Wealth Meets Health: Disabled Immigrants and Calculations of ‘Excessive Demand'

Document Type

Book Chapter

Publication Date



Immigration, Disability, Hilewitz


The Supreme Court of Canada has issued a number of high-profile health law decisions—Latimer, Rodriguez, and Morgentaler, and the most recent, Chaoulli. Health law has become of great interest to the public and a dynamic, relevant, and important site of jurisprudential activity. This book brings consideration of all of the major Supreme Court of Canada health law cases together in one place and in a coordinated fashion for the first time. In each chapter, the authors describe the relevant Supreme Court of Canada cases and explore the implications of the cases for their specific topic. Where relevant, the authors reflect on the following cross-cutting themes: the values of autonomy, dignity, liberty, equality, justice, privacy, and life; and the concepts of identity, personhood, community, property, embodiment, health, vulnerability, disability, and oppression. It is important for students, practitioners, policy-makers, academics, and judges to understand the ways in which such values and concepts play out in different ways in different contexts within the health sphere. This book demonstrates the sweep of issues addressed by the Court and encourages reflection upon the role of the Court in shaping, both directly and indirectly, health care delivery and health policy in Canada. The authors have endeavoured to provide careful and critical evaluation of this role. Health Law at the Supreme Court of Canada is designed to contribute to the development of jurisprudence and legislation in the area of health law, policy, and practice. Canada has a long history of singling out persons with mental and physical disabilities as undesirable immigrants, which is to say, undesirable members of Canadian society. Late nineteenth century legislation dictated that such individuals would not be permitted to disembark from the boat upon arrival in Canada, unless a bond was posted on their behalf. At best, these turn of the century policies essentialized disability as a source of social and economic burdens, and dependency. At worst, they were a eugenics-inspired head-tax. Such a conceptualization of disability and disabled persons has been, at least in principle, rejected by the Supreme Court and Parliament for Canadian citizens. However, disabled non-citizens appear to have been let behind. Our current immigration legislation, as interpreted by the Supreme Court in Hilewitz, continues to resonate with our nineteenth century legislation in its focus upon disabled individuals as an “object of expenditure,” as deficits in a fiscal calculation about whether it is worthwhile to let this individual and their family in.