Coyne, who has been writing about issues related to euthanasia and assisted suicide for many years, examines Canada’s move from cautiously considering euthanasia to Bill C-7 which nearly permits death on demand.
Six years ago, before the [Canadian] Supreme Court discovered a right to die in the constitution’s guarantee of the right to life, what most people understood as the case for assisted suicide was something like the following: a mentally competent adult, suffering acute pain from a terminal illness and facing more of the same to the end, comes to a firm and unwavering decision to kill herself – but is physically unable, by virtue of the same illness, to do so unaided, or fears she will be unable to when the time comes.
That was the condition of Sue Rodriguez, whose 1993 Supreme Court appeal challenging the constitutionality of the Criminal Code prohibition on assisting in a suicide, though unsuccessful, first brought the issue to public attention. It was also the condition of Gloria Taylor, the woman on whose case the Court based its 2015 decision legalizing the practice (Lee Carter, whose name is attached to the decision’s short-form title, was merely a co-appellant).
Had you predicted then that the right to an assisted suicide would soon come to apply, not only in cases of physical pain but psychological, and not only to patients in the last agonizing stages of death but those who were nowhere near it – had you predicted, indeed, that a patient’s request to be killed would not even have to be repeated and persistent for a doctor to act on it, that the whole process could be telescoped into a single day – you would have been accused of “slippery slope” thinking.
Had you predicted that, by 2019, just the third full year after it was legalized, nearly one in 50 deaths in the country would be by assisted suicide, even on the (almost certainly underreported) official numbers; and that, this having been accomplished, talk would turn to extending the procedure – not just to competent adults, but the mentally ill and even children – you would have been carted off.
Yet that, incredibly, is where we are. The cautious, limited exceptions that people understood the issue to involve at the start – what most people understand it to involve even now – have been overtaken by an accelerating drive toward death-on-demand. Had the public known this was where we were headed, they might have objected. Instead it has been done in stages, a series of bait-and-switch routines in which the courts and legislatures have taken equal part.
The irony is that the very foundation of the Supreme Court’s decision in Carter was that there was no such slippery slope. Perhaps assisted suicide, once legalized, might have spread and metastasized in other countries, barbaric places such as Belgium and the Netherlands, to include children, people suffering depression, prisoners serving life sentences, and so on – but that, the Court was certain, could not happen here. The evidence was “anecdotal.” The “medico-legal culture” was altogether different.
And yet the Court immediately undermined its own premise. Though the decision ostensibly applied only “in the factual circumstances of this case,” i.e., to “people like Ms. Taylor” or “persons in her situation,” i.e., “wracked with pain” and near the “end of life,” by the time the Court got around to working out the general principle to be applied in such cases it had ditched any requirement that a patient’s condition be either terminal or physical; rather just “grievous and irremediable.”
Still, the decision did not preclude governments from imposing such a rule, even if the court declined to do so – if not that death be at hand, then at least “reasonably foreseeable,” in the language the Trudeau government adopted in subsequent legislation. So when a Quebec Superior Court judge ruled that provision unconstitutional in September, 2019, she was essentially freelancing.
The government had ample grounds to appeal the decision to the Supreme Court. Instead, it drafted legislation – Bill C-7, which it is now attempting to rush through the House of Commons in time for Christmas – that obediently accepted the Quebec court’s opinion as its own. Worse, it went further.
No longer would there be a mandatory 10-day waiting period between a request for assisted suicide and its execution, to allow for a change of heart. (According to Health Canada, 263 such requests were withdrawn in 2019.) Neither would two witnesses be required: henceforth, one would suffice.
And the Justice Minister promises more: to the objections of some that the bill excluded those suffering exclusively from a mental illness, the minister promises this will be the subject of a forthcoming review. As will the idea of extending it to “mature minors.”
Well, of course it will. It was obvious it would from the start. This is the point “moderate” proponents of assisted suicide are either unable to recognize, or unwilling to disclose. There is a fundamental disjoint between the idea, on the one hand, that people have an absolute right to autonomy over their own lives, and on the other, that this can be hedged about with all sorts of limitations.
Assisted suicide was sold, initially, as a sort of conditional right, like the right to drink or drive or vote, which could be limited to certain sorts of people. But the logic of assisted suicide does not permit it. It presents suicide not as a tragedy we should wish at all costs to prevent, but as a blessing, a release from intolerable suffering – so much so, that we should not merely allow people to end their own lives, but others to do so on their behalf; and not merely allow it, but require it – even subsidize it. So it is that, in the space of a few years, assisted suicide has gone from a crime to a right to a public service.
It could not be otherwise. And if such a right is not conditional, but inherent, a basic human right, how can it be limited: whether by the severity of the pain, or the proximity of death, or the identity of the sufferer? On what principle of justice do we tell a person they may seek relief from endless torment on the basis of a physical disability, but not mental illness? How do we extend such mercy to an adult, but not a child?
Perhaps once, we might have held the line. But it is too late for that now.