Why disability advocates are worried about changes to Canada's medical assistance in dying bill

If Bill C-7 passes, the federal government will give many more Canadians access to medical assisted dying (MAID), particularly those in the disability community.

The legislation removes a requirement that a patient's natural death be "reasonably foreseeable," a change that would satisfy a September 2019 Quebec Superior Court ruling that deemed parts of the federal and provincial laws on assisted dying unconstitutional.

"Our government's efforts, particularly over the last few years, have been largely pushing forward on providing options to die as opposed to actually working to make things better and easier and more functional for disabled people," said Jeff Preston from his home in London, Ont., where he relies on the daily help of a personal support worker.

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Bill C-7 is headed for a third reading in the House of Commons and the government hopes to pass the legislation before the court's deadline of Dec. 18. The house rises on Dec. 11.

Preston, who has muscular dystrophy and requires a wheelchair to get around, is also a disability studies professor at King's University College and a strong vocal advocate in the community. He's worried the changes to the MAID legislation specifically target those living with disabilities. 

"We suffer because we are isolated in our homes, not because we're disabled, but because we don't actually move forward on accessibility," said Preston. 

"There is a ton of suffering experienced by disabled people that is actually not within the body, not within the person, but rather is caused by the systems of inaccessibility and ableism," he said.

90-day safeguard

Liberal London North Centre MP Peter Fragiskatos is confident there are enough safeguards in place to protect people living with disabilities. Plus, after a lengthy period of holding public consultations and speaking with 300,000 Canadians, he said most Canadians are comfortable with the change.

"The government's perspective and approach makes medical assistance in dying, not the first resort, but has the effect of it being the last resort," he said pointing to a 90-day assessment period for those seeking MAID whose death is not imminent.

"[It] allows practitioners enough time to carry out assessments to make sure that safeguards are met ... Bill C-7 has a number of protections in place to ensure that personal autonomy is respected and that coercion and other things that could stand in the way of personal choice and lead to an abuse of the legislation do not happen," said Fragiskatos.

He said the Liberal government is also committed to improving the lives of people with disabilities, by offering better mental health and palliative care services and investing more in home care.

But London, Ont. doctor, Ramona Coelho, who works with many patients with disabilities, said the 90-day safeguard is not nearly adequate and calls the bill very dangerous, especially when the research shows people with disabilities battle suicidal thoughts at a much higher rate than the general population.

"These people are asking for disability supports that are being declined. During COVID, the disparity with this community has become worse. Many of them are denied home care services, and yet they can die within 90 days if they become suicidal," she said.

"That is an extremely weak safeguard."

Add to that, if someone has a new disability, Coelho said it takes time to properly assess and manage that disability. "It take more than 90 days to see a rheumatologist, neurologist, or a psychologist to be able to meet and find out a treatment plan."

"90 more days is not going to make this world more accessible," said Preston. "90 more days is not going to provide the attendant care services, the equipment access, the therapeutic access. This is more than a time problem. Fundamentally, this is a systems problem and a money problem."

"It's okay for us to offer death, but we have to first be offering opportunities for life."