In Canada, Medical Assistance in Dying (MAID) Has Become a Matter of Ideology

In Canada, the debate over medical assistance in dying (MAID) has become one of ideology. That is, how we view human rights and a person's right to live is at stake.

Balancing patient autonomy with protection of vulnerable individuals - particularly those who have physical and/or mental impairments - can be a delicate balance to strike.

What is MAID?

Medical assistance in dying (MAID) is a healthcare service in Canada that allows physicians and nurse practitioners to administer drugs that cause death for eligible patients. Although MAID has gained widespread public support, an in-depth look reveals Canadians' opinions about it are nuanced and complex.

Many Canadians believe that MAID should be available to all who wish to die. However, a growing number of experts contend there are ethical considerations surrounding accessing this service. These include making sure those requesting MAID do so without seeking it out due to unmet social determinants or lack of resources.

This issue is especially pertinent when discussing Mental Health Insurance Denial (MAID) for individuals with mental illness. Some medical professionals and researchers have warned that providing MAID to those suffering from mental illness could leave them vulnerable to systemic coercion, exploitation, or other forms of harmful intervention.

Current eligibility criteria in Bill C-14, which went into effect on March 17, 2021, only permit Medical Assistance if a person's natural death can be reasonably anticipated. Furthermore, the law requires written requests for MAID be signed and dated before an independent witness.

In 2021, however, Canada amended the MAID legislation to permit people with mental illnesses who meet all other eligibility criteria to receive MAID benefits. These changes allowed for greater flexibility in providing MAID to these individuals while still guaranteeing health care professionals adhere to appropriate procedural safeguards and reporting requirements.

According to CPSP's survey of physicians in Canada, only a minority are encountering minors with MAID questions and needs. Although most consultations are exploratory in nature, some physicians report having had conversations with these patients regarding their wishes and preferences for MAID coverage.

These findings indicate the need for further discussion and research to better comprehend how MAID can be employed to address health equity concerns. However, until then, we must remain cautious when expanding its practice while advocating for changes to the law.

Why is it a matter of ideology?

The term "maid" has a long-standing tradition of derogatorily labeling women who work as house cleaners. In some parts of the world, this profession was seen as an indication that they had little or no education.

A maid is a woman employed to perform domestic tasks such as laundry, cooking, cleaning and shopping. In some societies this occupation is full time while in others it's either part-time or temporary employment. In Canada however, maids are considered employees in households who take care of all household errands.

In contemporary Western society, a maid is typically an upper-middle class domestic worker. Families may employ one single maid or have many.

There is much debate over whether maids deserve the title "maid." Some feel it derogatory to refer to a woman who cleans homes as a "maid," while others contend that maids are legitimate forms of domestic labour and should be protected from discrimination.

The term maid, commonly used to refer to a house cleaner, carries with it cultural and historical connotations that make the position untenable. Historically speaking, maids were seen as inferior to the owners of homes they cleaned and their jobs viewed as low-wage and non-skilled.

One of the reasons this term has taken on such a negative connotation is because it originated during an era when class structures were strictly defined and lower social classes relied on maids to do all their housework for them.

Another reason this term has become an ideological battle is that taking away safeguards from MAiD in the name of autonomy makes it harder for those with disabilities to make decisions independently, since they might not possess the same level of knowledge, training, and resources as those without disabilities.

For years, the morality of permitting MAiD has been a contentious topic in public discourse (Borovoy 1994; Chambers 2014; Somerville 2014). Recently however, the discussion is shifting to whether people with mental illnesses should have the option to die peacefully in their homes at the end of their lives.

What is the problem with MAID?

Medical assistance in dying (MAiD) has become a contentious issue in Canada, as more countries around the world now allow it to those who are not terminally ill. It remains an emotive topic and continues to spark heated debate.

Some supporters of MAiD have therefore argued that it is an essential way for individuals to exercise their right to control the end of their lives. This idea rests on the idea that giving suffering patients the option of ending their lives will be therapeutic and give them the power to choose how they wish to pass away.

However, some have questioned if MAiD is truly an appropriate method of end-of-life care, especially for patients with mental illness. Furthermore, there has been speculation that MAiD may be a source of exploitation and harm to vulnerable populations such as Indigenous individuals.

MAiD poses two issues: It creates health inequities and deprives people of dignity and respect. This is especially true for those suffering from mental illness, who cannot access all necessary healthcare services to maintain a healthy lifestyle.

Last year, the federal government expanded the legal framework for MAiD by granting MAID status to those with mental illness as their sole underlying illness in 2021. However, this plan has caused controversy and led some to doubt its legitimacy.

MAiD expansion for mental illness has been condemned by those who believe it is an unwarranted effort to restrict patients' rights to self-determination and control over their life. Furthermore, critics fear the expansion will reduce funding for palliative care - essential in providing support to those facing serious illnesses and their loved ones.

Canadians share this concern. While one-in-three aren't worried about MAID replacing improvements to social service programs, more than half are worried that this will occur.

What is the solution?

The solution to MAID lies in being able to provide medically assisted dying (MAiD) compassionately, ethically and without harm. To accomplish this goal, robust safeguards must be put into place that guarantee all aspects of MAiD - including care, counselling and support for patients - are properly managed. Furthermore, legal precedent should be founded on science rather than ideology.

At present, in Canada only those of full age with an irreversible and life-limiting illness who are nearing the end of their journey are eligible for MAiD. Under this policy, physicians provide MAiD if the patient expresses an "informed and voluntary" wish to end their suffering.

Recently, the federal government introduced legislation that would postpone MAiD expansion for one year to give them more time to establish standards. Justice Minister David Lametti and Minister for Mental Health and Addictions Carolyn Bennett explained that this delay will give medical professionals time to adjust and conduct ongoing studies on potential risks associated with including MAiD to this group.

Many have expressed worry about the weak safeguards in Canada's MAiD framework and how they could be exploited by those who abuse it. Alan Nichols, a 61-year-old British Columbian who died this year after opting for MAiD, serves as an example of the potential hazards this approach entails.

The MAiD program in Canada has been condemned by a variety of individuals and groups, such as the Canadian Human Rights Commission, Canadian Medical Association and Canadian Nurses Association. They contend that it demonstrates an irresponsible attitude toward euthanasia which serves to further segregate those with disabilities or immunodeficiency from mainstream society.

MAiD is increasingly seen as an acceptable substitute for a life filled with suffering and pain. Unfortunately, it may erode the dignity of those living with disabilities and mental illness, leaving them vulnerable to abuse and neglect.

It is essential that the MAID legislation safeguards the rights of all vulnerable people, particularly those with mental illness or disability. This includes making sure those who request MAiD receive support and aren't subjected to discrimination or stigmatization for doing so.

Nino Niederreiter Deal - First Domino to Fall in a Busy Deadline for Nashville Predators General Manager Kevin Seveldayoff

On Saturday, the Nashville Predators traded 6-time 20 goal scorer Nino Niederreiter to the Winnipeg Jets. This move marks a key development ahead of what promises to be an intense deadline for general manager Kevin Seveldayoff.

Recently, the Jets have been struggling to score. This move will provide them with a top-six forward who can help boost their offense. He's an experienced playoff performer whose contract is team friendly at $4 million AAV.

1. Nashville Predators traded Nino Niederreiter to the Winnipeg Jets

The Nashville Predators made their first major trade of the 2023 NHL Trade Deadline by trading Nino Niederreiter to Winnipeg Jets for a 2024 second-round pick. This move is well executed, providing Nashville with an elite winger at an economical cost and giving Winnipeg Jets an exciting young defenseman as compensation.

The 30-year-old Swiss winger is in the first year of a two-year deal with the Predators and has recorded 28 points (18 goals, 10 assists) across 56 games. After this season he will become an unrestricted free agent after having scored 199 goals and amassed 396 points across 12 NHL seasons with teams such as New York Islanders, Minnesota Wild, Carolina Hurricanes and Nashville.

He possesses the potential to be a top-six player, but he also has some limitations. He's an aggressive forechecker but can also score goals from close range with ease.

Furthermore, he's an impressive crease crasher and his shot-blocking has greatly improved over the course of his career. His expected and actual goals against numbers have seen a marked improvement recently, so it's easy to envision him becoming an invaluable asset on any rebuilding team.

Elliotte Friedman of Sportsnet reports that the Jets have acquired a player capable of playing both wings, which is essential as they look to add some firepower up front. He can join either Pierre-Luc Dubois or Mark Scheifele and should help them find success.

Although not a huge acquisition, the fact that he's signed to an advantageous team-friendly contract at $4 million is significant - especially in today's league where teams often operate with relatively flat salary caps. Kevin Cheveldayoff should consider adding him as another asset in his arsenal.

Though it's an investment for the Jets, adding a winger like this shows Cheveldayoff has faith in his squad. While it won't solve all their problems this year, it should provide them with some additional scoring and depth in the top six.

2. Nashville Predators trade Nino Niederreiter to the Winnipeg Jets

On Saturday, the Nashville Predators traded Nino Niederreiter to the Winnipeg Jets. As part of the exchange, Winnipeg received a 2024 second-round pick and a 2019 second-round pick in exchange for the Swiss forward.

Niederreiter, 30, is a big-bodied winger who has scored 25 goals each of the past two seasons and earned himself a reputation for creating secondary offence at an impressive clip. Additionally, his shooting ranges from 130 shots this season to 1,555 overall in his career.

He's an ideal addition for teams needing more speed and physicality up front. A superb puck handler, he can play either wing but prefers playing on the right side where he brings some Stanley Cup playoff experience with him.

Former first-round pick Niederreiter has been on NHL rosters for seven years and played in each of the last two postseasons with Carolina. In 82 playoff games, he scored 15 goals and amassed 30 points - including an overtime winner against Colorado Avalanche in 2014.

With the Jets, Pierre-Luc Dubois and Mark Scheifele will form their top line of right wingers, providing more depth for head coach Marc-Andre Fleury on that wing. Additionally, his 3.33 power play points per 60 minutes over his career should give them a solid chance on the power play.

Following the loss of Patrick Kane to Los Angeles Kings and Timo Meier to San Jose Sharks, it was only natural for the Jets to make a move at the trade deadline. General manager Paul Cheveldayoff made an informed decision by selecting this route; his team needed an offensive boost and more depth beyond their top six players.

No, this trade isn't particularly significant, but it does move the Jets one step closer to their playoff goal with a healthy and talented core. Could that be enough?

After a slow start to the season, the Jets have managed to win 23 out of their last 23 games. Now six points out of the final Western Conference playoff spot with 28 games left, Cheveldayoff appears to have an effective strategy in place for the remainder of this campaign.

3. Nashville Predators trade Nino Niederreiter to the Winnipeg Jets

After a disappointing week, the Nashville Predators have traded Nino Niederreiter to the Winnipeg Jets in exchange for a 2024 second-round pick. It marks an important step ahead of what should be a busy deadline for the Predators, who sit seven points out of the final Western Conference playoff spot.

The Jets needed a reliable complementary scorer who could play the right wing, and they've found just that in Niederreiter. At 30 years old, he has 18 goals and 28 points in 56 games this season - impressive numbers for an offense that desperately needed help scoring.

His 1.16 goals-per-60 at five on five ranks second only to Filip Forsberg on the Predators and 39th leaguewide this season. Additionally, he can play on the power play - a skill set which the Jets desperately need.

He's an impressive shooter (130 shots this season, 1,556 career) and a formidable crease crasher. His soft hands and strength around the net make him a perfect fit for the Jets.

Winnipeg made a strategic trade to upgrade their middle six and add depth on the top line. Furthermore, this deal doesn't cost them much money since they acquire a second-round pick for Niederreiter from the New York Islanders in 2021 through trade.

Both parties seem to agree that this trade is beneficial, as Niederreiter is a reliable scorer who drives play metrics and has been under contract for another season at $4 million. While that amount may seem high for a rental player, the Jets are getting quality player at an acceptable cost in this deal.

He may not be the missing piece to make them a top-five team in the West or the top-line stud his underlying numbers suggest, but he's an excellent addition for the Jets. A big, physical forward who can score, he adds depth to their forward group after Timo Meier was traded earlier this year.

4. Nashville Predators trade Nino Niederreiter to the Winnipeg Jets

The Nashville Predators have traded forward Nino Niederreiter to the Winnipeg Jets in exchange for a 2024 second-round pick. This deal is beneficial to both sides and should prove profitable over time.

Nashville gains a talented winger with an impressive scoring record. Additionally, he is signed for another year on his contract.

In his one season in the NHL, Niederreiter scored 27 goals and accrued 53 points. To go along with those goals, he also had nine power-play assists.

These numbers make him a viable option to drive play on the second line. He may not be an elite scorer, but he is capable of creating chances and shooting the puck into the net.

He boasts an impressive shooting percentage, ranking second only to Filip Forsberg among Predators shooters at 1.16 goals-per-60 -- ranking him 39th leaguewide.

However, his power-play points per 60 minutes rank 276th out of 427 players with at least 200 minutes of PPP ice time over the past five seasons.

Recently, however, the Jets have had difficulty scoring goals, going 6-9 over their current 15-game skid. While still playoff-caliber, this lack of scoring has left them looking vulnerable.

Thankfully, the Jets possess plenty of draft picks and prospect capital to restock their team for another round of hockey. Furthermore, they could use their cap space to bolster their blue line.

Some Western Conference teams still have a chance at success, and the Jets are no exception. If they can regain some offensive production, it will give them an edge over their division rivals and give them hope of earning a wild card spot in 2019.

Niederreiter is an ideal addition to the team, as he will provide more secondary scoring and provide some physicality on their top nine. He should fit well on Morgan Barron and Adam Lowry's third line but could also replace Mason Appleton as their starting right winger.

Roxham: The Little Country Road That Turned Into a Big Political Headache

Roxham:

A small country road that crosses the Canada-United States border has become a source of political friction for Quebec's government in recent years as thousands of migrants crossed it. Now, politicians are demanding Ottawa close it permanently.

Last week, Quebec Premier Francois Legault sent a letter to Trudeau asking for the closure of Roxham. Additionally, he has asked other provinces for assistance.

Why Are People Leaving the U.S.?

People move to different countries for many reasons. Some are fleeing violence or danger, while others seek a better life. Still others join family or friends already living abroad for various reasons.

Though people may choose to leave their home country for many reasons, one common thread unites those who move abroad: they desire a better life. That means having more secure employment, greater opportunities, improved health care services, and lower living costs.

Attracting more foreigners to a country depends on several factors. Climate and geography are two of the most obvious, but economic policies that promote entrepreneurship can also play an important role.

States that offer higher wages and more job prospects tend to attract more foreign nationals, particularly if they provide affordable housing and educational opportunities.

The United States offers a wealth of attractions, from snow-capped mountains in the North to tropical beaches down south. Unfortunately, there are also challenges that may deter some people from moving here permanently or even temporarily.

Issues can range from an unfriendly environment or high crime rates, to more complex ones like political instability or gun violence.

That is why it is imperative for those contemplating relocation here to be well informed about their potential new residence. They should take the time to research the local economy, explore other cities and towns, and ensure their new house is secure and friendly before beginning a life in America.

Last year, an unprecedented number of American workers left their jobs - a trend which is expected to persist for years into the future. This phenomenon is commonly referred to as "The Great Resignation".

Men and women alike cite similar reasons for quitting a job, regardless of educational attainment: not enough flexibility in scheduling their hours (52% men, 38% women), wanting to relocate elsewhere (41% men and 30% women) or working too few hours (37% men, 24%).

What Is the Safe Third Country Agreement?

Roxham: A Small Country Road That Became a Political Button for Trump Administration

Many countries around the world have adopted the concept of "safe third countries." These places are considered secure enough to send refugees back without risking being sent back home. Such agreements often serve to ensure predictable distribution of responsibility for refugees and prevent what is known as "asylum shopping," in which individuals move between countries in hopes of being accepted as a refugee in each one.

Though these agreements were intended to reduce the number of asylum seekers sent back home, a recent report from the European Council on Refugees and Exiles (ECRE) indicates they have in fact increased this problem.

This has caused growing concern that these agreements are not actually aiding refugees but instead jeopardizing the principle of non-refoulement - that states must not return a refugee back into an environment where their life or freedom could be threatened. The UN High Commissioner for Refugees has expressed her concern that such policies pose a danger to vulnerable groups like disabled individuals, transgender people and single women fleeing sexual and gender-based violence.

The Canadian Federal Court's declaration of the US-Canada Safe Third Country Agreement invalid has brought these issues into focus and put them into a comparative perspective.

In conclusion, the Court held that the Safe Third Country Agreement is incompatible with Section 7 of the Charter of Rights and Freedoms (Section 15), since it relies on an interpretation of law by the government. This landmark ruling sets an important precedent that governments must always respect asylum seekers' human rights.

What Are the Legal Issues?

Roxham: A seemingly small country road that became a political headache for Canada in 2017. It quickly became an entry point for migrants from the United States to cross into Quebec from New York and seek asylum, despite violations of the Safe Third Country Agreement (STCA).

Under the STCA, migrants seeking asylum must cross an official border between two countries at an international port of entry (POE). While some migrants have attempted to circumvent official POEs by crossing Canadian land borders without authorization, these often involve hazardous and arduous journeys across remote regions or on Manitoba farmland that have resulted in fatalities or severe frostbite.

In 2017, an estimated 56,515 migrants sought asylum after crossing Canada's land border without going through official port-of-entry (POEs), including those using Roxham Road. Most of these claims were for refugee status but some also sought political asylum.

As more claimants crossed Canada's land border at Roxham Road, Quebec settlement services became overwhelmed and stretched to accommodate their increasing number of incoming migrants. Meanwhile, an expanding backlog at Canada's Immigration and Refugee Board (IRB) caused significant delays in processing refugee claims.

Some of these claims were made for political purposes, while most were motivated by persecution of gender or sexual orientation. Many of these narratives were purchased from story sellers or travel agents who specialized in obtaining and selling asylum narratives that could be presented at the Canada-US border.

Narratives often included Donald Trump's anti-migrant statements, the threat of family separation and an increasing asylum backlog in America. Furthermore, they often referenced Canada's Safe Third Country Agreement which requires migrants to present their asylum claim before being allowed entry.

This legal requirement has made it increasingly difficult for migrants to gain protection in Canada, as they cannot make a second refugee claim without obtaining a new visa and applying from the United States. As of August 2019, there were 79,000 cases pending at Canada's Immigration Review Board (IRB), with average wait times of two years.