Canada’s MAID program: How Living in Poverty is Preventing People from Dying with Dignity

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In 2021, the Canadian Supreme Court ruled that Canada’s Medical Assistance in Dying (MAID) law, which provides terminally ill individuals access to physician-assisted suicide, was unconstitutional because it excluded persons with disabilities. Recently, MAID was expanded to include all individuals who are suffering from “a serious, incurable illness, disease, or disability that is enduring and intolerable.” While Canadians with chronic disabilities should certainly have the right to access MAID after exhausting all other options, for some, MAID is not the “last resort” that the government presents it to be. Some individuals with disabilities are turning to MAID not because their disability has become unbearable, but because the government has failed to provide them with resources to live comfortably with their disabilities. Poverty, not disability, is driving these individuals to apply for MAID.

According to Tim Stainton, the director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, not a single province across Canada provides a disability benefit income which puts individuals above the poverty line. Given that only 31% of individuals with severe disabilities are employed, a vast majority of them rely on this benefit for housing, food, and other necessities. For Joannie Cowie, along with many other persons with disabilities, this simply isn’t enough. Cowie receives a mere $1,228 a month from Ontario’s disability program and barely scrapes by. She feels trapped in an excruciating cycle of poverty which makes a good quality of life with her disability unattainable, driving her to consider MAID. Cowie is not the only one. In February 2022, a woman ended her life through MAID because she was denied affordable housing that would have helped ease her condition. Her disability payments left her little to survive on, adding to the pain of not having appropriate housing and eventually resulting in her decision to end her life. Les Landry used to be a truck driver but was forced to stop working after a hernia surgery went wrong. He suffered three mini strokes during the surgery, leaving him in a wheelchair with severe chronic pain. According to Landry’s calculations, he wouldn’t be able to survive off of Canada’s benefits, so he decided to apply for MAID because he saw no way of surviving. These are just three stories out of a potential 1.5 million people; according to Stats Canada, almost a quarter of persons with disabilities live in poverty. 

Poverty, not disability, is driving these individuals to apply for MAID.

Some doctors and policy-makers have argued that Canada’s expansion of MAID includes extensive safeguards to protect Canadians. Two doctors must approve the case and the process takes 90 days. Both poverty and a lack of social support are not supposed to be approved as reasons for requesting MAID. However, it is evident from the three stories mentioned earlier that those guidelines are continuously breached. Canada also does not have a review process for difficult cases. Even legal scholars have argued that Canada’s MAID laws are more permissive than any other country in the world. Doctors in Canada are encouraged to inform patients if they’re eligible for MAID, while in other nations, including Belgium and the Netherlands, doctors cannot present MAID as an option before exploring all other possibilities first. In fact, doctors are advised to avoid mentioning it at all. 

If Canada was truly concerned about the wellbeing of citizens with disabilities, they would provide them a liveable wage…

Critics of Canada’s MAID law argue it is too often framed as a medical intervention rather than a last resort. One man who was hospitalized for a degenerative brain disorder was informed that remaining in the hospital would cause him upwards of 1500 dollars, and was then presented with the option of MAID. In 2019, the UN Special Rapporteur on the Rights of Persons with Disabilities visited Canada. She reported seniors telling her that they were offered the choice between a nursing home and MAID. After this visit, the Special Rapporteur wrote to the Canadian government expressing concerns that expanding MAID would violate the protection and respect of people with disabilities. Clearly, the government didn’t listen.

Persons with chronic disabilities should have a right, like all Canadians suffering from chronic illnesses, to die with dignity if they have truly exhausted all other options. However, the expansion of MAID is untimely based on the appalling state of disability benefits in Canada and the lack of safeguards within the law itself. The Federal Government is currently tabling Bill C-22, which will attempt to reduce poverty among persons with disabilities by providing a Federal disability benefit and income tax adjustment. If Canada was truly concerned about the wellbeing of citizens with disabilities, they would provide them a liveable wage and Bill C-22 would have been a precursor to the expansion of MAID. While persons with disabilities deserve the right to die with dignity, they more importantly deserve the right to live with dignity, which the government has failed to provide

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