By Gus AlexiouCanada’s extremely liberal euthanasia laws, which, next year, are set to be extended to include people suffering from mental health conditions and potentially minors, have been slammed for being reminiscent of the way the Nazis dealt with people with disabilities by a leading academic in the field.
In an article published by the Associated Press last week, Tim Stainton director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia said the country’s uniquely permissive euthanasia laws were, “probably the biggest existential threat to disabled people since the Nazis’ program in Germany in the 1930s.”
The AP article additionally detailed the story of 61-year-old Alan Nichols who had a history of hearing loss and depression and, according to Nichols’ brother, was unlawfully “put to death” by the Canadian state in 2019.
Though Nichols’ family cited a pitiful lack of oversight and gross negligence on behalf of the medical professionals treating him, the Canadian Mounted Police in conjunction with British Columbia’s Health Ministry declined to bring forth any criminal charges.
Nevertheless, the episode, allied to the upcoming expansion of the laws governing euthanasia in Canada in 2023, raises serious questions.
Could it be that a country renowned for its “liberal universalism” and libertarian fundamentalism has grotesquely perverted the principle of accessibility when it comes to Medically Assisted Dying?
Accessibility is, in most cases, that precious ethos and lifeblood which allows people with disabilities to thrive as functioning members of society.
Yet, within this sphere, unfettered accessibility could indeed prove to be one of the most malignant forces the disability community has had to contend with since the “mercy killings” of the Third Reich almost nine decades ago.
A global issue
Around the world, euthanasia, where doctors use lethal doses of drugs to end the lives of patients with terminal and chronic illnesses, is legal in Belgium, Canada, Colombia, Luxembourg, Netherlands, New Zealand and Spain and certain parts of Australia.
Additionally, several U.S. states including California, Colorado and New Jersey permit a format in which a physician can prescribe barbiturates that are then self-administered by the patient.
Canada’s euthanasia laws came into force in 2016 and resulted in around 10,000 deaths last year.
Proponents of the practice in Canada claim there are robust checks and balances in place and health minister Jean-Yves Duclos said the national euthanasia law “recognizes the rights of all persons … as well as the inherent and equal value of every life.”
Nevertheless, there exist several trends and protocols that set Canada apart from other territories in which euthanasia is legal that have led opponents to express concern that the country’s medical establishment is faltering on a precipice.
Unlike in Belgium and the Netherlands, there are no monthly commissions in place to review problematic cases, whilst in Canada, the procedure itself can be undertaken by a nurse practitioner rather than purely being restricted to doctors.
Perhaps, most troublingly of all, and where the issue has become most politicized and conflated with liberal fundamentalism, is the manner in which euthanasia is proactively proposed as a “treatment option” by physicians caring for patients.
Whereas in other countries where it is legal, euthanasia appears to be more siloed away from all other medical remediations and viewed as something altogether separate – in Canada, it appears to be more deliberately inserted into routine dialogue between doctors and their patients.
For eligible patients, who don’t need to have a terminal illness but simply a life-limiting disability – it is not so much that physicians are encouraging them to choose euthanasia but rather proposing it as a choice of equal standing amongst other options for treatment and palliative care – in some situations without the patient themselves raising the topic.
Living with dignity
Dr. Ramona Coelho, a Canadian family physician told the Associated Press, “The whole premise of the legislation is built on a discriminatory approach to people with disabilities.”
Further continuing, “Most Canadians think that this is a service of compassion offered for people who have nothing left to be offered and are being offered death as a way out. When, in fact, the system is being applied so liberally and so easily in such a short time period that people are dying who would’ve recovered with greater care and resources to live.”
It is a view echoed by Marie-Claude Landry head of the country’s human rights commission who said that euthanasia “cannot be a default for Canada to fulfill its human rights obligations.”
Addressing the notion that, when patients are presented with treatment options by doctors, they are likely to be viewing their future life with disability through the lens of economic deprivation, Landry said, “In an era where we recognize the right to die with dignity, we must do more to guarantee the right to live with dignity.”
Last year, three United Nations human rights experts condemned the Canadian legislation as having a “discriminatory impact “on disabled people and running contrary to international human rights standards.
Meanwhile, during a recent visit to the country, Pope Francis attacked Canada’s culture of utilitarianism when it comes to its euthanasia policy, deploring the fact that “patients who, in place of affection, are administered death.”
Some may argue that interventions based on religious precepts simply risk polarizing a debate that is worthwhile and can no longer be sidestepped by any country in the world.
To extend the religious connotations – it is often said that the “devil is in the details” but, in the case of Canada’s euthanasia law, quite the opposite appears to be true.
Surely, the real danger lies in the vagueness, latitude and sense of laissez-faire brought about by the unique interplay of such an ethically complex and emotive policy area and Prime Minister Justin Trudeau’s unbreakable pact with liberal universalism.
There are unlikely to be any easy answers here.
However, a starting point might be to acknowledge that accessibility should only possess the remit of upholding the primacy of the welfare of people with disabilities and never be hijacked as a façade to prop up significantly wider political ideals.