Canada may expand euthanasia program to terminally ill minors

August 2024 · 5 minute read

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Canada could expand its already controversial assisted suicide program to include terminally ill “mature minors,” according to a recommendation in a new report from the Canadian Parliament’s Special Committee on Medical Assistance in Death [MAID].

The committee’s 138-page report released this month listed a number of recommendations, including offering euthanasia to those under the age of 18.

Under current Canadian law, which was passed in 2016, a person must be at least 18 years old to be legally euthanized.

Members of the committee, however, noted that minors suffering from terminal illnesses have been excluded from the program despite their physical and mental suffering or disabilities.

“For MAID and mature minors, the committee heard a mix of views about whether MAID should be available to those under the age of 18,” the report said. “Many witnesses believed that age alone does not determine whether someone is capable of consenting to MAID. At the same time, a cautious approach was recommended, especially since there is little evidence from youth themselves on this topic. 

“Most witnesses agreed that if MAID for mature minors were allowed, it should only be [death is foreseeable]. The committee recommends that mature minors should have access to MAID under track one. The committee also recommends that youth be consulted on the topic of MAID and mature minors,” the report said.

Over 10,000 Canadians died by euthanasia last year. Mike Schouten

A “mature minor,” according to the report, refers to a common law doctrine by which “an adolescent’s treatment wishes should be granted a degree of deference that is reflective of his or her evolving maturity.”

Committee members concluded that children with terminal illnesses, most likely between 14 and 17 years old, could be impacted by a number of factors and that “eligibility for MAiD should not be denied on the basis of age alone.”

The possible expansion of euthanasia for minors has sparked outrage from activist groups, many of whom think minors do not have the capacity to make such a weighty decision at their age.

There were more than 10,000 deaths by euthanasia last year in Canada — an increase of about a third from the previous year. A number of disabled Canadians have decided to be killed in the face of mounting bills.

“I think it’s horrible,” Amy Hasbrouck, who campaigns against MAID for activist group Not Dead Yet, told The Daily Mail.

“Teenagers are not in a good position to judge whether to commit suicide or not. Any teenager with a disability, who’s constantly told their life is useless and pitiful, will be depressed, and of course they’re going to want to die,” she said.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, told the newspaper that Canada is sliding down a “slippery slope” to widespread assisted suicide since the law was introduced in 2016.

Canadian lawmakers postponed expanding their assisted suicide laws to include those with just mental illnesses until 2024. Getty Images/iStockphoto

“We said we were going to have safeguards and guardrails, but the next government can simply open it up further by making a decision — and that’s exactly what’s happening,” Schadenberg said.

Mike Schouten, whose son, Markus, died of cancer last year aged 18, told the committee that instead of cutting his son’s life short, palliative care enabled his family “to spend every living moment we had yet with [our son] Markus living well,” the committee report said.

Conversely, another mother, Caroline Marcoux, testified before the committee that her son Charles wanted to have control over his death at just 17.

“I know that the decision to expand access to medical assistance in dying to mature minors is not to be taken lightly, nor did Charles, from the height of his 17 years, at the end of his life, take it lightly,” she said. “It might not have hastened his death by much, since he was already at the end of life. … But he was ready and he deserved that choice. It would have been his decision, in the end. It would have been he who chose the time to leave and the people who would be with him.”

While legislators voted last week to wait at least another year before expanding the program to those who are exclusively mentally ill, it’s not clear when the committee’s recommendations would move through the Canadian legislature.

The report recommends that the government consult with minors about MAID, including those with terminal illnesses, disabilities, on the child welfare system and Indigenous minors, “within five years of the tabling of this report.”

It’s not clear when Canadian lawmakers would vote to expand its assisted suicide law to minors or not. Getty Images

Euthanasia, where doctors use drugs to kill patients, is legal in seven countries — Belgium, Canada, Colombia, Luxembourg, Netherlands, New Zealand and Spain — plus several states in Australia.

In the Netherlands, MAID is available to minors 12 and over, while in Belgium there is no minimum age, so access is permitted as long as the minor “has the requisite capacity,” the report noted.

Other jurisdictions, including several US states, permit assisted suicide — in which patients take the lethal drug themselves, typically in a drink prescribed by a doctor.

Canada legalized both euthanasia and assisted suicide in 2016 for people aged 18 and over provided they met certain conditions: They had to have a serious condition, disease or disability that was in an advanced, irreversible state of decline and enduring “unbearable physical or mental suffering that cannot be relieved under conditions that patients consider acceptable.” Their death also had to be “reasonably foreseeable,” and the request for euthanasia had to be approved by at least two physicians.

The law was later amended to allow people who are not terminally ill to choose death, significantly broadening the number of eligible people and leading to criticism that there are not enough safeguards in place.

Today, any adult with a serious illness, disease or disability can seek help in dying.

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