Vulnerable Persons Standard

Parliament is currently considering how to implement assisted suicide and euthanasia in Canada. Members are working from a set of recommendations that go far beyond what was considered in the Carter decision. The recommendations would:

• Allow assisted suicide/euthanasia for people with non-terminal conditions
• Allow assisted suicide/euthanasia for people who have a psychiatric condition
• Allow assisted suicide/euthanasia for persons under 18 years of age (in three years’ time)
• Allow people who have been diagnosed with a grievous and irremediable condition to place in an advance care directive their desire to be euthanized
• Not require a written request if not possible
• Require all publicly-funded health care facilities to participate in assisted suicide/euthanasia
• Not require prior approval or review before assisted suicide/euthanasia is administered
• Not require palliative or home care services be made available before assisted suicide/euthanasia is administered

At the same time, 30 disability rights activists, doctors and lawyers released the Vulnerable Persons Standard that would go a long way toward ensuring that no vulnerable person would be induced to commit suicide in a time of weakness. The Vulnerable Person Standard would:

• Address problems such as social and mental health stresses, lack of access to palliative- and home care, and poverty and unemployment
• Mandate equal protection for vulnerable persons
• Limit assisted suicide/euthanasia to people with “end of life conditions”
• Require a vulnerability assessment to determine what social, medical or psychological factors may be putting pressure on the person to request assisted suicide/euthanasia.
• Require a detailed analysis of voluntary, informed consent
• Require before-the-fact arm’s length approval by a judge or administrative tribunal
• Ensure that communication accessibility (neutral and qualified interpreters) will be provided.
• Forbid the use of advance directives to request assisted suicide/euthanasia.

The Vulnerable Persons Standard can be found at: http://vps-npv.ca.

As a founding co-sponsor and contributor to the Vulnerable Persons Standard, the Council of Canadians with Disabilities thinks its provisions provide a reasoned and effective way to restrain virtually unregulated assisted suicide/euthanasia.

Strong regulations are essential to minimizing the number of unrequested deaths, as well as our ability to track the effects of the assisted suicide/euthanasia law once it is implemented.

Attached is a sample letter that individuals can send to their MPs supporting the Vulnerable Persons Standard and asking that its terms be incorporated in the law regulating assisted suicide/euthanasia. We suggest that a copy of the Standard be sent along with the letter, so that each MP can see exactly what is being suggested.

Thank you very much for your collaboration in this important effort

Rhonda Wiebe
Co-Chair
Ending of Life Ethics Committee

Dean Richert
Co-Chair
Ending of Life Ethics Committee

Sample Letter

Member of Parliament
House of Commons
Ottawa, Ontario
Canada K1A 0A6

I’m writing to urge you to incorporate the Vulnerable Persons Standard in any legislation governing medical aid in dying.

In the Carter decision, the Supreme Court expressed deep concern about protecting the lives of “persons who may be vulnerable to inducement to commit suicide in a time of weakness.” This statement does not set apart a particular group of people. Rather it signals a set of circumstances that can befall any person, which would render them vulnerable to social, medical, psychological, or economic pressure to request assisted suicide even if that is not the best solution for that person.

The Vulnerable Persons Standard is a series of procedures to identify those circumstances so that they are not the impetus for requesting medical assistance in dying. This would require efforts to offer other solutions that address these vulnerabilities, to seek to put the vulnerable person back on an equal footing with others who have more resiliency. These measures include:

• Requiring a vulnerability assessment to determine what social, medical or psychological factors may be putting pressure on the person to request assisted suicide/euthanasia.
• Requiring a detailed analysis of voluntary, informed consent.
• Requiring before-the-fact arm’s length approval by a judge or administrative tribunal;
• Ensuring that communication accessibility (neutral and qualified interpreters) will be provided.

A copy of the vulnerable person standard is attached to this letter.

The Vulnerable Persons Standard is an invaluable analysis for persons with disabilities, who experience higher rates of poverty, isolation and discrimination which can compromise their resilience. The Standard provides important procedural and substantive safeguards to ensure that Canadians requesting assistance from physicians to end their lives are not vulnerable to inducement and will not jeopardize their lives because they are persons who may be subject to coercion and abuse. I’m hoping you will act to ensure that federal legislation regulating physician-assisted death incorporate these safeguards.

Thank you very much for your consideration.