Thursday, June 02, 2016

Liberal Voices Stand Up for the Charter Right to Die Humanely

Dr. Hedy Fry, a veteran Liberal MP, has penned a thoughtful and reasoned op-ed in The Georgia Strait explaining why she refused to support the Trudeau government's compromised assisted dying bill.

I do not support Bill C-14 in its present state because I do not think that the final version of the bill reflects the intent of the Supreme Court of Canada's ruling on physician-assisted death (Carter case) nor do I think that it serves the patient's best interests.

I looked at this bill through the eyes of a family physician who had practised medicine for over 20 years. Over those years, I walked with my patients through their painful experiences of dying, their tortured fight with chronic irremediable diseases, disabilities, and mental illness.

‎I learned that each patient's experience was deeply personal and the level of suffering and endurance was unique to that individual. The eventual decision was driven by religious faith, personal ethics, family relationships, and a sense of dignity in suffering and death.

I do not think the current bill addresses this. I do not think the current bill recognizes the individual desire of a patient to choose whether to live or not in a body that has betrayed them.

The bill also does not give clarity to health-care professionals who struggle, daily, to provide the best possible physical, mental, and spiritual care and to fulfill the best interest of each patient.

The criteria in Bill C-14, requiring that "natural death is reasonably foreseeable” in order to allow medically assisted dying (MAID), is an ambiguous directive to physicians.

Does it mean that only those who are dying can access MAID?

Where does that leave those who endure "grievous and irremediable suffering"? That could escalate but not cause death? This definition was specific in the Supreme Court of Canada's ruling on Carter. Yet the definition has been limited in the bill to "serious, incurable illness disease and disability."

What does that mean for a patient who does not wish to take a “cure” for personal and other reasons?

I am also concerned that this bill does not allow for acceptance of clear, written, and witnessed "advance directives"‎ of the patient's intent regarding MAID—where the patient is of sound mind but concerned that he or she may not have the mental or physical capacity to do so later‎ in the illness or disability. As a physician, I have seen patients’ specific directives ignored, contravened, and debated by families who, out of love, seek to disregard them. I have seen families torn apart by these debates.

Meanwhile senator Larry Campbell says the Trudeau government's bill is unconstitutional.

The former coroner and mayor of Vancouver says the bill is unconstitutional in its current form because of its definition of "grievous and irremediable illness," and because it does not allow for advance planning in the case of a diagnosis like Alzheimer's that gradually renders a patient not competent in the late stages of the disease.

Campbell said the bill's importance makes it all the more vital to spend time on, or it will eventually end up being struck down by the Supreme Court.

"The idea that we have a gun to our heads and this has to be done in a certain timeframe — I believe the majority of senators reject this," Campbell told Early Edition host Rick Cluff. "I don't think the world will end on June 6 if this bill is not passed."

"It's our responsibility as senators to ensure that the bill is constitutional. That's what our job is."

Campbell's first concern with the bill is that its definition of grievous and irremediable illness does not include neurodegenerative diseases such as ALS. Those patients, he said, are "suffering horribly," but their deaths are not necessarily imminent.

His second concern is that the bill does not allow for advanced planning for legally assisted death in the case of a disease like Alzheimer's. Campbell says he has had his own end-of-life plan in place since his time in the B.C. coroner's office, where the suffering he saw affected him deeply. He wants Canadians in such situations to be able to legally plan for their deaths if — when the time comes — they are no longer able to do so.

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