(Mark Blinch/Reuters)

I always say that if you want to know what is likely to go wrong in healthcare (and society) in the coming years, you should read ethics articles in professional journals.

Case in point: With lethal-injection euthanasia now legal in Canada for patients age 18 and over whose deaths are “foreseeable” (a vague limitation sure to be erased eventually), eager bioethicists describe a proposed protocol to govern child euthanasia once legal authority expands to include minors (as it has in the Netherlands and Belgium). From “Medically Assisted Dying in a Paediatric Hospital,” published in the Oxford-based Journal of Medical Ethics:

In all other regards [than who initiates the euthanasia discussion], our working group has, at present, elected to conceptualise MAID as practically and ethically equivalent to other medical practices that result in the end of life. This theorisation of MAID is justified on the grounds that these practices share a common purpose of alleviating unendurable suffering and facilitate the patient dying on their own terms…and is reflective of our concern that the conceptualisation of MAID should not place additional burdens on the patient or function to limit the rights and freedoms to which patients are typically entitled.

Remember, the issue here is whether doctors should be allowed to kill children.

One would think that — at a bare minimum — such homicides should require parental permission. But no. If the child is considered mature enough to make decisions, parents can be kept out of the death discussions. Indeed, the authors envision scenarios in which parents aren’t even notified by doctors that they are going to kill their child! (My italics.)

If, however, a capable [legally underage] patient explicitly indicates that they do not want their family members involved in their decision-making, although healthcare providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected. If we regard MAID as practically and ethically equivalent to other medical decisions that result in the end of life, then confidentiality regarding MAID should be managed in this same way.

Can you imagine visiting your sick child, only to learn that hospital doctors killed her because she asked to die and wanted you kept in the dark? The rage and agony would be unimaginable.

And of course, we must do away with any stigma by turning child euthanasia into just another ho-hum medical procedure:

In order to protect staff members from potential violence and social harassment, we will not make public the names of the healthcare providers at The Hospital for Sick Children who have volunteered to provide MAID, nor will we disclose a full list of persons who comprised our working group. We will, however, as an institution, publicly discuss the provision of MAID in an effort to normalise this procedure and reduce social stigma for everyone involved. It is right and appropriate for this duty to fall to a well-resourced institution rather than rest on the shoulders of individual patients and providers.

The article is long, complete with flow charts for euthanasia protocols. But the gist is that the ground is being prepared to change the law to allow Canadian doctors to kill minors — and apparently doctors have already volunteered to do the killing.

Horrific. Immoral. And written in such dispassionate and sterile prose that reading the article chills the blood.