The Canadians are not prepared to call euthanasia that. They now have legalized medical assistance in dying: that is providing and administrating sufficient poison to kill someone. This is seen as a progressive thing, part of the narrative, and part of practice in teaching hospitals. It has become normalized. The rapidity of this is shocking.

The degree to which MAiD has become normalized within UHN and throughout Canada was unexpected, particularly in view of the controversy preceding its legalization. Nevertheless, participating physicians are still being advised to seek legal advice on each case in which they participate. This recommendation highlights persistent concerns regarding medical liability, although such close and ongoing legal consultation for the purpose of defending and protecting physicians does not necessarily encourage the optimal balance between the rights of health care providers and those of patients.
We discovered relevant practical and emotional needs among members of virtually every hospital department throughout our implementation process. We found that education and support are required for staff members directly involved in MAiD, including those providing nursing, pharmacy, and translation services, but also for those indirectly involved, such as those in housekeeping, transportation, and medical records departments. Fears that there could be overzealous delivery of MAiD may have been diminished by checks and balances in our framework, by the broad and inclusive approach we took to education, and by the fact that institutional leaders had not taken a position of either advocacy for or opposition to MAiD. It has been consistently communicated that the program’s goal is to provide patient-centered care that meets the institution’s legally mandated obligations, while safeguarding the rights and interests of both patients and staff.
Our early experience with MAiD has demonstrated that many patients who request MAiD do not receive it because death or loss of capacity supervenes. That occurred most often with requests made when the patient was within hours or days from natural death. We have now taken the position in our MAiD program that it is neither desirable nor practically feasible for MAiD to be delivered on an emergency basis at the very end of life. Indeed, the initiation of the MAiD process in actively dying patients may compromise symptom management, since patients may refuse opioids in order to retain capacity for consent; such late initiation also needlessly consumes the limited energy and time of patients and their families at the very end of life. Palliative sedation is available as an alternative for intolerable suffering that cannot otherwise be relieved in actively dying patients.

It appears that the more intervention of social workers, support, and involvement of their palliative team, the more likely they are to talk about dying this way. As if there is no moral issue. As if Hippocrates did not exist. And as if there shall be no boundaries. I do not hold with such. I became a doctor to preserve life, to comfort, to cure, and to minimise symptoms. I did not sign up to be part of a progressive profession, with the spine of a jellyfish, in love with death.

There are too many medical ethicists encouraging people to damn themselves as they take the role of our creator. We neither choose the hour of our birth nor that of our death. We are the created. The next generation will damn this normalization of evil

Our Canadian friends better have a church based hospital at the end of life, for the academics have lost all moral sense.