OPINION:
Physician-assisted suicide is legal in 11 U.S. states and the District of Columbia, and Illinois might join the list by the end of December.
The state recently passed a bill that would allow doctors to prescribe a lethal dose of medication to terminally ill patients. Gov. J.B. Pritzker has until year’s end to sign, ignore (in which case it automatically becomes law) or veto it — and veto it he must.
Several articles have called on Mr. Pritzker to veto the bill, urging him to uphold the dignity of the medical profession and protect vulnerable patients. In addition to these well-founded concerns, the governor should consider the example set by my home country, Canada, as a case study in the danger of legalizing assisted suicide.
In 2015, the Supreme Court of Canada struck down laws prohibiting assisted suicide in the landmark case Carter v. Canada. Several experts, including Belgian professor Etienne Montero, warned that euthanasia, once legal, is difficult to control. Nonetheless, the court rejected the plausibility of the slippery slope and posited that narrow requirements would provide the necessary safeguards.
In response to this ruling, the Canadian government in 2016 enacted Bill C-14, which set forth a regulatory framework for accessing assisted suicide. Under it, consensual homicide and assisted suicide were restricted to patients suffering from a “grievous and irremediable medical condition” that would result in their “reasonably foreseeable death.”
With the enactment of Bill C-7 in 2021, reasonably foreseeable death was no longer required to access assisted suicide in Canada. It’s now sufficient to be suffering from a serious medical condition. This can include a serious illness, disease or disability that causes “unbearable physical or mental suffering” that “cannot be relieved under conditions you consider acceptable.”
The resulting system should be categorized more as a regime. Since its legalization, more than 90,000 “medical assistance in dying” deaths have been reported in Canada. A recent article in The Atlantic reported that doctors are struggling to keep up with the demand, and many have wrestled with the implications of euthanizing the non-terminally ill.
One doctor in the article recounts the story of a man in his 30s with a diagnosed treatable form of cancer who insisted on medical assistance in dying. Despite being given a 65% chance of survival, the man refused treatment, rendering his condition as technically “incurable” — and him eligible for euthanasia. Canada is preparing to expand eligibility to those suffering from mental illness alone in 2027.
When Canada legalized euthanasia, it did so based on human rights, at least according to its primary advocates. Organizations such as Dying With Dignity Canada sport the slogan “It’s your life. It’s your choice.” An American organization, Death With Dignity, advocates for the “rights of the terminally ill to die on their terms” and aims to achieve assisted suicide access throughout the United States.
Clearly, the assisted suicide movement’s main prerogative isn’t the alleviation of suffering. If that were so, one wonders why it doesn’t instead work on developing and improving access to quality palliative care, which can address or alleviate almost all forms of physical pain. Rather than eliminating suffering, assisted suicide eliminates the sufferer — and often not because of physical pain but rather existential angst.
In fact, Health Canada has reported that a significant number of patients accessing euthanasia do so because their suffering produces “isolation or loneliness” and creates a “perceived burden on family, friends or caregivers.” Assisted suicide advocacy is about one thing: establishing a “right” to die.
Once society accepts the premise that we have the “right” to die, it’s only a matter of time until physician-assisted suicide is expanded. U.S.-based advocates already are arguing for the United States to replace the existing requirement that a patient’s death be expected within six months with a “reasonably foreseeable” requirement like Canada’s, a vague requirement that Canadian guidelines say does not require a rigid time frame.
In addition, groups such as A Better Exit have argued for expanding medical assistance in dying to patients with neurodegenerative diseases so they can self-administer lethal doses before they lose their cognitive and physical capacity to apply for them.
Mr. Pritzker’s decision is a microcosm of the broader dilemma the United States faces. We can choose to uphold the dignity of the dying patient by providing them with needed comfort — physical, emotional and spiritual — through proper palliative and long-term care. Or we can open the Pandora’s box of assisted death to usher in a “right to die” that is fundamentally at odds with the logic of suicide prevention.
In this instance, it’s safe to say that a tried-and-true conservative principle applies aptly: Whatever you do, don’t be like Canada.
• Liana Graham is a research assistant in domestic policy at The Heritage Foundation.
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