Thursday, March 9, 2023

Long COVID, Assisted Suicide, and Capitalism: What’s a Society to Do?

AnezkaBy Anezka Krobot, 2L at St. Louis University School of Law

The COVID-19 pandemic has been devastating to billions around the world who have lost opportunities, loved ones, and even their lives to the disease. COVID has also created a new phenomenon that is difficult to predict for the long-term–long COVID. Long COVID, also known as post-COVID conditions, is a wide range of new, returning, or ongoing health problems that people experience after being infected with the virus that causes COVID-19. The most common symptoms are neurological, namely chronic fatigue (similar to the experience of people diagnosed with chronic fatigue syndrome) as well as seemingly permanent loss of taste and smell. There are also heart and respiratory symptoms associated with long COVID. All these symptoms can result in someone having difficulty returning to work even after testing negative for COVID for quite some time. Some people with long COVID even have to quit their jobs and apply for disability.

This is the situation for a Canadian woman who recently made headlines for applying for Canada’s Medical Assistance in Dying program (MAiD) citing long COVID as her reason. Tracey Thompson, a former professional chef in her 50s, has been rendered completely unable to work by her symptoms, and sees no other option than medically assisted death. After more than two years of lost income,, no foreseeable ability to work and an absence of support, Thompson said she expects to run out of money very soon. She said she was applying for the program exclusively for  “financial consideration,” and that her only option is to “die slowly and painfully, or quickly.”

MAiD expanded its criteria in March 2022 to include people with disabilities or those suffering from pain even if they are not close to death and will begin accepting applicants citing mental health disorders as their rationale, further broadening the already broad criteria. United Nations experts pushed back on the original expansion in January 2021, arguing that extending assisted dying to people with non-terminal conditions contravenes Article 10 of the UN Convention on the Rights of Persons with Disabilities.  “It is not beyond possibility that, if offered an expanded right as per Bill C-7, persons with disabilities may decide to end their lives because of broader social factors such as loneliness, social isolation, and lack of access to quality social services,” reads the letter sent by the United Nations experts to the government of Canada prior to the expansion.

Not only has Canada broadened its criteria for MAiD, but it has started to become more proactive in offering it to potential candidates. Disabled veteran and Paralympian Christine Gauthier, 52, testified before a Canadian veterans affairs committee that while she was attempting to gain government assistance in having a chair lift installed in her home that she received a letter from a veterans' affairs employee saying, “If you’re so desperate, madam, we can offer you MAiD, medical assistance in dying.” The Veterans Minister indicated that there had been five similar reports but was quick to assure the committee that a single employee was the culprit, and that individual was now suspended. Still, this begs the question: what kind of culture has been created around MAiD that an employee felt comfortable offering assisted suicide to a person asking for mobility assistance? A wheelchair lift is a permanent addition to someone’s house and someone who wants to die would not invest that kind of time, effort, and money into acquiring such a permanent fixture.

The U.S. is more conservative than Canada in terms of medically assisted death – it is legal only in a few states (California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington) and the District of Columbia, and is permitted only under extremely strict parameters. If Canada approves Thompson’s request, though, this may galvanize people in the U.S. suffering with long COVID or chronic mental illness to do the same here, seeing no way out. The economic effects of long COVID may even be exacerbated by living in the U.S., particularly given the difference in the healthcare system between the U.S. and Canada. The combined burdens of losing healthcare coverage along with one’s job, stacking medical bills, difficulty in acquiring disability pensions, and skyrocketing housing costs may result in now-disabled COVID victims feeling as though they have no other choice. Also, the isolation that accompanies COVID may be contributing to suicidal ideation in long COVID victims, which should not be overlooked. The issue of long COVID has already been used in debate over an assisted suicide bill in Connecticut in 2021, with proponents arguing that assisted suicide is preferable to the isolated deaths that many who died of COVID experienced. Though that bill did not pass at the time, a revised version has made it out of the Connecticut legislature’s Public Health Committee and to the public hearing stage as of March 2023.

The UN Guiding Principles on Extreme Poverty and Human Rights states: “Persons living in poverty must be recognized and treated as free and autonomous agents. All policies relevant to poverty must be aimed at empowering persons living in poverty. They must be based on the recognition of those persons’ right to make their own decisions and respect their capacity to fulfill their own potential, their sense of dignity, and their right to participate in decisions affecting their lives.” The expansion of medically assisted death in Canada only pits impoverished people’s pain and suffering with economic needs, while giving them no support or methods by which their lives might improve. It is ableist, classist, and reminiscent of eugenics policies (especially if government officials continue to offer it unprovoked to disabled citizens merely seeking assistance) and should not become the model for medically assisted death going forward. Instead, governments should provide further economic and social assistance to disabled citizens to ensure that they are not forced into poverty by their medical circumstances. If disabled individuals are fully empowered in this way, their quality of life may improve such that medically assisted suicide is no longer their only option, and they can live fulfilling, successful lives, as is every human being’s right.

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