Last February, the Supreme Court of Canada released a landmark decision when it overturned the ban on assisted suicide and euthanasia. The justices gave the government one year to create new legislation to take its place.
However, it proved to be a monumental task, and the court recently granted the government a four-month extension to its original headline. In turn, the government has said that it will “move quickly, with care and diligence”.
This means that we can expect new regulations on doctor-assisted suicide by June—at the latest.
This is a both a highly controversial and an extremely delicate issue. The legal framework that must be created in order to facilitate the operation of legal, doctor-assisted suicide will require a great deal of thought, cooperation, and planning—from both federal and provincial governments. Realizing the extensive ramifications that this new legislation will have for generations to come, countless agencies, interest groups, and individuals have already weighed in on what ought and ought not to be done.
Last week, a comprehensive document was released by the Canadian Medical Association. It included a number of recommendations, squarely aimed at directing the government on how this legislation should be properly drafted.
It was created by the 80,000-member organization after consulting physicians, ordinary members of the public, and medical groups all over the country and focused on three big questions: how patients would become eligible for and access a doctor-aided death, what responsibilities doctors would have in dispensing this type of service, and how to properly balance doctor’s personally held values and freedoms with patient’s timely access to such services.
While a great deal is discussed in the CMA document, the ultimate takeaway is that legislators should respect the individual beliefs and personal values of Canadian doctors above all else.
The document states that no doctor “should be compelled to provide assistance in dying”. And it goes even further than that, stating that no doctor should be compelled to provide a patient referral to a college or clinic willing to provide the service, should they not wish to.
A number of other groups, including Dying With Dignity Canada, have already come forward to publicly condemn this stance. They say that the CMA’s list of recommendations does not do enough to protect patients who chose to have a peaceful, medically-assisted death.
They argue that if a doctor’s personal and spiritual beliefs are put at the legislative forefront, those living with chronic illness and intolerable pain are likely to be forgotten and will suffer unnecessarily.
In listening to the debates, it appears that there is a struggle brewing between the freedoms of doctors and the rights of patients—but balancing these two factors is really nothing new for our government.
For decades, Canadians have been dealing with this issue, as individual doctors routinely refuse to perform treatments or prescribe medications that they view as controversial or morally abhorrent. If you are having trouble thinking of examples of this phenomenon, or have not personally experienced it yourself, then you may want to ask any woman about accessing reproductive procedures and prescriptions, including, but not limited to, birth control, abortion, or sterilization.
Most—but not all—provinces recognize the potential for this kind of struggle between doctors and patients. They know that, if and when it emerges, it has the latent ability to cause harm to both parties.
In an attempt to balance these concerns, many medical regulatory colleges have established rules that require doctors to provide outside referrals should they wish to refuse medication or treatment to patients on a moral basis.
If these rules are to stay in place, they will likely extend to end-of-life treatments as well.
Indeed, many advocates for both doctors and patients alike have suggested the implementation of a multitier referral system. This would ensure that those who seek aid in dying are not left without any options, while also respecting the individual autonomy of doctors.
People living with chronic, intense pain or terminal illnesses are faced with choices that most of us are fortunate enough not to understand. The decisions they make are highly personal and do not come lightly.
At this stage, the vast majority of Canadians understand that. Over 84 percent of our population support the decision of a competent adult, suffering from terminal illness or unbearable pain, to end his or her own life with medical assistance.
It is now up to our government to decide how such services will be facilitated. This is no small task. But whatever our government decides to do, it will most certainly need to strike a balance between the protection of society’s most vulnerable individuals and the personal dignity that is afforded to all Canadians.