Re: “ Véronique Hivon’s long battle” (Gazette, July 2)
Bill 52 would not just extend access to “end-of-life care” which includes “medical aid in dying,” a euphemism for euthanasia to “dying patients,” as your reporter states, but to all “end of life” patients who fulfill the necessary criteria.
Among other requirements, those criteria require that a person “suffer from an incurable serious illness; suffer from an advanced state of irreversible decline in capability; and suffer from constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable.” The bill also provides that “a person may not be denied end-of-life care for previously having refused to receive a treatment or procedure or having withdrawn consent to a treatment or procedure.”
In other words, the person being euthanized might not have exhausted all reasonable pain and suffering management treatments; seems to have a complete discretion to decide whether they regard their pain or it might be the pain management interventions as tolerable; need not be terminally ill; and might be mentally, but not physically, ill. Many disabled, old, frail and vulnerable people would fulfil these latter two criteria, in which regard it merits noting that Bill 52 provides that “medical aid in dying” may be administered in “residential and long-term care centres” or a person’s home.
Your reporter, in painting what I regard as an unrealistically reassuring picture of the effect of Bill 52, also states that a “second doctor must also agree (with the treating doctor that “medical-aid-to-die”) is the best course (for the patient).” In fact, the second doctor need only “confirm that the criteria (for access to “medical aid in dying”) have been met.” In light of the fact that Bill 52 reflects a values stance that gives priority to radical individual autonomy, it would be inconsistent with the spirit and goals of the bill for doctors to override a patient’s wishes to have access to “medical aid in dying,” with their own view of what is the “best course” for the patient.
For reasons such as I describe, we need to consider deeply whether Bill 52 would create a very serious danger of the abuse of vulnerable people, especially those who are old.
McGill Centre for Medicine, Ethics and Law