The federal government has recently moved to delay the expansion of Medical Assistance in Dying to people whose only condition is mental illness.
MAID, a deceivingly pleasant-sounding acronym for what is actually assisted suicide and euthanasia, has been contentious since its inception.
The number of Canadian deaths via MAID has skyrocketed, increasing every year they have been recorded, from just 1,018 in 2016 to 10,064 in 2021, with a 32 per cent increase from 2020 to 2021.
MAID, which is publicly funded and offered free of charge, now accounts for three to four per cent of lives lost in Canada, with death care becoming increasingly normalized as a substitute for health care.
While death is more accessible than ever in Canada, the proposed expansion would have seen MAID reach even further, including to persons with a sole diagnosis of mental illness whose deaths are not foreseeable, and even newborns and preteens have been mentioned as potential candidates.
If you think this sounds rather macabre, you are not alone. Although there is generally public support for MAID under certain circumstances — and it does have its place in limited situations — there has also been vehement opposition in Canada and internationally, with MAID being called an “affront to equality.”
In delaying the expansion, the government has taken a baby step in the right direction, but it still does not seem to get it: too much time is spent considering who should die, rather than how to help people live.
When Canadians can access publicly funded death faster than they can access the supports needed to live a good life, something is seriously wrong.
Waits for health care across Canada have reached all-time highs of nearly 30 weeks, and in some cases, it takes people struggling with mental illness six months to a year to access ongoing treatment, while it can be just a matter of weeks from the time someone begins pursuing MAID to their death.
Disabled Canadians, one of the main focuses of MAID, are also more than twice as likely as non-disabled Canadians to live in poverty.
Rents have grown at record rates, putting even greater pressure on people already facing housing insecurity and who have little to nothing remaining to support themselves.
And Canada's long-term care system is broken, with seniors and people with complex disabilities paying the price.
Many facilities are understaffed and underfunded, leading to failures in meeting residents' care needs. Neglect and abuse are rife, residents have little to no control over their lives, and living with dignity is nothing but a fantasy for far too many of them.
It should come as no surprise then that depression rates are dramatically higher for people in long-term care institutions than those living in the community, as once vibrant individuals quickly become husks, barely recognizable to their families.
This is the context in which so many more people have started pursuing MAID over the last few years, being set up to fail due to structural shortcomings rather than directly because of their condition.
Delaying MAID’s expansion is not just a chance to reconsider whether the current and proposed eligibility and safeguards are appropriate, it is also an opportunity for the government to be bolder in addressing the reasons many people with disabilities or mental illness want to die in the first place.
That means, among other things, getting the Canada Disability Benefit into effect before any MAID expansion, implementing measures to ensure doctors and mental health workers are recruited and retained in greater numbers, and giving seniors and people with complex needs more options to continue living in their communities.
Federal health care funding to the provinces has also declined significantly, from roughly 35 per cent to just 22 per cent (depending on whose estimate you use), and with people’s lives at stake, it is incumbent on the federal government and the provinces and territories to find a more equitable arrangement.
But right now the signs are not promising. Premiers gathered in Ottawa yesterday to hammer out a new federal-provincial health accord, with the federal government’s offer of $46.2 billion in new health care funding over the next ten years, falling hundreds of millions short of long-standing provincial and territorial government requests.
In addition to finding more effective ways to work together, politicians on all sides must use the delay as extra time for reflection. Before any expansion, our policymakers must ask and honestly answer the following:
- Have we done everything possible to try to meet people’s needs before they apply for MAID?
- If MAID is for Canadians with irremediably grievous conditions, why are there so many documented cases of people pursuing it after being let down by public systems?
- And does expanding MAID normalize it as a convenient way to deal with disabled and mentally ill persons who could benefit from more robust and ongoing support?
If policymakers keep focusing on who should die, rather than how to help people live, they are not only missing the point, they are promoting the needless death of Canadians who deserve better.
Spencer van Vloten is a nationally published writer and community advocate from Vancouver. You can find more of his work at SpencerV.ca or follow him on Twitter at @BCDisability
Comments
I agree with the gist of the article. In fact, the topic came up during a recent family zoom tongue-wag.
This notion that the "state" will simply seek the lowest cost option that abides their ideological foundation is not to be treated lightly, in my opinion.
So, if the state (that is, the party/ideology in power) tolerates only minimal taxation and lacks a legitimate social conscience, then one can expect that MAID, being cheap in dollar terms, will be preferred to the financial burden of the accordance of a satisfactory quality of life to all.
Which brings me to the author looking to the Fraser Institute, of all things, for support when making an argument for a beneficial social outcome. There is no faster, more efficient way to score an own goal than to reference such an organization. In an instant, the entire argument was shot to hell as I looked for ulterior motives.
Mr van Vloten is, either intentionally or through ignorance of the issues, completely confusing his readers by lumping the need for MAID programs in with the need for much more investment and better management of our overall health care systems. Anyone who isn't blinded by religious indoctrination and has had to watch their parents or other loved ones suffer prolonged, tortuous deaths from terminal illnesses
knows that MAID should be available to any patients suffering from diseases that leave them in constant, long term pain with no hope for recovery. Medical science does not currently have the ability to heal or make bearable all illnesses and diseases that unfortunate members of our society have to deal with.
His arguments regarding mental health are basically the same old chestnuts (steep, slippery slope) that organizations that represent people with disabilities have been spouting to fight against MAID, often for religious reasons. There is no reason why appropriate checks and balances can't be parts of overall MAID programs to ensure all avenues have been explored without making it impossible for individuals or guardians to apply for MAID for themselves or loved ones.
The case of Robert Latimer is a perfect example of how screwed up our society's views are on MAID. His daughter suffered daily pain and distress from an incurable medical condition and her condition made it impossible for her to express her wishes. After watching her suffer for years with no hope from medical science for a better quality of life he could not bear it anymore and ended her suffering by painlessly euthanizing her, for which he was charged with murder by our legal system. If MAID had been available at that time he would not have had to end her suffering himself with the knowledge that it would result in him facing many years in prison. His crime? - not being able to witness anymore the torture that his daughter faced every day of her life.
Anyone with any empathy or compassion would not allow their companion animals to suffer needlessly from incurable diseases instead of having a veterinarian humanely euthanize them to end their torment. If this humane end to life is available for our beloved pets then it should be available to ourselves or our loved ones as well.
Agreed!! Also to be included in the list of best ways to spend health care dollars is increased support for holistic and compassionate palliative care...
The federal gov't demonstrated its pure disdain for seniors and ppl on provincial disability programs during Covid.
I wonder how much they saved in future pension payments and future health care payments, by letting disabled seniors "rot in place" in LTC homes during Covid.
I'd still love to know who it was who told the LTC "homes" not to transfer sick seniors to public hospitals, near the beginning of Covid.
And I'd still like to know whose job it actually was to make sure all the LTC establishments had procedures and protocols in place to prevent spreading of infection from one pt to another.
There was a phoney committee or commission here, provincially, about that, but there was no follow up to one of the LTC people's statement that they had been told *not* to transfer sick residents to hospitals ... i.e., those asking the questions didn't ask by whom and by what communication they "had been told" that.
I certainly agree that the emphasis must be on curing diseases or adequate treatment. It is totally inappropriate to offer MAID to people who have not been able to access the help they need either for mental illness or for example, chronic tick-borne diseases [TBDs].
The difficulty with achieving this goal is that medicine is a highly siloed profession that has lost its way. Shareholder preferences now control medicine and Goldman Sachs have made it clear that shareholders are no longer interested in cures, new antibiotics or vaccines. The paradigm of modern medicine is to palliate with treatments that provide lifetime annuities to the pharmaceutical industry. The profits from this industry pay for medical research, hospitals and political parties. Historically, infection was usually found to be the root cause of disease. There are no medical sleuths doing fine tissue research and looking for the root cause of disease. No one in medicine is being trained with advanced microscopy and lab research tools to look for microbes hidden inside tissue reservoirs and inside our brains.
In medicine the dead shall speak to the living but autopsies are expensive and no longer done unless violence has been involved. Physicians can do something the rest of us can’t, they can bury their mistakes.
Sir William Osler, the founder of modern medicine told his students to “listen to your patient, listen to your patient, he is giving you the diagnosis”. Today there are tests for most disease and the corollary to that for physicians is, if there is no test then the disease doesn’t exist and patients are given an inferior diagnosis of a somatoform disorder, no one searches any further and patients are thrown onto the compost pile of psychiatric disorders or MUS [medically unexplained symptoms].
Ticks are responsible for 95% of vector-borne diseases in Canada. When Lyme was discovered in the mid 1970’s, at about the same time as HIV/ AIDS and before they knew what they were dealing with, researchers tried to model Lyme disease and put it in a box. They defined the disease too narrowly and set the bar so high, the result being many people can’t get diagnosed and treated properly. They are still studying that same model and not the disease.
The number of cases of Lyme disease cases in Canada keeps growing and there is consensus that case numbers are under-detected but there isn’t agreement by how much. Officials only record those cases they are absolutely sure of so very conservatively there is likely to be at east 90% under-detection. The Canadian test for Lyme disease misses at least one third of patients who truly do have the disease but physicians haven’t been made aware of this.
All pandemics, from polio on down have their chronic forms. If caught early, Lyme is fairly easy to treat. However, similar to long-COVID it is agreed that 20% of patients will go to develop worsening health problems, be forced to drop out of school or the work force and are in danger of losing their homes. A small percentage of a very big number is still a big number. Suicide is not an infrequent outcome. Many Lyme patients have been disrespected, disbelieved, have suffered medical gaslighting, PTSD and as result are now applying for MAiD. Physicians are still graduating with the understanding that chronic fatigue [ME/CFS] long-COVID and Lyme are fake diseases. They are being taught to treat the patient nicely, just get the patient out of the office and send them to whoever will make them feel better such as the physiotherapist.
Lyme was misclassified as a minor nuisance disease in 1994 when the insurance industry red-flagged it as being too expensive to treat. It belongs in the same health threat category as cancer, Ebola, HIV/ AIDS, Zika, West Nile. Lyme is a very debilitating multi-staged, multi-system disease. Patients are clearly suffering and despite your point of view clearly deserve help.
Lyme is a highly contested disease with patients caught between two feuding medical societies with diametrically opposed views on the nature of the disease based on their interpretations of the same three small government studies, the most recent of which was completed 21 years ago. Most specialists have seen cases of Lyme but failed to recognize it because it can mimic so many others such as ALS, Alzheimer’s, fibromyalgia and ME/CFS. MS doesn’t just look like Lyme, in many cases it is Lyme. Infectious disease doctors are very unhappy dealing with neuro-invasive organisms such as COVID and Borrelia bacteria responsible for Lyme. Patients remain contested and diagnosis may depend on what lens the specialist is using.
The model for Lyme treatment should be TB. Complex disseminated Lyme is treatable with a combination of antibiotics to take care of the different forms this immune evasive bacteria [Borrelia burgdorferi] can take. Prof. Ying Zhang has compared current treatments with a single antibiotic to pretending to kill dandelions with a lawnmower. Unfortunately, PHAC has prioritized the preservation of the antibiotic supply over returning Canadians to health. Patients are just road kill on the way to profit for the long-term disability industry that doesn’t want to underwrite the cost of treating chronic Lyme. Death can be highly cost effective.
Our government Ministers seem unaware that the advice they are being given is corrupted and that their advisors are actually industry lobbyists. And so it is in the Department of Health where infectious disease doctors Howard Njoo and Tam with their close ties to AMMI Canada, the IDSA, CDC and WHO advise the Minister. PHAC is now reduced to a cheerleading role of health promotion and being gate keepers of research dollars and direction administered through CIHR. They refer physicians to the private AMMI website for Lyme disease management. AMMI Canada members don’t recognize chronic Lyme, don’t treat patients with chronic Lyme and any physician in Canada that treats Lyme beyond the 10 days allowed by the restrictive IDSA guidelines risks being investigated and loss of their medical license.