REALity April 2019

Physician-Assisted Suicide in Quebec Roars Ahead

Legislation to permit “physician-assisted suicide” is just a polite way to cover up the fact that this procedure is, in effect, euthanasia. This is based on the fact that the physician supplies the lethal drugs to individuals to either commit suicide themselves or for the physician to administer the drug. Because this procedure is such an extreme departure from the ethics of medicine, a euphemism for this legislation was required, so it is now called Medical Assistance in Dying (MAID). Whatever it’s called, this doesn’t change the fact that it is the physician or nurse practitioner who is killing the patient or is handing over the syringe for the patient to kill himself.

The Supreme Court of Canada handed down a decision in the Carter case in February, 2015, to legalize this heinous act of killing. In doing so, the judges smugly stated that assisted suicide, if properly designed, with stringent safeguards, was capable of protecting vulnerable people from abuse and error. The judges were misguided. They only had to look to the Netherlands, which decriminalized doctor assisted suicide in 2002. That law has been extended from killing the terminally ill to those suffering from chronic diseases, including those experiencing physical illnesses or psychological afflictions. Half of the deaths from assisted suicide are not even recorded in the Netherlands, and about a quarter of those are done without the patient’s consent. Belgium also legalized assisted suicide in 2002, and 12 years later began to euthanize infants born with handicaps. It is now legal to kill anyone in Belgium who is simply “tired of life”. The lack of background knowledge and common sense by Canadian judges, who made this major decision, legalizing assisted suicide, is disturbing.

Once the door to assisted suicide is opened, it becomes a slippery slope encompassing more and more individuals. No matter how the legislation is worded, assisted suicide becomes a train without brakes: it heads downhill at greater and greater speed to disaster. This is because advocates for physician-assisted suicide just hate any restrictions to the procedure. They firmly believe that individuals should be able to request instant death without any restrictions, hindrance or red tape.

The Assisted Suicide Law

The federal assisted suicide laws brought into effect in June, 2016, require that the patient’s death must be reasonably foreseeable before the assisted suicide can take place. Such a barrier is regarded as too restrictive a requirement by advocates for assisted suicide.

Previous to the Carter decision, Quebec had convinced the Supreme Court of Canada (it was not hard to do with a court invariably happy to overturn any laws based on time-tested Judeo-Christian ethics) that assisted suicide was not really a matter for the Criminal Code (federal jurisdiction) but really was only a matter of heath care to be determined by provincial jurisdiction. Consequently, Quebec’s own assisted suicide legislation was upheld by the Supreme Court in December, 2015 – six months before the federal legislation was passed into law. The Quebec legislation requires that assisted deaths may occur only at the end of life of a person who is in an “advanced state of irreversible decline in capability”. Predictably, court challenges have been launched to overturn these restrictions.

Shockingly, only 15% of patients in Canada receive adequate palliative care. Health care funds are instead directed to terminating life – which has become a legal, tax paid entitlement.

There was a 75% increase in assisted suicide in Quebec for the 9 months from July 2017 to March 2018, compared to the 12 months from July 2016 to June 2017. Further, of the 1,664 deaths between December, 2015 and March 31, 2018, by assisted suicide in Quebec, 10% were not administered according to the law, either because of incomplete paperwork, or because the law was simply ignored.

What is even more disconcerting is the fact, according to the Journal of Medical Ethics (September, 2018), that there is little or no attempt in the Quebec health care system to offer a patient alternatives, such as medical, social or psychological care to alleviate that patient’s suffering. That is, killing the patient by assisted suicide is the first and often only path offered to the patient. Thus, killing by assisted suicide has become normalized, and has become a tax paid entitlement without moral implications.

Palliative care has been lost in this turn of events. Good palliative care makes euthanasia unnecessary, and the failure to offer it to patients is a “no confidence” vote in the physicians’ conduct, and ability to control symptoms and to provide true compassion for patients.