Medical assistance in dying is suicide by another’s hand, one that was trained to heal and restore life. It’s now being targetted at people on the basis of disability. This issue is so serious the UN has weighed in on it. I wrote the following email to my MP this week (I’ve omitted my intro paragraph). If you haven’t written to your MP yet, I urge you to do so. You can use this as a template, and please share widely. People with disabilities deserve the right to life, liberty, and security of person under Section 7 of the Charter as much as anyone else.
Dear MP . . .
You cannot serve two masters, goes the old adage, which happens to be true. In this case, a physician and a society cannot serve both Zero Suicide and medical assistance in dying, for the latter directly prevents the former. When the state pays for a physician to carry out suicidal ideation, then it simply cannot pursue Zero Suicide anymore.
“Canada unveiled its first Zero Suicide campaign in May 2016 at the St. Joseph’s Healthcare Foundation in London, Ontario. This quality assurance initiative “set a bold, aspirational goal of reducing suicides and attempted suicides for individuals within our mental health program, and eventually throughout the London area.””
https://www.suicideinfo.ca/resource/ie23-aiming-perfection-zero-suicide-movement/
We barely understand suicide and suicidal ideation. Traditionally, suicide is seen as part of depression. Or in people with disabilities and terminal illnesses, a natural condition that arises out of suffering. But research is showing that suicide is its own disease, separate from depression or other mental illnesses:
“They base their argument on mounting evidence showing that the brains of people who have committed suicide have striking similarities, quite distinct from what is seen in the brains of people who have similar mood disorders but who died of natural causes.”
https://www.newscientist.com/article/dn23566-suicidal-behaviour-is-a-disease-psychiatrists-argue/
People who suffer greatly do not necessarily want to die nor do they seek suicide. Why some do should be researched and understood instead of assuming that anyone who suffers would, of course, want to die. Because who wants to suffer, goes the prevalent myth? People underestimate their desire for life in suffering and what they’re capable of until they’re in the midst of a crisis.
We human beings are where we are as a species because of our infinite in-built capacity to adapt to suffering and harsh conditions and innovate ways to better our conditions and ourselves.
Examples of suffering that perseveres and does not seek suicide litters history and current events. So why do we assume that suffering is the opposite of dignified? Why do we assume that given a choice, people with disabilities would rather be dead? And why do we assume suicidal ideation in a person with disability (mental illness) or terminal illness is normal, is acceptable and should be honoured but not in that of a person who doesn’t look or act disabled?
Fifty percent of the homeless in Toronto have brain injury. Untreated brain injury. I know it’s untreated because standard medical care of brain injury remains in the 20th century, as I’ve experienced and written about extensively, and is why I’m now creating a brain injury hub. Some are lucky enough or persistent enough to find and fund their objective diagnostic assessments and effective treatments. Perhaps they can also afford replacement for community care that’s been cut to the bone. These people can return to work and a social life. Untreated brain injury can land a person on the street because of minimal health care, decreasing community care, and loss of job, social support, and housing. There can be no greater suffering in Canada than being homeless. Their lives lack dignity in every sense.
Why is it we do not fund living with dignity?
Despite that, the homeless remain doggedly alive.
So suffering alone is not why people want to die.
Medical assistance in dying is the only non-researched “health care treatment” that’s fatal by design.
https://www.cbc.ca/news/opinion/opinion-medical-assistance-in-dying-maid-1.5934977
For no other condition would we consider a treatment that kills to be acceptable. The state does not pay for any treatment that isn’t researched extensively, even when approved by Health Canada. We barely understand suicide, and we certainly haven’t designed any research around a physician killing a person versus providing effective treatments and/or the state providing guaranteed liveable income support and/or robust social support. Shouldn’t we fix social determinants of health before considering paying a person to assist suicide?
Research proves that social support affects cardiac health. Those who live in caring, supportive neighbourhoods have healthier hearts and lower mortality rates even with bad diets and poor exercise. Given human beings are social animals and greatly affected by peers and the social group, this finding doesn’t surprise. How much more true must it be for mental health?
Chronic illness is disability. Mental illness is disability. Unhealed injury is disability. Bill C-7 targets on the basis of disability.
Canada is a signatory to the UN Convention on the Rights of Persons with Disabilities. The UN has stated that Bill C-7 “directly violate[s] Article 10 of the UN Convention on the Rights of Persons with Disabilities, which requires States to ensure that persons with disabilities can effectively enjoy their inherent right to life on an equal basis with others.”
https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=26687&LangID=E
Canada considers itself a supporter of the UN and progressive in its support of the vulnerable. Bill C-7 contradicts that reputation and reveals the myth of Canada as a caring nation to be false.
Bill C-7 also contravenes the Charter of Rights and Freedoms, Section 7.
“7. Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”
Charter of Rights and Freedoms, Canada
Medical assistance in dying on the basis of disability, and the presumptions behind it, challenges security of person, deprives people of life-saving health care, curtails liberty as one has to be careful where one goes or which doctor one sees so as not to be persuaded towards death, and is already leading to premature death.
I wrote about the plight of people deemed “vegetative” from medical prejudice:
How much more would such a person’s life be in jeopardy if the physician treating them killed people who requested it? Just as the state cannot attain Zero Suicide as long as it’s paying for medical assistance in dying, so too a physician cannot serve death and life at the same time. Life and death have always existed in conflict; death is easier to serve than life. Death ends complex doctor-patient relationships quickly. Serving the health care needs of a person with a disability lasts for decades and requires great deal of effort and time because of lack in treatment funding and the prejudices against liveable income support, society, and systemic ableism.
The pandemic has created new opportunities for assault against security of person when disabled:
People with disabilities are in such despair over Canada not supporting them in life, they’re seeking medical assistance in dying because the pandemic has starkly exposed the two-tier treatment of people with disabilities versus the abled. Doctors are already persuading their chronically ill patients into that route.
People with disabilities receive half the income support the latter received from the Trudeau government through CERB. Chronically ill and injured who are also homeless are told to stay in risky shelters while governments slowly, slowly build housing. Shelters is not living with dignity and threatens security of person and life. The disabled – who include those with chronic illnesses — have their homecare cut off or their personal support workers infect them with COVID-19. You can’t live without; but you may not be able to live with. The Ontario government replaced a robust subway with a less-accessible copy of the boondoggle SRT, and accessibility is seen as an expense best put off or reversed in spite of accessibility laws – people with disabilities rely on public transit because they don’t have the income to afford private transit. Governments don’t enforce their own accessibility laws and allow for letting people die from COVID-19 on the basis of chronic illness (disability).
https://pario.blogspot.com/2015/09/ttcaccess-legally-mandated-ttc-public.html
https://pario.blogspot.com/2016/09/ttchelps-got-this-button-fixed.html
https://pario.blogspot.com/2018/04/whither-torontos-ttc-accessibility-and.html
https://pario.blogspot.com/2018/09/co-designing-ttc-for-cognitive-visual.html
https://pario.blogspot.com/2015/09/ttcaccess-one-on-one-with-ttc-design-on.html
https://pario.blogspot.com/2018/12/how-ttc-made-bombardiers-accessible.html
All the points of discrimination such as sexism, racism, ableism, ageism drive the societal desire for euthanizing the disabled. Euthanasia of the disabled is predicated on the idea that mental illness causes extreme suffering, the falsehood that it and brain injury cannot be treated, that being injured is your own fault, and being disabled is akin to laziness. Mental illness and brain injury can be treated. Governments just don’t fund it well or at all, and too many physicians won’t educate themselves on it. Why not fix those problems instead of lazily offering death? Why not replace the awful provincial disability income support programs with guaranteed liveable basic income across the country to lift people up out of despair from below-poverty-line income?
Disability isn’t the problem. The problem is the way we’re shunned, rejected, abandoned, impoverished, and our health neglected. How unsurprising then that the path those societal actions lead to is medical assistance in dying instead of medical and government assistance in living. How deplorable.
A few words by those who are suffering because of the Government of Canada:
“it’s manslaughter” ->
This is just the tip of the iceberg. While the mainstream news are mostly silent on this subject, Twitter erupted. It’s the only place where we can speak out and feel we’re being heard.
“The experts said that even when access to medical assistance in dying is restricted to those at the end of life or with a terminal illness, people with disabilities, older persons, and especially older persons with disabilities, may feel subtly pressured to end their lives prematurely due to attitudinal barriers as well as the lack of appropriate services and support.” (UN)
https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=26687&LangID=E
Medical assistance in suicide has no place in a country that aspires to Zero Suicide. Zero Suicide is for all.
Our seniors and our disabled deserve better from our government.
Best,
Shireen Jeejeebhoy
