Policy Objectives: 1) stop the institutionalization of death; 2) replace MAiD regime with palliative care and support
Policy Action Items: 1) repeal current MAiD regime in Criminal Code and re-instate prohibition against assisted suicide to protect the vulnerable; 2) apply s. 33 of the Charter to overturn the Carter decision; 3) provide funding under the Canada Health Act for expanded palliative care; 4) support and encourage health care professions education that recognizes that the goal of the health care professions is to first and foremost do no harm which is recognized by preserving and protecting human life, relieving suffering and promoting healing
The UK’s Daily Mail reported on 13 August 2023 that Quebec’s La Commission sur les soins de fin de vie/Commission on End-of-life Care has “put the brakes” on Medical Assistance in Dying (MAiD) by suggesting that physicians remain within the law on MAiD. The request was made in the wake of a 55% rise in euthanasia cases between 2021 and 2022 (3,102 cases in 2021 to 4,810 in 2022). According to the Daily Mail, “Canada is on track to record some 13,500 state-sanctioned suicides in 2022, a 34 percent rise on the previous year”. Similar stories also appeared in the CBC and National Review.
The reaction from the pro-death lobby to the Commission’s “reminder to stay within the law and guidelines” has been predictable. The president of the Quebec Association for the Right to Die in Dignity, Georges L’Espérance, a neurosurgeon, is reported by the CBC to have been critical of the reminder believing that the Commission’s advisory could stigmatize the procedure or even dissuade some doctors from providing it. L’Espérance ‘s expressed concern that “…many doctors will be intimidated by that kind of memo…They will say that they don’t want to [administer] any MAID because they have fear.”
MAiD No Longer the “Last Resort”
The Quebec Commission’s story provides a timely and disturbing reminder of the inherent dangers of legitimizing state-sanction assisted suicide. Instead of allowing assisted suicide as a last resort in specific cases, i.e., for adults who have a serious and incurable illness being in an advanced state of irreversible decline and experiencing constant and unbearable physical or psychological suffering which cannot be relieved in a manner the patient deems tolerable, we are allowing MAID to become a normal “treatment” option that is anything but a “last resort”.
Alarming Increase in MAiD Numbers
Health Canada’s own statistics confirm an alarming trend. According to its most recent annual MAiD report from July 2022, MAiD accounted for 10,064 deaths or 3.3% compared to the overall average of deaths in Canada in 2021, with Quebec having the highest number of MAiD deaths in the country at 3,281 deaths, followed by Ontario with 3,102, and British Columbia having the third hightest number of MAiD deaths at 2,030.
Health Canada confirmed that the number of cases of MAiD in 2021 represents a growth rate of 32.4% over 2020 with all provinces continuing to experience a steady year over year growth.
These numbers continue to rise. In 2022, according to the Institut de la statistique du Québec, MAiD represented 6.1% of deaths—for 2023, Quebec’s MAiD death count is expected to reach 7%, twice the number for Ontario, and 4.5 times Switzerland’s rate! In B.C., the B.C. Ministry of Health reported that MAiD deaths accounted for 5.5% of deaths in 2022— as of June 30, 2023 MAiD deaths represented 6.2% of B.C. deaths.
To put the numbers into perspective, according to CDC and FBI statistical bases, in the United States, in 2021 the total firearms mortality rate (including homicides and suicides but excluding justifiable homicides) was 14.13 per 100,000 people. In 2021, Canada’s MAiD total was 10,500, for a rate of 27.5 per 100,000 people. Translated into the vernacular, this means that Canada’s assisted suicide rate is almost double that of the total American firearms mortality rate (27.5/14.13 = 1.95). We are extremely critical of the violence found in our southern neighbour, why are we not equally critical of the violence taking place under the MAiD regime?
The Institutionalization of Death
It wasn’t that long ago, 1993 to be exact, that the Supreme Court of Canada, in Rodriguez v. British Columbia (Attorney General), upheld the Criminal Code prohibition against assisted suicide as constitutional. And yet, some 22 years later, in 2015, the same Supreme Court (composed of different judges except for McLachlin who also took part in Rodriguez) overturned Rodriguez and ruled in Carter v. Canada that the Criminal Code prohibition was unconstitutional. Thus, was ushered in the MAiD regime of assisted suicide.
When the Liberal government of Justin Trudeau introduced amendments to the Criminal Code in 2016 to give legislative form to the Carter decision and the MAiD regime, it did so with a view to proscribing fixed limits on its availability.
Unfortunately, such limits have proven to be a pipedream. In response to the 2019 Quebec Superior Court’s decision in Truchon v Canada (AG) that held the requirement that natural death was “reasonably foreseeable” was unconstitutional, Trudeau’s Liberals—in a shocking display of moral cowardness by not appealing the decision, introduced further amendments to the MAiD regime which passed in 2021. The new MAID regime removed the requirement that a person’s natural death must be reasonably foreseeable. Is it any wonder then that MAiD is no longer a last resort but has become increasingly normalized and “accepted” as an alternative to proper end-of-life care?
The Slippery Slope of Industrialized Death
Despite the Supreme Court of Canada’s cavalier dismissal of the dangers of the “slippery slope” posed by legalized euthanasia, that is exactly what is happening in Canada as we have moved from a so-called restrictive MAiD regime (2016) to a more progressive and liberal MAiD regime (2021). The statistics regarding the frequency of MAiD are glaring evidence of this degeneracy.
The MAiD regime of Justin Trudeau’s Liberal Government has made Canada the “euthanasia capital of the world”. The MAiD regime is bad news for both health care professionals and its victims. Medically assisted suicide should never be regarded as “medical treatment”—to do so corrupts medicine and the healing arts making them nothing more than tools of a neo-Nazi ideology—an ideology that promotes a eugenics attitude to solving human “problems.”
Canada’s MAiD regime is showing all the hallmarks that give credence to such phrases as “slippery slope”, “camel’s nose” or “thin end of the wedge.” Under the guise of being humane and compassionate, MAiD is nothing else but the bureaucratization/institutionalization of state sanctioned death. What was once promoted as being something to use only as a last resort in exceptional dire medical circumstances, MAiD has now become a frequent “treatment” used in situations that are less than dire.
The increasing prevalence of “state sanction death” is a grim reminder that the Holocaust did not happen overnight. Before the Final Solution became a matter-of-fact policy, it was preceded by a eugenics euthanasia programme (Aktion T4) which was the normalization of state sanction medical-supervised termination for “health” reasons of those who suffered from severe psychiatric, neurological, or physical disabilities such as schizophrenia, down syndrome, cerebral palsy, blindness, “idiot children,” epilepsy, dementia, encephalitis, or “criminal insanity.”
Organizational Structure Dictates Outcome
One of the lessons to be learned from the Holocaust is that “Organizational Structure Dictates Outcome.” This maxim shows a keen insight into what happened in Nazi Germany and also to what is happening here in 21st Century Canada. We should not be so smug or self-righteous to ignore history or make the claim that “this is Canada, it could never happen here.”
Amongst other things, one of the consequences of Organizational Structure Dictates Outcome is that organizations have a life of their own, quite apart from the individuals who find themselves as clogs in the bureaucratic machinery. It is a further dehumanizing of decisions and the objects of those decisions, human beings.
Bureaucracy, with its rules and rigid structures, by its very nature dehumanizes the human person and thereby obscures the essential truth that there is a singular dignity of the human person—that each one of us has a dignity inherent in our humanity that demands respect that makes authentic human interaction, community and flourishing possible. It is a dignity that requires that each individual be treated as an end in themselves and never in an instrumental fashion, as a means to an end.
Humanize NOT Institutionalize Death
Death, like Life, are defining moments for each of us. How well we die is every bit as important as how we have lived our lives.
Bureaucracy’s dehumanization tendencies are furthered by our increasingly secularized techno-scientific culture which has the effect of denying the transcendental reality of our nature and existence. Slowly, our Judeo-Christian values and traditions are being replaced by a consumerism and materialism grounded in the cold and calculating utilitarian view of human life and death.
The elderly, those who find themselves in circumstances of serious illness and close to death as well as those suffering from physical and mental disabilities are increasingly becoming marginalized and are most vulnerable to the illusion that MAiD will solve their “problem.” This becomes all the more acute in a society that views the worth of human beings in material and utilitarian terms.
Time for a New Direction
The hard reality is that MAiD does not provide a real solution to those faced with dying or life’s hardships. Instead, MAiD denies those most in need of compassion and companionship the opportunity to live well, in the face of death. MAiD, by dehumanizing death, makes victims of us all, just not those it kills.
It does not have to be this way! We need to summon the courage and political will to not only once again make assisted suicide illegal, but also to commit the necessary resources to help the vulnerable through Hospice Care or with effective social/mental health services in order to share the journeys of those in dire straits. These are journeys that the state cannot make with us, only our fellow human beings can. Providing funding and support for those who make those journeys with us is something the state can do. Indeed, it is the human, humane and responsible thing to do.
Proposing the ending MAiD risks the pro-death lobby accusing you of being inhumane and cruel, but such accusations are without merit and miss the point entirely. The witness of government ought to be our own witness, one of hope and compassion, not despair and death. We will all die, just as we have all lost, and will lose, those we love and care for, whether to old age and/or disease.
Time to Reinstate Prohibition Against Assisted Suicide
There is a humane and dignified alterative to MAiD, it is called Palliative Care—and that is the strategy that ought to animate federal and provincial policies when it comes to end-of-life care.
Section 33 of the Charter ought to be utilized to overturn the evils of the Carter and Truchon decisions and the prohibition against assisted suicide re-enacted in the Criminal Code. The MAiD regime being subsequently dismantled, funding ought to be made available for not only Palliative Care but also health professionals’ education on medical ethics and Hospice Care specialization.