Compassion in the face of death
Last week, the Supreme Court of Canada unanimously struck down the law that makes it illegal for doctors in Canada to provide medical assistance to severely ill patients who wish to die.
The court decision permits physicians to assist in the suicide of “a competent adult person who clearly consents to the termination of life and has a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”
The decision reflects a fundamental shift in societal opinions toward end-of-life issues. It is worth noting, at this point, that attitudes toward death, life and intervention have never been static. As medical technologies advanced in recent decades, some (primarily religious) voices argued that these technologies interfere with the will of God by “artificially” extending life. Now, the reverse is apparently true. It tends to be religious voices today arguing that, in some cases, the withdrawal of life-extending technologies and treatments is akin to exercising the prerogatives of the Divine in ending life.
Whatever moral concerns surround this serious issue, an understandable dissonance has affected Canadians’ attitudes: it has been noted that there are times when we force human beings to endure suffering at the end of life beyond what we would permit our pet animals to experience.
Many Canadians who have watched loved ones suffer excruciating and slow illness and deaths recognize that human suffering could be more compassionately ameliorated. Among the first steps should be the provision of the best palliative care available. When absolutely no better option exists, assisted death may be the best choice for some individuals. Most of us can see this. We may wish it weren’t so and, of course, we hope we and our loved ones are never faced with these decisions. The fact is, many of us will.
Yet, every instance in which an individual, their family and doctor make decisions about end-of-life preparations must be entirely individualized. There is absolutely no way that one can apply the same criteria to two cases. Circumstances are not transferable between diseases, patients, families or belief systems. Two people with identical conditions and prognoses may justifiably choose diametrical endings.
Indeed, we must ensure that assisted death does not become a go-to “solution” when alternatives exist, or that any patient feels the slightest pressure to choose it. There is a real danger that some people will weigh decisions not on what is best for themselves but what they perceive as best for others or based on what others in similar situations have done. Not wanting to be a “burden” should not be a legitimate justification for assisted death.
There is genuine and justifiable fear around the potential for a “slippery slope.” It is important to note that this Supreme Court decision deals
with the rights of an individual of sound mind to make a decision on their own in consultation with those they trust to end a life of suffering dominated by unbearable pain and the absence of hope for recovery.
Euthanasia is an entirely different matter. It does not involve an individual’s free and informed choice. The fear is that the acceptance of assisted death will make our society more amenable to – or at least less vigilant against – euthanasia. This is not a consideration to be dismissed. The sanctity of human life is too great to ignore the fact that human beings have the capability of justification for all sorts of things. So, as Canada engages in discussions about this ruling, we should also be vigilant in reasserting our fundamental beliefs that the value of life is not diminished by the legalization of assisted suicide, but rather our humanity and the right of all Canadians to a decent life and a respectful death is part of a worldview that is life-affirming.
Certainly there is nothing happy about this subject, but if this decision makes the end of life more bearable for some Canadians then it should be welcomed. Safeguards are absolutely crucial and, as a society, as families and as individuals, we must discuss and understand the limits and potential misuses of this new freedom.
It is so important that we as a society get this right. The federal government will address this issue in the coming months. The Supreme Court has spoken, as often happens in this country, leading legislators in social progress. It’s our turn now. Canadians should have a long, thoughtful and nuanced discussion on this topic.