We've seen many times before how those pushing for euthanasia and assisted suicide create all sorts of euphemisms to disguise and to soften attitudes away from natural repulsion at the thought of a doctor killing a patient or in helping them to suicide.
Medically Assisted Dying is one of those fudges. Or, as the Canadians are now calling it, 'Medical Assistance in Dying'.
And when the various bureaucracies begin to deal with their processes, procedures and documentation, as is often the case, they will look for an acronym. Though it seems quite apposite to use MAD, this simply will not do.
Instead MAID is now being used on official documents, evocative of a domestic helper or an assistant paid to help make you dead. At least MAID will save on paper, being much shorter than: 'Making your patient dead - a step by step guide.' If that were not enough to make you shake your head in wonder, the Government of Ontario also wants doctors to register their interest in helping out. The Ontario College of Family Physicians explains:

"The Ministry of Health and Long-Term Care (MOHLTC) launched a clinical referral service to support physicians and nurse practitioners. The service is intended to support clinicians who are not able to refer within his or her own professional networks or through their local hospital."

Is it just me or is there something wrong with associating a ministry for 'Long-Term Care' with the abrupt and permanent ending of care?
There's the obligatory hotline number that doctors and nurses can call and a form you can fill out and email (don't forget, under Canadian Law nurses can also 'do the deed'). The idea is that a doctor or nurse can call the hotline to get that all-important second opinion or, indeed, find a colleague willing to give the needle or prescribe the lethal dose.
I wonder if the Minister of Health will issue any kind of notice of such registration. Here again the new acronym works. I can't imagine any doctor wanting a certificate on his or her office wall saying: 'MAD certified'!
Why is the Ontario Government pitching this registration as some sort of public 'service' to 'support' clinicians? The answer lies in the fact that the new Canadian law does not allow a clinician to refuse to be involved in making their patient dead. If they have any objection they 'must' refer and the law says that it must be an 'effective referral' – in other words, a referral to a clinician who will do the deed.
The policy document of the College of Physicians and Surgeons of Ontario puts it this way:

"Where a physician declines to provide medical assistance in dying for reasons of conscience or religion, the physician must not abandon the patient. An effective referral must be provided. An effective referral means a referral made in good faith, to a non-objecting, available, and accessible physician, nurse practitioner or agency. The referral must be made in a timely manner to allow the patient to access medical assistance in dying. Patients must not be exposed to adverse clinical outcomes due to delayed referrals."

By what leap of logic does a refusal by a doctor to end a patient’s life become synonymous with abandoning the patient? This is a slap in the face to good doctors everywhere and renders every genuine medical alternative, once the patient has asked to be made dead, into bad medicine or 'adverse clinical outcomes'. Moreover, it invites the conclusion that being made dead is a good clinical outcome. Hippocrates must be rolling in his grave.
To that I offer my own acronym: CAMADA - Call And Make Anyone Dead Anytime or Can Anyone Make A Dumber Acronym? Paul Russell is director of HOPE: preventing euthanasia & assisted suicide, which is based in Australia. This article has been edited and republished from his blog with permission.