By: Nicholas Tomaino – wsj.com – September 2, 2024

Assisted suicide was sold as compassionate. In practice it has turned out to be monstrous.

That principle became less clear with the advent of physician-assisted suicide. Krauthammer was writing about Vacco v. Quill, in which the Supreme Court would hold unanimously that the Constitution doesn’t create a right to that procedure. “We are being asked to become a society where, when the tormented soul on the ledge asks for our help in granting him relief, we oblige him with a push,” Krauthammer wrote, reflecting on the oral arguments.

Laurence Tribe, who argued the case for the plaintiffs, suggested the slope wouldn’t be so slippery. The procedure would be granted to the patient with end-stage heart failure, not the man on the ledge. At the same time, Mr. Tribe posited that people at the “threshold at the end of life” enjoy the liberty to decide how they die. Krauthammer spotted the argument’s hole. Why couldn’t the chronically ill “who face a lifetime of agony,” or the “healthy but bereft,” avail themselves of the same right?

Several states have since legalized physician-assisted suicide and others are considering it. Americans who are skeptical of Krauthammer’s warning might consider the experience of their northern neighbors.

Canada has undergone a crash course in what the country calls “medical assistance in dying,” or MAID. The experiment began in 2015, when the Canadian Supreme Court ruled in Carter v. Canada that “laws prohibiting physician-assisted dying interfere with the liberty and security” of people with “grievous and irremediable” medical conditions. Parliament codified the decision the following year.

Lawmakers thought they were imposing limits. “We do not wish to promote premature death as a solution to all medical suffering,” then-Justice Minister Jody Wilson-Raybould said. The plaintiff’s lead lawyer in Carter argued that “in almost every case,” doctors will want to “help their patients live, not die.” “We know physicians will be reluctant gatekeepers.”

Yet Krauthammer was right. The Superior Court of Quebec soon ruled that MAID was unconstitutional because it required that an applicant’s death from “a grievous and irremediable medical condition” be “reasonably foreseeable.” Parliament amended its “discriminatory” regime in 2021, opening wider the door to facilitated death. The new law dropped safeguards, such as the minimum 10-day assessment period between request and provision. It also proposed mental illness as an eligible condition, the implementation of which the government has delayed until 2027. The message for everyone else remains the same: If you want to die, you needn’t wait.

The consequence, Ethics and Public Policy Center fellow Alexander Raikin notes in a new study, is that what was meant to be exceptional has become routine. Using two government data sets, he estimates the program is at least the fifth-leading cause of death in Canada, claiming a reported 13,241 lives in 2022, up from 1,018 in 2016.

Mr. Raikin notes the government believed doctors wouldn’t merely rubber-stamp applications. Yet in 2022 more than 81% of petitions resulted in death, including for “vision/hearing loss” and “diabetes.” He documents that the percentage of denied written requests has been falling for years, from 8% in 2019 to 3.5% in 2022, even as the number of applications has increased. The upshot has been that 44,958 people have been put to death between 2016-22. One estimate, published in the New England Journal of Medicine in 2020, predicted that “approximately 2,000 euthanasia” cases could be expected annually. The MAID toll that year was 7,611. Thus “either in absolute numbers or when weighed as a percentage of deaths,” Canada has the “fastest-growing assisted-dying program” in the world.

Roger Foley, who suffers from a degenerative neurological disorder, cerebellar ataxia, has witnessed MAID since its infancy. In 2009, as Mr. Foley’s condition worsened, he resigned from his job at the Royal Bank of Canada. After several years in home care, in which he claims he was mistreated, he was placed in a mental-health ward.

“I became extremely suicidal,” Mr. Foley, 48, says in a Zoom interview from his bed in the hospital, where he’s lived since 2016. After he shared those thoughts with staff, he says they began to float the idea of euthanasia. That alarmed him, so he began to record conversations secretly. He later shared them with Canadian journalists.

In one, a hospital ethicist threatens Mr. Foley with denial of insurance coverage and says it would cost him “north of $1,500 a day” to stay in the hospital. When Mr. Foley protested, the ethicist retorted: “Roger, this is not my show. My piece of this was to talk to you about if you had interest in assisted dying.”

He didn’t. “I have a passion to live,” Mr. Foley says. He wants to volunteer and write songs. Many people like to “use the term ‘end suffering,’ ” he says. In practice, that means “Don’t help the sufferer, end the sufferer.”

“I deal with a lot of pain every day,” he says, “but you can’t give up at the point of any problem—you’re still of value, your life has value.” Mr. Foley isn’t religious, but to my Catholic ear, it sounds as if he’s saying life is sacred. Canada’s healthcare system wants not only to give up on him, but to compel him to give up on himself.

No one has offered Mr. Foley euthanasia for some time, given the public attention on his case. He’s attempting to secure financial support to leave the hospital and live on his own.

Yet as he rejects MAID, others seek to open its doors wider still. On Aug. 19, an organization called Dying With Dignity filed suit in Ontario Superior Court, claiming that preventing assisted dying for mental illness is discriminatory. That may not sound dignified—but, as Krauthammer saw, it is logical.

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Source: Welcome to Canada, the Doctor Will Kill You Now – WSJ