Bill C-7 expands medical assisted in dying to include those whose death is not reasonably foreseeable

C/O Bill Oxford

cw: mental illness, death, ableism

The Canadian government has passed Bill C-7, which changed the medical assistance in dying law. The bill was introduced in October 2020 after a September 2019 decision made by the Superior Court of Quebec.

The law previously required that the individual seeking MAID must be faced with a “reasonably foreseeable” natural death in order to be eligible. The law included the following: someone who has a serious and incurable illness, disease or disability, who is in an advanced state of irreversible decline in capability, who is experiencing enduring and intolerable suffering that cannot be relieved under conditions acceptable to them and whose natural death has become reasonably foreseeable.

The 2019 ruling found the requirement of a reasonably foreseeable natural death to be unconstitutional.

As such, Bill C-7 proposed amendments to the criminal code. This would expand MAID eligibility to persons whose natural death is not reasonably foreseeable. Individuals with mental illness will also be eligible for this within two years. The Senate passed Bill C-7 on March 17, 2021. The royal assent was given a week ahead of its court-imposed final deadline of March 26.

The bill will create two different sets of safeguards for those whose death is reasonably foreseeable and for those whose death is not reasonably foreseeable. Furthermore, Canadians will have a minimum 90-day assessment period for their MAID request in which they will be made aware of alternatives, such as counselling.

Bill C-7 has raised a lot of concerns from disability advocates. More than 300 disability groups in Canada opposed the change, as they believe it would create situations where people with disabilities are offered MAID instead of stronger support and community services.

Sarah Jama, co-founder of the Disability Justice Network of Ontario and a McMaster University alumna, expressed her concerns.

“How are we going to make sure that marginalized communities like the Indigenous, racialized people and those with disabilities, don’t feel pressured to access MAID because they feel like a burden on the state?” asked Jama in a CBC MAID town hall.

These concerns were also echoed by the United Nations Human Rights Council’s Special Rapporteur on the Rights of Persons with Disabilities, Gerard Quinn.

“We’re concerned that it massively expands the range of [MAID eligible] people with disabilities, who potentially will be given access [to MAID],” said Quinn in a CBC interview. “We’re concerned that there might be issues there . . . undermining their autonomy and their capacity to make the right decisions. I don’t mean the lack of legal capacity. What I mean is subtle pressure being brought to bear by, for example, lack of services or lack of community living options.”

MSU Maccess coordinator Calvin Prowse echoed concerns around the bill.

“Things like the lack of social services, the erosion of the social safety net, lack of healthcare… a lack of pharmacare so people can actually pay their medications…in many ways, [for] disabled people, their inclusion in society is being prevented . . . We’re trying to give folks with disabilities access to dying, but as a society, we are not actually helping people meet their needs and allow them to actually live,” said Prowse.

Prowse also pointed to the timing of the bill being discussed during the COVID-19 pandemic, as people with disabilities have already had to advocate to be prioritized for vaccines and more folks are developing disabilities and chronic illnesses. Some advocates worry that their voice is not being heard.

“I think that we see a lot of people with disabilities and a lot of disabled organizations coming forward and sharing their criticisms and concerns about this bill . . . There’s so many, but I think often that is lost or, truthfully, ignored when we have conversations about MAID. Those perspectives are often not considered,” emphasized Prowse.

The government has committed to launching a joint parliamentary committee to review additional unresolved details around the bill, such as whether mature minors should have access to the procedure and what the inclusion of individuals with mental illness will entail. This committee will be launched within 30 days of the royal assent.

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