Elaina Plott Calabro wrote an incredible article about nine years of Canada’s euthanasia laws (called MAID) in The Atlantic. In the past nine years, MAID has expanded from an option for patients with “reasonably foreseeable” deaths into Track 2, which allows for people who don’t have reasonably foreseeable deaths to request it anyway.
Over 5% of deaths in my country are now clinically assisted. It took Canada just a few years to reach that number; it took Belgium over twenty to do the same. And the number continues to climb. In Quebec, 7% of deaths are assisted.
The laws surrounding MAID are unclear and mostly assign responsibility to medical practitioners to determine if patients qualify, which means the entire thing is basically one giant loophole allowing legally assisted death.
One of the things it means to be Canadian is to honour the rights and wishes of other people. That’s part of what makes it a wonderful place to live: most people genuinely believe in equality and respect for others, including people who don’t look like them.
I think it’s good to respect the wishes of other people and honour their requests. But I also think it’s far too easy for political leadership in Canada to lean on the pretence of respecting a person’s right to die how they want. This country has major accessibility problems in its free health care systems. Some of these problems are provincial. Some are federal. It is irresponsible for the federal government to lean on assisted death, instead of providing more universal access to healthcare. In fact, the provision of MAID without adequate universal health care causes predictable, knowable problems.
Calabro writes:
For these critics, the “reasonably foreseeable” death requirement had been the solitary consolation in an otherwise lost constitutional battle. The elimination of that protection with the creation of Track 2 [note: an option for MAID despite no reasonably foreseeable death in the patient’s future] reinforced their conviction that MAID would result in Canada’s most marginalized citizens being subtly coerced into premature death. Canadian officials acknowledged these concerns — “We know that in some places in our country, it’s easier to access MAID than it is to get a wheelchair,” Carla Qualtrough, the disability-inclusion minister, admitted in 2020 — but reiterated that socioeconomic suffering was not a legal basis for MAID.
And later:
Nearly half of all Canadians who have died by MAID viewed themselves as a burden on family and friends. For some disabled citizens, the availability of assisted death has sowed doubt about how the medical establishment itself sees them — about whether their lives are in fact considered worthy of saving.
Finally:
MAID advocates dispute the charge that disabled Canadians are being quietly or overtly pressured to consider assisted death… Even so, this past March, the United Nations Committee on the Rights of Persons With Disabilities formally called for the repeal of Track 2 MAID in Canada — arguing that the federal government had “fundamentally changed” the premise of assisted dying on the basis of “negative, ableist perceptions of the quality and value” of disabled lives, without addressing the systemic inequalities that amplify their perceived suffering.
It is regrettable to me that so much of the pushback on MAID is from religious, conservative voices. Almost every left-leaning person I know would agree that it is the responsibility of our government to make healthcare easily accessible and available for all. But the instant Christian conservative voices get involved and start arguing about moral values, people bristle and suddenly there’s a polarized divide.
I can comfortably say this because I am a God-fearing Christian. I have my own personal qualms with MAID and am unsure I would ever request it, even if my death were “reasonably foreseeable.” However, I don’t accept my morals to be deterministic of national law, and I do not think that anything in our Canadian Charter of Rights and Freedoms would suggest otherwise, particularly in the twenty-first century.
But I am deeply uncomfortable with the fact that people who view themselves as a burden to the system, or people who view the system as unavailable to them, pursue MAID as a viable option. The queasiness is underlined by Calabro’s reporting, which includes this gem of a sentence:
Although cost savings have never been mentioned as an explicit rationale for expansion, the parliamentary budget office anticipated annual savings in health-care costs of nearly $150 million as a result of the expanded MAID régime.
In Canada, our annual health spending was expected reach $372 billion in 2024, so $150 million is 0.04% of our spending. I do not suspect it to be a primary motivator or rationale behind MAID. However, what would happen if we spent another $1 billion, or even $5 billion, on improving health care access for the sorts of people who feel abandoned by the system? That would be an increase of spending in 1.3%. (If our leaders are feeling particularly spineless, they could increase healthcare spending by 0.04%. Call it a re-investment of the savings back into the system.)
According to Calabro’s reporting, 60,300 Canadians received medical assistance in dying as of 2023. I would suggest that a better way to honour the rights of our fellow citizens would be to increase spending by a fractional amount, increase access to healthcare, and possibly save the lives of people who otherwise feel the system pressures them to choose assisted death, rather than be a burden.
Medicare is called a “universal health care system” for a reason. In any situation where it is not universal — and there are many — efforts should be made to make it so. Those efforts should not be “reasonable.” I should not look at their efforts and deem that they merely tried. Politicians should make unreasonable efforts to better the lives of the people. That is their job. To do any job well is to pursue it to a level that outsiders would deem unreasonable.
Unreasonable efforts must be made to improve our healthcare system, because if a growing number people rely on MAID as a solution, it suggests that the system is otherwise insufficient.
Regardless of your stance on this issue, Calabro’s reporting is excellent, and well worth an hour of your time.