Medical assistance in dying and mental illness: Perspectives from 2S/LGBTQ+ individuals in Atlantic Canada


Jay Tang, University of Victoria

Canada is currently on track to have one of the most permissive MAID programs in the world, with medical assistance in dying available to those with terminal medical conditions, those with non-terminal medical conditions, and imminently, those with mental illness. Though achieving legal access to MAID is often presented as a victory for disability rights, examining MAID through a critical intersectional, feminist lens resists its framing as a victory for the bodily autonomy of disabled people. Such a lens complicates the socially revered concept of autonomy in the context of a society that provides accessible avenues to death without providing equally accessible avenues to living and thriving. Despite a recent increase in research in the area of MAID for mental illness (MAID-MI), there remain several problematic research gaps. First, though autonomy and self-determination are central to the MAID debate, the literature surrounding MAID for mental illness largely fails to consult individuals with mental illness, instead highlighting the paternalistic debates of physicians, lawyers, ethicists, and other professional experts. Given that individuals with mental illness form the population that will most tangibly be affected by the change in legislation, there is urgent need to understand, amplify, and prioritize their lived/living perspectives. Second, there is a lack of research investigating the specific perspectives of marginalized people, who experience mental illness at disproportionately high rates due largely to the compounding impact of racism, homophobia/transphobia, ableism, and other forms of discrimination. Marginalization, in all of its forms, is inextricably linked with disability; this is accomplished through the pathologization of deviance/difference and through the targeted debilitation of marginalized populations under a capitalist, ableist, white supremacist cisheteropatriarchy (Puar, 2017). To provide the option of a state-facilitated death to disabled people, then, is to provide the option of a state-facilitated death disproportionately to those already marginalized. Further, to provide the option of a state-facilitated death uniquely to disabled people is to insinuate that there is a suffering unique to this population that makes the provision of their death a merciful act. An equitable and comprehensive examination of MAID necessitates an interrogation of the nature of this suffering and the efforts that have been made to ease it; this interrogation has thus far been lacking. As someone who is situated at the intersection of several marginalized identities, I am interested in the societal implications of providing disabled people – at any stage of their adult life – with a fast-tracked death. In this presentation, I will present preliminary findings from an ongoing SSHRC-funded project examining identity, marginalization, and MAID-MI from the perspectives of 2S/LGBTQ+ individuals with mental illness. This qualitative study highlights marginalized voices through semi-structured interviews analysed in a feminist-of-color disability framework, which disrupts the dominant (white) narratives in feminist disability studies and emphasizes the mutual integrality of race, gender, and disability studies. Developed by Sami Schalk and Jina B. Kim, this framework incorporates elements of feminist-of-colour critique, feminist disability studies, queer theory, and crip theory, and moves beyond identity politics and individualized constructs of “disability” in order to understand and critique the ways in which intersecting systems of oppression both create and define disability and impairment. Using this framework, I will contextualize participants’ perspectives within social structures of oppression and highlight the fundamentally intersectional nature of the systemic devaluation of disabled life.

This paper will be presented at the following session: