MAiD in Canada
His Majesty's Government has forgotten its duty to its people
In June 2016, while most Americans were preoccupied with a tumultuous presidential race, the Canadian Parliament quietly passed legislation legalizing Medical Assistance in Dying (MAiD), a policy that permits doctors to end the lives of consenting patients with certain medical conditions. Since its inception, MAiD has expanded to “serve” new categories of patients: as of 2021, the law no longer requires a person’s natural death to be “reasonably foreseeable” but includes chronic illnesses as well.1 After March 17, 2023, the law will even permit mentally ill patients with no physical ailments to apply for MAiD. More than 30,000 Canadians have already been killed through the program.2 It may seem merciful to allow the terminally ill to end their lives early, at least until one realizes that we are all, in some sense, terminally ill.
But allowing people with years to live to kill themselves—actively helping them to do so—crosses a line from misguided sympathy for their pain to blatant disregard for their lives. I do not know the pain of living with a condition that makes one eligible for MAiD. I do, however, know that medical science advances rapidly: yesterday’s “grievous and irremediable” condition, as described in the policy, could be treatable tomorrow.3 By accepting the wishes of those who choose death as the solution to chronic pain, the Canadian government demonstrates a pessimistic attitude towards medical advancement, not to mention a casual disregard for the value of life. I also know that the beauty of life remains despite its pain. Most people with qualifying conditions have no interest in such a program because they find that the joys of life are worth struggling for. I do not pretend that this is an easy position for everyone to hold. I can understand why someone suffering from a chronic illness would seek MAiD; nonetheless, it is incumbent on the rest of us to help them recover an appreciation for life.
It is difficult to shake the thought that MAiD arose as a convenient way to reduce healthcare costs in a single-payer system. Despite Prime Minister Trudeau’s insistence that no one would be driven to MAiD by a lack of “the supports and cares that [they] actually need,” this is precisely what is happening; stories abound of Canadians “driven to euthanasia by credit card debt, poor housing, and difficulties getting medical care.”4 Take Jacquie Holyoak, a 59-year-old resident of Ontario with fibromyalgia, who is considering MAiD largely because her condition prevents her from working and her disability benefits are insufficient: “I’m just sitting here wanting to live, but not knowing how.”5 Perhaps most disturbing are cases where people seek MAiD because of the burdens they feel they impose on others. Rosina Kamis, 41, had a myriad of physical health conditions. But despite her official insistence that her request for MAiD was due to her physical pain, she told friends that “I think if more people cared about me, I might be able to handle the suffering.” She later wrote, “I know I am hurting other people simply for having special needs.”6 Rosina was killed on September 26, 2021 by a doctor who presumably once swore an oath to “do no harm.” Progressive social policies, like the welfare state and single-payer healthcare system prized by many Canadians, were supposed to ensure people like Ms. Holyoak and Ms. Kamis wouldn’t fall between the cracks. Instead, the Canadian government found it more compassionate, and significantly cheaper, to pay doctors to kill the vulnerable.
MAiD is a gross indictment of any government that would permit it. It is a fundamental responsibility of any government to give its people a compelling vision of their future.
The Canadian government offers its people Progress—the idea that man can master all things. Of course, Canada’s utopian vision is often thwarted by reality. There are still conditions that cannot be treated, and even for those that can, the marvelously massive Canadian bureaucracy frequently proves incapable of providing care. Nevertheless, the Canadian government stubbornly clings to the ideology of Progress. Rather than admitting its mistake in allowing individuals to fall through the cracks, the Canadian government “empowers” these neglected patients to “die with dignity.” In reality, it is telling them that they have nothing to live for. MAiD demonstrates that the Canadian conception of man’s empowerment is empty, leading only to self-destruction. Many of the policymakers responsible for this program are likely genuine in their compassion, but no one whose compassion leads them to kill the vulnerable should be in a position of power. Health problems can be massively burdensome, but a government worthy of the name would help make such challenges bearable rather than encouraging its people to give up the fight.
Supporters of this system grasp at moral justification through the principle of consent. If man is free to live as he pleases, so the argument goes, he must also be free to die as he pleases. But consent is only meaningful when exercised by someone capable of assessing the consequences of his choices. Until now, Canada’s MAiD system has attempted to ensure informed consent: victims of MAiD are required to “make a voluntary request… that is not the result of outside pressure or influence” and demonstrate that they understand the nature of their illness and the treatment options available to them.7 When mental health disorders become sufficient justification for MAiD, though, this will change. While patient consent will nominally remain mandatory, it is far from clear that a person with a mental illness that weakens his grasp on reality is capable of understanding and thereby consenting to anything, let alone his own death. Canada’s track record, however, leaves little doubt that many such people will be euthanized. It is impossible to see this as anything but murder.
Until now, it has been almost universally held that the proper response to someone experiencing suicidal tendencies is to stop them from killing themselves and to resolve the root causes of those tendencies. Suicide was taken as the definitional case of acting against one’s own best interests; truly self-destructive actions were never seen as legitimated by consent. This most directly applies to those seeking MAiD because of mental illness, but it applies equally to those seeking it due to physical conditions. Governments have a duty to protect the freedoms of their citizens and healthcare providers have a responsibility to obey the decisions made by patients about their own care. But both are also called to act in the best interest of the people in their charge. These duties can be difficult to reconcile; it is hard to know when to limit someone’s agency.
In the case of attempted suicide, however, the answer is clear: an attempt at suicide is ipso facto proof that someone is incapable of taking care of himself.
In the absence of real government, Canadians must come together to reignite their passion for life—or at least convince their doctors not to kill them.
If you or a loved one is at risk of suicide, please call or text the United States’ National Suicide and Crisis Lifeline at 988. Help is always available.
MARCUS PORCIUS CATO
A version of this article originally appeared in Heal Thyself, the February 2023 print issue of the Salient.
“Canada’s Medical Assistance in Dying (MAiD) Law,” Government of Canada, Feb. 2, 2023.
Michel Martin, “Canada is Expanding Categories for Medically Assisted Death,” NPR, Dec. 11, 2022.
“Medical Assistance in Dying,” Government of Canada, Dec. 15, 2022.
Alexander Raikin, “No Other Options,” The New Atlantis, Dec. 16, 2022.
Padraig Morgan, “This Woman is Considering Medical Assistance in Dying, Due to a Disability. But Poverty is also a Factor,” CBC, Dec. 16, 2022.
Alexander Raikin, “No Other Options,” The New Atlantis, Dec. 16, 2022.
“Medical Assistance in Dying,” Government of Canada, Dec. 15, 2022.