Since Canada legalized euthanasia in 2016, there has been a strange balancing act at the heart of its medical system. There is a national suicide prevention hotline you can call 24/7, where sympathetic operators will try to talk you out of killing yourself. But today there are also euthanasia hotlines, where operators will give you the resources you need to carry out your wish. Doctors and nurse practitioners are now in the business of saving the lives of some patients while providing death to others.

Canada calls it Medical Assistance in Dying, or MAID. The term encompasses both assisted suicide, which is when providers give patients the means to end their own lives, and euthanasia, which is when a medical practitioner directly administers a patient’s lethal injection. But virtually all such deaths — over 99 percent — are euthanasia.

Supporters insist that this is not state-sanctioned suicide. Rather, it’s a dignified solution for those who no longer wish to suffer from terminal or chronic illness. MAID allows “for compassionate action, while also protecting those who are particularly vulnerable,” claimed David Lametti, the attorney general and minister of justice, in 2021.

…Important people — prominent politicians, physicians, and judges — promised Canadians that their rights to autonomy would be expanded. But the picture that emerges is not a new flowering of autonomy but the hum of an efficient engine of death.

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Once you make anything explicit, it changes it. Once you make something legal, it changes it. The moral compass moves all over due to complex factors that overwhelm the vastly simpler act of making something explicit or legal. As with all health care, providers are as much patients as the patients. ABN