On the surface, it sounds reasonable and harmless. Shouldn’t a terminally ill patient be able to choose when and how to die? The problem, as in all life and death issues, is that individual choices are never made in a vacuum. They impact other people and have far-reaching implications for broader society.
The call for people to be allowed to die on their own terms (assisted suicide) or to be allowed to end another person’s life in order to eliminate suffering (euthanasia) has all kinds of serious implications.
The danger of seeing this issue as simply a question of personal choice is that it diminishes human dignity and it removes the respect for human life that is a fundamental value in our society. All human beings deserve to be respected and protected, including persons who are severely depressed, ill, disabled, elderly, or feeling that they are a burden to others.
Allowing euthanasia and assisted suicide would also erode the basic trust that human life will be protected — a trust that is essential to the proper functioning of any society. Once you accept the premise of euthanasia and assisted suicide for some people, it becomes hard to limit it to terminal illness or end-of-life care. Accepting euthanasia and assisted suicide could contribute to the marginalization of disabled or very elderly people, whose lives might be seen as having less value.
In the Netherlands, where euthanasia is legal, not only have hundreds of people been killed without having asked for euthanasia, but people request the right to die if they have psychiatric disorders, or if they are over 70 and tired of living (even if they are still healthy). Doctors there can even actively end the life of infants born with a disability such as spina bifida.
Proponents of euthanasia and assisted suicide use euphemisms such as “medical aid in dying,” “mercy killing,” and “dying with dignity” (which implies that people who die of natural causes lack dignity, or that euthanasia and assisted suicide are justified so long as they are done “compassionately” or with the aid of a medical professional).
Euphemisms might make the issues more palatable, but they do not negate the fact that euthanasia is the deliberate taking of someone’s life in order to end suffering, with or without that person’s consent, and that assisted suicide is the act of intentionally providing someone with the knowledge or means to commit suicide.
Bottom line: killing is not part of good health care. Of course, no one wants to die in prolonged agony, and because of advances in pain management and in places where palliative care is offered, no one should. All human beings have dignity, and they do not lose that dignity when they are ill or dying. Rather than hastening their death, we should be helping them to live as well and as comfortably as possible until their natural time of death.
With regard to treatment options there are several misconceptions that need to be dispelled, because we are not required to do everything possible to stay alive as long as possible. Respecting a person’s choice to refuse burdensome treatment is not euthanasia. Neither is letting someone die naturally by withholding or withdrawing medical treatment when the burdens outweigh the benefits. Administering enough medication to provide pain relief is also not euthanasia, even if the higher dose of the medication (e.g. morphine) might shorten the person’s life.
What’s important here is the intent — to reduce suffering, rather than to hasten death. When burdensome treatment is refused, withdrawn or withheld, the intention is not to cause death but to allow the person to die peacefully of natural causes. But with euthanasia, the intention is to cause death, making the patient die before his or her time.
Instead of pressing for the legalization of euthanasia and assisted suicide, we ought to insist on implementation of the national palliative care strategy. All Canadians deserve access to good palliative care which, for persons facing the reality of impending death, offers holistic care, comfort, support, and relief from pain and distressing symptoms.
Good palliative care honours the true sense of the expressions “dying with dignity” and “a good death.”
Jelinski is president, Catholic Health Association of Saskatchewan