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MAiD in the COVID ShadeMAiD in the COVID Shade

MAiD in the COVID Shade

Peter Stockland reports on how the pandemic’s overshadowing of legislation radically expanding medical assistance in dying might reconfigure Canada’s future.

Peter Stockland
5 minute read

For two evenings this week, my Cardus colleagues and a panel of expert guests have engaged an in-depth discussion on YouTube on Canada’s post-COVID future.

They covered an impressive range of issues from education to the bifurcation of society as the pandemic exposed real, and really troubling, differences in how cohorts of Canadian society were affected (or afflicted) by COVID.

My own sense is that in addition to the Cardus COVID Exit topic list, an enduring legacy of the past 15 months might be a dawning awareness of the correlative radical expansion of Medical Assistance in Dying, a legal euphemism conflating two distinct acts previously criminalized as euthanasia and assisted suicide.

It’s an immense understatement to note that the MAiD-expanding legislation that passed through Parliament in parallel with the eruption and quelling of COVID was overshadowed by the entirely justifiable focus on the pandemic. But the shade on MAiD could conceivably lift when we enter another phase in March 2023 and federal law alters again to permit life-ending injections for mentally ill Canadians.

Just as the general population begins to finally forget what it felt like to wear face masks everywhere, constantly socially distance, and worry about “catching the COVID,” Canadians in the throes of depression, personality disorders and other psychiatric illnesses will be able to “choose” to die courtesy of public health care systems across the country.

We can agree or disagree about MAiD as a measure. We can approve or disapprove of it in principle and practice. But the legislative alterations that occurred within the pandemic penumbra – and those yet to come – represent a revolution in our understanding of what health care is and, more profoundly still, our shared conception of what human life is.

To get a sense of just how nation-redefining those shifts are, it’s helpful to plot them on a timeline.

On February 24th, 2020, I was in the theatre of the National Press Building as Justice Minister David Lametti and Health Minister Patti Hajdu introduced expanded MAiD legislation. At the press conference, I specifically asked Minister Hajdu whether the changes might put mentally ill Canadians at risk. She insisted the government had no intention of making MAiD an option for the mentally ill.

On March 17, 2021, a mushroomed version of the original expansion passed in both the Commons and Senate. In one year – a year of the worst pandemic to strike Canada in more than a century – Canada’s medically assisted dying law had transformed to the point where expert critics said it allowed for individuals – soon to include those with severe psychiatric conditions – to request MAiD in the morning and receive it by evening. 

The defining criterion for receiving MAiD will be “enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable….” (Emphasis added)

Again, whether we agree or disagree with MAiD, a single year to legalize such a wholesale change about the ending of human life signals a country moving away from its past at warp speed and toward…what? In fact, COVID disruptions of Parliament meant the bill died and had to be reintroduced in October. Full time focus on the legislation was little more than five months – months when the nation was riveted by pandemic lockdown.

And here is where the COVID overlay on the MAiD calendar becomes illustrative. The five-month expansion process came only five years after Canada’s historic legal change to allow medically assisted death. By contrast, the Supreme Court’s 1993 Rodriguez decision upholding prohibition of medically delivered death stood for 22 years before being successfully challenged. 

More, in Rodriguez, the majority made a point of noting that those prohibitions were part of Canada’s first Criminal Code in 1892 and formed “part of our fundamental conception of the sanctity of life.”

That fundamental conception endured for 133 years until the Supreme Court reversed itself in its 2015 Carter decision and threw out the concept of sanctity as a legal principle, paving the way for the 2016 legalization, which itself was amended five year later with two major overhauls during a single COVID pandemic year.

133 years. 22 years. 5 years. 1 year, which was really six months. And a deadline already set to further “inclusiveness” of administered death for the mentally ill. 

The pattern makes clear the Canada we knew did not survive the conflating of the otherwise distinct events of COVID and ever-expanding MAiD. A question for Canadians is: Could we, if we wished to, ever recover it? 

Raw numbers show us why the question matters and reveal a stunning irony of the correlation between the race to MAiD and COVID-19.

In 2020, there 7,595 MAiD deaths in Canada, an increase of 17 per cent over 2019, accounting for almost 1.5 per cent of all deaths in the country. 

By contrast, Statistics Canada reports 25,972 COVID-related deaths for 2020, but 11,007 of those involved co-morbidities, the most common by far being Alzheimer’s and dementia, which afflict more than half of seniors 80 or older who live in long term care homes. Indeed, in the first wave of the pandemic, 80 per cent of COVID deaths occurred in the 80 and above in care homes cohort. 

When comorbidities are stripped out, the 2020 death toll directly from COVID was 14, 965 according to Stats Canada, or only 7,370 more than died from MAiD in the same year. With and without comorbidities, deaths from the greatest health crisis in 100 years were only 2 to 3 times as numerous as deaths deliberately delivered by our medical system. 

Of course, with the advent of highly effective vaccines, public health stringencies, and other measures, pandemic deaths in Canada have dropped radically to the point where the COVID exit is in sight. MAiD, by contrast, will remain legislatively with us. Its death count will inevitably grow – perhaps not at 17 per cent a year but inexorably enough that the cumulative total must eventually outstrip pandemic deaths. And keep going.  

That might be a good thing. It might be a bad thing. But the thing is, in the pandemic year just past, with Parliament shut down, Canadians locked down, and our most vulnerable population ravaged by COVID in care homes, we rushed through legislation expanding MAiD availability. We affirmed rejection of the sanctity of life. We extended the 2016 legislation far beyond its original intentions. We ultimately set the stage for it to extend to the mentally ill. 

That conflation foreshadows the virtual impossibility of pivoting out of COVID and back to the Canada we once knew.

Photo by Mat Napo at Unsplash.com

Convivium publishes texts that do not necessarily reflect the views held by Cardus, the Convivium team, or its editors. In the spirit of discussion, dialogue, and debate, we ask readers to bear in mind that publication does not equal endorsement. Thanks for reading. Join the conversation!

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