WINNIPEG — Canada’s Supreme Court has ruled Canadians have the right to physician assistance in dying, but a professor of law and bioethics says Canadians don’t realize “this would include 25-year-olds in car accidents who have lost the use of their legs.”
Dr. Mary Shariff spoke at St. Anthony of Padua (West Kildonan) Church in Winnipeg June 16 to explain the Supreme Court decision, how Canada compares to other countries that have passed similar laws and the possible legal implications for Canadians. The evening was arranged by the parish’s Catholic Women’s League.
Shariff is an assistant professor of law at the University of Manitoba and was the 2011 recipient of the U of M’s Centre on Aging research fellowship for a project on autonomy, dignity and end-of-life decision making.
“Canadians weren’t wanting this,” Shariff said. “This has only come through this one case, it’s not like the Canadian public is saying this is a big issue.”
Shariff said in the U.S. states of Oregon, Washington and Vermont, where physician-assisted suicide is legal, the patient is provided with a lethal prescription, which he or she fills out at a pharmacy and then self-administers. This method, she said, provides for something of a built-in period of second thoughts and it is not uncommon for the prescription never to be taken.
This is opposed to euthanasia or assisted suicide undertaken with the aid of another person, not necessarily a physician, as it is practiced in Belgium, the Netherlands and Luxembourg (together known as Benelux) and involves the administration of a sedative followed by a lethal injection that stops the heart.
Shariff said in the Benelux countries the laws around physician-assisted suicide and euthanasia have come about because of strong cultural beliefs in individual autonomy, while in the U.S. it has been driven by a belief in death with dignity. “What we hear in Canada is ultimately all this has been collapsed into the idea of self-determination,” she said, adding that in the U.S. there is one principal group going state-to-state lobbying for physician-assisted suicide. “They want to craft it as a right,” she said.
Shariff said in the Netherlands the debate had gone on for up to 40 years before euthanasia and assisted suicide were made legal, with doctors arguing they were in a conflict of duties between whether to preserve life or relieve suffering by hastening death.
Shariff said in the Benelux countries euthanasia and assisted suicide are available to minors between the ages of 16 — 18, with the consent of the parents, if the minor is facing unbearable and constant suffering, be it physical or mental. Shariff said in her opinion a diagnosis of unbearable mental suffering is extremely difficult.
The Supreme Court is allowing the federal government and provincial legislatures 12 months, to February 2016, to enact new legislation that upholds its ruling. The court also made it clear that no level of government was required to enact legislation.
Shariff said in America, a culture of allowing the people to decide led to public ballots making physician-assisted suicide legal in Oregon and Washington, while in Vermont it was created via legislation. She said Canada is basically embarking on law-making without the public’s input.
“If federal and provincial governments don’t act, colleges of physicians will have to create some regulations,” she said, “and this is an issue because each province is trying to figure out what the law should be.”
Shariff said most physicians do not want to offer physician-assisted suicide, but the colleges of physicians must have their doctors abide by the new law, which a doctor in opposition can avoid by referring a case to a doctor who will do it.
“What about in remote areas where there is only one doctor?” she asked.
Shariff said it is unusual that Canada is not following the lead of the United Kingdom, where there has been no legal decision on physician-assisted suicide. Shariff said courts there are saying, “it’s not appropriate for the courts to decide, it must be democratic, but that’s what we’ve done in Canada.
“What we’re talking about legally is when does the law involve itself and not involve itself,” she said. “We haven’t had a fulsome conversation about that.”
The president of the Manitoba Provincial Council of the CWL, Faith Anderson, said although it is too late in the year for the CWL to form a resolution on physician-assisted suicide, there is still “lots of opportunity” before the next federal election in October to contact members of Parliament to see where they stand and to voice opposition.