Life has not been cheapened by MAID. Dignity, choice, and bodily autonomy have all been bolstered, André Picard writes.David Joles/The Associated Press
Thanks to the legalization of medical assistance in dying, more than 100,000 Canadians have been spared unnecessary suffering at end-of-life.
As we mark the 10th anniversary of Bill C-14, Medical Assistance in Dying, on June 17, we should be celebrating, not hand-wringing.
The culture of dying has changed fundamentally, for the better. About one in every 20 deaths is now medically assisted.
Life has not been cheapened by MAID. Dignity, choice, and bodily autonomy have all been bolstered.
Anti-choice activists claim there are too many MAID deaths – 16,499 in 2024, the latest year for which we have data.
But too many compared to what?
More than 95 per cent of people choosing MAID have deaths that are “reasonably foreseeable,” in the words of the legislation.
If these patients – most of whom have terminal cancer, heart disease, diabetes, chronic obstructive pulmonary disease (COPD) and the like – weren’t dying from assisted deaths, how would they be spending their final days and hours?
The most common choice for the terminally ill is VSED – voluntary stopping of eating and drinking. Others opt for palliative sedation, numbed by drugs until their “natural” death mercifully arrives. Some have DNRs, “do not resuscitate” orders that mean if their heart stops, medical staff don’t shock them back to life.
Are any of these methods inherently more humane or moral than MAID? Is allowing someone to starve to death slowly a better end than a lethal injection at a time of their choosing?
But offering MAID access to those whose deaths are “reasonably foreseeable” is not sufficient. Illness and suffering come in many forms.
MAID is a modern term for an ancient desire – to have some agency at end-of-life, to minimize suffering.
Those who oppose choice seem to believe suffering is a necessary part of the human condition, an unavoidable part of life and death.
It’s fine to embrace that worldview, but you should not be allowed to impose that belief on others, especially in the legislation of a secular society.
For many Canadians, MAID has become a ritual and ceremony, like marriage, or childbirth. In most cases, it is a celebration of life.
There are tears, laughs, music and all manner of deeply personal gestures, from carefully curated final meals to deeply deliberated musical choices to mark the passage. These are the kind of rituals that can only exist when death comes at the time and place of your choosing.
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When abortion was legalized, anti-choice activists issued dire warnings about fetal slaughter run amok. Never happened.
In fact, Canada hasn’t had an abortion law for almost 40 years and things function as they should, with women making deeply personal reproductive choices in concert with health care providers.
We’ve had endless warnings about the “slippery slope” of MAID as well, frightening claims that we will see the culling of the elderly, of people with disabilities, those suffering from mental illness, and those who live in poverty.
Hasn’t happened, and it won’t. Not all slopes are slippery. The cases that push the boundaries are a path to better legislation, and better care.
Let’s not forget that MAID laws have been overly conservative, and repeatedly liberalized by court rulings that remind politicians that individuals have rights, including bodily autonomy.
Tellingly, every one of the lawsuits that has resulted in expansion of MAID criteria has been championed by people with disabilities who want to be treated equitably, not in a patronizing fashion.
The changes we’ve seen, and should see, from dropping the “reasonably foreseeable” prerequisite, to allowing MAID for those whose sole underlying condition is a mental disorder, through to allowing advance requests for those with dementia, are driven by public demand and motivated by compassion.
Assisted death is on the agenda of every liberal democracy in the world, a debate driven by demographic and cultural trends and realities.
People are living much longer, but they want to live better. They also want to die better.
The public has always been way ahead of the academics and politicians on these issues. Canada has been a world leader, and we should be proud of it.
MAID is not an experiment anymore. It’s a legitimate health care choice, an integral part of end-of-life care.
Assisted death is not for everyone. But choice is.
MAID is a gift to those who want to control their exit from this world. A gift to be cherished, and nurtured, and fought for.