Recently, a patient of mine who I was really fond of, chose euthanasia. The politically correct would prefer to call it Medical Assistance in Dying (MAiD) since it sounds “softer.” But the fact of the matter is we are killing people (presumably to relieve suffering) which is the clear definition of euthanasia. Let’s call it what it really is.
My patient was a nonagenarian, had fairly advanced cancer with probably about 6-9 months left to live. They were still walking (albeit in some discomfort) and toileting independently. They did their own taxes, and anyone who can do their own taxes is mentally competent if not a genius. They looked at the natural course of their illness and, said to me:
“You mean I’m going to spend the last 3 months of my life, likely bedridden with some stranger changing my diapers and wiping my butt?”
And they chose euthanasia, which was provided to them this past year.
The above scenario represents exactly what most Canadians believed they were getting when euthanasia was legalized in 2016. Truth be told, even people like myself, who have qualms about the concept of healers taking lives, completely understand why my patient felt that way. It’s impossible to argue against the autonomous wish of a competent individual.
However, almost as soon as the euthanasia was legalized in Canada, physicians were warning that this was going to open up a slippery slope of ever loosening criteria and increasing permissiveness for euthanasia. Pro Euthanasia types derided these arguments for using “the fear of the unknown“. And yet, six years later, as a nation, we are now on the verge of expanding criteria for euthanasia to include:
- people who’s sole criteria is mental illness, essentially opening the door to people who are NOT competent to make such a decision.
- potentially allowing teenagers to make a decision to end their lives if they qualify as so called “mature minors”. I’m going to come right out and say it, there is no such thing as a mature minor. So much of human socialization/self esteem/identity formation occurs during our teenage years. It’s ridiculous to suggest kids who we won’t allow to vote should be allowed to kill themselves.
- allowing people with chronic disabilities to end their lives, if they have ongoing suffering, but not providing them with supports to live a dignified life, a move that has horrified the disabled, and their advocates.
- we are even considering allowing babies (!!) to be euthanized, a recommendation that shocked the Minister of Disabilities and Inclusion. (What did politicians think would happen when criteria expansion occurred??)
And finally, we have a report promoting what many all along thought was the real reason for allowing euthanasia. Basically, that it is cheaper for the health care system.
To be fair, one of the authors of the report, Dr. Aaron Trachtenberg does state that the work is meant to be “theoretical.” He also goes on to state:
“We are not suggesting that patients or providers consider costs when making this very personal and intimate decision to request or provide medical assistance in dying.”
But the blunt reality is that the authors put out a report broadly suggesting to the general public that there are cost savings if, you know, you did the decent thing and just ended it all when you became a burden on the rest of us. Intentional or not, the implication is clear that there is a monetary worth to your life and at some point, you dear patient, are no longer “worth it.” Reminds me of the Star Trek The Next Generation episode “Half a Life“, where the intrepid crew of the Enterprise meets a planet where everyone commits suicide at age 60.
It’s not only people like myself (who have been demanding conscience rights because we saw this coming) that are upset about this. The Toronto Star had a column saying Canada was going too far with euthanasia and warning of the dangers of abuse. The Canadian Society of Palliative Care Physicians has been expressing concern about euthanasia for some time. The Council of Canadians with Disabilities points out that the disabled cannot access supports to live a dignified life but can now access euthanasia. (I’m guessing Dr. Trachtenberg’s report did nothing to ease their concern). Dr. Sonu Gaind, a psychiatrist who himself has done euthanasia assessments has expressed significant concerns about the many flaws in the guidelines for those seeking death when their sole reason is mental illness.
Most tellingly, the National Post reported on a “crisis” in supply of doctors willing to provide euthanasia. Among the reasons cited are the “increased “legal risk and moral hazards” related to ever-widening eligibility.” Also a noted was that many euthanasia providers were curtailing and limiting their practice to those patients for whom the law was originally intended. You know you have a problem when even providers of euthanasia are telling you the rule changes are going too far.
Now perhaps some of the recommendations (like the one around babies) won’t make it through to legality, but the blunt reality is that the slippery slope that was warned about when euthanasia was legalized has come to pass. Its due a combination of lack of foresight and the ineptness of the initial legislation that we are at this place.
It was one thing to allow competent people (like my patient above) to self determine what to do in the face of an incurable illness or suffering. But it’s quite another to recklessly expand criteria . And it the case of those with disabilities, or mental illness, to not provide adequate supports as an option seemingly pushes them in the direction of choosing euthanasia.
Is this really what Canadians wanted?
As for the dollar value of a human life. The study authors write:
“we expect that net health care costs would be reduced by $33.2 million per year if 1% of deaths are due to medical assistance in dying”
This was based on their estimate of about 2,700 cases a year (there were over 10,000 last year). Based on their numbers however, your life is now worth $12,296.30
justanoldcountrydoctor 