In a unanimous 9-0 decision, the Supreme Court struck down our nation’s law against assisted suicide on February 6, 2015. The central figure before the Supreme Court was Kay Carter, 89, who had spinal stenosis, a condition in which bone presses on the spinal cord. She was not dying. She had an incurable condition and was enduring intolerable pain. Ms. Carter travelled to Switzerland in 2010 to end her life.
The Supreme Court delayed the effect of its ruling until June 6, 2016 to give Parliament and the provincial legislatures time to enact legislative guidelines.
Sadly, Bill C-14 does not follow the Court’s ruling that assistance should only depend on intolerable suffering. The proposed legislation adds the requirement for “a natural death that has become reasonably foreseeable,” in other words, maybe nearing the end of life, maybe in a couple of years: a fuzzy piece of wording, open to interpretation. The legislation adds: “in an advanced state of irreversible decline.” Again, open to interpretation. All of us are in a state of irreversible decline.
Will physicians feel comfortable to participate under such circumstances? They will want clarity, not fuzziness.
What can be said of Bill C-14? It has been given a name “MAID”: Medical Assistance in Dying. It tries to minimize controversy and make the June 6 deadline by providing assistance only to terminally ill adults.
Lee Carter is upset. Her mother would not have been allowed a doctor-assisted death under the government’s legislation as it currently stands.
The proposed legislation also does not follow the advice of the all-party Parliamentary Committee that patients with dementia be able to provide prior consent to assisted death, once diagnosed and while still deemed competent.
Both my wife’s parents suffered terrible years with dementia before they mercifully passed away. Both understood what was in their future. My wife and I saw the disease progress: eventually they no longer recognized their children and beloved grandchildren. Physically, they swallowed when nourishment was spooned into their mouth. But their minds were gone.
Senator Nancy Ruth, who sat on the Parliamentary Committee, was quoted: “This was the most uncourageous bill I’ve ever seen. … Why did they even waste our time?” adding that she’s in “no rush” to pass the bill if amendments can be made in the Senate. “I don’t think medical doctors … are going to go out and start murdering the population. Is that the implication of not getting it done by June 6?”
For me, Bill C-14 is a disappointment. It proposes to keep illegal the resolution of intolerable suffering that is not at the end of life. It will make it impossible to deal with dementia when the afflicted person is still competent. If ever there is a need for Medical Assistance in Dying, it is for conditions like dementia and intolerable suffering when the end of life is not in sight.
If the legislation is passed in its present form in the rush to the June 6 deadline, it will likely mean trips back to the Supreme Court for lawyers; and trips to a country like Switzerland for assistance with death for those who can afford to pay; and long suffering for others where natural death has not become reasonably foreseeable.
Dr. Peter Zalan is president of the medical staff at Health Sciences North. His monthly column tackles issues in health care from a local perspective.
