Canada is creeping towards dystopia with its Liberal embrace of MAID

Canada has made medically assisted death "health care," and therefore a right. The repercussions of this look dark.

Canada is touted as having one of the most admirable health care systems in the world. A common refrain among progressive Canadians, in defense of criticisms of the country’s government, is “At least we have health care!”

And while, yes, Canadians have access to free hospital and doctor visits, and won’t be stuck with a bill that could double as a down payment on a house because they happen to get sick or in an accident, there is a dark side.

What happens when health care is a right, and the right to die becomes “health care”?

Well, in Canada, the bastion of accepting inclusivity, we are moving towards accepting people’s desire to die, few questions asked.

The question of medically assisted death, or MAID, is a tough one for those invested in protecting individual choice and freedom. It could easily be argued that if a person is suffering and wishes to die, they should have the right to do so, and perhaps that this could be done humanely and painlessly with the help of a doctor. But in reality things are, as they tend to be, more complex.

Freedom of choice is on one hand imperative, but when it comes to harm and of course death, ethical questions complicate those choices. In the case of MAID, we are not just talking about someone’s choice to die, but the government aiding that person in dying; the question of profit, when individuals and industries are being compensated for selling death to an individual; the question of why death is offered as opposed to more expensive, holistic, long term support and treatment; and what might happen if a depressed, lonely, or otherwise suffering individual were actually offered the care and attention required to potentially feel less hopeless about the future.

In Canada, the stories we hear about those seeking out MAID do not inspire trust that the latter question is being addressed.

Canada legalized medically assisted death in 2016 for people with terminal illness after a 2015 court decision concluded that laws prohibiting physician-assisted dying interfere with the liberty of individuals who have a “grievous and irremediable” medical condition that causes “enduring suffering.” The Supreme Court of Canada determined that this right was “critical to their dignity and autonomy.” This law precluded “suffering” from mental disorders, as the qualification of resulting death being “reasonably foreseeable” was not viewed as eligible. But it wasn’t long before that exclusion was challenged.

In 2019, a new federal bill was introduced, proposing a repeal of the provision requiring a person’s death be reasonably foreseeable in order for them to be eligible for euthanasia. Bill C-7 claimed to exclude those whose sole underlying medical condition is a mental illness, but some complained this constituted “discrimination.” The Canadian Psychiatric Association, for example, argued that “Patients with a psychiatric illness should not be discriminated against solely on the basis of their disability, and should have available the same options regarding MAID as available to all patients.” Senator Stan Kutcher, a psychiatrist, agreed, introducing an amendment giving the government 18 months to come up with guidelines and safeguards before making MAID for mental illness available.

Such arguments have been made difficult to defeat in Canada on account of our “admirable” approach to health care. Unlike the in United States, health care in Canada is a charter right, meaning that once MAID was considered a medical procedure, excluding patients on account of mental illness became a question of breaching an individual’s constitutional rights.

Indeed, Kutcher argued that excluding those suffering solely from mental illness from accessing MAID is unconstitutional, as it violated the right of Canadians to equal treatment under the law, regardless of physical and mental disability, under the Charter of Rights and Freedoms.

He also argued that this exclusion “stigmatizes people with mental illnesses,” explaining to the Senate:

Intolerable suffering is a subjective personal experience. It cannot be negated or delegitimized by anyone else’s valuation of that suffering, no matter who that person is.

Kutcher went on to imply that this exclusion treats those suffering from a mental disorder as having a “second-class type of suffering,” insisting their suffering be taken “just as seriously as we take the suffering of those who request MAID for any other medical condition."

The legalization of MAID in certain extreme cases may seem humane, but is a slippery slope.

In 2021, the law was indeed changed, removing the requirement that death to be “reasonably foreseeable” in order to be eligible for MAID. Individuals suffering solely from mental illness were excluded from eligibility, but only for 24 months, in order to allow for an expert review tasked with making recommendations on protocols, guidance, and safeguards for MAID eligibility of those suffering from mental illness.

Since, rates of physician assisted death have blown up. While in 2016 only 1,018 people in Canada died via MAID, that number rose to 10,064 in 2021. That year, only four percent of those who filed written applications were deemed ineligible.

In 2022, the Ministers of Justice, Health, and Mental Health and Addictions, sought an extension of the temporary exclusion of eligibility for persons suffering from mental illness, meaning the exclusion now is set to end on March 17, 2024, at which point the Government of Canada will make a decision.

Not only are they considering allowances for those suffering from mental illness, but for "mature minors" — people under 18 deemed capable of making a decision to access medically assisted death. Dying With Dignity Canada, a charity committed to “protecting end-of-life rights,” recommends that “mature minors” be defined as “at least 12 years of age and capable of making decisions with respect to their health.”

As requests for physician-assisted death rise, so do requests from those suffering from mental illness. Last week, Reuters reported that a 47-year-old woman who has struggled with anorexia for much of her life is awaiting the government’s decision in 2024, which she hopes will allow her the right to die on account of her ongoing mental health issues.

It is undeniable that some are tortured by mental health problems. But the problem with things like depression or anxiety is that, while it’s happening, it feels like it will never go away. Any of us who have gone through grief, heartbreak, and financial struggles can relate. One can imagine that those (especially minors, who haven’t lived a long enough life to know that feeling bad isn’t usually permanent) struggling with such mental health issues might see death as their only escape. But the truth is that life is unpredictable. Things can and do change. A bad year can be followed by a good one. And fighting for improvement and survival is something that should be inherent or at least encouraged in humans.

But moreover, it is not the job of physicians to kill people. It is their job to try to make people feel better, to extend their lives, to ease suffering. “First, do no harm” seems in direct conflict with killing someone as “health care.” And surely, if a person is struggling with health issues or mental illness, the government should offer support to that regard, not the easiest, cheapest way out: to simply kill the individual. Isn’t this why we pay taxes, anyway? Isn’t the purpose of a socialized health care system to support its citizens, not abandon them because they can’t afford to access the life they need to feel better?

Life is not always easy. We don’t always feel good. Bad things happen. But it seems as though we are moving towards a society that believes life should be free from bad feelings. Younger generations view exposure to disagreeable views as traumatic and popping pills to resolve feelings of stress or unhappiness has become the norm.

We live in an ever isolated world, in urban centers surrounded by tens of thousands, somehow making many feel evermore alone — plugged into smartphones and laptops, reliant on social media that is the opposite of social. We no longer live in small communities, surrounded by family, as we used to. We have devalued face-to-face connection as Big Tech attempts to convince the world one can date, work, learn, and have sex online. We pack our elders off into homes to die, rather than keep and care from them with family, as was always the practice in the past and still is in other cultures. And humans are suffering for it.

Sadly, many of those wishing to access physician assisted death suffer from loneliness, as well as poverty. We also know that many mental health issues are rooted in past abuse and trauma. Is this all Canada — a relatively rich country with supposedly good social safety nets — has to offer it’s most misfortunate? How about offering community? Companionship? Holistic approaches to health? In home care? Financial support that allows for a life with dignity?

Rupa Subramanya reported on a number of MAID candidates for The Free Press last year, all of whom were not only struggling with health problems, but were on disability, supporting themselves on a meagre $1300 a month, barely able to buy groceries. A 53-year-old mother and 21-year-old daughter suffering from a variety of ongoing medical conditions, concluded that their only option was to apply for MAID. One doesn’t have to stretch one’s imagination very far to see that a more expensive solution would be for the government to offer the pair higher disability payouts. Indeed, MAID is cost-effective.

Subramanya also found that in October 2020, the Office of the Parliamentary Budget Officer issued a report in response to a request from a Senator to estimate the financial cost of Bill C-7, concluding that MAID would cut healthcare costs by over $66 million.

Proponents of MAID use words like “dignity” and “compassion” in its defense. But what about dignity in life? And true compassion for the living, via genuine care, community, and treatment? In truth, MAID sounds like a solution for the government, not for Canadian citizens.