Dying with dignity and as painlessly as possible
How will we protect the vulnerable while allowing these people constitutional rights
Currently in Canada we allow mature minors, people using advance medical directives who can’t otherwise communicate and those suffering solely from mental illness to make decisions that will end their lives. Across the country the courts, capacity and assessment boards, ethicists and medical personnel allow these people to refuse or stop medical treatment and therefore die.
We are now faced with the question, if these people choose death should they be allowed to die with dignity and as painlessly as possible? How will we protect the vulnerable while allowing these people the same constitutional rights as other Canadians in choosing medical aid in dying (MAID)?
In 2016 when the Parliament passed legislation to legalize MAID, the government committed to undertake studies to examine these three situations. The Council of Canadian Academies (CCA) was chosen to conduct the studies.
The CCA is an independent, not-for-profit organization that conducts evidencebased assessments to inform public policy issues, such as climate change and medicines for children.
The studies were initiated in December 2016 and are scheduled to be finished and released in 2018. They will be summaries of the information gathered without recommendations. It will be — as it was with assisted death — up to Parliament to act.
Across the country conferences, symposiums, institutions and panels are now exploring the issues involved in the three studies.
Quebec has a separate MAID law that was in place prior to the federal law. The Quebec government recently decided to examine whether or not to let people use advance medical directives to request assisted death. This would give people with dementia access to MAID. The Quebec Health Minister has stated that he wants an expert group to examine the issue and that the consultation process will take at least a year. A February 2016 Ipsos-Reid poll indicates that 8 out of 10 people support MAID for those with dementia.
MAID for mental illness is a difficult topic as polls indicate that the majority of Canadians do not understand that some psychological pain can be unbearable and incurable. However, constitutional rights are not subject to the will of the majority. Current law allows competent people with mental illness to make life-ending decisions. MAID and mental illness events are now underway to explore how and in what circumstances people with mental illness might access an assisted death.
Canadian courts have ruled that mature minors may refuse or stop medical treatment if they have the intelligence and capacity to understand the purpose of a proposed treatment and the ability to appreciate the reasonable foreseeable consequences of the decision. This means they can under existing law make decisions that would cause their death. In what circumstances should mature minors have access to MAID?
Next year when the CCA releases its MAID studies, the Parliament will have an opportunity to act in the interests of people suffering with unbearable and incurable pain and their loved ones. You should let your MP know your opinion and that you expect timely action rather than waiting for many years as these issues are litigated in the courts.
I, like many Canadians, have watched loved ones die with needless suffering. Decades ago the late Patrick Nowell-Smith, one of my graduate philosophy professors, brought the solution to this problem — assisted death — to my attention. He went on to co-found Dying with Dignity and then to serve as the president of the World Federation of Right to Die Societies. It’s time for us to continue Nowell-Smith’s work by providing prudent increased access to death with dignity.
It’s time for us to continue the important work of providing prudent increased access to death with dignity, writes John Wilson.