Bill C-14 (now before the Senate) is about to thrust Canada into the brave new world of assisted suicide. The “right to die” has been sold to the public as a triumph for personal autonomy. This rhetoric of individual liberty, however, is belied by the bill’s disregard for the conscience rights of Canadians.
C-14 does nothing to protect the right of objecting institutions or individuals to decline to participate in assisted suicide and euthanasia. It hands that problem on to the provinces. Unless amended by the Senate, the law’s conscience protections will be more meager than those currently afforded in the case of abortion.
Millions of Canadians oppose assisted suicide. According to a 2015 survey, 63% of doctors would avoid personal participation in the practice, and many of these reject the idea that killing has any place in medicine. Yet in the vanguard of the suicide revolution there is a determined effort to enforce complete conformity.
The illiberal logic of this hard-line position has been laid bare by Ricardo Smalling and the prominent bio-ethicist Udo Schuklenk, both of Queen’s University. In a recent issue of the Journal of Medical Ethics, Smalling and Schuklenk repudiate any and all “conscientious objection accommodations” among medical professionals. They would require full participation in assisted suicide, abortion, and indeed any putative “medical service” authorized by the government.
Smalling and Schuklenk exhibit contempt for religious people, whom they regard as dimwitted literalists nursing “arbitrary and random” moral beliefs. Indulging in shabby polemic, they dismiss as “idiosyncratic private views of the universe” what is in fact the product of careful moral reasoning they have not bothered to understand. Their aggressive atheism betrays them.
Above all, however, they demand the complete subservience of the medical profession to the mandates of the state. They argue that medicine is a “monopoly service,” fully funded and regulated by the state, and that professionals cannot enjoy the benefits of this monopoly unless they accept—without exception—the “scope of professional practice” set by government regulation. Non-conformists are free to find some other profession.
What boundless enthusiasm for state power! Medicine was not a government invention, nor was the state monopoly established by doctors or for their benefit. It was created by 20th-century laws banning the private contractual market for medical services. The effective provision of healthcare nevertheless continues to rely on the goodwill and competence of free individuals, cooperating in guilds that have their own understanding of their vocation and its best practices.
It is not at all clear that either the Court or Parliament has a right to define medicine, much less to redefine it as inclusive of killing. (Would education or engineering or philosophy accept such redefinition? If not, why should medicine or any other science?) At all events, intrusion of the state should be minimized, not expanded, and deference to dissent should be seen as a requirement of justice, even when it impedes the state and its purposes.
Schuklenk and Smalling’s statist instincts are evident in their extraordinary appeal to the seventeenth-century theorist Thomas Hobbes. Hobbes was an absolutist, who believed that no natural right except the bare right to life survived the creation of sovereignty. He required that all citizens, whatever their inward beliefs, conform their outward actions to the mandates of a single public power. Hobbes dismantled the rights to free speech, association, and religious practice. He empowered the sovereign to define the very nature of good and evil.
Remarkably, Schuklenk and Smalling endorse the Hobbesian dictum that “private consciences” are dangerous because they “weaken” the state, and must be comprehensively subordinated to “the public conscience.” This position is often disguised as “deference to society” but is really an idolatry of sovereignty. States (even democratic states) are deeply imperfect protectors of the social good. Granted regulatory powers difficult to oversee, driven to serve favoured constituencies, they frequently imperil civil society and individual liberty.
Prof. Schuklenk, we note, has previously celebrated the law-breaking of doctors inclined to euthanize their patients. Yet now he wishes to purge the profession of any possibility of dissent. Even those Canadians who share his enthusiasm for assisted suicide should hesitate, however, before supporting this purge. There is no disputing that assisted suicide regimes have a tendency toward mission creep. Careful controls erode, mechanisms of informed consent loosen, doctors and case managers assume ever more direct power. In England recently, “do not resuscitate” orders were routinely and illegally placed in thousands of patient files without their consent, resulting in untold premature deaths. In European jurisdictions, despite ostensible controls, hundreds of patients are involuntarily euthanized every year.
Given the fiscal incentives for modern states to push assisted suicide quietly toward voluntary or involuntary euthanasia, citizens on both sides of the debate may come to appreciate the protection of doctors and hospitals where assisted suicide is forbidden as a matter of principle. C-14 threatens not only the conscience rights of doctors, but the freedom of all citizens to access healthcare exclusively devoted to curing the sick and accompanying the dying. In our view, it is a disgrace that the energies and resources that ought to go into palliative care are being put instead into a regime for killing, and a coercive regime at that.
Jeffrey Collins, Associate Professor of History at Queen’s University, is author of The Allegiance of Thomas Hobbes.
Douglas Farrow, Professor of Christian Thought at McGill University, is author of Desiring a Better Country.