Luca Norton presents the problems associated with the influence of misinformation on policy about medical assistance in dying in Canada.

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As Canada prepares to expand Medical Assistance in Dying (MAiD) to include individuals whose sole underlying medical condition is a mental illness in March 2027, public discourse has erupted. With it comes a plethora of sensationalized headlines, outraged social media posts, and “experts” who have come out to condemn the expansion. For example, Dr. Jordan Peterson has compared the expansion to the Nazi euthanasia program (Aktion T4). However, much of this outrage and concern rests on misinformation (and disinformation) about MAiD. Kelsi Sheren, a Canadian veteran and social media influencer, is well recognized as being one of the most vocal sources of misinformation surrounding MAiD in Canada. Among other misleading claims, she regularly misrepresents MAiD in Canada as a eugenics program.

More generally, the dangers of this misinformation are neither overstated, nor hypothetical. The Council of Canadian Academies (CCA) released a panel report in 2023 detailing the rise of misinformation and its associated dangers. The report found that we are all susceptible to believing misinformation, and the communal harm felt from this generalized susceptibility is significant. Misinformation erodes our trust in institutions, groups, and individuals, can polarize communities, and warp public understanding of reality. Misinformation proves especially effective when the messages are “designed to evoke emotion”.

Image Description: An AI-generated photo that symbolizes online misinformation.

Suppose you have a family member who is nearing the end of their life and is considering MAiD. Suppose further that some, if not all, of the information you have been presented with regarding MAiD is designed to elicit a strong moral aversion to the practice. Perhaps it was a post online that stated that MAiD is being used to kill infants with disabilities. Or perhaps you came across an article, written by a “subject matter expert”, that makes use of emotionally-charged language meant to drum up disgust towards the practice. It is plausible that those susceptible to misinformation like this would feel a strong aversion to MAiD, especially if it concerned a dying loved one.

Central to the discourse around MAiD’s expansion lies the concept of dignity. We often speak colloquially of living and dying with dignity. This notion of dignity is intimately linked to our capacities for autonomous self-regulation and decision-making. To live a dignified life means, in part, to choose for oneself how best to achieve the aims and goals of one’s life, specifically those that are conducive to one’s flourishing. Similarly, dying in a dignified manner means to make end-of-life decisions that are conducive to maintaining one’s dignity, even at the end of one’s life and after. Misinformation around the expansion of MAiD’s criteria, however, specifically undermines this very notion of living and dying with dignity for those with a mental health condition. Denying those with a mental health condition access to MAiD is roughly equivalent to denying them the same consideration for their autonomy and dignity as those who do not suffer from a mental health condition, but rather a physical condition.

Consider the claim that individuals with mental illnesses have a lesser capacity for autonomous decision-making. However, “most people with mental disorders have the capacity to make treatment decisions” (as noted in a report on MAiD and mental disorders by the CCA).

One might argue that concerns around MAiD in general are well-founded, and that while misinformation can lead to societal harms, perhaps it also could contribute to the reduction of harm as well. If MAiD’s expansion is delayed or reshaped, or if the current law is repealed to some degree, are lives not being saved in the process? Is this not objectively morally commendable to save those lives?

Initially, this line of reasoning may seem compelling. However, this argument does away entirely with our notion of living and dying with dignity. Equating delayed or repealed policy to lives-saved fundamentally ignores what it means to make autonomous decisions about one’s own life. A life prolonged against one’s will, in the context of MAiD, is not a life preserved in any meaningful moral sense. And misinformation supporting delay or repeal would contribute to the further erosion of public trust, especially if spreading lies becomes seen as an “accepted” means of influencing policy. The CCA report on misinformation, for example, documents how misinformation is a threat to social cohesion.

How we approach MAiD’s expansion, therefore, speaks most to the kind of moral community Canadian society wishes to be. Should misinformation unduly affect our moral judgements and conclusions, we risk defaulting to restraint, in turn undermining the autonomy and dignity of an already vulnerable population. However, should we wish, as Canadians, to live in a society that wholly defends the dignity of its citizens and their right to self-determination, we must then combat misinformation and its harms so as to protect the population.

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Luca Norton is a Master of Health Ethics student at Memorial University.

This commentary was originally written in the context of a graduate seminar on health misinformation and lies.