National Post (National Edition)
Zero progress on assisted dying
On July 25, a groundbreaking piece of legislation known as the Assisted Dying Bill passed second reading in Britain’s House of Lords. This bill, supported in a recent poll by 73% of respondents, proposes to legalize a process whereby terminally ill patients, with less than six months to live, may self-administer life-ending medications. Should the House of Commons eventually vote the bill into law, England and Wales will join the company of Belgium, The Netherlands, Luxembourg, Switzerland, and the U.S. states of Oregon, Montana, Vermont, and Washington as the newest jurisdiction in the Western world to allow this practice. This development is especially relevant to us in Canada, as an accelerating whirlwind of recent events has pitted public opinion, lower court decisions and the decrees of individual provinces directly against the stated policy of our federal government on this issue.
Assisted suicide is currently illegal in Canada, considered a criminal act with a maximum penalty of 14 years’ imprisonment. However, in 2012, the Supreme Court of British Columbia struck down that section of the Criminal Code as unconstitutional, stating that it is “grossly disproportionate to the objectives it is meant to accomplish.” Despite a poll in late 2013 showing that the Canadian public is overwhelmingly in favour of decriminalizing assisted suicide, with only 16% of those surveyed stating a preference for criminal charges to be laid in such cases, the federal government has appealed this ruling, and the Supreme Court of Canada is slated to decide on the case in October of this year.
Adding fuel to the fire, the Liberal Party of Canada passed a resolution in February making the decriminalization of physicianassisted suicide an official part of its platform, while the province of Quebec passed legislation in June explicitly legalizing assisted suicide as of the end of 2015. The federal government, again going against popular sentiment (the Quebec bill received broad-based support from 80% of MNAs), has signalled that it is also considering a challenge to Quebec’s new legislation in the courts.
As a physician who regularly treats terminally ill patients, I am firmly in support of the decriminalization of assisted suicide for hopeless cases, and am very disappointed with Ottawa’s obstructionist and dated approach to the issue. The two most common arguments against decriminalization — that it somehow violates physicians’ Hippocratic oath, and that it opens the door to a “slippery slope” of abuse and growing suicide rates — hold little water.
The Hippocratic oath, taken by all physicians, offers as primary guidance
Why is Ottawa so determined to deny the wishes of terminally ill Canadians?
to the profession the command “Never do harm to anyone,” and when it comes to assisted suicide, many in policy circles have interpreted this only in its most literal sense. I and many other physicians, however, believe that in cases where patients are suffering from a terminal disease with no hope of cure, where every moment of their existence consists of pain and suffering, and where they are clear minded enough to express a preference to no longer live in pain, to deny this clearly stated desire — to essentially torture them against their wishes — is in fact a grave form of harm. As Peter Goodwin, a prominent American physician once said, “As a physician, I resent the term ‘physician-assisted suicide.’ I have never felt I was assisting a suicidal patient, but rather aiding a patient with his or her end-of-life choice.”
I have treated many terminal cancer patients who have begged for their suffering to end, for whom pain medication provided little relief, and who were in no way mentally compromised. In these cases, I believe Hippocrates would have understood that physicians acceding to such a wish would not be committing harm, but would instead be providing great benefit by alleviating suffering. There is no shortage of Canadian physicians who agree: A recent poll revealed that 26% of Canadian doctors would be willing to directly help a patient who expressed a wish for assisted suicide.
As for the “slippery slope” argument, the example of Oregon proves that this is a non-issue. Oregon’s assisted suicide law, which has been in place for 17 years, requires that a diagnosis of a terminal illness, with less than six months to live, be made by a primary physician and confirmed by a second consulting physician. These physicians must certify their patients are mentally competent to make and communicate health-care decisions, and these patients must then make a written request, which is witnessed by two individuals who are not primary care givers or family members. Finally, the law requires patients to request life-ending medication twice, with 15 days separating each request, to prevent impulsive requests. In the 17 years this law has been in place, there have been zero documented cases of abuse, zero calls to extend the law, and no rise in the rate of suicides. It is clear that a well-designed piece of assisted suicide legislation, with appropriate patient protections, poses little danger to patients or to society.
So the question begs to be answered: When the public prefers assisted suicide to be decriminalized, when experience from other nations shows that doing so presents little risk, and when the medical community is willing to provide this service, just who is our federal government representing as it continues to fight to ensure such acts of compassion be punished with time in prison?