Physician-assisted dying: the federal government’s request for extension

by Nsamba Gerald, 3L Student, Windsor Law

Legalizing assisted suicide would not increase choice and self-determination, despite the assertions of the Canadian Supreme Court ruling in Carter v. Canada (Attorney General), 2015 SCC 5 . It would in fact augment real dangers that negate genuine choice and control. The assisted suicide model is an act executed by professional medical personnel with the intention to end the life of the person who considers his or her life to be no longer worth living.

For some individuals, this medical service model brings an end to unbearable suffering. Section 241 of Criminal Code of Canada stated that anyone who counsels a person to commit suicide, or aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and may receive a term of imprisonment not exceeding fourteen years. The Canadian Supreme Court’s ruling in favour of the assisted suicide model rendered the provision inoperative.

There are benefits and disadvantages to ruling in favour of this assisted suicide model. For instance, the benefits of assisted suicide model provide the relief of extreme pain when a person’s quality of life is poor. This model frees medical funds to assist other people. It is also another case of freedom of choice. However, some of its disadvantages would be to devalue human life and this could become a means of healthcare cost containment. Thus, physicians and other medical care personnel should not be involved in directly causing deaths.

The Court stated that the model of doctor- assisted suicide is limited to consenting adults who are “suffering from grievous and irremediable medical conditions” but not necessarily terminal disease that causes “enduring and intolerable suffering”.

The assisted suicide decision suggests that patients who request the assisted suicide model must be able to communicate with the physicians. This requirement excludes people who are unable to speak, but may desire that their lives be ended through the model. Patients who are unable to communicate with physicians are disqualified or excluded.

Similarly, if someone has a chronic illness that is not  a “grievous and irremediable medical condition”, they are not eligible for assisted suicide under this ruling. Furthermore, any individual whose illness has brought about depression that affects their judgment is also ineligible.

Moreover, legalizing physician-assisted suicide would place those who are depressed, poor, disabled or elderly at risk. The Canadian Supreme Court ruling essentially tells the vulnerable that they are a burden to society. Patients who lack emotional support and psychological care could be more likely to internalize that message. When someone else is suicidal, society would get them help by sending them to a medical doctor. We would not hand him or her a loaded gun to expedite his or her death.

Legalizing assisted suicide would also affect socially and economically disadvantaged people who have less access to medical resources and who already find that the health care system discriminates against them. As Paul Longmore stated, “Poor people, people of colour, elderly people, people with chronic or progressive conditions or disabilities, and anyone who is, in fact, terminally ill will find themselves at serious risk”.

Fear, bias, and prejudice against disability could play an important role in assisted suicide. Supporters of assisted suicide argue that it would relieve untreated pain and discomfort at the end of life. However, patients who wish to request the assisted suicide model may not do so because of pain, but rather because of frustration stemming from the loss of their functional ability, autonomy, or control of their bodily functions.

In the Netherlands, many physicians stated that the main reason patients gave for seeking death was a “loss of dignity.” This loss of dignity may result from a decrease in autonomy, which could be the inability to get out of bed or use the toilet.

In the state of Oregon, one report found that 63% of cases cited the fear of being a “burden on family, friends or caregivers” as a reason for their suicide. This is very troubling as many innocent people could lose their lives due to pressure by family members who wish to eliminate unwanted burdens. Elderly individuals who do not want to be a financial burden upon their families might also request the assisted suicide model as it would eliminate their family’s obligations to them.

In this case, individuals with disabilities could be the most likely to end their lives. The experiences in the Netherlands show that legalizing assisted suicide could place strong, unwarranted pressures on individuals and families to utilize that option, which would lead very quickly to coercion and involuntary assisted suicide. A study in Oregon also found that the estimated savings of allowing people to die before their last month of life is $627 million.

In conclusion, the assisted suicide medical model needs to be about free choice and self-determination and government needs to undertake precautions whilst implementing this model. On December 15, 2015, The External Panel on Options for a Legislative Response to Carter v. Canada submitted its key findings from its consultations to the federal government, although those findings have not yet been released publicly. The federal government, for its part, has filed for more time to come up with suitable measures that would be utilized in implementing the assisted suicide procedures, and guide physicians in hospitals. This is a positive step in the search for an appropriate approach to this serious issue.