Evidence of meeting #28 for Medical Assistance in Dying in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was disability.
A video is available from Parliament.
Liberal
Dr. Heidi Janz via text-to-speech software
Yes, I think I do agree with Dr. Stainton. I think we have created a system where death is easier for people with disabilities than living, than living with dignity.
So really, until Health Canada as a whole admits its systemic ableism within MAID, then frankly I don't see much hope. MAID currently is eugenics disguised as autonomy, and the only way to fix that is to make it so that people with disabilities are able to live before they are able to die.
Thank you.
The Joint Chair Hon. Yonah Martin
I was pausing for the translation, so you have about 30 seconds if you want to hear from Dr. Shaw.
Liberal
Associate Professor, University of Calgary, As an Individual
Sure.
I would just say that I think the approach to developing MAID legislation and the implementation of it in Canada has been very intentional, and that we do have safeguards in place. I don't disagree with my colleagues about the need for better social and medical supports, but I worry about who gets to decide who is suffering too much in the meantime. I think we do have safeguards, and that at this committee like yours you're making these decisions with all of that in mind.
The Joint Chair Hon. Yonah Martin
Thank you very much.
Next we will go to Monsieur Thériault for five minutes.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Madam Chair.
I will address Dr. Stainton first.
I will cite an article by Maria Chang published on August 11, 2022, in which experts express concern about Canada's euthanasia laws and find the situation worrisome.
You said the Canadian legislation was likely the greatest existential threat to people with disabilities since the Nazi program in Germany during the 1930s. I imagine you were referring to Bill C‑7.
That's a little strong, in my opinion. Do you stand by that statement and did you really say it?
Director, Canadian Institute for Inclusion and Citizenship, University of British Columbia, As an Individual
Yes, I did—
Bloc
Luc Thériault Bloc Montcalm, QC
Okay, thank you. Since I don't have very much time, I will continue.
I take it you are appearing here as an expert and stating that the totalitarian regime, the terror regime of Nazi Germany, which sought to exterminate people, to practice eugenics, is equivalent to what we're doing as representatives of the people to try to respond to diseases, to ailments, to people with disabilities who are suffering. You're comparing that to a voluntary intention on our part.
Earlier, you also mixed up the concepts of mercy killing, euthanasia and assisted suicide. These are not the same things. Euthanasia must and can only be strictly and exclusively voluntary. You know that.
From the moment that decision becomes the person's, the patient's, how could you make a statement like that? It's a little heavy-handed.
Director, Canadian Institute for Inclusion and Citizenship, University of British Columbia, As an Individual
Perhaps I—
Bloc
Luc Thériault Bloc Montcalm, QC
I'm not done yet.
You're asking us to consider what you're saying, and I'm willing to consider it, but what is your understanding of the government's role in this matter?
I think the government's role at the most intimate time in a person's life, their own death, is not to decide for them what is right for them. It is to be able to create the conditions for them to exercise their free will and to guarantee that they will be free to decide what they want when they die, because they are suffering irremediably and irreversibly.
There's a difference between an intolerable situation and a disability that creates irremediable and irreversible suffering.
Now that I've issued these warnings, you may go ahead.
Director, Canadian Institute for Inclusion and Citizenship, University of British Columbia, As an Individual
Thank you for the opportunity to clarify.
What I said was that the comparison was with the existential threat to disabled people. I did not compare what we're doing to what the Nazis did. I compared the threat to the lives of disabled people. You're quite right that they're not comparable and I'm certainly not accusing our government of pursuing the same intentions.
What I was saying was that the outcome can have a similar effect and what we've heard from Dr. Janz and the other stories—there was another story in the paper yesterday—is that it's not as you described in all circumstances that people are being moved towards MAID. They're going to MAID out of despair, not that their suffering can be relieved with proper housing or proper supports and that's the existential threat that I'm concerned about.
Just to clarify, I was not comparing the processes or the motivations, I was comparing the outcome, if you like, and the threat level to people with disabilities and I stand by that. If someone can tell me another point in history when there has been this level of threat to the lives of people with disabilities I will happily retract that statement.
Thank you for the chance to clarify that.
The Joint Chair Hon. Yonah Martin
Thank you, Mr. Thériault.
That's five minutes, so we'll next go to Mr. MacGregor, also with five minutes.
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you very much, Madam Co-Chair.
I'd like to turn to Dr. Jessica Shaw. I really appreciate the niche expertise you're bringing to our committee with your experience in Canada's federal prisons.
I was very fortunate last summer to go on a tour of the Mountain Institution and the Kent Institution in Agassiz, British Columbia. That was certainly quite a wake-up call. I had some fantastic conversations with both the program officers and the parole officers who work so hard at their job and with such passion to try to make a difference.
Just with the conditions in Canada's federal prisons, you did talk a little bit about prisoners and their access to medical assistance in dying. From the stats that you had suggested, I'm guessing those were track one, that is, their death was foreseeable. Do you have any stats on track two, that is, prisoners who are living with disabilities? I'm just wondering if you can fill in some of the blanks on that area.
Associate Professor, University of Calgary, As an Individual
The short answer is no. I don't have information on track two yet.
We do need to look at those updated numbers since August 2020. I know there's certainly fear within the prison system of bringing up the possibility of seeking MAID because it's sometimes still equated to suicide, and the risk of being put in segregation and under mental health watch is highly undesirable.
Finding “MAID friendly” staff is an issue.
But no, we don't yet have information on track two.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Kent is British Columbia's maximum security institution. Mountain was medium security and there was certainly a huge difference in terms of the freedoms on both sites.
For prisoners who may develop a disability, who have been there for a long time and their health really starts going downhill, how does the Correctional Service of Canada start accommodating their unique needs as a disease might progress?
Associate Professor, University of Calgary, As an Individual
Several facilities offer specialized care. For example, Pacific Institution in Abbotsford has a palliative care program within the prison facility. They also have a peer support program. Some of the younger, healthier men care for some of the older, less healthy men. There has been some talk, or some rumblings, that perhaps that might be a model worth looking at replicating across the country, but people are moved as their needs shift and change.
I would again bring it up that when someone gets to the point where either they don't understand why they're in prison anymore because of dementia or they are incapable of harming themselves or anyone else, I would question why they're still in the prison system.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Despite that, “parole by exception” is still an exceptional use. It's rare, as you said.
Associate Professor, University of Calgary, As an Individual
It is. In another study that one of my colleagues did with 14 palliative care prisoners who had applied for parole by exception, four were granted parole. Those are folks who really are at the end of their lives.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Thank you.
Dr. Stainton, I'd like to turn to you now. You did make mention of the struggles Parliament has had in getting a Canada disability benefit act. I certainly understand that and sympathize with it. We're still unsure as to what that federal benefit will be. There's a legislative framework for it, but we don't yet know.
I think tackling the economic insecurity that so many disabled people in Canada live with.... I mean, we know the statistics. I have a constituent who's a real activist, and he refers to it as “legislated poverty”.
I guess for me, when we come to this theme of autonomy and respecting a person's autonomy, can we ever reach a point where a disabled person has—hypothetically, let's say—all of the supports necessary and is leading a fulfilling life; you can bring yourself to a position where you're satisfied that someone is living a dignified life with a disability; and you can bring yourself to respect that they may, even with that level of support, decide that it's in their own best interest that they want to engage with medical assistance in dying?
I think this is the struggle our committee is having. How do we respect that personal autonomy, which is so important to so many people who live with disabilities?
The Joint Chair Hon. Yonah Martin
I'm sorry, Dr. Stainton. You have about 30 seconds for a brief comment.
Director, Canadian Institute for Inclusion and Citizenship, University of British Columbia, As an Individual
Okay.
Certainly, if we got to a point where it was clear that people had the support they needed to make the choices that we all value, and that they had the money they needed to lead a life, then I would have a lot less reservations about them making the choice, as I would about people at the end of life. Obviously, disabled people should have that same choice as every other citizen. It's just that we're an awfully long way from being at that point. That would be my concern.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
Your point is well taken.
Thank you, Madam Co-Chair.
