mcguinty and tang: medically assisted death – let's offer humane and dignified living before offering a lethal injection
poor mental health, coupled with insufficient financial, personal and/or social supports, often leads to suicidal wishes in people overwhelmed by their circumstances. they need support, which too often is not available in a timely manner.
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individuals often face the prospect of choosing between an assisted death or continuing the uphill struggle of living with inadequate supports; to place an individual in such a predicament is cruel and fundamentally unjust.
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as the federal government seeks to expand eligibility for medical assistance in dying (maid) through bill c-7, canada once again finds itself examining the values and principles upon which our society is built. hospitals, hitherto considered places of refuge and care for the sick, are now arranging and facilitating the deaths of patients, the very outcome that most seeking care would hope to prevent. as highlighted by a case in nova scotia, once this is set into motion, concerned family have very little recourse to stop the train carrying loved ones to their death.
poor mental health, coupled with the stress of insufficient financial, personal and/or social supports, often leads to death wishes in people overwhelmed by their circumstances. current pressure to remove the exclusion of mental illness as a sole eligibility criterion in bill c-7 would make suicide prevention methods ineffective for individuals over the age of 18 who are contemplating suicide and suffering solely from psychological distress.
bill c-7 will grant non-dying people assistance to end their lives after 90 days (less time if their assessor feels they may imminently lose their capacity to consent to their death) without at the same time requiring that they have reasonable access to supports needed to live a dignified life. as required by the bill, offering information about alternative care options is a far cry from being able to actually access care in a timely manner.
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lack of adequate supports is often a direct stressor that triggers suicidal death wishes in an individual, yet wait times for psychiatric services can often exceed the 90-day assessment period allotted by bill c-7.
the deplorable state of scarce supportive human resources has been made abundantly clear by the covid-19 pandemic in long-term care facilities and in marginalized populations. a cbc story recently exposed the appalling conditions in which a 35-year-old hamilton man had been living, surrounded by feces and urine, prior to having his life ended through maid.
we would do better as a society to offer humane and dignified living before offering a lethal injection. while the federal government presumes in bill c-7 that allowing 90 days for an assessment for maid for non-dying individuals is sufficient, clinical experience has revealed that some services, such as specialized residences for individuals requiring intensive support, can take years to access.
without the necessary supports in place to parallel a permissive maid regime, individuals are left with the prospect of choosing between an assisted death or continuing the uphill struggle of living with inadequate supports; to place an individual in such a predicament is cruel and fundamentally unjust.
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a recent report by un human rights experts and special rapporteurs highlighted these concerns by saying: “people with disabilities condemned to live in poverty due to the lack of adequate social protection can decide to end their lives as a gesture of despair. set against the legacy of accumulated disadvantages their ‘architecture of choice’ could hardly be said to be unproblematic.”
the maid to mad declaration gives voice to concerns of more than 800 canadian physicians regarding bill c-7. we would be wise to heed the warning of those who witness daily to the pressures faced by people struggling to live without the resources required for dignified living.
in truth, maid legislation affects us all. as the current pandemic has demonstrated, our state of health is fragile, especially when exposed to prolonged stress and circumstances outside our control. if we as a society do not invest and advocate for life-affirming health care services and social supports to provide dignified living to all, we may one day come calling for help and find the only accessible option offered is death. perhaps we should pause for a moment and reflect on whether this is truly the kind of society we wish to build as a nation; what we sow today is what we shall reap tomorrow.
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dylan mcguinty jr., ma, jd, is a lawyer who practises in ottawa. sephora tang, md, frcpc, is a psychiatrist in ottawa.
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