Dying with dignity | The law is ambiguous about suicide and assisted death in Canada
Everybody dies, but not everybody dies with dignity.
As well, not enough people plan for death or think about how they would like the end of their life to be handled if there are choices to be made.
Given those facts, a palliative care doctor, a lawyer and a Dying With Dignity advocate discussed death and dying Sept. 11 at a session sponsored by the Southern Alberta Council of Public Affairs.
Medically assisted death has made recent headlines through a B.C. Supreme Court ruling involving Gloria Taylor, a woman with ALS, who sought the legal right to a doctor-assisted death.
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The court ruled in June that laws against doctor-assisted suicide were unconstitutional, but suspended the ruling for one year so Parliament can take any steps it sees fit. In the meantime, Taylor can seek a doctor-assisted death if she chooses.
The ruling is now under appeal.
John Warren, vice-president of Dying With Dignity, said a July Angus Reid survey indicated 80 percent of Canadian respondents supported medically assisted death.
“There are seven places in the world where medically assisted dying is legal, so why not us,” he said.
Oregon and Washington state both have legislation allowing it, as does the Netherlands, Belgium, Luxembourg and Switzerland. Montana had a law that was struck down, putting it in legal limbo but keeping it on the list of places where doctor-assisted death is possible without prosecution.
In all places except Switzerland, people must be residents and meet certain criteria before the option is allowed. Specific criteria are also required in Switzerland, but people from other countries can legally access assisted suicide there, Warren said.
Lethbridge lawyer Berga Moen said Canada has several criminal code sections that deal with suicide and assisted death, among them Section 241 that says anyone who counsels a person to commit suicide or otherwise aids and abets them in that pursuit is guilty of an indictable offence.
“There is no legislation that expressly permits suicide in this country,” said Moen.
However, neither is there a law that makes it illegal.
Moen said the B.C. Supreme Court ruling will go to appeal in March.
“There are a lot of things at play here from a legal point of view. The final hammer lies with the federal government.”
Warren said Dying With Dignity is encouraged by three recent Canadian reports that support the need to change Canadian laws on end-of-life decisions.
The Royal Society of Canada issued a report in November supporting doctor-assisted dying and in March, Quebec’s national assembly recommended changes with respect to palliative care, personal directives and doctor-assisted death.
The B.C. court decision is the third report that Warren said encourages legislative change.
The session did not include speakers who object to doctor-assisted suicide. Warren said the main objections come from people whose religions embrace the sanctity of life.
“Does the sanctity of life argument hold true in a secular society?” Warren said.
As well, he often hears the slippery slope argument, which suggests society will be unable to draw a line between acceptable and unacceptable killings, leading to cases of involuntary euthanasia and potential termination of society’s most vulnerable members.
Warren countered by referring to Oregon’s 1994 legislation, which has been unsuccessfully challenged and through which 50 percent of requests for doctor-assisted death meet the required criteria.
Palliative care specialist Dr. Brenda Ireland described the role of her specialty as providing patients with relief from pain and other distressing symptoms, but neither hastening nor postponing death.
She said many people don’t plan for how they would like to be cared for medically in the event that they can’t communicate for themselves.
Even when they do, such directives are not as effective as once hoped because they may not address the specific circumstances of a patient’s condition or are too vague to provide clear guidance.
As well, a patient’s feelings about treatment may change as their illness advances.
