Physician Assisted Suicide (PAS) in Canada
2011-NOV: Case before the B.C. Supreme Court
This is a continuation of an earlier essay.
Reactivating Sue Rodriguez' fight:
Some individuals -- often those suffering from a terminal illness later in life -- find their physical and/or emotional pain intolerable and uncontrollable. They would like to commit suicide, but lack the knowledge or physical ability to do so. They would like a physician to give them assistance in dying with dignity. However, giving such help is currently a criminal act according to section 241(b) of the Criminal Code of Canada as it is in almost all U.S. states.
During the early 1990s, Sue Rodriguez lived in British Columbia and suffered from late-stage ALS -- a.k.a. lou Gehrig's disease. She initiated a lawsuit through the federal court system for permission to obtain help in dying. She ultimately fought her case to the Supreme Court of Canada, where she lost by a vote of 5 to 4. She committed suicide on 1994-FEB-12, allegedly in the
supportive presence of her friend Svend Robinson, a former NDP (Socialist) member
of Parliament. It is not known whether she required assistance in dying.
Robinson and the attending physician were never charged with a crime.
During the late 1990's we wrote:
"It is likely that some individual who is faced with a fatal degenerative disease will bring a similar case before the Supreme Court at some time in the future. It would have to be a slowly progressing disease or disorder like ALS, in order to give the individual time to allow her or his case to grind slowly through the court system. The Supreme
Court might well decide to overturn its 1993 ruling."
We didn't expect that it would take over a decade before such a case was launched. However, it was only on 2011-NOV-14 that a new case was heard before the British Columbia Supreme Court.
2011: New constitutional case launched:
- The case has five plaintiffs:
- Lee Carter and her husband Hollis Johnson. They had taken Carter's mother to Switzerland during 2009 so that she could obtain help from a doctor to commit suicide. PAS is legal in that country if performed according to strict regulations.
- Gloria Taylor, 63, who is suffering from late-stage ALS, and expects a slow horrendous death from asphyxia as her muscles weaken to the point of paralysis. Like the late Sue Rodriguez, she hopes to legally obtain help in dying.
- A physician, Dr. William Shoichet, and
- The British Columbia Civil Liberties Association. 1
The lawyer for the plaintiffs, Joe Arvay, said that this is an important case because all Canadians in one way or another will watch friends or family members suffer horribly as they approach the end of life. He said:
"For most of those people we hope that they will be able to have a dignified death by the natural process of life and death. But for a small and important percentage, the process of dying will be very painful, very horrible, and very undignified. It is for those people that this case is about." 1
- There are two defendants: the provincial and federal governments.
- The Euthanasia Prevention Coalition (EPCC) has been granted intervener status. They are a Canadian group with a head office in London, ON.
Their web site states that their goal is to:
"... build a well-informed broadly-based network of groups and individuals to create an effective social barrier to euthanasia and assisted suicide. Our goal is to help build a stronger unified coalition of those who oppose euthanasia and assisted suicide." 3
As the case began, they had raised about CDN $12,000 to cover their legal costs from among supporters in the Canadian population of 30 million.
Alex Schadenberg is the executive director of the EPCC. He does not look upon PAS as being about the alleviation of suffering of terminally ill persons. Rather he views it as about whether physicians should be able to decide, perhaps without considering the wishes of the persons involved, whether to terminate the lives of any of their patients who is suffering. He said:
"Canadians should understand how wide this case is that’s being heard. The Carter case wants to define it as all people who are suffering and they are trying to grant doctors the right to cause their death. It’s not about choice, it’s about who is gaining the right to do this." 1
That is, his view is that the core issue is whether doctors should be able to legally murder anyone they wish to.
Schadenberg's comments indicate precisely why legislation governing physician assisted suicide should include precise limits and controls to prevent abuse.
2011-NOV-14: Demonstration outside the courthouses:
Demonstrators with the Euthanasia Prevention Coalition (EPCC) gathered in front of the court house. 2 They carried signs carrying messages such as:
- "Assisted suicide: a recipe for elder abuse."
- "Justice Smith: Parliament voted 528 to 59 against assisted suicide."
- "Prevent elder abuse: no assisted suicide."
- "Parliament spoke: assisted suicide bad for Canada."
John Coppard, 45, a veteran of military conflicts in Afghanistan and Bosnia, was one of the demonstrators. He had been diagnosed with brain cancer two years previously. Reporter Petti Fong writes that he was "given bleak prospects" for long-term survival. He said:
"I’m really concerned about what’s going on inside that building right now. They’re playing with my life. They say they’re representing people who are irredeemably ill. They want to give us the right as they call it, the legal means to allow a physician to take our lives. Putting a glass of barbiturates in front of people who are going through what I’m going through is irresponsible." 2
He apparently felt very depressed when he received his diagnosis. He believes that if PAS had been available, he would have taken that option, and not be alive today. Now, he feels good and hopes for a cure. His experience is a good indication of why PAS laws in other countries require people asking for PAS to undergo a psychiatric evaluation for depression. This is in place so that assistance in dying can be withheld from depressed patients in favor of treating them for their depression.
Contrasting the beliefs and approaches of the pro and anti PAS groups:
The EPCC demonstrators' signs highlighted an interesting conflict over physician assisted suicide:
- Those opposed to PAS appear to believe that if it is legalized, terminally ill persons who are in serious emotional and/or physical pain will have death forced upon them involuntarily, perhaps by a physician who has arbitrarily decided that it is time for their patient to die. The Coalition's fear-based signs imply that to force death prematurely on a sick person who actually wants to live is a form of elder abuse.
In a Toronto Star video, Coppard's concluding words referred to his doctors. He said, fearfully: if they had the legal power to kill me, I don't know who I could trust." 2 Coppard echoed fear-based words by Dr. James Dobson -- founder and then president of Focus on the Family -- over a decade earlier when he commented on the right to die law that voters had passed in Oregon. Dr. Dobson wrote: "For the moment, if you are elderly and ill, Oregon is the last place you should want to be." 5
- Those in favor of making PAS available for terminally ill persons who are in serious emotional and/or physical pain feel that the patients should be legally able to take the initiative by requesting help in committing suicide. Many supporters of PAS feel that to withhold that choice from the dying person who is in intolerable pain -- whether emotional or physical or both -- is itself a form of elder abuse.
So both sides in the conflict have determined that elder abuse is the core problem. One feels that allowing terminally ill patients to choose an early exit from living is elder abuse. The other side feels that withholding such a choice is a form of elder abuse.
It may be possible that the two pro and anti PAS groups might be able to compromise. They could form a committee to interview dying patients who are in intractable pain to see whether the latter feel it is choice of PAS or the denial of PAS that constitutes elder abuse, Unfortunately, this would require dialogue and cooperation between the two sides. Dialogue is one procedure that is almost completely lacking, as it is in other ethical and civil rights matters like access to abortion, and equal rights for lesbians, gays, bisexuals and transgender persons (LGBTs) including the right to marry the person that they love and to whom they are committed.
Experience in other countries with PAS might be helpful. Their laws typically require:
- That patients who are seeking PAS be seen by a mental health professional for evaluation. If their wish to die is motivated by depression, they are refused assistance in dying and are rather treated for their depression.
- That the initiative for PAS must always come from the patient, and never from the doctor.
- That the patient must make repeated requests for PAS before assistance is granted.
- That, when barbiturates or other medication are prescribed to cause death, the patient must freely take the pills by themselves.
If these precautions were written into a law enabling PAS in Canada, then all claims to that PAS is a form of elder abuse, and all concern about not being able to trust one's doctors should evaporate. What would be left is the belief among many Jews, Christians, Muslims, and followers of other religions that it is God that decides when a person should die, not the person themselves.
2011-NOV-14: The trial commences:
The trial began with two affidavits. One was by Peter Fenker, 71, who died of ALS earlier in 2011-NOV before he was able to appear in court. The other was by his wife, Grace Fenker, who described her husband's last four days in hospital.
His affidavit described how he had tried to kill himself with a shotgun, but wanted a better way. He said: "I would like my life to end in a dignified way, with the help of a doctor, and in a way that is not painful for my family. ... My body belongs to me and it always will. The government shouldn’t be able to tell me what I can do with my body."
In her affidavit, she described her husbands death in agony as his body became so weak that the was unable to support his internal organs and his body turned purple.
For the defendants, Donnaree Nygard representing Justice Canada testified:
"This is an emotional case. Some of the stories you will read and hear are heart wrenching, intended to evoke two strong emotions — the deepest sympathy for those who find themselves in difficult situations and an apprehension that someday we may find ourselves in similar circumstances. That does not mean we should euthanize people or assist people to kill themselves. The reason for that are there are other individuals who will be put at risk." 2
The word "will" in her final sentence is strange. Unless she believes that a law enabling PAS is inevitable, the word "would" seems like a better fit.
Upcoming reports related to PAS:
- The report of the Parliamentary Committee on Palliative and Compassionate Care (PCPCC) is scheduled to be released in on 2011-NOV-17. The group promotes end of life care while opposing assisted suicide.
- The Royal Society of Canada is expected to issue its report titled: "End of Life Decision Making" sometime during 2011-NOV.
The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.
- Petti Fong, "Landmark case renews debate on right to die," The Toronto Star, 2011-NOV-13, at: http://www.thestar.com/
- Petti Fong, "Dying man’s last wishes are heard as right-to-die challenge begins," The Toronto Star, 2011-NOV-15, at: http://www.thestar.com/
- "Vancouver right to die case," video, The Toronto Star, 2011-NOV-14, at: http://www.thestar.com
- The Euthanasia Prevention Coalition has a web site at: http://www.euthanasiaprevention.on.ca. Their address is: Box 25033, London, ON Canada, N6C 6A8. Their Email address is firstname.lastname@example.org. Toll free phone number is: 1-877-439-3348.
- James Dobson, "Dr. Dobson's Study: January 1998."
Copyright © 2011, by Ontario Consultants on Religious Tolerance
Original posting: 2011-NOV-15
Latest update: 2011-NOV-15
Author: B.A. Robinson