Bill C-7 Devalues the Lives of Disabled Canadians

Disabled Canadians need accessible healthcare, not just MAiD

Disability justice organizations and disabled people across Canada are speaking out against Bill C-7, a bill proposing an amendment of the Criminal Code to change the eligibility criteria for Medical Assistance in Dying (MAiD). The bill has been delayed for months and has been the subject of controversy since it was introduced in February 2020. The amendment seeks to replace the requirement of facing a “reasonably foreseeable death” with a new stipulation that those seeking MAiD must have a “grievous and irremediable medical condition,” which includes disabilities and chronic illnesses. Disabled people, activists, and the UN’s watchdog on disability have raised concerns, stating that this change will reinforce the ableist practices already entrenched in medical care. The Canadian government is devaluing the lives of disabled people by making death more accessible than support. By proposing that “suffering” as a result of disability or chronic illness should be the main criterion for accessing MAiD, the government is touting MAiD as a universal solution instead of providing accessible, affordable, and flexible healthcare.

Bill C-7: An Act to Amend the Criminal Code (medical assistance in dying) was introduced into the House of Commons by Minister of Justice David Lametti on February 24, 2020. The bill was presented following a 2019 Quebec Superior Court ruling of MAiD as unconstitutional, leading to the proposed removal of the “foreseeable death” requirement. According to the government, the bill comes after “extensive consultation” with “Canadians, experts, practitioners, stakeholders, Indigenous groups, provinces and territories, and an online questionnaire that received over 300,000 responses.” Despite these “consultations,” more than 300 disability organizations in Canada have spoken out against the proposed bill. “Canada cannot claim it has listened when every national disability organization opposes Bill C-7,” the DisAbled Women’s Network (DAWN) said in an online statement. “The voices of our community’s most marginalized cannot be heard above a voice proclaiming, ‘we consulted.’” The government’s goal with C-7, to “reduce unnecessary suffering,” is not feasible if more effort is put towards assisting disabled Canadians with death than providing support for their lives.

In a statement regarding Bill C-7, the Council of Canadians with Disabilities (CCD) criticized the rushed and cursory way in which the bill has been considered by the House and the Senate. “In short, everything from the online questionnaire to the in-person consultations were geared toward a predetermined outcome, namely, the expansion of Medical Assistance in Dying as a legally – and socially – sanctioned substitute for assistance in living.”

The bill also includes a new amendment establishing that “mental illness is not an illness, disease, or disability” for the purposes of MAiD. Rates of depression are much higher for disabled persons living without proper support or resources; research by Statistics Canada found that “[disabled] persons with unmet or partially met needs reported higher levels of stress and negative feelings […] 62% of care recipients with partially met needs experienced loneliness, compared with 31% of those whose needs were met.” 

In the years since its legalization, MAiD has already become a danger to disabled people. Roger Foley, who lives with cerebellar ataxia, told the CBC that “assisted dying is easier to access than safe and appropriate disability supports to live.” Testifying to the Justice Committee for his own ongoing lawsuits, Foley says he has been “denied proper care and was ‘coerced’ into choosing MAiD because his acute care needs were too much for hospital staff to handle.” This blatant form of ableism has only increased during the pandemic – a time when accessing care can be much more difficult, according to the CCD. “COVID-19 has clearly revealed the ableism that is rampant in Canada’s healthcare system,” the CCD said in a statement on the bill. “We’ve seen […] the introduction of critical care triage protocols which identify […] disability as an exclusion criterion for critical care,” when hospitals become overwhelmed.

At a time when support for people with disabilities is increasingly difficult to access, the government should prioritize disabled Canadians, not exclude them. Jeff Preston, a wheelchair user and disability studies professor at King’s University College, told the CBC that he is “worried” the new bill will target disabled Canadians. “There is a ton of suffering experienced by disabled people that is actually not within the body, not within the person, but rather is caused by the systems of inaccessibility and ableism.”

Though the Bill includes separate “safeguards” for those newly eligible, the proposed 90-day assessment period has been met with concern by disabled people and medical professionals alike. These “safeguards” are intended for those who are not dying and do not actually protect patients – the only rule that explicitly prevents potential doctor-patient coercion states that “the person must be informed that they can withdraw their [MAiD] request at any time, in any manner,” and the patient is asked to reconfirm their decision after a 90-day assessment period. London doctor Ramona Coelho, an advocate for patients with disabilities, calls the 90-day assessment period “not nearly adequate” and says the bill is “very dangerous, especially when the research shows people with disabilities [experience] suicidal thoughts at a much higher rate than the general population.” An assessment period is not a sufficient measure to ensure safety and prevent legislative abuse.

Currently, disabled Canadians are twice as likely to live below the poverty line; two-thirds cannot afford their medications, and many do not have accessible housing or transportation, per Spring Hawes, the co-founder of Dignity Denied. Further, the medical system is slow and full of barriers, and it may take people with new or newly diagnosed disabilities much longer than 90 days to get set up with stable care or support. Bill C-7 will only promote prejudice in medical settings where ableism is already commonplace, and prioritize convenience to the medical system over disabled Canadians’ quality of life. The Canadian government is choosing to perpetuate the notion that disability is a fate worse than death instead of providing disabled people with the support and care that they need. As Dr. Coleho puts it, “It’s okay for us to offer death, but we have to first be offering opportunities for life.”

The proposed amendments to MAiD could also put incarcerated disabled people at much higher risk. With MAiD already in place for eligible prisoners across the country, Correctional Investigator Ivan Zinger says that “the problem is that we’re allowing too many people to die in custody because of the lack of efforts to transfer those individuals. And they don’t have alternatives.” Instead of utilizing “compassionate” or “medical” release, the Correctional Service of Canada (CSC) is choosing to present prisoners with the single option of assisted death, giving them virtually no agency over their lives and bodies. 

Within the next week, Senate will be proposing and voting on amendments at the third reading of the bill, as well as considering a suggestion that came up during hearings that the “90-day period […] might better be used to actually put together an emergency task force to respond to the care and needs of particular individuals” – you can email your province’s senators to request that they support the amendments. If any amendments are passed in the Senate, the Bill will return to the House for debate, in which case it will be susceptible to rejection again. If this happens, you can contact your MPs and pressure them to speak out against the Bill, and to respect the rights of disabled Canadians. 
Additionally, Zinger is calling for a moratorium on the usage of MAiD in prisons. Put pressure on the Correctional Service of Canada to replace MAiD with compassionate release, or contact your local prison abolition group to learn how to get involved.