Tuesday, October 14, 2014

Choosing to Die

The Supreme Court of Canada is hearing a case on euthanasia this week. The case was advanced on behalf of two British Columbia patients who are arguing for the right-to-die. Quebec’s National Assembly earlier in the year passed a law to allow doctor-assisted suicide after extensive study. Quebec now joins a growing rank of jurisdictions in North America that has approved of euthanasia

Euthanasia is a delicate subject. Those in favour make a compelling case. There are those who are suffering from terminal disease and wish to die with dignity sometimes do not have the means to end their own lives. One of the plaintiffs, Gloria Taylor, had ALS, which robs its victim’s the ability to move, could not end her own suffering and so required medical help.

As we continue to advance medical science and life expectancy continues to rise we must come to confront the reality that more and more of us will die in long, drawn out diseases. Perhaps more frighteningly, our minds may give out well before our medically-assisted bodies. 

The problem is compounded by simple issues, like the fact that suicide is legal. So it is perfectly lawful for an able-bodied young adult to die, but an infirmed, terminally ill one cannot with the assistance of a doctor.

There are social and cultural implications to this. Opponents of the right to die say that sick patients may be pressured, actively or passively, to end their lives early. Governments have campaigns launched to stem elder abuse, could hospital personnel really be able to tell if a patient wants to die willingly, or is thinking about the good the inheritance would do for his/her beneficiaries?

There is a question of life as well. If we validate that people can terminate their own lives and that others can assist them with it (when medically appropriate), what are we saying about the value of life itself? This isn’t merely a question of the religious perspective on humanity, but on the value we assign each human being. Are the sick a burden upon whom we wait to die? What if euthanasia becomes commonplace for certain illnesses? Will those who choose to die naturally face additional pressures? Will this curb valuable medical research?

I am a big fan of the television program House so whenever I use the phrase “die with dignity” I hear Dr. Gregory House yell (paraphrasing), “There is no dignity in death! There’s only dignity in life!” The truth is, of course, that doctors across the country quietly provide medically-assisted death. Once the patient is ready a little too much morphine eases their passing. It is not pleasant, but it is the truth. The truth is that we live in a society paralyzed by a fear of death and aging and sickness and yet a cavalier relationship with life. It is parliament and our elected leaders who should be deciding this issue, not the Supreme Court. Emmet Macfarlane writes about the case before the Supreme Court far better than I ever could, check it out here

I personally don’t know what the answer is. Doctors should be able to help their patients, even when that means they are beyond help. The rules should be strictly written and guidelines very clear for when it is and is not appropriate. Other jurisdictions have models Canadian provinces could use, and I need not lay out any details. Ideally, like something like abortion euthanasia should be available but exceedingly rare and unnecessary in an ideal world.

It should be in our great house, the House of Commons, where an issue like this, as painful as it is, should be decided and discussed. Sadly leadership has been lacking, but perhaps the Supreme Court will once again force our politicians’ hands.  

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