Physician-Assisted Suicide in Canada: The Struggle Continues
Last week, in what turned out to be an incredibly disappointing statement, B.C Health Minister Terry Lake announced that he was refusing the recommendations of an all-party legislature committee that had examined the issue of physician-assisted suicide, and decided instead to delay legislative action until the Trudeau government has the chance to develop its own policies. By rejecting these recommendations, Lake has not only delayed the approaching decriminalization of physician-assisted dying in British Columbia – thus prolonging the suffering of many incurably ill Canadians – but in the process, has also missed out on an important opportunity to prepare the province for the inevitable changes ahead.
On the 6th of February 2015, in Carter v. Canada, the Supreme Court ruled unanimously to strike down the ban on physician-assisted suicide that had previously existed in the Criminal Code, thereby granting Canadians living in certain conditions the right to choose a medically-assisted death. These conditions were clearly stipulated, and are twofold, the first being that the patient “clearly consents to the termination of [their] life”, and the second, requiring them to have “a serious and irremediable medical condition…that causes enduring suffering that is intolerable to the individual.” Recognizing the enormity of this declaration, the Supreme Court also suspended this ruling for 12 months, in order to ensure that both federal and provincial governments had ample time to craft legislation or adopt policies meant to regulate this practice and guarantee their citizens access to this measure. This momentous decision reflected the views of an overwhelming majority of Canadians that support the right to die with dignity.
Since then, the Select Standing Committee on Health, a committee of the Legislative Assembly of British Columbia, has considered this topic and produced recommendations on the issue of physician-assisted suicide in British Columbia. Recognizing that their mission was not to determine whether or not to support this controversial issue, but instead to deliberate on how the province could address the ruling of Carter v. Canada, this Committee considered over two hundred written submissions and numerous presentations in order to propose five recommendations in their interim report. These recommendations, which are progressive yet fair, propose, among other things, the need to craft legislation in order to ensure equitable access to physician-assisted suicide for all B.C. residents, as well as the need to guarantee the right of conscientious objection to any unwilling physicians. These measures were recommended in the hopes that they would be adopted before the February 6th deadline, so as to more swiftly grant anguished B.C. citizens the right to die with dignity, and to avoid being unprepared when this change takes place.
The Health Minister’s suspension of these recommendations not only represents a blatant disregard for democratic process, but also presents a practical problem. There are a great deal of policy decisions, both legislative and institutional, that need to be formulated and initiated before physician-assisted suicide can be guaranteed to B.C. residents. While Quebec has already passed legislation on physician-assisted suicide, and Ontario has created an expert panel to consider this issue, British Columbia has instead ignored the views of its citizens, as well as the recommendations of its elected officials, and has chosen to further delay the decriminalization of a measure guaranteed to us by our country’s highest judicial body.
This highlights another important issue. While the approach of physician-assisted suicide is imminent, the topic remains a contentious one, and it therefore remains important to avoid the tide of misinformation and sensationalism that often surrounds this issue. Indeed, in light of the legislative struggles ahead of us, it is crucial that we continue to consider this issue critically and as impartially as possible. It is because of this, that the recent comments made by the solitary ‘no’ voter in the Committee, and MLA of Maple Ridge-Mission, Marc Dalton are so contemptible:
“That is based upon what is happening in other jurisdictions, such as the Netherlands and Belgium … for example, Holland has gone from voluntary to involuntary in many cases. It’s been extended to people who are depressed, to youth,” he said. “I’m concerned about the pressure upon the elderly and I am concerned personally about the weakest in our society, the disabled, the elderly and the infirm … I just feel that we need to ensure those voices are heard.”
There are a number of obvious issues with the above stated concerns. The first, which hopefully stems from confusion rather than wilful ignorance, is Dalton’s misunderstanding of the difference between non-voluntary and involuntary assisted dying. While the former is indeed legal in Holland, and refers to patients who are unable to explicitly consent due to being in a vegetative state or having experienced severe brain damage, the latter, involuntary euthanasia (also known as murder) thankfully remains illegal. However, perhaps the most concerning aspect of Dalton’s comments, is that they either reveal a complete misunderstanding of Carter v. Canada, or worse still, a deliberate intent to mislead. Due to the meticulous wording of the Supreme Court ruling, those seeking physician-assisted suicide must be suffering from an irremediable and agonizing condition and have the ability to clearly consent to this practice, which means that in Canada, this measure could not be used on either a non-voluntary or depression related basis. Finally, the slippery slope fallacy that his alarmist position rests upon is not only incredibly puerile, but baseless, as it implies that the voices of the elderly, disabled, and marginalized in our society have been ignored. However, the Supreme Court addressed these concerns, and concluded that the evidence presented to them confirmed that “a properly administered regulatory regime is capable of protecting the vulnerable from abuse or error,” a position that was later echoed in the interim report that Dalton voted against. Despite strongly held convictions on both sides of this issue, we should always strive to avoid fallacious arguments like the one recently extended by Dalton, and strive to base our legislative decisions on empirical evidence, rather than sensationalism.
Along with the B.C. Humanist Association, I call upon Health Minister Terry Lake to adopt these recommendations and begin preparing for the changes ahead, and I urge all other skeptics, humanists, and concerned B.C. residents to do the same.
Article update (December 3, 2015)
On Tuesday, in a similarly discouraging development, court justice Michel Pinsonnault of the Quebec Superior Court ruled to further prevent Quebec citizens the right to die with dignity.
Bill 52, Quebec’s comprehensive right-to-die legislation, was passed in the Quebec National Assembly in 2014, and was due to take effect on December 10th. The first of its kind in Canada, this legislation was passed with great support from within the Government of Quebec, and respected the conventions of Carter v. Canada, requiring any individuals seeking this measure to be both terminally ill and “capable of consenting.” However, the legality of this bill was recently challenged by the regressive Quebec Coalition of Physicians for Social Justice, which sought an injunction to oppose this provincial legislation. While Pinsonnault did not rule in favour of the Coalition, as was originally reported, his decision nonetheless promises to have lasting repercussions.
Noting that this new legislation would contradict existing provisions in Canada’s Criminal Code, Pinsonnault ruled that federal law must take precedence, and that because of this, Quebec’s right-to-die legislation could not be instituted until after the deadline set in Carter v. Canada. However, this ruling, to delay Canada’s first provincially sanctioned right-to-die legislation, has since become doubly unpalatable, as the federal government has recently petitioned for a 6-month extension of the Supreme Court’s deadline. The result of this unfortunate request means that, despite Quebec Health Minister Gaétan Barrette’s promise to appeal Pinsonnault’s ruling, incurably ill and suffering Quebec citizens may potentially have to wait up to 8 months in order to be guaranteed the right to die with dignity. Again, these developments highlight an inimical trend within provincial and federal politics; despite the enormously supported and cogently formulated plans of two democratically elected provincial bodies, fatally ill Canadian citizens nonetheless remain barred from access to physician-assisted suicide.
While the federal government’s desire to proceed with caution is admirable, as ensuring that there is a coherent legislative framework in place is important, delaying incurably ill Canadians access to this measure is unnecessary; as the CEO of Dying with Dignity, Wanda Morris, has recently pointed out, “existing laws and regulations are sufficient to ensure that assisted dying can be responsibly administered while the provinces and the federal government [develop] harmonized legislation.” The needless delay in the implementation of this ruling — especially in regards to the developments in B.C and Quebec — will not only perpetuate the suffering of many agonized Canadians, but will continue to force others to seek similar measures abroad, or worse still, through more drastic means here at home
Nicholas R.J. Chiasson, CFIC Member & BC Resident
- End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8519.2011.01939.x/abstract
- Maple Ridge-Mission MLA Lone ‘No’ Vote http://www.mrtimes.com/news/341187411.html
- Humanists Call on BC Health Minister to Adopt Assisted Dying Recommendations http://www.bchumanist.ca/humanists_call_on_bc_health_minister_to_adopt_assisted_dying_regulations
- Interim Report: Select Standing Committee on Health https://www.leg.bc.ca/content/CommitteeDocuments/40th-parliament/4th-session/health/reports/PDF/Rpt-Health-40-4-Interim-Report-2015-10-28.pdf
- Euthanasia in the Netherlands: Rick Santorum’s Bogus Statistics https://www.washingtonpost.com/blogs/fact-checker/post/euthanasia-in-the-netherlands-rick-santorums-bogus-statistics/2012/02/21/gIQAJaRbSR_blog.html
- Assisted Dying in Canada: Where do we go from here? http://centreforinquiry.ca/assisted-dying-in-canada-where-do-we-go-from-here/#sthash.gun4i1Yp.dpuf
- B.C. Delays Action on Assisted Suicide Policy http://www.vancouversun.com/health/delays+action+assisted+suicide+policy/11490170/story.html?__lsa=f7ff-74ae
- L.W Sumner, Assisted Death: A Study in Ethics and Law http://ow.ly/Us2hj
- Support For Assisted Dying is Growing Among Canadian Voters: Poll http://www.dyingwithdignity.ca/new_assisted_dying_poll_canada
- Vast Majority of Canadians in Favour of Assisted Dying: Poll http://www.theglobeandmail.com/life/health-and-fitness/health/vast-majority-of-canadians-in-favour-of-assisted-dying-poll/article20981301/
- Quebec Passes Landmark End-of-Life Care Bill http://www.cbc.ca/news/canada/montreal/quebec-passes-landmark-end-of-life-care-bill-1.2665834
- Quebec Injunction Delays Introcution of Physician-Assisted Suicide Law https://ca.news.yahoo.com/blogs/dailybrew/quebec-injunction-delays-introduction-of-physician-assisted-suicide-law-215830433.html
- Federal Right-to-Die Laws will Draw “Inspiration” From Quebec, PM’s Spokesman Says http://www.cbc.ca/news/politics/doctor-assisted-death-legislation-trudeau-1.3346960
- Quebec End-of-Life Law Contradicts Criminal Code and Can’t Take Effect, Court Says http://www.cbc.ca/news/canada/montreal/quebec-end-of-life-care-1.3345572
- Liberals ask Supreme Court for 6-Month Extension to write doctor-assisted dying law http://www.cbc.ca/news/politics/liberal-doctor-assisted-death-supreme-1.3349565
- New Canada Government Seeks Delay on Assisted Suicide Decision http://www.cbc.ca/news/politics/liberal-doctor-assisted-death-supreme-1.3349565
- Bill 52, An Act Respecting End-of-Life Care, http://ow.ly/Vsy59
- Feds Ask Supreme Court to Delay its Ruling on Assisted Dying http://ow.ly/Vsy59