A Good End: a look at doctor-assisted death
Pain may be multifaceted, but the Canadian Society of Palliative Care Physicians (CSPCP) insists, “No Canadian need feel that a deliberately hastened death is the only option to minimize suffering.”
Emphatically opposed when Quebec passed Bill 52, the CSPCP does not regard euthanasia as part of the practice of palliative care. “Palliative care affirms life, regards dying as a normal process, and intends neither to hasten nor postpone death,” the group says.
Instead the CSPCP advocates for improved access to affordable, equitable palliative care, more education for health care professionals, and access to advance care planning resources to empower Canadians in their own health care decisions. Specifically the CSPCP distinguishes between euthanasia—the deliberate administering of medication with the intent of ending a patient’s life—and continuous palliative sedation therapy. The latter is the proportionate administration of sedative medications intended to lower conscious awareness, relieving emotional, spiritual, and physical distress.
Now that the Supreme Court has cleared the way, a majority (74 per cent) of CSPCP members say they would not help patients commit suicide, but they do worry patients might face the significant gaps in access that women seeking abortions have encountered since the high court decriminalized it in 1988. That could certainly be a problem, with 54 per cent of Canadian Medical Association members surveyed in 2014 in favour of legalizing assisted death but only 27 per cent willing to participate. The Supreme Court has made it clear that doctors do not have to assist in death if it goes against their moral or religious beliefs.
“There’s nothing dignified about being killed,” Kelowna Right to Life Society’s executive director, Marlon Bartram insists. “We all have to die,” Bartram says, “But at the foundation of every civilized society, human life has dignity. At the foundation of the euthanasia movement is the idea there is life that is not worth living and that is a dangerous ideology to withhold.”
Which is not to suggest Bartram believes someone should be kept artificially alive either. “We have the right to refuse medical treatment in Canada and if a person of sound mind decides they don’t want life support or specific interventions, we don’t oppose that.”
The Canadian Society of Palliative Care Physicians says ‘No Canadian need feel that a deliberately hastened death is the only option to minimize suffering.’ The group advocates for improved access to affordable, equitable palliative care, more education for health care professionals and access to advance care planning resources to empower Canadians in their own health care decisions.”
Still, Bartram fears the slippery slope of legislating assisted suicide. “What we are opposed to is giving someone the right to end someone else’s life. If we do establish the right to die, how do we limit it to someone who is palliative? How do we keep the genie in the bottle? The door has been opened to widespread abuse.”
Freedom of Choice
Right to die advocates disagree, citing several US states, including Oregon, Montana, Vermont and Washington, that have legalized assisted dying, as well as Switzerland, Belgium, the Netherlands, and Luxembourg. They dismiss the notion a surge in assisted suicides will occur when legalized, pointing to the Netherlands, where less than 0.2 per cent of all deaths are assisted. Ultimately they believe in freedom of choice and the right of individuals to govern their own bodies.
Retired Kelowna accountant, Glenn Mageau, is a representative of the Okanagan chapter of Dying with Dignity. The national charity is committed to helping Canadians achieve quality in dying. With a member base from one end of the country to the other, a comprehensive staff and board, famous patrons including politicians, actors, and activists, and an advisory council of physicians, the organization is a powerful presence.
Like many Canadians, Mageau applauds the right to choose how to die in the case of terminal illness—a belief grounded partly in personal experience. He lost his 11-year-old son in a drowning accident in 1992. “They tried to keep him alive at any cost,” Mageau recalls. After five unfathomable days, Matthew succumbed to his injuries. While he might have been kept artificially alive, the essence of Matthew was gone and Mageau accepted that, taking comfort in knowing his son did not suffer in his final days.
More recently, Mageau witnessed the decline of his 93-year-old mother, bed-ridden with Alzheimer’s disease. Despite the exceptional care she received at a facility in Hope, Mageau knew it wasn’t where she would’ve chosen to spend her final days. “I have a daughter and three granddaughters. I don’t want them to go through this if I am terminally ill. I want the opportunity to have a choice to end it.”
That’s why he supports Dying with Dignity. The group strongly urges (and offers help in) advance care planning for Canadians. Such plans are designed to ensure patients get the treatment they want, bringing them peace, and alleviating their families of the burden of deciding what’s best. It’s been a battle, but Mageau is more optimistic about the future. “We’ve come a long way in the last 10 years. Hopefully we will see some common sense in new legislation.”
In the End
Perhaps none of us knows what we would do until faced with our own demise or that of a loved one. While we wait for a new chapter in Canadian history to be written, a doctor I know reminds me, “We are all dying; it’s just a matter of when.” Perhaps then our most important task is to revel in life.