Bioethics (and) MAID in Canada

Bioethicists in Canada (and elsewhere) have played a significant role in the formulation and implementation of legislation that has steadily expanded the scope of what counts as acceptable with respect to medically-assisted death, that is, which medically-assisted deaths should be regarded as acceptable to the Canadian public, whose deaths, and why. Some of these (and other) bioethicists have claimed that the criticisms which disabled activists and scholars make of the practice of medically-assisted suicide rely upon fallacious reasoning, especially slippery-slope fallacies and, thus, ought not to be taken seriously.

In a number of contexts, I have argued that bioethicists err when they discount and dismiss the criticisms and fears that disabled people articulate about the expanding legislative definitions of acceptable deaths and the practices and policies that these legislative decisions entail. In a number of places (e.g., here), I argue, for instance, that bioethicists (and others) who, in the aforementioned way, discount and dismiss the criticisms that disabled people make about “medical assistance in dying” (MAID) have misunderstood the productive character of modern forms of power; that is, they fail to recognize that, as I recently pointed out, modern power is most effectively exercised through coercion and incremental normalization, accomplished by the production of subjects who understand themselves as autonomous and free.

During the past few years, various philosophers have written or spoken publicly about issues that concern free speech on Canadian university and college campuses. Yet none of the accounts that I have read or heard has addressed the fact that the dearth of disabled philosophers (and disabled philosophers of disability especially) in Canadian philosophy departments very likely limits the ways in which and the extent to which disabled people’s perspectives, experiences, and arguments with respect to MAID (and other practices that directly affect them) are taught and reckoned with in bioethics and other courses of these departments, thus effectively stifling counter-hegemonic views on these interventions and rendering them indiscernible.

For a couple of weeks last month, the Government of Canada invited submissions from the Canadian public as part of a consultation process as it considers legislation that would widen the scope of what counts as an acceptable medically-assisted death, that is, whose death and which deaths medical practitioners can hasten. Some of the events that comprise the lead-up to this consultation process are summarized in the Government of Canada News Release and other information at the bottom of this post.

In recent months, a few posts that commend a wider definition of both what philosophers should deem an acceptable death and when “medical assistance in dying” is acceptable have appeared on prominent philosophy blogs. It must be said that these posts devoted little or no space to counter-arguments to the positions that they advanced. As a way to push back against these blog-posts, therefore, I have inserted directly below an eloquent (captioned) speech by Catherine Frazee that was part of a symposium last week organized by The Council of Canadians with Disabilities and the Canadian Association for Community Living. Frazee is a past Chief Commissioner of the Ontario Human Rights Commission and is Professor Emerita of the School of Disability Studies at Ryerson University.

Here is a relevant article by Frazee: https://www.cbc.ca/news/opinion/catherine-frazee-1.5330647

News release

January 13, 2020 – Ottawa, Ontario – Department of Justice Canada

The Government of Canada recognizes that medical assistance in dying (MAID) is a complex and deeply personal issue.

On September 11, 2019, the Superior Court of Québec found (Truchon v. Attorney General of Canada) that it was unconstitutional to limit access to MAID to people nearing the end of life. The Court’s ruling will come into effect on March 11, 2020, unless an extension is granted by the Court.

While this ruling only applies in the province of Quebec, the Government of Canada has accepted the ruling and has committed to leading an immediate and inclusive process to work with provinces and territories to respond to the recent court ruling regarding the medical assistance in dying framework.

To that end, the Honourable David Lametti, Minister of Justice and Attorney General of Canada, the Honourable Patty Hajdu, Minister of Health, and the Honourable Carla Qualtrough, Minister of Employment, Workforce Development and Disability Inclusion, today announced the launch of public online consultations to give Canadians the opportunity to provide their views on this very important issue directly to the Government of Canada.

These consultations are an important step in responding to the Superior Court of Québec’s ruling, and are part of the Government’s progressive approach to ensuring that the federal framework reflects the evolving views and needs of the Canadian public.

Canadians and interested stakeholders are invited to share their views through an online public consultation, which will be open until January 27, 2020, on key issues such as eligibility, safeguards and advanced requests.

Also:

  • Medical assistance in dying (MAID) became legal in Canada in June 2016.
  • The legislation currently sets out eligibility criteria for those who wish to apply for MAID, as well as safeguards physicians and nurse practitioners must follow.
  • The province of Quebec has its own medical assistance in dying legislation. On September 11, 2019, the Superior Court of Québec issued a decision in Truchon v. Attorney General of Canada in which it declared the “reasonable foreseeability of natural death” criterion in the federal Criminal Code, as well as the “end-of-life” criterion in Quebec’s provincial law on medical assistance in dying, to be unconstitutional.
    • The criterion continues to be valid in Quebec until the judge’s decision comes into effect on March 11, 2020, unless the court provides an extension.
    • This ruling only applies in the province of Quebec, which means that the “reasonable foreseeability of natural death” criterion will remain in effect in all other provinces and territories unless the federal law is changed.
  • In 2018, the Council of Canadian Academies completed three independent reviews in areas where MAID is not currently allowed: requests by mature minors, advance requests, and requests by individuals suffering exclusively from mental illness. These reports will further inform dialogue on this issue.
  • Canada’s current medical assistance in dying legislation requires a Parliamentary review of the law’s provisions, as well as the state of the palliative care in Canada, by one or more committees, starting at the beginning of the fifth year after becoming law. This would be in the summer of 2020. This review would allow for further public and parliamentary debate on all aspects of medical assistance in dying in Canada.

For more information about disabled people and MAID in Canada, follow BIOPOLITICAL PHILOSOPHY on Twitter at @biopoliticalph

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