John Ivison: A society that justifies euthanasia for children needs to reflect on whether it truly values life

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Buried deep in the new report by a committee of MPs and senators on medical assistance in dying, Dr. Gordon Gubitz, a professor of medicine from Dalhousie University, is cited as saying the Canadian public may not be ready for minors to receive MAID in cases where death is not imminent. He recommended the government proceed “thoughtfully, cautiously and in a stepped approach.”

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Another witness, Bryan Salte, legal counsel for the College of Physicians and Surgeons in Saskatchewan, questioned the constitutionality of limiting MAID to mature minors in their final days.

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The subject matter under discussion was not just whether Canada should join Colombia, Belgium and the Netherlands as a jurisdiction where dying children are assisted toward a more comfortable and compassionate death.

This discussion was on the prospect that assistance in dying be extended to minors with mental disorders who are not in an advanced state of irreversible decline

This discussion was on the prospect that assistance in dying be extended to minors with mental disorders who are not in an advanced state of irreversible decline.

The report of the special committee was tabled in the House of Commons on Wednesday. It makes a host of recommendations on palliative care, protection for Canadians with disabilities, advance requests for MAID and on the future of assisted dying for people where mental disorder is the sole underlying medical condition.

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But the most alarming endorsement is that the government of Canada should extend eligibility for MAID to include minors “deemed to have the requisite decision-making capacity.” For now, MAID should be restricted to mature minors whose death is reasonably foreseeable, the report said, “at least initially.”

We have come a long way from what was envisaged by the legislation in 2016, that saw Canada introduce medically assisted dying to adults with a “grievous and irremediable” medical condition.

The new report recommends amending the Criminal Code to include “mature minors” — a group that one witness suggested should include those as young as 12-years-old. The expert opinion was clear that a court challenge could very well open MAID up to adolescents with mental health problems, which, post-pandemic, appears to be most of them.

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The report also recommends that parents and guardians be consulted but that the will of the minor take priority.

In a dissenting opinion, the Conservative members of the panel said that MAID is a complex and deeply personal issue on which reasonable and well-intentioned people can disagree. That’s true.

But we are talking about the state assisting teenagers to kill themselves over feelings of fear and depression that, however painful, cannot be diagnosed by any doctor as irremediable.

The dissenting opinion said the Conservatives do not support MAID for minors and quoted Dr. Maria Alisha Montes, a clinical associate professor of pediatrics, urging caution “when biology shows that the ability to balance risks and rewards is one of the last areas of the brain to mature.”

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The decision to seek MAID is too momentous and irreversible to be left to — let’s use the word — children

Any parent who has reluctantly handed their progeny the car keys knows this intuitively. Suffering may not be a function of age but capacity is, and the decision to seek MAID is too momentous and irreversible to be left to — let’s use the word — children. 

The Supreme Court has deemed capacity is not dependent on age and Canadian minors are already allowed to make decisions on ceasing treatment. But they are rarely of the same magnitude as assisted death. 

To be clear, I supported the original MAID bill. Consenting adults facing intolerable pain should have the right to a compassionate end to their lives.

Further, I’m supportive of some of the useful recommendations made in the special committee report, including reforms to extend palliative care to vulnerable populations. 

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Another good idea is that Health Canada review its Special Access Program that regulates the availability of psychedelics like psilocybin — magic mushrooms. One expert witness said she has successfully treated patients with demoralization, fear and depression. Dr. Valorie Masuda said psilocybin is “highly efficacious and safe.”

There was also a sensible recommendation that the government amend the Criminal Code to allow for advanced requests for MAID from people who have been diagnosed with an incurable medical condition that will lead to incapacity, such as dementia. 

The report punted to a later date its recommendations on the extension of MAID to the mentally ill, a legislative change forced upon the government by a Superior Court of Quebec ruling that should have been challenged to the end of time. 

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The amended law created two tracks of MAID — one for people whose death is reasonably foreseeable and another for those not in an advanced state of irreversible decline. 

Parliament has just given itself another year to come up with a plan on how to implement assisted dying for the mentally ill, but there remain deep divisions among expert witnesses, and in society in general, on certainty with respect to the incurability of a mental disorder.

A recent Toronto Star article in favour of extending MAID to the mentally ill detailed how life had become intolerable for the writer’s friend and why the government should have given her the right to end her suffering. 

“If MAID had been extended to people with mental disorders just a few years ago, my sick friend Carrie might be dead right now. But she’s not. She got better,” Samantha Israel wrote. 

It was as good an argument for not extending MAID to the mentally ill as could be made. 

The extension to those whose condition is not “grievous and irremediable” is unsettling enough. But how much worse would it be if Carrie were 13? 

A society that justifies euthanasia for juveniles needs to pause and reflect on whether it truly values life.

• Email: jivison@postmedia.com | Twitter: IvisonJ