A proposed euthanasia bill is going through its second reading in Parliament. If passed, the bill would make euthanasia and physician-assisted suicide legal, so long as the patient is terminally ill and is in severe pain. The Canadian public is once again in a fierce debate: a recent poll shows 61 per cent of the population approves of legalizing euthanasia, in Quebec the number is near 75 per cent. But a large number in favour are also worried about the harms of enacting such a bill.
The worries are well-founded. The potential for a person to be killed against their will means it's essential to build a variety of measures to avoid that outcome into the process. Also, the majority of doctors are against active euthanasia, as they view it as a form of harm: the very thing they swear to never do when they take the Hippocratic oath.
The large number of websites protesting the bill are mostly troubled by the bill's wording and only in passing mention its deeper implications. Euthanasia supporters are similarly troubled by the prospect of people being killed against their will, so it isn't an argument against euthanasia at all. The word euthanasia, after all, means "good death," which would not the word to use if one was killed against their will. But to be fair, those who oppose euthanasia are simply trying to remain consistent: killing, they say, is always wrong, because human life has intrinsic value.
Feelings such as those are sincere, but mistaken. Killing ought to be done when the person asks for it as a means to escape tremendous suffering from which recovery is unlikely. The goal of medicine when treatment is no longer possible should be to limit suffering; choosing not to act is a worse decision if it will lead to more pain. Changing the focus to quality of life, instead of quantity, also means that active euthanasia should be promoted over its passive form: to let someone die of starvation or dehydration is cruel when the goal is death anyway. In any case, it should be the person's choice, as long as other treatment options have been ruled out.
The most important step to limiting abuses of euthanasia laws would be to educate every person to have a living will made. This would minimize the misreading of someone's wishes should they become incapable of vocalizing them in their disabled condition. Explicit instructions for what constitute grounds for euthanasia will be different for each person, but in each case the person making the living will should be aware of the implications of drawing that line in different places, or not at all. With such clear instructions it will be less likely that people will choose no action to end their lives: dignity, concern for one's family and a desire to avoid intolerable pain all are strong reasons to allow active euthanasia.
What about in cases where no living will was made? These are obviously more difficult. The best method would be to establish a consistent standard for making the choice on behalf of another, involving people close to the person, the doctor in charge of the case, another doctor uninvolved with the case and a different person to administer the drug.
This last addition is necessary for two reasons. First, it will avoid doctors having to break their code and minimize acting too early. In Switzerland, where assisted suicide is legal but euthanasia isn't, the lethal drug cannot be delivered by a doctor. Keeping the two practices separate is valuable. Second, doctors are trained in science, not ethics. This difference is important, because although doctors clearly play an important role in deciding a patient's future, their job is distinct from deciding when death is the best option; and most of them lack training to adequately explain arguments for or against euthanasia. Throughout life the family doctor should be given the role of encouraging patients to consider a living will and answering any medical questions they may have.
Bill C-384 is unlikely to pass. While killing is demanded if a pet is suffering, people still have difficulty causing a human death, even if it's the most reasonable option. The choice will be hard, but there is nothing ethical about letting nature take its course.