Webcast archive: 18/01/19

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

  • Review of Canadian disability rights legislation: New Brunswick
  • Swedish activist questions Oregon assisted suicide law

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

REVIEW OF CANADIAN DISABILITY RIGHTS LEGISLATION: NEW BRUNSWICK

  • Hi everyone, and welcome back to our series on disability legislation across Canada. Today, we’re looking at New Brunswick. Like most other provinces, New Brunswick has a combination of government programs, instead of one law describing the rights of people with disabilities, and the measures necessary to make equality a reality.
  • First, the provincial building code received a significant update in 2011. In new buildings for public use, the following elements must be barrier-free:
    • main travel paths;
    • doorways;
    • showers and bathtubs;
    • counters;
    • water fountains;
    • at least one out of every two building entrances;
    • Washrooms must be barrier-free unless they are in a business area measuring less than 500 metres squared that is completely separated from the rest of the facility;
    • Waiting areas must have some spaces for mobility devices; and
    • The number of accessible parking spaces ranges from one space in a lot of up to 15 stalls, to 10 spaces for lots with 1,301 stalls, and increasing by one accessible space per 400 stalls.
  • The building code requires access to hotels and apartment buildings; five percent of hotel rooms and apartments in buildings of more than 20 units must be accessible.  Small lodgings (like bed and breakfasts) of less than ten rooms are exempt from the accessibility requirements.
  • Social assistance is available to cover basic living costs.  Some people may also qualify for a supplemental disability payment, as well as coverage for medication, dental care, and eye care (not included in the regular Medicare services).
  • The Disability Support Program provides a number of resources, such as:
    • Respite care;
    • personal assistance within and outside the home;
    • supports for community involvement;
    • life skills training;
    • transportation support;
    • technology and assistive devices; and
    • services in residential institutions.
  • The Family Supports for Children with Disabilities program offers assistance, for which families are expected to contribute as much as they are able.  Services include:
    • Respite care;
    • transportation, meals, and accommodation to access medical services;
    • parental education;
    • some therapy;
    • childcare for youth over 12; and
    • some medical items.
  • The Health Services Convalescent/Rehabilitation Program helps people access adaptive equipment when costs are not covered by other agencies or private health insurance plans. Examples of equipment include:
    • mobility aids,
    • toilet and shower seats,
    • grab bars and rails,
    • lifts and transfer boards, and
    • hospital beds.
  • New Brunswick has five programs to help disabled residents find work:
    • The Work Ability Program is a subsidy for employers to hire disabled workers.  They receive minimum wage for up to 40 hours per week plus the employer’s share of benefits (for example, a pension plan, or employment insurance).  The duration of the placement depends on the person’s employment plan.
    • One component of the Workforce Expansion Program provides partial, temporary subsidies for hiring members of certain groups who are likely to be unemployed, including people with disabilities. The positions found through this program must eventually be full-time and permanent or long-term and seasonal.
    • The Training and Skills Development program funds co-op placements and Grade 7 to 12 equivalent education if a person is already receiving provincial employment assistance. Fees for tuition and books are included.
    • The Training and Employment Support Services program provides people with physical, intellectual, psychiatric, sensory, or cognitive disabilities skills and support necessary to qualify for, obtain and maintain employment. A client could receive an interpreter, assistive technology, or specialized tutoring for high school equivalency.
    • The Equal Employment Opportunity Program provides jobs in the provincial government to Aboriginal people, people with disabilities, and members of visible minorities.
  • The Premier’s Council on Disabilities appears to do much more than its equivalents in other provinces. They publish annual reports online every January, outlining the work done in the two previous years. Some highlights from 2015 and 2016 were: coordinating events for Disability Awareness Week, and meeting with a variety of non-profits and government agencies. The content of these meetings isn’t available on the website.
  • The Council’s website includes:
    • a list of government and non-profit services for people with disabilities;
    • a community calendar, allowing disability groups to advertise events;
    • a classifieds section to buy, sell or donate disability-related equipment;
    • a list of employment and education resources for people with disabilities and potential employers;
    • a career board for people looking to hire attendants, tutors, or intervenors;
    • a huge database of publications – topics range from building codes, to preparing for emergencies, to transition planning for teenagers, to gardening tips for people with limited mobility; and
    • a directory of services for persons with disabilities.
  • Last but not least, New Brunswick has a few interesting recreational options:
    • Disabled hunting permits allow hunters who have permanent physical disabilities to hunt from a stationary vehicle.
    • Provincial grants are available for organizations providing sport and recreation opportunities for disabled people.
    • Public libraries have materials in alternative formats, like audiobooks, talking books, and eBooks. Patrons can also use a computer with a variety of accessible software programs in order to view library resources.

SWEDISH ACTIVIST QUESTIONS OREGON ASSISTED SUICIDE LAW

  • Fabian Stahle, a Swedish anti-euthanasia activist who attended the Euthanasia Prevention Coalition conference in the fall, has recently become aware of efforts to legalize assisted suicide in his country.
  • Officials want to model a potential law after the one in place in Oregon since 1997. The Oregon law states that someone seeking assisted suicide must have a terminal illness; in other words, an “incurable and irreversible illness that will, within reasonable medical judgment, result in death within six months.”
  • Mr. Stahle exchanged emails with Craig New, a research analyst with Oregon’s Public Health Authority, the government body that oversees the “Death with Dignity” law. He later sent a record of the conversation and an article based on it to the Euthanasia Prevention Coalition.
  • While none of the information is new, the exchange pointed out some of the most troubling aspects of the Oregon law:
    • The definition of “terminal illness” applies even if the person’s condition is chronic and health is maintained with regular medical treatment, such as insulin for diabetes or dialysis for people with kidney failure.
    • The person will be considered “terminally ill” even if they refuse lifesaving treatment, or treatment for a chronic condition. In the words of the staff member, the law “does not compel patients to have exhausted all treatment options first, or to continue current treatment … if the patient decides they don’t want treatment, that is their choice. … the patient gets to decide … whether ‘all hope is gone.’”
    • Even if the person’s health care provider or insurance is not willing to pay for treatment, the person is still considered “terminally ill” and is therefore eligible for assisted suicide.
  • Mr. New did not talk about the difference between refusing unwanted medical treatment (and letting an illness take its natural course), and taking positive action (assisted suicide) to end a life.  Nor did he address the injustice of treatment denials leading to a terminal diagnosis.
  • Mr. New confirmed that the Oregon Health Authority does not verify whether the person seeking assisted suicide meets the eligibility requirements. Instead, it relies on the two physicians who make the determination to ensure each other’s honesty.
  • The impact of a psychiatric condition, like depression, on an assisted suicide request, is disputed. Mr. New said some professionals “have argued that the low percentage of patients referred for psychiatric evaluation (5%, and falling) suggests that some number of depressed patients are not being properly evaluated. Others argue that some depression is expected with a terminal illness, and that judgement is not necessarily impaired by this.”
  • Mr. New wrote that “If a physician believes that a patient meets the criteria (and a second physician agrees), then (technically) that patient does meet the criteria … This is not to say physicians are always 100% correct … but as long as the physician makes a good faith determination of the patient’s eligibility, the law is satisfied.”
  • Regarding the possibility that “a physician knows a patient does not meet the criteria, and falsifies documentation and reporting and proceeds with the [assisted suicide] process anyway,” Mr. New believes existing safeguards would prevent that outcome.  “Several professionals would have to be willing to risk their medical licenses to pull off something like that,” he said.