There’s virtue in caution

It’s no great surprise that Prime Minister Justin Trudeau faces a barrage of criticism over Bill C-14, the proposed legislation that makes Canada one of a handful of countries to legalize physicianassisted suicide, under strict conditions. It’s a hugely divisive, emotional issue.

As Parliament prepares to debate the right-to-die bill on Friday, the government is even being faulted by some in the Liberal ranks who feel it doesn’t go far enough in letting desperately suffering people seek help to end their lives. Independent Liberal senators James Cowan and Serge Joyal see it as “minimalist” and “restrictive.” Conservative Sen. Nancy Ruth calls it “uncourageous.”

This criticism is principled, to be sure. These senators worry that the bill doesn’t fully reflect the Supreme Court’s ruling that Canadians have a Charter right to seek medical help in dying, and might not survive a legal challenge. And they don’t want to see anyone suffer needlessly.

Neither do most Canadians. Most believe that fully competent adults who are suffering terribly should be able to seek help exiting peacefully, within strict limits. But most also believe that the state has a duty to balance compassion for the desperately ill with the need to protect the vulnerable, that society shouldn’t make it overly easy to choose a road of no return.

Polls confirm there is strong public opposition to giving children or people with psychiatric conditions or mental illness easy access to assisted dying. And the public largely recoils at forcing doctors and institutions to provide such services, over their moral or religious objections.

The government heard these concerns and rightly opted for a cautious approach, broadly aligned with public opinion and modelled on a Quebec law that has wide acceptance.

Bill C-14 gives effect to the court’s fundamental ruling that medical help in dying should be available to clearly consenting adults with “grievous and irremediable” conditions who face physical or mental suffering that they find intolerable.

But the bill is restrictive insofar as it requires a person to be 18, fully competent, in “an advanced stage of irreversible decline” from a serious incurable disease, illness or disability, and in circumstances where natural death is “reasonably foreseeable.” At root, it is an end-of-life option for competent adults.

There will always be a minority who oppose physician-assisted suicide entirely on religious or ethical grounds, or out of concern for the vulnerable and disabled. Others, like the critical senators, will always want to push the envelope.

But the Canadian Medical Association regards Ottawa’s approach as “thoughtful and comprehensive.” That’s a fair appraisal.

The Trudeau government made a credible effort in a very short time to respect the Supreme Court’s demands, with the appropriate caution, and to meet its June 6 deadline; to balance respect for civil rights against the need to protect the vulnerable; and to take into account sharply divided public opinion.

Given the challenges, the government deserves credit for getting the bill largely right. Certainly, it’s not up to the unelected Senate to rewrite it. Derailing the bill could leave Canada with no federal law, plunge physicians and patients into uncertainty and leave the vulnerable unprotected. That would be unconscionable. The bill deserves to be considered on its merits, not on whether it knocks down every last barrier to assisted suicide.

At the end of the day, the Supreme Court may be called on to decide whether Ottawa’s various restrictions — involving “mature minors,” the non-terminally ill and advance directives — are reasonable and justifiable. If so, the high court should give full, deferential weight to Ottawa’s duty to protect the vulnerable. The government’s intentions are decent, and it has agreed to study and revisit these matters once the new law’s impact can be assessed.

That should be enough for Parliament, for now. Bill C-14 puts Canada in the vanguard on this fraught issue, as the Supreme Court required. Beyond that, there’s virtue in caution.

The right-to-die bill deserves to be considered on its merits, not on whether it knocks down barriers to assisted suicide