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The fight for the right to die

Canada’s first assisted-suicide law draws fire in Quebec


 

Quebec Minister Véronique Hivon. (Fred Lum / The Globe and Mail / CP)

Quebec is on the cusp of allowing its doctors to actively participate in the death of terminally ill patients by way of lethal injection. Long the crucible of the country’s thorny ethical questions, abortion included, the province would be the first in Canada, and one of the few places in the world, where such a thing would be legal. And the proposed law pits Quebec against the federal government, which considers legal injection to be assisted suicide, a violation of the Criminal Code.

The bill, which received all-party consent upon its introduction this past summer, provides the legal framework by which a doctor may provide “end-of-life care” to a terminally ill patient. The patient must be of legal age, suffer an “incurable serious illness” and “irreversible decline in capability” resulting in “constant and unbearable pain.”

If Quebec’s legislation passes—it was adopted in principle this past week, and barring an election will likely become law—it will be “a template for the rest of the country,” said Wanda Morris, executive director of Dying With Dignity, a British Columbia-based right-to-die group. “If Quebec does this, and people see that it works and are happy with it, then I think much of the country would look to it and say that is something we need.”

The right for a terminally ill patient to choose his or her own time and means of death has broad support in the province, which is arguably the most socially liberal in the country. A recent Environics poll suggested 79 per cent of Quebecers support euthanasia, compared to 68 per cent in the rest of the country. Quebec’s college of physicians was an early backer of the right-to-die legislation, and it has the support of its associations of medical specialists and general practitioners—though, notably, not of its palliative caregivers, the very people charged with caring for the terminally ill.

Parti Québécois MNA and junior health minister Véronique Hivon spearheaded the legislation in 2009, and spent much of the last four years in consultation with doctors, patients, ethicists and the general public before introducing the bill in June. “An act respecting end-of-life care” (the official name of the bill) is a first in many ways. It not only lays the legal groundwork for doctor-assisted suicide, it equates the practice with “terminal palliative sedation,” a practice in which a terminally ill patient is induced into a coma, alleviating their pain while they die. Though TPS, as it’s known, is a medically accepted practice, few jurisdictions legislate how it can be used.

“The proposed law is meant for the five to eight per cent of patients who, despite the best palliative measures, still suffer from unendurable pain,” Hivon told Maclean’s. TPS doesn’t work for every patient, she says. “It works well for cancer patients, but not for sufferers of Lou Gehrig’s disease, for example. As well, there are many terminally ill patients who suffer pain even after being induced into a coma. This legislation integrates all types of end-of-life care, so we can best care for the suffering of all patients.”

The proposed law has several levels of checks to ensure a patient is giving clear-minded consent to death and is not being coerced, Hivon says. Under the legislation, a patient would sign and date a consent form in the presence of a physician to begin the process of what it calls “medical aid in dying.” (A third party can do so if the patient is physically incapable.) This physician would then ensure the patient meets the criteria set out in the legislation, and fulfills eight further requirements, including having made the decision “freely and without any external pressure.” The opinion of another physician is then sought; if this physician agrees, the patient’s wishes are granted, and “the physician must administer such aid personally and take care of the patient until their death.”

Quebec’s right-to-die bill faces potential legal hurdles, though Hivon is confident the law is on the Quebec government’s side. “It is amongst the most well thought out and structured bills we’ve had,” Hivon said. “It isn’t euthanasia, it’s medical aid in dying.” Because the law frames the issue of doctor-assisted dying as part of a continuum of care, Hivon believes the proposed law avoids the criminal definition of assisted suicide, which is an indictable offence according to the Criminal Code.

Yet the difference between allowing someone to die and actively inducing death through lethal injection is ethically fraught. “Yes, there’s a difference, but the end result is the same,” Hivon says. Many palliative caregivers beg to differ. Balfour Mount is the Montreal physician who invented the field. (He came up with the term “palliative care” in 1974.) For the 74-year-old survivor of esophageal cancer, the question of intent is critical. “With TPS, sedation is used as a point of going to sleep. The aim is to alleviate pain, not to kill the person,” Mount says. “Through palliative measures, we can control most physical suffering. If the suffering isn’t physical, if the patient is depressed, that can be treated as well. If the anguish continues, we would ask if the person would prefer to just go to sleep. That doesn’t need a change in legislation.” Opponents such as Mount and the Quebec-based Physicians’ Alliance for the Total Refusal of Euthanasia further argue that Quebec’s law will normalize assisted suicide—and, inevitably, make it an accepted substitute for palliative care. “It’s cheaper to kill patients than care for them,” said the Alliance’s Catherine Ferrier.

As with most contentious social issues, camps on either side come armed with duelling research, statistics and thinly veiled insults of their opponents. Even language is a minefield in which every word is loaded. Right-to-die proponents eschew terms like “euthanasia” and even “doctor-assisted suicide” while its opponents say expressions such as “dying with dignity” and “assisted dying” remove any suggestion of the act’s implicit barbarity. It also pulls at the heartstrings. Shortly before his death in September, noted microbiologist Dr. Donald Low made a widely publicized video pleading for right-to-die legislation in Canada.

The video and the Quebec bill were shots in the arm for Canadian right-to-die advocates, who are smarting from a recent B.C. Court of Appeal decision reversing a lower court’s ruling in favour of assisted suicide. “I love what Quebec has done,” says Morris, who sees it as part of a “worldwide phenomenon” pushing the issue to the forefront.

Proponents, Morris says, are Baby Boomers who’ve seen their parents suffer through the last chapter of their lives and want nothing of the sort themselves. “Boomers have always been in control. We don’t just go to the doctor, we go to the Internet to see what WebMD.com has to say. We do our own research. It’s a natural extension of that. When we look at the current options for dying, we say ‘I think we need a different one.’ ”

The feds have already come down squarely against Quebec’s right-to-die bill, setting the stage for a legal battle between Quebec and Ottawa. A court would have to decide whether the act of helping a patient along to his or her final resting place is a criminal matter or, as Quebec maintains, a relatively simple medical procedure.


 

The fight for the right to die

  1. Death Panels…. the Republicans were right.

    If Boomer’s want to save us all the trouble of caring for them in their old age, fine. They want control, let them have it.

    I would just ask that the legislation have a sunset clause of say 2059… the year the last baby boomer will turn 95. So that after 2059 we can go back to a normal society that cares for its aged and vulnerable and leave all these narcissitic, “me first” obsessions of the zoomers behind us as a culture.

    • You mean the “me first” pre-boomer seniors that expect their kids to give up their careers and nurse them in their homes for many years “don’t you ever put me in a home” like my neighbour did to her daughter. She expects her to come from New York State to look after her, putting her daughter’s whole future at risk.

      • While I think BC has parental care laws, most places have ditched those stupid laws.

        Sociologically and ideally, I agree in kids taking care of parents but do not believe it should be legislated. Reason is simple, many parents have no respect for their children, too dogmatic or belligerent. Some cultures like Chinese have codes of ethics parents and children traditionally abide by but it is a TWO WAY deal. Kids need a loan for education or home, they get it from the “family” estate if they are in good standing. But expected to pay it back too.

        But nothing like the smell of death and a will to bring out the ghouls. While I agree with assisted suicide, I also recognize the needs to assure undue influences are not in play and patients wishes come first.

      • I would imagine the daughter would have other options than to ditch her life to look after her mother, whether the mother expects it or not… But this article isn’t about that. It’s about a person’s right to decide their own end of life wishes under a certain set of circumstances.

        • The poster is saying that boomers and only boomers are selfish, only the 18 years of people born in those years, nobody else before or since, and that somehow pushing for assisted suicide is an extension of that. I am saying that the pre-boomers are the ones through their denial of death that have started the discussion.

    • Who is “us”? This has nothing to do with what you perceive about age groups and pop-culture labels.
      This article is about an individual’s right to choose and end of life option for her/himself.

      • Laurie… READ THE ARTICLE

        It is very clearly the BABY BOOMERS who want the right to determine their own end because of their self-centeredness. Here is the quote from the 2nd last paragraph:

        Proponents, Morris says, are Baby Boomers who’ve seen their parents suffer through the last chapter of their lives and want nothing of the sort themselves. “Boomers have always been in control. We don’t just go to the doctor, we go to the Internet to see what WebMD.com has to say. We do our own research. It’s a natural extension of that. When we look at the current options for dying, we say ‘I think we need a different one.’ ”

        BEFORE commenting please read the article.

  2. Anyone at any age with a terminal illness, and anyone of legal age who chooses to die. That should be the criteria.

    Get religion out of govt….if you don’t own your body….you own nothing.

    Dignitas of Switzerland should be the template for Canada.

    • Generally agree, but I would suggest there be some pretty damn serious steps taken to be sure that these people really want to die and it isn’t just a spur of the moment thing. Otherwise, it makes it too easy for doctors to commit homicide.

      • Dignitas manages just fine…..and if doctors wanted to commit homicide they could do that easily right now.

        Thing is we’re treating grown adults like children…like they’d make a serious decision on a whim….even though people make this decision now without any medical input or reason

        • So? I put more faith in people that make decisions that impact themselves far more than people making decisions for others and don’t have to live with the results (either way).

          • Only the patient has the right to decide

        • Sure they could.. but it’s more difficult, because evidence can be found.

          If all doctors need is a patient’s say so, then it could very easily become a question of the doc saying the person wanted to go, and the dead person not being able to counter that.

          That’s why it needs to be some serious steps, and the desire repeated at least over the medium term so that there’s opportunity to be sure it’s what the person wants.

          • Aaargh….why would you assume the doctor would be able to just casually say….’so, doya want to die today….’ and take a minor head movement as a nod to yanking out the plug??

            Gawd….other countries don’t have this much difficulty with a simple situation like this!

          • So then you agree there need to be some serious steps involved? You just assumed they’d be included automatically?

          • I think you guys just like to make up stuff to argue about. Cheesus.

            Never been in hospital? Never had an operation? I dunno what province you live in….but trust me, there is paperwork out the wazoo for even the most minor of things.

          • So then you agree there need to be some serious steps involved?

          • This comment was deleted.

          • LOL. Looks like Harper isn’t the only one unable to admit a mistake.

          • There is no mistake….you’re thinkking not thwimming I’m afraid

      • The steps need not involve religion, its about rational assessments and eliminating undue influences on the patient and religion is too “blind faith” to be unbiased.

        I don’t see it as homicide if the patient asks for it. Part of “do no harm” is to not let people suffer and lose their minds to the last painful twitch.

        • I’m confused.. who said the steps do need to involve religion?

          It’s not homicide if the person asks for it, true.. but we need the steps to make sure it’s really that person asking for it, under their own rational judgment, and not someone being pressured into it by a doctor or other party.

    • I agree. OTHER people’s religious bias/beliefs have no place in the decisions of the individual. If religious individuals have the freedom to impose certain restrictions on their own thoughts and behaviours then others have a right to freedom FROM the religious beliefs of others.

  3. You imply because of this law that we don’t care for them now? It’s supposed to be about compassion not wanting to be rid of our sick or elderly. It will still be the choice of the person who is already dying as to whether or not it is the right choice for them. You have obviously never watched someone you love slowly suffer in incredible amounts of pain all just to reach an inevitable end. Think before you speak.

  4. I don’t get anyone’s objection to this. If your dog or cat is in pain and dying we put them down, but someone terminally ill has to suffer. Religious beliefs have no place in our laws.

    • Exactly. I will never understand why some people feel it is their place to govern every aspect of everyone else’s life, down to the most intimate details like birth and death.

      • Because many people believe we should be managed like chickens in a city coupe and not have the freedom of how we die. Same people likely support government owning your wallet for statism.

        Far too many people today have no respect for others wishes.

  5. I can’t think of anything more barbaric or unethical than telling someone they must suffer intolerable pain until the day their body quits on them. How is there any opposition to this legislation? Has there every been a reasonable argument against it?

    • Only unreasonable ones

      • You are being too parochial to bother listening to the other side. Here are a few:

        – The fact that doctors and their patients may disagree on what constitutes quality of life (for whatever reason). Read the companion article about doctors desiring to determine end of life care over the wishes of patients and their families in this very magazine.

        – The fact that institutions will make mistakes, and if you institutionalize killing you will have people killed that should not have been killed.

        – The fact that people who are elderly and/or chronically ill are often merely depressed when they ask for suicide, and can be helped to deal with their reduced capacity and pain through proper support. Support which they might never have because they were depressed and chose at that moment to end their life.

        – The fact that where euthanasia is practiced (such as Belgium), the very criteria that Quebec is using has been extended to those who are not terminally ill but instead are disabled or mentally ill who desire to end their lives. People who could have in fact had long and even productive lives with proper support.

        None of those are reasonable objections?

        • 1. Doctors will stil not have the right to override the wishes of the patient, if the patient wishes to be kept alive even though the only outcome of their disease is slow, painful degradation and then death.

          2. “Institutions” will not be making the decisions about who dies or who lives. This is in no way similar to the issue of capital punishment, where it is an institution that decides who is guilty and who is not guilty. In this case it is the person suffering interminable pain, and only them, and only while they are in their right mind, who will be able to make the life or death decision.

          3. This law doesn’t apply people who are “elderly” or “chronically ill” in general. Read the legislation before you start having an opinion on it. It also does not apply to people with a mental disease or disability. This law applies only to patients who have a severe degenerative disorder and who have absolutely no possibility at all of surviving, and who, additionally, are suffering untreatable and unbearable pain as a result of their disease. Patients who are simply depressed but could otherwise

          • 1. Then why is there a case before the Supreme Court now? Aside from that, there are pressures doctors and nurses can bring to bear on people who they don’t desire to treat.

            2. The means and the execution are still going to be handled by the institution. That means different people who have differing opinions on what constitutes “unbearable pain”. In other countries where euthanasia has been legalized, depression due to disability or mental illness has been considered and/or approved as being the criteria necessary for unbearable pain.

            I am personally planning to rage against the dying of the light, now while I am sound in mind and body. Will you respect the wishes of the man that was sound in mind and body when I am in constant pain, weary, and depressed?

            3. http://www.cbc.ca/news/world/death-of-twin-brothers-fuels-debate-over-belgian-euthanasia-law-1.1334860

            In this case, the brothers met all of the critieria mentioned in the article. Namely: “The patient must be of legal age, suffer an “incurable serious illness” and “irreversible decline in capability” resulting in “constant and unbearable pain.”

            So let’s be clear here. This is what the legislation is opening the door to.

          • Some more points for #2. I would also say that medical mistakes (treating the wrong patient, or treating a patient improperly) happen. There is no reason to believe that

            It also the case in other court orders (wills for example) there are often misinterpretations or outright fraud of a persons true wishes. There is also no reason to believe that there will not be mistakes here as well that lead to an unjust death.

        • 1. Doctors will stil not have the right to override the wishes of the patient, if the patient wishes to be kept alive even though the only outcome of their disease is slow, painful degradation and then death.

          2. “Institutions” will not be making the decisions about who dies or who lives. This is in no way similar to the issue of capital punishment, where it is an institution that decides who is guilty and who is not guilty. In this case it is the person suffering interminable pain, and only them, and only while they are in their right mind, who will be able to make the life or death decision.

          3. This law doesn’t apply people who are “elderly” or “chronically ill” in general. Read the legislation before you start having an opinion on it. It also does not apply to people with a mental disease or disability. This law applies only to patients who have a severe degenerative disorder and who have absolutely no possibility at all of surviving, and who, additionally, are suffering untreatable and unbearable pain as a result of their disease. In order for a patient’s request to be accepted their pain must be untreatable by any means currently known to humanity – including induced coma. Yes, some people would actually rather see their parents “alive” and in a coma than just put out of their misery. Also, if a person is so severely depressed that they would like to kill themselves, they will probably do it whether they can get the doctors help or not. Do you have any evidence to support the notion that legalizing assisted suicide increases the rate of suicide?

          4. Where are you getting this? The law clearly requires that any person requesting an assisted suicide must be a fully consenting adult, must suffer from an incurable illness and be in an advanced state of irreversible decline in capability AND suffer from constant and unbearable physical or psychological pain that cannot be relieved. How could someone who meets all of these criteria (i.e. someone who would be allowed to receive this procedure) live a “long and productive life with proper support”.

          So, no, of course none of these are reasonable objections. You are speaking out of emotion and don’t actually have any facts or evidence to back up your position, just nonsensical rambling related in one way or another to the “sanctity of life”.

          • 1. Again, why are doctors seeking the right to override the wishes of patients and their families through the courts if this is not a danger? Also, why do you think that doctors and nurses will have no influence over vulnerable patients to choose death? Can you not see how that would be a problem in a system where euthanasia is legalized?

            2. What counts as your right mind? If I make a living will when I am sound in mind and body, and change my mind when I am in pain or ill do I suffer or am I granted death even though my mental state is clearly compromised when dealing with the pain and suffering of my illness?

            As for euthanasia being legalized increasing the amount of suicides, of course it does. Every case of euthanasia is a suicide.

            3. First you say that people who have a mental illness, a disability, or a chronic illness do not qualify for euthanasia under this legislation. Then you say in point #4 that those with “unbearable psychological pain” can be candidates for euthanasia. Which is it? Disability, Chronic Illness, and the reduced capacity that comes with age can indeed cause immense depression that cannot simply be medicated until it is “cured”, but can be livable and dealt with.

            The case in Belgium that I linked to is precisely a case where the person was not terminally ill and their pain could be managed. However, because they were considered to have psychological pain they were allowed to commit suicide with the assistance of their doctor. Belgium’s legislation is pretty much the same as Quebec’s and will lead to much the same result.

          • Re #4

            It would be easy to get a fully consenting adult suffering from an incurable illness to agree to end it all, if that’s what one wanted to get the person to do, if one had influence over that person.

            My brother and daughter were able to convince my mother not to accept treatment after her kidneys started to fail. She didn’t have to refuse treatment, but they stood over her and asked her, one at a time, So you agree not to accept further treatment and she apparently answered yes.

            I was unable to be there, otherwise I would have had a say in the matter. My mother was never able to stand up to my brother. Even when I started to write her memoirs, with her, all of a sudden she told me he would be writing them instead. And yes, I was the one with the writing ability, going into my third year university.

            You have no idea how coercive people can be. Perhaps you are one of those who are coercive and use your power to get people to do what you want them to do. But you are wrong in this. It isn’t even about the life being sacred or not. It is about people abusing their power, abusing people who are in their care.

          • Are you so sure that your mother was denied care against her will? Because if you have proof you have legal grounds for mounting criminal charges against your family and their doctors. If you don’t then you are just looking to blame someone for the inevitable.

            Plus, neither of you have obviously ever read this law. This is nothing like capital punishment. This is more like abortion. When abortion beame legal, we didn’t set up “death panels” to decide who should and should not be allowed to have a child. Women who are too unhealthy or too young to become mothers are completely allowed to have a child, even if there is no possibility that the child will have anything but an absolutely miserable life. This is the same thing. It is illegal to force someone to have an abortion, even if it’s obviously the best thing for the child and the woman, just like it will be illegal to force someone to have themselves put down, even if the only outcome of their illness is a miserable, painful existence sustained by machinery. Everyone will still have the right to milk millions of dollars from the healthcare system and be kept “alive” as a vegetable for as long as they want. The difference is that now the people who want to end this madness for themselves will not be considered criminals.

            If you think criminalization will stop something like this you’re out of your mind. Also, you will need a better reason than “it could go wrong” to oppose something with nearly 80% public support. It’s happening already it’s just now it will not be a criminal issue. It is the only compassionate thing to do.

          • My mother went into the hospital sick and was declared terminally ill within hours or a day or so. It was only within a short time, I can’t recall how many hours or day or so, that she went through a formal procedure, by which my brother, my daughter and probably a doctor, stood by her bed and asked her Is this what you choose to do – to have no more medical intervention to your terminal medical problem, and each time she was required to answer Yes or No.

            I think that not enough time went by that my mother was given, so that she could consider all the implications of giving up her life at that time. She died within a week or so of entering hospital, and it seems to me anyone would need more than an hour or a day to think about it, especially considering she just found out how serious this was.

            People can change their minds – that’s the nature of being human – but my mother never had the chance. If she did change it, she was so drugged up she could never say anything about it.

          • It’s like capital punishment in the sense that if mistakes are made, the result is death for an innocent person – or one who shouldn’t have been placed in that situation.

          • Exactly.

    • The argument against freedom of choice requires “blind faith” and dogmatism. After all, religion is about conformance of the flock for power and control.

  6. You people are all insane if you think that you can institutionalize the killing of human beings without that institution making mistakes and killing the wrong people. One of the bulwarks against capital punishment is the idea that it is better for 9 guilty people to be set free rather than execute on innocent man.

    The inevitable mistakes where people should not be put to death on “compassionate” grounds is simply too high a price to pay. People have value and human life is sacred even when you are elderly, chronically ill, dying, or mentally ill. They are not necessary sacrifices for the greater good.

    • Is human life more sacred than human choice over what to do with their own life?

      • I would say yes. But irregardless, my right to be safe and secure in a moment of extreme vulnerability, trumps the other person’s desire to commit suicide.

        • I would say no, human life isn’t sacred per se, but the choice of when to end it is. And I agree with all you say about the system – its mistakes as well as persuasive relations taking advantage of patients when they are at their most vulnerable.

          • How could anyone be taken advantage of. It is the person’s right to choose. Reasonable people already want this, the only difference is that now they will not be considered criminals.

          • Yes, it is a reasonable request, that people who choose to end their suffering in this way have the right. But as I have said, there are too many ways such a system can be taken advantage of of by coercive individuals, for personal reasons, or political.

        • That “would say” yes demonstrates the problem — you’re claiming subjective opinions as absolutes.

          That said, the simplicity of “there will be mistakes that lead to death, therefore this cannot be allowed” obviously falls apart as soon as you start looking at most aspects of modern life. Flying, for instance. Driving your car to work. The simple act of drinking alcohol if done in enough excess, can kill you. Should that be disallowed under similar grounds?

          • Yes, but I can always choose not to drive or drink.

            Ultimately I will need health care, and I will be at risk in hospitals where euthanasia is a standard and accepted practice. This is less like driving and more like being in a prison where voluntary suicide is accepted and encouraged.

          • As for my claiming absolutes, I’m doing no such thing. I am perfectly aware that war, abortion, capital punishment and euthanasia all are born out of a belief that the appropriate response to dealing with problematic human beings is to eliminate them. I am proud to hold the subjective opinion that human lives are inherently valuable.

            What I find problematic about euthanasia is that there is no way to create a system of killing humans where you kill humans that you don’t mean to kill. Period. With my own security of the person and the security of my loved ones at stake, I simply do not trust any system that anyone would draw up that says “We’re going to start killing people, but don’t worry we won’t make a mistake and kill you. Trust us.”

          • I can’t believe the logic you use, Thwim – the way you manipulate language to suit your own ends. That’s what “I would say” – meaning, it is my opinion and maybe you’re not but that’s the way your’e coming across to me.

            Irregardless, the other part of your comment is nonsense too. Flying and driving aren’t activities that involve “extreme vulnerability”, not unless you are the passenger and you know there is a terrorist on board.

          • Asking to die doesn’t involve extreme vulnerability either.

            Some people may be extremely vulnerable, yes, but that applies to every aspect in life. Some people are shitty drivers too. Do we want a society where the majority of capable people are controlled by the failings of a few? (This isn’t rhetorical, by the way.. there are some arguments in favor of such. I don’t think most people in our current society would agree with them, but who knows)

            When Yanni says, “I would say so”, he exactly means it is his own opinion that life is sacred. However, in the post above, he declares it as an absolute. He said, categorically, that “People have value and human life is sacred … “, as if it were an absolutely undeniable fact. When questioned on it, he cleared up that, no, it’s not really an undeniable fact, it’s his subjective opinion.

            He’s welcome to it, it’s, perhaps, an admirable one to have, but it is not a fact, so he shouldn’t try to use it to buttress an argument.

    • Hospitals make mistakes that kill thousands of Canadians every year. Canadians who actually wanted to live. Why don’t you leave those who wish to end the pain and suffering with a gentle death and focus on helping those who want to live through their next hospital visit? There seems to be no concerted Canadian effort to help them like there is to help those who want no help.

      • It is precisely the medical mistakes that kill thousands of Canadians every year that I fear that there will be mistakes made with the medical procedure of euthanasia. Administrative mistakes, legal mistakes, and mistakes made by doctors and caretakers.

        As for concerted Canadian effort to help them, there are groups, such as “Patients for Patient Safety Canada” among others. I would indeed urge you to support them.

    • We do need limits on how much is reasonable for anyone to cost society.

      If a person needs a million dollars a year to live, who pays? Are you going to give up a million dollars so everyone can consume ultimate care to survive a few more months?

      100 years ago they would give you herion or cocaine for the pain, and not much they could do. But today, how much money defines how far you go.

      • This more ties into the other article about doctors being the ones to decide when to end life.. which I think is actually a completely different subject.

  7. A lot of people seem to think that we’re adopting some sort of Nazi-era medical system where we just kill off the elderly and the weak. A very key part of this legislation is that it is the dying person themselves who must request the procedure in the first place. There is no possible way the life or death decision can be made by anyone other than the person who wants to die, themselves.

    Do not pay any attention to “arguments” about “mistreating the elderly” or “ridding ourselves” of them. If that’s what we wanted we would just do it. This is about compassion and sympathy — two key aspects of patient care.

    • “There is no possible way the life or death decision can be made by anyone other than the person who wants to die, themselves.”

      They can be pressured into doing so, or they can trust the wrong people to make those life and death choices for them.

      Listen, you cannot guarantee with 100% assurance that when I am sick or ill that there will not be a mistake made that leads to my untimely, unjust but ultimately legal death. So it becomes a question of how many acceptable losses are you willing to have (in unjust deaths) to achieve the “greater good” of the autonomy of the individual and the alleviation of pain.

      Where I stand, even breaking a single egg is worth the omelette. It especially isn’t worth it if I am being asked to take a chance that the system will have enough safeguards for my own very precious, very frail, life.

      • Why are you not convinced of the safeguards in a system like this? What specifically could realistically go wrong? A system like this would not allow for someone who does not want to be put down to be (like yourself — but would you REALLY rather just be fed by a tube and have your children change your own diapers while you sit and think about how much pain you’re in for decades?).

        This mechanism for ending one’s life has almost nothing to do with the doctors — it’s just decriminalizing what they’re already doing. This is about individuals who make a conscious decision about what’s best for them. You have no grounds for interfering in that.

        • Why are you so convinced, that with all the malpractice and errors in the medical system we have with our existing medical procedures, that there would not problems with the medical procedure of euthanasia.

          It is a fact that procedures are done now by mistake that patients didn’t consent to, or understand the full ramifications of what they were consenting to. These mistakes will happen with euthanasia, and has happened where it was legalized.

          As for whether I want to be fed by a tube and have my children change my diapers while I’m in pain… you are correct. That is what I’d rather have than to be dead. Death is not sleep, it is death. The end. The cessation of all that I am. Any afterlife is a desperate hope based on claims without any real evidence.

          Not all of us are utilitarians, where we measure out how much pleasure and pain are allotted to us, then commit suicide when the latter outweighs the former. If I was, I might have committed suicide myself already.

    • I don’t know why you think that if we wanted to get rid of the elderly we would “just do it.” This is exactly how ‘civilized’ countries like Canada do get rid of people who are no longer needed – by making legislation that allow it to happen.

      Only in ‘uncivilized’ countries are direct attacks on vulnerable groups committed overtly in society – against women, or poor people, for instance. Here, keeping them in their place is accomplished in a more subtle manner – and this proposed legislation is just one example of that.

      I agree there are people who need to have the choice so that they don’t have to live in pain unnecessarily, but like the law for capital punishment, there will always be those people who have their life ended when it shouldn’t have been.

    • It’s a bit naive to say that there is no connection between assisted suicide and elder abuse. I have spent the last five years with an ill mother and anyone who thinks that the elderly are being treated well by our healthcare system is high as a kite and living in la-la-land. I used to believe in the right to die…but after seeing my mother through the healthcare system, I no longer do. The elderly are already being treated poorly and puleeeezz!, paperwork is not all powerful! My mother’s and my family’s wishes were totally ignored, but passive-aggressively so we couldn’t fight it. So many right-to-die’rs have their laser-beam focused on one scenario — they are in agony and dying of cancer — and are ignoring the context euthanasia will be happening in. The problem we have is an uneducated public. Too many uninformed people are just acting on their fears, of dying badly, and aren’t able to see the bigger picture.

  8. This law is actually very narrow, it would pretty much only help people with terminal cancer or in the very last stages of ALS or some such thing. It certainly would not help the vast majority of people who end up with stuff like dementia. I’m at the point where I will get zero cancer testing after 65 just so that I can end up dying of that rather than living too long and having a worse ending.

    • Exactly. I think most people opposed to this law have actually never read it. There are no “death panels” are there are layers and layers of bureaucratic requirements that must be fulfilled for someone’s wishes to be carried out.

      • I have said no such thing. I simply say that those layers of bureaucratic requirements won’t be foolproof.

        All I need is one mistake where someone is killed improperly for me to be correct.

        • Unless you have one, though, you can’t say with certainty that it’ll happen.

          That’s like me saying that all I need is to capture a single unicorn to prove that they exist.

  9. I am all for doctor assisted death, as we already really do it, its called DNR (do not resuscitate). I will even go as far as to say why not for anyone asking, even if they don’t have a mortal disease. Say you are going blind?

    All they need to know, is I adamantly believe the patient, not the system should decide. Boards, doctors need serious limitations, where as patients wishes are the rule of the day. So if a doc/board wants to pull the plug but the patient says no, the answer is no.

    On the other hand if board says no to assisted suicide, then if patient wants it patient gets it through a process to assure it is not being done for nefarious reasons, the patient gets the wishes.

    No need for people to suffer to the last dying twitch if they don’t want to.

    • There is a huge difference between withholding medical assistant (in cases such as “do not resuscitate” or “pulling the plug” and having someone stick a needle in your arm to end your life.

      We are talking about the needle here. In other words, people who could live without medical assistance who no longer desire to do so.

  10. This comment was deleted.

    • Every first world country has an insurance based health-care system. And since more of them don’t have legalized euthanasia than do, that’s a completely false argument.

      • Spain, Italy, Britain have national health services. Sweden, Finland, and others have single payer-type systems. ‘Insurance’ is a fixed pool of money, collected from premiums–national health services or single payer plans are NOT ‘insurance.’

        • Okay. So your argument is even MORE defeated now.. by you, this time.

  11. If people really want the right to die, then let them pay a tax on it–a huge tax. Why? Because by getting a third party involved — as Duckworks has said — they are contaminating our trust in the healthcare system and I for one, would like some insurance against being euthanized inappropriately. If a dying person wants that kind of help, then they can agree to fork over a 1/3 of their assets to the government after their death. Those funds would be used to pay for palliative care for people who are a bit more courageous, and the dying person’s heirs would have to wait five years to collect what’s left. This would fund palliative care for those who want it and would safeguard the vulnerable elderly against financial abuse. The dying person’s worth would be determined by their last income tax filing and if they tried to get around the law by giving away their assets before death, then their heirs would be held responsible. After all, if heirs have to wait five years to share only 2/3rds of the dosh, then that would prove, beyond a reasonable doubt, that these heirs are asking to have the plug pulled for the right reasons: compassion. My question is this: how many takers do you think we would have here? I bet this would keep the numbers down! http://goo.gl/uQ0JJi

    • Simple. Sign a paper stating you want to have no right to die. Then the rest of us can have our choice and you will be protected from your fears of being murdered by a doctor. Illogical hack.

      • Oh yes the almighty paperwork should do the trick. Right.

        • You are an unreasonable afraid little child, please grow up.

          • Nice. Resort to to name calling why don’t you?

  12. These are all reliable sources :

    1) The abuse :

    In its report of August 25 2009, the Human Rights Committee of the United Nations denounces the extent of euthanasia and assisted suicide in the Netherlands and highlights the gap that exist between the reality and the safeguards provided by the law of 2002 which decriminalized voluntary euthanasia :

    “The Committee remains concerned at the extent of euthanasia and assisted suicides in the State party. Under the law on the Termination of Life on Request and Assisted Suicide, although a second physician must give an opinion, a physician can terminate a patient’s life without any independent review by a judge or magistrate to guarantee that this decision was not the subject of undue influence or misapprehension”.

    Source : United Nations, Human rights committee, Considerations of reports submitted by states parties under article 40 of the covenant : concluding observations of the human rights committee, ninety-sixth session, Netherlands, 25 august 2009, par.7
    (CCPR/C/NLD/CO/4).

    2) Link between the economy (finance) and the legalization of euthanasia :

    According to Jean-Louis Baudouin, a former judge of the Court of Appeal of Quebec, “the explosion of health care costs and the resulting economic pressure may favor euthanasia programs for certain categories of people more vulnerable, whose preservation compromises the finances of the state”(our translation). A large part of
    this explosion of health care costs will come from the ageing population of
    Quebec. According to Ménard 2005 report on the sustainability of the health
    care system, the ageing of Quebec’s population is “the third fastest of
    industrialized countries after Japan and Italy”. The report adds :

    “The age groups called to grow most quickly are the ones for which the use of social services and health cares is the highest. The resources per capita dedicated to the
    elderly aged 65 or more are about 3.7 times higher than the average of age
    groups. For people aged 85 or more, it is 7.7 times more per capita than the
    average population. The concentration of health care and social services
    spending at the end of life is particularly obvious for the services mainly
    offered to the elderly in loss of autonomy (…) which costs drastically
    increase from age 70″(our translation).

    Robert Evans, a professor of economics at the University of British Columbia, recognizes that non-voluntary euthanasia would be a way to improve the country’s finances, but believe that it would NOT BE THE BEST WAY:

    “I would not suggest that the best way to improve the fiscal situation of Canada is to
    introduce a non-voluntary program of euthanasia for people over the age of 70”.

    Source: Senate of Canada, Special Senate Committee on Aging , IMPLICATIONS OF AN AGING SOCIETY IN CANADA, Testimony of Mr. Robert Evans, December 10 2007, p.2: 34 , online: http://www.parl.gc.ca/Content/SEN/Committee/392/agei/02eva-e.htm?Language=E&Parl=39&Ses=2&comm_id=600

    In its predictions and foreseeable scenarios for the years 2007 to 2036, the ” Development, Concepts and Doctrine Center ” ( DCDC ) of the Ministry of Defence of the United Kingdom stresses that euthanasia of the elderly could become the
    political instrument to serve the young to reduce the economic burden of care
    for the elderly. I quote:

    « Declining youth populations in Western societies could become increasingly dissatisfied with their economically burdensome ‘baby-boomer’ elders, among whom much of societies’ wealth would be concentrated. Resentful at a generation whose values appear to be out of step with tightening resource constraints, the young might seek a return to an order provided by more conservative values and structures. This could lead to a civic renaissance, with strict penalties for those failing to fulfil their social obligations. IT MIGHT ALSO OPEN THE WAY TO POLICIES WHICH PERMIT EUTHANASIA AS A MEANS TO REDUCE THE BURDEN OF CARE FOR THE ELDERLY ».

    Source : United Kingdom, Ministry of Defence, Development, Concepts and Doctrine Center, The DCDC Global Strategic Trends Programme : 2007-2036, 3d ed., 2007 à la p.79, en ligne : http://www.cuttingthroughthematrix.com/articles/strat_trends_23jan07.pdf

    Japan is considering euthanasia as a solution to the economic burden posed by population aging on society.

    See the following article : Annabel Claix , “A Japanese minister asks its citizens to die ,
    and quickly” (January 22 2013) , online:
    http://www.ibtimes.com/japans-finance-minister-suggests-elderly-should-die-quickly-ease-health-care-burdens-1031418

    Already in 1958, Glanville Williams , who was vice-president of the “Voluntary Euthanasia Society” and regarded as “Britain’s foremost scholar of criminal
    law”, stated :

    “Kamisar expresses distress at a concluding remark in my book in which I advert to the
    possibility of old people becoming an overwhelming burden on mankind. I share
    his feeling that there are profoundly disturbing possibilities here ; and if I
    had been merely a propagandist, intent upon securing agreement for a specific
    measure of law reform, I should have done wisely to have omitted all reference
    to this subject. Since, however, I am merely an academic writer, trying to
    bring such intelligence as I have to bear on moral and social issues, I deemed
    the topic too important and threatening to leave without a word”.

    Source: Glanville Williams, « “Mercy- Killing” Legislation – A Rejoinder » (1958) 43
    (1) Minn . L. Rev . 1 p.11 .

    Eric Folot
    Lawyer and bioethicist

  13. I think we have to think long and hard before we allow doctors to kill patients. It’s a scary thing for those of us who are vulnerable or who are taking care of someone who is. http://youtu.be/i-shLhHfkAM

    • I am old and i want the right to decide when and how I will die,i do not want anyone else to decide for me. I believe strongly that everyone should have that right. When will our politicians wake up to this need?

      • You have the right to die, but you need to do it yourself, outside of a medical system WE ALL SHARE. How many times do those of us who are worried about our elderly parents need to repeat this? You can kill yourself, we won’t stop you, but we will (try to) stop you from bringing this into our healthcare system and rearranging its level of safety for all of us. The system serves all of us and it’s selfish to change it to suit you.

  14. You have my vote. Why suffer if you don’t have to.

  15. During my 16 years in England, I spent three years (1995-98) working as a caregiver – living with and caring for several elderly people suffering from advanced dementia. I saw first-hand how this disease leaves its victims trapped in a truly terrifying, living hell – with no way out except fading slowly and somewhat agonizingly into a merciful death. I often felt my charges were closer to anxious zombies than human beings – and did often wonder about the ethics of prolonging life as long as possible under those circumstances.

    My time as a carer left me decidedly unwilling to experience that kind of ‘life’ myself. As such, I can say hand on heart that the day I’m diagnosed with dementia is the day I start making moves to check out. When it comes that kind of illness, I’m going to quit while I’m ahead.

    In fact, maybe we should be a little more like Latin America – where people appear to embrace and celebrate death rather than attempting to ignore it and lock it away behind closed doors, as westerners seem inclined to do?

    Raising awareness
    This year, I self-published The Carer, a short e-novel based on my time as a live-in geriatric nurse. Described as a “gritty urban thriller with a social conscience”, The Carer offers a “Faustian tale of elder abuse, patricide by proxy and the corrosive effects of power.” You can buy The Carer for USD0.99 from Amazon and all other major ebook retailers.

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