Contents | Introduction | Concerns | Responses to Discussion Paper Questions | Bibliography
INTRODUCTION

The Manitoba League of Persons with Disabilities (MLPD or the League) is pleased that the Manitoba Law Reform Commission is examining this contentious issue and that we have an opportunity to participate. It is clear that Manitoba law on withholding and withdrawing life sustaining treatment must be reformed.

Who and What is MLPD?

As Manitoba’s membership based, cross-disability advocacy organization of women and men with disabilities, the MLPD works to remove barriers to the full, equal participation of people with disabilities in Manitoba society. Through its membership in the Council of Canadians with Disabilities (CCD) it is connected to Disabled Peoples International which gives the League a global context.

The MLPD has a lengthy, intense history of involvement with the subject of withholding and withdrawing medical treatment. In 1998 the League intervened in the Sawatzky v. Riverview Health Centre court case representing the rights of persons with disabilities in the application and removal of Do-Not-Resuscitate orders. In 2000 the MLPD produced a report researched by Rhonda Wiebe called Our Last Rights: Do Not Resuscitate Orders and People with Disabilities with a supplement by Sherri Walsh to which the Commission’s Discussion Paper “Withholding and Withdrawing of Life Sustaining Treatment” referred. That MLPD report and the general policy work of the MLPD, as part of the Canadian disability rights movement, have led the MLPD to the conclusion that it cannot support euthanasia, eugenics-style reasoning or any end-of-life policies or practices that can potentially harm people with disabilities.

MLPD policies are based on the following principles developed through national democratic forums:

Access - People with disabilities have a right to access places, events, services and activities that are generally available to citizens.

Equality - People with disabilities have the right to goods and services that give them equality of opportunity and outcome.

Citizenship - People with disabilities have the same rights and responsibilities as other citizens, with the same entitlement to equal protection and benefit of the law.

Integration - People with disabilities have the right to participate fully in the institutions of civil society (i.e. educational, employment, recreational, spiritual, health, commercial, cultural). People with disabilities have the right to services and programs that support inclusion in the general systems of society, rather than segregation in ghettoized environments such as sheltered workshops and residential facilities.

Inclusion - Society must consciously work to meet the needs of Canadians with disabilities, so that they have meaningful participation in their communities. For example, when cities adopt policies endorsing universal design they make a commitment to ensuring that the constructed environment meets the needs of all citizens in a non-stigmatizing manner.

Empowerment - This is the process by which people with disabilities replace common stereotypes about disability with a world view where:

- people with disabilities define themselves as consumers

- barriers are defined as the result of an environment which does not conform to universal design specifications

- disability problems are defined, not as deficiencies of individuals, but rather as barriers to be eradicated and

- solutions to problems, derived from the unique, invaluable and experience-based expertise of people with disabilities, flow beyond individuals with disabilities to benefit each other and society as a whole.

Self-representation - People with disabilities speak for themselves through their own organizations which are democratically constituted and therefore have the legitimacy to speak out to government and elsewhere about necessary public policy initiatives. Self-representation is the foundation of the MLPD’s method of operation and its legitimacy.

Self-determination - Like other citizens, individuals with disabilities have the right to make decisions and take risks, including challenges that may jeopardize their own well-being.

Self-management - Individuals with disabilities direct their own independent living service systems and are responsible for recruiting, training, supervising and paying their own service providers. Self-management is one of many ways to achieve self-determination.

Consumer Model - This is the theoretical concept which 1. at the political level says that people with disabilities control the decision-making structures in their own organizations and 2. at the personal level, says that individuals with disabilities make their own choices about their lifestyle, the services they use and the risks they assume.

Independent Living - This is a practical model of service delivery, developed by people with disabilities in response to the medical/rehabilitation model. It directs solutions at social, economic and attitudinal barriers, not at perceived deficiencies of individuals. This model also defines a set of services, such as peer support, individual advocacy, information, referral, research and service development, which are delivered through organizations staffed by people with disabilities. Operating on this model, Winnipeg’s Independent Living Resource Centre helped a number of disabled people develop a self-management system of home care.

Because these principles simply extend Canadian citizenship rights to disabled citizens, the MLPD recommends them to the Law Reform Commission and the Government of Manitoba for the work on DNR policies in Manitoba.

Note: For the purposes of this response, we will be using the word “patient” to refer to both disabled and other people in need of medical intervention. In doing so we are not deviating from our consumer philosophy. It simply distinguishes between doctor and patient more easily. We also do not want to create the misconception that we wish to become direct purchasers of medical care as the word “consumer” might imply to some. We want only to be treated respectfully as human beings and be given equal access to health care. We want available resources to be distributed without negative bias.


Contents | Introduction | Concerns | Responses to Discussion Paper Questions | Bibliography