The Current

'Cold comfort to be offered the choice to die' when not offered support to live, says disability advocate

Proposed changes to Canada’s medical assistance in dying law have been described as an existential threat to dignity by some disability advocates, who argue their communities need greater assistance in living instead. But others see it as a necessary balance between autonomy and security.

Government has until Dec. 18 to amend MAID law to comply with a Quebec court ruling

Catherine Frazee said Bill C-7 and the amendments it proposes undermines 'any kind of suicide intervention in the life of a disabled person.' (Courtesy of Catherine Frazee)

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When Catherine Frazee, professor emeritus at Ryerson University's School of Disability Studies, testified about Bill C-7 before the Justice Committee last week, she had just one question to ask.

"Bill C-7 begs the question: why us?" she asked. "Why only us? Why only people whose bodies are altered or painful or in decline?"

Bill C-7 comes off the back of a 2019 Quebec court ruling that found one of the provisions of the initial 2016 medical assistance in dying (MAID) legislation — that a patient can only get medical help in dying if their natural death is "reasonably foreseeable" — was unconstitutional. 

The proposed change attempts to strike a balance between an individual's right to personal autonomy and the need to protect vulnerable people who might feel pressured into a medically-assisted death.

Bill C-7 would make it easier for people whose natural death is considered to be reasonably foreseeable to receive an assisted death, but it would impose additional eligibility hurdles for those who are not near death. 

Frazee, who lives with a disabling medical condition, says that — through Bill C-7 — the government is making it possible for people with disability to kill themselves while doing whatever it can to prevent suicide for everyone else. 

"Now this amendment proposes opening up an entire new approach to assisted death, where it's now an alternative not to a painful death, but to a painful life — to a life that is considered intolerable or not worth living," she told The Current's Matt Galloway.

"And that extension will apply only to people with disabling medical conditions, and so for those of us who live with — and many of us who live well with — disabling medical conditions, we think the question has to be asked: why us?"

Frazee, who lives with a disabling medical condition, says that, through Bill C-7, the government is making it possible for people with disability to kill themselves while doing whatever it can to prevent suicide for everyone else.  (Jean Laroche/CBC)

According to Frazee, Bill C-7 and the amendments it proposes undermine "any kind of suicide intervention in the life of a disabled person."

"If we see someone approaching the edge of a bridge with the obvious intention to jump, the first thing we do not think about is their autonomy — we think about saving their life," she said. "And to hold that autonomy as an absolute, overarching value that must be restricted, even when a person wants to die, is a dangerous proposition, particularly when it is limited and restricted to people with disabilities."

"What is it about disability that makes people think this is OK? We think this is deep-seeded discrimination."

Frazee says the COVID-19 pandemic has brought to light the daily challenges disabled people face. She believes the government should be offering basic necessities and supports to help people with disabling medical conditions live full and meaningful lives.

"It's cold comfort, I think, to be offered the choice to die when you are not offered the choice to live a dignified life — when you are not offered the basic supports and the basic dignity that we as Canadians we'd consider, I think, minimal for all members of our community," she said. 

Striking a balance between autonomy and security

In 2016, Senator Chantal Petitclerc spoke about Bill C-14, which allowed eligible Canadian adults to request medical assistance in dying — a bill that she said was "not quite the bill that I was personally waiting for." 

Today, Petitclerc is sponsoring Bill C-7. She believes that, rather than restricting or targeting people with disabilities, it strikes a balance between autonomy and security.

"It really was the goal to make sure that, on one hand, you do respect ... the right to autonomy, self-determination, [and that] we do propose a bill that is not patronizing, and on the other hand, that makes sure that there are safeguards that are serious, that are responding to the risk," she said.

To me, those are very important safeguards, and if you combine that with the right to make your decisions, I think we have a bill that is quite balanced.- Senator Chantal Petitclerc

This is why Petitclerc, a Paralympic medalist who lives with a disabling medical condition, says she felt a great sense of security when she read the bill. 

"You look at Bill C-7 and you look at the the safeguards that says that the patient must be informed of means that are available to them and, you know, counselling services, mental health, disability support services, community services, palliative care, that the patient also must be offered consultation with relevant professionals," she said.

"To me, those are very important safeguards, and if you combine that with the right to make your decisions, I think we have a bill that is quite balanced."

Senator Chantal Petitclerc, a Paralympic medalist, says that Bill C-7's respect for autonomy and strict safeguards make it a balanced bill. (CBC)

But Petitclerc urges governments and organizations to continue to push for better services for people with disabilities.

"We need to make sure that lack of services will never be a reason to want to have access to medical assistance in dying, and I think everybody agrees on that," she said. 

Though not everyone agrees with her stance on the bill, Petitclerc said the diversity of voices will contribute to what she says is an important discussion and serious conversation.

"Even when we don't agree, I think it is important for Canadians to know that the community of persons with disability is not a community with one thought and one vision, but there are many diverse individuals with different disabilities and needs and vulnerabilities," she said. 


Written by Mouhamad Rachini. Produced by Lindsay Rempel and Paul MacInnis.

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