This week brought an impassioned argument against expanding access to MAiD, and a dispassionate analysis of where we’re at and how we got here.
I find that I learn something from every commentator, but am reinforced in my belief that individual op-eds are only one component of public-policy debates. Each writer expounds their own opinion with a view to convincing the reader, but there is no conversation: no actual debate. We would benefit from having more venues where people who hold strong viewpoints can both express their views and respond to challenges to them.
This is a complex issue and positions tend to be a muddle of many components:
- Strongly held beliefs (some religiously based but not all) on the value of life and the right to personal autonomy
- Political beliefs on the role of the state (at all and specifically in medical decisions) and the courts
- Legal views on the appropriate scope of criminal law
- Opinions about the medical possibility and what we might call the “cost practicality” of managing pain, both physical and mental
- The trade-offs involved in spending money in one healthcare area versus another
- Emotional reactions to experiences of intolerable pain, whether one’s own or that of a loved one
Mix in the different angles of how MAiD provisions can/might affect the elderly (with varying degrees of mental competence), the mentally ill, the disabled, those with terminal illness or incurable degenerative conditions, minors, and people who live in small or remote communities, and it’s amazing we can talk about it at all without coming to blows.
Anyway, first the analysis, then the passion. Both articles are worth reading in full if you have access to the National Post site. If not, the excerpts below will give you an idea of the range of commentary and approaches.
The amendment to Bill C-7 still needs to pass a final vote to become law, but the Liberals only need one party to support it, and it appears likely they’ll get it from the Bloc Québécois.
The federal government’s reform of its medical assistance in dying (MAID) legislation, Bill C-7, will permit Canadians to request a lethal injection, even if death is not proximate or reasonably foreseeable. It’s not exactly death-on-demand for anyone who asks, but that’s what it is for anyone who has a serious medical problem, even one that can be readily treated.
The Senate amendments to the government’s bill will permit MAID to be administered in response to a request made years in the past, such as in the case of geriatric dementia. The Senate amendments also pave the way for an expansion of MAID for mentally ill people who are neither elderly nor dying.
. . .
This will lead to more pressure put on the ill and disabled, especially in light of the rising cost of treatment. Why take up a bed for weeks, when you can be in the morgue by sunset? Why provide years of daily home care supports for the disabled when a lethal injection is available right now?
That would never happen in Canada, you say? But we were told just six years ago, by no less than the Supreme Court, that exactly what we are doing now would never happen in Canada. In 2015, it was about extreme cases. In 2021, it’s about making suicide mainstream health care.
And when that kindly ICU doctor asks whether or not grandma wouldn’t want to do her bit to protect the health-care system, to free up capacity for others, what will her family say? And when an accident victim arrives, facing a lifetime of disability and diminishment, won’t hospital administrators, influenced by their triage protocols, see an opportunity to save resources for cases with better prospects?
It won’t happen tomorrow. But it will happen — sooner rather than later.