A recent report from the Ontario Coroner’s Medical Assistance in Dying (MAID) Death Review Committee has made a few ripples; it properly should have made waves. It found significant socioeconomic differences between those receiving euthanasia under “Track 1” (for those whose death is reasonably foreseeable) and “Track 2” (for those whose death is not reasonably foreseeable.) It suggests that yet again, what the government was warned would happen is happening.
The committee found that 48.6 per cent of euthanasia recipients under Track 2 — people not already dying — lived in the most marginalized areas of the province, as opposed to 41.8 per cent of Track 1 recipients, which itself may be a troubling figure. A Western University study looked at all euthanasia requests in London, Ont. between June 2016 and December 2019 and found the rate of requests among those living in the poorest areas of the city was nearly three times higher than in the wealthiest areas.
When age and labour-force participation were factored in as measures of disadvantage, the review committee’s numbers are even starker: Fifty-seven per cent of Track 2 requests were made by those in the lowest, most disadvantaged quintile — as opposed to 42 per cent of Track 1 requests.
That’s not necessarily shocking: Poorer Canadians have higher rates of chronic and terminal illness. But crucially, this is not what researchers have found in other jurisdictions. A meta-analysis of studies from the Netherlands and Oregon found “death under the (Oregon Death with Dignity Act) was associated with having health insurance and with high educational status, both indirect indicators of affluence,.”
In the Netherlands, using postal-code data — as Ontario’s death review committee did — the study noted “the overall rates of assisted dying were somewhat higher for people (living in areas) of higher socioeconomic status.”
At the very least, this seems worth urgent further inquiry. Outside of Quebec, this debate has centred almost entirely around the federal government. But as ever, it’s the provinces who deliver health care, and in every respect your experience may vary.
It’s not like we don’t have horror stories to illustrate these statistics. We know what’s happening, we just don’t know how often. Readers will likely have heard of Sophia, (not her real name), a 51-year-old woman who received MAID for multiple chemical sensitivities — a perceived extreme intolerance to atmospheric contaminants (in Sophia’s case cigarette smoke and chemical cleaners) that clearly causes great mental suffering, but which doesn’t seem to be an actual disease.
What Sophia received wasn’t medical assistance in dying at all. What she received, at best, was social assistance in dying
For want of a suitable apartment — something many perfectly healthy and reasonably well-off Ontarians struggle with nowadays — Sophia chose death in 2022. “The government sees me as expendable trash, a complainer, useless and a pain in the ass,” Sophia said in a video.
Then there’s Mr. A (as the review committee report calls him). who had a psychiatrist pro-actively suggest euthanasia for his diagnosis of inflammatory bowel disease, with aggravating factors including “a history of mental illness, previous episodes of suicidality, and ongoing alcohol and opioid misuse.”
“No harm, no foul, was the coroner’s verdict in both cases.” But “multiple (review committee) members expressed concerns,” the report notes. That’s a relief, at least. Expanding MAID to cover mental illnesses alone has been pushed back; Conservative Leader Pierre Poilievre has vowed to cancel it if he’s elected. But “Track 2” is where the real horror stories are coming from. What is the Ontario government going to do about it?
As ever, this requires hauling oneself out of this unholy mess of a debate and looking at it clearly. What Sophia received wasn’t medical assistance in dying at all. Death is no more appropriate a prescription for multiple chemical sensitivities — or for the mental conditions that likely explain it — than chemotherapy or a hip replacement.
What Sophia received, at best, was social assistance in dying. For want of useful social assistance like an apartment she considered livable, or appropriate psychiatric care, we offered to put her cleanly out of her misery. Our serial failures on housing and health care make such horrible situations sadly inevitable, they do not confer on society any obligation to help someone like Sophia die.
An incredible number of Canadians disagree, citing concerns about “discrimination” and “fairness” — even as disability advocates wave their arms in panic, each of their predictions now coming rapidly true in sequence. But at the very least they could stop calling it “MAID.” Sophia got AID, and that’s not what Canadians signed up for.
Mr. A, on the other hand, was introduced to MAID in much the same way they sell Ozempic and Cialis on American television: “Why aren’t you taking these drugs?” If we can’t trust the system to establish and adhere to a rule as basic as “don’t bring up euthanasia proactively,” then we can’t trust the system, period.
National Post
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