Ethical questions burden MAiD expansion

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THE debate over medical assistance in dying (MAiD) has always been fraught with ethical contention. But as the Canadian government seeks to expand the parameters under which one might seek death under the MAiD program, making the framework perhaps the most expansive in the world, we have entered into especially messy territory.

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Opinion

THE debate over medical assistance in dying (MAiD) has always been fraught with ethical contention. But as the Canadian government seeks to expand the parameters under which one might seek death under the MAiD program, making the framework perhaps the most expansive in the world, we have entered into especially messy territory.

Under the program’s new structure, people will be able to apply for assisted death under the broad category of “mental illness.”

It is a surprisingly bold initiative from the Liberal government. On the one hand, granting citizens the choice to end their life to escape unmitigable suffering is a noble policy. On the other hand, a government must check a lot of boxes before it can morally implement such a policy — especially when it comes to something such as mental illness, which is vague umbrella term for a myriad of afflictions, many of which are exacerbated by, if not caused by, material conditions as opposed to physiological ones.

So we come to a conundrum: is the government implementing a policy that allows people to end their lives to escape the poor material conditions the government itself has the power to alleviate?

There can be little doubt people suffering from mental illness in this country could be better served by our government. Therapeutic supports are lacking for people who wish to engage them. Pharmacare is not readily accessible to everyone who might benefit from it. Everything from our housing policies to policing could be improved to better serve the mental health of everyone, but especially our vulnerable unhoused population.

Policy changes, both large and small, could be made to better serve the mental health of our nation. Of course, people of difficult political bents will argue about whether the government actually can alleviate these problems — though personally, I think they often say “can” when they really mean “should.”

But there can be no debate that our government is, most charitably put, lagging in its efforts to implement policies that many, from activists to experts, say it could be trying.

That does cast a pall over the expansion of our assisted-dying program. The harshest critics will say the government would rather leave these people to die instead of investing in social safety nets that might save them. Perhaps this isn’t an entirely fair judgment to cast on every MP who supports the new MAiD framework, but I truly hope that is something they grapple with every time they have to consider some new progressive policy measure.

I want that moral quandary to be front of mind every time they worry about political optics, or wring their hands about the budget, or shy away from decisive progress in favour of the warm security of slow, incremental change.

Having stepped into the realm of granting suffering people assistance in taking their own lives, our government absolutely has blood on its hands if the suffering could have been alleviated through other policies. And, I would argue, it will wear that blood with the coming expansion.

However, I still find my concern drifting to those people who are actually suffering. In the midst of these debates about political ethics, there are real people asking for immediate relief.

I find it very difficult to tell anyone that they need to go on suffering simply because we know things could theoretically be better for them if the government just got its act together. When these people tell us that they are ready to die now, ready to end their relationship with this world as things stand, they are speaking a very different language than we are when we discuss how we know the world can be made better for them.

There is an immediacy in their struggle that does not translate well into political discourse.

One thing is certain: we should not assign our government any nobility for this MAiD expansion; indeed, perhaps the opposite. And it is also true the government should be held to account for failing to otherwise alleviate such suffering.

But we must also ask another question: are we comfortable prolonging the suffering of these people for the sake of what virtually always proves to be the slow trudge of social progress?

Alex Passey is a Winnipeg-based writer.

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