OTTAWA - A long-awaited experts' report on how Canada and Canadian families handle the end of life calls on the federal government to decriminalize euthanasia and assisted suicide.
And if Ottawa won't co-operate, the panel says provinces should go it alone, by making clear they won't prosecute health-care professionals involved in assisted dying.
"Assisted suicide and voluntary euthanasia should be legally permitted for competent individuals who make a free and informed decision that their life is no longer worth living," says the report by the Royal Society of Canada's expert panel on end-of-life decision-making.
The report was two years in the making. It brought together a panel of experts on medicine, philosophy, ethics and health to look at what is being done in other countries, examine Canadian practices and sentiments, and formulate recommendations.
The panel was meant to be neutral, to inform rational debate and lead to solid policy in an area that is always emotional and controversial.
But the Euthanasia Prevention Coalition of Ontario dismissed the report before it was even public, saying at least one of the panel members is a noted euthanasia advocate.
"When we further investigated the panel members it was clear that ... this report would be a pro-euthanasia propaganda report," the group said in a news release Monday.
But the panel says that Canadians are overwhelmingly in favour of finding an even-handed way to allow voluntary assisted suicide but would not permit anything involuntary.
"We carefully considered Canadian values, international experience in permissive regimes, and legal and ethical aspects of these practices and came to the unanimous conclusion that Canada should have a permissive yet carefully regulated and monitored system with respect to assisted death," the report says.
In Canada and other countries where euthanasia and assisted suicide are against the law, it happens anyway, said panel member Jocelyn Downie.
She said that while euthanasia is clearly illegal in Canada, several other laws dealing with what doctors can and cannot do toward the end of a patient's life are unclear.
Indeed, the Supreme Court of British Columbia is holding hearings this week into whether doctors can help terminally ill patients die if the patients insist.
Controversy surrounding euthanasia aside, the main thrust of the Royal Society of Canada report was to stress that Canadian governments, institutions and families alike are doing a rotten job in preparing for death and dying.
"People simply do not talk and do not plan enough for the end of life," said Udo Schuklenk, a Queen's University philosophy professor who chaired the panel.
The panel urged far more attention to palliative care, living wills and public education about how to prepare advance directives for a patient's own health care.
Only a third of Canadians have any kind of advance directive, while fewer than half have designated someone who could act on their behalf, the report said. And just one in 10 has discussed the dying process with a doctor.
Palliative-care professionals are too focused on cancer patients and need to expand their expertise, the report urged.
The panel also dismissed the use of the word 'dignity' in discussions about the end of life. The word is abused by both sides of the euthanasia debate, and is too vague to do anyone any good, the report says.
Rather, in a desperate search to find some kind of common ground that would allow for a calm and respectful discussion on the end of life, the panel focused on 'autonomy' instead, said ethicist Daniel Weinstock from the University of Montreal.
The bottom line, he said, is that people want to be able to decide for themselves what will be done to them in their final days.