Thursday, April 14, 2016
Death with Dignity? Maybe, Maybe Not.
The Liberal government's doctor-assisted death bill is already attracting a good deal of legitimate criticism. The bill, which mainly amends other laws including the Criminal Code is being criticized as too restrictive and not covering many people who might need humanitarian intervention to help end unbearable lives.
No one under 18 is eligible, no matter how dire the circumstances. The act treats them as not competent to decide their own fate. It's also unclear whether some patients with terminal diseases that claim the patient's mind long before they take the body will be able to request intervention. For example, Alzheimer's is claiming a lot of lives. It invariably takes the mind first. Will Alzheimer's patients be allowed to leave a living will calling for the administration of life-ending drugs once their quality of life is gone and the physical ordeal begins?
The bill speaks of unbearable suffering and certainty of death but it doesn't speak to the issue of quality of life. It doesn't say that the destruction of a person's quality of life should permit them to receive intervention.
On a good note, the bill does seem to include the two most important pathways - physician or nurse administered drugs and self-administered life-ending drugs. It speaks of physicians being able to write prescriptions for such drugs, noting on the prescription the intended purpose (presumably to allow pharmacists to decline to fill the script on grounds of conscience which is expressly protected).
Exactly what they're getting at is a critical point. Oregon, for example, has had a Death with Dignity Act on the books for many years. It provides a means for terminally ill patients to obtain a prescription for life-ending drugs.
The humanitarian aspect of the Oregonian approach is that it's not required or even contemplated that once the terminal patient is approved that person will ever have the prescription filled or, if filled, will actually take the life-ending drugs.
Many individuals can go through the dying process without needing the drugs. Others may develop unbearable suffering and choose not to continue. What's important in either case is that having the drugs relieves the fear of winding up dying a lingering, agonizing death.
The idea that a terminally ill person should have the option to die as serenely as possible in their own home, in their own bed, perhaps with a friend in attendance or in the presence of family may become reality in Canada and, if so, it's been a long time coming.
The other thing about Oregon's experience is that it's been in effect for almost 20-years during which the process has been monitored, scrutinized, researched and reported on in credible academic journals. A lot of the dire warnings we get in Canada have been found to be just fear mongering.
For the terminally ill, the process of exiting life - as they must - ought to be on their terms with the minimum of government interference. I'm not sure the Trudeau government has gone nearly far enough but it's a start. The bill does provide for the matter to come back for Parliamentary review five years after implementation so there is hope that, by then, they'll find the courage to go further.