Don’t rush to change this law
You would have to have a heart of stone not to be moved by the story of Audrey Parker.
She’s the 57-year-old Halifax woman who ended her life on Nov. 1 with medical assistance, earlier than she had wanted. She was suffering from terminal cancer that had spread to her brain, and feared that might prevent her from giving final consent for an assisted death.
Parker’s wish was to enjoy one more Christmas, but she said she felt forced to go early while she was still alert enough to give fully informed consent on the day of her death, as Canada’s assisted dying law requires. She left with a public plea to the government to change the law and remove the lateconsent clause for those like her who have been approved for an assisted death. “People like me are dying earlier than necessary because of this poorly thought out law,” she wrote.
Others have taken up her cause, arguing the late-consent rule is just a form of bureaucratic red tape that is preventing Parker and others from fulfilling their true wish — an assisted death on their own terms.
It’s a tempting argument, and in Parker’s case the logic seems irresistible. She clearly met all the requirements of the law and had thought through the implications. She was articulate, informed and surrounded by supportive friends and professionals prepared to smooth her path to whatever outcome she chose.
But as they say, hard cases make bad law. If the law is to be changed, it must be changed not only with people like Parker in mind. Not everyone’s situation is so clear-cut. Not everyone is so rational or so fortunate to have family and friends with only their true interests at heart. Life, sadly, is a lot more complicated.
That’s why the government is right not to rush into changing the assisted dying law, even with Parker’s deathbed plea so fresh in the public mind. Justice Minister Jody Wilson-Raybould says the government has no plans at the moment to amend the law. That should be done only when the implications have been fully debated and appropriate safeguards are built in.
Canada’s Medical Assistance in Dying (MAID) law, after all, is only two and a half years old. A total of 3,714 people took advantage of it up until the end of last year, about 1 per cent of all deaths. As a society, we are still getting used to the idea.
As the law stands now, a person must be approved for the procedure by two doctors and affirm their choice in writing. They must confirm their decision just before a physician administers the lethal injection that will end their life.
This isn’t just a bureaucratic hurdle. The point of the law is to allow those who are suffering from a “grievous and irremediable medical condition” and whose death is “reasonably foreseeable” to end their life with assistance.
But the decision must always be that of the person involved — not a family member, caregiver or professional. People do change their minds, and the requirement that they confirm their decision at the end was included in the law as a safeguard against anyone taking it out of their hands. The sick, the dying and the old are, let’s face it, often inconvenient and expensive. The potential for abuse is real.
That said, the strongest argument for amending the law can be made for those like Audrey Parker, who have already been approved for assisted dying but fear they might not have mental capacity right at the end to give final consent.
Acase may be made to allow such people to give consent for a death within a fairly short time — a few weeks, say — if they lost the ability to give consent. That would have allowed Audrey Parker to affirm her choice but specify a final day right after Christmas, as she had wanted. Even then, the law would have to make clear who would make the final decision to administer the lethal dose on the chosen date. Do we want to leave such a fateful choice up to a single physician?
The government will soon receive a report on all this. The Council of Canadian Academies, an independent organization that assesses the science relevant to public policy decisions, is looking at situations where patients don’t qualify for an assisted death under current law.
An early draft of their study reportedly concludes that an advanced request for MAID would be less ethically complicated if it is made “shortly before” it was to be carried out. That makes obvious sense. In her final Facebook post, Audrey Parker herself wrote that she wished she could have taken things one day at a time, and authorize her death 24 hours ahead of time.
The council is also examining two other scenarios: cases where the patient is suffering from dementia, and cases in which a person hasn’t been diagnosed with a serious disease but wants to make an advanced request for MAID just in case they get sick.
Those are much more fraught. Who, for example, would make a decision for a person with dementia? We would all like to think that a loving family would have only the patient’s best interests in mind. In reality, a person may have no close family, or those around them may see them simply as a burden. The law must be written with all of that in mind.
Advocates for expanding Canada’s MAID law will find this frustrating. But this is one area where caution is the best approach.