Physician-assisted dying debate not over, Canada

OTTAWA—After fighting Lou Gehrig’s disease for two years, David Morrow refused medical care and asked his physician not to be resuscitated. On Dec. 3, 2013, a doctor unplugged David’s breathing machine; he died soon after.

He told his wife Joy Morrow that he did not want her to be in his room during this process. In Canada, it is legal for a patient to refuse medical assistance, and to then die of natural causes. But using medicine to help a patient die is punishable under the Criminal Code, as euthanasia.

Joy said her husband’s terminal illness was almost a blessing in disguise, because the nature of his illness meant he could decide how, and when he wanted to die.

“Others, who are very ill, who are experiencing excruciating pain and who are suffering, don’t always have that option,” said Morrow.

Lou Gehrig’s or amyotrophic lateral sclerosis (ALS) is a debilitating disorder that overtakes a person’s functional motor skills. It progresses so quickly that many patients die within two to three years after being diagnosed.

At the onset, things like writing or picking up objects become difficult, Joy explained.

“Something people really need to know is that my husband loved life. He absolutely loved it. It’s not that he was anxious to die. He just didn’t want to worry about how he was going to die, because he knew it was going to happen.”

Eventually, the disease paralyses the body and the person can no longer walk, eat and ultimately breathe.

Currently, there is no cure for ALS. There is treatment that can be administered to patients in the latter stages. But the medication only prolongs the person’s life by a few months.

Joy Morrow shares stories about her late husband David Morrow (© Laurene Jardin).

“He didn’t want to die like that,” she said.

“He wanted to be able to select when he’d had enough and have someone help him painlessly out of this world.”

Federal government dragging feet

Morrow’s husband died in December 2013, before the Supreme Court of Canada officially struck down a century-old ban on “physician-assisted suicide.”

So far, people suffering in the same way David Morrow did have found little reprieve in the Supreme Court’s decision.

After rejecting the criminality of assisted death last February, the Supreme Court of Canada asked the government to re-write the Criminal Code, bearing its new ruling in mind. The Tory government was then given one year—until Feb. 6, 2016—to draw up the new law.

But on Dec. 3, the new Minister of Justice, Jody Wilson-Raybould announced that she asked the Supreme Court for a six-month extension of the February deadline.

“The federal government’s response will affect all of society. That is why we are firmly committed to including Canadians and taking the time to develop a thoughtful, sensitive, and well-informed response,” Wilson-Raybould said in a news release.

Susan Desjardins, Ottawa’s chapter chair of Dying with Dignity, a group that has been a strong advocate for end-of –life care. Desjardins said she was disappointed with the government’s decision.

“People should know that most Canadians are for looking an option to end-of-life care,” said Desjardins.

An August 2015 poll done by Forum showed that 77 per cent of Canadians are in favour of physician-assisted dying—a three percentage point increase from the year before. In a special election poll in September, Forum reported that 63 per cent of Canadians were in favour of physician-assisted dying.

Karen Hill is among the group of supporters. She decided to prepare for her death after doctors announced that she had stage-three breast cancer. So far, Hill’s cancer treatment is working, but she said if her cancer advanced to stage four, she did not want to take anything to help her combat the illness.

Karen Hill says she likes to stay organized–even when facing death. (© Laurene Jardin)

Hill filed a Dying with Dignity Advanced Care package in addition to her own documents outlining how she wanted to be treated when faced with her imminent death. For instance, if she was in a state where only medication could keep her aliv­e Hill has written down that she does not want to be resuscitated.

“I couldn’t imagine my daughter having to do this by herself,” said Hill.

“It’s my final present to her.”

Quebec Superior Court says not yet

Until Dec. 1, 2015, Quebec was set to become the first province in Canada to enact a bill that would allow for physician-assisted end-of-life care.

But just two weeks before Bill 52, An Act respecting end-of-life-care, was scheduled to come into force, the Quebec Superior Court ruled to postpone it, stating that it contradicted the Criminal Code’s definition of euthanasia.

The injunction was ordered by the Physicians Alliance Against Euthanasia and Living with Dignity. Both groups argue that a doctor’s responsibility is to heal, not kill.

Living with Dignity chairman Aubert Martin said the government was going to have a hard time finding physicians to carry out the euthanasia process.

Maison Aube-Lumière and the Maison René-Verrier de Drummondville are the only two palliative care centres in Quebec that say they will help end a patient’s life.

In some countries that do have end-of-life care, Martin said, some studies have shown that the reason people ask to die is often because they feel they will lose their dignity in the eyes of others around them.

“They feel like they are going to be a burden for people around them,” he said.

“Your dignity doesn’t come from your state; it comes from being a human being.”

Karen Hill disagrees. She said the real crime was to deny a person who is suffering an option to exit their life without pain.

“I knew that I did not want to suffer. I have experienced pain and certainly discomfort,” she said.

“But the kind of terrible suffering I saw others experience I did not want for me and I did not want for my family.”

“Something people really need to know is that my husband loved life. He absolutely loved it,” said Morrow.

“It’s not that he was anxious to die. He just didn’t want to worry about how he was going to die, because he knew it was going to happen.”

Quebec’s Bill 52 crossed partisan lines. The province thought the bill would fall under provincial jurisdiction, because it treated the bill as a medical issue and not one of justice.

The provincial government has already said it will appeal the Superior Court decision.

In the meantime, Quebec Justice Minister Stéphanie Vallée has called on the Supreme Court of Canada to allow Quebec to go ahead with its bill as scheduled, until the federal government comes up out with its own legislation.

Joy Morrow said she believed the most important argument in this case comes down to a matter of choice.

“David did not believe that anyone should be forced to die. He would never tell anyone who didn’t believe in his choice that they were wrong.”

“But he also did not believe anyone should tell him, that his choice was wrong.”