Suicide booths? Don’t laugh

Among those who have tried to reckon with Monday’s assisted suicide ruling from the Alberta Court of King’s Bench, it is naturally our own Chris Selley who has done the best job of conveying the dystopian position in which our courts have manoeuvred themselves. Others don’t seem to feel there is anything shocking or even notable about the decision at all. As a supporter in principle of assisted suicide, I feel almost dizzied by it, as if the “slippery slope” had become literal and I am whirling down its north face. Legalized suicide for severe and advanced degenerative illnesses is a welcome thing, but we have adopted a much broader principle through improvised judicial fiat, and the result is an evolutionary process that may be altogether out of control.

The applicant in the case is “WV,” whose 27-year-old daughter “MV” lives in his basement. MV has concluded that her life is unbearable and wants to die with a medical professional’s help. What, you may ask, is the medical justification that the law allegedly requires? Go ahead and ask all you like: MV isn’t talking.

She submitted an affidavit to the court showing that she has two doctor’s signatures approving her “MAID” (“medical assistance in dying”) application — that is, she has fulfilled Alberta’s procedural requirements. But the affidavit, to quote the ruling, “does not address her medical condition, any suffering she may be experiencing, or why she wants MAID.” Dragged into court by a terrified parent, “she refused to answer questions concerning her medical condition and refused to produce any records she had concerning the MAID assessments.”

Now, if you believe WV, there is nothing physically wrong with MV at all, and her only psychiatric diagnoses are autism and attention-deficit disorder — two extremely survivable conditions that you and I could probably go get diagnosed with before the end of business tomorrow without even having to fib very much. A doctor’s report made in 2021 lists physiological manifestations that border on the pathetic, like “generalized weakness” and “numbness and tingling in her hands and feet.” That doc found MV to be fit, even strong, and neurologically ordinary. This report is technically hearsay, but the judge agreed with some reluctance to put it on the record.

Still, MV was able to find two doctors to agree with her MAID search — after some effort: when her first two physicians disagreed with each other, an Alberta Health Services “MAID navigator” arranged for her to seek out a third, and the fatal “tiebreaking vote” was cast. The prior Alberta and national case law made this an obviously tough situation for the judge, Colin Feasby. He decided he had to live with MV’S absolute refusal to account to the court for her death wish. Medical decision-making is, after all, private and sacred:

“It is the doctor or nurse practitioner’s job to form an opinion as to whether the MAID eligibility criteria have been met, not the court. Of course, if there were a criminal prosecution, the court would be able to explore whether the doctor or nurse practitioner held that opinion and that might well include an assessment of whether the opinion was honestly held. But that is not an appropriate inquiry to engage in on a pre-emptive basis. Parliament has put its trust in doctors and nurse practitioners and it is not for this court to second-guess that choice.”

THE RESULT IS AN EVOLUTIONARY PROCESS THAT MAY BE ALTOGETHER OUT OF CONTROL.

We have all learned to live with judges shredding statutes in a moment of dyspepsia, and, indeed, the original Criminal Code ban on assisting in suicide was overthrown in such a spirit. But doctors and nurses are, in today’s Canada, a higher species whose powerful force field repels any thought of judicial review. WV is confined to saving his daughter through strictly procedural arguments a month from now in the Alberta Court of Appeal: he has to somehow show that AHS didn’t follow its own written policies properly, and Justice Feasby does think he has a case worth hearing.

But various appellate courts seem to have created for Canadians a warped kind of mathematical equation here, a chain of principles no one person ever explicitly sought to weld together. Personal autonomy is paramount, for those entitled to exercise it; people who have decision-making capacity have the right to end their lives if they meet certain diagnostic conditions; since the purpose of governments is to facilitate the exercise of autonomy, doctors (and nurse practitioners!) must be allowed to practice euthanasia, even if this conflicts with their professional traditions; the law has no right to intervene in or even demand information about any medical diagnosis.

Splice these noble propositions together, and you don’t quite get to a science-fiction suicide-booths-on-every-street-corner scenario. It’s merely a pretty close approximation. (And let’s face it: if suicide booths were a popular idea — polls do indicate that Canadians are remarkably tolerant of euthanasia — Canada would never get around to procuring and installing ones that worked.)