OTTAWA (CCN) — Speaking on a euthanasia panel March 7, Margaret Somerville urged Parliament to set up a Royal Commission to investigate the implications of the recent Supreme Court’s Carter decision.
The founding director of the McGill Centre for Medicine, Ethics and Law said everyone she has spoken to has told her that it is “impossible to deal with this in” 12 months, that it is just not enough time “for the most important decision Parliament has ever made.” In Carter, Canada’s highest court struck down Criminal Code sections prohibiting assisted suicide, paving the way for physician assisted death (PAD) that could include voluntary euthanasia.
The court suspended its decision for 12 months from Feb. 6, to give Parliament time to craft a new law that would allow for PAD under certain circumstances.
Somerville called for the use of the notwithstanding clause to give the Royal Commission time to report or for Parliament to have the time to fully consider all the issues legalizing PAD raises. Invoking this Charter provision would suspend the court’s decision for five years. She acknowledged the use of the clause might not be politically popular.
“I would ask Parliament to stand up and have a backbone,” the founding director of the McGill Centre for Medicine, Ethics and Law told hundreds of conservative movement movers and shakers at the Manning Networking Conference here March. 5-7.
Somerville said the Supreme Court of Canada “bought into all of the pro-euthanasia arguments” that were found in the trial judge’s 377-page decision. Both the Supreme Court and the trial judge treated PAD as an incremental change, and that there was basically no difference between it and “currently accepted end of life interventions.”
“The ‘no-difference’ argument is a major plank in pro-euthanasia arguments,” she said. They argue: “All we are doing is one small, incremental step along a path we have already taken.”
Legalizing the taking of life is the acceptance of the argument that there is no difference between allowing a patient to die and killing him or her, she said.
This is not an incremental change, she said. “It’s a seismic shift in our most important value of respect for life.”
The debate about euthanasia and PAD is “the single most momentous decision” facing Parliament and, should it become legal, future “generations looking back” will see it as a “turning point issue in the 21st century,” she warned. Why have doctors been prohibited from killing their patients for the past 2.5 thousand years? she asked. “Why do we now think it is a good idea?”
If euthanasia is legalized, Somerville warned it would become “the norm.”
“How will our great, great grandchildren die?” she asked.
Also participating on the panel were Conservative MP Steven Fletcher, who introduced two private members’ bills in support of assisted suicide and voluntary euthanasia under restricted circumstances, and Canadian Research Chair in Palliative Care Dr. Harvey Chochinov.
Chochinov pointed out only 15-30 per cent of Canadians have access to quality palliative care at end of life. Without good palliative care, Canadians may have legitimate reasons to fear what might happen when they die, he said.
The palliative care physician did a study of patients with end-stage colorectal cancer, regarding their will to live and their level of pain.
The study found that will to live fluctuates and follows a similar pattern to the level of pain the patient experiences, he said.
All of those in medicine who deal with “catastrophic, life-threatening illness” see patients who experience a great deal of “anguish” and “existential distress,” he said. Under these circumstances, “it’s not uncommon to hear” patients say, “I no longer want to be alive.”
These wishes are strongest in those with pain of moderate severity or greater; those who have less available family or support systems; and those who experience depression, he said.
Chochinov also challenged notions of human dignity that prompt people to pursue euthanasia. In the Netherlands, “dignity is an important issue for the Dutch,” where one in every 28 deaths is now by euthanasia.
If any of us fell ill and became reliant on others for toileting, dressing and bathing, we might think we are “losing a sense of dignity,” he said.
Our human dignity depends a great deal on “how I appear” or “how others see me in terms of how I appear,” Chochinov said.
Dignity is not “simply about offering lethal injections,” but “attending to physical needs, managing symptoms as best we can” and depends a great deal on how caregivers “impart affirmation that you are important.”
“The single predictor of a lost sense of dignity is if you look in the eye of a health care provider and only see your illness,” he said. He put up a slide on the big screens in the hall showing an elderly man sitting in a room where one could see books lining one wall, and other signs of a life full of varied experience.
Instead of seeing a patient with an illness, the new “Dignity in Care” model for palliative care seeks to have health care providers see the whole patient in his or her human dignity, he said.
Fletcher, who represented the libertarian view on PAD, said he considered the Carter decision “very conservative” because of its stress on “autonomy” and the ability of individuals to control their own lives.
The MP and former cabinet minister, who experienced terrible physical suffering after his vehicle collided with a moose in 1996, leaving him a quadriplegic, supports the “right” of competent adults to ask for help in terminating their lives when facing unbearable suffering.
It’s a very conservative decision because it is all about autonomy and the ability of individuals to control their own lives, he said.