Canada’s rapid ascent to becoming a leading nation in euthanasia rates demands urgent introspection about our medico-legal culture and ethical responsibilities. Recent statistics from Health Canada’s report on the situation up to 2023
The Fifth Annual Report on Medical Assistance in Dying in Canada
suggests that Canada may have already surpassed the Netherlands, traditionally seen as the benchmark for assisted dying practices, in becoming the world’s capital of euthanasia. This raises critical questions about the safeguards and ethical considerations surrounding this sensitive issue.
In the 2015 Carter decision, the Supreme Court of Canada @SCC_eng confidently accepted that the risks associated with physician-assisted deaths could be managed through a well-designed system of safeguards. This assurance, however, seems increasingly tenuous given the recent data. It took the Netherlands 22 years to reach 5% of deaths resulting from euthanasia. Canada, astonishingly, has reached 4.7% in only seven years. This rapid increase challenges the notion that Canadian systems are inherently more cautious or ethical compared to their European counterparts.
In the Carter Case the Supreme Court was called upon to consider the permissive experience of Belgium that saw a marked increase in euthanasia. The Court rejected the argument and relied on the lower courts view that emphasized the uniqueness of Belgium’s medico-legal culture as justifying their different approach – it came from a “permissive regime” that is the product of a very different medico-legal culture than what happens in Canada.
However, this argument fails to acknowledge human nature’s universal vulnerabilities, transcending national boundaries. Are we to assume that Canadian medical professionals possess an unparalleled ability to uphold ethical standards? History has demonstrated that no status or professional standing renders one immune to the excesses of and the frailties of human nature. We must operate within a strong moral framework. This has been forgotten in our “advanced” “modern” age. We have so deconstructed what it means to be human in our “post-national state” that we have forgotten our ancient moral traditions that shaped our civilization for the good. We are now living proof of the failed policy that somehow we are above morality.
The ancient Hippocratic Oath, which includes a vow never to administer a lethal drug, underlines a foundational medical ethos that transcends time and culture. As we confront modern complexities, it is worth questioning whether our current practices, which permit euthanasia, truly reflect an advancement over the ideals espoused by Hippocrates 2,500 years ago.
Our progress should not be measured solely by the scope of legal frameworks or the sophistication of regulatory mechanisms. Instead, it should be assessed by our commitment to compassion, care, and ethical integrity in medicine. Yes, moral right and moral wrong. Canada’s leap to prominence in the realm of euthanasia necessitates a national conversation about the principles that underpin our healthcare policies and the societal virtues we wish to uphold.
This moment is a call to deeply evaluate our approach, to question if rapid legal acceptance has overshadowed ethical considerations. As we navigate this complex terrain, it is imperative to prioritize rigorous regulatory oversight and a renewed commitment to the ethical care of all individuals, ensuring that legal advancements do not compromise the core values of humanity and medical practice. It is time that we start rebuilding the old waste places and raise up the foundations of many generations that have served us so well.
Translation of the Hippocratic Oath
Translated by Michael North, National Library of Medicine, 2002.
I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract:
To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others.
I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
In purity and according to divine law will I carry out my life and my art.
I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.
Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.
So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate.
