Webcast archive: 17/12/08

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

  • Review of Canadian disability legislation: Nova Scotia
  • Legal assisted suicide affecting responses to “traditional” suicide attempts

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


  • Welcome back to our review of accessibility legislation across Canada. This week, we’re exploring Nova Scotia’s Accessibility Act which was passed in April this year.
  • As in other provinces, the Act aims to “[prevent and remove] barriers that disable people” by creating standards in a few major areas. The Nova Scotia Act focuses on:
    • goods and services,
    • information and communication,
    • transportation and its infrastructure
    • employment,
    • the built environment,
    • education, and
    • a prescribed activity or undertaking
  • More specific information about the accessibility standards in each of these areas is not yet available online. We don’t know, for example, whether all new city buses will be required to have ramps. The requirements are part of a strategy that will officially begin next year and lead to “an accessible Nova Scotia by 2030.”
  • These “disability rights” statutes are very discouraging insofar as they essentially move lawmaking from the open forum of the parliament to administrative departments under a procedure which is neither democratic nor transparent.
  • In the legislation, “disability” is defined as “a physical, mental, intellectual, learning or sensory impairment, including an episodic disability, that, in interaction with a barrier, hinders an individual’s full and effective participation in society.”
  • Two organizations have been founded to guide the Accessibility Act’s implementation.
    • The Accessibility Advisory Board will set priorities for the Act, including the design of standards, and evaluate whether measures currently in place are effective. Members will be appointed by the province’s Lieutenant Governor; currently Arthur LeBlanc.
    • The Accessibility Directorate will be responsible for conducting research, making recommendations, and reviewing policies and practices. The Directorate is appointed by the Minister of Justice, currently Diana Whalen.
  • The Act is enforced by the Compliance Director through inspections of businesses, orders to remedy non-compliance, or fines of up to $250,000. Unlike other provinces, where the fine goes into the general fund, the money “must be used for the purpose of accessibility initiatives, including public education and awareness.”
  • The Director will keep a database of “all complaints of non-compliance, inspector visits, orders issued, Director reviews, notices of administrative penalties and appeals.” However, that information is not available to the public. It is only used to prepare an annual summary for the Justice Minister.
  • The Minister of Justice will publish annual reports about their own activity under the Act. All public-sector organizations – municipalities, universities, and government departments – also have to create accessibility plans and make them available to the public. These plans must include:
    • Past, present and future actions to “identify, remove and prevent barriers,” and
    • How the agency will evaluate the accessibility of its “policies, programs, practices and services” and their related bylaws.
  • When designing a plan, the organization must consult people with disabilities as well as disability groups. They must also establish accessibility advisory committees, where at least half of the committee members are people with disabilities or representatives from disability groups. The plans must be updated every three years.
  • Private businesses need to keep records of what they have done to comply with the legislation.
  • Four years after the Accessibility Act comes into force – in 2021 – the effectiveness of the Act and its standards must be reviewed. After that, reviews will take place every five years.
  • The Accessibility Act isn’t the only disability-related law getting a lot of attention in Nova Scotia. In October, the controversial Adult Capacity and Decision-Making Act came into effect. The original version of this law allowed a court-appointed guardian to automatically control the financial, health care, and personal decisions of a person who is declared incompetent. Although this proposal was designed with good intentions, it violated the rights and freedoms of people with intellectual disabilities.
  • Many disability rights organizations and advocates, including the Canadian Association for Community Living, asked legislators to allow for supported decision-making, instead of putting guardians in place right away. However, all of their proposals were rejected. The law was eventually changed to require the “least restrictive and least intrusive form of representative decision making.” This includes:
    • recognizing that a person may have decision-making capacity in some areas, but not others;
    • requiring regular reviews of guardianship orders, and
    • allowing for supported decision-making where possible.
  • Because disability advocates had to fight for the law to be changed, many Nova Scotians are now aware of the disadvantages of guardianship and the need for Nova Scotians with disabilities to have as much choice as possible.


  • For a long time, advocates against assisted suicide have wondered about the effect it would have on society’s response to suicide attempts that are not medically assisted. We recently discovered a document released by the College of Physicians of Quebec in March 2016 that explored suicide attempts as “an expression of refusal of medical treatment.” (The paper is only available in French.)
  • It was written after the College learned that some people who attempted to end their lives by drug overdose in the fall of 2015 were not given treatment that might have enabled them to survive.
  • The College discusses the need for physicians to obtain the consent of a patient before starting treatment, as noted in the Civil Code of Québec and the Act respecting health services and social services. The Law on end of life care also allows for the use of advance directives – documents specifying the wishes of a person who has become incompetent.
  • Since the goal of medical professionals is usually to save the person’s life, and a suicide attempt is usually an emergency, doctors are unsure of their duties towards an unconscious person who has attempted suicide. The Civil Code and the Code of Ethics of Physicians say that “consent to care is not always required in an emergency.”
  • The authors ultimately conclude that suicide attempts are not the same as refusing medical treatment. Suicide attempts are considered emergencies, and a person’s suicidal state is not reason enough to deny them medical treatment. The doctor must have proof that a person doesn’t want to receive certain medical interventions – for example, a DNR order or other advanced directive.
  • The only form of suicide that should be “respected” by doctors is one in which they assist directly; euthanasia requested and approved according to the requirements of Bill 52 that came into effect in December of 2015.
  • That’s an interesting distinction, especially considering a question that is asked towards the end of the paper: how can suicide be called a refusal of treatment when that so-called “choice” is driven by:
    • a psychiatric condition that may affect someone’s decision-making abilities;
    • physical pain;
    • family conflicts or other social issues?
  • If the College recognizes that suicidal feelings and actions can be brought on by any of these factors, why does the approval of a doctor suddenly make suicide by euthanasia acceptable? Also, the process described by the College for determining whether the person has capacity or is subject to these influences is more thorough than that required by the euthanasia law.  Why a different process for those who attempt suicide, as opposed to those who apply for euthanasia?
  • The College fails to acknowledge the inconsistencies of the euthanasia law, medical ethics and suicide prevention policies.  It’s very frustrating to see organizations that should be consistent in their suicide prevention efforts buying into this line of thinking.