Proposed changes to assisted-dying law make death a viable option for people with disabilities, advocate fears

Legislation that would expand access to medical assistance in dying is a backward step in helping people with disabilities, a B.C. advocate says. 

Bill C-7 recently passed in the House of Commons and is now being debated in the Senate before tomorrow's court-imposed deadline. 

The bill was introduced earlier this year in response to a September 2019 Superior Court of Quebec ruling that found that the law's precondition for obtaining a physician-assisted death — that the individual seeking it must face a "reasonably foreseeable" natural death — was unconstitutional.

The bill proposes to remove that requirement. It also disqualifies those whose sole underlying condition is a mental illness from obtaining an assisted death.

Spring Hawes, a former Invermere city councillor and the co-founder of Dignity Denied, says the bill is problematic. 

It has the potential to create situations where people with disabilities could be offered a medically assisted death before, instead of, or at the same time as being offered those other supports to live a healthy and fulfilling life, she said.

"Rather than funding and making life a possible and viable choice for many people, we're entertaining this option of asking them if they would like to die, and it's very scary," said Hawes, who has a spinal cord injury and uses a wheelchair. 

"There is the danger that it might be considered a favour to offer someone dying when really that person just needs to have access to better care, better supports or the things they need to live well."

Two-thirds of disabled people live in poverty or can't afford their medications, and people with disabilities suffer violence at higher rates than the able-bodied population, she said. Many don't have accessible housing or transportation.

Hawes says studies show when offered these supports, people with disabilities report having a very high standard and satisfaction with their quality of life.

A few months after she suffered her spinal cord injury, Hawes said she couldn't move her arms and had a feeding tube.

"I had no way of knowing and appreciating what my life could turn out to be. If someone had come and offered me MAID at that point in time, there's a really good chance I would have taken it," Hawes told CBC's The Early Edition.

Hawes says this "profound and critical" bill should not be rushed.

Senate likely to discuss many amendments, expert says

More than 300 disability groups in Canada oppose the change and the Senate legal and constitutional affairs committee did a pre-study of the bill due to its compressed timeline.

It received 86 written submission and heard from 81 witnesses, including ministers, regulatory authorities, advocacy groups, legal and medical practitioners and other stakeholders.

That committee released a report last week outlining a summary of opinions it heard from witnesses, including concerns about Charter of Rights compliance, safeguards to protect the vulnerable and access to proper health care and support services.

The report says the committee heard from major national disability organizations which argued that removing "reasonably foreseeable natural death" would "single out disability" in violation of Charter-entrenched equality rights. They said a constitutional challenge likely would be launched if the bill passes.

On Monday, senators offered conflicting views on whether the bill is constitutional, does enough to protect people with disabilities, should be amended and even whether there's any real urgency to deal with it this week.

Trudo Lemmens, a professor and the Scholl Chair in Health Law and Policy at the University of Toronto, said the senate will likely discuss many proposed amendments to the bill.

The federal law's criteria of reasonable, foreseeable death can be interpreted differently across the country, he said. For example, the interpretation given in B.C. is broader than that in Quebec.

"What we see now at the Senate level is that the disability organizations particularly, but also law, ethics and medicine experts are saying, 'Well, we're now transforming a procedure that this is intended to facilitate the dying process into some form of therapy for suffering, but only for people with disabilities and chronic illness," Lemmens said.

Targeting people with disabilities in that way is stigmatizing, he said, because it sends a message that a life with disability is more "intolerable and perhaps less worth living."

"The concern expressed is people will be offered a fast track to an early death while in the system, the medical system and social support system, we don't have the adequate support for people with disabilities in place," he said.