Medical Assistance in Dying Committee on June 6th, 2022

[Ahona Mehdi]

The first thing is that about one in four Canadians with disabilities are unable to afford things like assistive devices, home care and that sort of thing. They can't afford the necessary aids, prescriptions and that sort of thing. I think for minors particularly, this can also sometimes cause financial strain in the family, which minors are seeing. A lot of parents of children with intellectual disabilities and that sort of thing are having to take time off work or not work, which results in the loss of income to take care of their disabled youth.

Something that comes in here is that disabled youth are seeing this financial strain and the struggle, and this impacts them. This might make them feel like a burden. Feeling like a burden is not a reason to die. We should be addressing why they feel like an burden and what can we do to make sure they don't feel like a burden.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

To be clear, in this committee, at the end of our life as a committee, we're going to table a report with recommendations. It's not necessarily going to result in the law being changed. We're taking a deep dive into this to get a clear understanding of what people in Canada feel about this, from all sides of the spectrum, because there are some very strong feelings on both sides of these questions.

On the topic we are studying today, we have five major themes. One of them was protection of persons with disabilities, and now we're on to mature minors.

Can you talk to me on what we should be looking at, sort of as a minimum, to make sure that disabled youth have been represented adequately in this process?

[Ahona Mehdi]

I think that this process is moving extremely quickly.

I also want to talk about the fact that on June 2, Senator Wallin tabled a bill to expand MAID with respect to advanced directives. As a senator sitting on this committee, by doing this, I think she has put in question the integrity of this committee as well.

I also think that there haven't been a lot of people who have been consulted, especially disabled youth like me. To my knowledge, I'm the only disabled youth who has been called as a witness. I am very doubtful that enough disabled youth have been consulted on this, and that scares me. It's not okay to be making decisions about us and about our right to live or our right to die when we are not at the table, and we are not there.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Regarding the earlier theme of protection of persons with disabilities.... When you hear that our committee has been charged with looking into that, as a theme, what does it mean to you?

[Ahona Mehdi]

I'm sorry, I didn't have my headset on. Could you repeat the question?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

The previous theme we looked at was the protection of persons with disabilities. When you look at that as a guiding theme for this committee, what does it mean to you?

[Ahona Mehdi]

I think that's important, but I'm not really seeing it in action.

We also need to be considering the many social determinants of health being neglected, right now. We need to be talking about the lack of housing, especially for racialized, Black, and indigenous disabled youth. We need to be talking about the disproportionate levels of poverty and housing precarity, and the fact that indigenous peoples experience suicidality and die by suicide at a disproportionate rate. Indigenous youth are being disproportionately targeted by this bill, as well.

I think those things are really being neglected, right now. I don't know if I see the protection of people with disabilities in this.

[The Joint Chair, Hon. Yonah Martin]

Thank you very much.

I'll now hand this over to my co-chair for a round of questions from the senators.

[The Joint Chair, Liberal, Marc Garneau]

Thank you, Senator Martin.

You raised a point, Ms. Mehdi. Just for your information, this is the first night we've looked at the issue of mature minors, so you're the kick-off to this.

We'll now go to the senators. These are three-minute rounds.

We'll start with Senator Mégie.

[Marie-Françoise Mégie, Senator, Quebec (Rougemont), ISG]

Thank you, Mr. Chair.

My three questions are for Ms. Mehdi.

If I understood correctly, when you were young, about 17 years old, you were very ill and you say you were eligible for medical assistance in dying. Why do you say you were eligible for medical assistance in dying? Who told you you were eligible for MAID?

Even if, as you say, you were eligible for medical assistance in dying, did you know that you would have had to undergo two assessments to see if you really met the eligibility criteria for MAID? Were you aware of that?

As a minor, do you feel that you would be free to refuse medical assistance in dying?

[Ahona Mehdi]

To my understanding, I think you asked why I would be eligible. I don't think that's something that's necessary for me to disclose here. I don't think it's necessary for me to disclose my disabilities, particularly to all of you here today.

You also asked a question about whether I would have been able to say no, had a doctor offered me medical assistance in dying. I was in the hospital because I was in crisis. I was at my worst. At that point in time, perhaps I would not have said no, because I was suicidal and in crisis. However, I'm telling you that a lot of youths could be put in the situation. If you think about it, had I been offered it at the time, I would not be here today.

[Marie-Françoise Mégie]

You know that it wasn't up to you to decide if you were eligible for medical assistance in dying. It would have taken an assessment by a physician or other health care professional to confirm whether or not you were eligible for medical assistance in dying. Were you aware of that assessment?

When a person is in crisis, it's not the time to assess their eligibility for medical assistance in dying. This is made very clear in the reports.

[Ahona Mehdi]

Yes, I was aware of this fact. I was aware they would have to consult with me, but I also have multiple disabilities. I don't think they would have seen the thing about me being in crisis.

I also mentioned earlier that disabled people, growing up in health care systems and having to navigate these systems, we're often able to mask our issues. We're often able to present ourselves as needing one thing when actually, internally, we are feeling another thing.

Yes, I am aware of this process, but I'm scared and I also don't know.... You say these processes are in place, but how can we ensure this? Many of you may have seen headlines about a registered nurse who murdered eight long-term care home residents in Ontario in 2019. No one would have known about this had they not disclosed it to a psychiatrist. How would you be able to guarantee this would not happen again?

I understand it's a different circumstance, but there is absolutely no way to guarantee this will not happen.

[Marie-Françoise Mégie]

Ms. Mehdi, I will stop you there because those are not MAID cases. The case you're talking about involving the nurse is not medical assistance in dying. It's a criminal case, and that's something else. Do you understand?

What I want you to understand is that you don't need to be afraid, because an assessment will be done by health care professionals, and you can trust in them. They can determine who is eligible for medical assistance in dying. That's kind of what I wanted to say.

Do you feel that you were capable at 17 of expressing your opinion voluntarily and thoughtfully, feeling no pressure?

[Ahona Mehdi]

Yes, so what I'm saying is that I believe, I understand, that those cases were not medical assistance in dying, but we know that medical racism exists, and we know that medical ableism exists. There is no way to guarantee that these medical professionals—right?—would not engage in these acts of coercion, knowing that these things exist, and I'm saying that as a 17-year-old I have a lot less power than those people in positions of power, so I would be in a very vulnerable situation.

[The Joint Chair, Liberal, Marc Garneau]

Thank you, Senator Mégie.

Senator Kutcher, you have the floor.

[Stanley Kutcher, Senator, Nova Scotia, ISG]

Thank you very much, Mr. Chair.

There are two questions and they're for both witnesses.

Thank you very much for being with us today.

MAID for mature minors is currently available in some countries. Do you know for what circumstances or conditions it has been provided in those countries? Can you share with us in what circumstances and conditions people have received MAID for mature minors in the countries where it's been provided?

[The Joint Chair, Liberal, Marc Garneau]

Do you want to start, Ms. Mehdi?

[Ahona Mehdi]

I don't know particularly, but I would assume around terminal illness, chronic illness....

[Stanley Kutcher]

I'm sorry?

[Ahona Mehdi]

I don't know particularly, but I'm wondering if it's around maybe chronic illness or terminal illness.

[Stanley Kutcher]

Okay. So you don't know?

[Ahona Mehdi]

No, I don't know.

[The Joint Chair, Liberal, Marc Garneau]

Mr. Henry, do you want to answer that question?

[Myeengun Henry]

I'm not aware of it either, unfortunately.