Medical Aid in Dying Is not a Hypothetical “Slippery Slope,” but a Clear and Present Danger

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This article is in response to the series, “The Case for Medical Aid in Dying” by Douglas W. Heinrichs, MD.

From the very beginning of the assisted suicide debate, the elephant in the room has always been the so-called “disabled community,” because this very diverse group contains large numbers of individuals who would logically be eligible for medical aid in dying (MAID); who have followed the question closely; who understand first-hand the reality of medical suffering; and who are, in an overwhelming majority, opposed to the legalization of assisted death.

Quite simply: No one has been able to explain why a special exception to the protections of the criminal code should be made for individuals who want no such thing.

I use the word “protections” because that is what the homicide prohibitions really are (or rather were): no individual might be killed or assisted to kill themselves by another, and no individual might suffer from another’s suicidal suggestion. Removing those protections for any specific group is like removing the life-preserver from selected boating enthusiasts. Their lives become more dangerous.

Now it is possible that a special and dangerous accommodation be made for individuals who understand the risk and claim it as a lucid privilege. However, in the present case, this also involves imposing that same risk, upon a much larger number of individuals against their will. Clearly, this is an important contradiction that should be taken seriously. But nothing of the sort has been done.

To blithely claim that there can be effective safeguards is simply ridiculous. The life-preserver is the boater's “safeguard.” And that is what has been removed.

It is at once interesting and distressing to see how many individuals have attempted to rationalize these facts in order to support their own fixed prejudice in favour of assisted death.

In order to avoid charges of Straw Man arguments, I will take as an example the specific words of Douglas W. Heinrichs, MD.^1-4

Tellingly, in this series of 3 articles, the disabled arguments were reserved for the “Slippery Slope” section, which is to say: fears of hypothetical difficulties which may or may not arise in the future. Heinrichs is therefore implicitly stating that the disabled suffer no direct harm from legalization; that their misgivings are currently imaginary.

“Spokespersons for the disability community have raised concerns that if MAID were extended to individuals based on pain, suffering, or dignity-depriving dysfunction, it could lead to a judgment that individuals with disabilities have lives not worth living and result in pressure for those individuals to request MAID.”

On the contrary, legalization of MAID does not “lead to” anything. The offer of assisted death to individuals suffering from severe medical conditions is a result of a preexisting judgment ("that such individuals have lives not worth living"). For if the political majority did not think such lives were worthless, the option of assisted death would never have been created for them in the first place.

What MAID really does is create a conduit for the actualization of that prejudice. The harms, therefore, are not hypothetical, but real and immediate.

As for “pressure to request MAID,” Heinrichs on several occasions uses phrases like "undue influence" and "excessive external pressure" to which the potential MAID client should not be subject. But why the adjectives? Is there a pressure to die that is not excessive? Clearly, for Dr Heinrichs, there must exist a category of "reasonable" suicidal suggestion.

And that of course, is the whole point: from the moment that any medically justified version of assisted death is legalized, one specific group of individuals is exposed to the dangers of suicidal suggestion. That group is targeted, not because they want to be, but because a widely held atavistic prejudice declares that they should be.

Gordon Friesen is a disabled individual who has followed the assisted death question closely since the early 1990s, and is currently President of the Euthanasia Prevention Coalition.

References

1. Friesen G. Lessons from the Canadian euthanasia debacle: utilitarian death-medicine piggy-backing on the power of choice. August 4, 2022. Accessed December 8, 2022. http://euthanasiadiscussion.com/wp-content/uploads/2022/11/connecticut_pdf_form_publish_v1.pdf

2. Heinrichs DW. The case for medical aid in dying: part 1. August 23, 2022. https://www.psychiatrictimes.com/view/the-case-for-medical-aid-in-dying-part-1

3. Heinrichs DW. The case for medical aid in dying: part 2. August 30, 2022. https://www.psychiatrictimes.com/view/the-case-for-medical-aid-in-dying-part-2

4. Heinrichs DW. The case for medical aid in dying: part 3. September 6, 2022. https://www.psychiatrictimes.com/view/the-case-for-medical-aid-in-dying-part-3