Since it first became legal in Canada in June 2016, 10 federal prisoners have been granted a medically-assisted death (MAID), according to the Correctional Service of Canada.
The Correctional Service of Canada (CSC) also says that as of Aug. 31 this year, a total of 32 prisoners have requested MAID. The numbers rose slightly from May 31, 2023, when the number of requests totalled 29. At that time, nine people were deemed eligible, and granted a medically-assisted death.
The CSC declined to provide a further breakdown of the numbers, citing privacy reasons.
But the procedures and practices of accessing MAID in Canada’s prisons is a cause for concern among advocates and experts alike.
Kim Beaudin is the National Vice-Chief of the Aboriginal Peoples Congress and has been advocating on behalf of Indigenous peoples in the justice system for two decades. He has concerns about the justice system as a whole and the disproportion representation and impact on Indigenous peoples.
Beaudin says he’s recently connected with an Indigenous prisoner who is struggling with stage four cancer.
“They will not let him go home,” Beaudin told Global News. “He does not want to die in a prison, he says, but they won’t let him go home. He’s never heard of the MAID program, but now he has. But he hadn’t before and he really said ‘I don’t want to die in here with that.'”
It’s something Tania Ross knows well. She spent 20 years in prison and said some of her friends never made it out, even if they weren’t assigned a life sentence.
She recalls one friend “in the really, really late stages of her illness in prison, and she didn’t get to go home and pass away in front of all her friends and her family. And she wasn’t a lifer, like she had a release date,” Ross told Global News, talking about a friend.
Ross says that friend was denied a compassionate release and then applied for medically-assisted death. She was denied that as well.
“That was hard, that was really hard. To see her suffer… she just wasn’t there anymore. She couldn’t do anything by herself anymore. She couldn’t go to the bathroom, she couldn’t eat. She was immobile, in a bed,” Ross said.
“She died in prison. Alone without her family. And she was a human being… I think if that was my mom or my sister, I would want them to pass away peacefully, with family beside them.”
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A scenario that is likely all too common, according to Jessica Shaw, an associate professor in the Faculty of Social Work at the University of Calgary.
Shaw was researching MAID in Canada before it was legal, focusing mainly on how it impacts the country’s most vulnerable population, including those who are incarcerated.
Her research involved studying and interviewing nine prisoners serving life sentences, and speaking to them about end-of-life care.
“There was a lot of fear around being prevented from accessing MAID. There were fears in the prison that if someone was to bring it up, they would be deemed suicidal. Potentially put in solitary confinement, which was a place no one wanted to go,” Shaw told Global News.
Shaw said she also heard concerns about being denied parole by exception, also known as compassionate release. She says many have applied for parole by exception, but most are denied, including prisoners who are in end-of-life stages.
“One of the men I was spoke with, talked about a friend that he was supporting who had developed dementia and said he doesn’t even understand why he’s incarcerated. What is the point of keeping him in prison if he doesn’t know why he’s here?” Shaw said.
“And some of the other folks I interviewed who are quite ill, physically would be incapable of committing a crime when they’re released. So, what is the point of keeping them incarcerated?”
Concerns about voluntariness was also something Shaw heard, with some prisoners expressing a desire to receive MAID as an alternative to serving a life sentence.
“We know that’s not legal in Canada, but the fact that some prisoners are talking about that warrants us to pay attention to that,” Shaw said.
“Especially when MAID for people who (have) mental disorders as the sole underlying medical condition becomes legal, we’re going to have to be very careful about how we distinguish a severe mental disorder that’s preexisting – and most people who are incarcerated in Canada do have some sort of mental disorder – from prison weariness and a desire to not have to do a life sentence and suffering that’s caused by incarceration and attending to how we differentiate between the two. And how we feel as a culture and a society that people are going through such psychological suffering that they would rather die than serve their sentence.”
In a statement to Global News, the CSS said prisoner eligibility requirements for MAID follow the legislative requirements that apply to all Canadians.
“Once an individual makes such a request, a physician or nurse practitioner will meet with them to discuss relevant information, offer referrals to support services (such as mental health professionals, Chaplains, Elders, etc.), and schedule the individual for an eligibility assessment,” the statement read.
“It should be noted that CSC’s guidelines require that an external Physician or Nurse Practitioner perform the second eligibility assessment, and that the procedure be completed externally to CSC, namely, in a community hospital or health-care facility, other than in exceptional circumstances.”
Shaw said one of her concerns, is if a prisoner applies for MAID and is denied on the first application, they are unable to get a second assessment, something that is granted to other Canadian citizens.
“Canada, out of all the jurisdictions in the world that have legal assisted dying, we’re the only country that has specific guidelines about how its implemented in prisons. And in Canada, the guidelines don’t actually align with federal policy in a couple of areas,” she explained.
“And one of them is around having the opportunity for a second medical assessment. So the rest of Canada, if you meet with someone and are not eligible for MAID you can seek a second opinion. That doesn’t happen if you’re in prison. If you’re shutdown, that’s the end of it.”
Shaw said she would like to see better data collection surrounding MAID in Canada’s prisons, and a review of how exception by parole is used.
“(It) brings in more of a philosophical question about – What is the nature of prisons in Canada? Is it to punish? And if it’s purely about punishment then it makes sense that if someone is sick and dying we want them to suffer more,” Shaw said.
“That’s not what I believe. I think we talk about our prisons being rehabilitative, and if that’s the case, we should have more compassion towards people, especially at end of life.”
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