People who request medical assistance in dying can be motivated by a range of factors unrelated to their medical condition or prognosis. These factors make some people vulnerable to request an assisted death when what they want and deserve is better treatment – to have their needs for care, respect, and palliative and other supports better met.
The Supreme Court of Canada’s Carter Decision and Canada’s first medical assistance in dying law (Bill C-14) recognized this reality. While the Supreme Court found that the absolute ban on assisted suicide breached a suffering person’s right to autonomy in some cases, it also found that an exception to the ban could make some people vulnerable to abuse and error. Therefore, access to physician-assisted death must be balanced by our moral and constitutional duties to protect vulnerable persons who have unmet needs. CACL believes medical assistance in dying in Canada must adequately balance protecting choice and autonomy while safeguarding abuse.
With court challenges already in place to Bill C-14, there is risk in losing ground on safeguards to protect vulnerable persons from being induced to commit suicide, and wide-scale perception that some persons’ lives are not worth living.
The inherent right to life of people with an intellectual disability is assured for all people with an intellectual disability.
Safeguards are upheld and expanded to include vulnerability assessments.
The Vulnerable Persons Standard was developed in 2016 as a response to the Supreme Court of Canada’s Carter Decision and to assist the Government of Canada as it developed Canada’s first medical assistance in dying law (Bill C-14) – it now assists policy-makers working to regulate the practice of medical assistance in dying. The VPS is a vital policy instrument for protecting vulnerable Canadians — especially those with disabilities — from direct and indirect forms of coercion, abuse and inducement to suicide.
The Standard was developed by a body of advisors with expertise in medicine, ethics, law, public policy and needs of vulnerable persons. These advisors continue to advocate on behalf of the Standard and are actively involved in on-going studies as well as litigation related to medical assistance in dying in Canada. CACL lead the convening of the Vulnerable Persons Advisors and Coalition and acts as the Secretariat for the VPS.
Currently there are several challenges to Canada’s medical assistance in dying (MAiD) law that are before the Courts. Broadly these challenges argue that any restrictions on the ability of an individual to seek medical assistance in dying constitutes an unfair barrier to access. VPS advisors will seek intervenor status in those cases where expanded access would contravene the Standard and place the lives of vulnerable Canadians at risk.
VPS advisors will also provide evidence to the Canadian Council of Academies which is studying aspects of MAiD, and participate in the development of vulnerability assessments used by health providers.
In partnership with the Centre for Inclusion and Citizenship at UBC, School of Disability Studies at Ryerson University, Tangled Art + Disability, and IRIS, CACL’s Human Flourishing initiative is developing and sharing cultural narratives about the meaning of disability, frailty and suffering in the context of an emerging system for medical assistance in dying (MAiD) in Canada. The initiative is guided by the legislative commitment in the preamble to the Criminal Code provisions for MAiD adopted by Parliament in June 2016, and which states in part the need to “affirm the inherent and equal value of every person’s life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled”.
Human Flourishing is intended as an innovative approach to helping to ‘avoid encouraging negative perceptions’ by developing positive narratives, artistic expression and educational resources about the quality of life of persons who live with disability, frailty and suffering, against the backdrop of medical assistance in dying becoming available for these very same conditions. It is designed as a proactive intervention to promote positive images and accounts of living with disability, given that some of the public and media discourses about MAiD have the effect of contributing to negative stereotypes about what it means to live with these conditions. Human Flourishing is crafting an alternative lens through which others can learn to see human life in its rich diversity, imagine different experiences of body, mind and well-being, and bridge to a sense of shared humanity.
Click here for resources on safeguards in MAiD and access to justice.