Oct 05, 2012 02:06 PM EDT

Quebec To Pass MD-Assisted Suicide Law


A bedrock decision in Quebec has determined that medical doctors will now be permitted to aid terminally ill patients die, in "exceptional circumstances" and with their consent. Medically assisted-suicide has fueled ethical, legal and even religious and moral debates. The contention surrounding medically assisted suicide and the issue of consent has arisen continually. However, according to social services junior minister, Veronique Hivon, "We really feel that it is necessary to put forward such a possibility for people who, at the end of their life, are suffering in an unbearable manner."

The Quebec legislature passed the report Thursday, after two years of work from the Dying With Dignity Committee. The action was part of the Parti Quebecois' election agenda (Parti Quebecois is the minority government in Quebec at present) and likewise had the backing of the all-party National Assembly committee.  The Liberals have remained silent on the issue. 

The new "service" will be offered solely to adult Quebec residents with a terminal illness and incurable illness. Consent will be needed. This is consonant with the Civil Code of Quebec which  provides the legal framework which cements the concept that a person holds certain inalienable rights which may not be violated, or, if violated, must be sanctioned. "Every person is inviolable and is entitled to the integrity of his person... Except in cases provided for by law, no one may interfere with his person without his free and enlightened consent."(Article 10 CCQ)

Proponents for the legalization of euthanasia claim that the individual consent, autonomy and their free will. However, research demonstrates that many persons at that stage feel they are a burden to their family, friends and fear being neglected or alone. What is found is that, even visits from family and friends can greatly improve the well-being and optimism of patients who were otherwise think that there is no more reason to keep on living in suffering. Thereby, serious deliberations should be had in the face of such findings and the best solution may not be to have doctors whom the patients, families and public hold in high esteem, assist in killing them. The potential for the overall culture of the healthcare system would invert. 

Hivon elaborates that, "We're really talking about people who have unbearable suffering and who have no chance of improving their quality of life and whose death is really going to happen."

Nonetheless, the Criminal Code still prohibits medically assisted-suicide. Hivon asserts that Quebec can pass the law without the support of Ottawa as "Quebec has jurisdiction over health and also over professional qualifications" which "gives us the confidence to introduce this medical aid in dying in our bill." The passing of the law will place Canada under the umbrella of other countries who exercise physician assisted-suicide such as Switzerland, Belgium and the Netherlands along with a few American states. 

The decision for medically assisted-suicide will incur abysmal sociocultural burdens upon Canadian society and communities across the board. Have legislature carefully considered the ramifications that such a decision will mean for already vulnerable populations? Lawyers for the Euthanasia Prevention Coalition argue that legalizing medically assisted-suicide will culminate in elder abuse and disabled. As per Professor Margaret Somerville, legalizing euthanasia could be a huge step "backwards" for "Canadian values, ethics and law". 

Legalizing will not necessarily ameliorate the predicament of the elderly, disabled and other vulnerable groups, such as marginalized (such as the poor, homeless and mentally ill) and racialized individuals who already receive less than adequate care than the dominant population. The level of institutional racism with the Canadian healthcare system is glaringly evident, as per IPAC president Dr. Marcia Anderson explains, "The anecdotal evidence suggests an intolerably high level of racism in health care, and so does the formal evidence" and as such the organization put forth a "systematic review of multilevel racism within the health care system." In a country that boasts of a colorless and discrimination-free history, the evidence of stigmatization of marginalized groups and the disparities of healthcare in the Canadian health and medical system is marked by partiality and prejudice. Legalizing medically assisted-suicide will not necessarily promote the safeguarding of the rights of vulnerable parties and render the practice opaque as already pressing issues of inequality are continually brushed under the rug. 

The potential consequences that legalization may have on the life and death of patients needs further investigation and analysis at the crossroads of intersectionality and self-critical examination. 

In other provinces, such as British Columbia, the courts have struck down the ban on medically assisted-suicide.The British Columbia Supreme Court judge stated that the law prohibiting medically assisted-suicide is unconstitional because it discriminates against the physically disabled. The landmark decision by Justice Lynn Smith entailed a 395-page ruling concerning Gloria Taylor, a British Columbian woman who. because of her incapacity from ALS (Lou Gehrig's disease) was unable to end her own life and embarked on a legal venture which would give permission for her doctor to help kill her. Seeing as suicidee is not illegal in Canada, a physician assisted-suicide would not violate Section 15 of the Canadian Charter which guarantees equality. The rationale underlying the case was that Taylor should not be denied the same rights which non-incapacitated persons can exercise on their own agency and with their own hand-to take their own life. The ban against medically assisted-suicide is thus seen as "perpetuating a disadvantage" against the physically handicapped and further infringes on their Section 7 right to life and liberty. Taylor was "grateful" for the alleged cogent judicial decision. 

On the other hand, euthanasia being a right which must be exercised and respected runs counter to the legal culture of Canada which strive for the right to life guaranteed under the Charter. Other endeavors to save the life of terminally ill patients, as in the case of organ transplantation will seem negligible. Organ transplants are infrequent gifts of life and the question of consent and its alleged altruistic nature are already a pressing issues. Likewise, the lives of the terminally ill are precious and the legislative change may serve to metamorphose the legal culture of one which strives for death instead of life and materially alter the values, principles and ambitions which serve as the strong fibre woven into the health care system and deteriorate the public confidence in the administration of medical care and in medical professionals. 

Legalizing euthanasia dangerously enters a grey zone in which it would have been once clear that we are not to kill each other deliberately. How could the Quebec government further "improve the end-of-life care" which is "so important for the ill and their families"? (According to Maryse Gaudreault it would mean allowing people to determine when to die). Could better palliative care and research better aid improve the end-of-life stages of patients? 

Legislation reflects the social psyche of the times; however, it can also recreate and reconstruct new ways of thinking. 67% of Quebecers think the government should focus on improving access to palliative care (Environics). Viewing as life is valuable, the Quebec government does have the option to invest more money and resources into the efficiency of the health care system and research and encourage administrative and procedural changes to enhance the quality of life of patients in a more inclusive and holistic manner. Nevertheless, doctor assisted-suicide is an attractive, low-cost method of reducing health-care costs. Concerns that patients may feel like not only a burden to their loved ones but also a health care costs, are incontestable. The legislation may not resound with the overwhelming concern Canadians have that "abused elderly people would be pressured to consent" and that "a significant number of sick, disable and elderly would be euthanized without consent" (Environics Report 2010). How could public accountability be ensured when Canada there is already an absence of drawing the line of when to "pull the plug"? 

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