A Better, More Humane Solution

Kevin Yuill writes:

A few weeks ago, I accidentally toured one of the awful tent cities in Vancouver, Canada. At the corner of Main Street and Hastings Avenue, homeless drug addicts spread their few possessions out on blankets and cover the pavement for blocks on end. It is only a short distance from the restaurants and attractions of this fairly affluent city and is easy to stray into.

So long as they are not violent, homeless addicts are generally ignored across the city. Vancouverites, in that polite Canadian way, accept their presence and do what they can to be kind. Nonetheless, everyone I met spoke about the ‘crisis’ of addicts in Vancouver, where drugs have effectively been decriminalised.

Now, the Canadian authorities seem to have come up with a novel, frightening solution to the crisis: euthanasia.

Currently, Canadians are eligible for the medical assistance in dying (MAID) programme if they have a ‘grievous and irremediable medical condition’, such as a serious physical illness or disability. If their condition has put them in an advanced state of irreversible decline and caused enduring physical or psychological suffering, they may request to be allowed euthanasia. That is, a doctor will actively end that person’s life. While MAID covers both euthanasia and assisted suicide, almost all MAID deaths in Canada are carried out by a doctor.

This is already horrific enough. But from March 2024, those suffering from mental illnesses – with no physical ailments necessary – will also be eligible for MAID. That includes people with substance-use disorders.

The true horror of this plan can be glimpsed in the national discussion surrounding it. Last week, a framework for assessing people with substance-use disorders for MAID was discussed at the annual conference for the Canadian Society of Addiction Medicine in British Columbia. Dr David Martell (ironically a winner of the Family Physician of the Year award) was one of the most vocal supporters of expanding MAID to drug addicts. Dr Martell declared that ‘it’s not fair to exclude people from eligibility purely because their mental disorder might either partly or in full be a substance-use disorder. It has to do with treating people equally.’

Dr Martell went on to explain that doctors will need to distinguish between somebody who has a ‘reasoned wish to die’ and someone who is merely suicidal. A person who is ‘thinking in a calm and measured way about wanting [their] suffering to end’, Martell said, might be considered for MAID. But he conceded that a person can exhibit signs of both suicidality and a calm and measured wish to die, and that it would be ‘fairly impossible’ to make the distinction if the person being assessed were intoxicated.

Making this distinction is indeed virtually impossible, as Christopher Lyon, whose suicidal father was granted MAID, has explained on his Substack. The lines of informed consent are extremely blurred, especially when drugs and alcohol are involved.

Since euthanasia and assisted suicide were legalised in Canada in 2016, the criteria have been extended both in law and in practice. In 2021, the Canadian government ditched the idea that death had to be ‘reasonably foreseeable’ to make someone eligible for MAID. Then last week, parliament defeated Bill C-314, also known as the Mental Health Protection Act. This would have amended the Criminal Code to provide that a mental disorder is not a grievous and irremediable medical condition for which a person could receive MAID. Almost every Progressive Conservative Party MP and left-wing New Democratic Party MP voted for the bill, while the Liberals, who control the government, voted against. This is despite the fact that only three in 10 Canadians themselves support MAID for the mentally ill.

Canada’s parliament – as we recently saw when it gave a standing ovation to a veteran of the Waffen-SS – could really do with a history lesson. Euthanasia as a solution for those living troubled lives is hardly a new concept. Those most keen on it were those associated with the movement for eugenics.

For instance, in the first few years of the 20th century, Dr Ella K Dearborn cheerfully called for ‘euthanasia for the incurably ill, insane, criminals and degenerates’. Similarly, in 1906, sociologist L Graham Crozier agreed with her medical compatriot: ‘I would personally rather administer chloroform to the poor, starving children of New York, Philadelphia, Chicago and other American cities, than to see them living as they must in squalor and misery.’

In an echo of today’s advocates for legalised assisted dying, Dr Dearborn once thundered: ‘Do not let sentiment or superstition retard the wheels of worldwide progress.’ In Canada, this so-called progress shows no sign of stopping. In the eight years since MAID was legalised for the terminally ill, it has been expanded to disabled people, homeless people and prisoners. And soon drug addicts will be next.

A better, more humane solution might be to offer treatment to addicts, instead of having them killed. Is that really such an unreasonable thing to ask for?

And James Billot writes:

Last year 4.1% of all deaths in Canada were due to MAiD (medical assistance in dying), according to the country’s health ministry. This amounts to a total of 13,241 people who died under Canada’s MAiD programme in 2022, marking a 31% rise on the previous year.

These findings provide succour to claims made by MAiD critics that the programme has become too permissive. Federal guidelines stipulate that clients must have a grievous and irremediable medical condition, make a voluntary request for medical assistance in dying that is not the result of outside pressure or influence, and give informed consent to receive medical assistance in dying.

But towards the end of last year, the programme was criticised for allegedly driving citizens into assisted suicide on the grounds of poverty or lack of healthcare. Stories included two separate cases of cash-strapped women suffering from chronic health conditions who successfully applied to end their lives. Elsewhere, four Canadian military veterans were allegedly “pressured” to opt for medically-assisted death by a now-suspended Veterans Affairs Canada caseworker.

Health Canada’s fourth annual report on MAiD shows a staggering rise in deaths. Since the programme was launched in 2016, there has been a thirteenfold increase. The most cited underlying medical conditions for choosing MAiD included cancer (63%) as well as various respiratory, cardiovascular and neurological conditions. But in 463 MAiD cases, the person’s natural death was not reasonably foreseeable, up from 221 individuals in 2021.

There was also a 27% rise in the number of written requests for MAiD in 2022 (16,104) since 2021, 560 of which were deemed ineligible. The most commonly cited sources of suffering by people requesting MAiD were the loss of ability to engage in meaningful activities (86.3%), followed by loss of ability to perform activities of daily living (81.9%) and inadequate control of pain, or concern about controlling pain (59.2%).

Canada legalised euthanasia in 2016, but the remit of MAiD has expanded in recent years. In 2021, the Canadian parliament passed Bill C-7, a law which repealed a requirement that only those suffering from a terminal illness whose natural death was “reasonably foreseeable” could request euthanasia. Next March, the programme will again be expanded further to include anyone whose sole underlying issue is a mental illness.

While advocates believe this move is an important step in recognised the suffering wrought by mental illness, Conservative politicians have criticised it as promoting a “culture of death”. “Those suffering from mental disorders, including depression, deserve mental health and social support and counselling,” said Conservative MP Ed Fast, who tabled a bill against MAiD’s expansion. “They need to find some joy and some meaning in life.”

Conservative leader Pierre Poilievre has backed Fast’s bill, adding that he would repeal the expansion of MAiD to those with a mental illness if he became prime minister.

The legalisation of assisted suicide would give to a High Court judge in the Family Division such power over life and death as no judge in this country had enjoyed since the abolition of capital punishment. My paternal grandfather was born before such working-class men could vote, and my maternal ancestors included African slaves, Indian indentured labourers, and Chinese coolies. We who come off the lower orders and the lesser breeds, and perhaps especially those of us who are disabled, know perfectly well who would be euthanised, and how, and why.

Even if we had made it past the industrial scale abortion that disproportionately targeted us, then we would face euthanasia as yet another lethal weapon in the deadly armoury of our mortal enemies, alongside their wars, alongside their self-indulgent refusal to enforce the drug laws, alongside Police brutality and other street violence, alongside the numerous life-shortening consequences of economic inequality, and alongside the restoration of the death penalty, which is more likely than it has been in two generations, and which would not be repealed if the Prime Minister were a former Director of Public Prosecutions who was now a war criminal.

All this, and the needle, too? This is class and race war, and we must fight to the death. That death must not be ours, but the death of the global capitalist system. Having subjected itself to that system to a unique extent, Britain is uniquely placed to overthrow it, and to replace it with an order founded on the absolute sanctity of each individual human life from the point of fertilisation to the point of natural death. That foundation would and could be secured only by absolute fidelity to the only global institution that was irrevocably committed to that principle, including the full range of its economic, social, cultural and political implications.