Doctors in Canada should have permission to euthanize a child who requests it, even if it’s against the parents’ will, a team of pediatricians proposed in a report earlier this month.
A policy proposal written by Carey DeMichelis, Randi Zlotnik Shaul, and Adam Rapoport at Toronto’s Hospital for Sick Children outlines how the hospital would decide which children to euthanize under Canada’s medical assistance in dying (MAID) law.
“We write our policy with an eye to the near future when capable young people may gain access to MAID,” the paper said, adding that, since minors in Canada don’t need parental permission or notification to withdraw life-giving treatment, they should also be able to request euthanasia without permission or notification.
“Usually, the family is intimately involved in this decision-making process,” they wrote. “If, however, a capable patient explicitly indicates that they do not want their family members involved in their decision-making, although health care providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected.”
The paper comes nearly two years after the Canadian Council of Academies’ began its government-requested review of expanding euthanasia to “mature minors,” people with dementia, and others who requested it in an advance directive. The organization will publish its findings in December. Canadian law does not set a minimum age for “mature minors,” but defines them as being able to understand the long-term consequences of their decisions. Currently, the MAID law only applies to people age 18 and older.
Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, said the proposed expansion of euthanasia to children is not only “shocking” but contradicts the common message of even euthanasia advocates.
“We were sold that this is all about freedom of choice and autonomy for competent people who feel they have no other option, who are suffering with pain, and have no other way to deal with those pain and symptoms,” said Schadenberg, adding that in the case of children, “It becomes very clouded, especially since they are usually, if not always, affected by the attitudes of their parents or caregivers.”
Other countries already allow euthanasia for children. Belgium has euthanized three minors since the country legalized the practice. The Netherlands allows euthanasia for children over 12. Both nations require parental permission.
Those nations forged the path for Canada, Schadenberg said, which in turn opened the door when it legalized euthanasia for adults in 2016. Numerous Canadian Supreme Court cases have already established equal rights for children, and he said it was always only a matter of time before the country extended euthanasia rights to minors.
“We’ve already legalized it,” he said. “So all we’re debating now in Canada is, for what reason are we going to allow killing?”