Originally published at The National Post Holy Post on October 10, 2013.
The Government of Quebec is wrapping up public hearings on what may decide whether June 12, 2013 becomes a forgotten date, or one that lives on in infamy. It was on that date that Quebec’s health minister introduced pro-euthanasia legislation designed to plunge both province and nation into debate over the limits of personal autonomy and the meaning of healthcare. All this less than five years after Bloc Quebecois’ Member of Parliament Francine Lalonde’s third failed attempt to have euthanasia and assisted suicide legalized in Canada. It was soundly defeated 228 to 59 in the House of Commons.
The subject of the hearings is Bill 52, An Act respecting end-of-life care, which is neither about care nor confined to considerations at end-of-life. In the course of seeking to legislate on both, L’Assemblée nationale defines neither well.
First, it creates the new term “medical aid in dying,” a euphemism for physician administered lethal injection. This is known as euthanasia, categorized under the Criminal Code as murder. In short, provincial government spin-doctors are seeking to authorize medical professionals to step outside the Criminal Code prohibition on murder in order to kill patients if a doctor agrees with the patient — or the patient’s care giver — that the patient’s life is not worth living. How is this care?
At best this is a grievously misdirected compassion that suggests killing as the remedy to what is hard about dying, or worse still, the cure to what is hard about life. Some have suggested that this is one answer to a system in crisis because of an aging population and rising healthcare costs.
Intentional killing is anathema to the Charter of Rights and Freedoms value of the sanctity of life and the related Charter value of human dignity — both described and upheld by the Supreme Court of Canada in the Rodriguez (assisted suicide) and Latimer (murder for compassionate reasons is still murder) decisions — and stands contrary to the societal condemnation expressed in the Criminal Code. There is no exception granted for intentional killing by request of one person to another as there is no legal recognition of the concept of consensual murder.
Second, the administration of “medical aid in dying” — in my opinion it is entirely appropriate that the Government of Quebec and others are using the acronym MAD — is not confined to those in pain on a hospital bed at the end of life.
The regulatory frameworks for administering MAD are the same ones that have proven uncontrollable in the few jurisdictions on planet Earth that have thought they had established the workable solution to the problem with this “end-of-life care” proposal.
It takes some digging through other pieces of Quebec law to secure the definitions for the eligibility requirements for MAD.
One must be 18 years of age or older and capable of giving consent. Please note that in addition to this young age, the patient’s care giver is authorized to provide consent.
The patient must suffer from an incurable serious illness with an irreversible decline in capability and constant physical or psychological pain.
This seems solid until one realizes that only the age for consent is actually defined. An incurable serious illness could include disability or mental illness, such as depression. An irreversible decline in capability could mean the illness, in the opinion of the patient (or their care giver) and doctor won’t get better; for example the early stages of dementia or multiple sclerosis. These requirements are met simply by the administering physician being satisfied that the appropriate life or death conditions have been met in her opinion, including mandatory reporting by any physician asked to administer MAD who is unprepared to do so.
The bill further directs that every health and social service institution designated under the legislation, including religious institutions, must have a policy for “end-of-life care” that complies with the guidelines, regulations and legislation referenced in Bill 52 – including the administering and reporting of “terminal palliative sedation” (using pain relief treatment to end the patient’s life) and the provision of “medical aid in dying.” This “service” may also be offered in private health facilities or in the patient’s home by physicians and accredited nurses.
When we’re sick we go to the doctor — Quebeckers included — and we expect help to get better. In the Netherlands and Belgium, which have their own MAD regimes, it is now reported that outcomes from a visit to the doctor may include legal euthanasia (following patient decision after conversation with a doctor) or involuntary euthanasia (following doctor decision after conversation with a patient).
If you think the same won’t happen here, or what happens in Quebec stays in Quebec, you could not only be wrong but dead wrong.
Don Hutchinson is Vice-President and General Legal Counsel with The Evangelical Fellowship of Canada. The EFC has produced the discussion paper Quebec’s Bill 52: Euphemisms for Euthanasia.