Good morning. As a rehabilitation specialist physician, I treat people with severe disabilities. I follow people with spinal cord injury from acute care, through rehabilitation, transition to the community, and life long follow up. I prevent complications and manage symptoms to help improve quality of life of my patients. My recommendations I am making are based on my research and clinical experience.
Particularly concerning in Bill C-7 is the removal of the criterion of the person being expected to die naturally in the reasonable foreseeable future, which means that anyone with a significant disability may request MAID, and the waiting period is 90 days. While I respect everyone having autonomy once able to make an informed, independent choice for their care, I do NOT believe that people who have a new, severe, potentially permanent neurologic disability such as spinal cord injury will have the ability to make this informed choice until they have had an opportunity to have lived with their new impairments and disability, reintegrate into the community, and realize the excellent quality of life that is experienced by most with such disabilities. People must have the opportunity to live this experience before being able to make an informed choice on an issue so important as ending their life.
I have seen cases where some health care providers, do not understand that most people with SCI live a long and satisfying, productive life, and , at times, have reflected there uninformed opinion onto their patients. Many, if not most, people with new spinal cord injury of a severe nature at least consider at some point the wish to end their life or “not go on”. However, once having gone through rehabilitation and integration back into the community within a few years these same people for the most part rate their quality of life quite high, many in fact higher than that of the non-disabled population. Being offered MAID in that early period when they are vulnerable and don’t realize the excellent quality of life their future may hold is a failure to understand the medical evidence. We should amend Bill C-7 to mandate that people with new severe disability should only choose MAID as an option once having become informed of their future life possibilities by living that experience.
Dr. Karen Ethans is a physician who specializes in Physical Medicine and Rehabilitation (also known as “Physiatry”), with a sub specialty in Spinal Cord Injury Medicine. She is an Associate Professor at the University of Manitoba and has worked for over 20 years as a clinician and researcher at the Rehabilitation Hospital of the Health Sciences Centre in Winnipeg, where she is the service chief of the Spinal Cord Injury Program.