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Online Exclusive: Euthanasia bill has my vote

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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.

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Adults should be able to determine the time of their own death. This should include psychological problems with no chance of correction.

For assisted suicide but against voluntary euthanasia !

About the difference between euthanasia and assisted suicide, one must distinguish between the legal, ethical and religious arguments. One cannot just say without qualification that there is no difference between the two : in one case it is the patient himself who take his own life (assisted suicide), whereas in euthanasia it is the physician. One must first specify on what grounds (legal, ethical or religious) he draws is arguments. In the field of ethics, one can reasonably argue that there is no difference between the two. However, in the legal field, there is a difference between euthanasia (so-called first-degree murder with a minimum sentence of life imprisonment) and assisted suicide (which is not a murder or homicide and which the maximum sentence is 14 years of imprisonment). In the case of assisted suicide, the cause of death is the patient\'s suicide and assisted suicide is somehow a form of complicity (infraction of complicity). But since the attempted suicide was decriminalized in Canada in 1972 (and in 1810 in France), this complicity (infraction of abetting suicide) makes no sense because this infraction should only exist if there is a main offence. But the suicide (or attempted suicide) is no longer a crime since 1972. So, logically, there cannot be any form of complicity in suicide. The offense of assisted suicide is a nonsense. Judge McLachlin said :

« In summary, the law draws a distinction between suicide and assisted suicide. The latter is criminal, the former is not. The effect of the distinction is to prevent people like Sue Rodriguez from exercising the autonomy over their bodies available to other people. The distinction, to borrow the language of the Law Reform Commission of Canada, \"is difficult to justify on grounds of logic alone\": Working Paper 28, Euthanasia, Aiding Suicide and Cessation of Treatment (1982), at p. 53. In short, it is arbitrary »

In contrast, voluntary euthanasia is considered a first-degree murder. The doctor kills the patient (at his request) by compassion to relieve his pain and suffering. There\'s a violation of one of the most fundamental ethical and legal principles : the prohibition to kill a human being. Our democratic societies are based on the principle that no one can remove a person\'s life. The end of the social contract is \"the preservation of the contractors\" and the protection of life has always founded the social fabric. We\'ve abolished the death penalty in 1976 (and in 1981 in France) in response to the « broader public concerns about the taking of life by the state » (see United States v. Burns, [2001] 1 S.C.R. 283) ! Even if voluntary euthanasia (at the request of the patient) may, under certain circumstances, be justified ethically, we cannot ipso facto concluded that euthanasia should be legalized or decriminalized. The legalization or decriminalization of such an act requires that we take into account the social consequences of the legalization or decriminalization. The undeniable potential of abuse (especially for the weak and vulnerable who are unable to express their will) and the risk of erosion of the social ethos by the recognition of this practice are factors that must be taken into account. The risk of slippery slope from voluntary euthanasia (at the request of the competent patient) to non-voluntary euthanasia (without the consent of the incompetent patient) or involuntary (without regard to or against the consent of the competent patient) are real as confirmed by the Law Reform Commission of Canada which states :

\"There is, first of all, a real danger that the procedure developed to allow the death of those who are a burden to themselves may be gradually diverted from its original purpose and eventually used as well to eliminate those who are a burden to others or to society. There is also the constant danger that the subject\'s consent to euthanasia may not really be a perfectly free and voluntary act ».

Eric Folot