Webcast archive: 17/11/10

In this episode of Euthanasia & Disability, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:

  • Review of Canadian disability rights legislation: Manitoba
  • Québec’s Commission on End-of-life care issues its second annual report

Please note that this text is only a script and that our webcast contains additional commentary.

REVIEW OF CANADIAN DISABILITY RIGHTS LEGISLATION: MANITOBA

  • This week, we’re continuing our review of Canadian accessibility legislation, looking at Manitoba. The Accessibility for Manitobans Act – sometimes shortened to the AMA – became law in December 2013. The government’s goal is “to achieve significant progress” by 2023; what that means isn’t defined in the Act.
  • Principles the Act is based on include:
    • accessibility;
    • equality (of opportunity and outcome);
    • universal design; and
    • systemic responsibility, which puts the responsibility of preventing and removing barriers on the organization that caused the barrier in the first place, rather than the person with a disability who is affected by the barrier.
  • The AMA lays out a process to create “accessibility standards” to “[prevent and remove] barriers that disable people” in five areas:
    • employment;
    • “accommodation;”
    • the built environment (which includes buildings, multi-unit housing and transportation);
    • goods, services, and information; and
    • “prescribed [activities and undertakings].”
  • The accessibility standards will include what kind of organizations must comply with the law, what they must do to remove and prevent barriers, and the date by which they must comply.
  • A barrier is defined as “anything that interacts with” a physical, mental, intellectual or sensory disability “in a way that may hinder the person’s full and effective participation in society on an equal basis.” They can be:
    • physical or built into the environment;
    • related to information, communication, or technology;
    • an attitude; or
    • found in a policy or practice.
  • The Minister of Families, currently Scott Fielding, is responsible for overseeing the development and application of the AMA. This includes drawing up and implementing the “accessibility standards”.  Only the standard for customer service is in effect right now. Standards dealing with employment, information and communications, the built environment, and transportation are still being written. Other important services, like education and health care, aren’t being touched yet.
  • As with Ontario’s law, the content of these standards is not easy to find, and the staggered implementation doesn’t take into account how barriers can overlap.
  • The Minister is also supposed to create an annual report and annual plan for implementing the Act. Right now, though, the links on the website lead to the wrong places and there’s no way to access those documents.
  • The Minister is assisted in his work by the Compliance Director and an Accessibility Advisory Council. Members of the Council must be people with disabilities, representatives of disability organizations, or representatives of organizations affected by accessibility standards. Summaries of Council meetings and Standard Development Committee meetings are available online.
  • The Act is enforced through records kept by businesses, inspections of businesses by the Compliance Director, or fines of up to $250,000 paid to the Government of Manitoba. However, the Compliance Director does not accept or investigate complaints from individuals.
  • Public sector groups – such as the province’s hydro and liquor companies, post-secondary schools, towns, and hospitals – must prepare accessibility plans every other year. These plans explain what they have done to “identify, prevent and remove barriers” in the past, what they will do in the future, and their strategy to evaluate the organization’s discriminatory “policies, programs, practices, services [and] bylaws.” Disability advocates and organizations must be consulted when drafting a plan. Plans are available on the organizations’ websites as well as the provincial government’s site.
  • The Act’s effectiveness must be reviewed every four years. If the first evaluation has been done, the results are not available yet.

QUÉBEC’S COMMISSION ON END-OF-LIFE CARE ISSUES ITS SECOND ANNUAL REPORT

  • Quebec’s Commission on End-of-Life Care released a report describing the euthanasia deaths that took place in the province from December 2015 to June 2017.
  • Last year at this time, (16/11/4) we reviewed the December 2015-June 2016 report provided by the Commission. One important thing to note from that time period is that two people were killed without being “at the end of life.” In any other circumstance, this violation of the law’s safeguards would be considered murder.
  • Most of the current report focuses on the twelve-month period from June 2016 to June 2017. During that time, a total of 634 applications were reviewed. 618 of these deaths took place in institutions, and another 20 occurred in a doctor’s office or at home.
  • 237 of the forms documenting the 634 deaths – 37% – didn’t contain enough information for the Commission to do a preliminary evaluation.  Even after asking for clarifications, the Commission lacked sufficient data to decide whether 19 out of the 634 deaths – 3% – complied with the law. In 12 cases, additional information given was insufficient. In four cases, the Commission did not receive the additional information they requested, and in three cases, the doctor refused to provide the requested information.
  • In fact, 8% of euthanasia deaths did not comply with the law. By way of comparison, the number of deaths per passenger-mile on commercial airlines in the United States between 2000 and 2010 was about 0.2 deaths per 10 billion passenger-miles.  What other industry that values public safety would accept so many violations and such a high level of risk?
  • The most common problem with the 31 non-compliant deaths (5%) was a lack of independence between the two doctors approving the euthanasia requests; this was observed 20 times. Québec has “solved” this problem by eliminating the requirement that the doctors be independent!
  • In seven cases, the doctor didn’t confirm that the person was informed, was making a free choice to die, experienced persistent suffering, and had a consistent wish to die. In another case, the person did not have a “serious and incurable illness.”
  • If the person didn’t have “a serious and incurable illness,” they were not eligible for euthanasia, so killing them is a criminal act.   Without proof that the person made a “free and informed” decision, they are not eligible, and their euthanasia is also a crime.
  • 377 people who requested euthanasia did not receive it:
    • 159 of them were declared ineligible,
    • 107 people died before the approval process was complete.
    • 79 people withdrew their request.
    • 15 applications were still being reviewed when the reporting period ended.
    • Others moved home or between institutions, had a medical condition “requiring another kind of treatment,” or hadn’t yet chosen the date of their death.
  • This report makes it very clear that safeguards do not do what the name suggests. They don’t keep people from dying unnecessarily, especially when the rules aren’t always followed.