On June 17, 2016, a hallmark decision regarding Canadian health policy was made. Bill C-14 was passed, legalizing medically assisted suicide and voluntary euthanasia in Canada in the form of MAiD (Medical Assistance in Dying). For many Canadians who lived with terminal illnesses, as well as loved ones who had been a witness to their pain, this was a moment to rejoice and celebrate. While this was a definite step forward for Canada, recent implications regarding the use of this policy have been deemed problematic by critics, as an increasing number of people are turning to assisted suicide as a method of liberation from poverty or other social injustices. Stronger social safety nets and more well-developed policies regarding the uses of MAiD are needed to curb this disturbing trend. As Canadians, we need to ensure that not only do we have the right to die with dignity, but to live in dignity as well.
While MAiD is a vital program for ensuring the rights of the terminally ill, the policy fails to ensure safeguards to protect those vulnerable to economic and social injustices from misuse of the program. The United Nations has expressed concern to the federal government that “persons with disabilities may decide to end their lives because of broader social factors such as loneliness, social isolation, and lack of access to quality social services” (Mulligan & Bond, 2022). Such circumstances have already come to light, considerably in the case of Amir Farsoud. Farsoud receives benefits from Ontario Disability Support Payments for his debilitating back pain, but unfortunately, the payments are insufficient to support him (Mulligan & Bond, 2022). Faced with the threat of homelessness, Farsoud chose MAiD as an alternative. Unfortunately, in this case, it was not pain or illness, but lack of access to financial aid and social support services that led him to the decision. Not just a lack of resources, but the possibility of coercion for MAiD has also come up. Roger Foley, who suffers from a degenerative brain disease, reported that he felt he was being manipulated into choosing MAiD as doctors brought up the possibility of MAiD if he was unable to get the self-directed funding he was aiming to get, citing the hospital bills he would otherwise incur (Harris, 2020). In circumstances as sensitive as these, should medical care providers be permitted to broach the possibility of MAiD without first exploring all other viable options and without the prompting of the patient? Cases similar to that of Farsoud and Foley have been reported, where a lack of policy of the MAiD system leaves one susceptible to exploitation by the system. Certain aspects of the management and procedural guidelines of MAiD must be addressed in order to remedy the issue.
Firstly, it is not feasible to think of the dissolution of MAiD as a viable solution. Assisted dying is an important medical freedom and must be maintained. Instead, it must be ensured that the system itself is improved in order to prevent abuse of the vulnerable. Inequities in our society are driving people to choose MAiD, and we must do our best to remove the inequities themselves, as this could lead to entirely different outcomes, as seen in the aftermath of Farsoud’s case. After going public with his story, Farsoud was met with an outpouring of support, significantly through a GoFundMe which raised money for him to find a new housing situation (Mulligan & Bond, 2022). This allowed him to rescind his application for MAiD, as he now possessed the provisions needed to live a dignified life. The situation showcases how a lack of resources can lead one to consider assisted suicide, and how the loss of life can be prevented by providing adequate support to them to live their lifestyle. Unfortunately though, this should not be happening through the use of a GoFundMe, but instead governmental support should be expanded to ensure that everyone’s social safety net can care for them. Looking critically at social policies regarding poverty, homelessness, and disability benefits and improving them not only strengthens society as a whole, but is vital in ensuring that the misuse of MAiD does not occur. Additionally, policies specifically pertaining to MAiD must be scrutinized themselves. For this, we can look at countries who have a longer history of performing voluntary euthanasia, such as the Netherlands and Belgium, as an example. In such countries, doctors must inform patients of all possible alternatives before referring MAiD, which is not necessary in Canada (Webster, 2022). This becomes especially important when patients are pursuing MAiD due to mental health reasons or reasons pertaining to economic distress, as finding an alternative to satisfy their needs could be the measure that leads them to reconsider MAiD. To add, in most places where euthanasia has been legalised, it is discouraged or disallowed for the healthcare provider to independently bring up the prospect of using MAiD, as it could lead to coercion (Kirkey, 2022). This is not the case in Canada. University of Toronto bioethicist, Kerry Bowman states it is “very problematic when we bring (MAiD) up to people who can’t pay the rent, or people who are living with disability who don’t have adequate access to the things that they need”, as “some people, no matter how well-handled your conversation, may infer that it’s essentially a suggestion” (Kirkey, 2022). Considering the power imbalances that are present in a patient-doctor relationship, an emphasis on patient initiative would be ethical. Overall, considering the societal and moral contexts that can lead to MAiD, efforts should be made to reconfigure the policy for the benefit of those seeking treatment by expanding government assistance and remedying current MAiD guidelines.
While, MAiD has been helpful to many across Canada in ensuring that they can have a peaceful and dignified end, there are also instances in which people have been abused and exploited by that same system. As the Canadian government moves onwards towards expanding MAiD eligibility, it becomes imperative to take a look at the current fallacies of the system so that they too can be addressed in a parliamentary manner through policy and guideline. It is time to ensure that death with dignity is not an alternative to life without dignity.
Works Cited
Bond, M., & Mulligan, C. (2022, November 16). Ontario man not considering medically-assisted death anymore after outpouring of support. CityNews. Retrieved December 13, 2022, from https://toronto.citynews.ca/2022/11/16/ontario-medically-assisted-death-support/
Harris, K. (2020, November 10). Disability advocates say assisted dying bill fails to protect vulnerable Canadians | CBC News. CBCnews. Retrieved December 17, 2022, from https://www.cbc.ca/news/politics/maid-assisted-dying-legislation-disabilities-1.5796697
Kirkey, S. (2022, November 2). Canadian doctors encouraged to bring up medical aid in dying first … National Post. Retrieved December 29, 2022, from https://nationalpost.com/news/canada/canada-maid-medical-aid-in-dying-consent-doctors
Webster, P. (2022, September 10). Worries grow about medically assisted dying in Canada. The Lancet. Retrieved Jan 3, 2023, from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01733-0/fulltext
Written by: Manat Sidhu
Edited by: Tiara Gonsalkoralage
Campus UNICEF 