The Supreme Court of Canada decided unanimously February 6 that doctors may lawfully help competent adults, who are grievously and irremediably ill, to end their lives. The court gave the federal and provincial governments 12 month to respond with legislation.
Dr. Margaret Cottle, a Vancouver palliative care physician who teaches at the UBC medical school (and is vice president of the Euthanasia Prevention Coalition and actively involved with the Christian Medical and Dental Society), expressed her reaction to Rick Cluff on CBC’s Early Edition the same day:
We’re very disappointed by the decision, but we certainly accept the court’s ruling from this and hope to be able to help to shape the legislation so that this applies as narrowly as possible. This is very disturbing, the ruling of the court, because . . . what they have said is ‘intolerable suffering’ – they have not made any mention of being near the end of life . . .
The reasons that people use in other jurisdictions [to seek assistance in ending their lives] are loss of control, disability of some sort – being unable to do the types of things they have done in the past. The concern is that if we see disability as a reason to allow people to have help killing themselves, or to kill them, then what are we saying about disability.
So, it’s not just about someone who says, “I’ve had enough.” It’s about the rest of us saying, “You know what, there are some lives that aren’t worth living and we’re willing to agree with you that your life is not worth living.” And I think we’re bigger people as Canadians and I hope that we can actually come alongside people, instead of saying, “We agree with you, your life is not worth living.”
I respect the court’s decision, there will have to be legislation made, but their ruling is very broad and I hope that we can make legislation that will be protective of people who are in situations where they may be desperate, but not necessarily right at the very end of their lives. They maybe have quite a bit of life left to live.
Today’s decision of the Supreme Court fundamentally alters end-of-life for all Canadians. The Council of Canadians with Disabilities (CCD) and the Canadian Association for Community Living (CACL) are profoundly disappointed by today’s ruling and extremely concerned about the implications of the ruling.
An immensely important discussion must now begin with Canadians and politicians at all levels, with civil society, health professions and the legal community. We start from the premise that the lives of Canadians with disabilities are worthy of the utmost respect. Such respect, regrettably, cannot be taken for granted.
The CCD released a list of 11 key concerns the same day:
1. The judgment creates the potential for the most permissive and least restrictive criteria for assisted suicide in the world, putting persons with disabilities at serious risk.
2. CCD and CACL are disappointed that the views of people with disabilities in Canada, as shared by the leading disability advocacy groups around the world, were disregarded by the Court.
3. The Court did not impose a requirement of terminal illness, as is required in the states of Washington and Oregon.
4. The judgment permits assisted suicide on the basis of psychological suffering. This places people with serious mental and emotional disabilities at risk, as well as people who have not yet come to grips with their disability.
5. The judgment allows people to decline palliative and other care that would alleviate their suffering, and imposes an obligation on the state to provide Assisted Suicide, but not palliative care.
6. The Court has focused on striking the law using two potentially expansive criteria – in doing so, it paid no attention to ensuring Assisted Suicide is limited to a small number.
7. The judgment makes the existence of a “grievous and irremediable medical condition,” rather than a terminal illness, one of the two primary criteria – this potentially means that all persons with a serious disability in Canada can access Assisted Suicide. This degree of permissiveness does not exist anywhere else in the world.
8. The second criteria, “intolerable suffering,” is completely subjective and will make it difficult to review decisions of doctors like Dr. Kevorkian who felt the existence of a disability was intolerable.
9. Numbers are revealing – in Belgium, the number of Assisted Suicide deaths has increased an average of 47.77 percent annually since 2003, and in the Netherlands it has increased 64.13 percent since 1995, with no end in sight to this increase.
10. Parliament can and should act to place crucial safeguards on the Court’s judgment to limit access to assisted suicide.
11. CCD and CACL call on Parliament to show national leadership on the issues of palliative and long-term care to reduce the number of people who will choose assisted suicide out of desperation because they do not have access to support systems to ease their end of life.
Archbishop J. Michael Miller of the Roman Catholic Archdiocese of Vancouver said:
The Supreme Court of Canada erred grievously in stripping Canadians of the protection that the law afforded them against assisted suicide. I am deeply troubled by the Court’s decision to overturn the law and I call on Catholics to join with other advocates for vulnerable persons to respond with urgency.
The diocese has created a page with a number of useful links – including the Evangelical Fellowship of Canada – on the issue.
And for a biting commentary, try A Truly Bizarre Lapse, by Peter Stockland of Cardus. After looking at some potentially good results of the Supreme Court ruling, and the obvious bad one that “there will be some form of assisted suicide available in Canada within the next 13 months,” he notes:
It’s entirely possible assisted suicides will take place in the absence of any law. This is the ugly prospect that few seem to fully recognize in the aftermath of the decision. . . .
We are, as many have noted, literally lawless on abortion, and have been for 27 years. There is no existing medical regime for assisted suicide. If Parliament fails to enact a new law within a year, we won’t have doctor assisted suicide. We won’t have a law governing assisted suicide. If recent history is a guide, we genuinely risk never having one. Enter the butcher and the public hangman. Enter the barbarians. That makes this decision, potentially at least, one of the ugliest moments in Canadian history.
We should have an interesting year ahead of us.