fbpx
Articles

Explainer: What you should know about Canada’s medical assistance in dying law

/
March 3, 2023

Last month, the government of Canada introduced legislation to extend the temporary exclusion of eligibility for medical assistance in dying (MAID) where a person’s sole medical condition is a mental illness until March 17, 2024. The legislation (Bill C-39) passed the House of Commons and has been introduced in the Senate.

Here is what you should know about Canada’s law that allows for voluntary euthanasia.

What is Canada’s MAID law?

MAID is the acronym for Canada’s medical assistance in dying law. The laws allows physicians and nurse practitioners (in provinces where this is allowed) to help a person commit suicide by either directly administering a substance that will end their life or prescribing such as substance so that it can be self-administered.

The law provides exemptions from the criminal law concerning suicide and provides protection from liability to pharmacists and pharmacy technicians/assistants, healthcare providers who help physicians or nurse practitioners, and family members or other people who have been asked to participate. They are able to assist in the suicide process without being charged under criminal law as long as they follow the legal requirements. 

This legal right to voluntary euthanasia has been in effect since March 17, 2021. Prior to that, the Supreme Court of Canada had ruled that a prohibition on medical assistance in dying violated the Canadian Charter of Rights and Freedoms.

What should Christians think about medically assisted suicide?

Medically assisted suicide is a form of euthanasia, the intentional act of taking a human life for the purpose of relieving pain and suffering. Christians should reject euthanasia because it denies the inherent dignity that God has given human beings and seeks to take the place of God in determining the end of life.

While those seeking MAID and those participating in the practice may want to eliminate suffering, what they are doing is actually undermining the objective value of life. Although the Bible does not speak about euthanasia directly, it teaches that we must regard life as belonging to God and approach issues of suffering with a critical and biblically-based approach. As Mary Wurster has written, “The value of human life in all its forms and at all stages is the central theme of the gospel, for it is the very purpose of Christ’s birth, death, and resurrection. To fail to respect human life at any point mocks the very essence of Christ’s mission to humanity.”

See also: How would you counsel someone interested in assisted suicide?

How many people are being legally euthanized under Canada’s MAID law?

In the five years since the law was adopted, there have been 31,664 medically assisted suicides. As the Canadian government notes, “annual growth in MAID provision continues to increase steadily each year.” In 2021, the total number of MAID deaths increased by 32.4% (2021 over 2020), compared to 34.3% (2020 over 2019) and 26.4% (2019 over 2018).

In 2021 there were 10,064 MAID related suicides, an average of 28 per day. MAID suicides account for 3.3% of all deaths in Canada. Across Canada, fewer than seven deaths were from self-administered MAID.

What is the reason people in Canada choose MAID?

According to the Canadian government, the most commonly cited intolerable physical or psychological suffering reported by individuals receiving MAID in 2021 was the loss of ability to engage in meaningful activities (86.3%), followed closely by the loss of ability to perform activities of daily living (83.4%).

Who is eligible for medically assisted suicide under MAID?

To qualify under MAID, a person wanting to take their own life must satisfy all the following criteria:

Does a person have to have a terminal illness to qualify for medically assisted suicide?

No. The diagnosis has to be considered “serious” but not necessarily “terminal” (i.e., a condition that cannot be cured and is likely to lead to someone’s death).

Does a person with a mental illness qualify for medically assisted suicide?

If the sole underlying medical condition is a mental illness, they are not currently eligible for MAID. However, this exclusion is only in effect until next March, at which time it will be automatically repealed.

This exclusion also only applies to conditions that are primarily within the domain of psychiatry, such as depression and personality disorders, and does not include neurocognitive and neurodevelopmental disorders, or other conditions that may affect cognitive abilities. For instance, a person who has dementia, Alzheimer’s, Huntington’s, or Parkinson’s are all able to receive medical assistance in their suicide. In 2021, 12.4% of MAID deaths were for neurological conditions.

Are medical practitioners able to refuse to participate in Canada’s MAID law?

The MAID law does not itself compel doctors or physician assistants to participate in the medical killing of another person. However, various Canadian provinces have issued guidelines that “strongly encourage” medical practitioners who are unwilling to provide MAID to refer their patients to other institutions or providers.

Some provinces violate the conscience rights of doctors and physician assistants by requiring transfer of care or referral  to a medical provider who will participate in the suicide. For example in the province of Ontario, objecting providers must make an “effective referral” to an available, accessible physician or agency willing to facilitate a request for assisted dying. 

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24