This is the most comprehensive critique of the AP piece I have read to date. The detailed rejoinder to each of the points Cheng raised merit consideration. I found his reminder of how disabled persons where at the heart of the court decisions allowing and widening MAiD to be crucial, turning on its head the counterpoints how MAiD ostensibly lessens the value of the disabled.
Perhaps the single most compelling argument the AP article raised is the inadequate health and social services network we still have in Canada, but it never asked the question if that in itself justifies limiting or ending MAiD. Eric Mathison's piece does that implicitly at least on page 13 on, where he elaborates on the cited cases where people chose MAiD over inadequate alternatives that were deemed intolerable to them. However, my own view of his points regarding choices that nevertheless existed for them detracts from his other points about patients deserving the best of care. It's simply not the case, for example, that home care is unreasonably expensive compared to institutional care. And we saw how long term care facilities were intolerably lacking and presented patients there with likely death sentences, dying without family and friends present during the Covid epidemic. Some Scandinavian countries have already made that calculation and have consequently offered patients the choice because home care not only proved to be less costly, but also more humane in every other way. Regrettably that is no where near comparable in Canada.
I rather preferred Eric's point that "...these cases show a failure of social support, not an overly broad MAiD regime." To weigh in on the decision these persons made in choosing MAiD over existing benefits tends to weaken the rest of his sound arguments. The bottom line that "...it's possible to support increased funding in these cases without being committed to preventing these people from accessing MAiD", is solid. I would add, holding persons hostage seeking MAiD to relieve suffering by persons lacking health and social services in Canada is illogical and heartless.
Of course, the whole issue of access to MAiD raises the question why there should be any barriers to assisted dying, agreed by Eric and many in the worldwide right-to-die movement as a basic human right to decide when, where, and how to die. While it is obvious and necessary to have limitations or qualifications to assisted dying that draws in government and the medical professions, other options that do not medicalize this final act must not be omitted or criminalized either. One of the best ways to stop impulsive, fear-based, and irrational suicide is to give people all the information available to them that range from MAiD to self-deliverance by other reliable, dignified and painless ways. People's last months or years arguably improves qualitatively when they know they have control over that. Not everyone wants doctors and other strangers involved in this very personal final act. Not everyone agrees to having first convince MAiD assessors and their doctors or nurses of their unacceptable quality of life ("intolerable suffering") before they can exit. It's been said if life is a gift, denying one the right to give it away turns it into an imposition.
If we really endorse patient-led intervention and a patient's right not to accept certain medical practices, then any prohibition to assisted dying by threatening criminal prosecution is undemocratic and unconstitutional. Alternatives to the "sickness" pathway to assisted dying are out there and merit full consideration by right-to-die societies that spell out these options such as Right to Die Society of Canada and Canada's chapter of Exit International.
While Canada has excelled in making dying more humane through its legislated MAiD pathway, other regimes like Switzerland (totally and incorrectly left out in the AP article) have a "rights-based" model that has removed the prohibition against assisted dying without adding a detailed legislated model to instruct how it must be done. Currently, it is the same for Germany.
Although not all can afford to travel to Switzerland to seek this remedy, we can become self-reliant, better informed, and knowledgable about what assisted dying may include without crossing any line that would open one up to criminal prosecution. Perhaps the next chapter will be Canadian courts specifying what assistance may or may not include. In any event, we are moving in the right direction by removing death and dying as a taboo topic usually relegated only to university sociology, psychology, and ethics courses into the broader public sphere.
Encouraging the patient to leave a letter for family members assuring them that MAiD was absolutely their independent choice is an option to avoid such misunderstandings as took place with Mr. Nichol’s family. (I know of one person who left a letter for his “combative” family so they would not harass his wife after his death.)
And on a personal note, my mother’s MAiD provider was a NP. She was wonderful and so generous with her time. It could not have gone better — for both my mom and for those who loved her. I have no idea what Ms Cheng’s beef is with NPs since she didn’t elaborate.
Further to your point about ensuring that patients are aware of their right to MAiD, this is absolutely required. Informed consent is required for every treatment or intervention offered to any patient. How can it be informed if patients who qualify for MAiD are not asked if they know about it? Of course it must be done with care. But it’s no different than any other interaction with a health care provider. Some are good at it and some…need to improve. But it must be provided.
Ms Cheng’s obvious bias against MAiD resulted in a ridiculous article which succeeded in stirring up outrage in those less informed about the process. Thank you, Eric, for taking the time to refute each egregious point.
This is one of the worst argued pieces I have ever read. Clearly Sean Tagert chose MAiD because of the unacceptable option of long term care-Truchon in the Quebec case also noted it was the prospect of institutionalization not his disability that lead him to seek the right to access MAiD. Yes all within the law but that does not justify the law on an ethical basis-MAiD is now an alternative to acceptable disability supports and as our Federal budget officer has confirmed -a money savers.. This is just embarrassing- aktion T4 was 'legal' in Germany as was the cultural genocide of indigenous children-sad and frightening to see this weak defence from some one who claims to be an ethicist
How refreshing to read such an article rebuttal to the sensationalist articles that have been in the media lately.
This is the most comprehensive critique of the AP piece I have read to date. The detailed rejoinder to each of the points Cheng raised merit consideration. I found his reminder of how disabled persons where at the heart of the court decisions allowing and widening MAiD to be crucial, turning on its head the counterpoints how MAiD ostensibly lessens the value of the disabled.
Perhaps the single most compelling argument the AP article raised is the inadequate health and social services network we still have in Canada, but it never asked the question if that in itself justifies limiting or ending MAiD. Eric Mathison's piece does that implicitly at least on page 13 on, where he elaborates on the cited cases where people chose MAiD over inadequate alternatives that were deemed intolerable to them. However, my own view of his points regarding choices that nevertheless existed for them detracts from his other points about patients deserving the best of care. It's simply not the case, for example, that home care is unreasonably expensive compared to institutional care. And we saw how long term care facilities were intolerably lacking and presented patients there with likely death sentences, dying without family and friends present during the Covid epidemic. Some Scandinavian countries have already made that calculation and have consequently offered patients the choice because home care not only proved to be less costly, but also more humane in every other way. Regrettably that is no where near comparable in Canada.
I rather preferred Eric's point that "...these cases show a failure of social support, not an overly broad MAiD regime." To weigh in on the decision these persons made in choosing MAiD over existing benefits tends to weaken the rest of his sound arguments. The bottom line that "...it's possible to support increased funding in these cases without being committed to preventing these people from accessing MAiD", is solid. I would add, holding persons hostage seeking MAiD to relieve suffering by persons lacking health and social services in Canada is illogical and heartless.
Of course, the whole issue of access to MAiD raises the question why there should be any barriers to assisted dying, agreed by Eric and many in the worldwide right-to-die movement as a basic human right to decide when, where, and how to die. While it is obvious and necessary to have limitations or qualifications to assisted dying that draws in government and the medical professions, other options that do not medicalize this final act must not be omitted or criminalized either. One of the best ways to stop impulsive, fear-based, and irrational suicide is to give people all the information available to them that range from MAiD to self-deliverance by other reliable, dignified and painless ways. People's last months or years arguably improves qualitatively when they know they have control over that. Not everyone wants doctors and other strangers involved in this very personal final act. Not everyone agrees to having first convince MAiD assessors and their doctors or nurses of their unacceptable quality of life ("intolerable suffering") before they can exit. It's been said if life is a gift, denying one the right to give it away turns it into an imposition.
If we really endorse patient-led intervention and a patient's right not to accept certain medical practices, then any prohibition to assisted dying by threatening criminal prosecution is undemocratic and unconstitutional. Alternatives to the "sickness" pathway to assisted dying are out there and merit full consideration by right-to-die societies that spell out these options such as Right to Die Society of Canada and Canada's chapter of Exit International.
While Canada has excelled in making dying more humane through its legislated MAiD pathway, other regimes like Switzerland (totally and incorrectly left out in the AP article) have a "rights-based" model that has removed the prohibition against assisted dying without adding a detailed legislated model to instruct how it must be done. Currently, it is the same for Germany.
Although not all can afford to travel to Switzerland to seek this remedy, we can become self-reliant, better informed, and knowledgable about what assisted dying may include without crossing any line that would open one up to criminal prosecution. Perhaps the next chapter will be Canadian courts specifying what assistance may or may not include. In any event, we are moving in the right direction by removing death and dying as a taboo topic usually relegated only to university sociology, psychology, and ethics courses into the broader public sphere.
Encouraging the patient to leave a letter for family members assuring them that MAiD was absolutely their independent choice is an option to avoid such misunderstandings as took place with Mr. Nichol’s family. (I know of one person who left a letter for his “combative” family so they would not harass his wife after his death.)
And on a personal note, my mother’s MAiD provider was a NP. She was wonderful and so generous with her time. It could not have gone better — for both my mom and for those who loved her. I have no idea what Ms Cheng’s beef is with NPs since she didn’t elaborate.
Further to your point about ensuring that patients are aware of their right to MAiD, this is absolutely required. Informed consent is required for every treatment or intervention offered to any patient. How can it be informed if patients who qualify for MAiD are not asked if they know about it? Of course it must be done with care. But it’s no different than any other interaction with a health care provider. Some are good at it and some…need to improve. But it must be provided.
Ms Cheng’s obvious bias against MAiD resulted in a ridiculous article which succeeded in stirring up outrage in those less informed about the process. Thank you, Eric, for taking the time to refute each egregious point.
This is one of the worst argued pieces I have ever read. Clearly Sean Tagert chose MAiD because of the unacceptable option of long term care-Truchon in the Quebec case also noted it was the prospect of institutionalization not his disability that lead him to seek the right to access MAiD. Yes all within the law but that does not justify the law on an ethical basis-MAiD is now an alternative to acceptable disability supports and as our Federal budget officer has confirmed -a money savers.. This is just embarrassing- aktion T4 was 'legal' in Germany as was the cultural genocide of indigenous children-sad and frightening to see this weak defence from some one who claims to be an ethicist