It was June 2016 when euthanasia was legalized in Canada, where it is called MAiD, which stands for medical assistance in dying. Canada was not the first country to embrace euthanasia: Belgium and the Netherlands were the first to legalize the practice in 2002. Luxembourg and Colombia followed, then Canada, and in 2021 Spain and New Zealand became the latest countries to do so.

That makes seven countries in total, plus several states in Australia. Ten U.S. states, plus Washington, D.C., allow assisted suicide, but none allow euthanasia, death administered by a physician.

As in the other countries, Canada’s turn toward euthanasia came after a high profile case that drew great sympathy, that of Gloria Taylor, who suffered from ALS, also known as Lou Gehrig’s disease. She argued, and the court agreed, that if she was not disabled she could choose suicide, but that being extremely disabled meant she did not, practically speaking, have the same choice to commit suicide — unless she could be assisted by physicians. Somewhat ironically, Taylor died of natural causes before the need for MAiD arose. The Canadian parliament then enshrined MAiD in law.

At the time many were worried where the new law would lead. Few could have foreseen how quickly problems would develop, despite a Canadian court ruling that opined “The fact that doubts have been raised is one thing, but any possible ‘slippery slope’ remains theoretical. ... There is no indication that a permissive regime in Canada with properly designed and administered safeguards cannot protect vulnerable people from abuse and error.” 

Oh, Canada!

Consider the case of Canadian Amir Farsoud. Farsoud is 54 and suffers from debilitating back pain. He qualifies for MAiD because his condition is considered “serious,” his decline “cannot be reversed” and he experiences suffering that “cannot be relieved under conditions that you consider acceptable.” His condition is not terminal and was not required to be terminal for his application to be approved under Canadian law, though two independent practitioners (doctor or nurse practitioner) must approve the application. Not counting those who died during the application process, 93% of applications were approved last year.

Straightforward? Not in the least. It turns out that Farsoud was being evicted from his rooming house because it was being put up for sale. The low level of government benefits Farsoud was receiving meant he would become homeless. He decided that he would rather die than live in a shelter. However, once a GoFundMe successfully raised $60,000 toward housing costs, Farsoud announced he did not want to die after all.

Farsoud commented, “If society is concerned about people like me, and like the half million other people on (government benefits) in poverty, then bring them out of poverty. That’s the obvious solution. If they were out of poverty and if they had a roof over their head and food in their mouths, I guarantee you MAiD wouldn’t be a consideration. The whole debate would become superfluous.”

Another woman openly stated, “I’ve applied for MAiD essentially ... because of abject poverty.”

Perspective: Inside the world of Canada’s assisted suicide — for ‘mature minors’
Perspective: Want to see the ‘slippery slope’ of assisted suicide? Look north

These are not the only troubling cases, nor the only type of troubling case.  Veteran Affairs Canada recently suggested MAiD to a serviceman suffering from PTSD. Alan Nichols, suffering from mental illness (which is not currently a qualifying condition for MAiD) and hospitalized for suicide prevention, was euthanized while “screaming uncontrollably,” according to his family. “Alan was basically put to death,” his brother Gary Nichols said.

Cheryl Romaire was denied palliative care for her medical condition, but approved for MAiD. There are many more such unsettling cases.

There are now intimations that the chronically overburdened Canadian health care system is even suggesting MAiD to patients as a way to save costs. One report published in the Canadian Medical Association Journal “calculated that implementing assisted suicide programs would cost $1.5 million to $14.8 million but could reduce annual health care spending by between $34 million to $136.8 million.”

Indeed, clinicians are urged to tell patients of the MAiD option in discussions with them about care. Consider the case of Roger Foley, as reported by The Associated Press:

“Roger Foley, who has a degenerative brain disorder and is hospitalized in London, Ontario, was so alarmed by staffers mentioning euthanasia that he began secretly recording some of their conversations. In one recording obtained by the AP, the hospital’s director of ethics told Foley that for him to remain in the hospital, it would cost ‘north of $1,500 a day.’ Foley replied that mentioning fees felt like coercion and asked what plan there was for his long-term care.

“‘Roger, this is not my show,’ the ethicist responded. ‘My piece of this was to talk to you, (to see) if you had an interest in assisted dying.’ Foley said he had never previously mentioned euthanasia. The hospital says there is no prohibition on staff raising the issue.”

Other forms of subtle pressure are also applied. One mother of a disabled child was told she would be “selfish” if she did not request MAiD for her daughter — and was told this in front of her daughter. It is revealing that Canadian doctors in some provinces are urged not to write death certificates listing MAiD as the cause of death, but rather only the pre-existing medical condition. One doctor, uneasy at these developments, came to a startling realization:

“I distinctly recall the day when it dawned on me that those of us who refused to participate in assisted death would be regarded as physicians of questionable ethics. We might be seen as more concerned for our own personal moral hang-ups than for the welfare of the patient. Where causing death was once a vice, it was soon to be a virtue. ... Several jurisdictions in Canada became the first in the world to require effective referrals with the threat of potential disciplinary action, and California will shortly join them. Once death is deemed a form of health care, health care ‘providers’ will be expected to offer it.”

Come spring of 2023, Canadians will be able to qualify for MAiD on the basis of mental illness alone. The government also plans to extend the right to MAiD for “mature minors” under 18. Furthermore, in October, the College des medecins du Quebec released a report stating that MAiD should be permissible for “babies from birth to one year of age who come into the world with severe deformities and very serious syndromes for which the chances of survival are virtually nil, and which will cause so much pain that a decision must be made to not allow the child to suffer. In that respect, the committee highlighted the Netherlands’ and other countries’ experience. This avenue could be explored.

“Finally, the committee considered the burden of living some elderly people carry. In geriatrics, we call it failure to thrive. For these individuals, life no longer makes any sense. Among other things, the fragility of life, diminished physical capabilities and existential pain become intolerable burdens.”

Let that sink in.

The use of MAiD has increased exponentially since introduced in Canada. In 2016, 1,018 individuals died under MAiD. In 2021, 10,064 Canadians died through MAiD, more than 3% of all Canadian deaths.

The introduction of euthanasia in Canada has become the slipperiest of all slippery slopes. Of course, the expansion of assisted suicide laws in the U.S. will produce the same troubling problems. 

Oh, Canada! Canadians have the right to die, but do they have the right to live in the face of medical challenges?

Valerie M. Hudson is a university distinguished professor at the Bush School of Government and Public Service at Texas A&M University and a Deseret News contributor. Her views are her own.