Assisted dying law leaves some people to suffer
Medical assistance in dying (MAID) is a constitutionally protected right. But 2½ years after legislation was enacted to support and protect Canadians facing irremediable suffering and foreseeable death — as well as their caregivers — it’s clear some people’s suffering is more equal than others.
Updating the law to reflect changing social mores takes time and care. When the Supreme Court overturned the ban on physician-assisted suicide, it imposed a reasonable deadline for new federal legislation. The Harper Conservatives dodged its advance like a boxer in a ring, pugnaciously daring it to expire.
By the time the incoming Liberals crafted a legislative framework in Bill C-14, there was significant pressure on the Senate to get it passed quickly. The chamber of sober second thought proposed a handful of amendments, the most important of which — removing the requirement of a reasonably foreseeable death — was rejected by the House of Commons.
Senators wanted MAID to be more broadly available to those suffering with no end in sight. But they were urged to defer to their elected peers in the House, who wanted more time to study MAID in three vulnerable circumstances: mature minors, mental illness as the sole condition, and advance directives for those who might lose their ability to consent.
The humbled Senate did get in a few well-placed jabs. One of these was to impose timelines on further study. The fruits of these labours are due this month.
A panel of experts from the independent, federally funded Council of Canadian Academies will submit three reports to Parliament in December. They will not make recommendations; rather, they will summarize evidence and identify gaps in knowledge relating to MAID for the three vulnerable groups.
Their observations won’t come in time for Audrey Parker, the Halifax woman who bravely put a spotlight on her final days — seeking MAID before she was ready — to highlight the human cost of denying advance directives.
Patients must be conscious and mentally sound immediately before death to affirm their final wishes. Parker had been assessed and approved for MAID, but feared the requirements of late-stage consent would rob her of relief when she was ready to die. “I can’t predict when the cancer will move into my brain,” she wrote in a final Facebook post. “Dying is a messy business.”
Canadians with dementia face the same conundrum. They can decide at what point the progress of their disease amounts to intolerable suffering, but their request for MAID must be denied if they are not lucid in their last moments.
People facing death should have a chance to change their mind. But what if they lose the capacity to speak for themselves? Erring on the side of preserving life amounts to protecting the vulnerable by prolonging their suffering.
Canadians can write a power of attorney for personal care, specifying in advance when they would refuse heroic measures, such as being placed on a ventilator. Ignoring these clearly articulated final wishes would be considered obscene.
Advance directives are a logical extension of the same principle. Assisted death is not the same as withholding treatment, but MAID is nevertheless a constitutionally protected element of compassionate care. The right to life is not a duty to live.
Following Parker’s untimely death, Justice Minister Jody Wilson-Raybould reiterated the existing law strikes the right balance between patient autonomy and protecting vulnerable Canadians. The coming reports, she said, will spark continued conversations, but: “We’re not considering changing ... the legislation.”
They needed more time for study; they got it. Considering changes is the minimum vulnerable Canadians deserve. Real suffering is at stake.