Through structural causes and common political interests, political changes and reforms that take root in one often spread to all Western countries in one way or another in the end. Therefore, taking a longer look at Canada’s assisted suicide program (MAID, or Medical Assistance in Dying), the most developed in the Western world, isn’t only useful for Canada itself, but for all of the West, where similar legislations have been passed or are at least being discussed. Being now the fifth leading cause of death in Canada, MAID will be expanded even further by next year, by becoming accessible to all people suffering from mental disabilities. The ethics of the practice are more questionable than ever and can easily be considered as a reintroduction of eugenism within Western society, rebranded as a personal choice. Those policies shouldn’t be allowed to spread beyond their current political and geographical borders, let alone exist in the first place.
When eugenics are discussed, most think first of the concept that was defined and enacted throughout the nineteenth and twentieth centuries, which can be defined by the pursuit of bettering mankind through the preservation of favorable genes and the elimination of others, leading to the sterilization or even execution of certain groups seen unfavorably, while the others are encouraged to reproduce. Historically, the targeting was based on racism and “usefulness” to society. People of color, people with disabilities, criminals, and people suffering from illnesses were the main victims of eugenic policies, without any scientific evidence of effectiveness (which, of course wouldn’t have excused what is a crime against humanity). This concept is today strongly associated with fascism, but beyond ideological justification, the structural nature of eugenics shows a clear main objective: removing the undesirable, the ones that you cannot extract value from. Many countries that didn’t experience fascism did often implement eugenics, viewed favorably by liberal leaders who saw in it a way to create the best citizens and economic agents in society and to eliminate unproductive. From Canada to Australia, for racial and economic reasons, eugenics policies were deployed throughout much of the Western world, up until the late 70s in both those countries.
Pushed by extreme ideologies favoring economic savings over anything else, several governments are now pushing for the return of eugenics policies. But given their strong political affiliation with fascism, a new framing was required: the personal choice. In societies where access to health is getting more difficult and vulnerable groups are getting more marginalized, the Medical Assistance in Dying comes to the rescue by offering a way out. “It’s your life, it’s your choice”.
As the program was created and expanded beyond palliative care, immense ethical concerns arose. Several cases appeared where patients used MAID without following proper procedure, such as clear disability or even warning the family that the patient requested the program. Other cases point to the fact that MAID was used by people who suffered from a lack of healthcare that could and should have been provided, questioning the preventability of those deaths. The misuses and lack of oversight are present on a systemic level, aggravated by the lack of funding in healthcare.
Western economies have, in large, chosen to drastically scale back health expenditures in the last decade. This is partly due to the respite following the Covid-19 pandemic (even if its effects mean more healthcare is required now than in the previous years), but also because of the neoliberal politics that defined the era, which promote austerity measures in the name of limiting the deficit as best possible. Hence, lack of funding directly impacts people eligible for assisted suicide who are not provided with the care that they would require. This directly engages the responsibility of governments that favor suicides programs over better funding in healthcare, which is all of them. The potential economic gains are, after all, considerable: according to a study, this could save up to 1,273 trillion dollars by 2047 for Canada, at the cost of 2,6 million lives, mostly the mentally ill and the elderly. That obvious economic incentive, alongside the general lack of consideration for the vulnerable populations that might request MAID, together make the intentions behind any assisted suicide program that accompanies austerity in healthcare as obvious as they are vile.
This piece doesn’t advocate the restriction of personal freedom, but rather aims to give insight into a worrying structural trend. Assisted suicide policies target the most vulnerable in our societies, not just because of disability, but also societal exclusion. Alienation of the disabled, sick, elderly and many others is a clear factor in suicidal tendencies. Indulging those is merely cruelty disguised as kindness. These programs are eugenical in nature by their direct targeting of the communities mentioned above, and by their exacerbated impact on vulnerable groups who don’t share equal access to healthcare or good living conditions. While the effects are nefarious in Canada, other countries might follow the same steps. France is currently discussing a law that would allow assisted suicide, although reserved for people suffering from terminal conditions without hope of recovery. But given the political context and the Canadian precedent, this is likely a first step that will alleviate the ‘burden’ on healthcare systems by allowing the people it should heal to, instead, die.