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Ray Pennings: Asserting a ‘right’ to suicide dehumanizes the most vulnerable

Commentary

Life and death decisions require explanations. Police officers who shoot a suspect need to explain why such action was necessary. Bus drivers or train conductors whose vehicles are involved in fatal collisions need to explain their split-second actions. Pilots who land planes in New York’s Hudson River also need to explain decisions that could have cost lives.

Justice ministers who change laws to help more Canadians end their lives aren’t making split-second decisions. But their judgement calls still carry the weight of life and death. They too need to explain themselves.

This applies to federal Justice Minister David Lametti. It’s why Cardus has called on him to explain his recent public comments on assisted suicide. 

On November 18, Minister Lametti stated that doctor-assisted suicide (euphemistically known as medical assistance in dying, or MAiD) “provides a more humane way” for Canadians physically or mentally incapable of ending their own lives to do so. When asked if the state had a role in facilitating suicide, the minister answered that “because some have a right to do it, we can’t say to others you don’t have a right to do it simply because you’re physically incapable.”

Minister Lametti’s comments come as Canada hurtles toward one of the most permissive doctor-assisted suicide regimes in the world. By March 2023, the federal government could fling open the doors to doctor-assisted suicide for adults suffering from mental illness. And some are pushing the government to go further by making children eligible too.

Given the public policy context, the minister’s talk of “rights” and “humane” ways to end one’s life are not just philosophical chit-chat over beers. His words require clarity and explanation.

Minister Lametti could start by explaining on what basis he asserts a “right” to suicide.

At best, it would be a struggle to find such a right in the 2015 Supreme Court decision that struck down the criminal prohibition on assisted suicide. The justices found that an outright ban of “physician-assisted death for a competent adult person” who meets certain conditions was overly broad and infringes the guarantee of life, liberty, and security of the person. The conditions the court specified regarded a “grievous and irremediable medical condition” that was leading to “a reasonably foreseeable death.” That’s a far cry from establishing a right to suicide.

The minister’s own department clearly understands this. In its explanation for the bill that originally allowed doctor-assisted suicide, the Department of Justice noted the 2015 decision says nothing about doctor-assisted suicide for “minors or persons with psychiatric disorders or minor medical conditions.” 

So, where does Minister Lametti base his comment? Has he misunderstood the court’s decision? 

What about the specific case of mental illness, where death is not foreseeable and recovery is possible, though unpredictable? Does the minister see a right to suicide in those cases? The Association of Chairs of Psychiatry in Canada recently warned that the issue is complicated enough that Canada should delay its expansion of assisted suicide. Dozens of doctors signed a petition by the Society of Canadian Psychiatry also calling for a delay. These aren’t questions to be swept away with questionable assertions of rights.

The minister also needs to explain what he means by “a more humane way” of ending a life. The debate in Canada has always been about drawing a distinction between “MAiD” and suicide. Yet Minister Lametti seemed to erase any such distinction in his comments. Was this a slip of the mask, perhaps? Does the minister see a distinction, and if so, what is it?

As it stands, the minister doesn’t appear to consider all suicides as tragedies or as evidence of our collective failure to meet the needs of some of the most vulnerable people in Canada. An average of more than 10 people a day die by suicide in this country. Is Minister Lametti suggesting that efforts to prevent those suicides violate Canadians’ rights? 

Ironically, the minister’s comments about “humane” ways to die are dehumanizing for so many of our neighbours, friends, and family. 

Yet there’s still more Minister Lametti should explain, like his tacit acceptance that the state has a role in facilitating suicide (all while funding programs to prevent it). “MAiD” redefines medical care to include the deliberate ending of a life. How does the minister see that fitting into the primary objective of health care policy, as set out in the Canada Health Act, “to protect, promote and restore the physical and mental well-being of residents of Canada?” This primary objective would appear to recognize the dignity of the person at any and all stages of life; doctor-assisted suicide does not.

Does the minister genuinely see suicide as medical care? If so, does he appreciate the difficulty this causes for many medical practitioners who would be obligated to participate in providing suicide?

There is good anecdotal evidence that doctors and other medical professionals are leaving their professions because of the redefinition of medical care. Media have reported on the “lack of access” to assisted suicide because of the low numbers of doctors willing to participate. As those with mental illness begin requesting assisted deaths, those numbers will only increase. One group of doctors has been warning for years that assisted suicide “is not the medicine that we have devoted our lives to practicing.” What does the justice minister have to say to them?

Yes, Minister Lametti has a responsibility to explain his comments and his thinking. But it would be even better if he also reflected on the relevant, cultural question of human dignity.

The minister (and the Supreme Court) understand human dignity as the ability to exercise individual autonomy. This makes personal choice the highest good in society. So, patients determine whether their lives have value—and end them at will. But this isn’t true. Our dignity is innate to who we are as humans. It doesn’t depend on our ability to make choices. This is why infants, unconscious people, people with developmental disabilities, and those living in poverty have human dignity equal to those with the faculties or bank accounts to choose the course of their lives more directly. Dignity is neither contingent nor conditional and is independent of privilege or the ability to make choices. A society that understands this sees every life as valuable regardless of personal characteristics.

That’s something for the minister, and all of us, to consider. In the meantime, Minister Lametti has a responsibility to those he serves to clarify his public remarks. Questions of life and death deserve no less.

Ross O’Connor: Canada’s China strategy is all bark and no bite—But at least we’re making some noise

Commentary

The Trudeau government has at long last released its strategy for Canada’s engagement with the Indo-Pacific region. For you younger people out there, please understand that Canada has been dithering on how to engage Asia since the 1970s and so I wholeheartedly welcome this contribution to the public debate. While the document rightly (and finally) recognizes that China’s disruptive behaviour conflicts with Canada’s interests and that stronger links to other countries must be cultivated, it also fails to come to terms with the full scope of China’s ambitions to influence Canada.

In short, this new strategy has the right attitude but lacks teeth.

Canada’s China policy of the past can be summed up as follows: show deference to Beijing with the hope that Chinese leaders will reward Canada by buying our products in bulk—a policy also known as the pursuit of fool’s gold. Even further disconnected from reality was the notion that increased trade with Beijing would gradually improve human rights and strengthen democratic reform, a strategy characterized by Canadian journalist Chantal Hébert as engagement with “eyes wide shut.” Although late in the game, Trudeau’s loss of innocence towards China and recognition that Japan, South Korea, and India are important partners is welcome. But is it too little too late?

The gathering storm 

At the start of his time in office, Trudeau’s sunny policies towards China reflected his wide-eyed exuberance which Beijing was only too happy to exploit. However, after the Canada-China free trade humiliation and the arbitrary detention of the two Michaels, Trudeau started to understand that Beijing was playing him for a fool and pushed back on China’s hostage diplomacy. Shockingly, Trudeau was under internal pressure from Canada’s foreign policy establishment to trade Huawei executive Meng Wenzhou for the two Canadians. To his credit, Trudeau held the line. 

However, one wonders if Trudeau’s newfound backbone is here to stay. Ottawa’s shift in tone was in large part the result of arm twisting by Washington to remind Canada that it needs to pick a side in what the Biden Administration has called “a decisive decade” with China.

Bureaucratic inertia is another potential hazard that could threaten the implementation of this new policy. Hard-wired not to rock the boat, Canada’s global affairs bureaucracy will be tempted to carry on as before, guided by the flawed assumption that it’s always in Canada’s interest to lock in more deals with Beijing. If that’s the case, it would be a grave mistake. 

Getting it right

Making the Indo-Pacific a top priority should go without saying—it’s the global epicenter of a significant share of future economic growth in the world. Alternately, it’s also where most of the political risk lies due to the growing Sino-American Cold War as the U.S. and China continue to challenge for dominance in East Asia. This combination of high risk/high reward makes choosing the right strategy crucial and will make or break our success in the region.

What this strategy gets right is its focus on security, increasing military relationships and operations, and enhanced intelligence and cyber security networks. On trade, the strategy rightly points out that Canada needs to modernize the Investment Canada Act to better protect our national interests. We need more of that.

However, notably absent from this strategy is the complete lack of acknowledgement of political interference after recent revelations by CSIS that China directly tried to manipulate Canada’s political process and its warning that China is the “foremost aggressor” (among others) when it comes to foreign interference. Also missing were specifics on how to assist Taiwan to survive the next decade, and the creation of a federal foreign agent registry (modeled on one in Australia) forcing former senior public officials and politicians to disclose their activities. 

Bet on Washington

However, what this strategy most fundamentally fails to understand in strategic terms is that our partnership with the U.S. ought to be the gateway to the Indo-Pacific region. China’s disruptive behaviour has reaffirmed Washington as the security partner of choice for many Pacific nations, presenting Canada with an opportunity to shore up support with Washington (by far our most important security partner in the Pacific) and gain favour with the emerging coalition of Indo-Pacific nations. 

As a start, Canada could invest in new submarines and autonomous systems which would allow us to dispense with our aging and rickety fleet, patrol the Canadian coastline and support U.S. naval operations to defend fortress North America as the Chinese navy grows stronger every year. Siding with the U.S. is also strategically wise as the long-term odds favour Washington over Beijing for three reasons. 

First, as a peaking power, China is in relative decline to other countries, such as India, which is rising at an accelerated pace. Second, China will get old before it gets rich. Without the people to work and generate income to pay for the rest of society, the demographics do not support Beijing’s long-term growth. Third, China’s private debt, particularly the real estate market, which makes up 30 percent of China’s GDP, is a ticking time bomb. It’s time we stopped pursuing fool’s gold. When it comes to choosing strategic partners, this is not a decision we should be struggling with. 

A policy, if you can keep it 

For the last 25 years, Canada’s relationship with China has been framed as a struggle between commercial interests versus the defence of human rights. During that time, Canada’s foreign policy establishment steadfastly defended trade with China as essential for human rights under the assumptions that it would make them live by the same global rules as everyone else, gain a billion customers for Canadian products, and strengthen the forces of domestic Chinese reform.

That misguided “willful blindness” has proven to be so utterly bankrupt that even Prime Minister Trudeau has turned against it. We must remain vigilant however to avoid backsliding into a “business as usual” mindset. Going forward the mantra ought to be: The sunny ways of the past are inadequate to the stormy present.