A/HRC/43/41/Add.2
disabilities have closed in Ontario, many persons with disabilities receive residential
support in nursing homes because of the lack of adequate community support.
65.
In British Columbia, Choice in Supports for Independent Living is a self-directed
option for eligible persons with physical disabilities. It is a self-managed model of care
whereby persons with disabilities receive funds and assume full responsibility for managing
their own services. However, the amount of money provided is insufficient to cover all
support needs, which often need to be supplemented with services paid for out-of-pocket.
Neither the Ontario or British Columbia self-directed programmes are “portable”, meaning
that persons with disabilities from those provinces risk losing their payments and access to
services if they move to other parts of the country.
66.
Access to support services for children and youth with disabilities remains
problematic. For example, in Quebec two thirds of families with at least one child with
disabilities reported not receiving the support they needed and, in some regions, persons
with disabilities were on waiting lists for family support for as long as five years. In most
provinces and territories, the organization of service provision is fragmented, undermining
continuity and complementarity. Family members have to take over the responsibility of
providing support, give up their jobs to provide personal care, manage the delivery of
multiple services and make themselves available at short notice when service provision is
cancelled. The Special Rapporteur was informed that parents might consent to foster care
placement because it is the only option available. At the age of 18, young persons with
disabilities who cannot be supported by their families’ risk being placed in nursing homes
for older persons.
67.
In November 2017, the Government launched the National Housing Strategy, which
set targets to make 20 per cent of the new units and 20 per cent of renewed housing
accessible for persons with disabilities. Some 2,400 new units will be created for persons
with intellectual disabilities. While acknowledging these measures, the Special Rapporteur
notes that absent adequate income support and services to live independently in the
community, major investments in infrastructure alone will not lead to systemic
improvements in housing for persons with disabilities.
H.
Right to life
68.
In June 2016, the Parliament of Canada passed federal legislation allowing adults to
request medical assistance in dying. The Criminal Code was amended to allow physicians
and nurse practitioners to provide medical assistance in dying and to allow pharmacists,
family members or other people to assist in the process without being charged under
criminal law. 21 As a general rule, the Criminal Code provides that persons who have a
grievous and irremediable medical condition that causes them enduring and intolerable
suffering are allowed to seek medical assistance in dying. The definition of a grievous and
irremediable medical condition includes disability. Recently, the Superior Court of Quebec
invalidated sections of both the federal and Quebec laws on medically assisted dying, ruling
invalid the Criminal Code requirement that a natural death be “reasonably foreseeable”
before someone can be eligible for assisted death.
69.
The Special Rapporteur is extremely concerned about the implementation of the
legislation on medical assistance in dying from a disability perspective. She has learned that
there is no protocol in place to demonstrate that persons with disabilities deemed eligible
for assistive dying have been provided with viable alternatives. Moreover, she has received
worrisome information about persons with disabilities in institutions being pressured to
seek medical assistance in dying and of practitioners not formally reporting cases involving
persons with disabilities. The recent judgment of the Superior Court of Quebec might put
additional pressure on persons with disabilities who are in a vulnerable situation due to
insufficient community support. As many persons with disabilities said during the visit,
21
Act To Amend the Criminal Code and To Make Related Amendments to other Acts (Medical
Assistance in Dying).
13
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