We live or die by the health of the physical environment which we struggle to conserve. Just as crucially, we are nourished by an ethical environment, the moral oxygen of our human world.
In the beautiful words of Dr. Margaret Cottle, a colleague of mine, we have been standing among ancient trees, an old-growth forest of noble principle. It has been growing organically for 2,400 years, since Hippocrates, a "delicate social ecology of mutual support and protection" which forbids the killing of a patient.
Carter v. Canada , the judge-decreed legalization of physician-assisted suicide and euthanasia in Canada, tries to take a chainsaw to that old-growth forest. Once it is gone, it will be gone forever. Plant some seedlings, but it will never be the same. Whether the prior Supreme Court of Canada ruling against this, and the clearly voted will of Parliament can be dismissed by a provincial court judge is now a topic of outrage.
What is notable and fascinating is how carefully this assault on our ancient and hard-won ethical environment has been planned. The door had to be opened, if only a crack, by using a story so compelling and a situation so extreme that ordinary people would be easily led by their compassion.
Carter v. Canada was at first only the tale of Lee Carter, an 88-year-old woman who was taken to Switzerland to die. The addition of likeable 64-year-old ALS victim, Gloria Taylor, four months after the lawsuit was launched, put meat on the bones of the case and has been a publicity triumph.
The general public thinks that the Carter ruling is only about appealing people like Gloria Carter with desperate terminal illnesses. Her lawyer, Joe Arvay, claims publicly that the case is only about a tiny number of people in clearly hopeless situations. This is a useful tactic to get one foot in the door.
It would be nice to know the final plan, and fortunately Jocelyn Downie, the architect of the whole strategy, spelled it out in 2008:
[T]here are many individuals whose lives are no longer worth living to them who have not been diagnosed with a terminal illness. They may be suffering greatly and permanently, but are not imminently dying. There is no principled basis for excluding them from assisted suicide.
Similarly, Arvay mused recently that his interest in the topic of euthanasia was sparked by seeing his mother "curled up in a fetal position for 5 years in a nursing home." Hard to give consent when you are demented. Maybe the need for competence and consent needs the re-thinking that is being urged in Washington state right now. Ominously, Arvay made this comment after delivering an invited lecture about assisted suicide and euthanasia at a Vancouver hospital for severely disabled children.
People who qualify to die under Carter would appear to not require physical disability (though it must be expected "soon"), and they must have a "serious" illness, which may be defined as "without remedy" if available care is not "acceptable to the person."
The suffering can be physical or psychological. ("Psychosocial" was disallowed in a burst of judicial restraint.) "Advanced weakened capacities." "No chance of improvement." The right number of hurdles to give some sport to the lawyers who will come after, but no problem jumping them if, say, you just stop taking your insulin: "Your honor, my client has had to thrust a sharpened tube of surgical steel into her person (see Section 7 of the Charter) four times a day for decades. How can the state force this agony to continue?"
Doctors have been free to abhor killing for 2400 years. It was a good run.