The future of MAiD has the disability community worried

An expansion of Bill C-7 would further the government’s history of eugenics

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A woman holding out her hand with three circular pills in it.
Disability community advocates for systemic change over facilitation of death. PHOTO: Michelle Leman / Pexels

By: Serena Bains, Peak Associate

Content warning: discussions of medical assistance in dying (MAiD), suicidality, ableism, eugenics, anti-Indigenous racism, and self-harm

As the COVID-19 pandemic continues, disabled people are not only experiencing an increased prevalence in ableism, but are also facing the increasing threat of Bill C-7. Bill C-7 is an act which amends the criminal code, specifically the section that addresses medical assistance in dying (MAiD). MAiD is where a person “seeks and obtains medical help to end their life.” Bill C-7 has generally been widely criticized for its impacts on disabled and low-income people.

Currently, Bill C-7 contains a clause which prevents mental illness from being the sole qualifier when accessing Bill C-7. This is set to end in March 2023 unless the bill is amended. Disability advocates are concerned about the options this will lead the government to take:

  1. They let the clause expire which would mean people could access MAiD with only a mental illness, 
  2. They amend the bill to include “mature minors” (also known as children), among other changes, or
  3. A combination of the above. 

Additionally, any of these changes could take effect as early as March 2023.

 

Initial expansion

The concern for the upcoming expansion comes from seeing MAiD be expanded once before on March 17, 2021. This removed the “reasonable foreseeability of natural death” clause amongst other changes that expanded the availability of MAiD to Canadians. The removal of the foreseeable death clause means that one’s natural death no longer has to be expected in the near future to be approved for MAiD. 

The 2021 expansion also created two tracks for MAiD requests: 

  • Track one for people who do have a foreseeable death, where the previous 10 day “reflection period” (gap between approval and procedure) was removed, and 
  • Track two for people who do not have a foreseeable death who have a 90 day waiting period between initial approval and procedure.

I’ve been waiting close to a year to see a psychiatrist in Surrey. If I were to seek MAiD, once I was approved, I would only have to wait 90 days to access it if my death is not foreseeable. If my death is foreseeable, I wouldn’t have to wait any period of time. The government will fund our death, but will not fund our being and healing. 

 

Consequences of another expansion

Any of these expansions in isolation would already be concerning. But if another expansion passes with the inclusion of “mature minors” and mental illness as a sole qualifier, it makes it possible for a scenario where a child whose only condition is major depressive disorder and who does not have a foreseeable death is eligible for MAiD. This would be beyond negligence, it would be eugenics in action. 

As someone with psychiatric disabilities who will be eligible for MAiD under the proposed expansion, I am fearful that the government is lowering my life expectancy in front of my eyes. I experience recurrent suicidal ideation, self-harming behaviour, and feelings of hopelessness (amongst other symptoms) as a result of my conditions. It’s more than possible that I may request MAiD in the future because of my suicidal ideation. 

With previous expansions, the government showed their prioritization of capital over the ability of disabled people to live. In fact, a 2020 report by the Parliamentary Budget Office stated that the 6,465 medically assisted deaths scheduled for 2021 would save the government a net $86.9 million in healthcare costs. Expanding the criteria again for who is eligible for MAiD would save the government an additional $62 million. Thus, not only does the government get to enact eugenics, it’s also a great way to save money. 

If you happen to be disabled, these expansions to MAiD not only feel like a threat, but a promise. A promise that the government is coming to kill us and that they’ll make it happen by any means necessary. They will deny us accessible housing so the only option left is MAiD. They will force us to live below the poverty line so the only option left is MAiD. And if we do not give into their coercion, they will make our lives unlivable.

The government will cover the costs of the medications needed for MAiD, but they won’t cover the cost of medications needed to live. They’ll make MAiD available in every health authority but if you need specialized care, you’ll have to commute to a large city like Vancouver. They’ll provide an email that will connect First Nations communities to a MAiD coordination team but won’t address the suicide crisis in these same communities

The government claims MAiD is an issue of autonomy and that it’s unconstitutional to not provide all disabled Canadians the choice of MAiD. But disabled folks are not being provided any choice in the matter. We don’t have the ability to choose housing, living above the poverty line, employment, marriage, having a family, living in community, healthcare, rehabilitation, healing, or even existence. None of these “choices” are accessible to us except MAiD. Therefore, in practice, many of us only have one choice: MAiD

The state of so-called Canada pushing a bill based in eugenics is not surprising given its history. The Sexual Sterilization Act of the 1900s aimed to prevent the transmission of disability from childbearer to child. There’s also the ongoing practice of forced sterilization of Indigenous women, among countless other examples of Canada’s long and ongoing eugenic practices and legislation. Not to mention, the government has re-opened non-essential services and removed pandemic precautions, such as mask mandates despite the disability community’s objections. It has become clear that Canadians largely do not care about disabled people and the government is capitalizing on this. The incentives from the government perspective seem numerous: reduced healthcare costs, less people registering for disability assistance, and no longer having to address systemic inequalities in housing.

 

Creating an accessible world

Medical professionals admit that people who seek MAiD for mental illness might want to live sometime in the future. It is clear that attempting to determine who is incurable will result in premature deaths to those who may have otherwise improved if provided the opportunity. Even if medical professionals believe they can determine who is suicidal and deny them MAiD, it is incredibly naive to believe that folks who experience suicidality haven’t determined what questions to say “yes” or “no” to when we’re asked the exact same series of questions to determine risk. 

Not to mention, even my diagnoses have been debated by healthcare professionals. BIPOC, folks of marginalized gender identities, poor people, people who use substances, etc. all have different experiences of diagnosis, disability, and treatment according to their intersectionality. Some groups are over or underdiagnosed dependent on their identity. If a diagnosis can change depending on the medical professional, using this as a tool to decide MAiD eligibility becomes fallible and problematic. Another expansion of MAiD will disproportionately impact marginalized communities who have less access to resources and thus are more prone to coercion from the state.

I am wholeheartedly fearful of what the future holds if these further expansions are implemented. The MAiD contagion has already begun. We continue to witness and mourn the deaths of disabled community members during the pandemic. I don’t know how we will be able to cope with the inevitable increase in loss we will be forced to experience if this expansion is successful. The loss of our friends, family, our community members, and ourselves. I’m scared for all of us.

To help fight this expansion, readers can support the Disability Filibuster which creates awareness about why the disabled community is against Bill C-7, keep up to date on opportunities to speak at or send in statements to the Special Joint Committee on MAiD, and call and email your local MP to let them know your opinion on Bill C-7.