Few people probably noticed -- what with spring in the air, and the Habs preparing to play a crucial game against the New York Rangers -- but Bill 52, an Act Respecting End-of-Life Care, was quietly re-introduced yesterday in the new session of the Quebec National Assembly.
In a rare show of unanimity, the motion was adopted by all four major political parties, prompting CJAD radio host Dan Delmar to tweet: "Killing people is literally the only thing Quebec's four parties can agree on."
The reason the bill was re-introduced is because, when an election takes place, all legislation that has not passed dies, leaving the new government with a clean slate. But Premier Philippe Couillard (a physician himself, it should be noted) made it very clear that this bill was a priority to him when he was elected.
If all goes according to plan, the end-of-life care bill could be adopted before the session ends in June, and Quebec could become the very first province in Canada and one of the few places in the world that would allow doctors to administer lethal medication to terminally ill patients whose lives are nearing the end and who are in excruciating pain that simply cannot be alleviated by drugs.
The good news is, despite a small group of doctors and pro-lifers expressing their opposition, Quebecers are all for this bill! A recent poll indicated that support for euthanasia in the province was at a whopping 85 per cent. And if it has the backing of the majority of the Quebec population and its lawmakers (Bill 52 passed its second reading in the Quebec legislature in October by a vote of 84-26), what could possibly be the problem?
The problem is that Section 14 of the Criminal Code of Canada deems that those individuals who cause a death, even with that person's consent, are guilty of a crime -- a crime punishable by up to 14 years of prison. That means that a federal court might challenge a law legalizing euthanasia if it ever becomes reality.
Knowing the legal wrangling they would face, Quebec lawmakers recently added a very important amendment to Bill 52, specifying that the patient must "be at the end of life" to obtain medical aid in dying. They're hoping a court challenge would be averted with this very important specification that would act as a safeguard for those worried about the "slippery slope" argument (more on that later).
While Belgium seems to have been the model for the Quebec bill (although the Netherlands and Luxembourg have had similar legislation for more than a decade), this amendment moves it a little closer to U.S. legislation where euthanasia and doctor-assisted suicide already exists in a number of states, like Oregon, Washington and Vermont.
Nothing but confusion
One of the major problems with debating end-of-life care and euthanasia, is that, aside from the obvious emotional baggage and anxiety people carry around over life and death issues, in most instances people don't even know what they're debating!
There are significant differences between physician-assisted suicide and voluntary euthanasia. The former involves a doctor helping a patient end their life by writing a prescription for a lethal dose of medication. The latter involves the physician administering the final step, either by IV or by injection at the patient's request. The American States I cited earlier allow for physician-assisted suicide. Bill 52 would legalize both physician-assisted suicide and voluntary euthanasia.
Another big difference between European and American legislation is that in Europe "intolerable suffering that cannot be relieved by any means" can sometimes be enough for physician-assisted suicide, while in the U.S. there's no requirement of patient suffering. The only requirement is that the patient has an incurable and terminal illness, where terminal means that death is expected within six months. By adding the "be at the end of life" amendment, Quebec lawmakers seem to have been inspired by European legislators, but added U.S.-inspired safeguards to decrease the possibility of any court challenges.
Margaret Somerville, the founding director of the Centre for Medicine, Ethics and Law at McGill University, strongly disagrees with Bill 52. In an article last year published in the Globe and Mail, she stated that Quebec is trying to legalize euthanasia by simply calling it something less; "medical aid in dying." As far as she's concerned, it's still wrong.
Even federal legislation on euthanasia in Canada is confusing because it distinguishes between passive euthanasia (withholding or withdrawing of life-preserving procedures including water and food) and active euthanasia (intentionally killing a person to relieve pain). Whereas passive euthanasia is legal in Canada, active euthanasia is illegal and is considered to be murder.
But there's some serious hypocrisy behind all these little loopholes disguised as definitions (and while I'm no legal expert, there are some blaring contradictions staring at me here) aimed at creating safeguards for people, but mostly assuaging people's guilt at feeling that they are somehow responsible for someone's death.
Honestly, what is the real difference between "passive" techniques and "active" techniques in a world that barely sees any natural deaths? Are "passive" techniques more morally acceptable because they permit a natural death? Anyone who has ever experienced a hospital setting or spent a significant amount of time with a sick person who's been hospitalized knows only too well that everything involving hospitals and physicians prevents a natural death. That term barely has any meaning in today's world and we know that, yet we cling to some outdated overly moralizing view of "letting things run their course," even if the person is suffering immeasurable pain.
At the end of the day, what's the difference between killing and letting someone die? What's the difference between action and omission? Isn't it hypocritical and illogical that most current laws allow doctors to accelerate death by withholding a drug, but claim it illegal to administer a drug to achieve the same end?
We go around and around in circles, debating the intricacies and the small print in such legislation, but the controversy over euthanasia is always one of ethics and what's morally acceptable. Those in favour of euthanasia cite man's inalienable right to free will and happiness, and those against it cite the sanctity of life and the need to protect it.
As polarizing as the debate seems to be, I've never had any qualms publicly declaring that I strongly support assisted suicide. To be frank, I have trouble understanding those who don't.
I find the laws baffling. Drunk driving in Canada claims more than 1,600 lives a year. Yet a third DUI offense will only net you 90 days in prison and three years driving prohibition. Numerous drunk drivers who killed behind the wheel have received such lenient sentences they amounted to no more than a slap on the wrist. But if I assisted a loved one who was dying a slow and painful death, out of compassion and a desire to end their suffering, I would be subject to the same or even worse penalties as someone who indiscriminately and unconsciously mowed down an innocent pedestrian while driving drunk. Why?
Dying with dignity
Euthanasia literally means "good death" in ancient Greek. Just like it is our soul's obligation to seek happiness and fulfillment in life, it is perfectly reasonable to want a dignified death. We can philosophize all we want about the sanctity of life, but at the end of the day, if you were facing certain death from an incurable illness, while suffering intolerable pain, would you not want the option of ending it all, while you still had the capacity to? And wouldn't you see that as the ultimate act of compassion; not as a crime? I know I would.
And, to be honest, I'm rather tired of the whole "slippery slope" arguments always thrown at me to incite fear of mass "death camps" and visuals of frail, elderly people being "finished off" to make room for the able bodied and the healthy. The usual tactic is to remind people of (and somehow allow them to form an equation with) the chilling Nazi experience with euthanasia as proof of how quickly something well intended could spiral so horribly out of control. But what happened during Hitler's regime was never euthanasia, but a racist, eugenic agenda carefully disguised as mercy killings.
Despite the fear mongering, the state of Oregon has had a physician-assisted suicide law since 1997 and since the "Death with Dignity Act" was enacted there, there's been no evidence that the elderly or the disabled have suffered from abuse or exploitation. There are simply too many safeguards in place, ensuring that patients are of competent mind and consenting, on top of suffering from an incurable and painful illness.
Vermont, which just celebrated the one-year anniversary of the governor signing a measure allowing terminally ill Vermonters to take a fatal prescription, has reported that only two (just two!) Vermonters have filled prescriptions for medication to end their lives, but both ultimately died of natural causes. This has prompted many to speculate that, for those two patients, just knowing that choice was available to them might have been all the comfort they needed in their final days.
Let's be brutally honest here. A life lived in extreme pain is no life at all. That pain becomes all-consuming and you just become a sad shadow of the person you used to be, as you face the prospect of living like that till you die.
Since I'm on a roll, here's some more upbeat news for you.
We're all going to die. It's inevitable.
But shouldn't we get to decide to die with dignity, if we can? Why should making choices about our last days be anybody else's business, most certainly in terminal and other untenable situations? Isn't preventing a person's choice to lessen their suffering simply inhumane and the complete opposite of compassion? Isn't my right to my life (and my death) a fundamental human right that I shouldn't be deprived of because someone likes to debate abstract notions about how euthanasia would cheapen life's value? What does that even mean?
When those against mercy killings talk about "the sanctity of life" are they willing to take into consideration its quality?
A good death should be just as seminal as a good life and it's about time we had legislation that was honest enough, brave enough and -- most importantly -- compassionate enough to reflect a value that paradoxically at its core is much more life-affirming than what is currently in place.
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