Every Death Is a Policy Choice

Is it just me, or is this federal election bumbling along as if more than 30,000 people haven’t died of COVID-19, toxic drugs and a historic heat wave in the last 18 months?

We know paying people to stay home when they’re sick saves lives. There is a mountain of evidence that providing regulated drugs to replace the criminalized supply stops drug poisoning deaths. And heat waves don’t have to be fatal if emergency management mobilizes to support the most marginalized, who are the most endangered by extreme heat. But over the years, governments have dragged their feet on solutions.

A couple of months ago, drug user activist and journalist Garth Mullins offered an interesting framework to understand the government’s response to increasing overdose deaths — Necropolitics. It’s a concept coined by philosopher Achille Mbembe to describe the political and economic calculations that make some lives disposable and others not.

Governments assign more value to some human lives than others, and that calculus determines the policies they implement (or don’t).

The pandemic made these calculations clear. The people who are dying of COVID-19 are overwhelmingly elderly, disabled, poor, people of colour and Indigenous people and racialized essential workers.

Their deaths are often tagged as “tragic” and “heartbreaking.” They’re talked about as if they’re inevitable — but they aren’t.

These deaths were the results of choices. Our federal parties and politicians need to make better ones.

Provincial leadership aside, federal powers under the Emergencies Act could have saved lives by keeping people home, or at least stopped wealthy Canadians who escaped to sandy beaches from bringing the virus home.

Ottawa could have limited mobility as people continued to travel within Canada and spread the virus, or declared minimum national rules for pandemic controls like masking, testing and isolating. But the prime minister refused.

This election, I’m watching for promises that recognize the power the federal government has to save lives.

That would include serious spending to ensure access to the social determinants of health that keep people safe and well long before there is a crisis — affordable housing, good employment, preventative health care, freedom from racism, queerphobia, sexism, ageism and ableism.

Both the NDP and the Greens want to expand public health care to include prescription drugs and more extended health services. The Conservatives also say they will spend more to support provinces with more mental health services and offer incentives for employers to provide mental health coverage.

Ten paid sick days for federally regulated workers — barely more than six per cent of the workforce — as the Liberals have proposed, will also help keep people well as COVID-19 continues to surge in Canada, particularly among the unvaccinated.

These are great first steps.

But health and mental health are financial and social issues too. We need to see commitments to end legislated poverty and systemic racism, and to build accountability at all levels of government. You can’t therapy your way out of oppression and discrimination.

Just like you can’t address drug policy deaths without naming the problem. It is clear from all the parties’ platforms that none understand the intricate reality of the toxic drug crisis when they’re still calling it an “opioid crisis.” Opioids aren’t the only poisoned drugs killing people, and bad drug policy is still much more to blame than the substances themselves.

Decriminalizing drugs would begin to undo the racist and colonial underpinnings of Canadian drug policy, destigmatize substance use and save lives.

But the Liberal government has failed to approve Vancouver’s relatively modest decriminalization proposal eight months after it was submitted.

Providing a safe supply of regulated alternatives to the street supply, which the Greens and NDP want to do, would save lives tonight, and every night afterwards, because people would know what they are taking and how much. Treatment, which all parties have committed to expand, is important for those who would like to begin recovery, but it cannot bring back the dead.

These are all paramount changes. And yes, none is a silver bullet (if you know of one, please let me know!). But the solutions are not as complicated as the last several years of federal handwringing would make you believe.

The next government, like every government, has a chance to save lives. Ignoring that opportunity could be even more fatal next time.

Additional readings reeled in from around the web.

Reimagining Elder Care: Long-term care was in shambles long before the pandemic, and parties are all posturing about how to fix it. But that it was in such a sorry state in the first place signals how Canada fails elders and family caregivers alike, and the ableism and ageism the system is rooted in. André Picard’s book Neglected No More is essential reading on how we can reimagine elder care in Canada, beyond long-term care.

Decolonizing the Medical System: Systemic racism is a key determinant of health for Indigenous people and other people of colour in Canada, from toxic drug deaths to surgical outcomes. There have been a number of recent solutions that have focused on reducing harm done by the colonial medical system. More important are policies that return economic and land resources to Indigenous peoples, making way for communities to exercise self-determination in health care guided by their values and provided by their own people.

Improving Data Management: Canada’s lack of comprehensive or transparent data collection or reporting has hampered public health efforts from the start, and may have unintentionally obscured thousands more pandemic deaths than previously reported, mostly among racialized and poor essential workers. If parties want to walk the walk, they need to invest in tools to help them see the path.

Stopping Overdose Deaths: Even the smallest of gains on overdose death prevention is at stake this election. Will Vancouver and Montreal’s tepid applications to decriminalize drugs survive the federal election? Will federal safe supply pilots continue? (Andrea Woo broke down the push for safe supply, federal barriers and who it could help in the Globe and Mail.) We know even touted treatment programs and alternative therapies are inaccessible and police people’s lives, so spending more on them won’t directly stop deaths.

Mobilizing for the Next Climate Catastrophe: Canada won’t have another decade to prepare for the next fatal heat wave as the effects of climate change make extreme weather events more frequent. Climate deaths are already here, and the other health effects will also be devastating. No matter what Ottawa chooses to do (or not) to prevent the most catastrophic effects of climate change, the consequences have always been life-or-death.