Killing Canada’s Most Vulnerable: A Critical Examination on Canada’s Controversial Bill C-7 (MAID)
June 19, 2023
In February 2015, the Supreme Court of Canada made the controversial decision in Carter v. Canada to modify the Criminal Code satisfactory with the Canadian Charter of Rights and Freedoms. The following year, on June 6, 2016, the Parliament of Canada passed Bill C-14, legislation permitting medical assistance in dying (MAID) for terminally ill Canadian adults. The new law sparked dichotomous opinions on the ethics of euthanasia, though several years later, the debate would incite further conversations on MAID’s ethical limitations.
More recently, on October 5, 2020, Bill C-7: An Act to Amend the Criminal Code (medical assistance in dying) was introduced by the Minister of Justice and Attorney General of Canada in Parliament as a proposal to remove foreseeable death as a requirement for MAID eligibility, appearing subsequent to the 2019 Superior Court of Québec’s Truchon ruling. Less than a year later, on March 17, 2021, Bill C-7 was officially passed, removing reasonably foreseeable natural death as an eligibility requirement and temporarily including eligibility for individuals battling mental health conditions. The latter persuaded the Government to introduce Bill C-39 until March 17, 2024, an attempt to extend the decision to make mental illness an eligibility criterion for MAID.
Ethical Concerns
In its original effect, MAID sought to ease suffering and alleviate the dying process; however, removing the requirement of foreseeable death undermines the main principles and ethics of Bill C-14. The most evident flaw, in this case, is the overlooked principle of disavowing MAID’s initial objective to diminish the suffering of those facing intolerable and untreatable life-threatening conditions. Thus, these changes raise profound ethical concerns about our healthcare systems and the rights of vulnerable people. For some, Bill C-7 is a vicious attempt to prey on the weak and vulnerable in Canada. Arguably, it can also characterize a lack of effort in producing long-term solutions to suffering in the medical field.
Equally as important is to look at the arguments in favour of Bill C-7. Some advocates suggest that psychological ailments are as distressing as physical conditions, and denying the fact would perpetuate further suffering, mental health stigmatisation and deny healthcare rights; consequently arguing that MAID is a branch of healthcare. For many, MAID aligns with autonomy over individual health and values decision-making rights over our livelihoods and bodies. Recognizing self-determination can mean respecting that individuals can understand the conditions of their suffering and should be free to choose a dignified and medically-supervised death. Dying With Dignity Canada describes it as a milestone “of enormous change, driven by compassion, an end to suffering and discrimination, and a desire for personal autonomy.”
I argue that the primary focus of concern is the distinction between using assisted suicide to diminish suffering or as a convenient solution to treatable pain. MAID’s new eligibility criteria require careful examination of which mental illnesses qualify for the practice and how medical practitioners assess qualifying candidates. For instance, would conditions like depression and anxiety disorders qualify for assisted suicide though they can be treated with long-term social and medical funding and intervention? Though doctors are required to advise applicants of alternative options, patients do not have to partake in them before proceeding with MAID. If certain mental health conditions are manageable with proper care and funded healthcare systems, euthanasia becomes an increasingly questionable option. Mainly, it calls into question the effort in allocating medical and social resources and the long-term sustainability of producing care for people with mental health conditions.
Another concern is measuring the ability of individuals with mental illnesses to provide informed consent for MAID. In the medical field, informed consent is a fundamental principle in patient care and medical ethics. We rely on it for bodily autonomy and protection from medical malpractice. For MAID, patients are informed about the nature, benefits, risks, and alternatives; however, cognitive abilities and consent pose substantial challenges when intertwined with mental disorders. Mental illnesses profoundly impact decision-making and the ability to understand the ramifications of choice, thus doubting the confidence in receiving consent. In other words, emphasising the importance of creating an accurate assessment process of mental capacity.
The Future of Canada
Nevertheless, Bill C-7 has shaken traditional conversations on medicine and brought attention to the evolving landscape in healthcare. Alongside these discussions, there is a clear and urgent need for government intervention to provide mental health resources in Canada. An increase in funding and research can help fill the gaps in our medical field and focus on early intervention and preventive education. Ultimately, the prevalence of evidence-based research, screenings, and awareness campaigns would alleviate the stigma of mental illness and encourage individuals to seek help.
Relying on current information readily available to us, we can only make a few deductions of the future of Bill C-7 and its applications. There are arguments on both sides of the spectrum worthy of scrutiny; however, fair judgement cannot be ascertained until a determination of Bill C-39 by the House of Commons. In the interim, I propose approaching the topic with great consideration and care while remaining critical of how Canada attends to mental health. These recent events have instigated a conversation on mental health and opened the minds of Canadians on what it means to have governance over our lives. With that in mind, the direction of our legislation should always aim to benefit the overall livelihoods of Canadians and abide by ethical standards. In doing so, we can strive for a better healthcare system.