MAID column didn’t fairly portray the entire picture

By Lethbridge Herald on March 16, 2023.

Editor:

Recently the Lethbridge Herald published an article by a Mr. Zekveld of ARPA that related the failings of medical assistance in dying (MAID) and its legislation in Canada. I know I don’t have to point out the one-sided and biased nature of that article to our astute Lethbridge Herald readers, but I wanted to reply with several opinions of my own.

Though the basic facts of the article were true, it didn’t portray the whole picture. The Special Joint Committee on Medical Assistance in Dying has deliberated three topics (eligibility for those with mental illnesses, MAID for mature minors, and the ability to request MAID in advance). Fact. Canada already has one of the most permissive “MAID regimes” – Also a Fact. However, the comment about “failing to protect vulnerable Canadians” is pure opinion.

In regards to eligibility for those with mental illness as the sole underlying condition, the article stated “A 2022 Expert Panel… noted significant risks and concluded this report is the beginning of a process.” Fact. The panel’s report also included the statement “the committee believes that such individuals should have access to MAID. The committee… wants to ensure that standards are in place before eligibility is permitted.”

The exclusion of those with a mental illness from accessing this constitutional right is stigmatizing and discriminatory, and requests for MAID by people whose sole condition is a mental illness must be treated on a case-by-case basis. The expert panel made 19 recommendations regarding requests for MAID by those with mental illness, showing their commitment to ensuring the correct assessments are made in these cases. Health Canada has convened a group which is currently developing practitioner standards and guidance for these situations.

“There’s no bringing … children back from the dead,” Mr. Zekveld writes. Fact. There’s no bringing anyone back from the dead. That is why there are safeguards and eligibility requirements in place for all medically assisted deaths. Nobody is suggesting that there will be a huge influx of children requesting MAID – only that in very specific circumstances, a capable individual who is a mature minor could have the same opportunity to be assessed as someone who was 18. 

In many jurisdictions across Canada, mature minors already have the right to make important decisions regarding their end-of-life care. This includes the right to consent to or refuse live-saving medical treatment. We, as a society, have an obligation to listen to the voices of children and to recognize their suffering. 

There is a difficulty in “anticipating in advance what a person might later feel is an intolerable condition.” Not a fact. Those with life-limiting conditions, who understand the path of their decline, and are experiencing this decline first-hand know what will feel intolerable to them. 

An advance request involves a competent person making a written request for MAID that could be honoured later, after they lose the capacity to make medical decisions for themselves. It would outline specific details and the personal circumstances of the condition that would lead to triggering this request. (Examples: If I no longer consistently recognize my partner/children; if I can no longer toilet myself). An advance request could save a person from having to endure months or potentially years of unwanted suffering. 

There is already the option of a Waiver of Final Consent. This allows a person who has already been assessed and approved, to receive MAID if they no longer have the capacity for consent at the time of the procedure. This is based on a signed and dated agreement, and is used only in specified circumstances. There are also many legal options (outside of MAID) that allow a person to refuse a ventilator, or life support even if they cannot speak for themselves. Do you have a personal directive? 

“MAID is already available to them Indigenous people.” Fact. It has been available to anyone who meets the eligibility criteria in Canada since 2016. There is a strong focus on Indigenous consultation and consideration throughout the aforementioned report, including from Health Canada on its engagement with First Nations, Inuit, and Metis people on the subject of MAID. This input will be valuable as Canada navigates changes and updates to MAID legislation, and will be invaluable to the ongoing work of truth and reconciliation. 

“The report summarized arguments about… whether Canadians will choose MAID due to lack of access to services.” Fact. The report did discuss this. Many of those advocating for MAID are also advocating for more available services for vulnerable populations, and more funding for healthcare, palliative, and end-of-life care. The lack of services and social supports is concerning (Fact). However, an individual is not eligible for MAID on the basis of inadequate supports. Conditions like poverty, homelessness, short intervals of depression or feelings of being a burden do not qualify a person for MAID. Suffering based on these things may lead a person to apply for MAID but would not lead to them being approved. 

I support the right of Mr. Zekveld to have and to share his own opinion, and I respect those who have decided MAID is not for them. I also fully support those who are advocating for MAID as an available option for the people who choose it. 

If you are interested in learning more, please seek out further resources. Great places to start include the Government of Canada website, Dying With Dignity Canada, and your local bookstore or library. Take good care.

Erin Quan

Lethbridge