Introduction

21,994 Casualties

To say that people at risk for euthanasia have a choice to die, while those at risk for COVID do not, may be an example of a distinction without a difference.

21,994 Casualties

By Heidi Janz, Ph.D. and Amy Hasbrouck

21,994.

That’s the number of Canadians who have died from COVID-19 as of March 1, 2021

That’s also the approximate number of people who’ve died by euthanasia since the practice was legalized in June of 2016.

Canada has vastly different public policies toward these two groups of people.  For people at risk from COVID-19 (which is everyone, but especially older adults), the government has imposed public health measures such as lockdowns and mask-wearing, has provided financial support to ease the economic burden of isolation, and has mobilized financial, human and logistical resources to vaccinate the populace. For people at risk from euthanasia (which is everyone with a disability – whether or not they also have a terminal illness – and especially older adults), the government has made euthanasia easier to get than palliative or mental health care, with no mandated capacity tests or suicide prevention intervention.  The medical assistance in dying (MAiD) monitoring system obscures data on the impact of euthanasia on vulnerable populations, and doesn’t verify that all euthanasia deaths are, in fact, reported. What’s more, the Liberal government is pushing to eliminate four safeguards and expand access to the program before it’s undergone a mandatory evaluation … in the midst of the global pandemic.

The Liberal government, and promoters of assisted suicide and euthanasia, (who are often one and the same) would say the difference between people at risk for euthanasia and those at risk for COVID is that one group has a choice in the matter, and the other does not.  This may be an example of a distinction without a difference in that it ignores the reality and impact of systemic ableism. Take the cases of Sean Tagert, Archie Rolland, Raymond Bourbonnais, Jean Truchon, Yvan Tremblay, Pierre Mayence, and Gabriel Bouchard. All of these people were living in long-term care or were at risk of institutionalization. All of them chose suicide or euthanasia rather than continue in what they considered intolerable circumstances. As far as we know, none of them received any suicide prevention intervention, or support to live independently in the community. Where is the choice in that?

The government has a choice; to warehouse people in institutions, or to use the same funds to enable elders and people with disabilities to live in their own homes with the help of attendants they hire, train, supervise and (when necessary) fire. The government also has a choice to provide suicide prevention interventions, palliative care and community supports before allowing euthanasia, thus putting the life-saving horse before the life-ending cart.

Disability rights advocates observe that medical ableism is common.  Medical professionals overlook ordinary problems (like job loss and relationship breakdowns), and blame stress linked to discrimination (like poverty, isolation, low self-esteem) to the person’s disability. Doctors routinely rate the quality of life of disabled people as lower than that of non-disabled people; which attitude influences how they treat their disabled patients. Such ableist conflations of disability with the structural oppression and social stigma which it engenders often results in people with disabilities being systematically nudged toward the “choice” to end their lives through MAiD.

The reality and effects of systemic ableism are likewise being ignored in government responses to the effects of COVID on ill, elderly and disabled Canadians.  Despite the initial media attention, public outcry, and governments calling in the military to help out in long-term care facilities last spring, public interest in the high death tolls and deplorable conditions in long-term care centres has evidently waned. So too, consequently, has the political will to begin to dismantle the dysfunctional and dehumanizing long-term care system. Witness the resistance faced by disability rights activist Jonathan Marchand of Co-op Assist in his efforts to shift financial and human resources toward a community-based, user-directed model of care in Québec. At the same time, triage protocols which list the pre-existence of a disability as an exclusion criterion for critical care, if rationing becomes necessary, have quietly been introduced in many provinces and territories.  Disabled, ill, and elderly Canadians thus continue to face multiple, lethal forms of systemic discrimination and social isolation, even in the midst of ubiquitous public health messaging touting the importance of “protecting our most vulnerable.”

Spurious governmental concern for “vulnerable” populations can also be seen in the lack of data tracking of race, indigenous and disability status, economic disadvantage and pre-existing conditions, both among those testing positive for COVID-19, and people who request and receive MAiD. This failure speaks to the way in which systemic ableism facilitates the erasure of people with disabilities, just as systemic racism erases indigenous and racialized people, and other disadvantaged populations are literally and figuratively wiped out. We aren’t counted because we don’t count, in the view of society.

The Liberal government seems unaware of the irony – the hypocrisy – of pushing to expand euthanasia through Bill C-7, while trying to decrease COVID deaths by protecting “the vulnerable.” What kind of intellectual and ethical contortions are needed to say that you’re trying to protect vulnerable citizens from COVID, while at the same time offering “autonomy” by making it easier for those same people to get help to die than it is for them to receive assistance to live? Oh wait! – Those must be the same intellectual and ethical contortions that allowed the Liberals to quote from the UN Convention on the Rights of Persons with Disabilities in the Preamble to Bill C-7, when three UN Human Rights experts have declared Canada’s MAiD regime to be in violation of that very Convention.

Can you say “hypocrisy,” Justin Trudeau, David Lemetti, Patti Hajdu, and Carla Qualtrough?

We can. (And one of us has a speech impairment.)