In the early 1990s, Sue Rodriguez captured a nation’s conscience. A woman in the Canadian province of British Columbia diagnosed with amyotrophic lateral sclerosis (ALS), she fought publicly for the right to a physician-assisted death as her body failed. Her articulate, dignified, and powerful plea – “I want to die with dignity” – resonated deeply because it was bounded.
It was about unbearable, irremediable physical suffering in a life’s final chapter.
The Supreme Court of Canada denied her in 1993, but the moral conversation she sparked led, two decades later, to the Carter decision (2015) and Bill C-14 (2016). Many Canadians, myself included, supported this carefully circumscribed form of medical assistance in dying. Autonomy in the face of terminal agony felt like a humane correction to rigid prohibition.
What followed was not the careful exception, the humane correction that many envisioned.
It became routine.
By 2024, Canada reported 16,499 Medical Assistance in Dying (MAiD) provisions – roughly 5.1% of all deaths in the country that year. The cumulative figure is around 100,000 deaths since legalization. What began as a last-resort option for those with reasonably foreseeable natural death (Track 1) expanded to cases where death was not imminent (Track 2).
Safeguards loosened.
Reports have increasingly surfaced of patients citing not only physical pain but loneliness, poverty, inadequate housing, or the feeling of being a burden. Palliative care remains patchy in many regions, and MAiD is sometimes raised early in conversations about treatment options. The system that was sold as the ultimate expression of compassion now operates with the bureaucratic efficiency of any other publicly funded medical service.
This is no mere policy drift. It is the predictable outcome of institutionalizing compassion under logic – a therapeutic state that wraps control in the language of care, dignity, and harm reduction.
Suffering, even pain, is reframed not as something to be endured, alleviated where possible, or accompanied with excellence in palliative support, but as a problem to be solved by eliminating the sufferer. The nurturing dialect smooths the transition: “autonomy,” “choice,” “reducing burden,” “dignity”. These words sound supportive.
They modernize newspeak by inversion – framing the acceleration of death as progress, the withdrawal of prolonged struggle as love.
The entropy of empathy renders legible.
In a bizarre twist, a society that increasingly prioritizes psychological safety and the avoidance of discomfort loses tolerance for the hard edges of human existence. And the hard edges matter, for every edge has a wedge. Chesterton’s Fence comes to mind, for good reason. Fences are boundaries, demarcations that contain and exclude. In tearing down the fence of rigid prohibition, we permitted entry to the grotesque.
That the grotesque wraps itself in the language of care and promotes that language via new meanings of care does not make the grotesque beautiful. Binding language to meaning precipitates actions. The Atlantic had a great piece late 2025 on the horrors.
Risk, frailty, decline, and dependence are no longer seen as parts of a shared human condition worthy of communal investment in living well; they become threats (and costs) to be managed out of existence. Homelessness and poverty also benefit from a final solution. The Safety Industrial Complex – health bureaucracies, ethics committees, and advocacy organizations – gains momentum by identifying new vulnerabilities and offering “solutions” that expand its remit. The frontier of resilience recedes along a new axis. What was once a solemn, narrowly tailored exception for the dying has become another administered service, complete with reporting forms, training modules, and normalization in medical culture.
And incentives (particularly new, unforeseen ones) reward institutions in the name of benevolence.
It is a growing business with a promising compound annual growth rate.
Data surprises underscore the shift. Early promises emphasized rarity and strict eligibility. Reality delivered rapid growth and broadening criteria. The pending Track 2 expansion to sole mental illness (delayed to 2027 amid pushback from psychiatrists concerned about irremediability and the overlap with suicidality) reveals the internal tension. When the therapeutic state defines suffering primarily through subjective distress and “autonomy”, boundaries erode. The same logic that justified limited physical cases now presses toward cases far more ambiguous. Institutions that once guarded life as default now position death as a valid, and increasingly preferable, treatment plan.
Once purchase is achieved, the wedge is driven deeper.
This evolution echoes broader patterns. During the COVID-19 outbreak, the state asserted sweeping authority over bodies and movement in the name of “collective care”. “Don’t wanna kill Grandma!” was the refrain. Dissent was pathologized as recklessness, selfishness, or worse. Violators were subject to summary judgment, fines, arrest, and jail. Dissenting professionals were censured, or delicensed, in some cases losing their careers.
Families and friends, including my own, remain gutted by the COVID decisions and activities of “the others”.
COVID’s long tail is more psychosocial than biological.
With MAiD, the therapeutic impulse turns inward: the state and medical system do not merely permit death; they facilitate and, in some reported cases, gently steer toward it when living appears too burdensome. The care narrative inverts consequences, including terminating patients who would not want to die if they could access proper treatment.
Reduced investment in robust palliative infrastructure or social supports is not framed as a policy failure but as reason to expand the compassionate exit. This steers funds away from infrastructure and supports. Does it also divert funds away from a healthcare system in crisis? Do you think healthcare actuaries have not done that math? Resistance – advocating harder for life-affirming options – can be cast as imposing suffering or denying dignity. Dissent brings harm.
I began as a supporter of the Rodriguez principle. My first job after university (c. 1989-1991) was as a long-term-care therapist at the Colonel Belcher Hospital in Calgary at the denouement of its Veteran Affairs administration and integration into the provincial (Alberta) system. Every patient admitted was never to be discharged. It was long-term care into palliative care. Some came to suffer dementia, many were incontinent, most socially constrained, some shut in. All were shadows of their former robust, war-tested selves.
Their care was compassionate and impressively kind. It was never lethal. The spirit of dignity permeated the hospital, even for the few who lived in a less dignified condition. Many of those men remain memorable to me now, their dignity preserved.
The evidence of how quickly good intentions institutionalized and scaled has forced my reckoning. Compassion without guardrails, embedded in a single-payer system under resource pressure, cannot remain neutral. It develops its own momentum and quiet incentives. The financial and cultural logic begins to favour the efficient resolution over the costly, uncertain path of accompaniment. In a Tayloristic twist, the revered god of efficiency can be brought to bear.
It expands. Killing is sold as harm reduction to create the space for greater efficiency, and greater efficiency is the most humane. We have seen that before.
Last week, a Catholic priest recovering from a hip fracture was twice offered euthanasia.
Troubling as that is, I encourage you to search for mainstream media coverage of it. Coverage remains on the periphery. Why?
True compassion in the face of suffering demands more than procedural autonomy. It requires excellence in pain management, mental health support, housing, and community. It requires resisting the seductive simplicity of elimination and the conveniences and secondary industries euthanasia encourages, including organ transplant requests.
Reduce, reuse, recycle has a new timbre. Gotta get those organs. Does the potential to donate organs become an inducement to ask to be killed?
It is not Logan’s Run (population control), or Coma (organ harvesting), or Soylent Green (food). Not yet.
Care and compassion: the twin, gentle hands offering release wrapped in kindness and concern, quietly reshape what we expect of ourselves and others when life grows difficult. The question Canada and other nations must confront is whether to build a society that accompanies people through suffering or one that increasingly offers to end it when the caring becomes inconvenient. When participation is best revoked.
Euthanasia, sold as benevolence in the face of unjust conditions, is quietly becoming a state-sanctioned, medically supported, marketing-driven form of abandonment. Compare healthcare wait times to deathcare wait times, where even the 10-day waiting period is being framed as cruel punishment.
“We gotta put Grandma down,” a scant lustrum after COVID’s contrary refrain, is spoken around tables more frequently. Those words and the discussions they inform are aided, abetted, and coached by incentivized parties and a state interested in encouraging them.
The original impulse behind MAiD was humane and human. Its transformation into routine policy reveals something deeper about how nurturing instincts, once they become bureaucratized, can erode the very resilience and dignity they claim to protect.
Fences resist impulses.
Compassion for life is a fence worth repairing.
(Richard LeBlanc – BIG Media Ltd., 2026)
