The following post is part of a structured, multi-week, simultaneously published exchange between Kim Carlson and Paul Magennis, authors of MAiD in Canada, and Gordon Friesen, President of the Euthanasia Prevention Coalition. These alternating messages will explore deeply divergent views on Medical Assistance in Dying (MAiD), and no mutual endorsement is implied.
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| Gordon Friesen |
Gordon Friesen, Monday, January 12, 2025. (Article Link).
Maid in Canada (MIC), January 19, 2025. (Article Link).
The Evolution of Medicine under Legal Compulsion
By Gordon Friesen
‘Homicide’ is the only English word which precisely indicates the taking of human life.
Criminal Code of Canada [i]
"* A person commits homicide when, directly or indirectly, by any means, he causes the death of a human being.
* Homicide is culpable or not culpable.
* No medical practitioner or nurse practitioner commits culpable homicide if they provide a person with medical assistance in dying"
Hence: MAID is homicide, permitted as medical treatment.
The revolution thus produced, in medical culture, may be crudely grasped in the fact that one Canadian hospital is actually being sued for refusing to kill its patients.[ii]
Nor has this dramatic transformation come from organic demand among medical professionals. It is the result of legal compulsion.
“Parliament in legalizing MAiD, affirmed that, in certain cases, a desire to bring about one’s death is rational, understandable, and can be assisted without violating the Criminal Code.”[iii]
Confronted with this Parliamentary proclamation, the Canadian Psychiatric Association (and Canadian Psychiatry more widely) have been attempting to invent a professional framework for the ethical homicide of patients exhibiting mental disorders only.
And yet, in spite of an obvious interest in harmonizing the practice of its members with decreed legal doctrine (and despite giving MAID-favorable theorists full latitude to develop their case since 2016):[iv] CPA has been unable --over the last 10 years-- to produce a positive endorsement of homicide for mental disorder alone.
Or as stated on the CPA web page:
“There are compelling legal, clinical, ethical, moral and philosophical questions that make this issue particularly challenging. At this time, the CPA has not taken a position on whether MAID should be available in situations where a mental disorder is the sole underlying medical condition.” [v]
One reason why psychiatrists might oppose medical homicide, concerns scientific disagreement as to whether MAID and suicide are different, at all; and the clinical difficulty of establishing such a difference even if it did exist.
(a difference, as earlier noted,[vi] which the Canadian Association for Suicide Prevention[vii] and the American Association of Suicidology[viii] [ix] both deny).
The idea, here, is not that mental illness causes uniform incapacity, but that the wish to be poisoned, specifically, should not be received as a capable request.
A more specific reason, for opposing medical homicide, for mental illness alone, concerns the similar difficulty of determining whether any patient's disorder might be considered "irremediable".
These problems are both cited in a formal American Psychiatric Association policy statement rejecting medical homicide for mental illness alone. Significantly, this is a purely psychiatric policy (unlike its Canadian counterpart) proactively established in the absence of legal coercion[x]
Homicide-friendly professionals apparently believe that they can make capacity and irremediability judgments which are "close enough".
For those opposed, however, the whole scheme looks like sending out colorblind hunters, to harvest certain species of game birds... but only the green ones.
Whether or not our friends from Maid-in-Canada actually deny these difficulties, they do apparently believe that a complete ban (or "categorical exclusion") cannot be justified. I take this to mean (correct me at need) that certain extreme cases must not be denied.
Unfortunately, the practical operation of legal permission cannot be restricted to extreme cases only. In a resource deficient systemic environment, rigor will inevitably be sacrificed to normalization. Homicide work will naturally be done by doctors favorable to that practice. And since there is no prohibition of "doctor shopping", it is the most zealous of these who will test limits and set standards, just as in our experience of MAID to date.
Indeed, once the good people of Salem were told that Witches walked among them,[xi] it quickly became possible to find a great number of these. And so also with persons for whom homicide is imperiously proclaimed, by Parliamentarians, to be a psychiatrically indicated treatment.
Finally: MAID-in-Canada has dismissed, as "speculative", my assertion that medical homicide for mental illness would lead to that of incapable patients more generally.[xii]
One man's "speculation", however, is another man's prudent forethought.
In reality, the liquidation of incapable patients is a strict ethical necessity of representing homicide as medical care. For medicine is ideally an objective science. And (allegedly) beneficial medical remedies can not be ethically withheld from anyone who might (allegedly) benefit from them: not for reasons of age, of mental capacity, or of anything else.
Our immediate interest (in capacity) lies with the mentally ill,[xiii] children,[xiv] infants,[xv] mature minors,[xvi] and demented seniors.[xvii]
Logically inevitable expansions of medical homicide are projected for each of these groups. These extensions may usefully be viewed as a cluster of poisonous flowers, all growing from the same infected root. Legal acceptance of any one will naturally facilitate acceptance of the others also.
This logical putrefaction can only be stopped as it began: with legislative action.
No medical homicide for mental illness. Support Bill C-218
[i] Criminal Code of Canada (R.S.C., 1985, c. C-46) https://laws-lois.justice.gc.ca/eng/acts/c-46
[ii] Schadenberg, Alex, Court case to force all healthcare institutions to provide euthanasia began on January 12 in Vancouver, Euthanasia Prevention Coalition, January 13, 2026 https://alexschadenberg.blogspot.com/2026/01/court-case-to-force-all-healthcare.html
[iii] Government of Canada, Final Report of the Expert Panel on MAiD and Mental Illness, 2.2 (suicidality) https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html#a223
[iv] Canadian Psychiatric Association, Task Force on Medical Assistance in Dying Member Survey Results 2016, (see question 2) https://www.cpa-apc.org/wp-content/uploads/CPA-MAIDTF-16Surv-Rep-FIN-EN.pdf
[v] Medical Assistance in Dying (MAiD), Canadian Psychiatric
Association
https://www.cpa-apc.org/medical-assistance-in-dying-maid/
[vi] Friesen, Gordon, Medical Homicide for the Treatment of Mental Illness: The Role of Decisional Capacity, Euthanasia Prevention Coalition, January 12, 2026 https://alexschadenberg.blogspot.com/2026/01/medical-homicide-for-treatment-of.html
[vii] Canadian Society for Suicide Prevention , Statement on MAID for mental illness, December 2022 https://suicideprevention.ca/media/casp-issues-statement-about-maid-for-mental-illness/
[viii] American Association of Suicidology, Update on Physician Assisted Death Previous Statement https://suicidology.org/aas-update-on-physician-assisted-death-previous-statement/
[ix] Good Old News: In Early 2023, Suicidology Group Withdrew Statement NDY Protested, Not Dead Yet, July 10, 2023. https://notdeadyet.org/good-old-news-in-early-2023-suicidology-group-withdrew-statement-ndy-protested/
[x] American Psychiatric Association, APA Official Actions, Position Statement on Psychiatric Participation in Physician Assistance in Dying (2025) https://www.psychiatry.org/getattachment/b63d8852-2acd-4074-8358-81471cbd4633/Position-Psychiatric-Part-in-PAID.pdf
[xi] Salem Witch Trials Documentary Archive and Transcription Project https://salem.lib.virginia.edu/home.html
[xii] Carlson, Kim; Magennis, Paul, Misinformation at Parliament: What Happened on October 28th Veterans and people with mental illness deserve better advocacy, Maid in Canada, Nov 29, 2025 https://maidincanada.substack.com/p/misinformation-at-parliament-what
[xiii] Mark S. Komrad M.D., Psychiatric Times, June 1, 2021, "Oh, Canada! Your New Law Will Provide, Not Prevent, Suicide for Some Psychiatric Patients" https://www.psychiatrictimes.com/view/canada-law-provide-not-prevent-suicide; June 15, 2021 (video) Are Psychiatrists who Assist in Suicide Betraying Their Professional Values? accessed December 28, 2022 https://www.psychiatrictimes.com/view/psychiatrists-suicide-betraying-values
[xiv] The Netherlands plans to extend euthanasia to children, Schadenberg, Alex, Euthanasia Prevention Coalition, April 14, 2023 https://alexschadenberg.blogspot.com/2023/04/the-netherlands-to-extend-euthanasia-to.html
[xv] Schadenberg, Alex, Is Euthanasia of Newborns with Disabilities next? Euthanasia Prevention Coalition, January 16, 2026 https://alexschadenberg.blogspot.com/2026/01/is-euthanasia-of-newborns-with.html
[xvi] Schadenberg, James, Government report recommends euthanasia for children and euthanasia by advanced directive, Euthanasia Prevention Coalition, February 16, 2023 https://alexschadenberg.blogspot.com/2023/02/government-report-recommends-euthanasia.html
[xvii] Schadenberg, Alex, Belgian Bioethics Committee supports eugenic euthanasia for advanced dementia, Euthanasia Prevention Coalition, December 12, 2025 https://alexschadenberg.blogspot.com/2025/12/belgian-bioethics-committee-supports.html
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