Euthanasia is a growing area of concern for those who advocate for the dignity of human life in all its stages. In Canada, its widespread legalization has led to concerning developments. OSV News' Charlie Camosy recently spoke with Amanda Achtman, who works to prevent euthanasia in Canada through her project Dying to Meet You. Achtman called attention to a controversial new policy in Quebec, starting Oct. 30, that will allow persons incapable of giving consent to provide "advance consent" to be euthanized.

-- Charlie Camosy: Can you give us a brief rundown of what's happened since Canada legalized assisted suicide in 2016?

-- Amanda Achtman: Since legalization in 2016, Canada has become the euthanasia capital of the world. Euthanasia now the fifth-leading cause of death in my country. In one particular jurisdiction, euthanasia accounted for 11.4 percent of total deaths during the past quarter. However, the numbers have ceased to shock many Canadians who are largely becoming desensitized. Furthermore, euthanasia lobby groups and the media have not only normalized euthanasia, but are glamorizing it as the ideal way to die.

Euthanasia was first introduced into Canada under the euphemistic acronym MAID, which stands for "medical assistance in dying." Much like the Terminally Ill Adults Bill currently being considered in the UK, the initial Canadian bill was intended to permit persons with a "grievous and irremediable medical condition" and whose "natural death has become reasonably foreseeable" to have a medical professional end their lives through a lethal injection. Given that this constitutes homicide, the Criminal Code was amended to exempt doctors and nurses from criminal liability for ending their patients' lives if they followed the policy.

It did not take long for proponents of euthanasia to argue that MAID needed to be expanded to those who are suffering but not necessarily at the end of life, and to those who are suffering mentally but not necessarily physically. Assisted suicide cannot remain limited because, once accepted by the society as a legitimate means to relieve suffering, there is no rational basis by which it should be restricted. Euthanasia will always be expanded on the purported grounds of equality.

And so, in 2020, the Liberal government introduced a new bill, undoing the initial safeguards and expanding eligibility to non-dying patients, such as persons with disabilities. This specific "track" specially singled out persons with disabilities as "qualifying" to have their lives ended prematurely by a doctor or nurse.

We now have a society in which some persons are offered suicide prevention and others are offered suicide assistance. This is leading many Canadians, understandably, to be very fearful. It is destroying the doctor-patient relationship. And, it is filling many people with insecurity about whether we will receive care instead of killing during an experience of weakness or vulnerability.

-- Camosy: But there appears to be a new development as of Oct. 30? What happened then?

-- Achtman: As of Oct. 30, 2024, the Canadian province of Quebec has expanded euthanasia to persons incapable of consent. As described on the Government of Quebec webpage, persons who have "been diagnosed with a serious and incurable illness leading to incapacity" to give consent (such as Alzheimer's disease) can now make so-called "advance requests" to be euthanized in the event that they lose the capacity to fully consent to it in the future.

This means that such patients receiving a lethal injection would not be able to give contemporaneous consent on their appointed death date.

This raises so many questions: Can a person with any degree of dementia actually give informed consent to be euthanized at some unspecified future point? What happens if the person, having made an advance request for MAID and subsequently having lost the capacity to consent, changes their mind or resists? Will their former self bind their future self so irrevocably that they are killed anyway?

Even before Quebec's expansion of death for dementia, Canada has been euthanizing persons with dementia. In fact, according to Health Canada's Fourth Annual Report on MAID in Canada, 9 percent of those who were euthanized in Canada during 2022 had dementia. This is because it was already possible for persons to waive final consent in a more limited way.

Now that Quebec is pushing the boundaries even further with these so-called "advance requests," I am devastated to warn that we can expect a dramatic increase in the premature deaths of those with dementia.

-- Camosy: This is deeply disturbing. What do you think it portends for the rest of Canada? Where are things headed overall, in your view?

-- Achtman: According to the Criminal Code of Canada, advance requests for euthanasia are illegal. Despite this still being a criminal offense, Canada's second-most populous province has decided to go rogue and do it anyway. Not only is the federal government turning a blind eye to this, but the Government of Canada has just launched "a national conversation" for three months to explore expanding death without consent nationwide.

As Canadian Member of Parliament Garnett Genuis has previously stated in opposition to the idea, "There has to be contemporaneous consent in the context of sexual consent. Why would we have a different and lower standard for someone consenting to die than for someone consenting to engage in sexual relations?"

Many people underestimate the quality of life of persons with dementia. Very often, fears and projection lead to thinking there could be nothing worse; some reports say that people fear a diagnosis of dementia more than cancer. But dementia is not and need not be a death sentence. And, caring for persons with dementia has the power to be transformative both for patients and those who love and help them.

Canada's trajectory can provide a critical warning to other jurisdictions that we can only hope will heed it.

-- Camosy: What lessons can those of us resisting these practices in the U.S. learn from what is going on in Canada? How can the church best mobilize to resist this?

-- Achtman: The first lesson is that euthanasia, once legalized, cannot remain limited.

The second is that, whatever eligibility criteria a society might introduce for the premature ending of human life cannot but devalue everyone who fits that criteria, whether they go through with it or not.

The third is that it is absolutely crucial for us to discover the value of life in the face of suffering and death. To many, the mysteries of human weakness, vulnerability, and loss are too overwhelming and become temptations to exit the scene altogether. Euthanasia is really a symptom of a much wider cultural crisis, what Pope Francis has called "throwaway culture." It represents a distinct form of self harm, stemming from insecurity and self-rejection, and often exacerbated by a wounded sense of self once we can no longer perform or contribute as we once did.

Pope St. John Paul II once said, "The great achievement is always to see values that others don't see and to affirm them. The even greater achievement is to bring out of people the values that would perish without us. In the same way, we bring our values out in ourselves."

This is our urgent task -- to see and affirm the value that others don't see, and to present a positive alternative vision so that we never lose sight that the ultimate identity and destiny of every person is to love and be loved, with courage and steadfastness to the end.



Charlie Camosy is professor of medical humanities at the Creighton School of Medicine in Omaha, Nebraska, and moral theology fellow at St. Joseph Seminary in New York.