Friday, June 20, 2008

An analysis of Bill C-562: An act to amend the Criminal Code (right to die with dignity)

On June 12, 2008 Francine Lalonde MP (Bloc Quebecois) from La Pointe-de-l’Île introduced Bill C-562: An Act to amend the Criminal Code (right to die with dignity).

In June 2005 Lalonde introduced Bill C-407. Bill C-562 has only minor revisions to Bill C-407.

Bill C-562 amends subsections 222(7) and subsection 241(2) of the criminal code.

Section 222 is the homicide provision in the criminal code. Bill C-562 legalizes euthanasia by amending subsection 222(7) of the criminal code.

Euthanasia is a deliberate act undertaken by one person with the intention of ending the life of another person to relieve that person’s suffering where the act is the cause of death. (Of Life and Death - 1995)

Section 241 is the assisted suicide provision in the criminal code. Bill C-562 legalizes assisted suicide by amending subsection 241(2) of the criminal code.

Assisted suicide is the act of intentionally killing oneself with the assistance of another who provides the knowledge, means or both. (Of Life and Death - 1995)

Bill C-562 amends the criminal code by adding to subsections 222(7) and 241(2) exceptions whereby the law can be circumvented.

• The bill states that the person must be at least eighteen years old.

This “safeguard” may be unconstitutional because it limits what is determined by the bill to be appropriate medical treatment based on the age of the person. Since the constitution recognizes that we are all equal under the law, therefore it may be unconstitutional to limit the rights of individuals, based on age, without good reason.

• The bill states that the person is eligible: after trying or expressly refusing the appropriate treatments available that they continue to experience severe physical or mental pain without any prospect of relief.

Therefore, a person is eligible if they experience severe physical pain without any prospect of relief. Physical and mental pain can always be mitigated. Modern palliative care and has substantially improved over the past 20 years. Whereas medical science has not solved all the every problem with pain and symptom management, the concept of physical pain without any prospect of relief is more a sign of a patient who has not been appropriately cared for and not a reason for euthanasia or assisted suicide.

The bill is a direct threat to the lives of people with disabilities and/or chronic conditions who are often viewed as being without any prospect of relief. People with disabilities and chronic conditions will often view their life experience differently from those who are making a judgement of their quality of life.

In this bill, a person is also eligible if they experience severe mental pain without any prospect of relief. Chronic depression and mental pain is always treatable. Further, one must question the concept of providing euthanasia and assisted suicide to a person who experiences a chronic depression or mental pain because you could never be sure that they are competent to consent.

The bill does not require medical practitioners to refer people with mental pain to a registered psychiatrist or a psychologist.

A person is also eligible if they have refused appropriate treatments that are available. How can a physician determine that there is no prospect of relief if the person refuses appropriate treatments?

• The bill states that the person is eligible if: they suffer from a terminal illness. The bill does not define terminal illness.

Many people live with a terminal illness but are not actively dying. My step-father died 2½ years after being diagnosed with terminal cancer.

This bill would have qualified my step-father for euthanasia or assisted suicide when he was diagnosed.

• The bill states that the person is eligible if: the person 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.

The assumption that someone is competent when they are appearing to be lucid is very questionable. To appear to be lucid cannot be considered an appropriate measure for competency.

The safeguard related to making two written requests more than 10 days apart is to prove the lasting intent of the person. The fact that the person who makes the request only needs to appear to be lucid renders the safe-guard ineffective.

• The bill states that if the person 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.

This means that a person can die by euthanasia if they have made the request in a valid advanced directive.

It is unclear whether the person who commits euthanasia on behalf of the incompetent person must be a medical practitioner. The bill states that “another person can act on his or her behalf with any medical practitioner when the person does not appear to be lucid.” This may mean that a person can cause the death of an incompetent person if it is done with a medical practitioner and fulfills the request within a valid advanced directive?

• The bill requires that written confirmation of the diagnosis been received from at least two medical practitioners. The bill does not limit the practice of doctor shopping. In the state of Oregon, people who are denied an assisted suicide prescription from one doctor will simply go to another doctor.

• The bill requires the medical practitioner to assure that there are no reasonable grounds to believe that the written requests for euthanasia and assisted suicide was made under duress or while a person was not lucid.

This safeguard is designed to guarantee competency. Since the person who makes the request only needs to appear to be lucid renders the safeguard ineffective.

• The bill requires the medical practitioner has informed the person of the consequences of the request for euthanasia or assisted suicide and of the alternatives that are available to the person.

This safeguard is designed to guarantee that the person is aware of the available options. Since the person is not required to try effective treatments renders the safeguard ineffective.

• The bill requires the medical practitioner to act in the manner indicated by the person and that the person may revoke their request at any time.

• The bill requires the medial practitioner to provide the coroner with a copy of the written confirmations of the diagnosis that were received from at least two medical practitioners.

This is a common “after-the-fact” reporting system that exists in other jurisdictions where they have legalized euthanasia and/or assisted suicide. After-the-fact reporting does not provide any protection for the person who has died already, it only provides protection for the medical practitioner.

• The bill defines medical practitioner as a duly qualified person by provincial law to practice medicine. The definition of medical practitioner is not limited to a physician.

Summary of Bill C-562:

• The bill legalizes euthanasia and assisted suicide in Canada.
• The bill does not restrict euthanasia and assisted suicide to citizens of Canada. Canada could become a haven for American Suicide Tourists.
• The person must be at least 18 years old.
• A person may refuse appropriate treatments and still obtain euthanasia or assisted suicide. How can a physician determine that there is no prospect of relief if the person refuses appropriate treatments?
• The person may be experiencing either physical or mental pain. The bill will allos death as a treatment for depression or other chronic mental conditions.
• The bill does not define terminal illness and it is not limited to people who are terminally ill.
• The bill measures competency based on appearing to be lucid. What does that mean?
• The bill requires the person to submit two written requests at least 10 days apart.
• The bill allows incompetent people to die by euthanasia if they have made the request within a valid advanced directive. It is not clear whether medical practitioners are the only ones who can carry out euthanasia on incompetent people.
• The bill requires at least two medical practitioners to confirm the persons diagnosis in writing.
• The bill requires that all requests for euthanasia and assisted suicide be made free of duress.
• The bill requires the medical practitioner to inform the person of all alternatives.
• The bill assures that the person may revoke their request at any time.
• The bill requires the medical practitioner to provide confirmation of the diagnosis to the coroner. After-the-fact reporting systems only protect the medical practitioner and not the person.
• The definition of medical practitioner is not limited to a physician.

Final comments:

Legalizing euthanasia and/or assisted suicide is always wrong because:
• It directly and intentionally threatens the lives of the most vulnerable members of society. The lives of people with disabilities and chronic conditions, people who live with depression and mental illness, and others are directly threatened by euthanasia and assisted suicide.
• It establishes euthanasia and assisted suicide as treatment options for problems that are properly solved by effective and compassionate medical care.
• It changes the trust relationship between the medical practitioner and the patient.
• Society cannot legislate autonomy and choice in relation to acts that intentionally and directly cause death. No level of safeguard will ever protect vulnerable people from the subtle pressure to “choose” death.

Canadians must reject bill C-562.

Canadians must promote the right of every Canadian to excellent end-of-life care and to guarantee that every Canadian is treated with respect and dignity until their natural death.

Bill C-562 can be read at:
http://www2.parl.gc.ca/HousePublications/Publication.aspx?DocId=3570851&Language=e&Mode=1&File=24

3 comments:

Wisdom Hunter said...

Thank you for the update ... very thought provoking. I also read your earlier blog on the "progress" of euthanasia in the Netherlands - my country of origin. May we never go down that road ! My mother recently died after having had Alzheimers for several years. Although it was not easy to watch her decline, I am grateful to have had the opportunity, together with my siblings, to have cared for her in her time of need. We need laws that protect the inherent value of human life, not laws that undermine this foundation-stone of civilization.

Kevin Andrews said...

Of course voluntary euthanasia should stay illegal! How else are my pharmaceutical shares going to increase in value?!

I've already bribed my local vet, so I've got all the insurance against a bad death I need. To hell with all you poor bastards who can't get a good death.

Anonymous said...

Physician Assisted Death (PAD)remaining illegal is discriminatory. Suicide is currently legal, however those who have limited physical functioning due to a progressive, irreversable disease or disorder are unable to exercise their right to make that decision. In order to do so, they need assistance. Those who claim the "slippery slope" argument, are ignoring the effectiveness of safeguards in states that have them in place (Oregon and Washington) and discriminating against a segment of the Canadian population. I believe that allowing this discrimination leads to a far scarier "slippery slope"

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