Introducing the Vulnerable Persons Standard
The Vulnerable Persons Standard is a series of evidence-based safeguards intended to protect the lives of Canadians.
These safeguards will help to ensure that Canadians requesting assistance from physicians to end their life can do so without jeopardizing the lives of vulnerable persons who may be subject to coercion and abuse.
We are calling on all members of Parliament to ensure that federal legislation regulating physician-assisted death incorporate these safeguards.
Why is vulnerability important?
Vulnerable persons who request physician-assisted dying may be motivated by a range of factors unrelated to their medical condition or prognosis. These factors are important and can often be addressed with adequate and appropriate care. As a society, we have both moral and legal obligations to address the needs of vulnerable persons. Access to physician-assisted dying cannot be allowed to diminish or undermine these important obligations.
Unmet needs should not be a cause of death
Extensive research shows that a wide range of factors related to social, financial, psychological and spiritual suffering can lead patients to request physician-assisted death.
The U.S. National Cancer Institute describes such requests as “a sign that unmet needs have built to an intolerable level.”
Vulnerability has many causes
There are many important factors which contribute to a person’s vulnerability and which can often be alleviated by adequate and appropriate care. These can include:
- Psychosocial factors and mental health issues causing distorted insight and judgment. These may include depression, hopelessness, loneliness, fear, grief, shame; coercion by others; and the psychodynamics of the physician-patient relationship.
- Lack of access to disability-related supports that can improve a person’s resilience and ability to live with greater dignity, comfort and self-determination.
- Insufficient or inaccessible palliative care options which can alleviate pain and suffering and improve well-being of patients and their loved ones.
- Poverty and unemployment which can cause significant mental anguish, social stigma and a sense of hopelessness.
- On-going physical, mental or emotional violence.
- The likelihood or experience of abuse and fraud, especially affecting elders and people with disabilities.
The Vulnerable Persons Standard introduces a series of safeguards that are designed to identify and address these and other forms of vulnerability. In this way, we can ensure that those accessing physician-assisted death will do so without jeopardizing the lives of Canadians who may be subject to coercion and abuse.
Who is at risk?
Canadians living with severe disabilities, mental illness and dementia, as well as seniors living in long term care may be more vulnerable to stigma, abuse, coercion, isolation and depression. Consequently, they may be more inclined to suicidal ideation, intent and behaviour. The psycho-social needs of vulnerable Canadians can be met by providing appropriate care and support, significantly reducing mental anguish as well as a person’s motivation to request physician-assisted death.
* More than 40 advisors from across Canada with expertise in medicine, law, public policy, ethics and advocacy for people with disabilities contributed to developing the Standard.Share