How do Canadians feel about expanding eligibility for euthanasia to include those with mental illness? The House of Commons Special Joint Committee on Medical Assistance in Dying accepted submissions until the end of June and heard from 348 Canadians. We spent some time reviewing the submissions to see what Canadians are saying.

On both sides of the argument, there were submissions from doctors, patients, Canadians with disabilities, those with mental illness, family members, organizations, and advocates. Interestingly, there was an almost even split between submissions in favour of euthanasia and those opposed. But some disturbing ideas and trends are reflected in the pro-euthanasia submissions. As we advocate against the expansion of euthanasia these trends are worth keeping in mind.

Advance directives for euthanasia

The primary message from those writing in favour of euthanasia is that it doesn’t go far enough. The number one request was to add advance directives. This issue was raised in about 150 of the 175 submissions in favour of euthanasia. Advance directives allow a person to decide what circumstances they would consider intolerable to live with, and to give written consent for a doctor to euthanize them should those circumstances occur, even if they occur after a person has lost the capacity to give consent.  

Dr. Catherine Ferrier, a geriatric physician who specializes in dementia, writes strongly against advance directives for euthanasia. She concludes, “It is absurd and alarming that written directives, having failed for ordinary treatment decisions, are now being contemplated for MAiD. To cause the death of a person with dementia, who is not asking for it, on the basis of advance consent that is necessarily uninformed, is contrary to autonomy and beneficence, and has nothing in common with treatment withdrawal decisions… If MAiD by advance request became legal and binding, Canada would be the only place in the world where a state agency is obliged by law to kill an innocent and defenseless person.”

Euthanasia for mental illness

Other submissions argued in favour of euthanasia for those with mental illness, an expansion which will already come into effect in March of 2023 if the government does not change the law. A submission from Bobbie Garnett Bees explicitly states his desire to die by euthanasia as soon as it becomes legal for people with mental illness. He asks for more relaxed safeguards so he will not be forced to try treatment first in order to qualify.

Bees writes, “In closing I would ask the committee to understand that this life of mine belongs to no one but myself. I had absolutely no say in the matter of my conception or birth. I had no say in the matter of my sexual abuse or how my sexual abuse was dealt with. I had no say towards how my mental health as a child was neglected. Allow me the dignity to determine how and when my life will end. Allow me the dignity to die in a peaceful and painless manner. Allow me the dignity to not have to die alone.”

On the other hand, for those writing against euthanasia, the expansion to those with mental illness was the primary concern raised. Psychiatrists, psychologists, doctors, patients, and family members alike wrote passionately against the expansion of euthanasia to those with mental illness. Most doctors do not want to provide this service for the mentally ill. Would we really be doing Mr. Bees, or any other person who has been victimized, a service by killing them?

We hope the committee heard the opposing submissions loud and clear. Suicide prevention efforts must be directed at all those with mental illness and offering assisted suicide as a solution to mental illness is completely incompatible with this.

Euthanasia for children and teens

A third recurring theme from those in favour of expansion was that of euthanasia for minors. These submissions generally came from known MAiD advocates and organizations, such as Dying with Dignity and the Canadian Association of MAiD Assessors and Providers. While many submissions were written with the aim of expanding eligibility for euthanasia to mature minors, particularly those with cancer or severe disabilities, others take it further. Dr. Natalie Le Sage, a self-described “physician devoted to medical assistance in dying” and an experienced MAiD provider, writes, “I can tell you that, as a MAID provider, I am quite comfortable providing MAID to children whose cases have been assessed within the guidelines.” One of her recommendations, then, is to “expand eligibility to children aged 0 to 1 with life-threatening conditions and to those aged 14 or older who otherwise meet all MAID eligibility criteria.”

This is the natural progression that comes from embracing absolute autonomy. However, expanding euthanasia to children aged 0-1 is no longer about patient autonomy – it is about parental autonomy. It extends the logic of abortion to born children, allowing parents to determine whether a life is wanted or worth living. When we fail to recognize ourselves as the created and God as the Creator, we arrogantly assume the responsibility of choosing who is deserving of life and who is deserving of death. .

Moving forward with compassion

The submissions to the committee overwhelmingly refer to euthanasia as compassionate and patient-centred care. Doctors who provide euthanasia have convinced themselves that their job is to do what their patient wants, regardless of any moral right or wrong. Patients have embraced the sense of control that comes with a scheduled death, and family members have accepted that a dignified death requires this option of control. Fighting against euthanasia in this cultural and political context is an uphill battle. But it is a battle worth fighting.

It is understandable that suffering people would look for a solution to their suffering. We must have compassion for those who believe that euthanasia is what compassion looks like. But we must also continue to speak the truth in love. And the truth is that we are not in control of the number of our days or our level or type of suffering, and we do not have the authority as human beings to euthanize other human beings.

We want to thank those of you who took the time to respond to our call for stories and submissions. It is a testament to the work of many of you that the submission numbers were as close as they were, and we hope that the committee took note of the clear divide among Canadians on this issue. Pray that our country will proceed with caution and find its way through to once again care, not kill, when a fellow human is suffering.

To take action against the expansion of euthanasia in Canada, go to CareNotKill.ca