Back in April, the CTV News program W5 ran a wonderful documentary entitled Death Wish, about medical assistance in dying (MAiD) and its evolution since being legalized in Canada in 2016.
Reporter Avis Favaro focused on Vancouver Island, the “assisted death capital of Canada,” presenting a poignant look at how patients choose MAiD, and featuring well-known provider Dr. Stefanie Green, author of This Is Assisted Dying.
The documentary followed the journey of Ray Cole, a 72-year-old with lung cancer who chose to end his life with the doctor’s help. It also featured John Priddle, 69, who suffers from Friedreich’s ataxia. He too wanted MAiD, even though his death was not imminent.
The documentary, among other things, made the point that access to MAiD tends to be inequitable, that it’s largely the well-heeled, well-educated and well-connected who can access medical assistance in dying. That’s because finding a doctor is fairly difficult, and the process requires some planning and paperwork.
That largely explains why 7.5 per cent of deaths on Vancouver Island are by MAiD, three times the national rate of 2.5 per cent.
It’s ironic, then, that what really made a splash was a follow-up story by Ms. Favaro featuring “Sophia,” a 51-year-old woman suffering from a chronic condition called multiple chemical sensitivities (MCS) who had a MAiD death earlier in the year.
She opted to end her life because of an inability to find affordable, specialized housing, which would allow her to live a tolerable life with MCS. In a video left behind, Sophia said “the government sees me as expendable trash, a complainer, useless and a pain in the ass.”
This story sparked a polemic about people opting for “assisted suicide” because of a lack of affordable housing, one that was cranked up a few notches as a second person with MCS, 31-year-old “Denise,” came forward to say she had been “conditionally approved” for MAiD too.
(CTV decided to protect the privacy of both women by not identifying them by their real names.)
These cases drew attention to the fact that since March, 2021, Canada has had two “tracks” of patients eligible for medically assisted death: Track 1 is for those with conditions where death is “reasonably foreseeable,” and track 2 is for individuals with a “serious or incurable condition” for whom death is likely not imminent.
The case of Denise attracted the most attention because she said her choice of MAiD was “essentially because of abject poverty.”
Like most people living with a disability in Ontario, she receives $1,169 monthly (plus a $50 special diet supplement) in social assistance, which is not even remotely close to a livable income in Toronto, especially if you need specialized housing.
Anti-MAiD activists pounced on the story to argue that Canada is “euthanizing the poor,” which is nonsensical rhetoric.
Of course, assisted death is not a solution to poverty or poor housing, but these cases are not as black-and-white as they have been made out to be.
Sophia’s physical pain and suffering were real and deemed intolerable. Denise also has a painful and debilitating spinal cord injury. (And, under the MAiD law, there is a rigorous set of criteria, which is especially arduous for track 2 applicants, and includes a 90-day assessment.)
Lack of housing is a travesty but doesn’t make people eligible for MAiD – or ineligible for that matter.
The most disturbing aspect of these cases is the appallingly poor treatment of people with disabilities, and how we condemn them to live in poverty because of a lack of access to housing.
The stories of Sophia and Denise were further complicated by their diagnoses of multiple chemical sensitivities, and the need for special housing. (It’s worth noting that, after the media attention, Denise found special housing and has withdrawn her request for MAiD.)
As palliative care physician Dr. Naheed Dosani said on Twitter: “There is something severely wrong with a society where it is easier to die through MAiD than it is to find affordable housing.”
But the answer to that problem is to improve social assistance for people with disabilities, with a Canada Disability Benefit, and more and better social housing.
The solution is not to condemn people with disabilities – physical or mental – to suffering.
Yes, we should make it easier to live with dignity than die with dignity.
But no one should be denied either. You don’t resolve one injustice by creating another.
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André Picard