Years after medical assistance in dying was legalized, the debate rages on

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Advocates on both sides of the issue are bracing for a fight in the new year over expanding access to medical assistance in dying (MAID) and whether this would pose risks to them. Canadians with disabilities.

In March 2021, Parliament passed Bill C-7. The law made a number of changes to Canada’s MAID law, passed in 2016 – the most notable being the repeal of the requirement that an individual’s death must be “reasonably foreseeable” to be eligible for medical assistance.

Helen Long is CEO of Dying with Dignity Canada, a national organization that advocates for the rights of MAID. She said the law gives a new group of people the right to end their suffering.

“So that opened up what we call a ‘trail two,’ a whole new trail for people with a different type of disease who weren’t eligible in the past, even though they may have suffered in a way. equally intolerable, ”she said. noted.

Another notable change introduced in C-7, she said, allows those who have requested medical assistance in dying and who have been deemed eligible to still receive it if they later lose the ability to consent.

The effects of C-7 on the number of people seeking MAID in Canada are not yet clear.

The federal government has published annual reports covering AMM statistics for the past two years. The most recent covered 2020; it reported 7,595 cases of physician-assisted dying in Canada that year, a 34.2% increase from 2019.

When CBC News asked for the 2021 numbers, a Health Canada spokesperson pointed to the most recent report.

Long said data from some provinces indicates that we could see a very small increase in the number of medically assisted deaths in 2021.

And changes to the law might not be the only reason more people are seeking medical assistance in dying, she said.

“I think this is partly due to the changes, but also the number of MAs is increasing a bit each year, just as people realize that it is something that they can consider at the end of their life,” he said. she declared.

Kristin Raworth’s mother-in-law, Marie, received medical assistance in dying. Marie died in December at the age of 70, after a form of Parkinson’s disease took over her life.

Raworth, who lives in Edmonton, said she was grateful her stepmother had the option.

“It was something that she wanted a lot, and it was very peaceful and she was surrounded by love and people who loved her,” she said.

“She was able to come out of this world on her terms, so I feel very grateful to be available and to be the option that she is – especially now that I have experienced her as a member. of the family.”

The push for advance directives

Marie’s condition deteriorated so rapidly that her medically assisted death date came sooner than expected.

Currently, the law does not allow so-called advance directives – which would allow a person to legally arrange a medically assisted death before being diagnosed with an illness that could one day hamper their ability to give consent. .

Raworth said she thinks this option might be useful.

“Having an advance directive, I think, would be helpful for a lot of people who might want to try and make the most of life before they degenerate and before they are unable to make that decision,” she said. .

Kristin Raworth of Edmonton, whose mother-in-law recently passed away with medical assistance, believes advance directives would be helpful for many people. (Terry Reith / CBC)

Long said many people contacting his organization wanted advance directives to be enshrined in law.

“And we hear about it most often from people with a family history of dementia or Alzheimer’s,” she said.

Dying with Dignity also wants the MAID regime to be open to people with only mental health problems, which current law does not allow.

Long said she wanted Parliament’s special joint committee on physician-assisted dying to be brought down to review existing legislation on physician-assisted dying. A committee was appointed earlier this year, but it was dissolved in the 2021 federal election.

According to Health Canada, the committee was tasked with reviewing “the provisions of the Criminal Code relating to MAID and their application, including, but not limited to, matters relating to mature minors, prior requests, mental illness, the state of palliative care in Canada and the protection of Canadians with disabilities.

The office of Health Minister Jean-Yves Duclos did not respond to a request for comment from CBC News.

A committee of the National Assembly of Quebec recently recommended legalizing prior consent to medical assistance in dying, but rejected expanding access to those whose only problem is a mental health disorder.

Krista Carr, executive vice president of the disability rights organization, Inclusion Canada, said the law as it stands poses a threat to Canadians with disabilities.

She said many people with disabilities would prefer more government assistance – through measures like income support and accessible housing – to the option of physician-assisted dying.

“One of the things the disability community really fought for was to keep [MAID] end of life, ”Carr said.

“They don’t really want to die, they want to live. But they want to live a life on an equal footing with others, which is entirely possible with the right support. But yet we are not ready to provide them that.”

Krista Carr, Executive Vice President of Inclusion Canada, opposes any expansion of AMM. (Supplied / Krista Carr)

Carr said that although efforts to overturn Bill C-7 have been unsuccessful, Inclusion Canada will continue to fight to have the C-7 changes repealed and prevent expanded access to aid. medical death. She called the existing law “enabling” and “discriminatory”.

She said her organization is hearing more and more people with disabilities who are giving up on leading a decent life. She said she was particularly alarmed at the prospect of extending physician-assisted dying to people whose only illness is mental illness.

“It scares me in the light of day”

“We have extremely long wait lists for mental health services… and people have been waiting literally years for mental health services that would help them,” Carr said.

“It will cost a lot less to eliminate people than to support them, and that scares me.”

She said members of the disability community are considering challenging the Bill of Rights of the AMM law. Carr said the law could also violate the United Nations Convention on the Rights of Persons with Disabilities, which Canada has signed.

Raworth wrote about his experience with MAID in the online publication The Line. She said the responses she received showed her that this is a topic that still makes a lot of people uncomfortable.

“Almost everyone told me that they thought they couldn’t talk about it publicly, either as a provider or as a family member who went through this, because there is still a quantity significant stigma attached to it. ,” she said.

Jennifer Laewetz of Prince Albert, Saskatchewan, whose sister died of a medically assisted death in 2018, said medically assisted dying is widely misunderstood because very few people have felt the need for it.

“It is torn apart by a lot of people who were not affected by it,” she said.

Earlier this year, Laewetz thanked Jody Wilson-Raybould, the former justice minister and attorney general, for her work to make physician-assisted dying legal.

Within months of the death of Laewetz’s sister, Saskatchewan stopped labeling medically assisted deaths as “suicides” on death certificates. It was a decision she said she greatly appreciated.

“For me, personally, MAID was one of those things where it was probably the most beneficial thing that my sister had the opportunity to choose for herself in the end,” Laewetz said.

“I say this with a lot of compassion, because when it comes to MAID, people just don’t know until you’re around.”


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