“MAID has become a way to compensate for lack of resources and reduce healthcare costs.”
Kotalik maintains that there had been far too little investigation or oversight of MAID since its introduction. “There is no real governance of this national programme, which relies for the purpose of collecting information about applicants and deaths entirely on self-reporting by providers,” he said. “I’m concerned about the possibility of people choosing MAID without the full or correct diagnosis, especially in cancer when oncologists are not involved. Options for a cancer patient should not be assessed just by a general practitioner or nurse practitioner so I worry patients are not fully informed about alternative options with different treatments and more comfortable outcomes.”
Such warnings become even more pertinent in light of the surging MAID toll on Vancouver Island, a haven for wealthy retirees with its beautiful beaches, forests and mountains. Euthanasia campaigners often reject claims that reform leads to a “slippery slope”, although numbers keep rising and icriteria have been expanded in nations that led the way. In the Netherlands — which in 2002 pioneered assisted dying for patients — it accounts now for one in 20 fatalities, with 58 couples dying together last year and the rules extended to include terminally ill children.
Canada has also seen MAID cases soar each year — and once again, protections have been eroded. In 2021, the central rule that natural death had to be “reasonably foreseeable” was removed. Latest figures disclosed that 13,102 people ended their lives under the scheme in 2022, a rise of 30% over the previous year despite postponement until 2027 of the controversial expansion to people with chronic mental illness. The country is catching up fast on Holland’s rate with 4.1% of deaths aided by doctors. Its annual MAID report also revealed that more than one-third of those choosing to die felt themselves a burden on family, friends or caregivers. Inevitably, there have been significant controversies with reports of pressurised fatalities involving disabled, elderly and impoverished citizens.
Meanwhile, the rate of MAID cases under Vancouver Island’s health authority is more than twice as high as the rest of Canada; indeed, it may well be the world’s highest since it accounts for almost one in 10 deaths. I heard various explanations for this, ranging from the struggling state of the region’s cancer services through to a history of legal, social and medical activism in support of euthanasia.
Prominent practitioners include Stefanie Green, founding president of the Canadian Association of MAID Assessors and Providers, who has assisted more than 400 deaths. She spent two decades as a family doctor focusing on maternity and new-born care before turning to assisted dying. “I’d always been interested in the intersection between medicine and ethics,” she told me. “The more I looked into it, the more I was drawn to it. The skill set was almost identical. It required a knowledgeable person to take people through a natural event. I would be with them during a very intimate event. It would take time to build up the trust. It is intense, it is intimate, there are the family dynamics.”
When I asked if medically induced death was really “a natural event”, she insisted that “the death is imminent” before adding that she found the work deeply moving. “Patients are grateful, families are grateful, and I am facilitating their final wishes. I am certain in all the cases they are 100% eligible, both legally and medically. The work is done properly. It is not for me to decide on their situation. It is their personal autonomy.”
Green is both passionate and proud of her work: intriguingly, she faces far more protests over the single day a week she spends performing infant circumcisions from campaigners who argue it is an infringement of the child’s rights. She agrees, however, that patients such as Allison have every right to feel disappointed. “She should feel aggrieved that the Canadian health system is not working efficiently and failed her. I will also demand better resources with more doctors and nurses. The government has failed — but that is not reason to cancel the MAID programme. It needs to be delivered carefully and cautiously.” Likewise, she agrees society often fails people with disabilities. “We must act to remedy this — but this shouldn’t mean we cancel desired, needed, legal medical services.”
Green stresses that MAID requires people to make their own request to terminate their lives. “It cannot be triggered by anyone else. It cannot be coerced — subtly or explicitly. It must be consistent with their own values; they must demonstrate capacity. It is far, far more common to see people coerced out of their request for MAID than to have someone show up who has been coerced into making this choice — which we then note and find them ineligible.”
This debate is a moral minefield, with emotive and valid arguments on both sides. There is, however, a global drift towards legalisation of assisted dying, from Ecuador to Germany. In Britain, as lawmakers across the Channel prepare to debate assisted dying, YouGov polling suggests similar legislation would be backed by 44% of voters, although 31% remain unsure — and surveys have suggested twice as many people with disabilities would be concerned by a change in the law as support it, despite claims from campaigners to the contrary.
Christopher Lyon, a social scientist at the University of York, believes Britain should be very cautious in following Canada’s lead after witnessing his father’s assisted death in a drab Victoria hospital room in the summer of 2021. He was left highly disturbed by the experience, believing his father failed to meet the correct criteria for being moved rapidly to the category of “reasonably foreseeable” death, as well as being depressed and possibly drunk when giving consent. “It was absolutely horrific,” he said. “Britain would be wrong to go down this path. You see some people making the same arguments as in Canada about personal autonomy, control and the right to make decisions to end your life. It is perhaps a choice for people in very rare cases with extreme and unmanageable suffering at the very end of life, which is not what we see in Canada. But there is no doubt the evidence points towards a slippery slope with widening access — although it is really more of a cliff face. Ultimately, I doubt any assisted death system can be made safe.”
Lyon told me he was neutral on this issue before seeing his 77-year-old father die. “It is horribly hard to see your father in distress being killed by a doctor with no attempt to help. It is almost indescribable. It came across as so cruel — but also so avoidable.”
Main Edition
US
FR
Join the discussion
Join like minded readers that support our journalism by becoming a paid subscriber
To join the discussion in the comments, become a paid subscriber.
Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.
SubscribeCure a man of his disease, and you’ll just have to treat him again someday. Cure him of life, and you’ll never have to treat him again.
More time on the golf course. More left in the budget. What’s not to like?
So the argument seems to be that because the health care system (whether in Canada or the UK) is struggling, and some people are going to die of cancer who, in an ideal world, would survive it, the problem should be compounded by ensuring that those people who do die must die in a lingering and painful way rather than quickly and painlessly? Have I understood that correctly?
No, you haven’t understood correctly.
Well, that’s what it looks like from my reading of it.
Me Too (sorry).
I must admit that was my general reading of it.
In a perfectly performing health sector some of these people would have a better chance of survival, but that isn’t the system we have in many cases. So given the choice between waiting times causing a lingering death or popping some pills for a quick one I’d choose the quick one
The problem here is that the universal system has to quantify individual human beings as units based on how much they cost the human collective. There is absolutely a socialist financial calculation being made here. It’s strict utilitarianism not compassion.
Why do ALL citizens have to participate in a “shared insurance system” that “ethically” suggests certain people would cost far less if they weren’t around? Personally, I would not want any of my tax dollars going to assisted dying and neither would many others…at least in the less “enlightened” parts of the U.S.
I have, in my long life, always opposed socialism in all its forms. Nonetheless we (in Western countries at least) pay taxes to governments, and acquire (with any luck) certain benefits in return. Why shouldn’t those benefits include some things that we might find useful at some point, like the opportunity to die painlessly at a point of our choosing? The decision on whether to die is after all the individual’s alone.
Why do you want the government involved in that? The point of taxes (at least in America) used to be building basic functional infrastructure (roads, bridges, water lines, power plants, sanitation systems, etc) and fund services that protect the community and infrastructure like cops and firefighters. The role of government used to be coordinating those basics. Do we need to keep continually expanding the government’s role until it’s a Perpetual Nanny State?
Why does anyone want the government involved in population sorting? I don’t wish pain on anybody but it’s incredibly obvious that you’re going down a slippery slope by casually assuming “Assisted Dying” is a liberatory program.
Well, it would seem that you live in the US. In the US, pretty much everyone has access to a gun, and can thus take their own life easily enough. Even though I am in Australia, I too am in that fortunate position, so it’s not really an issue for me. However, not everyone is in that position, particularly in the UK, where gun ownership is rare. Is your objection purely a financial one? Would you be happy enough with me going to my doctor and saying “Give me the green needle” if I pay the full cost of it, and don’t put you to any expense, or is there some “religious objection” underlying your position?
It’s about the type of local society I want to live in. I’m under no illusion that I can prevent Canadians or Australians from implementing these assisted dying laws. I can’t even prevent Oregon or California. But I can at least have a say in the laws of my state and I think our laws are infinitely better than Oregon or California’s laws. As a result, the culture is better. For instance, we don’t permit public encampments to signal our “compassion for the unhomed.”
In a Federal Democratic Republic like the US, Healthcare is local. You get to decide what sort of society you want funded with your tax dollars. I don’t feel any need to help fund projects that merge “bioethics” with cold, calculated utilitarianism so I don’t live in a State that does. I didn’t want to wear a mask everywhere so I left the place that forced me to do it. It’s not me imposing anything. I don’t want to be part of any universal public insurance system because eventually it will have to police lifestyles and ration services due to demand constraints. Assisted dying is just a bureacratic cost solution. It speaks to a culture of nihilism.
Opinion noted. I for my part value freedom, and I can think of no greater freedom than the ability to choose when to leave this world.
Then why do you need the Gov’t to help you?
He’s explained why he can make his own autonomous decision to end his life. But in countries like mine that solution is not available to most people, so we need medical professionals to provide assistance which they cannot do without appropriate legislation.
What if I’m incapacitated? What if my hand is not steady enough to load the gun, point it the right way, or pull the trigger. I have long planned that if I find myself with a degenerative disease, I will rehearse the process every day, and when I get to the day where I say, “I might not physically be able to do this tomorrow”, then the gun goes “bang” that day. However, what if I get it wrong?
We are allowed to choose… until we’re not.
But it is no longer the individual’s choice at this point. There is a sickeningly coercive element here, especially when a government is involved whose attitude towards large swathes of its own population is infamously less than positive, and whose primary concern is not the lack of compassionate care for those suffering, but instead the lack of bureaucratic oversight throughout the whole ‘suicide’ process.
Ultimately the individual still has a choice if they want to die. It’s not a good choice, and it’s a very messy one, but it’s still their’s. Involving the government does not make it any better or less messy; it only runs the risk of that choice being taken away from people entirely.
I think it should always be the individual’s choice, but once the individual has freely indicated they want to exercise that choice, then it is nobody else’s business at all.
Well, yes it shouldn’t be anyone else’s business. But involving the government *makes* it someone else’s business, namely the taxpayer. And the water-cooler dictators in charge of the public purse don’t give 2 sh**s about your autonomy.
But all of this seems to be dancing around the point. I am not arguing against a person’s right to choose in the abstract, but against giving government bureaucrats the power of life and death over the citizenry. And not in any kind of abstract theoretical, but very literally in the here and now. I live in Canada, and let me tell you as someone with a disability who’s been dealing with our much vaunted healthcare system for over 20 years, there was probably a dozen or more doctors or administrator’s at any given point who would’ve *gladly* suggested my parents euthanize their defective child if it had been an option open to them. People like myself are little more than a number in a spreadsheet, and a particularly annoying and burdensome one at that.
This whole issue has moved well beyond whether or not a person suffering unbearable pain at the end of their life should be allowed some extra help out the door. It’s about whether human life has any intrinsic value. It’s about whether there should be something standing in the way of governments deciding to bump you off because you’re too inconvenient, ’cause their own morality certainly isn’t going to. It’s about whether we want to live in a society that sees nothing wrong with the idea of state-sponsered euthanasia of the physically and mentally feeble. I recall Germany tried a policy like that sometime in the early 20th century, with the way people talk about this now I’m surprised that era isn’t looked back on more fondly.
The whole idea of ‘dying with dignity’ in this case is a croc. I can’t think of a death *less* dignified than being put down by the state because your existence unbalances the books. Too often proponents of these policies invoke the idea of ‘well if I was in that position I’d want that as an option’. But are you in that position? The comfort you derive from that abstract theoretical should not come at the cost of a very real threat to the lives of someone like myself.
Seriously? You actually think that someone is going to come in and give you the “green needle” without your consent?
Because the evidence of euthanasia in the countries that have introduced it is that medical systems begin to stop offering palliative care to those don’t choose to kill themselves. In nationalised health systems, your desire to kill yourself at a moment of your choosing conflicts with my desire to be treated humanely as I lay dying. You obviously haven’t read the article, but do do you understand the premise a bit better now?
Show me this evidence & find some manners while you’re at it.
The article in question is full of evidence. And I’m sure I could scrounge up quite a few more examples, if that would please you.
This isn’t a new phenomenon. It’s quite a longstanding issue here in Canada, one that is going *exactly* as many of its critics feared it would.
Ok Dr Death, while I find some manners why don’t you read the article? There is evidence in it from the UK and Canada. Real world experience beats theoretical talk about freedom.
The article says nothing of that nature, that palliative care is restricted to push people towards assisted dying.
If people choose to go the expensive route (palliative care) why shouldn’t the government paying the bills push them toward the less expensive option?
Yes it does:
“Concerns have been highlighted by Canadian bioethics professor Jaro Kotalik, co-editor of the first full analysis of his country’s reform, who warned British MPs last year that MAID seems to be more and more “a way to compensate for lack of resources and reduce healthcare costs”. He added that palliative care “appears to be a casualty of MAID” with reduced access, leaving some patients to feel that assisted dying was their only option since “their suffering has been inadequately addressed or because they perceive that their families or social supports would carry an excessive burden”.”
I see no conflict. If you choose not to ever avail yourself of “assisted dying”, I support your right to remain in this world until the time of your “natural” (by which I mean “unassisted”) death. However, it seems the converse is not true.
And that’s the crux of it. Those who’re arguing against legal assisted dying are seeking to curtail your freedom to choose not to prolong unnecessary pain and distress. If they wish to choose the latter, those in favour of assisted dying are happy to let them.
I’m not arguing against assisted dying. I’m arguing against euthanizing the disabled. It’s simply that implementing the former without stringent and ironclad safeguards based on the intrinsic value of human life will inevitably lead to the latter. That isn’t some baseless fear mongering, but observable fact.
And bureaucratizing suicide is not ‘giving people more freedom’. All it is, no matter how much you gussy it up with pretty language, is granting the government the right to decide which of its citizens is worthy of life saving treatment, and which should be ‘encouraged’ to spare the rest of us the burden of their existence.
I’ve never seen any evidence of this. Where can I find it?
Errm not so fast.
Here are 3 recent papers which would indicate that as ever, it is way more complicated than the average UnHerd contributor would like it to be :
The Relationship of Palliative Care With Assisted Dying Where Assisted Dying is Lawful: A Systematic Scoping Review of the Literature June 2020
Assisted dying and palliative care in three jurisdictions: Flanders, Oregon, and Quebec March 2021
Irish Hospice Foundation Paper. International experience of assisted dying April 2023
The last reference has a nice even handed summary over pp 27 – 29
“Assisted dying” in these papers would also appear to include what most people would call euthanasia.
They don’t. They’re free to pay for private care if they don’t want to use the public system
Death is universal, we’re all doomed, imagine how bad it will be after 2030 when all the boomers are over 65, there will be millions more people they won’t be able to take care of, whether it’s private or public. Soylent Green will be coming back to the theater near you
70 years ago radiotherapy and chemo were poorly understood and very expensive. Because the alternatives were dying early and painfully, we put enough effort into their development and supporting infrastructure such that they are now cost effective treatments available to all in the developed world, saving lives daily. Except in Canada today, where assisted death is now promoted above even basic palliative chemo as this story highlights.
If 70 years ago we logically and rationally decided it was too complex and too expensive for ordinary people and instead opted to simply end the lives of ordinary people to avoid pain, the development of the infrastructure to support widespread use of radiotherapy and chemo would not have happened, and today they would remain expensive and restricted.
Assisted suicide will rob ordinary people of access to future medical advancements. Assisted suicide will absorb all social and political pressure to do better for ordinary people. Assisted death will be used to mask the outrageous failings of public healthcare management in Canada and elsewhere.
How can the term “rob” be applicable when a path has been freely chosen? I may die today of something that could be easily cured in a year’s time. Them’s the breaks. Some may choose to cling to life with white knuckles, hoping for a “new treatment” (as is their right), but when my time comes, I intend to stride up to the door to the “other side”, turn the handle, and walk through.
You don’t seem to be listening. Paths are not being ‘freely chosen’. No one’s free will and autonomy are being respected. Vulnerable people in desperate need of help are being encouraged to rid society of their burden because a utilitarian calculus has been made and decided that they’re not worth giving lifesaving treatment. Multiple stories have surfaced of people accepting MAID purely because they don’t have the money or resources available to cope with their conditions. One man in BC was given MAID and the main underlying condition cited in the report was ‘hearing loss’. Several war veterans have come forward and said that the Department of Veteran’s Affairs would not give them the treatment they needed, but would be more than happy to refer them to MAID. And that’s just scratching the surface.
That’s on top of questions over whether the drug used, one that is also used in executions in the United States, is really all that humane or painless. Autopsies show death is caused in part by a build-up of fluid in the lungs, which suggests that it’s a death tantamount to *drowning*.
But again, you fall back on ‘when my time comes’. I’m sorry, but I’ll say it again, and I’ll keep saying it until I get my point across: *your* comfort shouldn’t come at the cost of *my* life.
I am listening, I just a) don’t believe some of the “facts” you put forward, and b) to the extent that I do believe them, I don’t think they should be an issue. If I have “hearing loss”, and it destroys my quality of life to the extent that I don’t want to continue living, what business is that of yours?
It becomes my business when it sets a precident that a disabled person doesn’t deserve to live. This isn’t just a slippery slope, it’s a frictionless cliff. If you don’t believe me, look up news stories regarding MAID. Why would a government pay to help someone live if it’s cheaper to help them die instead?
If personal autonomy is so important to you, why involve the state in your death? There are plenty of ways to end it on your own. There are a plethora of options available to you, why insist on the one that actively threatens my well-being?
Pretty much!
Can’t speak for CA (spits) but sure AF happens in UK. Beneficiaries include HMRC, care homes, drug co’s/NHS, hospice charities and countless others except the victims and their families. Weaponised “medicine” as with SARS Cov2, but with a nasty commercial spin-off. Mengele is a good analogy. Will they get away with it? he did – many of his cohort did not.Time will tell.
That’s what you are in a system with “free” medicine; a cost sink that they’d rather kill. I’d much rather be a paying customer who’s a source of revenue and profit, thank you very much!
Social darwinism, survival of the fittest, solves everything right
What an odd non sequitor.
I’ve never liked the look in the eye of the Canada goose down at the lake. His name is Justin.
Who names goose down?
A Boy Named Sue?
Note to editor, It’s debulking surgery, not debunking surgery.
Otherwise, my god, medical ethics is in a mess these days.
That has been corrected, so feel free to remove your comment
Really? It’s still a funny comment.
The bad news, the cancer’s going to kill you in months.
The good news, we can kill you instead if you want.
Well, the second of those two has the advantage of involving far less suffering, so that’s the one I’d choose.
And the worst news is that there was a treatment that would’ve saved your life.
Not in every case by any means.
True, but if possible curative options aren’t available or provided in a timely manner, the situation is unacceptable.
Not in most cases
Often the treatment is either very risky or unproven.
“…there was a treatment that would’ve saved your life”
No. A treatment that merely delays your inevitable death.
Remember. Life is terminal.
What are you waiting for then?
I’m not going to be one of those sad types clinging on to life, just waiting for the “next treatment”. When the time is right, I’m out.
Right. So because you’re scared of a bit of potential suffering and pain (before you’ve even faced it), as a formal State we collectively need to ditch tens of thousands of years of fundamental Human instinct, plus the Hippocratic Oath, plus pretty much every principle and value of civilised, Enlightenment and progressive thinking, ignore the repeated historical lessons of State-empowered barbarianism, expose current and future generations of governments and medical sectors to all kinds of liability, and send a message to huge numbers of our fellow living Humans that the affliction, condition or biological fate that life has dealt them – including feeling a bit sad and getting a bit old, apparently – renders their life a little less worth living than a ‘normal’ one.
Poor Martin M wants to be allowed – nay, helped – by Big Mummy-Wummy-Statey-Watey to make the hurty-wurty go away. Goodness gracious we’re living in the Age of Supreme Narcissism. And what a pack of sooks we’re turning into, too.
Spine up, Martin. Neck some whiskey and bite on a chunk of leather or something. And if that doesn’t work, put a bullet in your own head.
But do keep us out of it.
It is called DEBULKING and not DEBUNKING surgery.
I have nothing against those wishing to truly exit life. What I have an issue with is state sponsored execution. When doctors start killing people then my faith and trust in that profession goes out the window. State sponsored euthanasia will be economic led. If you’re wealthy enough you’ll have access to end of life care. Those without will be steered towards the lethal injection.
I agree, and no amount of legal caveats will stop that. It’s as natural as water flowing downhill.
Bear in mind that the Nazis had no trouble in recruiting large number of doctors to participate in unspeakable things
If a doctor has an issue with “giving me the green needle”, then leave the substance in tablet form, and I’ll take it myself.
I can see it now, available in generic form from the mail order pharmacy.
Do you believe that there are any benefits to anyone in keeping older people alive against their own wishes?
Doctors see horrendous prolonged suffering every day, they even give fatal morphine injections to some in their last hours, so why should they be squeamish about ending that suffering formally?
I wonder why one would be squeamish about the idea of doctors formally killing their own patients…
You make it sound as though it’s a mere subjective preference, of the sort one might have for a particular type of food, but as far back as the Hippocratic oath doctors have understood that their work is about healing their patients. The moment one of the treatment options becomes to kill them instead, the Rubicon has been crossed, and the trust between doctors and patients becomes irreparably damaged.
Intent. Palliation is about the longest good quality of life.
I believe Poilievre has vowed to scrap MAID if elected? Possibly change ahead if so.
I think he has vowed not to expand it rather than scrap it (Trudeau has plans to expand to mental health conditions and for mature minors aged 12 and upwards)
A dreadful tale but the resultant either/or argument is very disappointing. If we refused to do anything because someplace else had screwed it up we would still be hunter gatherers.
The pro-euthanasia people need to engage positively with the ‘slippery slope’ objections instead of dismissing them as baseless.
If there is such a thing as an inalienable human right then it should be to decide on the time and manner of one’s death if that is what one chooses.
It should not be beyond the wit of civilised countries to allow that whilst at the same time protecting the vulnerable.
Forcing those in horrendous pain to live out their days in misery to satisfy someone else’s moral code is despicable cruelty.
‘It should not be beyond the wit of man’… doesn’t seem to apply in Holland, Belgium or Canada where men, wits or otherwise, have singularly failed to keep the matter within the original legal boundaries. Your comment is just another plea based on emotion not reason. Hopefully there are better wits than yours who can resolve the matter but it is far from easy.
Reason without emotion solves nothing. Insults don’t help much either.
What Neiltoo said is entirely rational. It’s emotion that’s driving people to oppose assisted suicide. Rational is to ask who benefits from keeping people alive at the stage of life where there is no hope, only suffering? Not the sufferer, not their loved ones, not the health or social services. No-one.
99.99% of people don’t get to choose the time or manner of their death. Nor do we get to choose the time or manner of our birth, or our family, or most of the other things that happen to us in life. Why on earth would you extrapolate the desire of a tiny % of people who want to kill themselves into a right? Much less an inalienable one.
If you do not have the right to end your own life then you are not truly free. There are many rights that people never avail themselves of, suggesting that if you don’t use it you lose it is pretty scary logic.
Who ever said you were “truly free”? You’re not allowed to kill, or steal. A whole lot more people would like to do those things, than want to kill themselves. The idea of a “truly free” autonomous individual is a dumb, modernist conception. Everyone is bound into a web of overlapping rights, prohibitions, and obligations.
As Janis Joplin so aptly said “Freedom’s just another word for nothing left to lose”. The last thing I ever want to be is “truly free”. That means you care about nothing and no one, and no one cares about you. If you love, you’re not “truly free”.
Janis Joplin? Really?
Look what happened to Janis Joplin. Her addictions killed her at 27.
But you do have it – at any point you can choose to end your life in any manner you like, suicide is no longer a criminal offense.
Because we can.
Because if you organise your own death your nearest and dearest (if you have any) can get used to the idea, ahead of time.
Because it ought to galvanise you into organising your affairs before you die, minimising work for the people left behind.
Because you can organise the event in such a way that there is less mess to clear up afterwards.
Because some people are altruistic.
Because physical and mental pain in a small percentage of people, is untreatable, uncontrollable and unbearable.
Then do it yourself. Don’t make anyone else complicit in your self-murder. Don’t put your guilt on your family and some hapless medical staff.
No-one is asking medics to do anything their conscience won’t allow them to do.
I have all the necessary gear in the garage for self deliverance, thank you.
We should all bear in mind however, that even if we are well prepared to do the job ourselves we may become suddenly physically incapacitated and will then be reliant on someone else to carry out our wishes – hence the current debate.
Because we can
Because if your nearest and dearest (if you have any) know what is going to happen ahead of time, they can prepare for it
Because it should galvanise you into getting your affairs sorted out before you die
Because organised appropriately, you will leave less mess when you die.
Those are good points. I am perfectly happy to blow my brains out when the day comes, but I do feel sorry for whoever has to scrub the ceiling.
Not looked at the demographics? The numbers of aged and therefore sick people is skyrocketing in the next decade or two.
”Beyond the wit of civilized societies…” I think experience and history have shown that so called civilized societies are not as “civilized” as we naively assume—particularly when they have abandoned Judeo-Christian values. Look what happened with Covid—instead of focused protection of the vulnerable, everyone was subjected to government-ordered restraints on freedom and personal autonomy. There is no reason to think that MAID will be handled any differently.
“It cannot be triggered by anyone else. It cannot be coerced — subtly or explicitly.
how do you square that with the opening paragraph
By the time she saw a specialist early last year, he warned that she might only live a few months longer: chemotherapy tended to be ineffective for her cancer, buying a bit more time at best, and she was inoperable. Instead, she was told to go home, sort out her papers, and decide if she wanted medical assistance in dying.
It was still her choice.
It was a choice between two unpleasant alternatives. She was not offered the third. She had to find that out for herself, and then pay for it herself. That’s directly at odds with the myth presented by the advocates of socialized medicine. To take this to the reductio ad absurdum, the most effective and efficient socialized medicine would have the provider offer two alternatives:
1) Here’s two aspirin. Go home and get well by yourself.
2) Or I’ll kill you.
Simple, cheap, easily administered — and everyone gets treated equally. The ideal socialist solution.
During Covid Antibiotics were denied to anyone with a positive covid test. This was by order of the Chief Medical Officer and the Chief Phamaceutical. There was then the un monitored use of midazolam.
Why anyone should really feel that the state has inadequate provision of health care but we will offer to very rapidly euthanise you so please do not worry.
For me the arguments for assisted dying are all overwhelming – until you come to our old and awkward friend, real world consequences. End of life care? I’m listening. But assisted suicide? Nah.
You’re completely cool with unassisted suicide though, right? If life gets to be a chore for me, and I blow my brains out, you have no issues whatsoever?
The thing I find odd is that most Canadians who I know consider state-sponsored killing to be a “medical procedure” because it is done by a doctor. It’s actually a gross perversion of medical ethics. In Canada it seems that medicine is no longer about healing people but instead the core ethos is to reduce suffering, even if this requires killing the person. This had led to state-sponsored killing as an alternative to medicine and to state-supply of harmful and dangerous drugs to addicts instead of treatment (“safe supply”). The sleight of hand used by the proponents is to use an edge case that many sympathise with (terminally ill people tormented by pain) to justify what fairly quickly becomes suicide-on-demand for any problems in life.
The thing I find odd is that most Canadians who I know consider state-sponsored killing to be a “medical procedure” because it is done by a doctor.
.
It’s a matter of habit. The German Zondercommands consisted of completely ordinary German burghers. The first mass shootings were a problem for them, then it became regular work.
People mistakenly think that the taboo against killing is innate and powerful, whereas it is taught and can be quite easily forgotten.
Well, the world’s militaries do their best to ensure that their soldiers can kill in appropriate circumstances.
You are making the assumption that most doctors spend most of their time “healing people”.
I suppose if you are just talking about setting broken bones then this is a correct statement.
I would argue that doctors spend most of their time reducing suffering (as you accuratley point out) and this can be as simple and as hopeless as planting a seed of hope – that the individual will feel better / be “cured” of their cancer / reduce their cholesterol so that they might live forever … or whatever.
It’s not a broken healthcare system, it’s a broken society one step from Nazi treatment of mentally sick. Progressives in its best.
I agree with the arguments that assisted dying will be abused ‘as surely as water runs downhill’, as someone has commented below. But I also have a deep unease about the loss of our ‘humanity’, the ineffable quality of conscious human life.
I lived in the U.S. for six years, early in my career. I didn’t have a special job or anything, but I had insurance the entire time and very good healthcare. Coming back to Canada in 2006, things were worse than they had been when I left. They’ve gotten much worse since then. At least I had a doctor I could get to see within a few days and access to same-day nurse practioner. Now I only have a nurse practioner and it takes a couple of weeks to get an appointment.And I live in one of Canada’s largest cities.
Next time you live in the US, try it without insurance, and see how good the healthcare is.
Ah, yes that’s the typical Canadian response. Rather than recognize how bad things are, the smug Canadian approach for decades has been to haul out tropes of how bad the U.S. is and pat themselves on the back with satisfaction.
I can’t comment on whether or not it is the typical Canadian response. I am Australian.
if we make others feel they are a burden to us to the point they would rather end their life we are doing the whole human thing terribly wrong
Having just seen my dad out of this world, I can’t agree with you more
Has it ever occurred to you that not everyone sees “end of life” in the same negative way as you? My view is that when life stops being fun, it’s time to stop doing it.
Surely your life has stopped being fun many times already?
But, here you are.
Presumably, the fun started again too.
Life stops being fun all the time. Fun moments happen all the time too and often very unexpectedly. Even the gravely ill often enjoy a good laugh in their last days.
Nope, my life has always been fun. Sure, some days have been better than others, but if I had my time over, I would not do a single thing differently. Still, I have had my health and faculties so far. If that changes, I want to keep my options open. After all, nothing lasts forever.
GB and Canada are both areas I would never live due to the health system. I have known people waiting for help in Canada who died while waiting…This socialist/whacked out idea of govt run health is great for a commune but not for a real country. The USA will NEVER have it and I am glad…Need real healthcare? Real experts? The Best? Come to America…we protect your countries and glad to protect your health…
TR
Hmmm… the USA which you say has “the best” healthcare actually has only the 47th best survival rate in the world. The 46 other countries with a much better survival rate have a highly subsided or completely subsidised national health system.
Nationalized medicine, like anything else that is nationalized, suffers from the finite nature of other people’s money. I have had to endlessly explain to Americans who think it’s a great idea that such systems operate by necessarily saying “no” to things that people here believe can only be answered with “yes.”
The MAID program is an offshoot of fiscal reality, whether one wants to acknowledge it or not. When the state saves money by killing people rather than treating them, it has created a massive incentive to kill even more people. What began with the terminally ill has since expanded well beyond its stated intentions, which is par for the course with almost any govt initiative.
Name anything any government does that isn’t either overdone or skimped.
I’ll wait.
Yeah. Far better in the US, where you get excellent treatment (provided you have $200,000, of course).
Our medical system in canada is openly failing and our leaders do nothing. It is surreal here.
“Hard cases make bad law” comes to mind. This one case had a promising ending, the longer term survival of this one particular patient. So, therefore the reasoning goes, that it must be right that hundreds of other patients, not so extremely lucky, must suffer in extreme agony till nature takes it’s course, and they can only die then. It is imposed cruelty that we would never visit on our loved pets.
Life is suffering.
Sure that’s right – look how many suffer in UK, enriching care homes, HMRC and the drug companies that de-facto rule the NHS. This one lady was fortunate. Many are not. Wife and I have advanced decision wills and luckily live in a jurisdiction that respects that bequest. There is something of Mengele in the glassy -eyed zeal of the MAID crew and their NL and OR affiliates. They are the wrong people in the wrong place – such a sensitive issue requires experience, knowledge and calm, not some cranked up leftist bot – a 30-40 year old going on 14.
No one has to be in extreme agony. They can give people enough morphine to dull pretty much any pain. The fact that they don’t is yet another failing of the medical system.
Maybe just leave the morphine in the drip, and let the patient decide how much they have (up to and including a fatal dose).
Not everyone can tolerate morphine, there can be very nasty side effects. If I have the choice between living for months in a drugged-up semi coma and a dignified exit where a doctor gives me the tools to do it myself I will choose the latter every time.
Nothing is dignified about self-murder.
Leaving aside the debate and strong cultural bias against euthanasia from a trad Kantian/Christian perspective, there does seem to be a practical applied issue at hand here. Leftists and public sector blob- bots seem to want to propagate a type of Mandatory Suicide. ( thanks Hanneman, J. RIP) This has nothing to do with a persons inability to tolerate their living circumstances, it is more about how many people they can kill. I do hope they can turn this view point back on themselves and leave the innocent alone. Perhaps they should take the advise of another great composer, Allin, GG: use a gun, use a knife, take some pillls just take your life.
A similar argument to the present piece is given in Noah Smith’s Substack. He is an economist and notes “the perverse incentives for euthanasia”. It is a cheap form of “treatment” so providers seek to substitute it in place of more expensive forms. There is a lot of money to be saved.
I have, in searching around this issue found two points that this piece does not make. First, in the USA, rates of assisted dying have stayed pretty constant. This may be because all that is permitted is providing poison for the “patient” to drink (assisted suicide), not actually putting them to sleep (euthanasia).
Second, it is suggested that the more strongly a right to die is asserted the more euthanasia there is.
The point that access to euthanasia goes along with reduced access to palliative care is not one I have heard before. I am not sure that it is always true, but it is an important point.
https://www.noahpinion.blog/p/the-perverse-incentives-of-euthanasia
“The country is catching up fast on Holland’s rate with 4.1% of deaths aided by doctors.”
There’s a problem with the statistics here. How many of those opting for assisted dying would have taken their lives by other means if it was not available? Is there a corresponding reduction in the rate of suicides?
Very good point.
Just keep voting for TrueDope and you’ll be seeing more of this insanity
This was inevitable from the moment governments and collective profit driven organizations like insurance companies got involved in healthcare systems. Traditionally, there have been situations, such as warfare, where there are a large number of injured in various states of medical peril but only enough doctors and resources to treat so many. Battlefield medics have to make choices about who can be saved and who can’t, who gets immediate treatment and who must wait. It’s a part of warfare. This is battlefield triage practiced on a national scale. In that respect, the dilemma is understandable. The problem lies in who is making the decisions and who’s being pressured to do what by whom to protect whose vital interests.
Traditionally, people have little problem killing one another for money and advantage individually and collectively. We have tended as a society to demand higher ethical standards and greater scrutiny of doctors for that very reason. It’s not perfect and there are still bad doctors who are driven more by profit than a desire to help, but I think that’s probably a minority, and the social pressures and organizations of medical professionals tend to minimize the impact here. The problem is that doctors and patients aren’t the only people putting their two cents into medical decisions these days.
Since people decided governments needed to intervene in matters of healthcare, they now have a seat at the table, and who in human history has been more callous and less considering of human life than governments? The government has a different set of interests. The doctor’s interest is to treat patients and make a living doing so. The patient is balancing health benefits versus costs. The government, as well as insurance companies in private healthcare systems like the USA, have a different set of interests independent of doctors and patients. Driven to cut costs and/or increase profits, they have an incentive to push for cheaper treatments. Bureaucrats and insurance adjusters are not subject to the same level of public scrutiny nor do they require similar education levels. Doctors are, for many reasons, the best of us. The effort and expense required to attain that M.D. are such that few other than those who have a genuine desire to help people will ever attain them. Bureaucrats, as is often discussed on this site, are most assuredly not the best of humanity, nor are politicians. Politics, the exercise and use of power over other people, tends to attract the worst sorts of ambitious and Machiavellian characters. That’s why our ancestors protested and rebelled and established democratic systems to put a leash on the power of such people. Bureaucrats tend towards myopic pillars of mediocrity who try to please whoever is in charge, the aforementioned politicians, or just meet whatever budget they are assigned. Letting these people into medical and end of life decision making was never going to end well. Is there a way to do assisted dying fairly, without pressure from external sources to reduce costs. Yes, but not in a government subsidized care system. Preventing MAID from devolving into a triage systems where politicians, bureaucrats, and insurance adjusters are making some if not all of the decisions would be a constant, uphill struggle requiring the same level of scrutiny and ethics that the medical profession does. In a perfect world, I’d always favor some form of MAID, but in the world as it is, I’m skeptical that the positives are sufficient to justify the the overwhelming ethical problems and the potential for governmental or corporate misbehavior.
“Allison’s very existence challenges those who argue that Britain — with its flailing health and social care systems, shamefully long waiting lists and historically poor cancer survival rates — should rush headlong into legalisation of assisted death.”
You can spin that argument both ways.
In the UK, it is pretty obvious that as things stand, with our aging population and long term structural economic problems, future cancer patients are going to have no choice whatsoever but to suffer horribly while receiving inadequate care for their condition.
Of course, I would love it if adequate funding were magically made available to the NHS to address the above, but given that I don’t believe in magic and I can’t see where the funding will otherwise come from, I am strongly in favour of assisted dying in the UK because I want to have choices available to me that don’t involve me “suffering horribly while receiving inadequate care for my condition”.
If anyone would rather spin the argument the other way and argue that the collapsing NHS is an argument for not legalising assisted dying, that’s great! But please tell me where the funding will come from to make adequate and timely cancer treatment in an impoverished future an actual option and not just some unreal fantasy?
“She had stage 4 peritoneal carcinomatosis, an aggressive condition. ..” I see nothing wrong with presenting MAID in such a painful circumstance. It is an uncoerced OPTION, and one each of us should be able to consider. If we also have the will and the means to aggressively pursue alternatives, as Ducluzeau did, that is likewise fine. Maybe they’ll work, and maybe they won’t.
Each of us is a sovereign individual and deserves to have all options before us when making ultimate decisions. We can accept or reject according to our circumstances, resources and personal values. But suggesting a particular option — for treatment or for medically assisted dying — should be withheld from individuals making these choices is arrogant and paternalistic.
We live in the reality in which we live — including floundering health care systems — and people are living and dying in that reality, not in some future utopia in which these systems function ideally. Let’s give people their options and respect their autonomy enough to let them choose without moralizing from the bleachers.
Doesn’t each of us want that for him- or herself? I know I do.
Well except dying by euthanasia is not that easy – did you know that even with the injections they give it can still take hours of agonising suffering for some people to die and yes they use the same drugs that they use for death penalty. So many years later they have no new drugs that can kill a person in quick and predictable manner. Don’t even get me started on assisted dying at home – everyone envisions this as peaceful slipping away surrounded by loved ones when the horrible reality is that to die they have to crush literally hundreds of tablets and drink them quickly and hope they keep it down because if they vomit those tablets that’s dying botched up.
That’s odd. When the vet puts a pet down, they die quickly and painlessly. Are doctors so much less competent than vets?
It’s not either or – decent cancer treatment or assisted dying. We need to do both. Cancer isn’t the only reason to choose to die.
However, at 56, she was too young not to receive some sort of treatment option
If it’s a public health service and in her case unaffordable for that health service, or considered too risky, then crowdfunding is a good option.
At least she had a choice. We wouldn’t get that choice here in the UK.
I’m sure if you had $200,000 USD, you could travel to the US to get the treatment.
I’ve always opposed State-sanctioned VAD for the sole reason of the ‘value’ message it sends to all of society about ‘quality of life’ judgements. The argument that is rammed in our faces constantly about VAD – that is an ‘individual’ decision alone, of no business to or impact on anyone else or the community as a whole – is so much tosh. If you decide to kill yourself, by yourself (or with your own bespoke crew of VAD supporters) then fine: that IS ‘your decision’. Go ahead. You’ll get no argument from me. If you’ve decided you want to die – you great big independent free-livin’ libertarian, you – then frankly as an aged, disability and palliative carer I really do have about a million more important things to do with my limited vocational time and empathy than try to stop you. Much less provide intellectual, moral and ethical reassurance/legitimisation (or clinical help) to you, by saying State-approved VAD is just peachy.
Nope. It’s not. Because it demands that, as a whole society, we all get shanghaied into this diabolical business of deciding what is a ‘worthwhile’ life. You VAD champions can pretend all you like your decision to kill yourself is an ‘individual’ one, but if you need the State to approve it…then it’s no longer just yours, is it. Sorry, but I want no part of saying: yes, this life is ‘not worth living’. Yes, regardless of what the person living it says themself. Because once we’ve crossed the line of agreeing with them, as an organised tribal whole with organised defining influence and power (the State)…then it’s just a matter of haggling over where that subjective ‘not worth living’ line is to be set (and re-set, and re-set…).
By all means noose yourselves, if you please. Just stop trying to rope us all into your individual choice.
Personally, I’d be happy with a system where the State doesn’t approve it, but merely doesn’t oppose it. I’m fairly sure I could get one of my nearest-and-dearest to give me the pills when the time comes.