By Sabrina Almeida
All attention is on the Senate which has the daunting task of giving Bill C-14 (medically-assisted dying) an appropriate form by June 6. Despite due diligence the senators might still not be able to craft a version that it is accepted by all Canadians given the country’s distinct polarization into pro-life and pro-choice groups. Then there are those undecideds who subscribe to the idea of being given a choice but are unsure of what it really means.
Some in the pro-choice group feel current guidelines for eligibility are too limiting and would like to include advanced consent for patients with degenerative disorders as well as extend the right to die to “mature minors”. When tabled in Parliament in April, the bill restricted doctor-assisted death to mentally competent adults who have a serious and incurable illness, disease or disability who are “suffering intolerably” and whose death is “reasonably foreseeable.”
I agree with the “mentally competent” but am extremely uncomfortable with the “mature minors” part, perhaps because I am a mother.
On the other hand, the pro-life group (many of whom are governed by religious sentiments) is afraid of the consequences of having such a legislation. Some believe that simply having the choice might tempt or provoke eligible patients to choose death. Healthcare providers with a pro-life stance are also torn between their professional responsibilities and moral code. Many feel they will not be able to act contrary to their values and should not be forced to recommend other practitioners who will perform the necessary services either. It is similar to aiding and abetting suicide.
For others that are wavering in their decision it is not as simple as being pro-life or pro-choice. Accepting or consenting to a loved one’s right to die is a bitter pill to swallow. While it is the patient’s choice, there is no doubt that family members can sway their decisions. As one gentleman who is pro-choice remarked, even in the case of the terminally ill hope can prolong life. To consent to death is to give up hope and vice-versa. Is that fair?
My personal experience with several cancer patients compels me to agree. What other explanation is there when two men who were given six months to live by several doctors defied the odds. One lived for more than six years and the other over four. Whether they had quality of life or not is subjective. As an observer I can only say that they made the best of the time they had. Were they still with us, I would like to hear their perspective.
Others are worried about whether the bill will encourage healthcare practitioners and hospitals to hasten death in cases where the end is perceived to be close. This might seem ludicrous keeping in mind the Hippocratic Oath, but is disturbingly true. I’ve been told by more than one person about the deliberate neglect of the elderly and terminally ill in order to hasten death and make space for other patients. In fact one lady was beside herself with worry for her elderly mother. Having being a nurse in a prominent hospital for many years, she was familiar with the scenario. Divan Chand who is fighting to keep his wife Veena on life support at an Alberta hospital might agree.
While the medically-assisted dying bill does not put the decision in the hands of doctors, there is no doubt that their opinion prompts a patient decision. Imagine if the men I mentioned above had decided to end their lives based on the initial prognosis. One of the greatest burdens the seriously ill must bear in addition to their own pain and suffering, is what it does to their loved ones. They might choose death simply not to be burden. While it is still ‘their choice’ and irrespective of the motivation, this is not the spirit of the bill.
What is also uncertain is how it can be determined whether or not a patient is being coerced into the decision by vested interests.
Isn’t it also shameful that some Canadian believe the terminally ill or those nearing end-of-life should not be a burden on the system i.e. waste valuable healthcare dollars and hence choose to die?
What is also not clear is whether an individual can make decision in advance of being ill. I’ve come across many men and women who do not wish to be put on life support should the situation arise. Will such wishes which are documented in a living will be upheld?
The Senate’s decision (or lack of) will shape many life and death choices going forward, yet there will be more than a few Canadians who will continue to grapple with this deeply personal decision. After all it is not an easy one to make in advance or when the time comes.