Introduction

Webcast archive: New U.N. report restates the Special Rapporteur’s position

This week, we look at a new report from the UN, and a brief update on Bill C-7.

Webcast archive: New U.N. report restates the Special Rapporteur’s position

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

  • A new U.N. report restates the Special Rapporteur’s position on AS & E
  • A four month extension is granted to pass new MAID law

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

A NEW U.N. REPORT RESTATES THE SPECIAL RAPPORTEUR’S POSITION ON AS & E

  • We learned on March 3 of a new report from the Special Rapporteur on the Rights of persons with Disabilities, Catalina Devandas-Aguilar.  It studies the impact of ableism in medical and scientific practice, including assisted suicide and euthanasia (AS & E).
  • The press release announcing the report, entitled “New eugenics: UN disability expert warns against ‘ableism’ in medical practice,” signaled the serious concerns expressed by Ms. Devandas over the bioethics issues covered in the 18-page report.  This is the first statement on bioethics by the Special Rapporteur on the Rights of Persons with Disabilities, and the first application of principles contained in the 2005 UNESCO Universal Declaration on Bioethics and Human Rights to people with disabilities.
  • Paragraph 35 of the report concerns withholding and withdrawing of life-sustaining treatment on the basis of disability.  The text says “it has been reported that physicians may exert pressure” on patients “based on the belief that further treatment would be futile, non-beneficial or potentially inappropriate, particularly for patients with severe impairments.” Ms. Devandas said a physician assessment may be “influenced by ableist views of living with a disability,” and she cautions that “cost-effectiveness considerations may also result in the denial of life-sustaining treatments to some persons with disabilities.”
  • The report focuses on AS & E in paragraphs 36-38.
    • Paragraph 36 states that AS & E are a contentious issue.  It describes the difference between assisted suicide and euthanasia, where they’re legal, and points out that places where access is limited to people with terminal illness have lower rates of assisted death than do places where there is no “end-of-life” eligibility criterion.
    • Paragraph 37 reads in part: “From a disability rights perspective, there is a grave concern that legalizing euthanasia and assisted suicide could put at risk the lives of persons with disabilities.”  The report predicts potential problems If AS & E is made available to people whether or not they’re at the end of life.
      • The assumption “that it is better to be dead than to live with a disability.” could cause “persons with a newly acquired impairment [to] opt for assisted dying based on prejudices, fears and low expectations of living with a disability, before even having the chance of coming to terms with and adapting to their new disability status.”
      • “Persons with disabilities may decide to end their lives because of social factors, including loneliness, social isolation and lack of access to quality support services.”
      • “Persons with disabilities, particularly older persons with disabilities, may be vulnerable to explicit or implicit pressures … including expectations from family members, financial pressures, cultural messages and even coercion.”
    • Paragraph 38 says: “Generally, when life-ending interventions are normalized outside the end stage of terminal illness, persons with disabilities and older people may increasingly feel the need to end their lives. … Nevertheless, many disability rights advocates also oppose assisted dying in terminally ill contexts, as they fear it will put at risk persons with new or progressive disabilities or diseases, who may be mistakenly diagnosed as terminally ill but who have many years of life ahead of them.”
      • Is the first sentence intended as the default position, while the second sentence (the Not Dead Yet position) is meant as an “alternative” opinion?
      • The NDY position isn’t described as thoroughly as the other; does that mean that the special rapporteur doesn’t favour it?
  • In paragraph 73, Ms. Devandas uses the “E” word. “… [E]ugenic aspirations persist in current debates related to medical and scientific practice concerning disability, such as … assisted dying.” The disability rights-based opposition to AS & E has always been aware of this link, but we’ve been called “paranoid” by AS & E proponents whenever we raise the subject.  Will the U.N. report transform playing the eugenics card from “instant death” to a useful strategy? It’s hard to know. It may be that disability activists will have to let our allies (or what Heidi Janz calls our “backup singers”) croon that chorus.
  • Finally, Paragraph 70 sets out the safeguards Ms. Devandas believes are necessary “If assisted dying is to be permitted,”
    • “First, access to assisted dying should be restricted to those who are at the end of life; having an impairment should never be a reason for assisted dying to be permitted.”
    • “Second, the free and informed consent of persons with disabilities must be secured on all matters relating to assisted dying and all forms of pressure and undue influence prevented.”
    • “Third, access to appropriate palliative care, rights-based support, … home care and other social measures must be guaranteed; decisions about assisted death should not be made because life has been made unbearable through lack of choices and control.”
    • “Fourth, accurate information about the prognosis and availability of peer-support counselling must be provided.
    • “Fifth, accountability regulations must be established requiring collection and reporting of detailed information about each request and intervention for assistance in dying.”
  • So our (oversimplified) reading of the Special Rapporteur’s opinion can be summed up as follows: “AS & E for people with terminal illness?  OK, if you must, but only with safeguards. AS & E for disabled people? No way!”

COURT GRANTS EXTENSION TO PASS NEW MAID LAW

  • The four-month extension for Parliament to refine and pass Bill C-7 in response to the Truchon decision has been granted. Justice Minister David Lametti filed a motion requesting the extension on February 17. Judge Christine Baudoin approved Lametti’s motion on March 2, saying that the federal government’s new legislation and recent public consultation show the government’s “diligence” in the matter.
  • The new deadline is July 11. In her ruling, Judge Baudoin allows those whose deaths are not “reasonably foreseeable” to apply for an exemption through the courts. She notes that for some people, this extension prolongs both their suffering and “the violation of their rights to life, liberty and security and equality of the person.”