Conservative warnings on assisted suicide worth heeding

While assisted suicide today is not as high-profile an issue as abortion or transgender rights, it is another controversy that pits a progressive vision of individual freedom against the conservative call for social constraints.

It’s also a painfully complicated issue where experience suggests that, even from a liberal secularist point of view, conservative warnings about the dangers of liberalization deserve to be heeded. With New York State debating a bill that would legalize medical assistance in dying for terminally ill patients, this experience is worth a look.

The expansion of assisted suicide eligibility criteria in Canada is a troubling case in point.

Legal doctor-assisted dying in Canada is a recent phenomenon. The prohibition of it was struck down by the Supreme Court of Canada in 2015 as violating protections for individual liberty. Legislation formally regulating medical assistance in dying for the terminally ill was passed the next year. Then, the criteria were expanded in 2021, giving the option of assisted suicide to non-terminal patients with incurable conditions such as cerebral palsy.

The effect, critics say, has been to normalize doctor-enabled suicide for people whose real problems may not be medical but social — for instance, isolation and loneliness related to disability. In a recent article in The Bulwark, Columbia University philosophy professor Dhananjay Jagannathan writes that such factors were cited by one in six assisted dying recipients in 2021.

In one highly publicized case last year, a 51-year-old Ontario woman ended her life after being denied a request for specialized housing to mitigate severe allergic reactions to chemicals. For critics, the symbolism was shocking: It seemed that the state was unwilling to provide a disabled woman with assistance in living, but willing to assist her in dying.

In another incident reported by The Associated Press, a man with a history of depression and other health issues was granted euthanasia based on a request in which the only problem he listed was hearing loss. In a grimly ironic twist, he filed the application while hospitalized due to concerns that he could be suicidal. His family believes hospital staff improperly helped him apply for assisted death and did not take steps to improve his life (such as ensuring he wore an implant that enables partial hearing).

A new, hotly debated expansion of Canada’s assisted suicide law, which takes effect early next year, will grant such assistance to people suffering from mental rather than physical conditions. The Reuters news agency has profiled a woman in her forties who wants to die because of an eating disorder.

Those alarmed by Canada’s assisted death program (which accounted for about three percent of total deaths in the country in 2021) include disability advocates. Many progressives are also troubled by a shift in attitudes, among medical ethicists and among the general public, that views poverty or homelessness as sufficient reasons to provide assistance in dying: more than one in four Canadians endorsed such a view in a recent poll.

The assisted dying legislation proposed in New York is far more modest: It would provide assistance only to terminally ill patients after counseling to ensure the request was not due to psychological impairment. My own view has always been that such an option should be available to end intolerable suffering. But Canada’s experience should give us pause. In this case, the slippery slope seems all too real.

Opinions expressed by Cathy Young, a cultural studies fellow at the Cato Institute, are her own.

By Cathy Young

Cathy Young is a writer for The Bulwark.