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The Evolution of MAID - Could the New Revision for the Eligibility Criteria Leave Homeless Individuals at a Greater Risk?

Written by: Aansah Imran

Edited by: Thuwaraka Mohanakumar


Medical Assistance in Dying (MAiD) was first officially legalized as of June 2016 in response to the Carter v. Canada trial. This case asserted that sections 241(b) and 14 of the Criminal Code, which respectively prohibited aiding a person with committing suicide and consenting to the infliction of death on oneself, violated section 7 of the Canadian Charter of Rights and Freedoms, which provides all citizens with the “right to life, liberty, and security” (Carter v. Canada, 2015). These sections of the Criminal Code were ultimately deemed to be unconstitutional by the Supreme Court and thus eventually altered through the enactment of Bill C-14 to account for MAiD. 


At first, MAiD was only provided as an option to individuals suffering from a terminal illness. In other words, to qualify for MAiD, a person’s death had to be “reasonably foreseeable” (Government of Canada, 2023b). However, in March 2021 with the passing of Bill C-7 by the Canadian government, the eligibility criteria for MAiD was expanded to include individuals suffering from intolerable pain whose death was not reasonably foreseeable but still prevented access for those suffering solely from mental health conditions (Government of Canada, 2023b). This is expected to change once again in March 2024 with another revision to the criteria for MAiD, this time to also include individuals whose sole underlying condition is mental illness (Government of Canada, 2023).


These changes have sparked controversy and one important concern brought up by those opposing this alteration is whether it truly addresses the needs of individuals experiencing mental health concerns, and its implications for populations left vulnerable to mental illness due to conditions of extreme adversity, such as homelessness. Mental health supports continue to be heavily underfunded in Canada, and according to the Canadian Mental Health Association, only about 5-7% of the healthcare budget is allocated towards mental support (The Editorial Board, 2022). As one opinion piece published by the Globe and Mail highlights, legalizing MAiD on the sole basis of mental illness could mean that Canada would be using public funds to medically assist the deaths of those who are unable to access underfunded treatments that could improve their quality of life (The Editorial Board, 2022). 


Additionally, serious mental health concerns often arise in individuals facing other hardships, for example, according to a previous report by the Mental Health Commission of Canada, “90% of Canadians with serious mental illness are unemployed” (The Editorial Board, 2022). Thus their limited financial security further inhibits their access to adequate mental health support, and instead, these individuals are often left navigating “through a world of underfunded community supports, crowded shelters, [or encountering] the criminal justice system” (The Editorial Board, 2022). Another alarming problem is the fact that a large portion of the Canadian population seemingly favours bringing about more lenient changes to MAiD that take it beyond its original purpose of alleviating incurable suffering from illness. For example, in one recent poll conducted by a Vancouver-based research group, it was found that 28% of Canadians were in favour of providing MAiD as an option to individuals experiencing homelessness, even without any other underlying medical conditions (Hopper, 2023). 


While MAiD does require that individuals be faced with intolerable suffering, and evidently many Canadians believe that homelessness would qualify as such, MAiD fails to adequately discriminate between avoidable and unavoidable suffering (Zivo, 2023). From a harm-reduction standpoint, it is difficult to justify how providing assisted death as an option to end the very suffering that could be entirely avoided by addressing current barriers to receiving sufficient treatment is a reasonable next step. Yet, the question remains, with so many Canadians in favour, how can public opinions be altered to advocate for other interventions such as better access to support? 


References 



Government of Canada. (2023, June 19). Canada’s medical assistance in dying (maid) law. Government of Canada, Department of Justice, Electronic Communications. https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html#:~:text=As%20of%20March%2017%2C%202021,the%20result%20of%20external%20pressure


Government of Canada. (2023b, November 27). Charter statement Bill C-7: An act to amend the Criminal Code (medical assistance in dying). Government of Canada, Department of Justice, Electronic Communications. https://www.justice.gc.ca/eng/csj-sjc/pl/charter-charte/c7.html 


Hopper, T. (2023, May 16). One third of Canadians fine with assisted suicide for homelessness. National Post. https://nationalpost.com/news/canada/canada-maid-assisted-suicide-homeless 


The Editorial Board. (2022, December 7). Globe editorial: Euthanasia without real mental health care is a moral failure. Fund it now. The Globe and Mail. https://www.theglobeandmail.com/opinion/editorials/article-euthanasia-without-real-mental-health-care-is-a-moral-failure-fund-it/ 


Zivo, A. (2023, October 26). So now we’re going to euthanize drug addicts? National Post. https://nationalpost.com/opinion/so-now-were-going-to-euthanize-drug-addicts 


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