Good evening, and thank you for this opportunity of contributing to your reflections.
I'm opposed to this change in Canadian criminal law. I don't think Canada will ever be ready, from a public policy perspective, for MAID for persons with mental illness. Adoption would alienate and harm people with disabilities in Canada, contrary to our charter and to our international human rights law obligations, and it will diminish our well-earned UN reputation.
First, medical assistance in dying is a misnomer for persons with mental illness who die from other vulnerabilities: stigma, discrimination, social exclusion, impoverishment, violence by others and poor physical health.
Next, the intersectional realities of mental illness, intellectual disability and substance use disorders amplify my concerns. There are higher rates of dying by suicide not only for persons with mental illness but also for others experiencing health inequities, including indigenous peoples, trans people, trauma survivors and the increasing number of persons facing psychosocial and economic stressors.
As noted by CAMH, different suicide prevention strategies will be needed for different populations, but everyone deserves those efforts, not the legal normalization of dying by suicide.
The Supreme Court concluded in 1991 that people with mental illness have historically been the subjects of abuse, neglect and discrimination. In 2020, they said that stigmatizing attitudes persist, and they provide support for legislative solutions and justifications for social inequities and injustices.
This would be a vast extension of existing MAID justifications, which would enable departure from the regular criminal law, which must protect our most vulnerable. Those who participate in MAID in good faith are not individually culpable, but society will clearly be demonstrating, as the Law Reform Commission of Canada feared 40 years ago, its ignoble motives if it extends MAID.
This stretching of MAID is not a benefit advancing equality. It's quite the contrary. It aggravates discrimination, marginalization and inequality. As the Supreme Court cautioned in 2020, laws like this give discrimination “the force of law” because it “reinforces, perpetuates or exacerbates [a group's] disadvantage” and “violates the equality guarantee”.
The principles of the Convention on the Rights of Persons with Disabilities are obligatory. Article 4 requires the abolition of “laws...that constitute discrimination”. Article 10 demands the “effective enjoyment” of the “inherent right to life”. Article 25 is “the right to the enjoyment of the highest attainable standard of health”, including the right to an adequate standard of living.
The extension of MAID to persons with mental illness would amount to a terrible setback under the CRPD. It is morally disconcerting and violative of democratic values that the protests of persons with disabilities have been dismissed, but it's also contrary to the CRPD, article 4, which requires us to “closely consult with and actively involve persons with disabilities” to, in article 29, “ensure that persons with disabilities can effectively and fully participate in political and public life”.
There is strident opposition, for example, by the Council of Canadians with Disabilities, which speaks for 170 NGOs. They say, “MPs...have stubbornly ignored the concerns expressed by the disability community.... This is a fight for our lives.”
Organizations like People First Canada, for which I am currently a provincial adviser, have repudiated this initiative as well. They say, “it makes it easier than ever to cancel us out.” It's “dangerous and discriminatory”. It “could be deadly to Canadians with disabilities”. As the president said forcefully, please vote to “kill the bill”, not us.
Canada has sullied its reputation with the United Nations. The Special Rapporteur on the Rights of Persons with Disabilities said, in 2019, Canada must “ensure that persons with disabilities do not request assisted dying” simply because there are no “community-based alternatives”.
In 2021, three UN special envoys were unusually worried that “a social assumption might follow (or be subtly reinforced) that it is better to be dead than to live with a disability”, that the extension would “result in a two-tiered system in which some would get suicide prevention and others suicide assistance, based on their disability status and specific vulnerabilities.”
Canada is at a crossroads. Either protect the rights of persons with disabilities, specifically with mental illness, or extend state-authorized death to make those with disabilities feel more silenced, devalued, betrayed and abandoned.
Thanks so much for this opportunity.