Silver Lining

Personal Stories | July 14, 2023 | Bonita Thompson

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A photo of dark clouds with light shining through

I have been distressed lately by the tone and nature of the discourse about access to medical assistance in dying (MAID). But I wonder perhaps if there is a silver lining to these dark and threatening emotionally-charged clouds – a place to find common ground and purpose.  

In Canada, we are by in large uncomfortable talking about death – its inevitability, its definition, its meaning, the circumstances under which and where it occurs and our rituals around it.  

Not only are we uncomfortable discussing it but just as often we fail to plan for it – an inevitable event for all of us whether occurring quietly after a very long life or after a sudden, unexpected and tragic event, or after unsuccessful treatment following a dire diagnosis.  

Our heated conversations about MAID have taken these topics out of the shadows and into the spotlight.  

Our debates over access to medically assisted death have served to highlight important issues that until recently have not received the same kind of public scrutiny: effectiveness of treatment for mental disorders; quality of life as seen through the eyes of the poor and homeless; fears arising from social stigma felt by the disabled; scarcity of and access to medical treatment of physical and mental disorders; availability and access to “end of life” care.  

Each of these issues is very important and deserving of the specific attention being given to them now BUT, in my view, not at the expense of the related but different subject – autonomy to determine the time and manner of one’s death in the circumstances outlined in the 2015 Supreme Court of Canada decision.  

How you want to live and how you want to die are two different issues and should not be confused.  

Yes, everyone should have access to palliative care – in a hospice, hospital or at home when the time of death approaches with the focus of care changing to quality of life in the time remaining. Accessing palliative care is a decision to live as best as one can until death occurs.  

Yes, everyone should have access to medical care and treatment for their physical and mental conditions. But ensuring that these conditions exist and are available should not be used to restrict the right to end one’s life with dignity. This is not a zero-sum game. Failure to make adequate provision for health care should not be the reason to argue MAID should not be provided.  

Yes, everyone should have sufficient resources to live a healthy and fulfilling life in housing suitable for their needs. But again, arguing that MAID is bad policy because we have too many people whose quality of life is unacceptable is not a reason to pause or revoke access to MAID, it is a reason to ensure that we also focus our attention and resources to addressing poverty and homelessness.  

We afford dignity to people when we give them access to the care they need when they need it.  

We afford dignity to people who choose to end their lives in palliative care at a place of their choosing.  

We afford dignity to those with a mental disorder by destigmatizing their conditions and by giving them access to mental health care.  

We afford dignity to those with disabilities by ensuring that they are afforded the same opportunities that the rest of us take for granted to enjoy life to the fullest.  

And finally, we afford dignity to people who can no longer endure their suffering and who wish to end their lives with medical assistance. 

Regardless of our points of view and the issues we hold closest to our hearts, what value is there in trying to outshout each other with our advocacy? 

How can we in good conscience try to silence the voices of those who have struggled for so long to have access to MAID – to end their lives with dignity.  

Our common grounds are dignity and autonomy – we honour the dignity and autonomy of each individual by recognizing and accepting their personal definition of what those terms mean.  

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