If only Canadian politicians had the courage of patients
TheGlobeandMail.com – Globe Debate
Jan. 19, 2016. André Picard
In recent days, in a Quebec City hospital, a physician cracked open a “medical aid in dying” kit and injected a terminally ill patient with three drugs in succession: a benzodiazepine, a calming sedative; then a barbiturate to induce a coma; and, finally, a neuromuscular blocking agent that caused the heart and lungs to stop. The whole process took about 15 minutes.
Given the fearsome debate that has gone on for years, Canada’s first physician-assisted death occurred with surprisingly little fanfare.
But that is exactly what death – physician-assisted or otherwise – should look like: pain-free, private and dignified.
The history-making patient, most likely suffering from untreatable cancer, made the choice to die at least 15 days earlier, as provincial law requires. This was followed by a lot of paperwork – because, in Quebec, the two certainties in life are paperwork and death. The two doctors consulted, then followed the protocol established by the Collège des médecins du Québec and carried out the patient’s wishes for a lethal injection.
Quebec’s law took effect on Dec. 10 after a series of legal challenges were exhausted. On Friday, when the Supreme Court of Canada ruled that Ottawa could have four more months to craft legislation on assisted death, it ruled that Quebec’s law could remain in place.
At least two other terminally ill patients in the Montreal region have opted for assisted death, according to the advocacy group l’Association québécoise pour le droit de mourir dans la dignité, and there are a handful of requests pending.
To date, all the patients have chosen to remain anonymous and, as a result, there has been very little media attention. This is to be expected.
When fighting for social change, such as the decriminalization of assisted death, a few brave souls need to come forward and become the faces of the cause. In Canada, we had Sue Rodriguez, then Gloria Taylor and Kay Carter, whose legal battles ended up in the Supreme Court. (Sadly, none of them ever benefited directly from the changes they helped bring about: Ms. Rodriguez had an assisted death when it was still illegal [no one was ever prosecuted], Ms. Taylor died of an infection and Mrs. Carter opted for an assisted death in Switzerland.)
But very few people want to die in the glare of the media spotlight, nor should they have to. Let’s not forget that people are choosing to hasten their death because they are gravely ill, and often in terrible pain. Like every other patient, they have a right to privacy.
Under Quebec law, which includes an important data collection and oversight component, we will learn some of the details of assisted deaths in September, when the Commission sur les soins de fin de vie publishes its first report. Some regional health authorities might release cursory details earlier, as the one in Quebec City chose to do, but others will only report every six months, as the law requires.
In Quebec, the right to die is the new normal. Meanwhile, in the rest of Canada, the foot-dragging continues.
The Supreme Court ruled on Feb. 6, 2015, that denying a hastened death to those who are suffering “intolerably and permanently” is cruel, and denying Canadians that choice is also unconstitutional, but it gave legislators a one-year reprieve to get a new law in place.
Last Friday, the court, rather inexplicably, gave Ottawa four more months to do its right-to-die homework.
But it also ruled that patients outside Quebec can apply to the Superior Court in their home province for “relief in accordance with the criteria” established in the 2015 ruling. In other words, if you want to exercise your right to die in Canada, you need a court order. This is preposterous and flies in the face of the initial Supreme Court ruling.
The choice to live or die should be made between a patient and his or her doctor, like any other medical decision.
What the recent assisted death(s) in Quebec show, more than anything else, is that patients with grievous and irremediable health conditions are ready to exercise their right to die thoughtfully and judiciously.
We should expect the same dignified response from the judges and legislators. What we have instead is yet more dithering and disrespect for patient rights.
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