Tuesday, June 07, 2016

B.C. College of Physicians and Surgeons Issues Assisted Dying Regulations

They're relatively brief, 5 pages in all, and to the point. The directives of the B.C. College of Physicians and Surgeons should also put to rest any concerns about some wave of assisted dying while Parliament  gets on with its job of legislating.

The regulations are interim only. It's expressly stated they will be in effect only until a medically assisted dying (MAID) law is enacted.

The college, probably anticipating that a federal law isn't far off, imposes a stipulation that the patient must be fully competent both at the time of making the request and at the time the drugs are administered.

In other words there'll be no advance directives in which a patient can stipulate when they reach a certain recognized stage in a progressive terminal disease, a final stage at which sufferers normally aren't competent, that the procedure should be undertaken.

For some individuals that will mean that they will be assisted to die but not on their terms, on the doctor's. And, once that window of competence is closed, they'll just have to tough it out.

The directives were issued yesterday.


Anonymous said...

My take is that "a stipulation that the patient must be fully competent both at the time of making the request and at the time (of assisted death)" is absolutely necessary. Always...

The Mound of Sound said...

A..non. Are you familiar with the 7 stages of Alzheimer's or the similar stages of progression of other terminal diseases?

Let's say you received an Alzheimer's diagnosis. You were told you had anywhere between 4 to 8 years. Being mildly interested you began to delve into your affliction whereupon you learned of the 7 stages that you would inescapably pass through without intervention. When you got to the particulars of stage 6 you said, "whoa, I don't ever want to have to go through that. Stage 5 maybe, at the outside, but stage 6, never."

It's your choice. You could ask your doctor to give you a head's up when he felt you were getting toward the end of your competency, perhaps around stage 3. You would then have to choose to die at that stage lest you be consigned to endure the excruciating and protracted demise at the latter stages.

How do you feel about it now? Should we require the terminal to go prematurely to be sure they can go at all? That seems to be what you would contend. Or should the afflicted be able to specify that when - not if, but when - the disease progressed to a specific point and only then he be administered the end of life drugs?

Here's the other thing you must keep in your mind. To you, this is an abstract concept. Only those diagnosed with terminal conditions can see it from that perspective. The rest of us who don't, as yet, have "skin in the game" think it's up to us to call this for those who do.

How do you square that with your ability to decide the fate of another class of people, the terminally ill?

Toby said...

Doctors tend to get sued. Their stance makes sense. Until the law lets them off the hook (something like a "good Samaritan" law) they can and should persist with their competency requirement.

Yes, the Trudeau government needs to get out of their stupor and do this right.

Anonymous said...

Our death is the most important issue in our lives, right there with our birth. My stance of requiring full lucidity&consent at time of requesting it is logical and, in my opinion, more morally defensible than euthanizing people who lost their wits.
I have inkling that some folks are thinking that they "are entitled to their entitlements" to quote that Ding wall.
And death was with humanity since the beginning (of what, I do not know) so why this obsession? Palliative care is very advanced these days, mercy killing, a.k.a. terminal sedation, is rampant in hospitals and googling cocktails for ending your life is easier than ever...

The Mound of Sound said...

A..non, I respectfully disagree. You stray from both logic and morality when you try to frame this as a matter of "entitlements." This is about constitutional protections, Charter rights, not how long you have to wait to collect EI or when your CPP kicks in.

You also seem to think that a fierce defence of the Charter against those who would compromise it by denying some individuals their Charter rights for the sake of keeping the mob happy is an obsession. I question your judgment. Would you be so complacent if your Charter rights were infringed, cancelled? I doubt it.

Mercy killing is "rampant" in hospitals. For some, perhaps, but not for all. We would not have had the battles of Sue Rodriguez, Kay Carter and patient E.F. if what you claim was remotely accurate. It's not.

It's disingenuous that you cast this as a matter of "euthanizing people who lost their wits." No one is suggesting that happen and you know it. This isn't about euthanizing people. It is about the relief of unbearable suffering in the face of irremediable physical conditions. The only way you can claim your position is morally defensible is to strip it of all reality.