A local man struggling to survive on government assistance with deteriorating health is considering medical assistance in dying rather than face the uncertainty of homelessness.
Medical assistance in dying or MAiD laws were introduced in 2016 with recent changes in March 2022 to permit people with disabilities or dealing with pain to access the procedure, even if they are not close to death.
The change to the federal law “removes the requirement for a person’s natural death to be reasonably foreseeable” helping other people who want to access assisted suicide become eligible.
Amir Farsoud, a St. Catharines resident, has medical conditions including degenerative disc disorder, spinal stenosis, spondylosis, and chronic obstructive pulmonary disease (COPD). He lives in constant pain which impacts his standard of living and quality of life.
Even using strong pain medications there are days when Farsoud said he finds it difficult to move.
“My best day is about a six to a six and a half, my worst day is about a nine, there’s days I can’t get out of bed,” he said referencing a pain scale.
“I originally approached the topic saying when MAiD comes to be and if my life ever becomes nothing but pain management, then, I’m probably going to go that way.”
On average he takes upwards of 20 pills per day to manage the pain along with three inhalers for his COPD.
Farsoud said it took convincing to get his doctor to sign off on the first stage of the MAiD application, but now it’s a 90-day waiting period for his second assessment to see if he still qualifies for the procedure.
“It took me awhile to get my doctor on board,” he said.
“He knows physically I qualified, but he was quite hesitant because I told him the straw that broke the camel’s back, in this instance, was my impending homelessness.”
The building in which Farsoud lives is being sold and he said there is no reasonable option for affordable housing.
It is terrifying to think it comes down to housing or death, he said.
“Death is something that petrifies me, and I was going to tough it out as long as I possibly could until we got to the landlord saying the place is up for sale,” he said.
Farsoud doesn’t blame his landlord, as he has been the best landlord he has ever had and understands there is monetary issues involved in selling the apartment building, he said.
Farsoud, who is on the Ontario Disability Support Program, said he would rather die on his own accord, than to be homeless and die on the streets, as prices of housing have well outpaced ODSP rates.
A single person on ODSP receives about $1,169 per month or $14,028 per year, to pay for rent, food, medication, and a cellphone. This is far below the poverty line in Ontario, which is estimated to be $19,930, a difference of $5,902.
Rent in St. Catharines for a single room vary wildly between $600 per month to more than $1,000, but Farsoud needs accessible accommodations due to mobility issues, which he says are almost non-existent.
That could all change, if Bill C-22 passes into law and ODSP rates get increased closer to the poverty line so people could afford to pay rent, said Farsoud.
For David Fancy, a Brock University professor and disability advocate, more needs to be done to help people who are accessing MAiD because of socioeconomic issues preventing them from living their lives.
“I am fully in support of people making decisions about when their end of life is, I have no aversion to the legislation or the spirit behind it, which is to increase individual patient citizenship autonomy,” he said.
Fancy points out the issue for him arises when it comes to several factors outside the medical aspect of the procedure impacting people’s ability to live fully.
“My problem occurs when there are social circumstances resulting from lack of access to resources, care, and psychosocial supports that restrict individual’s autonomy,” he said.
Fancy adds this leaves people feeling there are no other options than to apply to end their life, creating what he calls a Hunger Games style situation.
“It’s like The Hunger Games because people are competing to try to stay alive and they’re being given an option to take themselves out,” he said.
“It’s these dystopian circumstances for the people who have to make this choice.”
He said it becomes a problem when its not actually a choice they want to make, rather something they must do to prevent suffering.
“They would much prefer to be alive and there are simple social means such as housing or additional funding support that could reduce their suffering significantly to the point where they wouldn’t need to try to reduce their suffering by having their life taken for them,” he said.
Fancy likens it more to a cliff than a slippery slope when there is evidence of the continued erosion of the social safety net including policies of disinvestment and socioeconomic supports coupled with new legislation on MAiD providing people with a way to “take themselves off the government’s payroll.”
“We shouldn’t be making it harder for people to survive, while at the same time offering legally legitimate ways for having their life taken,” he said.
“The choice is clear, we need, as a collective, as a society, to continue to invest in the social safety fabric, in a way, that provides support for people who are suffering from a range of overlapping reasons and provide them other ways of reducing suffering.”
Fancy said other disability advocates have described it as political assistance in dying or PAiD.
“The acronym PAiD really draws attention to the fact this is about money,” he said.
“This is about disinvestment in the social safety net and it’s about a disregard of vulnerable persons.”
According to the third annual report of Medical Assistance in Dying in Canada, in 2021 more than 10,000 MAiD provisions were reported in Canada, which accounted for about 3.3 per cent of deaths in the country.
When it comes to MAiD laws for people who are going to lose their autonomy through dementia or other cognitive impairments, it was a long time coming said Pauli Gardner, professor of Public Health and Masters of Applied Gerontology Program in the Department of Health at Brock University.
“One of the things they’re trying to balance is the tension between allowing people to make a choice about end of life as an individual decision and whether or not people are aware, of what’s involved in that decision making,” she said.
“We can’t be paternalistic about levels of education and income as ‘you can’t make your own decision about things like this,’ so it’s incredibly complicated.”
Farsoud said he is petrified of becoming homeless as he wouldn’t survive long on the streets in his current condition.
“If I were to become homeless tomorrow, I’d be dead in a month anyway. The only difference between that and being dead from MAiD is I get to die in my bed with a health professional giving me an injection and me drifting off,” he said.
“Or I can freeze to death on a subway grate in Toronto in a month and a half.”
He said MAiD offers a semblance of dignity and pain relief in the final moments of life, something that being homeless wouldn’t allow him.
Coming to this conclusion was not easy, said Farsoud
“As much as death frightens me, homelessness frightens me a hell of a lot more,” he said.
“I wish instead of MAiD, society would decide disabled people actually deserve to be able to have a dignified life.”