March 22, 2023

The Quebec Intellectual Disability Society (the Society) released today its brief on Bill 11, An Act to amend the Act respecting end-of-life care and other legislative provisions.

Summary of the Society’s position

A major paradigm shift for medical assistance in dying

For the Society, Bill 11 constitutes a profound paradigm shift with respect to medical assistance in dying (MAiD). By opening MAiD to people other than those at the end of their lives, the government is changing the spirit of the Act and the parameters set out in the Carter decision. It is important that these changes take into account the specific realities of people with intellectual disabilities, particularly in order to protect them from potential abuse.

Ableism and Medical Assistance in Dying

The Society is very concerned about how MAiD could be extended to people with disabilities. Indeed, ableism is still a strong force in society. The lives of people with disabilities are often seen as less worthy of living, as experiencing more suffering and of lower quality. However, many studies show that this is not how people themselves evaluate their quality of life. It is therefore important to ensure that ableism does not put any pressure, however unintentional, on people with disabilities – especially those with intellectual disabilities who are more easily influenced – to resort to MAiD.

Advance requests and consent

Finally, the Society is most concerned about the issue of valid consent in advance MAiD requests. The Carter decision placed the issue of free and informed consent of individuals at the center of access to MAiD. It is by definition difficult, if not impossible, to verify consent once a person has become incapacitated. This represents a real danger for vulnerable people, including people with intellectual disabilities, especially in a context where ableism is still prevalent.

Given the irreversible aspect of MAiD and the seriousness of the consequences of the procedure, the Quebec Intellectual Disability Society is of the opinion that the precautionary principle should be exercised and that vulnerable persons should be protected before considering the use of advance directives with respect to MAiD.

Brief on Bill 11

The full brief is available below.

View the brief