Wesley J. Smith of National Review tackles a tough subject this weekend, dealing with the national healthcare system in Canada and their approach to euthanasia and assisted suicide. The questions being raised cover a couple of different areas, both equally disturbing and difficult to contemplate.

One is the possibility of children being euthanized at the request of their parents. While not currently in play legally, Canadian doctors report being asked about assisted death for kids with “progressive terminal illness or intractable pain.” If that’s not enough to keep you awake at night I don’t know what is.

The other subject, in some ways even more wrenching, is the idea of patients suffering from advanced stage dementia or Alzheimers who would be bound by the decisions of their children or other appointed guardians since they would be unable to give consent on their own.

Now, after more than 600 sick people were put down in Quebec 2016-2017–if we are going to reduce medical ethics to veterinary standards, let’s use the proper lexicon–provincial leaders are talking about expanding the lethality to those who cannot decide to be killed. From the Toronto News story:

Veronique Hivon of the Parti Quebecois said “a lot of people” approach her about modifying the law to allow family members with degenerative illnesses such as Alzheimer’s access to the procedure…

“There is a very clear desire within the population to debate expanding the legislation. We need this debate to happen.”

Smith is clearly in the never, no way, absolutely not camp when it comes to assisted suicide and euthanasia, as are many in the conservative cause. He makes this abundantly plain in the linked article on child euthanasia when he states, “Once a society agrees that killing is an acceptable answer to human suffering, there are few logical off ramps.”

It’s a position which I understand, hear frequently from conservative writers and can respect. But as those of you who are regular readers know, I’ve long held a different view on the subject, at least in certain circumstances. I’ve always seen something of a disconnect in the thinking of people who ostensibly champion personal responsibility and minimizing the government’s intrusive role in private lives, yet want to forbid adults who are capable of providing informed consent making one of the most personal decisions imaginable. While there certainly need to be limits (and many of them at that), people who are nearing the end of their lives in agony with no reasonable hope of recovery through current medical technology should be allowed to choose their own path into eternity.

You may argue that it’s against God’s will. Again, that’s between the patient and their God, not the government. You can also argue the slippery slope aspect of it as Smith does here, but we unfortunately deal with slippery slopes all the time.

None of this means that I’m disagreeing entirely with the author in this instance, however. Some of these scenarios playing out in Canada take us into uncharted waters. It all comes back to the idea of consent which I already mentioned. I have some personal experience in this area, since two years ago my own mother passed after a years-long battle with advanced dementia which left her unable to recognize her own children. Yes, there were dark times when both my siblings and myself privately despaired over her condition to the point where we might have briefly wondered if it might be better for her suffering to end. But she had never had a discussion about this when her faculties were intact and that’s simply not a decision we could make for her even if it were legal. What they seem to be considering in Canada is far closer to euthanasia without the patient’s consent than any form of assisted suicide.

The issue with the children is equally difficult to absorb. At what point would a minor be able to offer the sort of consent I mentioned above if they were on a sure path to a lingering, painful death? We don’t allow children to give meaningful consent for sex, drinking alcohol, driving a car, joining the military or getting a tattoo until a certain age. Surely the decision to face one’s own mortality must be at least as daunting.

But then I stop and think about children in their teens who have been faced with these terminal struggles. If they are willing to go to the last ditch and explore every medical avenue available to cling on for a few more days of precious life, they must be allowed that choice. But what if they’ve been fighting it for years, have accepted that the end is coming and simply want the pain to stop?

As I said, these daunting debates are far too intractable for my simple mind to ring up any authoritative answer for others. They encompass questions which few of us would dare to say we know the answers to with unfettered certainty. I definitely wouldn’t want anyone else making such decisions for me, least of all the government. But that applies no matter which way my decision falls.