OTTAWA (CCN) — Bioethicist Margaret Somerville warned 11,000 to 12,000 people could be euthanized a year in Canada if a new law does not ensure euthanasia is exceptional, rare and only a last resort.
The founding director of the McGill University Centre for Medicine, Ethics and Law told the parliamentary committee on physician-assisted dying Feb. 4 she thought “Canadians would be extremely worried” and “upset if they thought there were between 11,000 and 12,000 Canadians being killed by lethal injections given by doctors every year.” (See related story.)
Somerville said her estimates are based on the rate of euthanasia deaths in the Netherlands and Belgium at four per cent and 4.6 per cent of deaths annually. “I could almost not believe it when I worked out those figures and I actually tried to go back and make sure they were correct,” she said.
Both euthanasia and assisted suicide are “inherently wrong and should remain criminally prohibited,” she told the committee, but she was willing to offer some recommendations to “limit the risks and harms of legalized euthanasia.”
Any framework to allow it should respect the constitution and the Charter of rights and aim to “do the least harm to the value of respect for life,” she said.
Respect for life is not just a religious value, she stressed. “It’s a foundational value in every society in which reasonable people would want to live, and it must be upheld at two levels, that of the individual person, and that of the society in general.”
Religions were the institutions that used to uphold respect for life in the past, she noted.
“In 21st century secular western democracy such as Canada medicine and law are the main institutions carrying the value of respect for life for society as a whole,” she said. “Both are implicated in physician-assisted death which would damage their capacity to carry this value. It is in every Canadian’s interest to make that damage as small as possible.”
Any person requesting euthanasia must be offered “high quality palliative care and pain management,” she said. That must be “legally required in order to obtain informed consent to euthanasia.”
The legal prohibitions against euthanasia and assisted suicide must remain in force “to avoid future normalization of euthanasia,” she said, noting any legislation allowing it must make it clear it is an exception that “should only be used as a last resort,” and “rarely.”
Somerville suggested the legislation should be “entitled ‘an act to amend the Criminal Code to allow for an exception to conviction for culpable homicide and assisted suicide.’ ”
“This means those not complying with the law allowing euthanasia could be criminally liable and also that the person seeking euthanasia must show they fulfil the conditions for having access,” she said. “That is they have the burden of proof.”
Access to proper pain management is a human right, Somerville stressed. She cited palliative care expert Dr. Harvey Chochinov, who said people who request euthanasia often change their minds when offered good palliative care and pain management.
Somerville also said euthanasia should be restricted to the terminally ill whose life expectancy is less than four weeks. It should not be allowed for children. Psychiatric evaluations must rule out “all possibility of coercion or duress.”
A superior court judge should certify any request for euthanasia, as the Supreme Court is requiring now for those seeking exemptions to the suspension of the Carter decision that is to come into effect on June 6.
For nearly 2,500 years, physicians have not recognized assisted suicide and euthanasia as medical treatment and “this position should be maintained and these interventions kept out of medicine,” she said.
“Consequently, a new profession should be established to carry out euthanasia,” she said. “The practitioners should not be health care professionals, or if so, only ones who have permanently retired from practice.”
“Practitioners should be specially trained, licensed, and have travel money provided to give people across Canada equal access to euthanasia,” she said. “If this approach is not adopted, two publicly available lists of physicians and institutions should be established, those who will provide euthanasia and those who will not. This is a reasonable compromise between Canadians who agree with euthanasia and those who oppose or fear it.”
“The Supreme Court emphasized that the Charter right to security of the person includes freedom from fear about what could happen to us when we’re dying,” she said. “This seems often to be forgotten with respect to those fearful of euthanasia.”
“You are not just legislating for the present, but for future generations of Canadians with respect to how they will die,” she said, pointing out legalizing euthanasia and assisted suicide are a “seismic shift” in Canada’s foundational values.
Somerville was among the last of the 62 witnesses who have appeared before the joint parliamentary committee on physician-assisted dying. The committee also received 100 written briefs.
The committee began considering the testimony Feb. 5, and will present its report Feb. 26.