In the US, the culture war over the question of the beginning of human life has been amplified by those who want to reshape the end of human life. The debate over legalizing medical care for suicide began in Oregon nearly thirty years ago. The scheme in which doctors prescribe lethal drugs and instruct patients who want to end their own lives has been sold to the public as “death with dignity.” It would be carefully restricted to individuals over 18 years old who have incurable and irreversible diseases, and do not have a life expectancy of more than six months . This new approach to end-of-life care violated the laws of all 50 states that made it a crime to help a human being commit suicide. . For doctors, it violated the millenary Hippocratic oath: “I will not administer poison to anyone, even if they ask me to; nor will I suggest such an expedient.”
Early advocates of this radical shift in the doctor-patient relationship assured the Oregon public that there would be sufficient safeguards against abuse, and that this medicine lethal would be self-administered. His legislative proposals included barriers to ensuring informed consent and required psychiatric evaluations for applicants who appeared depressed. Anyone seeking assisted death also had to receive referrals from the palliative care center, as well as comfort care and alternatives for pain control.
With all these precautions, Oregon referendum in 2002 passed with 51 % against %, and the American experiment with assisted suicide began. As a Supreme Court decision the same year ruled that there was no constitutional right to assisted suicide, the battle to expand this form of suicide shifted to other legislatures. Those who advocated liberalization of laws argued that their goal was to alleviate and honor the right of individuals to die on their own terms. They claimed that hastening death was not the same as killing; and that compassion, rather than cost cutting, was their only motivation.
The infamous Hemlock Society , which at that time was the leading voice in defense of assisted suicide and euthanasia, changed its name and later merged with another similar organization to become “Compassion and Choices” [Compaixão e Escolhas]. She put on makeup by removing unsavory words like “suicide” and “euthanasia” from her speech as she continued her national campaign to offer citizens “all options for end-of-life care.” This change in identity and tactics paid off. Nine more states and the District of Columbia have decriminalized assisted suicide and followed Oregon’s regulatory model. In 2022, legislative efforts to introduce this practice or expand it have failed in Vermont, Washington, Hawaii, Delaware, Virginia, Massachusetts, Arizona, Indiana, Kentucky, Rhode Island and Connecticut.
But in Canada, much progress has been made and in full swing. Thanks to Prime Minister Justin Trudeau, the Doctor of Death of modernity, the slippery slope anticipated by critics is now sliding downhill in broad daylight. Shortly after its first federal election in 2015, Trudeau’s Liberal Party lobbied Parliament to pass the Medical Assistance to Dying Act (MAID). English that sounds like “lady” or “maid”). A candidate to die of MAID had to demonstrate that her death was “reasonably predictable” and that an incurable, serious and irremediable disease existed and was in “an advanced state of irreversible decline”. Individuals with mental illness or non-terminal disabilities were not eligible.
But Trudeau had bigger plans. Less than five years later, his government expanded the law to make Canada what can be called the assisted death capital of the world. Gone is the “reasonably predictable” death requirement, thus paving the way for disabled people who otherwise had their whole lives ahead of them. The requirement to wait ten days was also dropped, as well as the obligation to provide information on palliative care to all applicants.
Likewise, doctors are no longer the only ones healthcare professionals authorized to sign a quick death prescription. Nurses can also play this role. As for the two independent witnesses who previously had to confirm that the applicant had given informed consent and even signed the form, now one is enough. Unlike other countries where euthanasia is legal, Canada does not even require an independent review of the request to certify the absence of coercion.
Not satisfied with simply offering exits for the non-dying disabled, Trudeau even offered the possibility of MAID for the mentally ill. In March of next year, individuals in Canada who by definition cannot give informed consent because they are mentally ill will be able to request euthanasia or assisted suicide. Imagine what some Canadians wouldn’t do when they saw someone about to jump off the 20th floor of a building…
Today, the young prime minister’s pioneering spirit in death of the sick, the crippled and the mentally ill, approved by the government, includes the extension of MAID to “mature minors”. This measure is now under review by lawmakers, which – if history is any guide – means that such an expansion in eligibility for young people in Canada is inevitable.
That said. , reports of abuses in the Canadian assisted-death system – including the coercion of vulnerable and sick people by hospital staff – caused many to rethink Trudeau’s pro-death campaign. Furthermore, a recent government report brought unwanted press attention by pointing out that MAID could save 50 millions of dollars while ignoring the fact that the program encourages the government to deny important care and domestic services to those in need.
Where will this social experiment lead? It is no longer a dystopian fantasy to imagine that an artificial intelligence algorithm, rather than a medical professional, will ultimately determine MAID eligibility. It’s not out of the realm of possibility that a button technology would allow death by nitrogen gas. Such changes would leave the doctor completely out of the unpleasant business of intentionally ending life. In the Netherlands, the first country to legalize euthanasia, this lethal chamber is already in advanced development and about to be tested on its first human guinea pig.
The good news is that there is still some time for the US to find an alternative to the rerun of the scream-based dispute between “pro-choice” and pro-life on the abortion issue. Better pain management, earlier access to palliative care, improved community mental health services, expanded care options for the poor, a renewed emphasis on self-determination through guidelines that lead health systems to respect and honor the choices of patients without inciting suicide, and an outreach by religious organizations to the lonely, disabled and depressed, can help policymakers avoid the “pain or poison” dynamic that characterizes the current policy parameter.
In the end, it will always be easier to kill people than to care for them. In fact, unless some steps are taken quickly, the “right to death” will be within reach of the poor and the disabled.
Jim Towey was legal advisor to Mother Teresa of Calcutta for the last twelve years of her life. He served as director of the White House Office of Community and Faith-Based Initiatives from 2002 to . He is the founder and CEO of Aging with Dignity [Envelhecer com dignidade], a non-profit organization with offices in Tallahassee (Florida) and Washington (DC).
© 2022 National Review. Published with permission. Original in English.