The medical assistance in dying predicament: undermining disability advocacy

Senators are about to make a decision that will have a big impact on the rights of people with disabilities in Canada: will they or will they not pass legislation to delay an expansion of medical assistance in dying (MAID) that is otherwise set to take effect on March 17? This decision on Bill C-62—which would delay by three years the legalization of MAID for mental illness as the sole underlying condition—is not exclusively a question of MAID policy. Fundamentally, it’s a test of Canada’s dedication to disability rights as a signatory to the UN Convention on the Rights of Persons with Disabilities (CRPD). Kurt Goddard is the executive director of legal and public affairs at Inclusion Canada, a national federation advocating for people with intellectual disabilities. Photograph courtesy of Inclusion Canada My perspective on this issue is both professional and personal. My father’s violent and public suicide, and my mother’s complicated mental illness have informed my understanding of the complexities surrounding mental illness and the impact of suicide, shaping my conviction that state-assisted suicide must not be the answer to gaps in treatments and support. I view this issue through the lens of the social model of disability—a perspective starkly absent in current discussion in the Senate. As per the CRPD, the social model of disability recognizes that disability results from the interaction between a person’s “impairments” and the attitudinal and environmental barriers that hinder their full participation in society on an equal basis with others. In other words, under this approach, ‘suffering’ tied to disability isn’t inherent to the person’s disability itself. It’s tied to the discriminatory societal factors that prohibit a person from thriving.The social model is in conflict with the now-outdated medical model of disability which identifies disability as a defect within the individual that is to be cured, fixed, or—in this context—terminated. Natalia Hicks is the director of community justice and health equity at Inclusion Canada. Photo courtesy of Inclusion Canada Under the social model, people with disabilities have the authority, but we all have a collective responsibility to prioritize lived experience, reduce physical and attitudinal barriers, make quality supports available, facilitate life in community, combat ableism, and guarantee equitable access to healthcare when needed. We all can play a role in building an accessible and inclusive Canada. However, under the medical model, the power to improve the lives of persons with disabilities is held by a small group: doctors, healers, and now MAID providers. I raise this philosophical dichotomy in order to make one point: the Senate seems to be stuck in the past as their discussions are obviously deeply rooted in an outdated medical model. At a quick glance of the Senate’s website, I count roughly 10 per cent of Senators as being medical professionals. When it comes to MAID, they leverage their experience as authority, and it is most always well received.So what would a social model approach to MAID look like? Ask Senator Marilou McPhedran. In the discourse surrounding Bill C-7—which legalized track two MAID for those with a disability whose natural death is not reasonably foreseeable, and introduced a timeline for the legalization of MAID for mental illness as the sole underlying condition—McPhedran emerged as the beacon of reason. She championed a rights-based approach to disability that aligns with the social model. Her dedication to exposing the shortcomings of Bill C-7 and its potential to amplify discrimination against people with disabilities is noteworthy. So, too, is the sad reality that McPhedran’s arguments didn’t land because so few Senators genuinely grasp disability beyond the medical model. McPhedran said in the Senate: "UN experts conveyed that the bill… may be of a discriminatory nature, or have a discriminatory impact, as by singling out the suffering associated with disability as being of a different quality and kind than any other suffering, they potentially subject persons with disabilities to discrimination on account of such disability."According to the social model, Parliamentarians should be grappling with how—when people with disabilities whose deaths are not reasonably foreseeable are suffering to the point that they want to die—we, as a society, have a crisis on our hands. The objective would be to eliminate suffering by eliminating barriers, not people.Is it paternalistic to not facilitate MAID for people who autonomously request it? Not any moreso than it is to prevent suicide for any non-disabled person. The push to ever expand MAID comes from the medical-model view that if a person can’t be fixed, or healed, and the suffering they experience is embedded in their being, then it would be more compassionate to facilitate their death, as requested, as long as those who can be healed are kept safe. This is the conversation being had right now around MAID. What is presented as a right to MAID under track two is, in essence, discrimination masquerading as autonomy, contradicting Canada's international human rights commitments. The Senate's approach to disability issues, especially concerning assisted dying, requires immediate and comprehensive reform. It is imperative to cultivate a legislative environment that reflects the diverse experiences and viewpoints within the disability community, moving beyond medical qualifications to a profound understanding of disability rights. The question now is whether the Senate will seize this opportunity to rectify its course or continue to neglect the rights it is sworn to protect. Kurt Goddard is the executive director of legal and public affairs at Inclusion Canada, a national federation advocating for people with intellectual disabilities. Natalia Hicks is the director of community justice and health equity at Inclusion Canada. The Hill Times

The medical assistance in dying predicament: undermining disability advocacy

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The medical assistance in dying predicament: undermining disability advocacy

The Senate seems to be stuck in the past as their discussions on MAID are obviously deeply rooted in an outdated medical model.

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