The following post is part of a structured, multi-week,simultaneously published exchange between Kim Carlson and Paul Magennis,authors of MAiD in Canada, and Gordon Friesen,President of the Euthanasia Prevention Coalition. These alternating messages will explore deeply divergent viewson Medical Assistance in Dying (MAiD), and no mutual endorsement is implied.

Gordon Friesen

Previouslypublished installments have been:

Gordon Friesen, Monday, January 12, 2025. (Article Link).
Maid in Canada (MIC), January 19, 2025. (Article Link).

TheEvolution of Medicine under Legal Compulsion

By GordonFriesen

‘Homicide’ is the only English word which precisely indicatesthe taking of human life.

CriminalCode of Canada [i]

      “* A person commits homicide when,directly or indirectly, by any means, he causes the death of a human being.

      *Homicide is culpable or not culpable.

      * No medical practitioner or nursepractitioner commits culpable homicide if they provide a person with medicalassistance in dying”

Hence: MAIDis homicide, permitted as medical treatment.    

Therevolution thus produced, in medical culture, may be crudely grasped in thefact that one Canadian hospital is actually being sued for refusing to kill itspatients.[ii]

Nor has thisdramatic transformation come from organic demand among medical professionals.It is the result of legal compulsion.

“Parliamentin legalizing MAiD, affirmed that, in certain cases, a desire to bring aboutone’s death is rational, understandable, and can be assisted without violatingthe Criminal Code.”[iii]

Confrontedwith this Parliamentary proclamation, the Canadian Psychiatric Association (andCanadian Psychiatry more widely) have been attempting to invent a professionalframework for the ethical homicide of patients exhibiting mental disordersonly.

And yet, inspite of an obvious interest in harmonizing the practice of its members withdecreed legal doctrine (and despite giving MAID-favorable theorists fulllatitude to develop their case since 2016):[iv] CPA hasbeen unable –over the last 10 years– to produce a positive endorsement ofhomicide for mental disorder alone.

Or as statedon the CPA web page:

“Thereare compelling legal, clinical, ethical, moral and philosophical questions thatmake this issue particularly challenging. At this time, the CPA has nottaken a position on whether MAID should be available in situations where a mentaldisorder is the sole underlying medical condition.” [v]

One reasonwhy psychiatrists might oppose medical homicide, concerns scientificdisagreement as to whether MAID and suicide are different, at all; and theclinical difficulty of establishing such a difference even if it did exist.

(a difference, as earlier noted,[vi] which theCanadian Association for Suicide Prevention[vii] and theAmerican Association of Suicidology[viii] [ix] bothdeny).

The idea,here, is not that mental illness causes uniform incapacity, but that the wishto be poisoned, specifically, should not be received as a capable request.

A morespecific reason, for opposing medical homicide, for mental illness alone,concerns the similar difficulty of determining whether any patient’s disordermight be considered “irremediable”.

Theseproblems are both cited in a formal American Psychiatric Association policystatement rejecting medical homicide for mental illness alone. Significantly,this is a purely psychiatric policy (unlike its Canadian counterpart)proactively established in the absence of legal coercion[x]

Homicide-friendlyprofessionals apparently believe that they can make capacity andirremediability judgments which are “close enough”.

For thoseopposed, however, the whole scheme looks like sending out colorblind hunters,to harvest certain species of game birds… but only the green ones.

Whether ornot our friends from Maid-in-Canada actually deny these difficulties, they doapparently believe that a complete ban (or “categorical exclusion”)cannot be justified. I take this to mean (correct me at need) that certainextreme cases must not be denied.

Unfortunately,the practical operation of legal permission cannot be restricted to extremecases only. In a resource deficient systemic environment, rigor will inevitablybe sacrificed to normalization. Homicide work will naturally be done by doctorsfavorable to that practice. And since there is no prohibition of “doctorshopping”, it is the most zealous of these who will test limits and setstandards, just as in our experience of MAID to date.

Indeed, oncethe good people of Salem were told that Witches walked among them,[xi] it quicklybecame possible to find a great number of these. And so also with persons forwhom homicide is imperiously proclaimed, by Parliamentarians, to be apsychiatrically indicated treatment.

Finally:MAID-in-Canada has dismissed, as “speculative”, my assertion thatmedical homicide for mental illness would lead to that of incapable patientsmore generally.[xii]

One man’s”speculation”, however, is another man’s prudent forethought.

In reality,the liquidation of incapable patients is a strict ethical necessity ofrepresenting homicide as medical care. For medicine is ideally an objectivescience. And (allegedly) beneficial medical remedies can not be ethicallywithheld from anyone who might (allegedly) benefit from them: not for reasonsof age, of mental capacity, or of anything else.

Our immediateinterest (in capacity) lies with the mentally ill,[xiii]children,[xiv]infants,[xv] matureminors,[xvi] anddemented seniors.[xvii]

Logicallyinevitable expansions of medical homicide are projected for each of thesegroups. These extensions may usefully be viewed as a cluster of poisonousflowers, all growing from the same infected root. Legal acceptance of any onewill naturally facilitate acceptance of the others also.

This logicalputrefaction can only be stopped as it began: with legislative action.

Nomedical homicide for mental illness. Support Bill C-218