Everyday, Given: Asking the right questions in the age of MAiD

Bill C-62 has passed in the Canadian senate. Medical assistance in dying (MAiD) access for individuals solely living with a mental illness is officially delayed until March 17, 2027.

Opposers of the Bill and the delay will protest what they consider to be discrimination against people with mental illness who seek access to assisted suicide. Opposers of MAiD celebrate this cautionary delay in what otherwise appears to be an ongoing, rapid expansion of access to medical assistance in dying.

I hope that Canada will ultimately pull back on its untethered charge towards more permissive MAiD criteria. My prayer though, regardless of where this legislation lands, is that we will use this pause to ask the right questions.

In HBO’s hit show, True Detective: Night Country, the lead character Elizabeth (Liz) Danvers – a brisque, broken, and barely likeable detective in Northern Alaska – insists that those around her ask the right questions if they want to discover the truth. This is a reoccurring theme from the first season of True Detective. The wrong questions present themselves first and tend to attract the most interest. Often, they are no more than a distraction or evasion from the real, difficult questions that lie under the surface.

In the pause of asking whether MAiD should expand to people on the grounds of mental illness, we must return to questioning what kind of circumstances people (with or without mental illness) face that cause them to seek death in the first place.

Having recently hit “middle-age” (and still working to become comfortable with this description!), I have faced some dark days over my 40+ years. However, I have never been diagnosed with depression. I count myself fortunate, as 17% of men in Canada struggle with their mental health, we are less likely to access mental health services, and men make up 75% of the approximately 4,000 people who die by suicide in Canada each year.

Growing up near Sault Ste Marie, Ontario, I had my “up” and “down” days. A typical teenager (I can say that, now with teens of my own!), anything could affect my mood. Factors could be trite, like my latest interaction with a girl that I had a crush on. They could also be significant.

My grandma on my mom’s side, who we called “Nanny,” lived in a granny flat beside our house. I’ll never forget the moment I took the call to hear from my dad that Nanny had taken her own life, and the rush of emotions that coursed through my body that day and the days that followed. When people choose death – whether they gain assistance to do so or not – it is never an individual matter. It impacts us all.

Through these days, the song “Every New Day” by ska band Five Iron Frenzy kept my head above water. Its chorus proclaimed:

Dear Father, I need You,
Your strength my heart to mend.
I want to, fly higher,
Every new day again.

These words reminded me that, no matter what I was going through, a new day was just around the corner. Every day was a new opportunity for God to “show up” in the midst of my life and circumstances.

Fast forward several decades and similar verses from Lamentations 3:22-23 (NIV) kept me afloat during the COVID-19 pandemic:

The steadfast love of the Lord never ceases; 
his mercies never come to an end;
they are new every morning;
great is your faithfulness.

When the world is crushing us, we need to know that help is coming. This may be in the form of divine intervention, as in many biblical accounts. Or God may be working in more ordinary ways: a message or meal from a friend; someone who stays with us through the night when we can’t fall asleep; or a letter from the government saying the services or medical intervention we depend on are now available – and free.

I know my mental health cannot be detached from my circumstances. More than 1 in 3 people (36.6%) with a mood, anxiety, or substance use disorder report unmet or partially met health and mental health care needs. As I serve people with intellectual and developmental disabilities, I’m mindful that a 2017 Stats Can survey found that only 17% of people with developmental disabilities described their mental health as “excellent” or “very good”, compared to 70% of the general population aged 15 years and older. I can’t imagine that stat has improved since the pandemic.

We know that this population is chronically underserved and the field of support for people with developmental disabilities is severely underfunded. Indeed, a class-action lawsuit is moving forward in Ontario which asserts that  the province has been negligent and breached duties to people with developmental disabilities under the Canadian Charter of Rights and Freedoms, with broken promises to significantly reduce the waitlists for services.

It is no wonder then, with the shortfall of critical supports and services, that we are bombarded with tragic accounts of people with various kinds of disabilities ending their lives through MAiD. The waitlist for needed services is often longer than the wait for assisted death! Even the recent provision of the Canada Disability Benefit has been short-changed and severely limited.

When the only “mercy” people can hope for in the morning is death, we know we are living in a society that asks the wrong questions.

We have reached the place where the lives of people who don’t meet certain societal criteria of “quality” are considered worth eliminating. People living through profound suffering, for instance. We are constantly faced with, and asking, the wrong questions.

We end up asking “Should we allow [this group of people] to take their own lives?” because we have spent so long avoiding the question “How might we cultivate a society where everybody knows they are celebrated and valued, and have access to the supports and services that they need?”

These, then, are some of the right questions. How can we be part of a world:

• Where disability is not equated with suffering?
• Where finding meaning through suffering is possible and plausible?
• Where disabled lives are equally valuable to nondisabled lives?
• Where people who require more care than the general population are not thought of as burdens?

It’s time to work for a world where, from hospitals to hospices, we’re not obsessed with simply fixing bodies, but where whole-human healing is celebrated; healing that includes people’s loved ones, their community, resources, and their faith.

I do not mean to minimize the momentous decisions facing our country in the days and months ahead, nor the decisions that have already transformed our reality – a reality where over 4% of deaths are medically assisted.

We must act. We must pray. But we must also live into a world where we ask the right questions.