The right to die

As of Thursday, euthanasia is, quite likely, technically legal in Quebec — at least for now. The government of Quebec decided to begin offering “medical aid in dying” yesterday, despite the fact that the province’s highest court will begin hearing an appeal of a judge’s order to delay the law on Dec. 18. Much of the appeal seems to hinge on the fact that what’s on offer does not constitute “medical aid,” so much as straightforward “dying.” The Quebec Superior Court thus suspended key parts of it on the grounds that it conflicted with federal criminal law, which still bars euthanasia outright.

In the meantime, euthanasia is probably mostly legal in Quebec. The Criminal Code still prohibits doctors from helping terminally ill people to die, sort of, but last year the Supreme Court of Canada struck down that law and gave the federal government until Feb. 6 to craft an alternative — the newly elected Liberals have asked the court to grant a six-month extension.

In short, the current legislation around euthanasia in Quebec is a confusing mess. Even if the law’s status is in flux, it seems unlikely that a doctor in Quebec would be prosecuted for helping to end a long- suffering patient’s life — no provincial prosecutor would be eager to take that case given the current legal situation. On the other hand, few doctors would want to take the risk, given that the letter of the law is likely to be spelled out more clearly sometime in the coming months.

In the meantime, as euthanasia critics try to delay the inevitable by a few weeks, many chronically ill patients will be left in limbo.

There are, of course, reasonable concerns to be addressed about a federal euthanasia law. I would expect the coming legislation to include a clear set of guidelines for what constitutes intolerable suffering, for example, and how best to ensure proper and informed consent. Conscience rights of doctors must also be enshrined — although the Quebec law also demands patients be made aware of their options and be given a referral, if required.

We will inevitably have to come to terms with people who wish to end their own lives after many years of trying unsuccessfully to treat chronic depression, which has become a controversial issue in other jurisdictions where euthanasia has been permitted.

Hopefully Canada will enact a regime similar to Oregon’s Death with Dignity Act, which allows the terminally ill to end their own lives with prescribed medi-

Anyone who values individual rights over collective ones should find the arguments against euthanasia intolerable

cations. (It is not technically “euthanasia,” as the doctor doesn’t physically administer the drugs.)

Among participants in that state, the three most oftcited concerns were loss of autonomy followed by loss of enjoyment of life and loss of dignity. The vast majority were cancer patients. Since the law was put into force in 1997, 1,327 prescriptions have been filled and 859 people have ended their own lives. In other words, Oregon’s program is transparently conducted and infrequently used.

Here at home, the critics’ best efforts to beat back the growing acceptance for assisted- suicide laws by demanding more and better palliative care has been uncompelling, to say the least. There’s nothing contradictory about advocating humane end- of- life care, while also respecting the need for a euthanasia law. The paramount concern should focus on giving us all better choices.

If palliative care is preferred to a planned and painless death for moral reasons, well, that’s hard to fault. However, palliative care can never be a panacea; some are always going to prefer to end their lives on their own schedule. Not everyone is compelled by the same moral codes and, ultimately, competing moral codes are what this whole debate boils down to.

We don’t have to dig too deep into the objections over euthanasia to find the word “God.” To many religious people, the notion that man should have the final say over his own destiny is blasphemous. It undermines the sacred gift of life and, more damning, it allows the individual to assume God- like powers to countermand God’s will and plan.

Note that very few religious denominations require adherents to undergo artificial interventions to prolong that sacred life. But they all seem to demand we maintain the illusion of spontaneity in passing, regardless of what additional pain this may cause the dying. “Letting nature take its course” is often the polite way of putting it.

The secular version of this argument replaces “God” with the “state.” But the same logic that makes suicide illegal demands those who take their own lives be buried outside the walls of the churchyard, as if the dead still care about the condemnation of the living.

Those who oppose euthanasia are really saying that one’s life doesn’t belong to that person alone, but to a higher power, whether God, the family, society or the state; that one’s personal dignity should be subordinate to our broader appreciation for the sanctity of life. Euthanasia is a private mercy, but a crime against the public body.

Anyone who values individual rights over collective ones should find these objections intolerable.