The Autonomy Disguise

RIP to all the casualties of society’s most recent atrocities towards disabled people.

Last week, I read an article published on 30 April by The Spectator, in which the matter was discussed of Canada indiscriminately allowing people with disabilities to be euthanised. For various reasons, many of these disabled people can simply not afford to keep on living (with or without dignity), which is the only reason that they opt for assisted suicide in the first place.

Fair warning to those who may feel that my style of advocacy is too angry. This is going to be an unapologetically angry article. I have no time for patiently entertaining the notion that there is more than one justifiable side to a story in which a population group is essentially being forced or coerced to die. This is nothing more than convenience for the nondisabled, being disguised as autonomy for the disabled.

Both the topics of assisted suicide and of poverty have been fresh in my mind recently, given that my previous two blog posts touched on euthanasia (the review of Me Before You in which a man chooses death above disability) and poverty (the difficulties faced by disabled people in finding employment). I happened to come across the article about the situation in Canada on a disability community Facebook group of which I am a member, and my jaw dropped.

It all started in 2015, when Canada’s ban on assisted suicide was lifted. The following year saw the enactment of legislation allowing euthanasia for people with a terminal illness, in the case where the person’s natural death is reasonably foreseeable. Five years later, Bill C-7 was enacted, dropping the “terminal illness” and “reasonably foreseeable” conditions altogether, and allowing anyone suffering from an illness or living with a disability which cannot be relieved under conditions that the individual considers acceptable to choose death. In addition, these individuals can die for free with funding from the government, due to the option of making use of ‘medical assistance in dying” or MAID.  What a perfect example to use in explaining to someone who does not understand the concept of a slippery slope!

The Canadian government claims that this law is all about prioritising the autonomy of disabled people. I, as well as Canadian disability rights groups that opposed the law and were ignored, believe otherwise. You see, autonomy is all about having a choice. The Canadians who have opted for assisted suicide so far felt that they had no other choice.

A woman in Ontario (who the media refers to as Sophia) diagnosed with a chronic condition called multiple chemical sensitivities (MCS) chose death after the failure of her desperate attempts to find affordable housing where she would not be exposed to chemical cleaners and cigarette smoke. She, her supporters, her friends and her doctors made multiple phone calls and wrote numerous letters over a time period of two years to officials on all levels of government, fruitlessly asking for assistance. Eight days before Sophia’s death, she filmed a video which was eventually shared with the media, in which she said: “The government sees me as expendable trash, a complainer, useless and a pain in the ass”. The president of the Environmental Health Association of Québec, who spoke to her on a daily basis after learning about the approval of her application for assisted suicide said: “It’s not that she didn’t want to live, she couldn’t live that way.” To me, that doesn’t sound like someone with autonomy.

An article published by Maclean’s magazine entitled “Dying for the right to live” tells a similar story of a woman with multiple disabilities (referred to as Susan) who chose a lethal injection above an existence in which she could not afford to eat. Food banks were not an option, due to dietary restrictions linked to her disabilities. She said: “An increase [in income support] is the only thing that could save my life. I have no other reason to want to apply for assisted suicide, other than I simply cannot afford to keep on living.” In the minutes before her death, Susan asked medical staff to make a call to the prime minister in which she would plead her case. His response would determine whether she would live or die. I do not know if she ever got through to the prime minister. I do know that she died.

Another article tells the story of a woman from VANCOUVER  (referred to as Madeline) who could no longer afford the medications and services that made her chronic pain bearable, and who was already deep in debt. She said that she chose assisted suicide, not because she wanted to die, but because her income was not enough to keep her under a bearable pain threshold.

Yet another article mentions a 35-year-old man who resorted to euthanasia. When his family visited him at his care home to say goodbye, they were horrified to find him in a room with urine and fecal matter on the floor and in his bed, as well as dark specks on the walls and in the sink. His brother believes that the deplorable conditions under which he was living had a massive impact on his decision to die, rather than to endure such indignity.

Not that assisted suicide should be pushed as the answer for people with mental health issues such as depression, but both Madeline and Susan said that they were not at all depressed. Susan said: “Every time I look out the window, I see joy, I feel happiness and I’m really a happy, contented and chill person.” A happy, contented and chill person is highly unlikely to want to die by choice, unless they feel that there is no other option. Both Sophia and Susan had another reason for choosing death though. Sophia wrote in an email to friends: “If my death helps to show the government that those of us with MCS will keep on having MAID if they don’t act soon, then I’m glad I could help someone else not have to suffer the way I have.” Susan expressed her disappointment in a society that undervalues the contributions of the disabled and doesn’t consider them worth financially supporting. She said: “I’ve received awards and accolades for my community work.” But, “I wasn’t earning a weekly pay, so I was considered useless to society.” Both of these women partly considered their deaths to be acts of protest. Personally, the only autonomy that I see in their decisions to die is exactly that: The message they are sending to the authorities that be. It is absolutely shameful that life is the price tag attached to the mere possibility that one just might be heard.

So how is it that the disabled find themselves in these positions in the first place? My bet would be that the Canadian government just vastly underprioritises the livelihoods of their disabled citizens. Palliative care is only available to a minority, with many disabled people finding themselves unable to access it. Of course, Covid created a massive public health crisis, and Canadians who receive the disability tax credit were extended the opportunity to apply for a one-time payment of 600 dollars. However, in only one example of how difficult it is for Canadians to be approved for this grant, a disabled student told the media that her doctor’s response to her request that he fill out the relevant form was as follows: “You’re not disabled enough…You have to be sitting in the corner drooling to be able to get this.”

To underline to what extent the Canadian government underprioritises disabled people, the original article I mentioned by the Spectator points out that university students received 5000 dollars in additional assistance from the government during Covid, whereas disabled people received only 600 dollars.

The most damning evidence, in my opinion, of the reasoning behind MAID having nothing to do with the autonomy of disabled people is in a report published by Canada’s Parliamentary Budget Officer about the cost saving that MAID would create. The report dispassionately states that Bill C-7 would result in additional net savings of 62 million dollars per annum, and although healthcare is expensive, assisted suicide only costs taxpayers 2,327 dollars per case. No wonder Sophia and Susan both made statements that indicated that society was making them feel like burdens on the system. The state would pay for them to remove themselves, but not to make it possible for them to stay alive.

To make matters worse than they already are, next year, people suffering from mental illness will also be eligible for euthanasia. This is another demographic that is disproportionately poor. There is also talk of allowing mature minors to have access to assisted suicide options. The problem that I see with this is that I do not believe that either group are necessarily able to rationally make such a decision. At what point did it become okay to essentially encourage teens to take their own lives? At what point did society decide that it is no longer important to acknowledge that mental illnesses such as depression have suicidal ideation as a symptom, and that it is no longer necessary to try one’s utmost to proverbially talk people who are in this dark place down from the ledge?

I have suffered from depression for a large portion of my life. It was worst when I was a teen. Now that I am in a much better space, I recognise that I was entirely irrational as a result of my mental illness. I am glad to be alive. Life holds so many opportunities. Death holds only one: rest. But I will have enough time for rest after I’ve experienced all there is to experience here first. It comes for us all eventually, and it is final. As a teen, I had less life experience, I was not in my “right mind”, and I was never more pro the idea of euthanasia. Now, I have lived many more years. They held many tears, but they also held moments of happiness and pleasure and sunshine that I would gladly cry each tear to pay for a thousand times over. They also held lessons. One of those lessons was that my life is immeasurably valuable.

Thinking of a very bright, high-achieving, popular and gorgeous friend of mine who committed suicide resulting from severe depression as a teenager, I can’t help but wonder if she wouldn’t feel the same way that I do now if she had gotten the help she needed. Make no mistake: she needed help, not government sanctioned enablement.

In South Africa, there is currently a court case underway in which a doctor and her patient are seeking to have euthanasia legalised. Given that it has already become apparent that the law in Canada is affecting the poor, it stands to reason that this will be the case in South Africa too. We are a developing country, and millions of people live in poverty. A massive proportion of these people are disabled, and healthcare, as well as government financial assistance for people with disabilities lags far behind what is available in developed countries such as Canada. Right now, the legal challenge only pertains to euthanasia for the terminally ill. However, as is clear in the Canadian case, this is a very slippery slope. How long until scores of poor people are lining up in front of hospitals to choose death, and what will our government decide is more important? The lives of citizens, or keeping the money that could have been used to save them?

I understand that arguments can be made for there being a place in society for allowing people the right to decide what happens to their own lives when they can undeniably prove that they are of sound mind. Yet, I cannot see how this could ever be a viable option in a society that is as unequal as ours, where so many don’t have access to the most basic of resources.

Finally, I believe that, regardless of the quality of life (which can always improve), each life has inherent worth. Like Linkin Park’s late great Chester Bennington sang in response to the question: “Who cares if one more light goes out in a sky of a million stars?” I too say: “Well I do.”

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