Government proposes legislation extending the temporary exclusion of eligibility for MAiD on the sole basis of mental illness

A bill has been introduced in the House of Commons to introduce legislation that would delay the expansion of Medical Assistance in Dying (#MAID) ‘s eligibility requirements—particularly for people with mental illness as their only underlying condition— to March 2024. Read the government’s press release here.

We empathize that for people with mental illness who have been wanting to apply for MAID, the possible passing of this bill will come as a huge disappointment. We feel for those who are not currently able to apply for MAiD but wish to do so. We also strongly advocate for comprehensive and holistic supports and safeguards that can provide greater access to necessary treatments and access to services that reduce poverty and increase  quality of life. No one should feel that their only choice is MAiD due to poor societal conditions alone. 

If this bill is passed, we hope that over the course of the next year, actionable work on clarifying eligibility criteria can be informed by the input of those most impacted.

Article: I'm Fighting to Live, But...

This article was written by Madeline, and originally appeared in DABC’s Transition magazine on Dying for Health Care: Navigating an Ableist System (Fall/Winter 2022). Read the issue here.

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My name is Madeline. I’d like to tell you how and why I find myself at a place where I’ve applied for and been accepted for Medical Assistance in Dying (MAID).

The lack of financial support for the health care I need is driving me to a preventable slow, excruciatingly painful and isolated death.

I’m not using my real name because my medical team advised me that my health is so fragile that public scrutiny and pressure could kill me. The energy I’m using to write this article is costing me dearly. But, if I don’t tell my story, I don’t have a chance at survival.

My Life So Far

For four decades, I’ve lived with post viral syndrome which requires a range of essential treatments–none of which are covered under BC’s Medical Services Plan (MSP) because the disease has been virtually ignored in medical research.

Over the years, I did my own extensive research and found treatments that helped. I have been able to pay for some myself through a combination of the Persons with Disabilities (PWD) benefit, accumulating massive personal debt and donations through a GoFundMe page. But these minimal treatments were just enough to keep me alive. I continued to deteriorate.

The donations are going to run out very soon. The treatments will stop and I will die.

Let me be clear: I want to live.

Since my disease disabled me 25 years ago, I’ve appealed to MSP, the Ministry of Health, the Ministry of Social Development and Poverty Reduction, my MLA and my MP.

One of the problems I’ve faced–on top of the devastating nature of my illnesses–is the gender bias in medical research. Because most of my diseases affect women more than men, they have not been given proper attention, legitimacy and funding. The result is a lack of coverage for my life-saving treatments.

This bias has ensured my deterioration to the point where I face an early–and avoidable–death. It will be slow and brutal. I’ll be unable to move, speak or eat–trapped and isolated, in a poverty-level care home.

Given this reality, I applied for MAID and was approved in the spring of 2021.

Disability and Poverty

How can this be the only choice left to me and people with conditions like mine?

It begins with the financial and health-related supports for people receiving PWD which don’t come close to covering the costs of living with disability. BC’s PWD rates are far below Canada’s poverty line. Add to this all of the extra costs of living with disability and we inevitably fall further and further into poverty.

Then, twenty years ago, the BC government cancelled coverage for critical treatments that helped me, like physiotherapy and naturopathy. At the time, I was in a self-employment program for people with disabilities. I paid for my treatments on credit, but the debt I started to accumulate was crushing. I had to end treatment, my condition deteriorated and I couldn’t continue the program.

In my situation, denial of support for my treatments has been not only inhumane, but fiscally irresponsible. If my disease had been properly diagnosed, managed and treated 20 years ago, the government would have saved money. Now, the financial cost to turn around my deterioration will be massive–if it is even possible. And, if some treatments had been covered by MSP, I may have been well enough to work and pay for additional treatments myself.

Being Silenced

When I did my first news story, I was warned by an advocate that the government might retaliate. While I am grateful that didn’t happen, someone with experience actually thought it might.

This is why some people with disabilities who receive income assistance are afraid to use the laws that are meant to protect us. So, nothing changes–unless people with some power speak up.

When health supports were cut 20 years ago, one podiatrist kicked up a fuss for his PWD patients who lost coverage for orthotics. He was able to have coverage reinstated.

If just one committed doctor could do this, can you imagine what could change if physicians spoke up collectively? One part of my post viral syndrome, Myalgic Encephalomyelitis (ME), receives just $280,000 a year in research funding–a fraction of funding devoted to other diseases like MS and Parkinson’s.

So, I ask the politicians, the medical community and the general public, “Where have you been? Where are you now?” What is happening to me can happen to anyone, especially with the onset of long COVID affecting 10% of those who have had the virus.

There was a small flicker of hope this summer from BC’s Select Standing Committee on Finance and Government Services. The Committee put forward a recommendation for next year’s provincial budget to create billing codes for ME. This would mean that doctors could recommend treatments for ME patients that would be covered under MSP.

This would be a huge step forward for this misunderstood, under-diagnosed illness. However, even if the recommendation is accepted, the changes will come too late for me.

Last Thoughts

But none of this says who I am. Maybe a poem a family member wrote when I was little sums it up.

“My child dances like a feather, always singing all the time.
Runs outside in snowy weather, cold and snow she thinks are fine.
If we’re sometimes not together, always she’s My Valentine.”

I’ll say it one last time: I want to live.

You can learn more about Madeline and support her at: https://www.gofundme.com/f/MadelinesMiracle

The BC Food Security Gateway

The BC Food Security Gateway (the Gateway) is an online resource that provides BC communities with up-to-date food security information.

The Gateway is meant to inform and link you to projects, initiatives, and organizations in British Columbia as well as publications, tools, guides, and news – so that you, too, can contribute to building food security in BC.

The Provincial Health Services Authority (PHSA) manages the Gateway in partnership with the Public Health Association of BC (PHABC).

Check out their website, which also has an interactive map of BC that you can explore to find out about food security networks and food policy councils in your community.

http://bcfoodsecuritygateway.ca/