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Perspective: Inside the world of Canada’s assisted suicide — for ‘mature minors’

Canada’s already controversial euthanasia laws could expand to include children who qualify. This policy will nurture the country’s growing culture of death

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Michelle Budge, Deseret News

Abel Pelletier was only 4 years old when his mother, Karie-Lyn Pelletier, began petitioning the Canadian parliament to allow a physician to take his life in a medically assisted death.

Abel was severely disabled because of a rare condition called Mednik syndrome. The disease is incurable, although medications can manage certain aspects of the condition. Still, this case isn’t what most people think of when they think of euthanasia or assisted suicide. They think of elderly people with a terminal illness, not 4-year-olds.

But this is where Canada’s notoriously broad laws permitting medically assisted suicide have wound up.

Despite controversy over other cases — including Alan Nichols, who had only one health condition listed on his euthanasia application, hearing loss — the laws are set for expansion next year.

As soon as March, Canada could allow “mature minors” to die by euthanasia or assisted suicide without the consent of their parents. “Mature minors” is a loosely defined concept without a specific age; children who are considered able to make their own medical decisions would be able to request a medically assisted death.

To put that in context, before children in Canada can drive vehicles, they may be allowed to consent to physicians taking their lives. Equally appalling is the number of adults speaking in favor of expanding the law to include mature minors and also infants and the mentally ill.

Dying With Dignity Canada has written in support of extending eligibility to minors, proposing 12 as the minimum age requirement.

Dr. Louis Roy, from the Quebec College of Physicians, recently recommended in a parliamentary meeting that babies up to 1 year old be candidates for assisted suicide if they have “severe deformations or very grave and severe syndromes.” While Roy specified that this should be for babies with hopeless diagnoses or extreme suffering, bioethicist and physician Felipe E. Vizcarrondo has said that neonatal euthanasia cannot be “ethically permissible” and “there is much room for parental, physician, personal, social and economic bias.”

In fact, 64% of Canadians support access to medically assisted death for “mature minors.”

Killing the vulnerable

Medically assisted death for minors isn’t an entirely new phenomenon. Netherlands allows it for 12-year-olds with parental consent and 16-year-olds without it. Additionally, euthanasia for babies 12 months and younger is legal in Netherlands. Its neighbor to the south, Belgium, has no age restriction, but requires parental consent for children younger than 18 and mandates that the child have a terminal illness or be near death.

Billed as health care and cloaked in seemingly compassionate language, medically assisted death is described by proponents as a way to preserve human dignity, but it seems to be a way to kill the vulnerable. U.N. officials have already written that Canadian euthanasia laws seem to violate the Universal Declaration of Human Rights and that they discriminate against the poor, the elderly and people with disabilities.

Of equal concern when it comes to children and young adults, whose minds have not yet fully developed, is that some may see medically assisted suicide as an escape for circumstances that are likely to improve.

Writing for Common Sense, Rupa Subramanya told the story of Kiano Vafaeian, a 23-year-old Canadian who was approved for medically assisted death with depression and diabetes as the qualifying conditions. The procedure was scheduled for Sept. 22.

On Sept. 7, Vafaeian’s mother, Margaret Marsilla, found an email the doctor wrote to her son explaining the process. After Marsilla was able to draw media attention to her son’s case, the doctor refused to perform the procedure. She was able to temporarily halt her son’s death (even though he was over 18) by drawing attention to it. But if Canada expands its laws regarding medically assisted death, parents of minors may not be able to intervene.

Proponents argue for medically assisted death on the basis of human rights. Dr. Derryck Smith, a psychiatrist at the University of British Columbia, has said, “MAiD is about relieving suffering, respecting human dignity, and recognizing the inherent right for individuals to make decisions affecting their health and even their death.”

‘Perverse disincentive’

Good people can disagree on whether it’s morally acceptable for human beings to choose the timing of their death. But there is no question that medically assisted suicide provides what one Toronto physician has called a “perverse disincentive” for Canada’s publicly funded health care system to prefer death over expensive treatments and support. Canada already ghoulishly speaks of medically assisted death as a policy that can save millions of dollars.

One Canadian patient with a degenerative brain disorder, Roger Foley, said that the director of ethics talked about the cost of keeping him in the hospital. When Foley asked about long-term care, the director said, “My piece of this was to talk to you, (to see) if you had an interest in assisted dying.” Another doctor reportedly called a mother “selfish” when she refused medically assisted death for her daughter.

Canadians’ attitudes about medically assisted death seem to have been broadly influenced by a criminal case from nearly two decades ago. Before assisted suicide was legal, Robert Latimer killed his daughter because of her extensive medical issues, which included cerebral palsy, compressed organs, chronic pain and the inability to talk or feed herself. He was sentenced to life in prison with no chance of parole for 10 years. A poll conducted shortly after his sentencing determined that 73% of Canadians believed that Latimer should have received a more lenient sentence and 41% of Canadians believed that “mercy-killings” should be considered legal.

Last year, more than 10,000 Canadians opted to end their lives with medical assistance, a number that climbs every year. Abel Pelletier, the 4 year old whose mother petitioned for a medically assisted death, wasn’t among them; he died earlier this year. But Canada’s grim accounting of MAiD deaths may well include children in 2023 — to its shame.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.