Doctors Who Kill: Medical Assistance in Dying and the T4 Program

Up here in Canada, doctors can legally kill people under certain circumstances.  The law allowing the murder used to be referred to as “Medically Administered Death” (“MAD” for short) until possibly someone with eyes noticed the acronym and changed the title to “Medical Assistance In Dying” (now “MAID” for short, which sounds much nicer).

       The law began to gain emotional traction by focussing upon certain heartbreaking cases such as that of Sue Rodriguez in 1993 who suffered from Lou Gehrig’s Disease with no hope of cure.  Surely it was cruel to deprive her of the means of ending her life and insisting that she continue to suffer?  Thus the drive for euthanasia began here in Canada, promoted by calling it such edifying titles such as “Dying With Dignity”.

       Originally the focus was on people like Rodriguez suffering physically, but it was soon expanded to include those suffering mentally as well.  This opened up an entire field of problematics, given the subjective and varied views of what constitutes significant mental suffering.  Is such suffering restricted to long-term clinical depression?  How about short-term depression?  How about post-partem depression?  How about teens who struggle with teen depression?  What counts as suffering severe and untreatable enough that the sufferer should be killed?

       Up here in the Great White North where secularism has gone into overdrive and where woke virtue-signalling is our true national sport it did not take long to expand the definition of what counted as such suffering.  A euthanasia bill was passed into law in 2016 “for those suffering unbearably from an irremediable medical condition and whose natural deaths are reasonably foreseeable”.  This law was expanded in 2021 (a mere five years later—hardly time enough to gather enough data to seriously consider the question) “making it de facto available for disabled persons with ‘an irreversible decline of capability’ who may otherwise have had years or decades of life left”.  (The above quotes are from a 2022 article published in a University of Toronto research repository entitled “TSpace”, volume 68, issue 4.) The original bill specifically disallowed the killing of persons requesting it for reasons of mental illness, but expansion of permission was granted in 2023 to include such requests.

       Obviously the government and the officials involved in the killing emphasize that safeguards in place to prevent abuse of the law by killing those who should not be killed.  It all sounds very impressive on paper and online, but it has been plagued by problems from the outset.  Sometimes the problems make the news.

       Take for example the 2023 case of 77 year old John Lyon, a B.C. man who lived in a houseboat and who struggled with depression and suicidal thoughts. After entering the hospital for treatment of sepsis and multiple falls, he began thinking about the possibility of MAID.  Not long afterward, he applied for MAID and was approved.  His son Christopher was concerned that he had applied for euthanasia and sought answers from his dad’s assessor at Royal Jubilee Hospital in Victoria, B.C.  Too late:  though he spoke with the assessor on Thursday, he received few answers, and by the next day his dad was dead.  The physical component (such as his infection) was not mentioned on the assessor’s form.  His son spoke out publicly in the media and said to a parliamentary committee that if his dad had better access to housing and health care the result would have been different.

       Or take the example of a 53 year old Alberta woman whose case at time of writing is still before the courts.  She struggled with a bipolar condition but had no physical ailments.  She applied for MAID in her home province of Alberta but was denied, since medical professionals there said her condition was “treatable and transitory”.  She then contacted Dr. Ellen Wiebe in Vancouver, B.C. who agreed to administer MAID’s lethal dose.  The woman’s common-law partner applied to a B.C. judge for an injunction to halt the process, which injunction was granted.  The case is still before the courts so that the name of the woman and her partner have not been disclosed.

       In yet another case, an unemployed man in his 40s had an inflammatory bowel disease, few social supports and struggled with alcohol and opioid addictions.  He wasn’t offered treatment for these addictions, but the hospital did offer him MAID when psychiatrically assessing him and his MAID provider personally drove the man to the location where he would be euthanized.

       Concerning this case Dr. Sonu Gaind, a psychiatrist and professor of medicine at the University of Toronto (who does not object to such euthanasia in principle) cautioned, “I think we have gone so far over the line that people cannot even see the line that we’ve crossed…It’s pretty clear that some providers are going up to that line, and maybe beyond it…This is actually suicide facilitation in some cases.”  In this case, Dr. Gaind said, “This poor guy could not get access to medical treatment for his addictions but he could be chauffeured by our medical practitioner to receive death.  I think there is something deeply wrong with that.”

       Indeed.  But what about all those impressive-sounding built-in safeguards against such abuses and escalation?  Why are they not working?  The answer is:  because we have embraced a culture of death and forsaken a culture of life.  In the culture of life, physicians took the Hippocratic Oath which included a provision to “do no harm” to their patients (which included a refusal to administer an abortion).  Life was sacred, and the physician’s task was to preserve it if possible.  Now our culture is one of death.

       Or, in more sociological and less theological terms, we may answer that the safeguard prototcols are not working because we are driven by ideology which we consider more important than protocol.  The protocols intended to prevent abuse have less weight with us than our ideology which insists that individual rights trump everything else, and so we are prepared to ignore the protocols to conform to that ideology.  The B.C. man and the Alberta woman mentioned above stated their desire to die and our ideology which exalts individual choice above all else says that this must be respected and obeyed, regardless of existing protocols.  The desires of the sons or partners of those requesting death have no real or decisive weight.

       We have seen before how ideology quickly renders safeguard protocols obsolete.  In the late 1930s of Germany, the reigning ideology had to do with what was euphemistically called “hygiene”, a term applied both to race (“racial hygiene”) and to the weak and disabled.  The desired hygiene was promoted by the so-called “T4” programme, named for the street address of the programme’s coordinating office in Berlin at Tiergartenstrasse 4.   

The government programme at first was aimed at euthanizing newborns and children under the age of three who showed signs of severe mental or physical disability, since such would prove a financial burden to the State if allowed to live.  All physicians, nurses, and midwives were therefore legally obliged to report such cases to the authorities.  The children were then murdered by lethal injection or starvation.

       The programme quickly expanded its purview and reach and soon included disabled adults living in institutional settings.  Public health officials, workers in hospitals and mental institutions and nursing homes for the ill and aged were required to identify the following:  those suffering from schizophrenia, epilepsy, dementia, encephalitis, and other chronic psychiatric or neurological disorders; those not of German or “related” blood; the criminally insane or those committed on criminal grounds; and those who had been confined to the institution in question for more than five years.  (See here and here for more details.). Those selected for murder were rounded up and gassed.  Their families received a fictious report of the cause of their death.

       In this programme, there were also safeguards, and at least three doctors had to sign on to the euthanasia, ironically by making a cross on the relevant form.  But such protocols were quickly abandoned in favour of conformity to the ideology undergirding the programme.

       I do not mean to suggest that our current MAID programme is equal or comparable with the T4 programme.  But the parallels are instructive.  They both had (or have) safeguard protocols which did not or do not work as intended on paper.  And they are both driven by ideology:  in Nazi Germany the ideology of racial or social hygiene and in secular Canada the ideology of the supremacy of individual choice.  In both Germany and Canada the reigning ideology is what counts and what overwhelms the safeguards, rendering them all but useless.  And in both Germany and Canada we discern a tendency to escalation, as the murderous policy is expanded to include more and more people.

       We can already see how this escalation will work.  Almost anyone suffering distress or depression who wants to die will be allowed to kill themselves with doctor’s help and with society’s respect and approval.  In fact, the pressure is already present for those who are of compromised health and who require care.   

Thus Grandpa may not be suffering from terminal cancer, may not be in pain, may not be depressed, and may not be facing imminent death.  He is, however, expensive, since it costs thousands of dollars each year to keep him in a nursing home. 

You don’t even have to mention this unfortunate fact to grandpa:  being a smart guy, he can figure out for himself how he can save his beloved family a fortune in health care costs.  A little paperwork, a quick injection, and presto!  Grandpa has just heroically and selflessly saved his family tens of thousands of dollars in health care costs that they can scarcely afford.  Memory eternal, grandpa. 

Other groups of people are also as smart as grandpa and under the same threat.  The handicapped and disabled, for example, are not slow to understand the consequences of living in a world which has embraced a culture of death and in which life is no longer sacred.  Our current ideology may be different than that of Germany with its T4 programme, but the savings in costs to the State remain just as significant in both places.

In the days to come, we can expect the escalation to continue as the West continues to rebel against its Christian heritage and embrace a culture of death.  As followers of Christ, we need to see through the government propaganda and speak the truth.  Dying slowly may (or may not) come with true dignity.  Murder never does.