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The Council for Canadians with Disabilities (CCD) and the Canadian Association for Community Living (CACL) are extremely dismayed that the recommendations contained in the report released today by Parliament’s Special Joint Committee on Physician-Assisted Dying will jeopardize the lives of vulnerable Canadians. They do not follow the Supreme Court’s call for “stringent limits that are scrupulously monitored and enforced.”
“We are concerned that the Committee’s permissive approach would put vulnerable people at risk. Their recommendations exceed guidance from the Supreme Court, as well as UN Conventions to which Canada is a signatory” states Tony Dolan, CCD Chair.
“We appreciate that members of the Joint Committee were alert to concerns about vulnerable persons,” says Michael Bach, Executive Vice-President of the Canadian Association of Community Living. “Nevertheless, we are alarmed by the committee’s conclusions. We believe the recommendations contained in the Committee Report fall well short of the minimum safeguards we believe are essential to protecting vulnerable Canadians. Clearly there is a lot of work still to be done.”
Together CACL and CCD represent the concerns of Canadians with disabilities. Both organizations believe that their members will be harmed if the government adopts the committee’s recommendations. They have four principle concerns.
First, both organizations believe the committee has erred by not accepting the trial judge’s definition of “grievous and irremediable medical conditions” to exclude psychosocial suffering as an eligible condition, and meaning an advanced state of weakening capacities with no chance of improvement.
Second, the Committee suggests that concerns about vulnerability can be addressed within the context of physician assessments of decision making capacity. The evidence does not support this claim. Physicians are not generally trained or have expertise in the kinds of vulnerabilities that are known to motivate requests for assisted death. For example, a survey of U.S. physicians found that only 2% had training, experience or expertise in identifying signs of elder abuse in their patients, despite this growing demographic. “The Committee’s recommendation, which instructs decision makers to pay attention to vulnerability does nothing to assuage our concerns,” states Rhonda Wiebe, Co-Chairperson of CCD’s Ending of Life Ethics Committee.
Third, the Committee recommends allowing for advance directives. This is not consistent with the Supreme Court decision which clearly stated that a person has to be capable in the actual circumstances of taking the intervention intended to cause death. Advance directives would empower substitute decision makers to determine when someone should die. This should be explicitly prohibited in federal legislation. The risks to the most vulnerable in society are obvious.
Fourth, the Committee rejected proposals that requests be authorized through an independent prior review, instead relying on two physicians to make the assessment and authorize the intervention to terminate a person’s life. These are fundamentally irreconcilable roles, and combining them exposes physicians and patients to conflicts of interest and increases risk of abuse. A check and balance of prior review is essential.
CCD and CACL will be urging the government to adopt a stronger system of safeguards, and to adopt a clear standard for protecting vulnerable persons. Canadians requesting assistance from physicians to end their life should be able to do so without jeopardizing the lives of vulnerable persons who may be subject to coercion, inducement and abuse.
Michael Bach, CACL Executive Vice President, Tel: 416-209-7942
Tony Dolan, CCD Chairperson, Tel: 902-569-2817
Dean Richert, Co-chair CCD Ending of Life Ethics Committee, Tel: 204-951-6273.
Rhonda Wiebe, Co-chair CCD Ending of Life Ethics Committee, Tel: 204-779-4493
GAATES (Global Alliance on Accessible Technologies and Environments) has developed a handbook for emergency planning for persons with disabilities.
Access 2 Entertainment is a personalized card for people with permanent disabilities who require the support of an attendant while going to the movies or visiting other participating attractions. The card grants 1 free entry to the cardholders attendant while the person with the disability pays the regular admission price.
List of locations where the cards are accepted.
Application Form and Guidelines