Of course we can 'discriminate' against people seeking a medical procedure for which they have no medical need
There is remarkably widespread and politically diverse agreement: Canada is not currently in a position to allow euthanasia for patients suffering solely from mental illness.
“The (health-care) system needs to be ready,” Health Minister Mark Holland averred Monday, after announcing the government wouldn’t meet a self-imposed March 17 deadline to expand access. “It’s clear from the conversations that we’ve had that the system is not ready and we need more time.”
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“What we’ve heard loud and clear … is that those health-care system actors are not ready,” Justice Minister Arif Virani agreed.
Conservative MP Michael Cooper, a member of the Parliamentary committee studying what we call “Medical Assistance in Dying” (MAID) and everyone else in the world calls euthanasia, concurred: “Canada isn’t ready.”
The conservative governments in Alberta, Saskatchewan, Ontario and New Brunswick joined the NDP government in British Columbia in asking for more time to … well, it’s not totally clear what they want to do, but they want it.
Quebec, being Quebec, has been legislating on euthanasia all by itself — and has thus far explicitly excluded mental illnesses, on their own, from its regime. Quebec has consistently led the way among Canadian provinces in advocating legalized euthanasia. When you’re way out in front of Quebec on expanding access, it’s evidence enough that a rethink is in order.
Not everyone agrees, naturally.
The suddenly ex-MP David Lametti (a Quebecer, ironically), told The Canadian Press he would have no qualms about legalizing euthanasia solely for mental conditions. (He was justice minister when the government gave itself the 12-month extension that expires March 17.)
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“It will be a very minimal number of people who will have access to medical assistance in dying in such circumstances,” said Lametti, days after the Toronto Star and the Investigative Journalism Bureau reported “Canada is the fastest-growing adopter (of legalized euthanasia) in history” — which is emphatically not what we were promised.
Liberal MP Nathaniel Erskine-Smith also attempted to defend expansion, arguing “medical assistance in dying has been an overwhelming success in Canada.” The vast majority of deaths are more or less in keeping with what most Canadians seemed to expect from MAID cases, he argued: Terminal illnesses, intractable pain, natural death being otherwise foreseeable.
It’s an uncharacteristically lame argument. The stories of people seeking and potentially receiving euthanasia because they have fallen through (or are about to) the last layer of the social safety net don’t horrify and frustrate Canadians because there are tens of thousands of such people. They horrify and frustrate Canadians precisely because there aren’t that many such people, and yet we still can’t manage to find them suitable housing and medical care.
And all that mess is before we expand access to people suffering only from mental illnesses.
Then there’s the oddly activist gang of Senators who insist on greater “access” to MAID. Nova Scotia Sen. Stanley Kutcher, a psychiatrist, insisted this week we must be “led by … compassion,” but also made a legalistic case for expansion: “We can’t discriminate against some people being allowed to make an end-of-life choice.”
Begging the Senator’s pardon, of course we can “discriminate” against people seeking a medical procedure for which they have no medical need — especially one that results in death. Some might even call it a moral obligation. Doctors, for example.
We’re doing it right now, as I write this. We’ve done it ever since MAID was legalized in Canada, and no court has told us we can’t: For no good reason, the government simply accepted an amendment, moved by Kutcher on the Senate floor, to slap an 18-month sunset clause on the otherwise explicit exclusion of mental illness as a sole justification for MAID.
It probably seemed like the easiest thing to do: keep hope alive among those disability and mental-health advocates who see MAID for the mentally ill as an expression of human rights; keep fury at bay among those disability and mental-health advocates who see MAID for the mentally ill as an engraved invitation to further abuse, neglect and degradation. Eighteen months is an eternity in politics.
Well, we’re 30 months into this shemozzle. And nobody in the government knows what to do except punt again until we’re somehow “ready.”
It’s a grotesque notion: Once we get a handle on Canada’s myriad mental health-care crises, then we’ll be in a morally justifiable position to euthanize the mentally ill? Once we solve the housing crisis, then it’ll be fine to euthanize the homeless? These are artifacts of a debate that has gone miles off the rails.
“Not ready” aren’t the words Canadian politicians are looking for. “Not ever” are the words.
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