The Globe and Mail - 18.02.2020

TUESDAY,FEBRUARY18,2020 | THEGLOBEANDMAILO A

OPINION

NEWS |

I

n May, 2017, Quebec City police
discovered the body of Véro-
nique Dorval in the trunk of
her car, with a plastic bag over her
head.
In a letter sent to media outlets
just before her suicide, the 38-
year-old biochemist decried the
fact that she had been denied
medical assistance in dying
(MAID).
“People with cancer can die
with dignity and be comforted,
surrounded by their loved ones. A
person with mental illness must
die alone, in the trunk of her car. I
so badly wanted to be accompa-
nied and helped,” she wrote.
For more than a decade, Ms.

Dorval suffered from bipolar dis-

order, which she described as a

“cancer of the soul.” Medication

provided little relief from her suf-

fering and debilitating side ef-

fects.

In Canada, people with mental

illness, no matter how painful or

irremediable, cannot choose as-

sisted death because their death is

not “reasonably foreseeable.”

That is going to change on

March 12.

In a landmark ruling issued on

Sept. 11, 2019, Justice Christine

Baudouin of the Quebec Superior

Court invalidated the “reasonably

foreseeable” death clause of fed-

eral law and a similar section of

Quebec law that says people must

“be at end of life” to access assist-

ed death, and gave legislators six

months to amend the law. The

ruling was not appealed.

What legislators – both provin-

cial and federal – had to do as a re-

sult was to craft amendments that

recognize that people with men-

tal disorders as their sole underly-

ing medical condition (or MD-

SUMC, the acronym for that med-

ico-legal jargon) are real patients

with real health problems, and

with the same rights as others

who choose medically assisted

death. At the same time, they

need to recognize that wanting to

die is often a symptom of severe

mental illness, a symptom that

can be (but is not always) tempo-

rary and treatable.

That’s a fine line that will re-

quire some thoughtful law-mak-

ing.

Yet, in the months since the

Quebec court ruling, govern-

ments have mostly dithered,

something that has been the

norm during three decades of the

assisted death debate.

Ottawa did an online consulta-

tion that garnered a staggering

300,000 responses. Quebec an-

nounced recently that it will con-

sult on the issue “for as long as it

takes.” The Quebec College of

Physicians said it will suspend

MAID for MD-SUMC until a law is

in place.

In other words, the court ruling

won’t be respected for the foresee-

able future. And that could trigger

yet another court challenge.

Opponents of allowing assisted

death for MD-SUMC patients have

two principal arguments: It is im-

possible to determine if a mental

illness is irremediable, and vul-

nerable patients will be encour-

aged to die because of a lack of

mental health services or evil-

doers who want to rid society of

people with disabilities.

The latter – the well-worn “slip-

pery slope” argument – is getting

tiresome. There is no evidence

vulnerable patients are being

pushed into assisted death

against their will. If anything, the

contrary is true. MAID has be-

come an option for the elite, while

people with physical and mental

disabilities have repeatedly had to

turn to the courts to have their

right to choose respected.

The other argument – essen-

tially, “we know better than you

that your suffering is not unbear-

able” – is insulting. We don’t insist

that patients with terminal can-

cer content themselves with

hopes and prayers, and we

shouldn’t expect people with in-

tractable mental illness to do so

either.

Unquestionably, people with

mental illness need better access

to treatment and support, just as

patients with terminal illnesses

need better access to palliative

care. But this does not obviate the

need for assisted death.

To exclude MD-SUMC patients

from accessing MAID would be

discriminatory and unjust. But

that doesn’t mean there can’t be

additional eligibility criteria.

In a recent paper, the Halifax

Group – comprised of eight ex-

perts from the Council of Cana-

dian Academies who review the

state of knowledge on medical as-

sistance in dying – articulated this

approach thoughtfully. It recom-

mended that assessment condi-

tions and the decision-making

process be strict, to ensure that

MD-SUMC patients are compe-

tent enough to make a decision to

end their lives. In other words,

MAID requests must be well-con-

sidered, not impulsive.

Let’s not forget that these cases

will be very rare. Even in the Neth-

erlands, a country with a long-

standing liberal law, fewer than 1

per cent of assisted deaths involve

patients with mental illness – 42

of 4,828 cases last year.

These issues are complex and

can make us uncomfortable. But

the law-making isn’t going to get

any easier. Soon, we will have to

decide if mature minors and pa-

tients with dementia can choose

assisted death.

In all these cases, we must pro-

ceed with caution. But we must al-

so stop acting with contempt for

the suffering.

LegislatorsmuststopditheringonMAID

Canadianswithmental

illnessstillcan’taccess

medicalassistancein

dyingdespiteacourt

rulingnixingtheclause

thatpreventedit

ANDRÉ
PICARD

OPINION

I

n recent months, a populist
turn of events in India has tar-
nished Gandhi’s vision and the
country’s future as the world’s
largest secular democracy.
We were born in the same pro-
vincial city in postcolonial India.
We grew up on a steady diet of sto-
ries about the fight for independ-
ence. Our parents burned their
Western-spun clothes as part of
the national protest against En-
gland and donned home-spun
khadi in support of Mahatma
Gandhi’s dream of a free, demo-
cratic and secular India, home to
a new country for many cultures,
languages and religions.
Through twists of fate, both of
us find ourselves in Canada as
grateful and engaged citizens of
this country. But we continue to
take an abiding interest in India,
its people and its politics. We are
both, therefore, saddened and
dismayed by the developments in
our country of birth.
In 2019, the Parliament of India
amended the Citizenship Act to
provide a path to citizenship for
members of Hindu, Sikh, Budd-
hist, Jain, Parsi and Christian reli-
gious minorities who fled perse-
cution in Pakistan, Bangladesh
and Afghanistan before Decem-
ber, 2014. It’s the first time reli-
gion has been overtly used as a
criterion for citizenship under In-
dian nationality law.
The amendment has been

widely criticized as discriminat-

ing on the basis of religion, in par-

ticular for excluding Muslims.

The Office of the United Nations

High Commissioner for Human

Rights called it “fundamentally

discriminatory,” adding that

while India’s “goal of protecting

persecuted groups is welcome,”

this should be accomplished

through a non-discriminatory,

“robust national asylum system.”

The government has defended

its position by pointing out that

Pakistan, Bangladesh and Af-

ghanistan are Islamic countries,

where Muslims are unlikely to

face persecution. This argument

fails to take into account that cer-

tain minority Muslim groups,

such as the Hazaras and the Ah-

madiyyas, have faced and contin-

ue to face persecution in these

countries. In addition, there is

widespread concern that the bill,

coupled with the new National

Register of Citizens, would render

many Muslims stateless, as they

may not be able to meet the strin-

gent birth certificate require-

ments.

Indians have not stayed quiet

in the face of this discriminatory

law. Intellectuals, artists and par-

ticularly young students are

speaking out with courage. Wom-

en are the leading voices in many

cases. Sadly, the media and the

courts appear to have largely suc-

cumbed to political and populist

pressure and fallen silent.

The 17.5 million Indians who

comprise the world’s largest dias-

pora have been watching careful-

ly. Demonstrations were held in

New York, Toronto, San Francisco

and Connecticut on Jan. 26, In-

dia’s Republic Day. They were

joined by leaders of civil rights

groups such as Reverend Chloe

Breyer, the executive director of

the Interfaith Center of New York.

She noted that Martin Luther

King Jr., who was inspired by

Gandhi, “called to speak for the

voiceless.” She went on to say that

the Citizenship Act “makes an

enemy of India’s own precious

people, damaging the pluralistic

democracy that has existed since

1947 and has been such an inspi-

ration to the world.”

What has inspired us the most

is the involvement and initiative

taken by young people. In Toron-

to, peaceful protests have been

planned and led by university

students. These students light the

way forward for the rest of us.

Their unwillingness to walk away

from the reality of the situation

and their passion to stand by

what’s right for humanity has

been so moving.

Canadians and in particular In-

do-Canadians need to add their

voices to those demanding a re-

peal of the act. We need to re-

member that the persecution of

one group or one religion or one

culture opens the door to the per-

secution of others. As the world

seems to increasingly fall prey to

strong-man politics, we should

do our best to ensure the health

of the world’s largest democracy.

We, proud Indo-Canadians,

find ourselves labelled “anti-Indi-

an” because we are against the

bill and its nature. But the truth is

that it is our very “Indianness”

that makes us feel so fiercely in-

dignant about what is happening.

It is said that you can take an

Indian out of India but not India

out of an Indian. And this has

never been as relevant as it is to-

day. Although we are not in India

dealing with the immediate ram-

ifications of the situation, we can

still stand by our fellow Indians in

solidarity as they face it head on.

Humanity is taking a hit, and we

cannot stand idly by waiting for

change. We do not become who

we are in isolation.

India’snewcitizenshiplawisdiscriminatoryandshouldberepealed

RATNAOMIDVAR
DEEPAMEHTA

OPINION

RatnaOmidvarisanindependent
senatorfromOntario.

DeepaMehtaisanaward-winning
filmdirector.

IndianwomenholdcandlesinBangalore,India,onFridayduringaprotestagainstanewcitizenshiplawthat

opponentssaythreatensIndia’ssecularidentity.AIJAZRAHI/ASSOCIATEDPRESS

M

uch like weddings and
funerals in any family,
leadership conventions
can bring out the best or worst in
folk. The coming Conservative
leadership battle will be no dif-
ferent.
Part of what determines if the
best or worst in us emerges is the
disposition of the leadership
candidates themselves, and their
ability (or inability) to ensure the
comportment and standards
used by their campaigners,
whether they be paid or volun-
teers.

This risk-management con-

text is particularly acute because

a minority Parliament, as Canada

has now, can defeat a govern-

ment at any time, and the prime

minister can visitthe governor-

general to seek an election when-

ever it is clear there are not

enough votes in the House of

Commons to sustain parliamen-

tary confidence.

That means there may not be

the typical gap between a lead-

ership convention and a general

election, during which a new par-

ty leader would moderate what-

ever extreme things were said

during a leadership campaign in

order to win the support of the

broader electorate. The oft-used

approach of appealing to the en-

trenched base by indulging in the

narrowest ideological excess

would be a dangerous path for

any candidate to choose. It

would hurt the party intensely in

the coming election.

For Conservatives, this means

many things. Ad hominem at-

tacks on Prime Minister Justin

Trudeau, or questions about his

motivation, may feel good for

some in the base. But the results

of the last election underline

how little wood it chops in the

cities and major population cen-

tres.

Questioning the Prime Minis-

ter’s policies and choices is the

legitimate role of the Opposition.

But even that should be accom-

panied by alternate Conservative

proposals: What they espouse,

and why they would be better for

Canada’s future.

Leadership candidates for the

Conservative Party of Canada

will need to showcase real,

thought-out policy directions

with which to identify out of the

starting gate. There’s a reason the

Liberal Party has been the de-

fault choice for Canadians for

most of our history; competence

and policy credibility count.

For Conservative leadership

candidates, the old game of per-

sonality, organization, money

and networks – with as little pol-

icy as possible – is not good

enough. The digital universe is

constantly probing for weakness

and substantive vacuums all the

time.

Many of the self-proclaimed

“organizational pros” often pro-

pose going policy-free, so as not

to offend any potential support-

er, often doing so while launch-

ing treacherous negative person-

al attacks against other leader-

ship candidates, through friends

in the press where possible.

Leadership candidates of char-

acter should and can set these

low-ball tactics aside in favour of

policy courage and a measure of

civility. The Conservative Party

has succeeded electorally when

red Tories, blue Tories, socially

conservative Tories, Quebec-“de-

centralizing” Tories and big-busi-

ness Tories all get to be part of

the family, with no single group

ever allowed to win every argu-

ment.

The essential component of

effective Conservative leadership

is managing this diversity be-

cause it reflects large parts of

Canadian society. They need to

inspire hope and trust with bal-

anced new policy priorities for a

plurality of electors and win back

progressives who abandoned the

party when it no longer reflected

their social values. Leaders like

Diefenbaker, Mulroney, Lough-

eed, Davis and Harper did this as

successful first ministers. Leaders

who failed never had a chance.

There is immense need and

room for new ideas and fresh

thinking in a range of areas, in-

cluding fiscal policy, federalism,

equalization, immigration, de-

fence and foreign aid, foreign

policy and reconciliation and

reparations with First Nations.

Conservative leadership candi-

dates should be out front on

these issues with policy ideas

that reflect their views of Canada

and its priorities. Ambition to be-

coming leader and prime minis-

ter is an important part of what

energizes our democracy, but it is

not enough.

Stating clearly why you want

to be prime minister, and what

you would like to change or con-

serve, should be as much of the

needed table stakes for prospec-

tive party leaders as large finan-

cial deposits and a lengthy list of

signed-up supporters. Canadians

deserve no less, and they will re-

member if they get no more.

CanadiansdeserveaConservativeleadershipraceanimatedbyideas,notideology

HUGHSEGAL

OPINION

TheMathewsFellowinGlobalPublic
PolicyattheQueen’sSchoolof
PolicyStudiesandsenioradviserat
AirdBerlisLLP.In1998,hewas
runner-uponthefirstballotofthe
ProgressiveConservativeleadership
conventionthatchoseJoeClark.In
2005,hewasappointedtothe
SenateandsatasaConservative
fromOntario.