Critics argue laws are being misused to punish the poor, but experts say cases represent country’s failure to care for its most vulnerable citizens.
After pleading unsuccessfully for affordable housing to help ease her chronic health condition, a Canadian woman ended her life in February under the country’s assisted-suicide laws. Another woman, suffering from the same condition and also living on disability payments, has nearly reached final approval to end her life.
The two high-profile cases have prompted disbelief and outrage and shone a light on Canada’s right-to-die laws, which critics argue are being misused to punish the poor and infirm. In late April, the Spectator ran a story with the provocative headline: Why is Canada euthanizing the poor?
But medical and legal experts caution that oversimplified media coverage of the cases fail to capture the realities of the system – and warn that sensationalist coverage of a handful of “extreme” cases ignores a larger crisis in the country’s healthcare systems.
In February, a 51-year-old Ontario woman known as Sophia was granted physician-assisted death after her chronic condition became intolerable and her meagre disability stipend left her little to survive on, according to CTV News.
“The government sees me as expendable trash, a complainer, useless and a pain in the ass,” she said in a video obtained by the network. For two years, she and friends had pleaded without success for better living conditions, she said.
Now a second case has emerged with several parallels: another woman, known as Denise, has also applied to end her life after being unable to find suitable housing and struggling to survive on disability payments.
Both were diagnosed with multiple chemical sensitivity (MCR), a condition in which common chemicals, such as those in cigarette smoke and laundry detergents, can trigger nausea, blinding headaches and in extreme cases, anaphylactic shock.
Both had also argued that specialized housing – where air flow is more controlled – would ease their debilitating symptoms.
Unable to work, they each received $1,169 per month – placing them well below the poverty line in Canada’s most populous and expensive province.
For activists, the cases have come to represent Canada’s failure to care for its most vulnerable citizens – and raised questions about how assisted-suicide laws are applied.
But experts caution the cases are also being used by groups opposed to medical assistance in death (Maid) in an attempt to scale back legislation – rather than looking at how governments can improve people living with disabilities
“Inadequate housing is not one of the eligibility criteria for medical assistance in dying. While somebody’s living circumstances may contribute to their suffering, it does not constitute the grievous and irremediable medical condition, which must exist,” said Chantal Perrot, a physician and Maid provider.
Perrot said that while housing could have helped, it was only a part of a broader struggle against the chronic condition.
“The only treatment really for that is avoidance of all triggers. That’s pretty much impossible to do in ordinary life. So better housing can create a temporary bubble for a person – but there’s no cure for this,” she said. “We do this work because we believe in people’s right to an assisted death. It’s not always easy to do. But we know that patients need it and value it. We live with the challenge of the work, in part because it is important to alleviate that suffering.”
When Canada introduced legislation on assisted suicide in 2016, advocacy groups raised fears that vulnerable populations could be targeted, or that physicians would be forced to override the oaths they’d taken to protect patents.
“Many of the slippery-slope arguments that were made initially never happened,” said Hillary Ferguson, a bioethicist at Dalhousie University. “There were fears that the floodgates would open, and all these people would be accessing Maid or even forced upon them. But that’s not been the case.”
Last year, lawmakers revised the criteria for MAID after the country’s supreme court ruled that a previous version of the law, which excluded people with disabilities, was unconstitutional.
The issue is once again before a special joint parliamentary committee tasked with deciding whether to expand access to consenting children and those with mental illness.
Jocelyn Downie, a professor of law at Dalhousie and expert in end-of-life policy, said there are extensive guardrails in the system to protect Canadians.
“You have to meet rigorous eligibility criteria. And being poor and not having a home, or a home that is suitable for you, does not make you eligible,” said Downie. Cases that involve a chronic condition are often time-consuming because clinicians are working to exhaust all other options to ease the suffering of their patients, she said.
Downie said that the cases do highlight societal failures – but not with the country’s assisted dying laws.
“Listen to what people living with disabilities have been asking for years,” she said, pointing to investments in accessible housing and transportation.
Instead of fighting over the law, which lawmakers are unlikely to repeal given a string of supreme court cases upholding the right to physician assisted death, Downie said a
greater emphasis should be on disability supports and services and mental health supports.
“The reality is, it’s a small number of people who qualify for Maid. But investments in mental health and disability resources would go so far to help so many more people live their lives.”