When suicide masquerades as health care

National Post, 25 February 2021

Canada's changing medical culture is increasingly offering patients a lethal injection alongside other treatment options, as if being helped to die is equivalent to being helped to live.

The legislative expansion of assisted suicide, combined with four critical developments in the last year, herald a new medical ethos in Canada: the state medical apparatus will have control over the deaths of an increasing number of Canadians.

No one professes to want that result, but the underlying plates are aligning in such a way as to do just that.

The federal government’s reform of its medical assistance in dying (MAID) legislation, Bill C-7, will permit Canadians to request a lethal injection, even if death is not proximate or reasonably foreseeable. It’s not exactly death-on-demand for anyone who asks, but that’s what it is for anyone who has a serious medical problem, even one that can be readily treated.

The Senate amendments to the government’s bill will permit MAID to be administered in response to a request made years in the past, such as in the case of geriatric dementia. The Senate amendments also pave the way for an expansion of MAID for mentally ill people who are neither elderly nor dying.

If C-7 passes, Canada will have abolished medical assistance “in dying” and replaced it with “medically assisted death,” independent of whether the patient is dying or not. Suicide — and the right to have another administer the lethal injection or fatal dose — will become a positive good, in law and in medicine.

Bill C-7 is about making suicide mainstream. In 2019, assisted suicide accounted for two per cent of all deaths in Canada, a 25 per cent increase from 2018. The change in medical culture will soon drive that figure much higher. Four trends are in place for that acceleration.

First, palliative care is lacking. It is what most Canadians want — an end to burdensome therapies, sophisticated symptom treatment, pain management, comfort and care with family close by. Yet most Canadians can’t get it, as palliative and home care are chronically underfunded. Lack of access to palliative care for the terminally sick, and to effective home care for the disabled, are big drivers of MAID.

Nowadays, suicide promotion is being foisted upon palliative care. Patients increasingly report being offered MAID as an option when they enter into palliative care. Some palliative care budgets — which are already stretched — are being used instead for MAID. British Columbia recently shut down a longstanding hospice because it would not perform MAID, even though it is readily available nearby.

A second trend is the effort, which is increasing in the medical community, to make MAID a option of first resort, rather than last. That’s why the disabled community is aghast at C-7. One parliamentary witness testified that she was asked to consider MAID when she had a very treatable case of pneumonia — and she was in her 20s! Far from extreme cases in close proximity to death, the changing medical culture offers patients a lethal injection alongside other treatment options, as if being helped to die is equivalent to being helped to live.

Those two trends affect the supply side of suicide. What about the demand?

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