Webcast archive: Vulnerability and the Carter case

This week, we discuss the connection between vulnerability and disability.

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

  • Vulnerability and the Carter case
  • UK elections
  • South African assisted suicide
  • Scottish parliament report

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


  • In our online discussions, we’ve talked about who would receive assisted suicide according to the Supreme Court following their decision in the Carter case.
  • Physician assisted death will be available for competent adults who have “serious and irremediable medical conditions (illness and disability)” which “cause enduring and intolerable suffering.”
  • We can think of this provision as an opening that allows entry to certain people. Thus far, in the online discussions, we’ve discussed strategies to restrict this opening.
  • But in a presentation last week, Catherine Frazee explained another way to approach the problem. She pointed out that, in the Carter decision, the Supreme Court supported the goal of protecting “vulnerable” persons.
  • “…the objective of the prohibition [of assisted suicide] — the protection of vulnerable persons from being induced to commit suicide at a time of weakness — is pressing and substantial”
  • The court did not define who is “vulnerable” nor under what circumstances. Nor did it define the terms “weakness” “suffering” nor “enduring.”
  • It’s up to Parliament to explain these terms within the meaning of the law. And it’s up to us to provide our expertise as disabled people to educate Parliament.
  • Frazee offered a few ideas. She said that vulnerability is a universal trait. We all need farmers, producers, truckers, and groceries to provide our food, infrastructure and utilities for our everyday lives.  We only have to watch what happens to victims of natural disasters to see how we are all vulnerable to the collapse of these systems we all depend on.
  • Frazee suggested that there are elements that enable people with disabilities to be resilient in the face of the problems that accompany our limitations.
    • Positive family relations and friendships, (especially with our disabled peers);
    • Respect and honest recognition;
    • Material security (adequate housing and income, healthy food and environment);
    • Necessary equipment and support services.
  • When these elements are absent or threatened, we face physical and psychological danger, and we’re more susceptible to suicidal feelings.
    • Isolation and abuse make people docile and easy to control.
    • Insults and low expectations damage self-esteem and self-confidence.
    • The lack of material security endangers health and causes stress.
    • A lack of equipment and support services is the difference between having a disability and being disabled.
  • Vulnerability flows from discrimination, exclusion and disenfranchisement.
  • Vulnerability causes a weakened response to traumatic events and shocks, such as the offer of a hastened death.

Who is vulnerable?

  • One possible definition of “vulnerability” might be: a person whose individual characteristics, in combination with social prejudice and environmental conditions, place her at a physical, social, economic, and/or political disadvantage, especially where such disadvantage is likely to lead to victimization or exploitation.”
  • People facing catastrophic changes in circumstances, and who don’t have control in their lives, or the resources to build their resilience.
  • People who have a hard time asserting their autonomy.
  • People who’s pain is acute, not well managed, or will take time to decrease.
  • Those whose self esteem is weakened by social exclusion, discrimination and disadvantaged status.
  • How can we incorporate these ideas into a “complex regulatory response?”
    • Requires an individual consideration of each person who asks for euthanasia or assisted suicide
      • Does the person have the elements of resilience – good family relationships and friendships, respect, material security and support services?
      • Is the person susceptible to the elements of vulnerability – Isolation, abuse, poor self-esteem and assertiveness skills, lack of material security and support services?
      • Is the person dealing with other causes of vulnerability – Catastrophic changes, abuse, problems in asserting autonomy, poorly-managed pain or emotional suffering?
    • These are not exactly things that can be determined following a half-hour doctor visit.
    • We can add these ideas to others we’ve already considered:
      • Remove the causes of requests for assisted suicide:
        • Loss of autonomy and control;
        • Loss of ability to do things one enjoys;
        • Feelings of loss of dignity;
        • Feelings of being a burden.
      • Limit eligibility criteria
      • Create formal and detailed procedure
        • Mandatory and detailed psychological evaluation.
        • Change the “competency” determination to beter reflect the gravity of the decision
        • The demand must be approved by a court.
      • Remove doctors and interested parties from the process.
    • If you want to share your opinion with your MP, don’t hesitate. Go to parliament’s website at parl.gc.ca and choose the “senators and Members” tab to find contact details for your MP.
    • You can also make a short video expressing your opinions on assisted suicide and euthanasia. Send it to info@tv-ndy.ca


  • Elections in the UK – The conservative party won a majority of 330 seats (of 650) in the British parliament yesterday. That means the Cameron Government’s cuts – the independent living fund, health services and draconian work capacity assessments will continue.  Obviously this is a devastating outcome for Britons with disabilities.
  • Scottish parliament report – The Health and Sport Committee of the Scottish parliament published its report on the assisted suicide bill last week. The report stated:  “The Committee believes the Bill contains significant flaws. These present major challenges as to whether the Bill can be progressed. Whilst the majority of the Committee does not support the general principles of the Bill, given that the issue of assisted suicide is a matter of conscience, the Committee has chosen to make no formal recommendation to the Parliament on the Bill.”
  • A 65-year-old South African man wins right to assisted death –  Robin Stransham-Ford said that he’d been in constant and extreme pain since January, and that he could no longer get out of bed. He said it would be “a gross violation of [my] basic human right to dignity” to deny him to end his life by euthanasia or assisted suicide by a doctor. Judge Hans Fabricius ruled in his favour, but the ruling was handed down one hour after Mr. Stransham-Ford had died.