A warning from Canada

The bill to allow assisted suicide to be debated in the UK parliament on Friday comes with restrictions and safeguards. The experience of similar legislation introduced eight years ago in Canada is that these protections prove impossible to maintain

Euthanasia, or medical assistance in dying (ubiquitously referred to by the sanitised acronym “MAID”), was legalised in Canada in June 2016, when the Criminal Code was amended so that doctors and nurses would not be prosecuted for homicide if they ended their patients’ lives according to certain criteria.

At first, these criteria required the patient to be an adult, capable of consent, making a voluntary request, with “a grievous and irremediable condition”, and whose natural death was “reasonably foreseeable”. Then, in October 2020, the Canadian Minister of Justice tabled a bill to reduce some of the safeguards and expand assisted dying to those whose deaths are “not reasonably foreseeable” but are suffering from “a grievous and irremediable condition”. This euthanasia expansion, enacted in 2021, means that many persons with disabilities now live with the dehumanising awareness that they qualify for state-sponsored assisted suicide.

Why would Canada expand assisted dying to include the non-terminally ill? And what could justify removing safeguards that had initially been deemed essential? To understand this, and to see why the safeguards included in the proposed UK legislation will not last, it is crucial to grasp the grounds on which assisted dying is rationalised. If assisted dying is a compassionate response to people who are suffering, as those who are now arguing for a change in the law in the UK argue, then there is no reason why it should be limited to those who are terminally ill. Many people suffer – not only physically but also psychologically – throughout life. If euthanasia is an expression of dignity and autonomy, then why limit it to select demographics? There was never a reason why death by lethal injection would remain a “last resort” once it became marketed as “dignified” and “compassionate”.

Since legalisation, Canada has become the euthanasia capital of the world. More Canadians have been killed by doctors and nurses in hospitals, homes, national parks, and even funeral homes and prisons than the total number who died of Covid. MAID is now the fifth-leading cause of death, and it is quadruple the ordinary suicide rate. Not only has medical assistance in dying become normalised and routine, it is actually romanticised and glamourised. A few years ago, I was working in the office of a member of parliament, striving to oppose the bill that would expand euthanasia to persons living with disabilities and struggling with their mental health.

Church steps up warnings against legalising assisted suicide

Assisted dying and the importance of evidence

We created a petition and, in a few days, many thousands signed it. Then we sent an email to petition signers inviting them to tell their stories about how the euthanasia expansion would affect them and their loved ones personally. Suddenly, it was as though our parliamentary office became a suicide prevention centre. Reading those hundreds of desperate emails amid the pandemic shook me to the core. A mother wrote to us about her adult son: “He has gone to the emergency department and indicated he feels unsafe because he wants to kill himself. Our family is quite certain that he goes there, often, simply because he has the need to interact with people.”

Many of the emails we received came from medical professionals, either worried for their patients or sharing their own history of depression, burnout, and thoughts of suicide. One wrote, “I have a patient who struggles with mental-health and substance-use issues. She has previously asked about MAID and, at least at the time, I could tell her that she would not qualify. She often speaks of the part of her that wants to live and the part that wants to die, how they are at war within her. Now, if she asks again, I am afraid that she would qualify, without taking into account the fluctuating nature of her suicidality.”

Another wrote, “I am a retired physician who has personally experienced severe depression, and I am opposed to the relaxation of criteria for medically assisted death. I am enjoying my time now and appreciate everything life offers.” Many of the personal stories can be summed up as saying, “If MAID had been available, I would not be here today.”

Since then, I have had conversations with other young professionals impacted by euthanasia in unexpected ways. A medical student was jolted to realise that the cadaver he was working on had been “a MAID recipient”. A law student told me she was dumbfounded when, during a will and estate meeting, an elderly man asked if he could make an advance directive to “get put to sleep” if ever he cannot live independently. And, a young paramedic told me of his utter consternation at having been called to the home of a “botched MAID”, unsure of whether the patient who was trying to have his life ended might resent him for attempting to save it. Legal euthanasia is corroding more spheres of life than anyone could have imagined.

I have found that the request for euthanasia is not so much the expression of a desire to die as it is the expression of a disappointment. It will always be more demanding to be curious about the reason for someone’s disappointment than simply to concede to it. But people deserve the effort.

Appeals to autonomy betray a fear of abandonment, and do not represent our genuine aspirations. Even proponents of euthanasia know this. After all, “assisted dying” is not autonomous; suicide simply put is autonomous. What the proponents of assisted dying get right is that the dying person deserves not to be abandoned. But we shatter all meaning of genuine presence, of keeping vigil, and of true accompaniment when the solemn act of a person’s death is reduced to a lethal injection scheduled at a quarter hour interval. Similarly, appeals to control betray the insecurity of being shown callousness rather than care and appeals to dignity betray a lack of self-worth rooted in who we are, not only in how we look, what we can do, or how we can perform.

Euthanasia is a symptom of certain anthropological, cultural and existential crises of our time and in our own hearts. I often wear a T-shirt that says “It’s good you exist” and people usually smile shyly when they see it. Sometimes I pause long enough for a person on the street, perhaps someone struggling with homelessness or addiction, to read it and give a look of perplexity that the message could be meant for them, too. Recently, a woman doubled back toward me and said, “May I get a photo? You have no idea how much I needed to see that today.”

Assisted dying ‘puts vulnerable people at risk’, Starmer warned

Is the proposed change to assisted dying legislation really about denying choice?

In our world, we have so much brokenness, so much loneliness, so many long-term effects of the pandemic, so many addictions, so many mental-health crises. As a young person, I look out and wonder: what is on offer? The proposal surely must be better than death. We have to have more to offer amid the crises of our time: love, friendship, generosity, communion, and the gaze of another that instils a sense of my own value that I cannot give to myself.

Mindful of Canada’s euthanasia experiment, I urge you: do not go down this path, you are made for better, and you so deserve so much more.

Amanda Achtman works to prevent euthanasia and encourage hope across Canada and beyond through her project, Dying to Meet You. She is also the Ethics Education & Cultural Engagement Lead for Canadian Physicians for Life.