Authored by William Andersen via The Mises Institute,

Christianity Today recently published an article by Kristy Etheridge that was very critical of Canada’s Medical Assistance in Dying (MAID) program, something that would not be surprising, given the magazine’s evangelical Christian outlook on issues.

The article—again, not surprisingly—dealt mostly with how many Christian groups, and especially the Roman Catholic Church, have spoken out against Canada’s program and similar programs in Europe and in the US.

Wrote Etheridge:

Many Christians spoke out against assisted suicide in the 1990s when Dr. Jack Kevorkian became a household name for participating in dozens of suicides in Michigan. Since then, evangelical passion against assisted suicide seems to have waned. While evangelicals have left a void in many public spaces regarding end-of-life issues, the Catholic church has often stood in the gap. As more states and countries consider legalizing the practice, believers must raise their voices together in defense of life.

Christians who oppose assisted suicide affirm that life is sacred. God created human beings in his image (Gen. 1:27), and we do not have the right to destroy ourselves or each other.

Brad East, writing in Christianity Today, noted:

The church’s moral teaching has always held that murder—defined as the intentional taking of innocent life—is intrinsically evil. It follows that actively intending the death of an elderly or sick human being and then deliberately bringing about that death through some positive action, such as the administration of drugs, is always and everywhere morally wrong.

Promoters of assisted suicide always couch their arguments in the language of compassion for those suffering from terminal illness, and 11 US states also permit assisted suicide, all of them except for Montana being dominated by the Democratic Party. This practice always has been couched in the language of “death with dignity,” and it generally has strong support from the political left, although the hard-left socialist publication, Jacobin, recently had an article by Jeremy Appel critical the circumstances under which some Canadians choose suicide, declaring:

But the legalization of MAiD has brought to the fore some disturbing moral calculations, particularly with its expansion in 2019 to include individuals whose deaths aren’t “reasonably foreseeable.” This change opened the floodgates for people with disabilities to apply to die rather than survive on meager benefits.

I’ve come to realize that euthanasia in Canada represents the cynical endgame of social provisioning within the brutal logic of late-stage capitalism — we’ll starve you of the funding you need to live a dignified life, demand you pay back pandemic aid you applied for in good faith, and if you don’t like it, well, why don’t you just kill yourself?

The problem with my previous perspective was that it held individual choices as sacrosanct. But people don’t make individual decisions in a vacuum. They’re the product of social circumstances, which are often out of their control.

It is not surprising to see Jacobin blaming capitalism for something done within the confines of a socialist system, but socialists go by the mindset that says if something is bad, it is the fault of capitalism, since socialism produces only happy results. But Appel is not wrong in pointing out that what began as a way ostensibly to end the suffering of terminally ill people has morphed into a program responsible for one in 20 Canadian deaths, with more than 100,000 people killed since the program began a decade ago, as Canada’s government did away with the requirements that only those with terminal illnesses could request doctor-assisted suicide.

Indeed, the government is happy to recommend MAID to people for a variety of reasons. An 84-year-old woman who visited a Vancouver emergency room with back pain was offered MAID by an attending physician, a suggestion the woman turned down. The government is even expanding its program to cover people with mental illness, including veterans who experienced PTSD as a result of trauma suffered in combat in places like Afghanistan, with MAID eligibility for these people coming in 2027. Appel writes:

In another instance, retired corporal Christine Gauthier, who is paraplegic and competed for Canada at the 2016 Rio de Janeiro Paralympics and the Invictus Games, was offered assisted suicide, with Veterans Affairs offering to provide her with the necessary equipment.

Gauthier had been fighting for five years to have Veterans Affairs provide her with a wheelchair ramp. They wouldn’t provide the ramp, but they would give her the means to end her life.

Most Critics Fail to Recognize the Real Reason Maid Exists

There are plenty of religious and moral reasons to criticize this kind of a program. Although many libertarians have openly supported assisted suicide (with some exceptions), it is important to separate the “right to die” movement from programs like MAID in Canada and in Europe, such as the Netherlands, which has had an assisted suicide law on the books for more than 20 years. Whether or not one supports such policies, as bad as many believe they are, it becomes much worse when government healthcare agencies are the entities recommending that people have doctors put them to death, as there is no way a program like this does not become coercive.

In a country like the US, the government cannot refuse medical care to someone who does not seek another doctor to end one’s life. In Canada and most European countries, that is exactly what the government can do. While entities as far apart religiously as many religious groups and Jacobin might decry the same things—for different reasons—they are united in their support for the welfare state and state control over medical care.

The Christianity Today writers and others in the evangelical camp such as World Magazine tend to frame MAID as a purely ethical issue, and while ethics obviously play an important role in all of this, none of these writers seem to understand that Canada’s government-controlled system has made good medical care even more scarce than it should be. It should be obvious even to someone like Appel that Canada’s system reduces the amount of available care, which should surprise no one who is familiar with socialism.

As noted before, many of complaints against assisted suicide are rooted in a belief that people choose to have medical providers kill them is because they lack resources. Appel writes:

An excellent piece from Global News reporters Brennan Leffler and Marianne Dimain, headlined “How poverty, not pain, is driving Canadians with disabilities to consider medically-assisted death,” notes the “excruciating cycle of poverty” that leads disabled people to choose assisted death, rather than live a life filled with barriers to their existence.

Appel then declares more government spending as the solution:

We’ve let the MAiD genie out of its bottle. There’s no going back. We must ensure that our health care systems have sufficient resources to guarantee everyone, regardless of ability or mental health, a dignified existence.

Appel, however, has it wrong. Poverty supposedly does not matter in the Canadian system because no one pays for medical care. This isn’t a case of Joe dying of liver disease because he can’t afford a liver transplant; this is about Canada’s system having shortages of doctors, equipment, medicine, and all of the other components of healthcare, and shortages are a feature of socialism.

In other words, the way to keep people from using the medical establishment from taking their own lives is to expand medical care, and since outfits like Jacobin see government as the only legitimate provider of health care, that means pouring even more tax revenues into the medical system. Yet, it should be clear that government control of the medical system—especially in Canada—has very predictable results: shortages and denial of care. 

More than 20 years before Canada instituted its MAID program, Jane Orient—a practicing physician—predicted that the Canadian system would find that the premature death of patients would provide financial savings to the program.

Writing about government-provided care, she likened it to providing only freeways to move automobile traffic:

Wouldn’t it be wonderful to have all the medical care you needed or wanted, without ever worrying about the bill?

And wouldn’t it be wonderful to drive to work every day without ever paying a toll or stopping at a red light?

The second question usually provokes much more critical thought than the first. Before people vote the money to build a freeway through their downtown, a lot of inconvenient objections are raised.

The first is this: Do we want to tear up the main business district of town?

The idea of “comprehensive health care reform” to “assure universal access” should stimulate the same thought process. To build such a system, you start by destroying the insurance and medical system that we already have.

She continued:

When we build a freeway, we don’t necessarily destroy all the other roads. In Britain and Germany, private medicine is allowed to coexist with nationalized medicine. But in Canada, it isn’t. If you’re a Canadian and want something the government isn’t willing to pay for, or you want it now instead of three years from now, you have to go to the United States.

A lot of proponents of “universal access” want to close the private escape hatch. They want no other roads, just the freeway. Of course, there may be some back alleys or secret tunnels or special facilities for Congressmen, but those won’t provide American-class medical care to ordinary folk.

Some think we don’t need other roads if we have a freeway. But remember what a freeway is: a controlled access road.

Orient continued her freeway analogy, noting that the Canadian system is not built on ensuring better care, but rather promoting equal care, even if that care might be substandard or even non-existent:

In Canada, you don’t have to pay to get medical care. In fact, you are not allowed to pay. Once the global budget is reached in Canada, that’s it. The on-ramps are closed. It doesn’t matter if you have money. Hospital beds are empty for lack of money to pay nurses, and CT scanners sit idle all night for lack of money to pay a technician. But if some people are allowed to pay, Canadians fear that some people might get better care than others.

In other words, Canadian care is more about people equally sharing scarcity than being able to get medical help for their ailments. She noted that the government systems like what we see in Canada routinely deny care for serious illnesses and medical problems, while promoting euthanasia as a solution:

The roadblocks are at the exits that lead to the hospital. The global budgeters “contain costs”—ration health care—by denying those things that you do need insurance to pay for: heart surgery, radiation treatments for cancer, hip replacements, things like that. Out of “compassion,” reformers may open another exit: the one that leads to the cemetery. Do you think it’s accidental that euthanasia and “universal access” are on the agenda at the same time? When government gets involved in providing health care, health care must be rationed.

Given that medical care is a scarce good, there always will be tradeoffs and some form of rationing. However, government systems discourage entrepreneurship and are more likely to be restrictive, increasing the scarcity problems and making it even more difficult for people to receive care that can make the difference between life and death.

Advocates of state-sponsored medical care claim that rationing by price is immoral, but rationing by bureaucratic decree is a moral imperative.

Thus, if Joe were to die because he could not afford a heart transplant, that would be immoral, but if he were to die because the government agency making those decisions denied that care, that would satisfy all moral criteria.

Conclusion

Assisted suicide is on the increase in places like Canada because it permits the government to deny medical care in the name of compassion and “dying with dignity.” It should not be surprising to see increased rates of doctor-sponsored killing running parallel with more government involvement with health care.

As we see more state involvement with medical care, the relative scarcity problems with health care will increase, and as medical scarcity increases, physician-assisted suicide rates also will rise. Death is already built into socialism, so we should not be surprised to see practitioners and advocates of socialized medicine welcoming the Grim Reaper as one of their own.

Perhaps the greatest irony is that the mainstream Christian groups (such as the Presbyterian Church USA and the Episcopal Church) that openly support the Canadian system and demand it be implemented in the U.S. are silent about the proliferation of medical suicide incidents, either ignoring the problem altogether or quietly supporting it.

Because they are blind to the negative effects of the massive state-sponsored intervention they support, their response to MAID and other assisted suicide movements is to call for more of the same.