness with “reasonably foreseeable” natural death. Justice Minister David Lametti considers it “a compassionate action, while protecting those who are particularly vulnerable”, and Health Minister Jean-Yves Duclos maintains that the euthanasia law “recognizes the rights of all people. .. as well as the inherent and equal value of every life.”

This program, called MAID (for its acronym in English Medical Assistance In Dying – medical assistance in dying) began to be applied progressively in an increasingly liberal and easy way. Cases, thus, jumped from 1,000 in 2016 to 10,000 (3.3 percent of total deaths in Canada) in 2021, when new legislation enabled it for people with serious illness or disability that “cannot be alleviated in the conditions it deems acceptable.

This meant that they could apply for MAID even when the death of the person is not foreseen in any way or if they are otherwise in good health. For Marie-Claude Landry, head of the country’s human rights commission, MAID is functioning as “the default option for Canada to meet its human rights obligations.”

Yuan Yi Zhu, a researcher at Nuffield College in Oxford, in analyzing MAID, resorted to Anatole France’s phrase that “the law, in its majestic equality, prohibits both rich and poor from sleeping under bridges, begging on the streets and stealing bread”, to conclude that “Canadian law, in all its majesty, has allowed rich and poor alike to commit suicide if they are too poor to continue living in dignity. In fact, the ever-generous Canadian state will even pay for their deaths. What it won’t do is spend money to allow them to live rather than kill themselves.”

The threat to disabled people

Prime Minister Justin Trudeau declared that no one will have to resort to MAID because they are not “receiving the support and care they really need.” But increasingly people with diseases that require a certain level of expenses to be able to bear their suffering, but without sufficient resources to face them, request the MAID for not having support from the State. Their poverty means that their suffering “cannot be alleviated in the conditions that it deems acceptable”, and they opt for euthanasia.

Amir Farsoud, a disabled 54-year-old who cannot afford housing, explained his choice by stating: “I don’t want to die, but I don’t want to be homeless any more than I don’t want to die”. Richard Ewald, with stage four chronic obstructive pulmonary disease and liver disease, plans to turn to MAID because of his poverty. “I’m not suicidal,” he says, but “sometimes it’s a choice between burning to death or jumping off a high-rise building.” Sathya Dhara Kovac chose to die at age 44 not because of the genetic disease he suffered from, “but because of the system… He could have had more time if he had had more help,” he said in his obituary. Denise, disabled with other serious complications, who at 31 chose to die after trying in vain to find affordable housing, said: “I applied for MAID essentially… because of extreme poverty.”

Nearly a quarter of disabled people in Canada rely on welfare because they have difficulty working. For Naheed Dosani, a doctor and professor at the University of Toronto, that means living “in utter poverty” — which prompts them to seek MAID, considering that Canada’s social care spending is the “lowest among the In industrialized countries, palliative care is only accessible to a minority and waiting times in the public health sector can be excruciating. A study by the Canadian parliament in 2020 calculated that by 2021 extending MAID would be equivalent to only 20 percent of health expenditures, managing to avoid spending the rest. With the new legislation, a similar drop is expected.

Dosani says the cycle of living in poverty and stress is making people sick and making people with disabilities choose MAID because they “don’t have money to live on.” For this reason, Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, sentences MAID as “the greatest existential threat to disabled people since the Nazi program in Germany in the 1930s.” .

A free service

In March 2023, MAID may be offered to people with mental illness. For Andrew Bennett it means that “our country sleepwalks towards a tragic dystopian reality. We have become a society in which you are only recognized as having inherent dignity or worth as a human being if you possess a sound mind in a sound body and that you are socially, economically and, dare I say, politically useful.”

According to Health Canada’s latest Medical Assistance in Dying report, 17.3% of people cited “isolation or loneliness” as a reason and 35.7% being a “burden on family, friends or carers”. In 2021, in the state of Oregon, which legalized the program in 1997, 54.2% justified their decision as being a “burden on family, friends or caregivers” and 92% as being “less able to participate in activities that make make life nice.” Of the total deaths since 1997, 27.5% have mentioned “inadequate pain control or worry about it” as one of their concerns at the end of life.

But there are proposals to further extend MAID. Louis Roy, speaking on behalf of the Quebec College of Physicians before the Special Joint Committee on Medical Assistance in Dying, recommended that MAID be made available to older people who are ‘tired of living’. Senator Pamela Wallin, a strong supporter of MAID, has introduced a bill that would allow involuntary euthanasia by advance directive when a person is unable to consent to being killed.

Meghan Nicholls, CEO of a soup kitchen in Ontario that serves 30,000 people, warns that many of those who attend “are considering death with medical assistance or suicide because they can no longer live in extreme poverty.” Catherine Frazee, professor emeritus at Ryerson University’s School of Disability Studies, said it is “cold consolation to be offered the option of dying when you are not offered the option of living a dignified life.”

But for him National Review, euthanasia is killing the poor in Canada; in the opinion of bioethicist Wesley J. Smith: “In Canada, medically assisted dying is a solution to poverty.”

From assisted death to assisted suicide

For Nicole Scheidl, executive director of Canadian Physicians for life, MAID is being offered “to people whose motivations are driven by social concerns such as loneliness, poverty and neglect.” For her, “when someone is suicidal, they cannot see the light at the end of the tunnel. We should help them get to the light, not facilitate the end of their lives.”

Justice Minister David Lametti, in the face of criticism regarding the expansion of MAID next March to people with mental illnesses without adequate social and medical support, declared that it should be remembered “that suicide is generally available to people. This is a group within the population that, for physical and possibly mental reasons, cannot make that decision for themselves. And ultimately, this gives them a more humane way to make a decision that they otherwise might have made if they could have done otherwise.”

Contrary to what Lametti said, Althia Raj from Toronto Star Question. Did the Minister of Justice say what he was not meant to say?

Andrés Ferrari Haines is an associate professor in the Department of Economics and International Relations of the Faculty of Economic Sciences of UFRGS. he NEBRICS researcher.

The scope of euthanasia in Canada | It will also be allowed to people with mental illnesses