Assisted Suicide Not ‘Death by Doctor’

If Murray Lewis, editor of Good Times, the magazine for retirees which comes 10 times a year with your Cape Breton Post subscription, wanted to introduce a little shock and awe into the assisted death debate, he probably succeeded in his editorial in the July/August edition. He strongly criticizes the Trudeau government’s recent “right to assisted death” law, Bill C-14, although readers asked their views on the law indicated their satisfaction with it. In fact, polls show that 72% of Canadians support assisted death, although many would like further changes to the bill; 74% think people should be able to give advanced consent rather than seeking the assistance only when death is “reasonably foreseeable.”

Lewis takes issue with using the term “assisted death” or “medical aid in dying,” (shortened to “MAID”) to describe what he insists is suicide and even “murder.” A quote from Shakespeare, “A rose by any other name would smell as sweet,” Lewis explains, says it all. He contends that having a doctor “kill” you is no different from using a “pistolUntitled or a freight train” and seems to have convinced himself that stating this in as stark a manner as possible could encourage someone, ravaged by disease and ready to make the decision for assisted death, to have second thoughts.

Most people’s experience of suicide involves discovering that someone they know has killed themselves, perhaps violently — a life-threatening illness not necessarily a deciding factor. But whatever the reasons for the act, suicide, when successful, is often a sad and solitary way out, chosen because no other option is available. When unsuccessful, it can leave a person worse off than before. And while “death by cop” has become a too-familiar mantra in America, Lewis’ “death by doctor” seems cruel and unnecessary hyperbole when the Supreme Court, in the Carter v Canada case, has already decided that “consenting adults have a right to assisted death.”

Lewis contends that substituting “assisted death” for “suicide” makes people feel more comfortable with an act that actually amounts to murder and is worse when we expect medical practitioners to be complicit in the deed. Bill C-14, however, limits assisted death to those who are terminally ill, mentally competent, over 18 and have chosen, with free will and meeting strict legal safeguards, to take medication that will end their life. Death must be “reasonably foreseeable” as well, although many Canadians, as noted above, want to be able to give advance consent to the procedure. In fact, online discussion refers to “assisted suicide” and “assisted death” interchangeably and as for asking medical practitioners to commit “murder” as Lewis contends, according to the Globe and Mail, the Canadian Medical Association strongly supports Bill C-14 and is “pleased that historic federal legislation on medical aid in dying is now in place.”

While there has been a great deal of discussion of Bill C-14, a quick look back at the process that preceded it might be helpful. In the Carter v Canada case, the Supreme Court ruled unanimously on 6 February 2015 that Canadians have the constitutional right to decide how they die in some circumstances, because the “sanctity of life” also includes “the passing into death.” The deadline imposed by the Court for the government to pass new legislation was postponed until 6 June 2016 with the compromise that people “seeking a doctor’s note to end their lives” could apply to a judge for permission during that time.

‘Reasonably foreseeable’

Interestingly enough, Bill C-14 went further than the Supreme Court’s decision that a person must be suffering from a “grievous and irremediable medical condition” to state that a person seeking assisted death must be suffering from a “serious and incurable illness, disease or disability, in an advanced state of irreversible decline, and that “natural death has become reasonably foreseeable.”

Both Justice Minister Jody Wilson-Raybould and Health Minister Jane Philpott, who introduced the bill, have stated that “the legislation strikes the right balance between personal autonomy for those seeking access to medically assisted dying and protection of the vulnerable.” In addition, “it gives dying patients who are suffering intolerably while in decline on a path toward death, the choice of medically assisted death.” The Government of Canada has also committed to developing non-legislative measures to support “a full range of options for end of life care, respect for the personal convictions of health care providers and to explore other situations—each having unique implications—in which a person may seek access to medical assistance in dying such as requests by “mature minors,” advance requests and requests where mental illness is the “sole identifying consideration.”

As a result of Bill C-14, there has also been renewed discussion of palliative care and whether its availability and quality would be negatively impacted by assisted death legislation. According to Justice Lynn Smith of the Supreme Court of British Columbia, reliable evidence does not support this claim. In fact, she states, “availability and quality of palliative care are better in some countries that permit assisted death than in others that prohibit it.” She indicates that Belgium and The Netherlands where assisted death is allowed “rank higher than Canada for ‘end-of-life care.’” She further states that “in light of assisted death laws in Oregon, the Netherlands and Belgium, palliative care provisions have improved.” Of course, improvements in palliative care in Canada, which are much needed, “would require a “commitment of public funds since healthcare in Canada is largely delivered through a public system.”

Smith admits that “public debate in the United States has raised questions whether health insurers would refuse palliative care when assisted death is available although there is no evidence that this has become a reality in Oregon or Washington.” Smith finds it “difficult to imagine Canadian politicians, public officials or healthcare providers would reduce resources for palliative care if physician-assisted deaths were legal.”

The debate will no doubt continue but anyone reading Bill C-14 would have to admit that much thought and debate has gone into the bill and the government has been very careful to strike the right balance so that while assisted death is available to those who want and need it, no pressure would be placed on those who prefer to let nature take its course. We must hope that palliative care will be funded so that those with life-ending sicknesses will find comfort physically and medically, as well as spiritually.

Featured photo: Supreme Court of Canada building by Peregrine981 (Own work), via Wikimedia Commons


Dolores Campbell


Dolores Campbell, a lifelong resident of Sydney, is a freelance writer whose work has appeared in The Cape Breton Highlander, the Nova Scotian, Cape Breton Magazine, Catholic New Times and The Cape Breton Post.