Why Choice is an Illusion?

Wednesday, January 17, 2024

This Is Where the Right to Die Leads Us

By Alex Schadenberg*

Spiked published an in-depth article by Lauren Smith on January 15, 2024 titled: "Canada has revealed the horror of assisted dying." Smith tells the stories of the many people who have felt forced into  considering death by euthanasia.

Smith sets the stage for her article by calling Canada's euthanasia law a gruesome, state-sanctioned industry. Smith states:

There is nothing remotely civilized about Canada’s medical assistance in dying (MAID) programme. Assisted dying in Canada was initially considered a last resort for terminally ill patients suffering from incurable pain. But in the space of just a few years, euthanasia has been made available to pretty much anyone who is struggling with an illness or a disability. Even Canadians facing homelessness and poverty are feeling compelled to end their lives, rather than ‘burden’ the authorities.

Canada's euthanasia law will get worse with the approval of euthanasia for mental illness in March 2024. Smith explains:

Things are about to get even darker. In a few months time, on 17 March, Canadians will be able to apply for MAID on the grounds that they are suffering from a mental illness. If this expansion to the MAID programme goes ahead, anyone struggling with a serious mental-health condition may be eligible for either assisted suicide or euthanasia, even if they are not suffering from any physical pain at all. This would include people dealing with drug addiction or other substance-abuse issues.

Canada's euthanasia law has expanded very quickly. Smith explains how this happened:

At the time, MAID was sold to Canadians as a question of autonomy. The ‘right to die’ was presented as a fundamental human right. In 2015, the Canadian Supreme Court, in the case of Carter v Canada, ruled that denying someone assisted suicide or euthanasia denied ‘equality to the physically disabled’. Essentially, this ruling established that people have the right to be assisted to kill themselves, or be euthanized, provided that they meet certain criteria.

All of this successfully framed assisted dying as a merciful and dignified act. It isn’t fair, advocates said, that someone should be in pain during the final stages of their life, if death is near and foreseeable anyway. Surely it would be better for someone to end their life on their own terms than for them to suffer on in agony for a few months more? Or so went the argument.

Smith then explains the influence of the euthanasia lobby:

Campaign groups like Dying With Dignity fought hard to portray MAID as a question of individual choice. The Canadian public seemed broadly to agree. In 2014, not long before MAID was introduced, 79 per cent of Canadians supported assisted suicide being offered in limited circumstances. Back then, Canadians were told assisted suicide and euthanasia would only be offered to those with a terminal illness and with only a short time left to live. But it didn’t take long for those restrictions to loosen.

In 2021, five years after MAID was first introduced, Canada expanded the eligibility criteria. Those with serious and chronic physical conditions became eligible, even when their illness is not life-threatening. This meant that a natural death no longer had to be ‘reasonably foreseeable’ for someone to be accepted for MAID. A long-term health condition that made life ‘intolerable’ was now enough. Applying for the MAID programme became significantly easier.

After the expansion of euthanasia in 2021 Canadians began to read about stories of euthanasia for poverty, homelessness, disability and an inability to receive medical treatment and even veterans with PTSD. Smith writes:

It didn’t take long for people to start applying for MAID for reasons that had little to do with poor health. One of the most infamous cases was that of Amir Farsoud, a 54-year-old disabled man who applied for MAID in 2022 because he was about to be made homeless. Farsoud was quite open about the fact that he didn’t actually want to die. He simply didn’t know what else to do. He felt that he was being abandoned by the authorities. He decided that he would rather be dead than homeless.

Homelessness, or fear of it, is not one of the reasons Canadians can apply for MAID. Not yet, at least. Farsoud applied on the basis of his chronic back pain. He got as far as receiving one of the two doctors’ signatures required to proceed. Thankfully, after a public outpouring of support and a wave of donations, he decided that he didn’t want to go through with it.

Others weren’t so lucky. In February 2022, a 51-year-old woman called Sophia (not her real name) was euthanised by doctors. She suffered from an extreme sensitivity to household chemicals and cigarette smoke, which made life unbearable for her. Because of her complex needs, the local authorities found it difficult to house her. After two years of asking for help with her living situation, all to no avail, Sophia decided that MAID was the only solution left. Four doctors wrote to federal-government officials on Sophia’s behalf, begging them to help her find alternative accommodation. But their pleas fell on deaf ears. She was killed instead.

In a similar case, 61-year-old Donna Duncan was euthanised in 2022, after she was deprived of the treatment she so desperately needed. A car accident caused her to have a particularly bad concussion. This led to months of mental and physical decline. She was never seen by her local clinic for complex chronic diseases, thanks to its months-long waiting list. But when she applied for MAID she was approved within a few days. Her daughters maintain that she did not have the capacity to consent to being euthanised.

Stories like these are shockingly common. For many unwell Canadians, accessing MAID is easier and cheaper than getting the treatment or care they need. More and more people are applying for MAID because they cannot afford to go on living, or their families cannot afford to support them. In 2021, 35.7 per cent of MAID patients said that they believed themselves to be a ‘burden on family, friends or caregivers’. These are not medical concerns, but rather economic and social ones. In the words of one anonymous disabled woman: ‘MAID, for me, is not a life-and-death choice. It’s about what kind of death I want when I run out of money.’

The Canadian authorities are all but promoting death as a cheaper, easier alternative to life’s struggles. Far from being a last resort for those with incurable health issues, MAID is all too often viewed by officials as the first port of call. In one disturbing example, an army veteran called up Veterans Affairs Canada in 2022, seeking treatment for post-traumatic stress disorder and a brain injury. He was offered MAID instead. In another disturbing case, Christine Gauthier, a Paralympian and veteran, asked the authorities if she could have a stairlift installed in her home. She received a letter asking if she had ever considered euthanasia.

Smith then reports on the push-back by disability rights groups wanting to protect their lives.

Thanks to cases like these, disability-rights campaigners have become some of the fiercest opponents of Canada’s euthanasia laws. In January last year, more than 50 organisations warned that MAID poses an existential threat to disabled people, devaluing their lives and providing the state with an excuse to forgo its responsibilities to vulnerable citizens. These groups rightly argue that Canada should be improving its healthcare services for disabled people and helping them to live decent lives, rather than offering them assisted dying as a ‘solution.’

The same applies to terminally ill patients, too.  The priority should surely be ensuring the best quality end-of-life care, rather than ending people’s lives sooner than is necessary. Indeed, it is the absence of decent palliative care that is driving so many terminally ill patients to seek euthanasia in the first place.

The concerns about the expansion of euthanasia to people with mental illness is real. Smith writes:

With the MAID programme set to expand to the mentally unwell in only a few months’ time, we will undoubtedly see a new wave of shocking cases. Already, people who have been suffering from mental illnesses are preparing to apply. One woman, 47-year-old Lisa Pauli, plans to apply for MAID as soon as the law changes, on account of her debilitating anorexia. She has ‘tried everything’, she told Reuters recently, and is now ‘too tired’ to go on.

Forty-year-old Mitchell Tremblay said in 2022 that he also planned to seek out MAID services once the law changes. He has been diagnosed with ‘anxiety, alcoholism, personality disorders and continual thoughts of suicide’. He cannot work and receives a meagre monthly disability payment. ‘You know what your life is worth to you’, he says, ‘and mine is worthless’.

One mentally ill woman admitted to CTV News that she is terrified of the expansion. She is worried that she will seek out MAID when she next has suicidal thoughts. Her fears are not unfounded. Instead of talking suicidal people out of killing themselves, the Canadian authorities increasingly offer them a chance to die.

Originally the Canadian government planned to implement euthanasia for mental illness in March 2023 but it has been delayed until March 17, 2024. Further to that, the Hon Ed Fast sponsored Bill C-314 in parliament to overturn the decision to permit euthanasia for mental illness. C-314 didn't pass but it did get significant support in parliament. Smith comments on the expansion of euthanasia in Canada:

Unfortunately, tragedies will continue to occur so long as deathcare remains more accessible than healthcare. In 2022, MAID was responsible for over four per cent of all deaths in Canada. That was up from 3.3 per cent in 2021 and 2.5 per cent in 2020. In Quebec, a shocking 6.6 per cent of all deaths in 2022 were attributable to the MAID programme.

As if all this were not horrifying enough, there remains a vocal minority – among them high-profile physicians and healthcare professionals – that is advocating to expand MAID criteria even further, well beyond the mentally ill. Children born with severe disabilities and elderly people who are ‘tired of being alive’ have recently been put forward as potential candidates for legalised euthanasia.

Smith ends her article by stating:

All of this is well beyond the bounds of what Canadians were originally told MAID would entail. But stories of homeless, poor, disabled and desperate people accessing a state-assisted death, because it is the ‘easier’ option, are merely the grim, logical consequence of legalising assisted dying in the first place. Assisted dying undermines the value of life. It elevates death as the ultimate solution to suffering. Canada is a warning to the world. This is where the ‘right to die’ leads us.

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*  Executive Director, Euthanasia Prevention Coalition