American Thought Leaders - How Euthanasia Became an Epidemic in Canada | Amanda Achtman

Episode Date: September 3, 2025

In less than a decade, euthanasia has become tied for the fifth leading cause of death in Canada, accounting for one in every 20 deaths since it was first legalized in 2016. Over 60,000 Canadians have died via euthanasia.“This marks a massive cultural shift in how we live and die in Canada,” says Amanda Achtman, a leading critic of the practice and the founder of the Dying to Meet You Project.Patients no longer need to be terminally ill to request euthanasia, and there are ongoing debates about whether minors or people with mental illnesses should be able to apply. Disability advocate groups have been some of the leading critics of the program, arguing it sends a disturbing message: that the lives of those who are disabled are worth less.What are the ethical implications of Canada’s euthanasia program? How is it changing family dynamics, societal norms, the meaning of a life well lived, and the fundamental role of a physician?Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

It's the most effed up thing in the world knowing that your father is going to die in seven days, then five days, then three days, then in 15 minutes. And that's shattering. That's a loss that is almost impossible to bear because the person has sent the message that they don't love you enough to stay in the world. Euthanasia in Canada now accounts for one in 20 deaths. This marks a massive cultural shift in how we live and die in the world. in Canada. Amanda Achtman is the founder of Dying to Meet You and a leading advocate against

euthanasia, or what's called in Canada medical assistance in dying or made. Euthanasia is not a declaration of freedom, it's a declaration of defeat. I have heard from persons with disabilities who say, this is the first thing the government has told me I'm eligible for. To be told that you qualify for a premature death is already killing the person. it already deflates and defeats your sense of worth. This is American Thought Leaders, and I'm Yanya Kellick. Amanda Ackman, such a pleasure to have you on American Thought Leaders.

Thanks for having me. So euthanasia now in Canada has become tied for the number five cause of death, as I've been reading, or also known as medical assistance in dying or made. chart me what happened here. In 2016, Canada legalized euthanasia nationwide, and this was in response to a court decision. And that's largely how the changes have happened, not so much through public conversation, but through the courts. And so what happened was the government had a deadline to create a law that essentially

legalized euthanasia across the board. And of course, as it always begins, euthanasia, or as it has become known, medical aid in dying was officially and initially for persons whose deaths were deemed reasonably foreseeable. Of course, all of our deaths are reasonably foreseeable, but sort of... More in an immediate sense. In an imminent sense, maybe, and not with a specific time horizon. So reasonably foreseeable with grievous and irremediable condition. That's how it was ushered in. And since then, euthanasia has become a leading cause. of death in Canada. Euthanasia in Canada now accounts for one in 20 deaths. And so, as a

Canadian, there's almost not a day that goes by that I don't hear a personal story of how this is touching people. Many people know someone who has been euthanized or who is thinking about it. And so this marks a massive cultural shift in how we live and die in Canada. So, I mean, the number, let's just talk about the actual numbers. I mean, from what I I read since 2016 to 2023, that's as far as the data is available. That's just over 60,000 people who have died this way or committed suicide this way. Actually, how would you describe that? Many people are sensing a loss of meaning as they approach the end of their life. And that's what the government's own data bears out. Each year, the government asks people about the

kind of suffering leading to the request. And while people may be living with a terminal illness or a disability, or perhaps with ALS, or dementia, and yet when asked what kind of suffering leads them to request made, the number one kind of suffering by people's own admission is a loss of ability to engage in meaningful life activities. And so this, though it is in the public health care and medical context,

really marks an existential crisis, a crisis of meaning. So, I mean, that's fascinating. But what do we even call this? Is this committing suicide? Is there another name for it? Like, how is it described? How do you, what do you call it? Or what is it generally, how is it viewed in Canada?

Even the former liberal minister of justice referred to euthanasia, to medical aid and dying, as a species of suicide. He said that on a program. And so it is a form of suicide. And psychiatrists have made this point that it puts them in an impossible position as psychiatrists where on the one hand their responsibility is to provide suicide prevention. And yet when there's a whole segment of the population for whom medical assistance in dying is available,

then why do we now have this world where some people get suicide assistance and others get suicide prevention? And we know that there are certain demographics who are being met with this often. of state facilitated assisted suicide. And I have heard from persons with disabilities who say, this is the first thing the government has told me I'm eligible for. To be told that you qualify for a premature death is already killing the person. It already deflates and defeats your sense of worth.

That's the impact that euthanasia is having on Canadians. I want to explore that a little more in a moment, but presumably the difference, right, between a time where you would get help. Well, it's consent, isn't it? Like, isn't that, that's when you would get help in doing it, right? If you said, yes, this is what I would like. Many people will say, isn't this the defining characteristic of modern medical aid in dying, that at least the person is asking for it?

I would say to that, if what a person is requesting is to be killed, Is that not itself a red flag? Let's consider the nature of what is being requested. And why do we look at that as reasonable and in the service of the person when it is never in the person's interest not to exist? This is a cry for help. And we have to receive it as such. Well, so many things to unpack here in what we just discussed.

Why don't we just start off with you telling me a little bit how you actually got into, you know, this very, very fraught issue. Sure. So when I was in high school and my early university years, my grandfather lived with my family, which is not that common to necessarily have grandparents in the home, but he was very present in my life. And we had a very warm relationship. He was also my kind of intellectual sparring partner.

And it was around the time that the government started talking about legalizing euthanasia for people whose deaths are deemed reasonably foreseeable. And I thought, okay, this concerns people like him, and this affects families like mine. And so from that early stage, I started to pay attention to this and to see this as an affront on the dignity of older adults, of seniors, of the elderly, and of people who might be susceptible to the pressure, whether from their family or from a doctor, to have a premature ending to their life. My grandfather, thankfully, died a natural death just before the euthanasia law was ushered in. But I had seen him in moments of suffering and agony where he could have been susceptible. And it struck me that it doesn't actually surprise me that sometimes people have a temptation to consider death. But what we must not tolerate is everyone else concurring with that.

when we go through a difficult time or face even suicidal ideation, that's not so surprising. What's surprising is when people gather around and say, sure, I affirm you, go for it. That is what we cannot abide. That is what I could not tolerate seeing happening in my country. And so some years later, I started working with a member of parliament. And it so happened that the issue became the liberal government was intent on expand, euthanasia beyond the preliminary parameters. And this always happens because once legalized euthanasia cannot remain limited. Here's why. If euthanasia is seen as a reasonable and

compassionate means to alleviate suffering, why would you limit it? Why would you withhold it from anyone? It doesn't make any sense. Why would you withhold it from children or from people who cannot necessarily... Well, children, you would say because they're unable to give consent. But what about, you know, people? Let's first talk about people that are of age. We have, I do think it's important to mention children, though, because in Canada, a turning point in our euthanasia debate nationally happened when a father named Robert Latimer

killed his disabled daughter in Saskatchewan, 12-year-old daughter who had cerebral palsy, and he gassed her in the back of his truck. And this was an international story. It was covered in the New York Times. a key turning point. Why? Because many people sympathized with the father that he had done something merciful, that he had put his daughter out of her suffering. And that was when many people with disabilities thought, oh no, something is amiss because people are

sympathizing with the father who ended his daughter's life. She couldn't consent. She was not able to speak. And the way that she was described with such dehumanizing language compared to the father who was described in these glowing terms is part of the story. Now you're talking about the media coverage around the media coverage and the response of ordinary Canadians. And now this man is living outside of jail and he's back on his farm in Saskatchewan. And so we are also seeing an explicit push for euthanasia for they're not referred to as children. They're referred to as mature minors in the debate around euthanasia. and the head of the Quebec College of Physicians and Surgeons

testified before Parliament that he thinks it's important that may be considered for children with severe deformities and abnormalities, as he put it, and the leading euthanasia lobby in Canada has suggested may be expanded to those mature minors who they think have the capacity to consent, maybe along with a parent or guardian agreeing, but are able. So this is an actual conversation in the policy space across Canada. And we already see the elimination of the requirement for consent with the euthanasia of persons with dementia who might make an advance request, but then are unable to really change their mind.

Their former self can bind their future self so irrevocably that they are not required to give consent, final consent, which was a former safeguard that we had before the moment of their death. And so these crises of consent also get eroded. But yes, by and large, most Canadians are ostensibly consenting to have their life ended. And maybe interestingly to note, many people want to die in their own home. That's a common hope. And now euthanasia doctors are coming. well, they're doctors who come and provide made.

That's the language that's used in a person's own home. And I think this is partly because of our culture where we order our food, we curate our playlist, we have so much in the way of preferences that why shouldn't we be able to curate the way that we die and create a kind of social media-like death that is palatable to others? But I think that that denigrates the experience of dying that every person deserves to have.

Why don't we look at very quickly what qualifies you for being able to do this? Because it's not that everybody off the, anybody off the street can say, doctor, I'd like help with this. The criteria for choosing medical aid and dying is rather subjective because it largely rests on the person's account that their suffering is intolerable to them. The majority of persons seeking euthanasia have a terminal illness like cancer or maybe live with illnesses like ALS or MS and these conditions are challenging. Obviously there's a kind of concurrent mental health challenge in facing these conditions. But what message does it send when the response to getting a diagnosis or entering into this phase of life is to prematurely cut it short and end it.

It makes everyone else who has that diagnosis more precarious. It makes all of us more precarious because as soon as there's a social criteria by which life becomes less bearable and it becomes less reasonable to live, then everyone with that, that condition, whether they would want it or not, is regarded as living a life that might be less worth living. Well, so there was, as we started a little bit earlier, talking about, you mentioned that at the beginning, the criteria were much stricter. And you were actually involved in some legislations working with a Canadian Parliament member on, well, trying to stop legislation that would widen it.

But can you chart that course for me, about where it started and where we are today? Right. So when Canada first legalized euthanasia was for this grievous and irremediable condition, and for those who were at end of life, and there were more stringent so-called safeguards where there needed to be independent witnesses, there needed to be a 10-day reflection period, These were the safeguards that were removed for those who were deemed imminently dying. And so what Canada did in 2021 was usher in a two-track system. Track one is for those terminally ill persons and for those whose deaths are deemed imminent. And track two is for those whose deaths are not reasonably foreseeable.

And that is the track that brought in euthanasia for people with disabilities. Once euthanasia is seen as a reasonable response to suffering, then why would you limit it to those only at end of life? And so this was the rationale by which euthanasia was expanded to those with disabilities, that many people suffer even more throughout their lives than some do when they approach the end of their lives and are dying naturally. And so wouldn't they be entitled to the same option to relieve their suffering through death? What is the status of euthanasia for mental health conditions?

Because I know this has been the subject of debate and in some cases has been mischaracterized. When I was working in politics, the liberal government was seeking to expand euthanasia first on the basis of disability, and this was called Bill C-7. And so with the member of parliament with whom I was working, we put up a website called No Same. day death because part of what this ushered in is the ability to request euthanasia and be killed on the same day, no more 10-day reflection period. And so opposing the eradication of those safeguards that had been deemed essential just some years prior, we put out this petition and many, many thousands of people signed it. Then we put out a call for stories and said, we need your stories about how the expansion of euthanasia can affect you and your loved ones.

And because the Senate had added a proposal to also expand it to those for whom mental illness was a sole underlying condition, we received stories about both mental illness and disability. Well, those hundreds of stories poured in of people begging and imploring us not to allow this expansion of euthanasia on these conditions and how it would affect people themselves and their loved ones. And I was pouring over these letters at the height of the pandemic. in this parliamentary office that had felt like it became a suicide prevention office and feeling the responsibility to respond to each one and to address them in their candid vulnerability. And people were writing to us saying that they had struggled with suicidal ideation,

that if this law had been in place when they were struggling, they would not be here. And so the weight that we felt working on this issue knowing that if this law passed, many people would would be lost was quite overwhelming. And so this is what happened, though. The legislation was brought in. Euthanasia was expanded to include this so-called track to persons with disabilities. And it was also including euthanasia for persons

for whom a mental illness as the sole underlying condition. However, that piece of the legislation, mental illness is a sole condition, was postponed. And it has since been postponed. year after year so that it's set to take effect in March 2027 unless there's a change. So basically, we do already have euthanasia for persons who are struggling with their mental health, if not with a diagnosable mental illness, but as a compounding factor so that if you use a wheelchair and you're depressed, you qualify for euthanasia. But if you're only depressed, you don't.

And that is what has led people in the disability community to say that this has made persons with disabilities into a killable class. You know, I'm thinking back. I just recently interviewed Laura Delano, who spent 14 years on psychiatric medications. And at times, she tried to commit suicide, almost succeeded. It was almost a miracle that she didn't succeed. but she deeply wanted it and was actually when she survived, she was really unhappy about the fact that she made it. But, you know, multiple steps ensued. But in the end, when she started weaning herself off of certain types of medications,

she kept rediscovering that will to live. It's a very fraught area. What I'm trying to say is this is such a fraught area because you could be convinced for a while, right, that death is the only solution, it's the only reprieve from the suffering you're experiencing. But, you know, very quickly with some kind of inspiration or, you know, you might change your mind. Right. Your worst day should not be your last day. And how many people, I'm sure we all know people who have experienced something that they thought they would never come out of.

Heck, I'm sure we can all ask ourselves if we were shown a preview of all that we would suffer in this life, ahead of time. Who would think that they could bear and withstand and go through the whole ordeal of a life? And yet, I think it's interesting how inspiring most people find Holocaust survivors. Man Search for Meaning is one of the best-selling books. And we look at these stories of resilience with appropriate admiration. And I think part of what suffering entails is it can narrow that horizon of transcendence that reminds you that you are not, there is a uniqueness and a deeply personal dimension to suffering, but you're not the only person who's ever suffered. In fact, your suffering is the basis of your deeply human solidarity with everyone else. And we need

to be reminded and reawaken to our humanity when we recognize that suffering is the basis for our communion and fellowship with other human beings. It does not throw us and cast us out of the human community, it actually constitutes it. But only when we rise to the occasion are there for one another and we help make some meaning out of what we've suffered. I think often of quotation of a writer, Isaac Dinnison, who said, any sorrow can be born if you can put it in a story or tell a story about it. And a leading Canadian psychiatrist, Dr. Harvey Chalkanov, has this brilliant dignity therapy final words for final days, which is about drawing out that meaning at end of life.

I think that people can bear things when someone comes alongside them and has a posture of saying, what do you have to teach me? But when everyone falls away and that person is abandoned in their loneliness, of course we have a crisis. But that is the more demanding cause that we must address and the occasion to which we must rise. Euthanasia is not a declaration of freedom. It's a declaration of defeat and no point of pride for a society. And so I have such nobler aspirations that in the face of suffering and death, we would have exemplary deaths that would be educative for the rising generation about how

to contend with the whole ordeal of the lives we lead. Is there any scenario where euthanasia is appropriate in your mind? No, because in every case, the person's existence implies that they have a task in the world. Maybe that task is to receive the loving attention of others. Maybe it's something to be discovered and unlocked. But I think that to exist is to know that you have a place in the world, that you are needed for something and that also we short circuit our opportunities to love when we evict people from the human community based on their suffering.

It's very lazy on our part to decide that once people become inconvenient, complicated, and demanding, that they have no place in our lives. Instead, we have to address this risk to the kind of kindness quotient in our society that euthanasia poses. It actually, of course, first and foremost, matters to the person him or herself. The suffering, dying person deserves not to have their death reduced to a 15-minute coffee appointment or legal appointment, not to have their death scheduled neatly into the lives and schedule of another. But part of dying naturally is its unexpectedness, its unpredictability. The way in which it is inconvenient is part of what is in it for us to discover.

And I was just listening to a friend of mine who was accompanying her father in his last days, and she said, it's good when death takes time and is slow. And yes, you need palliative care. You absolutely need to manage the pain where this is not about being masochistic. We don't need to seek out suffering. And yet, with proper palliative care, the dying process can be the gradual surrender with the accompaniment of others that will be instructive in how to live and that will leave a legacy. You know, I mean, this is what I'm thinking about. Like, it's, you know, you're young, you look healthy.

You know, you probably have a long life ahead of you. You know, and there's just people that are old and a ton of pain and, you know, are, you know, are, you know, don't. don't see the point in sticking around. And maybe, as you were alluding to earlier, they're thinking to themselves, you know, I'd just like to make it easier on my offspring or whatever. I'm under a lot of pain. Like really, this really does seem like a better solution,

quite frankly, like objectively. I mean, I've heard this argument made, right? And I don't even know how to respond to that if someone's making that choice. Sorry, sorry, you can't. You have to suffer and you have to be a burden and all those things. or you're not, you can't make that decision.

This is the kind of the core question in a way, but to me, but what do you think? The only response to the cry of the heart that you describe is love. No argument but presence. And so it is incumbent upon me and my friends and my generation to tell a different story, which is that we need you in our lives. Don't go through with this. and I speak very often to older adults, and I make the point that as long as this is a legal reality in Canada, the rising generation's growth and development will be stunted because

we lose those opportunities to go out of ourselves and to be confronted even with our own mortality in the ways that coming alongside someone gives us. Like, I think back to when I was 18, I went on a Holocaust study trip to Germany and Poland for my first time, and I traveled with two survivors, walking hand in hand with them, to the sights of their trauma. And it awakened me. Those were the moments that helped me to take life seriously. And I've had other events throughout my life, facing up to the shortness of our life and to the drama of mortality, that have awakened my sense of life's value.

And I think this is something that we don't want to miss. We don't want to miss the moral urgency that comes from the preciousness of life in its limits. And so I really like to say to older people, I'm watching how you die, so do it well. Your death sends a message to me. I was recently speaking with a 28-year-old wife,

woman in Canada whose grandmother, she described as the paragon of strength in the entire family, the ultimate matriarch, and no one messed with grandma. But then her grandma, in her 90s, and as she was imminently dying, opted for a maid. And this 28-year-old woman said to me that she struggles with mental health challenges. She's gone through a lot, and she says, if my grandmother, who was such a figure of strength in my life, could choose that in a moment of weakness, I don't stand a chance. What can I do? And so these things affect each other. And what message can an older person give a younger person with respect to resilience or to even not harming themselves with behaviors that are self-destructive if they go and

prematurely have their life ended. It might seem neat. It might seem coordinated and all of this with a euthanasia doctor ending the life in 15 minutes in this kind of curated way. But it's not real. It's not real. And that unreality is shattering. You know, you're making me think of this. You made a series of these short videos of kind of very interesting case study. the things that I hadn't contemplated, one case in particular, Christopher Lyon, where he gets a call from a provider, I guess, is the term, saying, you know, you've got two days to see your dad. Your dad is scheduled for dying in two days come or you won't see him again. I mean, I'm being paraphrasing here, but basically that was the message he got. And so he's talking to you. Let's actually roll that clip and then we can discuss it. My opposition to euthanasia is not speculative, it's not abstract, it's not theoretical, it is experiential because I watched doctors kill my father in front of my family on a family member's birthday. Tell me about your father's life.

Growing up, my dad was a complex man. He was a... He was in many ways a very loving father. He was very, very proud of having his kids. You know, he would hug you very quickly. He was an affectionate guy. But he also had a dark side. And I noticed this as a teen. He would talk about drifting off into Georgian Bay

on a canoe whenever to return again. And he would talk about deaths he witnessed in the police. And it wasn't until years later that I saw that as indicative of somebody who is deeply traumatized or deeply depressed. But that was the dark side of him. The light side was this loving, jovial man who would laugh heartily.

Were you concerned that he would commit suicide long before euthanasia was ever legal? Absolutely. My dad had been suicidal in the past. I dealt with it at different times. And so when Maid came along, it was the perfect flattery. It's telling him suicide.

side is okay. It's telling him, you know, it's dignity, it's somehow even beautiful or something like this. On what basis did your father apply for and be deemed eligible for euthanasia? Two months after the government expanded euthanasia for people who were not imminently dying. My father applied for it under that new law. He had arthritis, diabetes, chronic conditions like that. None of them were imminently fatal. And that's how he applied for me. He was approved on that basis. He's approved on that basis as far as we can tell. Frailty was another reason. Some proponents of euthanasia have said that family members are their biggest problem. What do you think about that? I find that remarkable. The people most

affected by a maid death before and after it occurs outside of the person dying are the family members. We're the ones who have to live with the grief, the anticipation of the upcoming death, the questions, especially if there's doubt about the qualifying illness, if we weren't consulted, but also there is no legal requirement for the assessors to reach out to family members. In our case, we weren't contacted about my father's maid until two days before he died. Did the news of your father's impending death by euthanasia come as a shock? It shocked us that he applied, and then it shocked us again because He was killed halfway through the 90-day assessment period for people whose deaths aren't reasonably foreseeable.

It was a Wednesday. We got a call from his provider. The provider is the term they used for the person who administers the lethal injection, and that person is also an assessment. In this case, it was a doctor, and said that essentially that your dad's scheduled to die on Friday, and if you want to see him before he dies, he dies, you have two days to get here. So you have to move quickly. I pushed for the last minute psychiatric assessment and then after he died, I managed to get a copy. It's one of the few documents I have about his maid is a slightly redacted copy of his psychiatric assessment

and it's full of errors. Claims he wasn't suicidal and he had this whole history of suicidality. It states that he didn't think he was depressed and yet on the list of medications it lists antidepressants. Did you hope until the last moment that you might be able to change his mind? Absolutely. You know, I tried to explain to him that he couldn't kill himself on a family member's birthday that that was wrong. I tried a soft touch. I tried a hard touch. Now tell me about the day of and being in the room. I mean, that was the worst day of my life. That day and those moments in that room, there's nothing. I've been through some things in my life and there's absolutely nothing that compares to it. We were lost. All of us are trying to make sense

of a situation that defies sense. A provider was sitting beside me, like on a couch right next to me, injecting very large syringes of propofal, which looks like milk and other drugs, into my father and taking his life. His head rolled, flopped down on his bed when he went unconscious. He was propped up. A few seconds before he'd been animated, and then he was a corpse. This is certainly not a scenario that I considered when thinking about this issue. When we see how euthanasia is affecting people directly, it changes things. You see how the safeguards did not work to protect Christopher's father. And some people would dismiss this and say, well, those are outliers.

By and large, the system's working well. Would you say that to the family? Would you say that to the son? There's no substitute for his own father. These stories are not reducible to statistics. And the purpose of highlighting the stories of people directly affected is to let people face up to the drama of this in people's everyday lives. I have conversations every single day with people who are touched by this in one way or another.

I even had an Uber driver who asked what I do for work. and I said, I prevent euthanasia, and I encourage hope. And he said, oh, my dad had made, it hasn't even been a year ago. And I said, I'm sorry to hear that. Do you want to talk about it? I said, actually, I would. And he said, my father was an ideal candidate. Stage four, terminal cancer.

My brothers and I supported it. And my mom was agreeing that this could be good for him. And so in our living room, he was scheduled to have made. And he said, upon reflection, though, that it's the most effed up thing in the world knowing that your father is going to die in seven days, then five days, then three days, then in 15 minutes. And you're just powerless. And you know that your father is going to die at a predictable time that you can count on.

And that's shattering. And he also told me that his father had gone to the doctor in November and asked whether there was any chance he might make it to Christmas. And the doctor said there is a chance you'll make it to Christmas, but if you do, it won't be a Christmas with you that your family will want to remember. That is a push. That's a nudge. And so he was euthanized before Christmas. And this Uber driver told me that he had not discussed this with anyone until he had discussed it with me. This is the quiet suffering. This is the way that everyday people are being wounded in ways that we haven't even begun to contend with.

I have these conversations constantly, and I'm hearing from the grandchildren and children of people who have opted for maid, and they say, we are wrecked by it. We are unsettled because it's different when we lose someone or something, for example, in a natural disaster. This is something that happens to us. But as people have told me,

it's completely different when someone decides to orphan you on purpose. That's a loss that is almost impossible to bear because the person has sent the message that they don't love you enough to stay in the world, that you're not worth one more day, one more hour, one more visit. And how many people say, of those they love, what I would give to have one more conversation, more look, silent look and exchange. How can we regain relishing one another with that degree of intensity? That is what humanizes us. So in Canada, between 2016 and 2023, I believe,

there's been now a total of 60,000 of these euthanasia cases. In the U.S., throughout the entire time that there was euthanasia, there's a few states that have allowed it. I think the total number is under 10,000 and it averages around 300 years. What is it that's different in the Canadian system that has created this exploration? Because of course the Canadian population is a lot smaller than the U.S. population. In Canada, medical aid in dying includes both euthanasia and assisted suicide. The distinction being that euthanasia is where doctor or nurse directly administers the lethal injection. And in the U.S., assisted suicide involves the patient being required to take the lethal substance him or herself. And this is a

dramatic difference. Because in Canada, what we see with the more than 99% of cases being euthanasia, being doctor or nurse administered, is a kind of mutual outsourcing of responsibility. Why would someone self-administer if they could have a doctor or nurse do it? And so the vast majority opt for that. And we have this mutual outsourcing of responsibility where the patient says, I'm simply undergoing a publicly funded medical procedure. And the doctor says, I'm simply enacting the patient's wishes. And their underlying illness is what's killing them.

And I'm simply providing the response to their request. And so that is the singular point of dramatic distinction. And yet, I would warn Americans to be vigilant because as soon as you have a case where someone says or someone is advocated for on the grounds that they're incapable to take the lethal substance themselves, then on the grounds of equality, it will be argued that they ought to have someone else to do it for them. presumably a doctor. And so watch out because euthanasia, assisted suicide, always gets expanded on the grounds of equality. Once it exists for a certain segment, for a certain demographic, there's no rational basis really to limit it if it is presumed to be a good and compassionate and reasonable thing. You know, presumably, you know, the act of administering it to yourself itself could be viewed as a form of suffering to be alleviated.

Right? Because, you know, not that I've contemplate this, but I would imagine it would be a difficult process, right? And requiring the self-administration is a kind of safeguard because it is a deterrent. Many people would not do it or they maybe receive the drugs and then they don't go through with it. They change their mind. It gives you that opportunity to have a kind of pause. And so that's very important, and I do think it makes for a dramatic difference in the numbers. And yet, what we're seeing with euthanasia in Canada is that it is not exceptional anymore. It is going from exceptional to routine, as Alexander Rakin put it in one of his studies. And that's notable because many people presume that it is a kind of ideal way to die,

Rather than being exceptional, it is becoming romanticized and even glamorized as the ideal way to die. I read an obituary that began with the words, hello everybody. They wrote their own obituary. It's a self-authored first-person obituary of someone before his death by medical aid and dying. We're not meant to have self-authored first-person obituaries. It defies the genre in multiple senses. And so this cultural shift is so intense, and it's changing the fabric of our society. And then when it normalizes to the extent that people are regarded almost as foolish for not going for it,

that also has a massive toll on patience. You know, one of the things that I've covered a lot on this show is how as human beings were quite influenced by us. others around us. And in some cases, you know, there's almost sort of, you know, kind of outbreaks of certain types of, you know, mental constructs or realizations or behaviors just because people around us are doing them, those things. There's definitely a contagion element with conventional suicide and with medical aid in dying euthanasia. And this is partly why it's so disconcerting, especially to, for For example, indigenous Canadians that euthanasia would be so widespread that the government

would be offering to provide made forms into indigenous languages, if that's not a form of ideological colonialism, given that this is so antithetical to most of these indigenous cultures. Indigenous communities traditionally and by and large have a reverence for the elderly. seniors don't want to be called elders in the mainstream but in the indigenous community to be an elder is a position of reverence and authority within the community and so particularly for a community that has a youth suicide crisis as the indigenous community has when elders opt for medical aid and dying that perpetuates the youth suicide crisis

there is an interplay between these realities and so what I would say to someone who says if a person consents and in their autonomy wants to seek medical aid in dying I would say there's no such thing as that kind of autonomy your death affects other people your death has consequences you could ignore those consequences but your death still has consequences even a natural death has consequences on others in people's lives. But we live in a society that's so alienated, so fragmented, that we can easily forget that we belong to one another and that our deaths do reverberate and send a social message. So how we die actually matters.

You know, one thing you mentioned a bit earlier is that you can get this euthanasia in a kind of house call type format. It's sort of, is our house calls just in general something common in Canada? I mean, they're a lot less common in the U.S. and, you know, I haven't been around as much. I'm assuming that it's similar. It just seems odd to me somehow that this house call option is, is it standard? I'm trying to understand this. The government does say that even if you do not have a family doctor in Canada, they will send a maid provider to your home. And we live in a situation where many, many Canadians do not have family doctors. And so euthanasia is bizarrely a kind of health care without a wait list. And every other form of health care in Canada has

some kind of wait list. The expeditiousness with which people are getting phone calls once they make an inquiry about medical aid and dying is enough to spook some people out of it because they've never gotten a call back on a healthcare related matter that quickly. And so that is alarming. But no, it's not typical for doctors to necessarily go to people's homes. And we're seeing this very unique willingness on the part of maid providers to go and bill for the same kind of palliative care.

That there's a sort of abuse of the billing codes for this very cheap. practice of killing patients that it has nothing on the real palliative care that people deserve to receive. And that is so much more demanding, but that is also so much more human. And so it's a form of laziness on the part of those doing it. And it is so non-specialized to end a patient's life. There was an article with a euthanasia provider wearing a stethoscope. And in the photo. And yet this euthanasia doctor said, I find myself checking that the heart has stopped in the work that I do. That's what it's for. This is such a distortion of medical practice

and who can really trust their doctor if you know that this doctor has killed some of their patients. We're hearing from some doctors who say, it's actually really hard to provide maid to someone who I've cared for for many years in family practice. Well, no kidding. No kidding. But where is the ethical sensitivity for the stranger? For the marginalized patient, for the new patient, who you don't know, that really gets to me. How, I mean, presumably you've spoken about this with doctors and perhaps philosophers, but about, you know, how does this comport with the Hippocratic Oath, right? It's a good question.

The first do no harm demands uncovering first what is harm. And there is a euthanasia doctor in Canada who discusses the Hippocratic Oath in her book. And she says, when I started doing medical aid and dying, I didn't see it so much as a harm, as a help. The underlying illness was what was killing the person. And I was simply enacting the patient's wishes. And so if you don't consider killing the patient

to be harmful, then there's no rupture with the Hippocratic Oath. And so I would say we have regressed from the Hippocratic Oath, which says first do no harm, to the preliminary question, first, what is harmed? So really in that situation, it's what the patient defines it, I suppose, right? You're kind of going by how the patient is viewing that.

It's as though living has become the harm. And that is partly how euthanasia was legalized. Under Section 7 of the Canadian Charter, which is part of the Constitution, which is about life, liberty, and the security of the person. It was the right to life, liberty, and the security of the person that was used as the grounds to justify ending patients' lives. How? Because if a person was suffering, they might commit suicide,

sooner than they would want to if they're not able to avail themselves of a doctor-assisted death. And so this was the twisted rationale by which euthanasia was ushered in, that it actually upholds in some bizarre way the security of the person to have it in their back pocket that they could ask a doctor to end their life if their suffering ever becomes unbearable and tolerable to them. You speak with a lot of different people about this, people that have, you know, faced this issue in one way or another. Maybe offer me a few examples that might not be immediately obvious to the typical viewer. Sure. One of the persons I interviewed is named Roger Foley.

And he lives with multiple disabilities and has been in the hospital for some years. and while he has been in the hospital due to inadequate and negligent home care that led to certain injuries, he has been offered euthanasia repeatedly, despite wanting the resources and the self-directed funding that he needs to live. And so there is a dimension by which our euthanasia regime has become predatory, where people beyond doctors and nurses are raising it with patients. For example, we have heard from Veterans Affairs Service agents proposing medical aid and dying to veterans. We have heard from hospital social workers mentioning it. We have heard that, for example, you could be undergoing chemo and see on the screen in front of you,

the made grief support is available for your family should you choose to end your life through medical aid and dying. There are pamphlets for all kinds of illnesses and diseases. that mention made in the pamphlet or on the website. And so the idea is constantly being planted. Plus, our state broadcaster is frequently putting out stories that defy all protocol around journalism and suicide prevention. News stories that glorify and sensationalize euthanasia deaths, people choosing to die together,

people choosing to die on dates of significance that are particularly wounding, for family members, and yet this is touted as a form of personal autonomy, no regard to the incredible trauma that it inflicts on a person to have a death date selected on a certain anniversary. And so, yeah, in the course of speaking with Canadians, I'm realizing all the surprising ways that this is touching people. For example, I heard from a paramedic who got called to what he said was a botched maid. What do you do?

You're a paramedic. If you save this man's life, is he going to resent you? Are you, you're not, it puts the person in an impossible situation. I heard from a second year medical student that the cadaver that he was working on in medical school had been a maid recipient. That's peculiar. And so all these ways in which this is touching us and affecting the culture at large, it's incalculable.

Well, I mean, one example that we haven't really talked about, which seems to me probably the, I don't know, the most obvious one, which is just, you know, young people who don't care much for their parents, sort of, you know, kind of encouraging them to not be a burden or something like that. Like I can imagine, that's the scenario that I, does that happen? And often, do you have any data on this? Like, that seems to me to be, would be a highly problematic variant of all these scenarios you're describing it.

It is definitely suspect when there is an article mentioning that all of the children were supportive of their parents dying by medical aid in dying. That's indicating some of the social coercion and often financial coercion. We start to pay attention to the financial abuse of seniors, there's no greater abuse. than saying, I wish you were dead. And of course, people are not stating that explicitly. And yet I do hear from doctors and from people working in banks that they intuit and intimate these kinds of abuse and social and financial coercion inherent. And so I think it's important to pay attention to both. I'm frequently asked, is the government doing this to save money?

Well, the government did publish a cost savings estimate of total cost, savings projected based on the expansion of euthanasia. And so the parliamentary budget officer put that document out. But let's also pay attention to the more micro level, at the family level, of the extent to which people are calculating whether the parents or grandparents themselves or whether it's the potential recipients of that money, we have to attend to what a desecration of relationship this is when people either feel pressured or are grasping for for money when the greatest resource in our life ought to be the love and the relationship that we can actually give to one another what about for the

providers is first of all do providers need to be medical doctors and doctors or nurses or nurses that's interesting and I mean are they required if they work for the health system to do this as a treatment or could explain that to me? When Canada legalized euthanasia, it was by creating an exception to the criminal code offense of homicide, specifically for doctors and nurses when doing medical assistance in dying according to the parameters specified. And at the bottom of the list of those parameters, it says that no doctor or nurse can be compelled to participate in euthanasia against their conscience or against their

will and yet what we are seeing is a real affront to institutions and so while individuals have some modicum of conscience protection we're seeing all kinds of lawsuits against institutions hospitals that don't want to provide euthanasia on site being yeah brought to face lawsuits over their non-provision of made these would be For example, Catholic hospitals, or there was a hospice called Delta Hospice that was shut down because they wouldn't provide euthanasia. And so what that really means is that we don't have made free spaces because a lot of patients want to be receiving care in a space where they know that euthanasia will not be raised or that it will not be offered. And so it's actually an affront to patient rights to not have institutional protection to include made free, made for,

free spaces. So, you know, is there legislation being considered around this or anything? It would be good to have protections for conscience rights, both for physicians and for institutions. That's a bit weak right now. And many people do face a lot of professional pressure and sort of social coercion to, if not participate in the made regime to at least acquiesce to it. Well, so what's next here for, you know, what do you expect will happen next as if, you know, I don't know, the law doesn't change? I think euthanasia poses such a question to all of us about who we are and who we want to be as a society. This is a kind of symptom of a broader nihilism about the world. and of a broader incapacity

to suffer well throughout life. What are our lives about? And when we face suffering, is it, does it throw the whole script of our lives or can it be part of the story of the lives we lead? Ultimately, I think there's no good story without suffering, not that we seek it. We don't need to seek out suffering

and all will come, plenty will come each of our way. But if we don't suffer, then there's no drama. There's no real story. And so I often encourage people to think. Think of any person you admire. If I was to ask you to share about someone you admire and consider exemplary, I'm sure the person who comes to mind suffered.

And it is precisely in that resilience. It is precisely in the noble response to the suffering they faced. That is the basis for your admiration. And so what are we really trying to flee? and what might we lose if we cut life short prematurely? I really see euthanasia then as a big opportunity to face up to these bigger questions

of suffering, death, meaning, and hope. And that's actually why I'm engaged in this as a young person who cares about my country and for whom the most patriotic thing I think I can do as a Canadian is to warn other countries not to be like Canada in this respect. I have found my task and my mission

in saying that my country has done an experiment by prematurely ending the lives of patients and we're not made for this. It doesn't cut it. We deserve better. And you can avoid going down this path, and you ought to. So for the benefit of those non-Canadians that are watching,

you mentioned some things to watch out. for, right, that kind of irrevocably put you on this path towards euthanasia as being kind of normalized across society? What are the things to watch out for? Sure. Let's look at the grounds on which euthanasia gets legalized. Either it's about consent, in which case if it's always about consent, that throws out all suicide prevention efforts because a person opting for suicide purportedly consents or wills it. So there's that. Now if there's a more seemingly rational logic and criteria for who qualifies, then that

social criteria implies a judgment on the value of life in the face of those conditions. Those are two distinct things, the consent or criteria. And so watch from those angles. Either one eliminates the need for suicide prevention, wholesale, and it's problematic there, or the criteria denigrates people living with an illness or condition. in virtue of qualified. For example, disabled people, because we, you know, we, we, in our society, we value disabled people greatly, right?

I mean, we have people who have all sorts of disabilities that perform, you know, incredibly important functions in society. And who knows if they had, if they saw this as an option, or if their loved ones saw this as an option where they would be to do that or not be. Right. And simply knowing that you qualify to have your life prematurely ended is already shattering. That's so important to bear in mind. That's already having a toll. It's already deeply affecting people. So that's one thing. The other thing is once legalized euthanasia

cannot remain limited. Once it is presumed to be a good and compassionate response to suffering, it will be expanded to more and more people on the grounds of equality. And so watch out for that. and the other is watch out for this equality argument that if someone is incapable of killing him or herself, that it would be a help to do it for them. Suicide is never helpful. That's why the language of assistance is so problematic. Medical assistance is a misnomer. Palliative care is using medicine to assist people at end of life. Providing lethal drugs that are intended to end the person's life is not helpful. It's not assisting anything. So we have to also watch out for the abuse of language that desensitizes us. And I think one of the most important things

that people can do if they want to change the culture and if they want to create a more human picture is to start having conversations about suffering and dying. Many people hold back and they think if people knew that I had suffered this or that I'm grieving, they wouldn't want to talk to me. I'd be a bit of a bore. I'd be a downer. No. Share your suffering. Share your grief. Share your losses. And you will see how it becomes a basis for intimate conversation, for a kind of communion in that suffering, for a depth of friendship and relationship that you would not have had access to otherwise. And I really do believe that if people reflect on the conversations of greatest depth on the times of greatest connection. They have been those

moments where you put down your phone, you sit at the bedside, everyone is silent. These deep interior and communal moments are what make for the depth and drama of life. And I desire this so fully for people. I desire it especially for those with whom I vehemently disagree on this issue. And there is no one for whom I wouldn't will the good of a natural death and of accompaniment in their end-of-life moments. What the dying person requesting euthanasia betrays is a kind of insecurity that they'll have anyone to keep vigil and wait with them. And so they kind of schedule the vigil by scheduling the death. But that's a sham. We need to do the much more demanding thing, which is showing up, being steadfast, and willing to risk the

unexpectedness that is inherent in dying naturally because it is so much more human, just like the unexpectedness into which we are born. Well, Amanda Ackman, it's such a pleasure to have had you on the show. Thank you. Thank you so much. Thank you all for joining Amanda Ackman and me on this episode of American Thought Leaders. I'm your host, Janja Kellick. Thank you. Thank you.