In 2016, Canada passed landmark legislation to legalize what it euphemizes as Medical Assistance in Dying (MAiD) — physician-assisted suicide, or euthanasia by doctor. At the time, it was hailed as a progressive victory allowing Canada to join the ranks of liberal scions such as Belgium and the Netherlands, which had legalized such practices in 2002 and 2001, respectively. But the unfolding of the MAiD program since its inception, coupled with recent and upcoming legal changes in Canada, have done more to reveal the moral poverty of the neoliberal project and its attendant conception of autonomy than to buttress the country’s progressive credentials.

The history of the movement for MAiD — and the larger discussion of end-of-life issues in biomedical ethics — is usually understood as a cultural victory over traditional prejudices. This is due in no small part to the fact that the most strident opponents of MAiD in the United States are conservative evangelical Christians. Those working to legalize MAiD have tended to ally themselves with other activists working on causes thought of as progressive, such as efforts to legalize marijuana, expand abortion access, and so on. In the United States, such efforts resulted in a broad-based coalition of voters approving a ballot measure legalizing physician-assisted suicide for terminally ill patients in Oregon in 1994. (Following legal challenges, the law took effect in 1997.) Other states followed suit not long after; it is now legal in eleven states as well as Washington, DC.

But it would be too hasty to conclude that all of the changes in end-of-life law in the Western world seen in recent decades are unambiguous victories for individual liberty. Analyzing the political-economic context in which Canada has full-throatedly embraced its relatively new MAiD program brings serious moral concerns to light.