CCBI News – MAID/Euthanasia in Detail, Terminal Illness Not Required; Widening Access—Mature Minors; Church Teaching; What to Do

May 26, 2023

Dear Friends of CCBI,

Legalized Assisted Dying: California 3,344; Canada 31,664

A friend of CCBI forwarded an article in Bioedge comparing the number of deaths by euthanasia in Canada with the numbers in California, and asking: “In 2016 both Canada and California legalized assisted dying. But from then to 2021, 31,664 Canadians — 3.3% of all deaths — died under Bill C-14, compared to 3,344 Californians under the End of Life Option Act. What explains the difference?”

MAID — A Softer Name for Euthanasia

A good part of the reason for the difference is that the MAID law passed in Canada in 2016 clearly stated that, to qualify for the procedures, a person had to suffer only from a grievous or irremediable illness. The Act also included ‘disability’ as a qualifying provision. The words ‘terminal illness’ were not used and the law made it obvious, even then in 2016, that euthanasia and assisted death were meant to go far beyond that idea. I don’t think most people realized that at the time and many still do not know, which is why education of the Catholic population in these matters is still necessary. It’s amazing that so many still seem surprised that MAID is actually euthanasia under a ‘softer’ name. There is a general presupposition that MAID/euthanasia is meant for terminally ill people who are also experiencing great suffering. In reality, MAID covers many other situations that do not involve terminal illness at all.

Although the following section from the Medical Assistance in Dying Act, 2016, is quite long, I hope it will be helpful for people to know its exact wording, which is rather different from what many imagine it to be. Here is the relevant section:

Eligibility for medical assistance in dying

241.‍2(1) A person may receive medical assistance in dying only if they meet all of the following criteria:

• (a) they are eligible — or, but for any applicable minimum period of residence or waiting period, would be eligible — for health services funded by a government in Canada;
• (b) they are at least 18 years of age and capable of making decisions with respect to their health;
• (c) they have a grievous and irremediable medical condition;
• (d) they have made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure; and
• (e) they give informed consent to receive medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.

Grievous and irremediable medical condition

(2) A person has a grievous and irremediable medical condition only if they meet all of the following criteria:

• (a) they have a serious and incurable illness, disease or disability;
• (b) they are in an advanced state of irreversible decline in capability;
• (c) that illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable; and
• (d) their natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining.

Terminal Illness Not a Requirement

On reading this it becomes clear that the law did NOT ever require that a person be suffering from a terminal illness and not only that but, from the beginning, incurable diseases qualified and so did disabilities. The Section required that death be ‘foreseeable,’ but as soon as the law was passed it became clear to many that it would be challenged at the earliest opportunity. After all, “reasonably foreseeable” can be said about everyone’s death, therefore using vapid terminology left the new law open to almost immediate changes and extensions. Lawmakers must have known that, especially in crafting legislation of a sensitive and divisive nature.

In fact, within two years of passing the Act, Parliament set up commissions to consider euthanasia for mental illness, euthanasia for children and euthanasia by advance request. Euthanasia for ‘mature minors’ is not recommended at this time, but neither has it been rejected. It is to be studied further for five years to develop better safeguards and to ascertain young people’s views on a topic that concerns people their own age.

Euthanasia and assisted death for mental illness and on advance request were approved in an Act in 2021 that amended the MAID Act of 2016. Implementing the procedures on account solely of a mental illness was delayed, however, until March, 2023, again under the proviso of allowing better safeguards to be drawn up.

Current MAID Provisions

The situation in Canada as of March 17, 2021, is that persons who wish to receive MAID must satisfy the following eligibility criteria:

• be 18 years of age or older and have decision-making capacity
• be eligible for publicly funded health care services
• make a voluntary request that is not the result of external pressure
• give informed consent to receive MAID, meaning that the person has consented to receiving MAID after they have received all information needed to make this decision
• have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2023)
• be in an advanced state of irreversible decline in capability
• have enduring and intolerable physical or psychological suffering that cannot be alleviated under conditions the person considers acceptable

The amendments to the 2021 law were resisted by many disability rights groups, who argued that the law “…devalues the lives of people with disabilities, particularly those who are Black, racialized, Indigenous or otherwise already marginalized and face discrimination in the health system.” They fear such vulnerable people will be pressured, directly or indirectly, to end their lives.

At the same time, the amendments were a ‘wake-up call’ for many Canadians about what is allowed through MAID. Contrary to what the Act says, we know that mental illness is not irremediable and is, thankfully, treatable in most cases. Objecting psychiatrists told government and the Justice Department that they are trained to help people not only to survive, but to overcome their illnesses. Suicide prevention agencies protested that they, too, exist to help people to value their lives, assisting them through desperate circumstances. Concerns were raised about people with dementia perhaps being discouraged from pursuing treatment and opting for an early death through MAID while they are still able to consent. Professionals also stated that assessing people’s mental illnesses is a difficult task, not one that can be undertaken lightly or accurately. If a patient were to make a request for MAID, psychiatrists indicated that it not as straightforward as making a physical prognosis.

Catholic Teaching is Firm

It is of note that these types of concerns and objections were raised even by those who believe euthanasia is sometimes permissible. It is never permissible in Catholic teaching, which draws a firm line in the sand: we respect the sanctity of life as stewards of God’s creation, from conception until natural death. Concerns were also raised about the capacity to consent when one is suffering from a mental illness: how valid is the capacity to choose death by someone suffering from serious depression? Many psychiatrists have professional doubts about this category and have started to question it, perhaps not realizing along with most of the general public that these provisions for euthanasia procedures had already been legalized in 2021. Implementation was not to have taken place until March 2023, but they were not simply questionable proposals. Despite that, there was such a hue and cry (rightly so!) that the Justice Department decided to delay implementation for a further year, until March 2024, in order to craft more suitable safeguards. CCBI has repeatedly said that there are no safeguards robust enough to prevent mistakes and tragedies, no matter how many years are spent drafting them. We can say that because we know that safeguards fell away in the Netherlands, Belgium and Luxembourg a few years after original euthanasia legislation, and they have already fallen in Canada as a result of the Act amending MAID in 2021. Death need not be foreseeable, advance requests for MAID can be made, and, unless the amendments passed in 2021 are reversed, euthanasia procedures solely for mental health will be implemented in March, 2024.

Can We Still Make a Difference?

Now that more people are aware of what is really happening in this field, perhaps more can be done to prevent the extension of MAID to mature minors, the next step of the Justice Department’s plan to widen access to MAID. Minors giving full consent to being euthanized? Decision-making regarding death at such a young age? There are clearly many questions begging better answers, and we can direct them to Parliament via local MPs, the Canadian Justice Department, medical regulatory bodies in the various provinces and any relevant agency. Every voice counts! CCBI agrees with what the CWL is currently advocating: “Now go make a difference!”

Why is California lagging behind Canada in assisted dying? – BioEdge

Canada’s medical assistance in dying (MAID) law (justice.gc.ca)

Pope Francis’ Intentions for May: For Church Movements and Groups

We pray that Church movements and groups may rediscover their mission of evangelization each day, placing their own charisms at the service of needs in the world.

Moira and Bambi