Mary Zwicker, European Correspondent:

Several lobbying groups are pushing the Canadian government to expand its Medical Assistance in Dying laws to include mature minors, citing various European countries as examples of how it could be done.

“Sadly, once killing by euthanasia becomes a legal option the law will continue to expand,” said Alex Schadenberg, executive director for the Euthanasia Prevention Coalition. “There is only one ethical line in the sand, that being, it is illegal to kill. Once killing is OK the only remaining questions are: who can do the killing and for what reasons.”

MAiD has been legal in Canada since June 17, 2016. Originally only available to adults suffering with terminal illness, the law was extended in 2021 to include those with non-terminal conditions. In February 2024, a bill demanding that MAiD be accessible for those who suffer solely with mental illness received royal assent, and is scheduled to go into effect on March 17, 2027. Canada has the highest euthanasia rate in the world.

Despite this, groups such as Dying with Dignity are pushing the Canadian government to further expand the laws to include euthanasia for those under 18. “It is unfair to allow a 70-year-old with terminal cancer the choice of a peaceful death but deny a 17-year-old who has been given the same prognosis and demonstrates a clear capacity to make the decision as an adult, the same choice – especially when the 17-year-old already has the legal right to accept or refuse medical treatment that may prolong their life,” the pro-euthanasia organization states on their website.

The Canadian Association of Social Workers has also recommended MAiD for minors, writing in a published report that “CASW recommends that: following a period of further study, the Criminal Code of Canada be amended to allow mature minors, under certain circumstances and commensurate with their capacity to provide informed consent, to request MAID.”

While MAiD currently remains illegal in Canada for minors, there are those who would wish to see such killings extended to even the youngest members of society: infants. In 2022, during a meeting of the Parliament of Canada Special Joint Committee on Medical Assistance in Dying, Dr. Louis Roy, a representative for the Quebec College of Physicians, suggested that euthanasia be made legal for babies under the age of one when suffering is extreme and recovery unlikely. MAiD should be available for “babies from birth to one year of age who come into the world with severe deformities and very serious syndromes for which the chances of survival are virtually nil, and which will cause so much pain that a decision must be made to not allow the child to suffer,” he told the committee.

Canada would not be the first country to expand euthanasia to minors. In 2002, the Netherlands legalized euthanasia for adults and for mature minors over the age of 12. Only three years later, in 2005, infant euthanasia for babies under one year of age was also legalized, regulated by what is known as the Groningen Protocol: a set of guidelines for doctors to follow in order to determine in which cases infants become eligible for euthanasia.

Under this protocol, five criteria must be met; namely, “(1) diagnosis and prognosis must be certain; (2) hopeless and unbearable suffering must be present; (3) diagnosis, prognosis, and unbearable suffering must be confirmed by at least one independent doctor; (4) both parents must give informed consent; (5) the procedure must be performed in accordance with the accepted medical standard.”

A 2008 article by The Lancet demonstrated the various problems with such criteria, pointing out that not only is an infant unable to communicate their level of pain, but that parents are also unable to consent on the child’s behalf – they are only able to give permission. Thus, one is unable to accurately determine whether the infant is experiencing unbearable pain, and the infant is further unable to consent to being killed. The Lancet also criticizes the fifth criteria, saying that there should never be an acceptable medical standard for infanticide.

Schadenberg has also expressed a similar opinion on the Groningen Protocol. “The concept of euthanizing infants, also known as infanticide, is very different than killing competent adults by euthanasia,” he said in 2022. “Infants are unable to ask to be killed and they are unable to consent to their death.”

In Belgium, euthanasia has been legal for minors since 2014. Belgium has no age requirements at all, as long as the child is able to voluntarily express their wish, and to understand what they are asking.

“Euthanasia for mature minors is one issue but euthanasia of newborns with disabilities can only be described as eugenics,” Schadenberg said.