Canada has the broadest euthanasia law in the world. Both people who are ill and people who have disabilities deemed to cause them to suffer may request that a doctor or nurse practitioner provide them with a drug induced death. (1) Alan Nichols, a 61-year-old man with a history of depression was euthanized, over the strong objections of his family, after he listed hearing loss (which he acquired at twelve) as the medical reason for his request.
His euthanasia implies nothing about what it is like to have hearing loss – people with impaired hearing, like everyone else, lead varied lives – but it speaks volumes about the failure of Canada’s safety net. “Alan was basically put to death,” his brother said. (2)
There were more than 10,000 deaths in Canada by euthanasia last year, an increase of about a third from the previous year. The association of Canadian health professionals who provide euthanasia advises physicians and nurses to inform patients if they might qualify to be killed, as one of their possible “clinical care options.” (3) Indeed, people with disabilities who have been hospitalized and their families have reported instances where hospital staff have brought up euthanasia even though the individuals had not indicated a bit of interest in it. (4) Canada is a textbook example of how society’s thinking “evolves,” to use Prime Minister Justin Trudeau’s term (5), once assisted suicide and euthanasia is legalized.
Into this milieu, the Canadian Virtual Hospice has produced a colorful, soothing activity book for kids ages six and up to help them cope with the euthanasia of someone they know. (6) Whether intentional or not, the book encourages the youngest members of the public to think that in some or many instances it is better to be dead than disabled and it is reasonable for medical providers to act accordingly. This 26 page book refers to disability twelve times. (7)
Entitled Medical Assistance in Dying (MAID) Activity Book, the book calls the death inducing drugs “medicine” and never uses the term euthanasia. Yet it is candid in stating that “A doctor or nurse practitioner (a nurse with special training) uses medicines to stop the person’s body from working.” The person is given three drugs by IV. The first calms them. The second puts them in a coma. The third is what does it. The book states, ‘the third medicine makes the person’s lungs stop breathing and then their heart stops beating…When their heart and lungs stop working, their body dies. It will not start working again.” (8)
As for the end of the process, “once the MAID provider has checked everything and they are sure that the person has died, they will leave the room to fill out some papers. Then they will pack up their supplies and leave….” (9) It all seems so ordinary and mundane, almost as if a visiting nurse has given grandpa a blood pressure check, chatted a bit and then gone to the next house.
Kids are asked to make their choices. Do they want to be in the room where it happens, in the next room or somewhere else? If they are not there, how do they want to be notified? Do they want to see the body or get a photo? (10)
They are assured that euthanasia does not hurt. (11) There seems to be no conclusive evidence though either way as to whether it may involve pain. Brain and heart monitors are not used and since the person is given paralyzing agents, distress may be masked. (12)
The book makes the dubious statement that “no one can cause another person to have so much pain and suffering that they choose MAiD.” (13) No indication is given that some people can be made to feel like a burden, or steered or coerced towards this awful decision. The authors seem not to have heard of elder abuse. Their view is perversely Pollyannaish. Kids are encouraged to talk about their feelings about an impending euthanasia, but missing is any suggestion that if the child truly thinks the person is being bullied or steered, they should take their concerns to someone on the outside like a trusted teacher.
It would, of course, be wrong to place on a six-year-old the responsibility to talk an adult down from dying by euthanasia. Yet kids can be told that some people get quite sad when they are very worried about how to manage things in their daily lives or thinking about expenses and that there is much other people and the community can do to help.
The nub of the book for me and what I think underlies its biased nature are the authors’ explanation as to why an ill or disabled person would gravitate towards euthanasia. According to the book, “people might ask for MAID if their illness or disability will not cause their body to die, but it causes too much pain or suffering for them to keep living with it, and there is no way to make the illness or disability get better or go away…some things still cannot be cured, and some pain and suffering cannot be taken away. This is no one’s fault.” (14)
The language may be simplified for the audience but this is just the medically oriented better dead than disabled viewpoint taken to its logical conclusion. It reflects the tired idea that a disability in and of itself defines and perverts a person’s life. If a person’s disability is permanent, they are up a creek without a paddle as long as they are in this world. Voluntary euthanasia is seen to offer them a way out. However, this doesn’t explain the euthanasia of Sean Tagert, a 41-year-old with ALS, who was quite explicit that he was “choosing” this path because he could not obtain the funding for a few extra hours of daily aide support that he needed to be able to stay at home and continue to participate in the raising of his beloved young son. (15)
To put it charitably, this is an egregious failure of the imagination on the part of the Canadian Virtual Hospice.
It is speculative whether the book might impact a child’s perception of a person with a disability or illness they meet in daily life. It is speculative whether the book might motivate a child to suggest “MAID” to grandma when she complains about her knees. It is speculative whether the book would influence a child who feels hopeless to give up or would make a child who identifies with having a disability herself feel devalued. Also speculative is what effect it might have on the healthcare consumers and policymakers of tomorrow.
It can be asserted though that the better dead than disabled ethic is inimical to inclusion, respect for diversity, problem solving in dealing with adversity, and horror at taking lives – values 21st century kids need to succeed.
The Canadian Virtual Hospice has produced some constructive resources on dealing with illness but the Medical Assistance in Dying (MAID) Activity Book seems little more than propaganda that may even sway adults. The organization needs to do some hard thinking on the precepts they want to promote.
They should be aware that even though euthanasia is allowed under Canadian law, United Nations Human Rights experts have raised serious questions on whether the law has a discriminatory impact on disabled people and is inconsistent with Canada’s obligations to uphold international human rights standards. (16)
