Surprise support for anti-MAiD campaign

One of Canada’s leading supporters of Medical Assistance in Dying is in favour of an anti-MAiD campaign launched by the Christian Medical and Dental Association of Canada and backed by Ontario’s bishops.

Dr. Sandy Buchman was president of the Canadian Medical Association when it changed its code of ethics to accommodate legalized euthanasia. He is a MAiD assessor and MAiD provider, founder of a proposed MAiD-providing hospice in North York and medical director of the Freemen Centre for the Advancement of Palliative Care at North York General Hospital.

Even as a passionate advocate for MAiD, Buchman believes a society that gives people the option of medically terminating their lives must also give them all the medical and social support they need to continue living.

“What kind of society are we?” he asked. “Are we a caring, compassionate society? Are we going to condemn people to live with these disadvantages — in poverty, lack of adequate housing? Are we not going to attempt to deal better with their mental health and addictions? Their access to physical therapy, occupational therapy, the resources that everyone needs in a consistent way?”

The campaign — No Options, No Choice — argues that provincial governments need to spend more on palliative care, mental health treatments, social and housing supports to ensure Canadians don’t choose doctor-assisted suicide out of despair and frustration.

“Support additional services for Canadians so that they have real options to live,” says the campaign’s website (nooptionsnochoice.ca). 

“I’m in full agreement with a lot of that,” said Buchman

Buchman argues that health care and social service budgets must prioritize the most vulnerable.

“We’re talking about people who need these sorts of supports to maintain normal, basic life,” he said. “People are living hugely below the poverty line in this time of rampant inflation, food prices. It’s just unjust… What drives death, really? What drives deaths is these inadequate social circumstances and social support services that people are living with. If you or I were in those, we would ask for MAiD.”

The No Options, No Choice campaign won’t overturn the law that makes voluntary euthanasia legal in Canada, said Deacon Larry Worthen, executive director of the Christian Medical and Dental Association. But it at least proposes alternatives.

“Am I saying this is going to eliminate MAiD altogether? Probably not,” said Worthen. “But how many lives will be saved in the interim?” 

The Archdiocese of Toronto, along with every other diocese in Ontario, has thrown its support behind the No Options, No Choice campaign.

“We’ve long argued for expanded funding for palliative care,” said archdiocesan spokesperson Neil MacCarthy. “Governments at all levels need to look at how we can make housing affordable for those living with disabilities, along with other support systems to ensure they are not living in poverty or isolation. We need to look at all solutions as to how we can support the vulnerable and ensure they are not forgotten.”

The campaign has been timed to coincide with when provincial governments are drawing up their budgets, Worthen said. One priority would be bringing provincial disability pensions up over the poverty line, he said. Queen’s Park increased Ontario Disability Support Program payments five per cent this year, but in a year of eight-per-cent inflation an ODSP cheque still buys less than it did a year ago. 

Vancouver palliative care physician Margaret Cottle, a member of the Euthanasia Prevention Coalition, has thrown her support behind the No Options, No Choice campaign. Cottle worries about the moral shape of a society that makes a lethal injection easy but housing, palliative care, effective psychiatric care and home care incredibly difficult.

“What does this say about us as a culture if we do this?” she asked. “In British Columbia it takes less paperwork and less assessment to get MAiD than it does to receive government-supported home oxygen.”

While Cottle disagrees with Buchman fundamentally about the definition of palliative care and the compatibility of MAiD with the Hippocratic Oath, she has the same concerns about patients choosing MAiD because society can’t or won’t provide the necessities of life.

“The whole thing is just, it’s heartbreaking is what I can say,” said Cottle. “I’ve had a patient who said that he was going to pursue MAiD because he couldn’t get decent home care… The government made MAiD part of the rights under the Canada Health Act and palliative care is not. How crazy is that?”

Health Canada doesn’t see a problem with the availability of palliative care.

“The available evidence suggests that the choice to seek MAiD is not driven by inadequate palliative care services, nor lack of availability of these services,” Health Canada spokesperson Natalie Mohamed said in an email. “The Third Annual Report on MAiD in Canada indicates that, in 2021, the majority of MAiD recipients (80.7 per cent) received palliative care.”

The bureaucratic form-filling behind such statistics doesn’t convince Worthen.

“Our role as Church is to come alongside people like that — whether they are in our parishes or they may not even be regular church-goers,” he said. “They are individuals in our society who are suffering from loneliness, isolation and in some cases discrimination and prejudice. Our role as Christians should be to come alongside them and to support them and to help them realize that God loves them and that they have dignity outside of what our society says about them.”

The Canadian Conference of Catholic Bishops said its Office for Family and Life has received information about the No Options, No Choice campaign. Before the CCCB opts into the campaign, the Office for Family and Life must present the case to the Standing Committee for Family and Life and the Executive Committee of the CCCB for approval.

“The CCCB is very supportive of any and all initiatives that promote and advance the culture of life, including palliative care, which we understand is the focus of this particular initiative,” the CCCB Communications Service said in an email.