Euthanasia and the Dehumanization of Disabled Canadians
Overlooking the Dangers of Ableism and Elitism in Canadian Law and Medicine
Note: This is a reprint of an article originally published in 2022
The Controversy of Track Two MAID
The Canadian public does not well understand Medical Assistance in Dying (MAID) or that it is split into three tracks. Track one is what most of us believe euthanasia is about; it is intended to provide compassionate relief during the dying process for people whose natural death is reasonably foreseeable. Track two is the more controversial and poorly understood part intended for those whose death is not reasonably foreseeable. Track three does not yet exist in an accessible form; if and when track 3 MAID is put into practice, it is intended to open doctor-assisted suicide to Canadians with a non-terminal mental illness.
The controversial and not well-understood part of Canada’s new euthanasia laws stems from Bill C7 following Madam Justice Baudouin’s 2019 Quebec Superior Court decision in Truchon v. Canada. What the Trudeau government, Attorney General of Canada David Lametti, and Madam Justice Baudouin missed in Truchon is the existence and impact of profound ableist and eugenic attitudes throughout Canada, especially within the medical establishment.
Truchon and Bill C7 are good examples of how poorly informed decisions can produce dangerous and harmful outcomes. The existing legislation leaves all the checks and balances to doctors who may have unconscious elitist and ableist attitudes and provides no meaningful protection for vulnerable Canadians who may volunteer under the extreme duress of unmet needs or poverty. Canada's Minister of Justice and Attorney General David Lametti has continued to overlook the existence and impact of ableist and eugenic attitudes within the Canadian legal and medical communities in his defence of the Liberal Party’s poorly regulated euthanasia policies. Without legal direction based on a full understanding and acknowledgement of ableism in Canada and within the Canadian medical establishment, MAID will contribute to human rights atrocities as Canadians who could be meaningfully supported to live high-quality lives through the meaningful enforcement of rights and protections that today exist only on paper are put to death.
Self-Agency and Acts of Oppression
There are legitimate limits to self-agency and there need to be reasonable ways to appropriately deal with situations involving Canadians who are prevented from working as a result of medical issues, impairments and disabilities. There need to be meaningful efforts to address the physical and attitudinal barriers in Canada to ensure that higher education and the workforce are accessible to everyone and that simple medical issues, impairments or workplace injuries aren’t neglected or abused in ways that can decompensate into severe and costly disabilities. In 2023 our systems of health and justice long damaged by irresponsible acts of attrition, corporate profit-focused policies, and unprecedented conflict between the different levels of government, have made access to healthcare and justice difficult or impossible for all but the wealthiest Canadians who can seek healthcare in other countries and hire expensive lawyers. With health and justice used as economic dividers mediating who can work and who can’t a growing number of chronically ill or disabled Canadians are falling into poverty or homelessness and are applying for (and receiving) euthanasia under extreme oppression and economic duress.
Falling Down; It Can Happen to You.
For those fortunate to be healthy and doing well post-pandemic, it is important to understand how health disparity and poor access to justice impact society. Not everyone has the same defensive capability, supports or opportunities to help them navigate economic disruptions like pandemics and wars. Without a supportive family or significant savings/wealth in the absence of accessible healthcare and justice, all it takes to fall into the margins is one severe and disabling accident or illness followed by costly corporate predation when you’re down. Once a Canadian is unable to work, each successive loss or negative experience can make recovery more difficult adding to the cycle of decline. By the time a Canadian has reached the point that track-two MAID becomes the only accessible option to address suffering, there have likely been hundreds of missed opportunities to restore health and productive life.
In his 1845 work, The Condition of the Working Class in England, Friedrich Engels coined the term social murder to describe murder committed by the social and political elite where they knowingly permit conditions to exist where the poorest and most vulnerable in society are deprived of the necessities of life and are placed in a position in which they cannot be reasonably expected to survive and will inevitably meet an unnatural and early death.
In keeping with Engels's social murder, there are too many examples of unnecessary deaths that followed preventable decline after delayed or withheld medical care, delayed or denied social support and delayed or denied justice. One of the most tragic examples is the Feb 2021 euthanasia of a Toronto woman named Sophia, who was euthanized because she could not find disability-safe housing. Would this case be different if she were not disabled and was killed only because she was a woman? All she needed was a safe workspace and a safe place to live, and she could have survived and contributed to society for another 30+ years. How is killing Canadians like this disabled woman who didn't want to die different from the T4 euthanasia program of the 1940s?
The Human Cost of Class Division and Not so Universal Healthcare
Sadly, many healthy Canadians misunderstand and take our single-payer healthcare system for granted. Many, if not most, do not understand that our universal healthcare system is provincially run and far from universal. Where I live in Ontario, universal health care does not cover non-emergency mental health care, psychological therapies, prescription drugs, dental or optical care, physiotherapy and rehabilitation, paramedical services like pain management and in-home disability care like diabetic foot care and housekeeping. It also only partially covers disability aids like wheelchairs and in-home assistive aids. The limitations of our universal healthcare system leave many disabled Canadians forced into poverty, unable to afford desperately needed assistive aids.
Thanks to the pandemic and an alarming report from the Canadian military about conditions in long-term care homes, we are all now aware of the sub-human conditions elderly and disabled Canadian citizens are forced to endure. During the height of the pandemic, for-profit LTC homes were consistently among the worst in patient care and had the highest infection and death rates. To be clear, the problem is not our public healthcare system; the problem is the intentional political attrition, lousy government policy/practices and corporate greed that contributes to social decline and an environment unsuitable to sustain human life.
Canada’s Injustice System
Any just, free and democratic society needs a system of laws to keep the peace and resolve disputes peacefully. Where there is a breakdown or failure in this system of laws, there will be a corresponding breakdown and failure in keeping the peace and resolving disputes. In Canada today, with growing deaths of despair and social violence, we see such a breakdown and failure of law and society. Canada’s justice system is cost prohibitive, seriously backlogged and largely inaccessible to Canada’s most vulnerable and desperately in need of legal protections. In terms of cost, with the average lawyer charging a retainer in the high thousands and the cost of a trial in the hundreds of thousands, if not higher most working Canadians cannot afford the cost of legal protections.
This challenge is exponentially worse for Canadians with disabilities forced out of the workforce and into poverty. For those who qualify, legal aid is an underfunded abomination that most capable lawyers are loath to deal with and frequently fails to provide sufficient funding to see a case through to its completion. Even Ontario’s tribunal system, which is supposed to make justice more accessible, tends to lean conservative and has a dismal track record of finding in favour of well-represented defendants who can afford the best protection against self-representing disabled or otherwise disadvantaged plaintiffs. In February 2023, the Canadian Human Rights Commission came under fire for committing human rights abuses against its employees, further demonstrating that the system designed to protect human rights in Canada is grossly inadequate and ineffective.
For disabled litigants, beyond cost, physical and attitudinal barriers are a serious problem in Canada’s courts. At the superior court in Guelph, there is only one handicapped parking space available to the public, the ramp in front is a winding labyrinth of hell inaccessible to someone using a sizeable manual or electric wheelchair, the elevator doesn’t always work, and the clerk’s office is too small to accommodate a large wheelchair. For litigants with invisible disabilities, the legal community and judiciary are not only far from trauma-informed, they are highly elitist and discriminatory, frequently allowing ableist stereotypes and involuntary impairments to be used against the sufferer.
The result is that vulnerable Canadians, especially those with disabilities, are easy targets for abuse, neglect and discrimination. I can say from experience that even as a university-educated Canadian, after many self-represented legal battles fought and lost against seasoned lawyers at the Ontario Human Rights Tribunal I’ve been forced to accept that as a disabled Canadian, I can not win and can not hope to claim in any meaningful way the constitutional, human rights and disability protections Canada’s government and highest court claims to provide.
The truth is that without meaningful and accessible enforcement, Canada’s human rights and disability protection laws aren’t worth the paper they’re written on. More importantly, without meaningful protections, the ableist thinking and behaviours practised by elitist doctors, lawyers, judges, legislators and business leaders ensure that ableism continues to be a severe problem in Canada.
Competing Perspectives
As discussed above, Canada’s pervasive ableism, unresolved human rights issues, economic exclusion, out-of-reach therapeutic care, inaccessible courts and public indifference are a critically important context to any discussion about track two MAID. When disabled Canadians like me, who could thrive with just a little support and protection, volunteer to be killed, it must be understood as voluntary under extreme duress. Using the infamous falling man as an analogy, following the 9/11 attacks, desperate people jumped to their deaths from the upper floors of the twin towers to avoid burning to death. These people did not commit suicide; they were murdered by Al-Qaeda terrorists. Terrorists come in many forms; what we should all be asking ourselves is why our country is placing its vulnerable citizens under that kind of inhumane duress.
While the federal Liberals and Justice Minister David Lametti ignore the existence of pervasive ableism and defend the provision of track two MAID under the exclusive discretion of the medical community compassionate care, as a disabled Canadian living in poverty, I call it ableist oppression, class domination and social genocide.
The only way I can reconcile this difference in perspectives is to say that wealth and privilege provide rose-coloured glasses that hide the callous realities of life in a stratified society created by divisive and discriminatory practices. Those who live in the privileged unoppressed strata can enjoy the protective false delusion that every Canadian has what they have and that Canada is a truly fair and just society. In reality, the difference in our lived experience is so vast that our wealthy leaders and jurists can make claims of no wrongdoing when they make decisions from their perspective on high that injures or kills people different from them. Such is the case with Truchon and Bill C7. If Canada is to be a truly just, free, and democratic society that escapes the unjust social conditions Engel described as social murder, we must extend meaningful protections to our most vulnerable citizens.
As a disabled Canadian, I hope I've been able to make clear the point that while mass euthanasia can appear kind and merciful, the overlooked context and perspective present a very different reality. I hope the federal Liberals and Minister Lametti will reexamine the issue and ask themselves if track two MAID is an act of mercy or a well-rationalized form of oppressive violence on Canada’s disabled and vulnerable citizens. From where I stand (or sit in my wheelchair) that doctor’s needle could just as easily be a soldier’s knife or a gun. The result is the same, with a death count of over 13,500 last year alone.