The Ice Flow Society

How Compassion Drifts into Obligation, and Obligation into Death

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“The ice flow is not always forced; sometimes it is volunteered.”

We have long wrestled with the question of how a society should treat the dying, the suffering, and the vulnerable. Euthanasia—helping a person die to end intolerable suffering—is as old as human civilisation. In Sparta and other harsh polities, the weak and deformed were exposed or discarded, the individual sacrificed for the supposed health of the whole.

For most of history, life was short: in antiquity, the average life expectancy was barely into the 30s or 40s. Old age was rare, and with it came the temptation to view the elderly not as storehouses of wisdom but as surplus mouths. Some cultures, like among the Inuit, have legends of elders walking out onto the ice when they felt themselves a burden. Modernity stretched our lives into our 70s and 80s, and with antibiotics, anaesthesia, and ventilators came new agonies of survival — people living longer, but also lingering in pain, confusion, or dependency.

“The ice flow is not always forced; sometimes it is volunteered.”

Assisted Drifting

From last-resort compassion to first-resort convenience

It is against this backdrop that modern societies, beginning in the late 20th century, legalised euthanasia or assisted suicide under carefully circumscribed conditions.

In Canada, the euphemism is MAID (Medical Assistance in Dying). Legal since 2016, it permits either clinician-administered euthanasia or assisted suicide under conditions of “grievous and irremediable medical condition,” intolerable suffering, and reasonably foreseeable death. The public was told — and wanted to believe — that this was about mercy, autonomy, and dignity.

And sometimes, it still is. The terminal cancer patient in unspeakable pain, the neurodegenerative sufferer gasping their last in misery: these cases are not difficult to defend. To deny such people a controlled exit is not reverence for life; it is barbarism.

This condition we are calling stage one, when the patient is suffering, and death is forthcoming and assured.

But the danger is not in stage one. It is in what follows. Policies drift. Bureaucracies metastasise. Incentives whisper louder than principles. And so we arrive at what I call assisted drifting: the process by which a culture teaches its sick, its poor, its weary to shuffle toward the exit — not with a shove, but with a bureaucratic smile.

Canada’s numbers should jolt the conscience. In 2023, MAID accounted for 4.7% of all deaths. It would be higher for those over 75. One in twenty. In some provinces, the rate is higher still. That is not a medical anomaly. It is a national habit. And habits, once sanctified by paperwork, harden into entitlements.

If Canada’s sprint into the top tier of euthanasia states — again, 4.7% of all deaths — doesn’t make one pause, then what would? Speed alone should give us pause; the fact that we are now virtually tied with the Netherlands for liberalised killing ought to slow any sober-minded polity.

Yet the old refrain returns: “Trust the experts; we know what we’re doing.” Spare me. History shows that those exact words are the most dangerous thing a clinician can say.

Remember Semmelweis in Vienna, laughed out of the maternity ward for insisting that doctors wash their hands; remember thalidomide, once hailed as a miracle medicine, until whole limbs vanished into deformity; remember the mania for eugenics in Canada, not some crank on a street corner, but a movement endorsed by the learned classes.

In Alberta, the Sexual Sterilisation Act of 1928 remained on the books until 1972, during which sterilisation boards, armed with the blessing of cabinet ministers and the signatures of physicians, ordered the cutting of more than 2,800 people — mostly Indigenous women, the poor, the institutionalised.

In British Columbia, a parallel law sanctioned the same practice, justified in the language of “public health.” Canadian doctors and professors, those apostles of progress, spoke of pruning the “unfit” from the population as if humanity were a garden in need of weeding. Eugenics was taught in universities, funded by governments, and applauded in polite society; it was considered respectable, even forward-looking — science with its conscience surgically removed.

And the Germans noticed. Nazi legal scholars studied these Canadian statutes, along with sterilisation programs in California and Virginia, as useful precedents. The infamous Nuremberg Laws had a genealogy that ran through prairie legislatures and American statehouses.

Where Alberta sterilised thousands, Berlin sterilised hundreds of thousands — some 400,000 by 1939, under the Law for the Prevention of Hereditarily Diseased Offspring. Where Canadian doctors spoke of “mental defectives,” German physicians refined the vocabulary into lebensunwertes Leben — life unworthy of life.

The movement had its champions: Ernst Rüdin, the Swiss-born psychiatrist who became the Reich’s “father of racial hygiene,” preached sterilisation with evangelical fervour. At the Kaiser Wilhelm Institute for Anthropology, Eugen Fischer and Otmar von Verschuer used pedigrees, twins, and skulls to “prove” their hierarchies of human worth. It was the same pseudoscience, only with more jackboots and more funding. And what began with sterilisation metastasised into euthanasia.

Aktion T4 — the program of “mercy killing” for the disabled and mentally ill — murdered roughly 70,000 people by 1941, with buses retrofitted as mobile gas chambers and clinics piping carbon monoxide into sealed rooms. The techniques were then exported wholesale to Auschwitz, Treblinka, and Sobibor. Behind it all lay a philosophy chilling in its rationality: humanity as livestock, life as breeding stock, the state as farmer. Canada and California supplied the footnotes; Berlin supplied the efficiency.

Recall, too, the arsenic tonics and Fowler’s Solution peddled as panaceas, mercury chewed for syphilis until jaws and minds gave out, radium elixirs that irradiated rather than healed, laudanum handed out like a kindly sop while dependence and death accumulated in the margins, and the fashionable lobotomy, which left thousands reduced to docility in the name of progress.

And lest anyone be comforted by the antiseptic sound of modern hospital accounting, note this small, ugly reality: a clinician caught on video cheerfully describing gender transition surgeries — double mastectomies on healthy young breasts, hysterectomies, vaginoplasties, phalloplasties, the surgical remaking of bodies that were not diseased — as “huge money makers.”

And the institution, with a straight face, hurriedly assured the public that the revenue was “immaterial,” as if a multimillion-dollar line item could be dismissed with a mere mention of jargon.

One is asked to believe, with a straight face, that hospitals expand entire gender programs out of pure altruism, not because the procedures are billed in the tens of thousands apiece. They count the revenue quietly in back rooms while denouncing anyone who mentions it as a bigot.

This is the oldest hypocrisy in medicine: pretend it is about compassion, when in fact it is about cash.

Whether that isolated moment is evidence of systemic rot is arguable; the point that matters is simpler and less polite: hospitals run on budgets as well as ethics.

When the clinic’s ledger rubs up against the clinic’s conscience, incentives whisper. That does not prove venality across every operating theatre — but it does mean we should not be gullible when the same guardians who once recommended bloodletting now insist we must accept ever faster, ever broader permission to kill ourselves with a statute’s blessing.

So yes: a pause. Not because we don’t trust doctors, but because we should not be gullible about the infallibility of institutions that, across centuries, have been repeatedly humbled by their mistakes.

“Shut up, laypeople, and let us do what’s best” is a dangerous sermon when history shows the pulpit has long been used to sell poisons. If we are to meddle in life’s last and most consequential chapter, let it be with caution, scepticism, and a memory that will not be bullied into silence.