The latest buzz on Facebook among Canadians, it seems, is a new bill put before Parliament which would amend the Canadian Criminal Code with regards to Medical Euthanasia. (Currently, any type of euthanasia on a human being is illegal by Canadian Law) Naturally, the idea of the “right to die with dignity” is a very, very hot topic.
My first resort in the face of such a hot topic is to seek facts, so I tried to find this bill on Google. Right away, the search engine displayed many websites set up in opposition to the bill, but not the bill itself. Plenty of emotion and very little fact is out there to be seen, which motivated me to start researching and writing. I find that many opinions on such sensitive topics are emotionally based, reactionary and prone to various types of fallacy (particularly opposing opinions), which I think does a disservice to both sides of the argument.
The purpose of this essay is not to take a definite position either for or against this bill, but to examine the arguments made against it and how they stand up to the actual wording of the bill. I am “playing Devil’s Advocate” because I have not found any really compelling arguments in favour of this Bill, which skews the argument in one direction in my opinion.
After some digging, I did find the actual Bill and I am going to provide the link and provide the word for word bill below first so that it can be referred back to if needed.
Link to the Government of Canada website where the bill is posted:
http://www2.parl.gc.ca/HousePublications/Publication.aspx?Docid=3895681&file=4The actual wording of Bill C-384 (1):
C-384
Second Session, Fortieth Parliament,
57-58 Elizabeth II, 2009
HOUSE OF COMMONS OF CANADA
BILL C-384
An Act to amend the Criminal Code (right to die with dignity)
________________________________________
FIRST READING, MAY 13, 2009
________________________________________
MS. LALONDE
402101
SUMMARY
This enactment amends the Criminal Code to allow a medical practitioner, subject to certain conditions, to aid a person who is experiencing severe physical or mental pain without any prospect of relief or is suffering from a terminal illness to die with dignity once the person has expressed his or her free and informed consent to die.
Also available on the Parliament of Canada Web Site at the following address:
http://www.parl.gc.ca
2nd Session, 40th Parliament,
57-58 Elizabeth II, 2009
HOUSE OF COMMONS OF CANADA
BILL C-384
An Act to amend the Criminal Code (right to die with dignity)
R.S., c. C-46 Her Majesty, by and with the advice and consent of the Senate and House of Commons of Canada, enacts as follows:
1. Section 14 of the Criminal Code is replaced by the following:
Consent to death 14. Subject to subsections 222(7) and 241(2), no person is entitled to consent to have death inflicted on him or her, and such consent does not affect the criminal responsibility of any person by whom death may be inflicted on the person by whom consent is given.
2. Section 222 of the Act is amended by adding the following after subsection (6):
Exception
(7) Despite anything in this section, a medical practitioner does not commit homicide within the meaning of this Act by reason only that he or she aids a person to die with dignity, if
(a) the person
(i) is at least eighteen years of age,
(ii) either
(A) continues, after trying or expressly refusing the appropriate treatments available, to experience severe physical or mental pain without any prospect of relief, or
(B) suffers from a terminal illness,
(iii) has provided a medical practitioner, while appearing to be lucid, with two written requests more than 10 days apart expressly stating the person’s free and informed consent to opt to die, and
(iv) has designated in writing, with free and informed consent, before two witnesses with no personal interest in the death of the person, another person to act on his or her behalf with any medical practitioner when the person does not appear to be lucid; and
(b) the medical practitioner
(i) has requested and received written confirmation of the diagnosis from another medical practitioner with no personal interest in the death of the person,
(ii) has no reasonable grounds to believe that the written requests referred to in subparagraph (a)(iii) were made under duress or while the person was not lucid,
(iii) has informed the person of the consequences of his or her requests and of the alternatives available to him or her,
(iv) acts in the manner indicated by the person, it being understood that the person may, at any time, revoke the requests made under subparagraph (a)(iii), and
(v) provides the coroner with a copy of the confirmation referred to in subparagraph (i).
Definition of “medical practitioner”
(8) For the purposes of subsection (7), “medical practitioner” means a person duly qualified by provincial law to practice medicine.
3. Section 241 of the Act is renumbered as subsection 241(1) and is amended by adding the following:
Exception:
(2) A medical practitioner is not guilty of an offence under this Act by reason only that he or she aids a person to commit suicide with dignity, if
(a) the person who commits suicide meets the conditions set out in paragraph 222(7)(a); and
(b) the medical practitioner meets the conditions set out in paragraph 222(7)(b).
Definition of “medical practitioner”
(3) For the purposes of paragraph (2), “medical practitioner” means a person duly qualified by provincial law to practice medicine.
Published under authority of the Speaker of the House of Commons
________________________________________
Available from:
Publishing and Depository Services
Public Works and Government Services Canada
________________________________________________________________
Upon reading the bill in its entirety, I then started to look at the opinion sites to see what kinds of arguments are being made for or against this bill. I shall examine some arguments and compare it to the bill.
Looking online, I have found many arguments against this bill and very few in favour. Therefore, I am going to play devil’s advocate and look at these arguments/ask questions. Most groups who are against this are disability rights groups and religious organizations.
Some of the arguments being made against Bill C-384:
Argument one: “This bill includes depressed 18-year-olds who refuse ‘appropriate treatments’ like say, refusing to take their Prozac. So killing off depressed teens who refuse their meds is now ‘ultimate compassion.’” According to Licia Corbella, an opinion columnist seen in a few newspapers (1) - First off, the bill states that only medical professionals can conduct this action after certain steps are taken, including: having “provided a medical practitioner, while appearing to be lucid, with two written requests more than 10 days apart expressly stating the person’s free and informed consent to opt to die.” Medical practitioner by definition in the bill is a person who is licensed to practice medicine (not just someone who works in the medical field - they have to be certified by the Canadian College of Physicians and Surgeons). If a person is suicidal, they are considered mentally ill, which is generally not considered lucid. The person might also be considered as being “under duress” which again voids their eligibility.
Therefore, if said 18 year old refuses his meds and wants to commit suicide per this bill, he would have prove lucidity and not be “under duress”, write two notes to his doctor within 10 days apart. Also, the doctor will have to receive written confirmation of the diagnosis of depression (easy enough), then has to determine said 18 year old is lucid (mentally capable of making such a decision – highly unlikely in the case of a mental illness like severe depression with suicidal feelings/behaviour), not under duress, etc. The doctor also has the right to refuse such a request. I don’t see many doctors being too keen on allowing this to happen.
This bill only prevents criminal charges of murder against those doctors who choose to carry this out.
The chances are more likely that said suicidal 18 year old is just going to go and commit suicide on his own rather than go through this process, only to most likely be turned down by his doctor anyway.
Will this bill change that likelihood of this person committing suicide? Likely not since a suicidal person with strong intent to end his/her life will do so anyway without seeking the help of doctors. To use an emotional argument for a moment: I know of enough suicides to know those folks tend to do it alone. They don’t get a whole lot of support for their actions from medical professionals!
Argument two:“Bill C-384 directly threatens the lives of people with disabilities and/or people with chronic conditions. People with disabilities and chronic conditions are often perceived as being without any prospect of relief.” (Council of Canadians with Disabilities, 2009)
“Living without dignity and suffering are common misperceptions that able-bodied Canadians have about the lives of their fellow citizens with disabilities. Bill C-384 does nothing to protect those who find themselves socially devalued in these ways,” states Dean Richert, Co-Chair of CCD’s Ending of Life Ethics Committee. (Council of Canadians with Disabilities, 2009)
First off, one of the conditions states that the individual must have “provided a medical practitioner, while appearing to be lucid, with two written requests more than 10 days apart expressly stating the person’s free and informed consent to opt to die” or “has designated in writing, with free and informed consent, before two witnesses with no personal interest in the death of the person, another person to act on his or her behalf with any medical practitioner when the person does not appear to be lucid”.
Unless the person with said disability/chronic condition makes the request for him/her self of his/her own free will or has already legally prearranged an advocate to make this request on his/her behalf, this is a moot point. The desire has to come from the individual… not the person’s family, doctor, neighbour, friend or anyone else (unless previously and legally arranged beforehand) with an interest in their death. In fact, the advocacy statement has to be witnessed by at least two people who have no interest in that person’s death!
How does this threaten a person’s life at any level of ability or health? I beg the people at CCD and other disability rights groups to read the bill again and tell me how this threatens the lives of Canadians with disabilities or chronic conditions because I’m just not seeing anywhere in the bill that says that anyone else can make this decision for a person with a disability or chronic condition and thus threaten their existence!
To take it one step further, most people see people with disabilities and those with chronic conditions as not being lucid (if we want to use the argument that society devalues people with disabilities and doesn’t see them as being lucid) or being in a state of duress, which again voids eligibility under this new bill. The danger to those with disabilities or chronic conditions is actually quite low in this regard because of the inability to meet all of the requirements! (and yes… all of these requirements must be met… there is no “or” in the bill except in the case of appointing an advocate)
In fact, those people with disabilities or chronic conditions may find themselves having a hard time getting this even if they do want it and they go through the proper channels!
Is this assumption not the kind of assumption people with disabilities are trying to fight against? Can we assume that a person with a disability is not “lucid” or competent enough to make the choice to continue living or die on their own?
What do people with disabilities or the chronically ill need protection from here? A bill that allows them to make an informed decision about their own life or death and be able to access the right to die with dignity if he or she so chooses without fear of legal repercussion upon the doctor who agrees to help with that decision? A bill that simply prevents a doctor from getting nailed if all of the requirements laid out in the bill are met?
As a person with a perceived disability, I would take huge offence to the ideas that I am vulnerable, unable to make my own decisions or need to be subjected to a painful, low quality of life (should my circumstances ever warrant that type of life – touch wood) because some do-gooders think they know what’s best for me!
People with non-progressive disabilities may not want to end their lives prematurely and there is absolutely no threat to that here.
This bill has absolutely nothing to do with them or anyone else not wishing to end his or her life!People with progressive disabilities or conditions that could end up being quite painful and unbearable currently do not have the choice to end their lives and their pain because of Section 14 of the Criminal Code. That is a violation of a person’s right to make a choice about his/her own life, in my opinion. This amendment to Section 14 of the Criminal Code simply keeps that option open for them.
Argument 3:This might justify what Robert Latimer did and encourage other parents to do the same thing with their disabled children! (This was mentioned to me by a few people in conversation and not an article or website, so there is no proper source to cite)
For those not in the know, Robert Latimer was the father of 13 year old Tracy Latimer. Tracy was born with deprivation of oxygen due to birthing complications which resulted in cerebral palsy and severe mental and physical challenges. He killed her via carbon monoxide poisoning in 1993 because he felt that her quality of life was low.
There are several things that don’t work in this argument:
1. Tracy was 13 years old – underage in the eyes of the law and
therefore ineligible.
2. Tracy did not make the request herself and she likely would not have been considered lucid enough to make such a request and
therefore ineligible3. Robert Latimer was not a doctor or any other professional licensed to practice medicine in Canada. He was a farmer and
therefore ineligible to perform the act of euthanasia.
Even if Bill C-384 had been passed into law when this unfortunate incident happened, Mr. Latimer still would have committed a criminal offence in the eyes of Canadian law and would still have to suffer the penal consequences of his actions.
I have seen many, many stories of the atrocities committed against people with disabilities, particularly children, such as mercy killings, killings due to caregiver/parent frustration or even medical mutilation (see the story of the “Ashley Treatment” AKA: Pillow Angel for an example of this:
http://ashleytreatment.spaces.live.com/blog/).
I do not agree with these acts at all. For starters, these acts were decided upon and committed by third parties, with no choice given to the person at the business end of their actions. The disabled person did not request these actions, nor were medical professionals involved in the killings. There were medical professionals involved in the "Ashley Treatment", unfortunately, and they are being investigated by the appropriate parties.
These folks also would not be permitted to end the lives of their children, clients or loved ones under Bill C-384 because of the requirements of eligibility. They would be committing a criminal offence: that of murder, the unlawful taking of another human being’s life, no matter what their excuse was.
They have no excuse now and they would still have no excuse if Bill C-384 was passed.Argument 4:“The language of the bill is not clear whether medical practitioners are the only individuals who can intend the death of an incompetent individual.” (Euthanasia Prevention Coalition, 2009)
Actually, the language is quite clear. Legal documents are not the easiest to read at the best of times, but it quite clear that this process has to involve the person and the medical practitioner (and all of those criteria need to be met unless there is the word “or” in between the criteria)!
See the first Exception where it says that “a medical practitioner does not commit homicide within the meaning of this Act by reason only that he or she aids a person to die with dignity, if (a) the Person [followed by criteria] AND (emphasis my own) (b) The Medical Practitioner [followed by Criteria]”
The summary at the beginning also states quite clearly: “a medical practitioner does not commit homicide within the meaning of this Act by reason only that he or she aids a person to die with dignity…”
Argument 5:“Lalonde’s (the MP who has proposed this bill) husband Guy Lemarche is the communications director of the euthanasia lobby group - l’Association québécoise pour le droit de mourir dans la dignité (AQDMD)." (Euthanasia Prevention Coalition[2], 2009)”
This is just an ad hominem fallacy in my opinion and I do not see how this is a compelling argument for or against Bill C-384.
Argument 6: Appropriate palliative care and support should be provided, not a bill that allows euthanasia! (A few sources have said this, so I cannot point to one source in particular)
I used to work in palliative care and I can tell you that the system for the most part is wonderful. There are some great people and facilities out there doing what they can to help people at the end of their lives. There is lots of support and lots of options available to keep people “comfortable”.
However, those options don’t always last for long. Some people develop a tolerance to painkillers so none of them will work. Some folks might have nasty allergies or reactions to the drugs that are needed to keep them “comfortable”. Sometimes family members will request that the person be taken off painkillers because the person is not "lucid" enough to talk to their families. (Yes, I have heard of actual cases where this has happened)
I’ve seen my fair share of terminally ill people who live many weeks or months in pain because they are unable to get the benefit from such drugs anymore or they have worse reactions to such drugs and the pain is the lesser of the two evils.
“Providing palliative care” is just not that simple a solution, in my opinion.
Further comments I have about the opposition of the bill:1. This does not give people carte blanche to run off and commit suicide just because they are depressed. I am hard pressed to find a doctor who would allow for this.
2. This is simply an amendment to the Criminal Code to prevent charges of homicide against medical practitioners (people licensed to practice medicine in Canada by the guidelines of the law and the4 Royal College of Physicians and Surgeons) who assist with suicide which adhere to the guidelines set forth in the bill. A non-medical practitioner or any other person trying to get off a charge of murder is not going to get off of the charge by invoking this bill.
3. This is not going to set off a task force to kill all of the people deemed to be in pain, incompetent, etc. I've seen some folks mention what the Nazis did and how this might escalate. The invoking of Godwin's Law notwithstanding, this is an example of a Slippery Slope Fallacy. How does this logically translate to genocide?
All that said, I do believe Bill C-384 has its limitations, which need to be addressed before this is brought up in the House of Commons again. Those who are attempting to put this through should really listen to the arguments against and seek to address those within the bill because it is just too vague in certain areas.
Criticisms I have with the wording of Bill C-384:1.
Terminal illness is not adequately defined – I agree that there should be details about what constitutes a “terminal illness” in this act. This is a rather vague term and could be easily misinterpreted.
2.
“Mental pain” needs to also be more succinctly defined since it is very easy for people to assume that depressed people should be able to seek out assisted suicide. 3.
“Appearing to be lucid” really needs to be defined since this leaves the term open to a lot of misinterpretation, which is what opposition groups are focusing on. What and who determines “lucidity”?
4.
Does this also apply to non-Canadian citizens or people who have permanent residence outside of Canada? Nothing is mentioned in the bill whether the person has to be either a permanent resident of Canada (after a certain length of time) or a Canadian Citizen. This could lead to people coming to Canada just to take advantage of this bill. This should be clarified.
I hope this essay has provided some insight into the arguments for and against Bill C-384. As I mentioned earlier, I believe factual information is a great guide in the face of such hot topics and I hope that this might help people make compelling arguments for or against this bill.
References:1. Under authority of the Speaker of the House of Commons. Bill C-384. Retrieved on
August 5, 2009 from:
http://www2.parl.gc.ca/HousePublications/Publication.aspx?Docid=3895681&file=42. Council of Canadians with Disabilities. Fast Facts About Bill C-384. Retrieved on
August 5, 2009 from:
http://www.ccdonline.ca/http:/%252Fwww.ccdonline.ca/en/humanrights/deathma king/euthanasia/fastfactsbillc3843. Council of Canadians with Disabilities. Council of Canadians with Disabilities (CCD) Opposes Bill C-384. Retrieved on August 5, 2009 from:
http://www.ccdonline.ca/http:/%252Fwww.ccdonline.ca/en/humamrights/deathmaking/euthanasia/pressreleasebillc3844. Euthanasia Prevention Coalition. An Analysis of Bill C-384. Retrieved on August 5, 2009 from:
http://www.euthanasiaprevention.on.ca/Analysis-BillC384.htm5. Euthanasia Prevention Coalition. Complete Analysis of Bill C-384. Retrieved on
August 5, 2009 from:
http://www.euthanasiaprevention.on.ca/Analysis-BillC384.htm#Complete%20Analysis%20of%20Bill%20C-384
Warning: this is a rant post, so if you're not up to reading a rant, please stop reading now.
