The Committee is extremely concerned about the 2021 amendments to the State
Party’s Criminal Code made through Bill C-7, which expanded the eligibility criteria for obtaining medical assistance in dying, by removing the “reasonably foreseeable death”
criterion and thus creating what is referred to as “Track 2” for requests for medical assistance in dying. The Committee notes that similar concerns about Track 2 have been addressed directly to the State Party by the Committee on the Elimination of Discrimination against Women, the Special Rapporteur on the Rights of Persons with Disabilities and during the universal periodic review. The Committee further notes that the Special Rapporteur on the rights of persons with disabilities, the Special Rapporteur on extreme poverty and human rights and the Independent Expert on the enjoyment of all human rights by older persons have stated that disability is not a reason to endorse medical assistance in dying. The Committee
also notes with concern:
(a) That the federal Government did not challenge the decision by the Supreme Court of Québec in the Truchon and Gladu v. Canada case, which fundamentally changed the whole premise of medical assistance in dying – from one restricted to cases in which natural death is reasonably foreseeable to one that establishes the possibility of medically assisted dying for persons with disabilities – on the basis of negative, ableist perceptions of the quality and value of the life of persons with disabilities, including the view that “suffering” is intrinsic to disability, without recognition that inequality and discrimination cause and compound “suffering” for persons with disabilities;
(b) That the concept of “choice” creates a false dichotomy, setting up the premise that if persons with disabilities are suffering, it is valid for the State Party to enable their death without providing safeguards that guarantee the provision of support, and on the basis of ableist assumptions that de-emphasize the myriad of support options that could allow persons with disabilities to live dignified lives, and about the systemic failure of the State Party to address the social determinants of health and well-being with regard to poverty alleviation, access to healthcare, accessible housing, prevention of homelessness, prevention of gender-based violence, and the provision of community-based mental health support and employment support;
(c) That evidence from the Office of the Chief Coroner for Ontario and data compiled by the federal Government indicate that Track 2 medical assistance in dying is disproportionately accessed by women with disabilities and persons with disabilities in marginalized situations, and that there is an upward trajectory in the number of persons with disabilities killed through Track 2;
(d) About the expansion of Track 2 in 2027 to persons whose “sole underlying medical condition is a mental illness” (through Bill C-62) and the proposed expansion of medical assistance in dying to include mature minors and advance requests for such assistance;
(e) About the inadequacy of the process of consultation with Indigenous Peoples, including non-status and off-reserve Indigenous persons with disabilities, in relation to medical assistance in dying;
(f) About the absence of a federal independent oversight mechanism to monitor, regulate and handle complaints in relation to medical assistance in dying.
20. To ensure the right to life for persons with disabilities, the Committee recommends that the State Party, in close consultation with and with the active involvement of persons with disabilities, through their representative organizations:
(a) Repeal the Track 2 medical assistance in dying provision, including the provision to, in 2027, Track 2 for persons whose “sole underlying medical condition is a mental illness”;
(b) Not support proposals for the expansion of medical assistance in dying to include mature minors and advance requests;
(c) Significantly invest in and implement, at the federal, provincial and territorial levels, comprehensive measures to ensure that the systemic failures in relation to the social determinants of health and well-being are addressed, with regard to poverty alleviation, access to healthcare, accessible housing, prevention of homelessness, prevention of gender-based violence, and the provision of community-based mental health support, care services at home and personal assistance, and employment support;
(d) Strengthen distinctions-based, community-led consultation processes with Indigenous Peoples, including non-status and off-reserve Indigenous persons with disabilities, respecting the principle of self-determination;
(e) Establish and provide resources for a federal independent oversight mechanism to monitor, regulate and handle complaints in relation to medical assistance in dying.