Euthanasia wordplay confuses on purpose

As politicians and activists in multiple countries continue to promote euthanasia and assisted suicide, they use different terms to refer to—and often downplay—legalized killing. Last week, a 29-year-old woman who suffered from depression died at the Euthanasia Expertise Center in The Hague. She was otherwise physically healthy.

In the Netherlands, regional euthanasia review committees examined 8,720 death requests in 2022, while the 13,241 deaths from Canada’s “Medical Assistance in Dying” program made up over 4 percent of all deaths in the country that same year. The self-governing British territory of Jersey took steps last week toward legalizing euthanasia and assisted suicide, even though England criminalizes the practices. Last year, 367 people died in Oregon from taking lethal drugs prescribed under the state’s “Death With Dignity Act.”

In 1985, the Netherlands defined the foundational terms used to expand today’s linguistic landscape of legalized killing. A state commission initiated by the Health Council of the Netherlands defined euthanasia as “intentionally terminating another person’s life at the person’s request” and assisted suicide, also referred to as “assisted dying” or “medical assistance in dying,” as when a doctor prescribes the lethal drugs and leaves the killing to the patient.

Regardless of the terms a country uses, Canada’s Euthanasia Prevention Coalition Executive Director Alex Schadenberg said the multiple labels blur public perception of the practice and bury the fact that all of the terms refer to death. Once a country opens the door to considering one form of euthanasia, Schadenberg said, it’s nearly impossible to limit it.

“These are all terms that were created by the euthanasia lobby to make us feel better about killing,” Schadenberg told me. “It’s a homicide. It’s a murder. And assisted suicide is assisting suicide. . . . But in order to get rid of the uncomfortable language, they redefine it.”

In 2016, Canada’s original “Medical Assistance in Dying” law allowed euthanasia only for patients who were capable of consenting until the time of their deaths. Lawmakers loosened the rules in 2021 to require consent only at the time doctors approved patients to die so that people who might lose their decision-making capacity as part of their illness could still be killed.

The Netherlands allows parents to request the killing of their children living with terminal illnesses between birth and age 12, and it permits children ages 12 and up to choose euthanasia with parental consent. Starting at age 16, youth do not need parental consent.

“What happens is it becomes impossible to hold on to these safeguards because they are seen as a hindrance preventing people from having their right to die,” Schadenberg said. “The original goal post is, ‘Can I kill you?’ or ‘Can I not kill you?’ They’re trying to justify legalization based on the most extreme grounds . . . because once you legalize, then it’s OK to kill. Therefore, the goal posts have changed.”

One of the arguments for legalizing euthanasia is that the laws include safeguards to protect people with mental illness or disabilities from killing themselves or being killed. But some countries have moved the goalposts—as Schadenberg described—replacing the “terminal illness” requirement with the phrase “irremediable medical condition.” That language implicitly includes psychiatric diagnoses which have no guarantee of healing. In March, a Calgary judge ratified a 27-year old autistic woman’s application to kill herself under Canada’s “grievous and irremediable medical condition” qualification despite her father’s legal pushback.

Theo Boer is a professor of healthcare ethics at Protestant Theological University in Amsterdam, the Netherlands. He served for nearly 10 years on the Netherlands’ euthanasia review committee. When the Dutch formally legalized euthanasia and assisted suicide in 2002, Boer believed that transparently acknowledging and regulating the practices would reduce the numbers of those choosing it. The results changed his mind. In the first 20 years of legal euthanasia in the Netherlands, the number of so-called assisted deaths doubled twice over.

Boer is less worried about which labels people use and more concerned about cultural apathy. He said apathy created euthanasia in the first place and continues to increase demand for it, create confusion, and disguise the reality of killing.

“At stake here is the question of whether we have hope, whether we have resilience, whether we have patience,” said Boer. “Patience means that you have the comfort of God to give you strength and power to endure. And I think there’s an erosion in our capacity to endure life’s hardships, and that is very serious. That really undermines our resolve to deal with suffering. So in the end, the offer of euthanasia doesn't help us to become stronger. It rather weakens our capacities.”