Canada’s Medical Assistance in Dying Program is Ableist, Classist, and Coercive

by Sophie Trist

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A 2015 ruling by the Canadian Supreme Court in the case of Carter v. Canada paved the way for the country to legalize physician-assisted suicide (PAS) and euthanasia in 2016. At first, the Medical Assistance in Dying (MAID) program was strictly limited to competent adults with terminal medical conditions, which is bad enough. But in 2021, Canada passed the horrific Bill C7, which drastically expanded the eligibility for MAID, opening the door for disabled people and people with psychiatric disorders to be killed if their suffering seems intolerable.

Canada’s disability rights activists vehemently opposed Bill C7 on the grounds that vulnerable people will face increased coercion to die with dignity rather than being given the necessary social supports to actually live with dignity. Suffering is an extremely subjective measure, and society as a whole and doctors specifically hold overwhelmingly negative views about disability and mental illness. Because of this, programs like MAID create two healthcare systems, where the wealthy and able-bodied receive suicide prevention and the disabled and poor receive suicide assistance. The implementation of Canada’s MAID program over the past few years shows how the country’s healthcare system has systemically devalued disabled lives, killing thousands of people and putting profit ahead of human dignity.

In Quebec, the College of Physicians had to issue an ethics bulletin after several doctors denied care to people who had attempted suicide, believing that their attempts to take their own life represented an implicit refusal of treatment. It should go without saying that when someone in a dark and desperate mental place attempts suicide, they do not forfeit their human dignity or right to rigorous medical treatment. As Quebeca’s College of Physicians pointed out, doctors’ first duty is to save lives. The normalization of suicide and the devaluing of certain lives goes directly against the primary medical precept: “First, do no harm.”

In 2017, just one year after Canada legalized assisted suicide, Sheila Elson claims that a doctor at a Newfoundland hospital pressured her to choose this option for her twenty-five-year-old daughter Candice, who has spina bifida and cerebral palsy. When Elson insisted that she would never kill her daughter, the doctor accused her of being selfish. A social worker clarified that because Candice could communicate, she would not have been eligible for MAID in 2017, but whether her life would be protected under the new expanded guidelines is in considerable doubt. This case aptly illustrates the ableism that pervades every facet of the medical industry.

Statistics show that the number of people dying by PAS and euthanasia in Canada has steadily increased every year since 2016. Since MAID expanded to include disabled and mentally ill people in 2021, the increase has been downright horrifying, with 10,064 people being killed last year alone, up from 7,603 in 2020. The number of assisted deaths increased by 32.4% in just one year, accounting for 3.3% of all Canadian deaths. Since Canada spends less on healthcare than most other industrialized nations, it’s no surprise that pressure to choose assisted death falls disproportionately on poor people and those reliant on government assistance.

In many cases, people at the end of their rope choose assisted suicide because the government does not provide them with the holistic support they need to live fulfilling, dignified lives. According to statistics published in the National Review article above, only 15% of Canadians have ready access to palliative care. A 42-year-old Ontario man, Roger Foley, claims that medical staff repeatedly offered him PAS, despite his requests for home care. Another patient, a thirty-one-year-old disabled woman from Toronto applied for MAID because she could not find affordable, accessible housing. She only suspended her request after well-wishers donated enough money for her to get a place to live. Let that sink in for a moment. A disabled woman felt pressure to end her life because the Canadian government refused to help her find accessible housing. Poor people are especially vulnerable to pressure to end their lives. Another woman chose assisted suicide simply because she couldn't afford to live.

Pushing PAS and euthanasia on poor and disabled people is good for Canada’s bottom line. According to a 2021 report published in a premier Canadian medical journal, PAS could save the country between $34 million and $136 million in healthcare spending. Because of their reliance on doctors, insurance providers, and caregivers, many disabled people are vulnerable to coercion and pressure to end their lives. Proponents of medically assisted dying claim to look out for disabled people’s interests, but programs like MAID only further entrench classism and ableism in society and do nothing to protect disabled people from abuse.

Instead of killing its poor, disabled, and chronically ill citizens, Canada should ramp up its efforts to support them physically, socially, and psychologically so they can live fulfilling, dignified lives. Disability and poverty should never be a death sentence. As long as the medical establishment and society more generally do not appreciate the innate human dignity of disabled people, thousands will continue to die needlessly under the guise of mercy and compassion.