Canada is looking to expand its medically assisted suicide eligibility even further by allowing adults who do not have any physical ailments to receive one.
“Canada is preparing to expand its medically assisted death framework to become one of the broadest in the world, a change some want to delay due to concerns that vulnerable people have easier access to death than to a life without suffering.
Starting in March, people whose sole underlying condition is mental illness will be able to access assisted death. Mental illness was excluded when the most recent medical assistance in dying (MAiD) law was passed in 2021.
That will make Canada one of six countries in the world where a person suffering from mental illness alone who is not near their natural death can get a doctor to help them die.
People will still need to apply and be deemed eligible by two clinicians who must determine whether they have an irremediable condition causing them intolerable suffering and whether they have capacity - whether they understand and appreciate their condition, the decision and its consequences.
‘Tired-of-life cases in Canada are happening’, said Madeline Li, a cancer psychiatrist specializing in palliative care who put together an assisted death framework for her Toronto hospital network.
‘I've become very comfortable with MAiD for people who are dying. I am less comfortable for expanding indications. ... We've made MAiD so open you can request it for basically any reason’.
More than 30,000 Canadians have died with medical assistance since it became legal in 2016 - more than 10,000 of them in 2021, accounting for 3.3 percent of Canadian deaths in 2016, according to official data.
The vast majority were deemed close to their ‘natural’ death. In 2021 4.5 percent of deaths in the Netherlands and 2.4 percent of deaths in Belgium were medically assisted.
Clinicians and experts are working on a model MAiD standard of care for mental illness for groups regulating clinicians.
But some are calling for the expansion to be delayed; others say the existing system is flawed because people suffering for lack of treatment or supports may access assisted death.
Some individuals have come forward in local news reports saying they are seeking assisted death because they lack appropriate housing or other supports.
The federal agency serving veterans says at least one employee suggested assisted death unprompted to at least four veterans between 2019 and 2022.
It is investigating another such allegation, a spokesperson said in an email, adding that advice on assisted death is not a department service. Some have pointed to this as an example of system misuse.
A spokesperson for Health Minister Jean-Yves Duclos said the government is working with its counterparts to ensure ‘a strong framework is in place’ when assisted death becomes available for mental illness.
A delay would mean ‘people who are currently suffering intolerably ... would have to continue suffering’, said Toronto doctor Justine Dembo, who assesses patients for assisted death and was on an expert panel on the topic.
Jocelyn Downie, who is part of the group establishing practice standards, said while some people suffering intolerably might suffer less if they had timely access to treatment or supports, denying them assisted death does not solve the problem: It just means they keep suffering.
L.P., who suffers from anorexia and asked to be identified by her initials, hopes to access assisted death when it is available. Without it, she said, she will keep suffering until the illness or suicide kills her”. -Anna Mehler Paperny, Reuters
Back in 1994, when Doctor Jack Kevorkian was advocating for this very thing, his attorney, Geoffrey Fieger predicted that it would some day become a reality and eventually a “common procedure”.
While I understand the supposed purpose of “mercy killing” terminally sick people to put them out of their misery, the process of “assisted suicide” or fulfilling someone’s desire for self-slaughter when they’re perfectly capable of doing it themself seems like a way to provide a coward’s way out for the coward’s way out.
And, the argument of dying with dignity is not pertinent given that there is hardly anything less dignified than attempting to absolve oneself of the responsibility for one’s own death and place the burden on someone else instead.
Instead of being a caitiff, one must at least go down with a fight or if nothing else make a truly dignified effort to finish stoically. Even if something like a tragic accident that left permanent ailments made life into not worth living through any longer, there might still remain a few more honorable ways of going about it that could at least make the end count for something. The Samson option, for example, was termed after Samson who took vengeance on the Philistines who enslaved him and took away his sight at the Temple of Dagon.
Samson said to the servant who held his hand, “Put me where I can feel the pillars that support the temple, so that I may lean against them”. Now the temple was crowded with men and women; all the rulers of the Philistines were there, and on the roof were about three thousand men and women watching Samson perform. Then Samson prayed to the Lord, “Sovereign Lord, remember me. Please, God, strengthen me just once more, and let me with one blow get revenge on the Philistines for my two eyes”. Then Samson reached toward the two central pillars on which the temple stood. Bracing himself against them, his right hand on the one and his left hand on the other, he pushed with all his might, and down came the temple on the rulers and all the people in it. Thus he killed many more when he died than while he lived.
Judges 16: 26-30