Canada’s pending legislation on euthanasia and assisted suicide raises a question: What shall we call people who are legally involved in the destruction of human life—particularly those who do the actual killing? Shall we call them medical executioners? They are indeed executioners, as none can deny, but what they are doing is not medicinal, unless what the hangman does is medicinal. It has no healing properties. It is deliberate destruction.
We know those who kill the unborn as abortionists. Those who kill the sick or injured are sometimes called euthanizers. But, though what the latter do is not as grisly as what the former do, it is at best an ambiguity, and at worst a lie, to say that the latter bring about a good death. (What is a good death anyway, and by what authority do we designate it as such?) No, “euthanizers” won’t do.
To put it frankly, but fairly, both are simply terminators. Or, in not a few cases, exterminators; that is, people determined to eliminate as far as possible those who suffer or who cause suffering. When you cannot kill the disease, kill the patient. Then you will not have to accompany that person any further. Or if one of the patients is the “disease,” which is how the unborn are often regarded, then kill that one to spare the other one the burden of accompaniment.
What heartlessness! What cowardice! What grotesque misrepresentation to call this “compassion” when in fact it is nothing but fear of passion or suffering! What nonsense to call it medicine! Even those who do not themselves terminate, but only provide an assisted-suicide service they refer to as medical aid in dying (MAiD), are certainly not practicing medicine. Nor are they helping anyone to practice the art of dying. They are themselves practicing the death arts. (That perverse province, Quebec, in Bill 52 deliberately conflated palliative care with both MAiD and active euthanasia in order to obscure this very point.)
The Supreme Court of Canada recently granted Parliament an extension of four months to produce legislation regulating the death arts, having last year struck down the Criminal Code prohibition of assisted suicide by creating ex nihilo a legal right not to be afraid of future suffering. (Was it trying in Carter to channel Jesus somehow, or St John Paul II?) While the Court focused on MAiD rather than on active euthanasia, it now falls to Parliament to decide, before the new year is even half out, how to certify and regulate both kinds of termination all across the country.
Taking a page from Professor Somerville, I recommend that Parliament not try to maintain the Quebec fiction, which by calling assisted suicide and euthanasia “medicine” erases the distinction between killing and healing, between harming and doing no harm. Let Parliament proceed to isolate both assisted suicide and euthanasia from the practice of medicine. Let it create a policy manual for terminations and a Register of Terminators.
Of course some of the latter, perhaps even a majority of them, will also be exterminators, ideologically speaking. Which means that they will press for the gradual relaxation of whatever regulations the Trudeau government manages in haste to create for them. But never mind that for now. The important thing at the moment is to distinguish between doctors and terminators. There is no need for a terminator ever to have been a doctor, and the fewer of that sort the better! Only a very tiny amount of the knowledge and skills belonging to doctors is required in a terminator.
How would this regime work? A patient not satisfied with what the doctors have to offer could ask them to certify, on a standard form, that they have offered everything they have to offer. That addresses what the Supreme Court called the irremediable, when it mandated MAiD for “a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” At which point the patient would be legally free to call for a terminator, certifying to the latter, again on a standard form, that the suffering is (from the patient’s point of view) grievous and intolerable.
Medical services would continue, if desired, right up to the point of termination. But those offering them would have no duty to assist in the termination or to approve of it or to refer the patient to a terminator. Terminators would be available from the Register of Terminators. This would solve the conscientious objection problem for doctors, which has been flagged for the Court, and the problem for the many patients who do not wish to entrust themselves to doctors who are also terminators. It would also solve the problem of the medical societies, which would no longer have to quarrel over policies governing both healing and harming, doctors and terminators. Doctors would not be terminators; and terminators, if ever they were doctors, would be doctors no longer. They would have their own professional associations.
There is, of course, a fly in the ointment. Or rather two flies. The first is that terminators who terminate babies in the womb—there is much talk these days about the right to terminate them also outside the womb—can only do so by way of bodily interference with the mother, who is therefore also at risk. In other words, the mooted plan makes more sense for terminators who are euthanizers than for terminators who are abortionists; for the latter require a higher degree of medical knowledge than the former, though they too are engaged in dealing death rather than in preserving life. Perhaps terminators must be differently trained and licensed for these different professional tasks, those who kill the unborn having a higher ticket, so to say, that allows them (like a paramedic) to give emergency aid to the mother.
The other fly is infinitely more dangerous and difficult to deal with. Isolating as far as possible the medical profession from the terminators and exterminators doesn’t solve the political problem of a state that claims a license to kill the innocent and itself dispenses such licenses. We must make no mistake here. What Quebec has done democratically, the Supreme Court has done autocratically. It has determined that the state may kill the innocent and indeed must kill the innocent, under the conditions specified respectively for the unborn and the already born. And a state that presumes to justify the killing of the innocent, whether it regulates that killing well or poorly, is a wicked and barbarous state. Morally speaking, its own condition is irremediable and will soon enough prove to be grievous and intolerable.
Douglas Farrow holds the Kennedy Smith Chair in Catholic Studies at McGill University in Montreal.