Roger Foley is determined to live his life the best he can.

At 49, he can no longer walk. He was born with spinocerebellar ataxia, a genetic disorder that has progressed to the point where he needs help swallowing, washing and emptying his bowels. He is confined to a hospital room in London, Ontario. – where he has been offered medical assistance in dying (MAID) four times – because he cannot get the support he needs to live at home. Before his condition worsened, Foley was national director of electronic business at Dominion Securities and took care of his ailing father.

In 2020, Foley implored parliamentarians on the House of Commons Standing Committee on Justice and Human Rights to reject Bill C-7, the law that sought to extend MAID to people whose natural death was not reasonably foreseeable (Track 2 AMM).

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Bill C-7 received Royal Assent in 2021. Today, a coalition of Canadian disability groups who filed a Charter of Rights challenge to Track 2 MAiD is garnering international and domestic support. Opponents, however, argue that the lawsuit, filed in Ontario Superior Court in September, infringes on the constitutional rights of people with disabilities.

Dutch bioethicist Theo Boer, who previously served on a Dutch euthanasia review committee, supports challenging the charter. He sees similarities between the expansion of MAID in Canada and the Dutch experience, saying that “for an increasing number of people (in the Netherlands), euthanasia is becoming the default way of dying.”

Matthew Valliere, president of the New York-based Patients’ Rights Action Fund, which works to prevent the expansion of physician-assisted suicide for the terminally ill in the United States, agrees, calling the Canadian program Track 2 MAiD of “total disaster”.

But Dying with Dignity Canada, which is pushing for the expansion of MAID, expressed disappointment with the Charter challenge. The group says the law supports the autonomy of people with disabilities and launched its own legal challenge last August to lift restrictions on MAID for the mentally ill.

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Krista Carr is laser focused. As executive vice-president of Inclusion Canada, which advocates for the full inclusion of people with disabilities in society, she works with Indigenous Disability Canada/British Columbia Indigenous Network on Disability Society, the Council of Canadians with Disabilities and the Network of Disabled Women of Canada to repeal Bill C-7, whose activists fought hard to prevent its passage.

Inclusion Canada was an intervener in the Carter case, which led Parliament to pass MAID for terminally ill patients in 2016. Even then, Carr says, the group knew where things were going. But he couldn’t predict how quickly Canada would expand eligibility.

Two individual plaintiffs – only one of whom agreed to be identified – have joined the fight. In 2023, Kathrin Mentler, 40, struggling with suicidal tendencies, was shocked when a clinician at Vancouver General Hospital suggested she consider MAID as a treatment option.

Carr says she “can’t count” the number of similar stories she’s heard from people who suffer not from their disability but from the lack of support to live. When people with disabilities seek help to lead dignified lives and are then offered MAID – which is both cheap and available – their sense of worth plummets, Carr adds.

The coalition’s message is clear: prioritizing the autonomy of privileged Canadians who seek a controlled death over the safety of unprivileged disabled people is discrimination.

Since the lawsuit was announced, Carr says the coalition has been inundated with emails from Canadians happy that “someone is finally doing something” about Bill C-7. Some able-bodied Canadians say they can’t believe Canadian doctors have been legally killing non-dying patients since 2021. ‘We’re doing this?’ they ask incredulously, Carr says.

There is also some opposition. This comes from the fact that able-bodied people fear losing control in the face of a future disability, Carr explains. It reminds her of the hostility in Parliament when members of the disabled community, some in wheelchairs, gave evidence against the adoption of Track 2 MAiD: “The bias was so obvious,” she says.

“The bias was so obvious.”

Doctors and nurses are not immune to ability bias either, she adds. They may unconsciously lead disabled people to death by implying that their lives are not worth living.

Carr says that while Inclusion Canada and its partner organizations hear stories “every day” of people with disabilities being offered MAID instead of the health or social supports they need, she is frustrated that federal agencies are not do not collect this data. Track 2 represented 682 deaths in 2022. Without further updates, it is impossible to know who accepts MAID. Are they members of the queer community? People with disabilities who give up because they can’t get the support they need to live?

Recent reports from Ontario’s Office of the Chief Coroner reveal that vulnerable people, including some with untreated mental illness, have died thanks to Track 2 MAID. Of 116 deaths occurring in 2023, 40 for One hundred said they had been isolated in their lifetime, while almost 63 percent said they had been disabled. Women accounted for 61 percent of deaths, which occurred more often among people living in poorer neighborhoods.

Carr calls these “real people with real stories.” But when data gaps make it impossible to gather evidence, she says, these cases are dismissed as anecdotal and alarmist.

Stefanie Green, former president of the Canadian Association of MAID Assessors and Providers (CAMAP), declined an interview. So did CAMAP, which emailed a statement saying it “does not comment on legal challenges nor does it advocate for legislative changes related to MAID.”

The federal government invited Boer, a professor at the Protestant Theological University of Groningen, to Montreal as an expert witness during the 2019 investigation. Truchon v. Canada case in which the plaintiff, who suffered from cerebral palsy but had years to live, sued for the right to die. Boer says he is “very disappointed” that Quebec has deemed the “reasonably foreseeable natural death” clause contained in federal legislation on MAID to be unconstitutional. This decision led to the adoption of Bill C-7 18 months later.

In 2023, Boer wrote to British lawmakers warning them against passing euthanasia legislation in that country. He particularly cited the rapid expansion of Canadian MAID laws from 2016 to 2023.

Before resigning from the euthanasia review committee in 2014, Boer reviewed 4,000 euthanasia cases in the Netherlands. At first, he said, he felt reassured knowing that the Netherlands had struck the right balance between respecting autonomy and protecting human life. But as the number of euthanasia cases increased and doctors began to euthanizing people with decades to livehe became disillusioned. In 2014, 41 euthanasia deaths were caused by terminally ill patients with mental illness; in 2023, this number increased to 138.

It says 5.4 percent of deaths in the Netherlands were linked to euthanasia in 2023 and adds that this figure is set to increase this year. Boer is troubled by the fact that 80 percent of the Dutch population thinks this is normal, “just like the doctor gives a flu shot.”

Offering death to people with disabilities is like saying “people like you.” . . are beyond all hope. Not only do we sympathize with your death wish, but we will arrange your death for you.

Boer also describes the paradoxical but compelling vulnerability of the rich. Some Dutch citizens living in expensive areas of Amsterdam, where the euthanasia rate is 15 percent, choose death because they cannot face the emptiness of a life without a deceased spouse, without adult children occupied with their own life.

In the United States, medical assistance in dying for patients with a prognosis of six months or less to live is legal in 10 states as well as Washington, DC. Doctors prescribe an oral cocktail that eligible patients swallow.

“We don’t call it suicide” because these patients are dying, says Geoff Sugerman, national policy strategist for Death with Dignity. His organization defends the right of adults capable of choosing the terms of their death without state interference. But following the MAID route in Canada is a “big no”. Sugerman says this is not the U.S. way, and his organization has “never wavered” from this position.

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Roger Foley continues to campaign against AMM. On November 5, he made his third appearance on a YouTube podcast hosted by Canadian combat veteran and resilience coach Kelsi Sheren. He was lying on his hospital bed, dressed in his hospital gown, sometimes slurring his words.

“I’m doing everything I can,” he told listeners. “I’m not going to give up until my last breath.”