Imagine a Canada where doctors could prescribe death to depressed teenagers, shadowing the online predator who coached 18-year-old Nadia Kajouji to drown herself in the frozen Rideau Canal three years ago.
A Royal Society of Canada expert panel would see such a nightmare become reality, urging in a landmark report that government should legalize euthanasia and physician-assisted suicide for all “competent” adults who want to end their lives, regardless of whether they actually have a terminal illness.
But before Canadians consider making assisted death a “choice,” shouldn’t we first address the untreated physical, emotional and existential suffering that’s making it an imperative?
The fact that some 67 per cent of Canadians agree that death by doctor is a necessary alternative to the supports provided by our health system and social services speaks more to the abject failure of our society to care for its most vulnerable than it does to the wisdom of physicians donning executioner hoods.
People who would give doctors a license to kill argue that denying Canadians access to assisted death essentially sentences them to enduring immense, unmanageable and prolonged physical pain at end of life.
This should not be.
Modern medicine is capable of managing most pain through palliative care. Where ordinary pain relief measures fail, patients have the option of being kept unconscious until they die. Patients with terminal illness can also refuse life-prolonging interventions, including food and fluids, and receive comfort care to alleviate thirst, hunger and other discomforts in the interim.
The clear legal and moral difference is that the physician is working to improve the patient’s quality of life within the spectrum of interventions they have consented to, as opposed to actively ending the patient’s life via lethal injection or toxic cocktail.
Some 95 per cent of deaths would benefit from such care, but as many as 70 per cent of Canadians lack access because hospice and palliative care programs are unevenly distributed across Canada, the Royal Society panel estimates.
They contend that Canadians can’t wait for palliative care to be “optimized” before offering euthanasia and assisted suicide as an alternative. But let’s not pretend that patients are free to choose when the options are torture or death.
The appropriate treatment for unmanaged pain at end of life is palliative care.
But inadequate pain relief isn’t the only reason why Canadians are requesting death, as made evident by the plaintiffs in a British Columbia legal battle that’s currently being waged to overturn the Criminal Code’s prohibitions against assisted suicide.
They want to be allowed death at the hands or with the help of a doctor because they believe, like too many Canadians, that disability is a worse fate.
Considering the social climate in Canada towards people with disabilities – the hallmarks of which include institutionalization, neglect, abuse and impoverished resources – it’s easy to see why they feel this way.
Over two million Canadians adults with disabilities lack one or more of the educational, workplace, home or other supports they need, according to the Council of Canadians with Disabilities.
More than 56 per cent are unemployed or out of the labour market. And more than 10,000 persons with intellectual disabilities are confined to institutions.
Those who would endorse so-called ‘mercy’ killings as a solution are only further perpetuating the negative attitudes that cause these social ills in the first place. It’s a sick kind of mercy that would grant people the dignity in death that was withheld from them in life.
And can the suicide of a person who experiences constant societal devaluation be deemed free from coercion?
Indeed, is anyone truly a competent decision maker if they are suicidal?
This question is particularly disturbing when one considers that the Royal Society expert panel would provide the same access to death to a heartbroken 18-year-old as it would to a 90-year-old in the terminal stage of an illness.
Depression, or simply going through a rough patch in life, should be answered with counselling and community, not a poison pill.
Meanwhile, abuses in jurisdictions that permit doctors to kill or assist the suicide of patients are well documented.
In Belgium, one-third of euthanasia deaths occur without the explicit request of the person killed, according to a 2010 study.
Reports from the Netherlands indicate that 500 people were put to death without their consent in 2005 alone.
Death being facilitated by the same institutions that are supposed to preserve life can also create a deadly conflict of interest in resource-limited environments.
Cancer patients in Oregon, for example, have received letters from the state health plan explaining the financing body won’t pay for costly yet potentially life-saving drugs, but will pay for assisted suicide.
The Royal Society panel members contended at a press conference that such cases of involuntary euthanasia and coercion already occur under the radar in Canada, and changing the law would allow health authorities to monitor such abuses better.
But the argument that abuse of the law necessitates changing the law is ludicrous.
Allowing physicians to kill people because physicians are already illegally killing people is no different than lifting prohibitions on murder because a serial killer is on the loose.
Until Canada closes the gaps in our health and social services that cause people to request death, the choice to die will never be free.
So before Canadians go gently into that good night, they deserve better access to the services that bring light into life.