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Last year, the Canadian Supreme Court created a right to euthanasia and assisted suicide. To qualify for death, the court ruled unanimously, one must be a competent adult with a medically diagnosed condition causing “irremediable suffering”—a circumstance wholly determined by the patient and including “psychological suffering.”

The decision went well beyond mere legalization. Indeed, the court manufactured an enforceable legal right for qualified patients to receive what Canadian policymakers are euphemistically calling “medical aid in dying” (MAID).

But what about doctors opposed to euthanasia? The court left with Parliament and the medical colleges (associations) the decision of whether and how to accommodate doctors with conscience objections, granting a one-year (now extended) period within which to enact laws to govern the practice. Since then, civil liberties groups, provincial medical colleges, and official government commissions have urged Parliament [see here and here] to pass laws that would coerce doctors who are religiously or philosophically opposed to euthanasia to cooperate actively in mercy killings by forcing them to procure death doctors for their patients. Here’s how the federal panel put it:

RECOMMENDATION 10 That the Government of Canada work with the provinces and territories and their medical regulatory bodies to establish a process that respects a health care practitioner’s freedom of conscience while at the same time respecting the needs of a patient who seeks medical assistance in dying. At a minimum, the objecting practitioner must provide an effective referral for the patient.

Gobbledygook: Requiring “effective referral” would materially violate—not respect—a “practitioner’s freedom of conscience” through forced complicity in euthanasia, thereby trampling his faith under the boot of the state.

All of this would seem to fly in the face of Canada’s 1982 Charter of Rights and Freedoms, which states, “Everyone has the fundamental freedom of conscience and religion.” Illustrating the utter lack of regard that secularized Canada now has for religious liberty, the Canadian Civil Liberties Association—that country’s counterpart to the ACLU—applauded the parliamentary committee’s call to stomp upon religious conscience as a “promising step forward.”

Doctors aren’t the only ones threatened with religious persecution under Canada’s looming euthanasia regime. Provincial and federal commissions have both recommended that nurses, physician’s assistants, and other such licensed medical practitioners be allowed to do the actual euthanizing under the direction of a doctor.

This is particularly worrying from a medical conscience perspective, because it leaves no wiggle room to say no. For example, objecting doctors might be able to defend their refusals by claiming that the euthanasia requester is not legally qualified. Nurses, however, would not even have that slim hope, since they would merely be delegated the dirty task of carrying out the homicide. This leaves nurses with religious objections to euthanasia with the stark choice of administering the lethal dose when directed by a doctor, or being insubordinate and facing job termination. The same conundrum would no doubt apply to religiously dissenting pharmacists when ordered to concoct a deadly brew.

Even Catholic and other religious nursing homes and hospices may soon be required by law to permit euthanasia on their premises, for the federal commission recommended that federal and provincial governments “ensure that all publicly funded health care institutions provide medical assistance in dying.” That is a very broad category. Canada has a single-payer, socialized healthcare financing system that permits little private-pay medical care outside of nursing homes. Not only that, but as Alex Schadenberg, director of the Canada-based Euthanasia Prevention Coalition told me, “religiously-affiliated institutions [in Canada] have become the primary care facilities for elderly persons, those requiring psychiatric care, and dying persons. They are now being told that as a condition of providing those services they will be required to permit doctors to kill these very patients by lethal injection. If they refuse, they will find themselves in a showdown with the government.”

That leaves medical professionals who oppose euthanasia—five thousand religiously oriented doctors have joined the Coalition for Healthcare and Conscience to protest the proposals—in a very tight spot, raising the question of what options will be available to conscientious objectors:

  • They can keep their heads down and pray they are never asked to kill a patient.
  • They can surrender and become part of the death machine—at the risk of the eternal consequences that their faith beliefs portend.
  • They can give up their careers and hand the keys of what are now religious medical institutions to secular ownership (or, move to the United States where, at least for now, doctors and nurses enjoy conscience protections).
  • Finally, the difficult but most righteous course would be to engage in a policy of total non-cooperation with the culture of death, forcing the national and provincial governments and medical colleges either to turn a blind eye or to inflict unjust punishments on doctors for refusing to kill. Perhaps such draconian measures would bring the country to its senses.

Where are the church organizations in all of this? Some notable Canadian prelates and other faith leaders have spoken out strongly against the pending coercion. But in Canada’s highly secularized society, it will probably require louder voices than these—for example those of Pope Francis and the Dalai Lama—to turn the tide. But the hour is very late. The embarrassment caused by the wildly popular pope condemning a nation that considers itself the epitome of reasonableness might be the only preventative measure that can save religious liberty in what used to be the free country of Canada.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. His next book, Culture of Death: The Age of “Do Harm” Medicine, which will be published in 2016.

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