Josie Luetke:

Interim writer, Josie Luetke, Talk Turkey

It’s perversely fitting that an act that renders so many speechless (literally and figuratively) lacks any appropriate descriptors in speech. “MAiD” or “medical assistance/aid in dying,” as it’s most commonly referred to now, is the latest inception of a long evolution of palatability-tested phrases. 

“Medically-assisted death” was discarded, presumably because the unfortunately apt acronym “MAD” provided endless fodder for clever headlines and critical commentary.

I recall a time when “physician-assisted suicide” (PAS) was the nom du jour, but it has now fallen out of favour.

The U.S.-based organization Death with Dignity lists “assisted suicide,” “doctor-assisted suicide,” and “physician-assisted suicide” as “incorrect and inaccurate terms that opponents of physician-assisted dying use in order to mislead the public.”

Their preferred terms all contain some variation of “death” or “dying.”

They no longer have a page on “terminology” (perhaps because of the stench of social engineering), but back in 2021 they explained on their website: “‘Suicide’ is politicized language deployed with the intent of reducing support for the issue. It implies a value judgment and carries with it a social stigma.”

The hand-wringing over misleading the public is nauseatingly rich coming from them.

“Dying/death with dignity” is an insidious phrase, implying that natural deaths are undignified, and that society’s abandonment of patients at their most vulnerable is inexplicably an affirmation of their human dignity, instead of a rejection of it.

“MAiD” is hardly any better, siphoning the positive connotations of “medical,” meaning “of or relating to medicine”—the prevention and treatment of disease. (As an aside, if killing the patient is on the table, I suppose we now have a way of “treating” all diseases. A real triumph for mankind.) 

Anyway, we nearly all want medical aid in dying. Unless my death is instantaneous—I get hit by a bus or struck by a stray meteorite—I’d like medical help to make my final days as comfortable as possible. Please provide pain relief, improve my oxygen intake if needed, turn me so I don’t get bed sores, etc.

I suppose you could refer to most of palliative/hospice care as “medical aid in dying,” really. It’s an encouraging term, but one that’s very vague and broad. What sort of “medical aid” are we talking about?

Here’s another problem: In 2021, 219 people who received “medical aid in dying” in Canada weren’t actually dying. When Parliament passed Bill C-7, the eligibility requirement that one’s death be “reasonably foreseeable” (whatever that means) was removed. If “medical aid in dying” is expanded to the mentally ill, as it’s scheduled to be in 2024, yet another population which is not dying will receive “aid” in doing so.

Imagine using this politically correct language in any other context: “Your Honour, I did not murder him. I simply provided him aid in dying.”

Part of the appeal of “medical aid in dying” is blurring the distinction between killing and letting die. (And there are quite a few philosophers, like James Rachels, attempting to do the same.) “MAiD” apologists have an interest in confusing the two because letting die is already a normal and accepted part of health care—respecting “Do Not Resuscitate” requests, or a patient’s personal opposition to receiving an organ transplant or another round of chemotherapy. Generally speaking, no one is obligated to pursue burdensome extraordinary measures to put off one’s natural death for as long as possible.

So, “MAiD” is out. Scratch it from your vocabulary. Don’t participate in the government’s propaganda campaign.

What term do we use then? Do we revert to “assisted suicide,” despite Death with Dignity’s objections?

It can be used to make an effective rhetorical point: Whose suicides does our government aim to prevent, and whose suicides does our government help facilitate? How can a society possibly be successful at suicide prevention when it actively promotes it in other circumstances? Doesn’t everyone have the right to suicide prevention? (This argument is made by Blaise Alleyne and Jonathon Van Maren in their book, A Guide to Discussing Assisted Suicide.)

Alas, “assisted suicide” is technically misleading too.

Consider its rather self-explanatory definition: It’s the act of bringing about your own suicide with someone else’s assistance. For example, a doctor supplies a deadly substance that you ingest yourself.

Euthanasia, conversely, refers to someone else bringing about your death. For example, a doctor injects you with a lethal substance. (Further distinctions can be made between active and passive euthanasia, and voluntary/nonvoluntary/involuntary euthanasia.)

Of 10,064 “MAiD” deaths in Canada in 2021, fewer than seven were “self-administered,” i.e. assisted suicides—“a trend consistent with previous years.”

Such a trend is curious indeed—validating the assertion of Alex Schadenberg of the Euthanasia Prevention Coalition that this issue was never about autonomy.

It is anathema to turn the knife upon oneself, even when one loses the will to live. It is perhaps the greatest betrayal. So, getting someone else to do the dirty work provides a certain psychological cushion.

It is interesting to note that in places like Oregon, which has only legalized assisted suicide, and not euthanasia, their rate of assisted suicide (0.6 per cent of total deaths) is significantly lower than the rate of euthanasia/assisted suicide in Canada (3.3 per cent of total deaths), despite Oregon’s law being in effect since 1997. Sure, there are other differences that could account for this discrepancy. Overall, though, rates are significantly higher in Canada, Belgium, and the Netherlands, where both euthanasia and assisted suicide are legal, than in jurisdictions where just assisted suicide is legal (e.g. California, Colorado, D.C., Hawaii, Maine, New Jersey, Vermont, Washington, and Switzerland). Whether this trend will hold as euthanasia and assisted suicide are normalized in other parts of the world remains to be seen.

Regardless, it should be apparent that the distinction between assisted suicide and euthanasia is an important one to maintain, and collapsing both under the umbrella of “assisted suicide” obscures the full picture.

So, often I’ll write “euthanasia/assisted suicide,” even though that’s rather cumbersome and clunky. Because euthanasia is so much more prevalent than assisted suicide, sometimes I’ll just say “euthanasia.”

Technically, though, “euthanasia” means “good death” in Greek, and that’s not true either. Thankfully, I imagine this origin is unknown to most, because with what alternatives are we left?

“Mercy killing” isn’t merciful, and the smarter we get—“legally exempted homicide” or “murder-by-medical-professionals”—the more we estrange ourselves from the public and lose a common lexicon with which we can debate the subject.

“A rose by any other name would smell as sweet,” and so too a corpse smell as foul.

If language matters to our opponents, though, it should matter to us. At the very least, avoid “MAiD.”