Just Because You Can…

It can be difficult reading articles that highlight shortcomings and failures within systems you, on the whole, endorse and support. This difficulty presented upon reading Harold Braswell’s editorial in The Washington Post commenting on alleged abuses suffered by disabled Canadian citizens. As someone with family connections to Canada and as a proponent of universal healthcare coverage, I regularly check on stories and opinions that focus upon controversies or changes in that country’s healthcare landscape.

In 2016, in response to a court ruling that preventing medical assistance in dying (MAiD) violated Canada’s Charter of Rights and Freedoms, the nation’s parliament enacted new legislation allowing certain terminally and irrevocably ill citizens access to MAiD. The piece in the Post attempts to draw (or at least suggest) a connection between that law and the abuses and mistreatment experienced by some disabled Canadians at the hands of their caregivers. The thesis, however, is not entirely clear as Braswell split his attention between two points:

1. The care of severely disabled Canadians should be more centralized (much like the nation’s mainstream healthcare system) and

2. That the current statutory language pertaining to MAiD creates an environment in which caregivers are (or can be) less inclined to provide even basic care for their disabled charges and that the law can (or could) lead hospitals and other organizations to coerce disabled people to pursue medical assistance in dying as a cost-effective and expeditious alternative to long term care.

The 2016 legislation allowed individuals suffering “grievous and irremediable” medical conditions to request medical assistance in ending their own lives. In principle, this particular policy does not seem to have been especially controversial, at least not within the context of the essay. The issue, in the writer’s mind, is that the law can and, perhaps, even has been used as a tool to pressure disabled but otherwise healthy and competent people to seek medical assistance in dying rather than face a future of institutionalization. The cases, cited in the essay, while compelling, are anecdotal at best and, if anything, better demonstrate the potential for abuse and neglect in any congregate living environment or under the care of others. It is hard to distinguish whether the abuses and neglect reported were directly or indirectly related to the victims’ disabled states or if the mistreatment was evidence of a more ‘garden variety’ that can be found in any healthcare setting. Whatever the source of the abuse and neglect, it cannot be tolerated and should not be allowed to fester among hospital and care home staff. However, I hesitate to embrace the implied thesis that expanding MAiD laws (something already being discussed in Parliament) will lead to some nationwide eugenics campaign against disabled Canadians under the guise of ‘right to die’.

Will there be an uptick in the number of disabled individuals choosing to end their lives rather than carry on with debilitating and, in many cases, progressively worsening conditions? Almost certainly, Those people should be assured safe and timely access to MAiD services. At the same time, individuals also must be protected from external coercion from family, caregivers or medical professionals. The writer, however, seems to be using this shaky premise as a basis to introduce what I feel is his real concern: that expanding MAiD access will someday lead to medical practitioners performing ‘on-demand’ suicide assistance to people for the slightest of reasons. This particular ‘slippery slope’ approach is not unknown as it is a favorite tactic among the so-called ‘pro-life’ agitators to sow fear that it is only a matter of time before radical leftists and feminists make abortion an accepted form of regular birth control. In a few places Braswell summons the specter of government sanctioned (and financed) suicide becoming a mainstream medical procedure, but nowhere is this more clear than in the essay’s closing lines where he embeds the image of what we might call ‘vanity suicide’:

…in the 18 years since Belgium permitted this sort of euthanasia, the laws and regulations meant to protect patients from abuse “often fail to operate as such.” Much like in the Netherlands, the eligibility criteria had steadily expanded to the point where more and more people pursued it not for medical reasons but simply for “tiredness of life.” [my emphasis]

Perhaps I could take this editorial more seriously if Braswell had included any kind of data to suggest widespread abuse and neglect as a result of more permissive medical assistance in dying laws, but there are none. The lack of concrete numbers (even speculative ones or educated guesses) greatly reduces the strength of the argument and, in many ways, makes what could be a very real and outrageous issue appear to be merely a problem of the writer’s own creation.

Reference:
Braswell, Harold. “Canada is plunging toward a human rights disaster for disabled people”. The Washington Post, 19 February 2021. Online.

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