'FUNDAMENTALLY FLAWED ETHICS': Professors who created MAiD training curriculum criticize it

The curriculum used to train doctors and nurses practicing MAiD is being criticized by former members who created it for its lack of moral standards when assessing patients whose main form of suffering is their social vulnerabilities. The curriculum, developed by the Canadian Association of MAID Assessors and Providers (CAMAP), was criticized by three different members, most recently by Catherine Frazee, a professor in Disability Studies at Toronto Metropolitan University.Frazee wrote an article, expressing her disapproval of the curriculum as it stands in assessing Track 2 MAiD cases, in patients whose deaths are not reasonably foreseeable. Frazee's qualm lies with the curriculum's views of people with debilitating illnesses and/or those in poverty, which she says "reconfigur[ing] death as a remedy for lives deemed intolerable."."Practitioners were trained to verify cognitive capacity and document voluntariness, but not to examine how suffering might have been rooted in abandonment, systemic inequality, or internalized oppression," Frazee wrote.CAMAP's curriculum is funded by Health Canada and is the only nationally accredited curriculum for healthcare workers administering MAiD, although practitioners are not required to take it to provide MAiD.As Frazee points out, the curriculum presumes disabled people's lives "are not just hard — but unlivable."She says many patients who die from Track 2 MAiD could have lived if their suffering had been viewed for what it really was, "a response to marginalization, exclusion, and despair — not to their impairments.".Citing cases that exemplify her point, she tells the story of a homeless 19-year-old man with cerebral palsy who died by MAiD while hiding from his abusive family.She calls his MAiD assessment "ethically blinkered" while the young man's assessor labeled his state as "level-headed and articulate," with his disability meeting the legal requirement for an "irremediable condition.""Under this narrow frame, there was no obligation to question the material deprivations or psychosocial trauma driving his despair," Frazee highlighted.In another case, as Frazee tells it, a young man with an unidentified disability was killed by MAiD after expressing despair at the prospect of never having a romantic relationship or a loving family..His mother supported his decision due to her resentment over being left without support to raise a disabled child. In an interview with Frazee, Canadian Affairs reports she reaffirmed her concern about how individuals are approved for MAiD. “It was that lack of hesitation or doubt that really troubled me,” she stated about the cases.In a fictitious case used as an example in the CAMAP curriculum, a mother of young children became paralyzed due to a spinal cord injury. .The woman had wanted MAiD because she didn't want someone to help her use the bathroom. The working group said the woman's distress over needing help from others was a personal value and should not be questioned, recalled Frazee. Another professor, Dr. Madeline Li, a psychiatry professor at the University of Toronto, also resigned in September 2023 from the group, which she chaired.“We went into that [curriculum process] really well-meaning,” stated Li..“We really thought that we were going to — or at least I really thought that we were going to — develop a curriculum that would safeguard the practice.” Although Li supports MAiD, she has expressed concerns regarding how it's administered to those who are not at the end of their lives.Li also notes why the curriculum might view Track 2 MAiD in this light — the prioritization of individual autonomy over everything else.She says this is why some doctors who practice MAiD get "defensive" about any critiques of MAiD. .Li provides an insider's perspective, stating many of the members' views were in the "messy middle," where MAiD should be "done well" when it is best for patients, while still showing concern for those who are receiving MAiD because of "social vulnerabilities."Another member, Dr. Timothy Christie, professor of bioethics at Dalhousie University, resigned from the group in January 2025.Christie claims he told CAMAP he could not endorse the final product of the curriculum, his objections were not noted, and he was told to resign.His concerns encompassed social vulnerabilities such as homelessness, and how these social conditions could influence a patient's decision to request MAiD. .“The reasons the person is asking to be euthanized are very relevant,” Christie recalled. “This committee would say that if a person is autonomous, their reasons don’t matter.”Christie says he does not oppose MAiD in all cases.However, in others he says just because it's legal does not mean it's ethical.“When the suffering is because of social injustice, we shouldn’t be using euthanasia to solve social injustice,” he stated..He also says the MAiD curriculum is “based on some fundamentally flawed ethics.”“We deeply value the input that was given by people who chose not to have their names associated with the final product, but the overall content of the [MAID curriculum] is richer as a result of their important contributions,” said CAMAP in a statement to Canadian Affairs.The organization also stated CAMAP cannot regulate who practices MAiD.“While it is not mandatory, the curriculum is a nationally recognized educational resource that helps clinicians build the competencies required to provide MAiD safely, ethically, and in alignment with current legal and clinical standards.".Frazee says from her experience, the feds have put too much trust in medical professionals to oversee MAiD. “The law has produced a regime where vulnerable people are dying prematurely and tragically for reasons that have nothing to do, or little to do, with their medical condition, and that isn’t what the [Supreme Court] intended [when it struck down prohibitions on MAID],” she stated. “No one is taking responsibility for it.”

'FUNDAMENTALLY FLAWED ETHICS': Professors who created MAiD training curriculum criticize it

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