MAiD PART 5:
The Line That Wasn’t Supposed to Move
The Promise That Made MAiD Acceptable
Canada’s MAiD framework was sold to the public on a narrow moral promise:
That assisted death would never replace care.
That consent would be meaningful, not inferred.
That vulnerability would trigger protection, not eligibility.
Those assurances were not rhetorical. They were foundational. They were what made Carter possible.
Part 5 is about the moment those boundaries stopped holding — not because anyone voted to remove them, but because the system quietly worked around them.
Capacity, Consent, and the Quiet Redefinition of Choice
The recent Macdonald-Laurier Institute analysis raises a question institutions are now trying to avoid:
Are we still meaningfully assessing consent and capacity — or merely documenting them?
When suffering itself becomes evidence of capacity, the test collapses.
MLI’s warning is precise:
Safeguards are being treated as procedural hurdles, not substantive protections. Assessors are left to infer consent in contexts where alternatives are unavailable, delayed, or denied.
That is not what Carter envisioned.
Jolene Van Alstine and the System That Could Not Answer
Jolene’s case exposed something MAiD’s defenders cannot easily explain away.
She did not seek death because treatment failed.
She sought it because treatment never arrived.
CBC’s coverage framed her story as an exercise of autonomy. What it avoided was the more dangerous truth:
That MAiD approval occurred faster than surgical care could be arranged.
Once that happens, choice becomes conditional. Autonomy exists on paper, but not in practice.
A system that can schedule death but not care has crossed a line — whether it admits it or not.
Exclusion as Pressure: The Sheila Problem
Some cases never make headlines because they implicate too many institutions at once.
Sheila’s story forces an uncomfortable question:
What happens when policy exclusion, not illness progression, pushes someone toward MAiD?
When access to care is withdrawn, restricted, or conditioned, and suffering accumulates in that gap, the resulting “choice” is no longer free in any meaningful sense.
No one needs to intend this outcome for it to occur.
The system simply has to remain rigid long enough.
Why the Debate Feels Flat Right Now
This is not because the issue has cooled.
It’s because the contours are now visible.
We are no longer discovering new arguments. We are watching institutions:
defend
reframe
normalize
and deflect
That is what happens after a boundary is crossed but not yet acknowledged.
The Line That Matters
The real question is no longer whether MAiD can be compassionate.
It’s this:
Can a system that fails to provide care still claim consent when it offers death?
Everything you’ve documented points to the same answer.
And that’s why Part 5 matters.
Not because it adds outrage —
but because it identifies the line Canada said it would never cross.
And shows where it quietly did.