Monday, December 8, 2014

A critique of Canadian Senate Bill S - 225 - An Act to Amend the Criminal Code (physician-assisted death)

By Alex Schadenberg, 
Executive Director - Euthanasia Prevention Coalition

Alex Schadenberg
Senate Bill S - 225 is designed to legalize euthanasia and assisted suicide by amending Section 14 and Section 251 of the Criminal Code of Canada.

The Euthanasia Prevention Coalition (EPC) opposes the legalization of euthanasia and assisted suicide for several reasons including the fact that legalizing physician-assisted death gives physicians, in law, the ultimate power to cause or assist the death of their patients. When abused, the result is the death of a vulnerable Canadian.

EPC supports measures to improve: disability rights, pain and symptom management and suicide prevention.

The bill was originally written by Stephen Fletcher MP for his own potential death, and thus it is written for a person who is not terminally ill, who requires a wide application for euthanasia and assisted suicide.
  • The bill specifically allows euthanasia and assisted suicide for people with disabilities. 
  • The bill is not limited to terminal illness. 
  • The bill allows euthanasia or assisted suicide for "psychological suffering," which is not defined.
  • The bill requires physicians to self report the death after it has occurred. This assumes that physicians will self-report abuse of the law and it does not provide protection for the patient. 
Bill S-225 is particularly concerning because it specifically focuses on intentionally causing the death of people with disabilities who already lack equality and acceptance within Canadian culture.

Our concerns related to the conditions in Bill S-225 are:


Section 3(a) be eighteen years of age or more;

  • This is only a temporary “safeguard.” It will be considered a form of discrimination to deny assisted death to someone because of their age if the person claims to be physically or psychologically suffering. 
Section 3(c) have been diagnosed by a physician as having an illness, a disease or a disability, including a disability arising from traumatic injury,
Section 3(c)(i) that causes the person physical or psychological suffering that is intolerable to that person and that cannot be alleviated by any medical treatment acceptable to that person,
  • This section provides uncontrollable access to euthanasia and assisted suicide. Physical or psychological suffering that is intolerable to that person and cannot be alleviated by any medical treatment acceptable to that person is completely subjective. This section offers no objective reasons for a physician to say no to a lethal injection.
  • The term psychological suffering was interpreted in the Netherlands to enable a 63-year-old healthy man who had worked all of his life, who never married, to die by euthanasia because he was retiring, depressed and lonely.
  • The term psychological suffering was interpreted in Belgium to enable a healthy 70-year-old woman to die by euthanasia because she became very depressed after a long-term relationship ended.
  • Psychological suffering is not defined and no “safeguard” can protect people from the abuse that may occur and from the expansion of the law that will occur, as is the case in the Netherlands and Belgium.
Section 3(c)(ii) that results in the person being in a state of weakened capacities with no chance of improvement;
  • This section is so wide that you can drive a hearse through it. What does it mean to be in a state of weakened capacities with no chance of improvement? Many people with disabilities and other frail people fulfill this criteria.
Section 3(d) be of sound mind and capable of fully understanding the information provided to him or her under subsection (6)
  • a study from the Journal Clinical Oncology (September 20, 2005) found that people in the Netherlands experiencing feelings of depression were 4.1 times more likely to request euthanasia. The study found that depression is a primary risk factor for requests for euthanasia.
Section 3(e) be acting voluntarily, free from coercion or undue influence.
  • Elder abuse and the abuse of other vulnerable persons are growing problems that are under-reported. You cannot assume that all assisted deaths will be voluntary and free from coercion or undue influence.
  • A study published in the CMAJ (June 2010) found that people who died by an assisted death without request tended to be over the age of 80, in a hospital and incompetent to make decisions for themselves. The study stated:

“Our finding that the use of life-ending drugs without explicit patient request occurred predominantly in hospital and among patients 80 years or older who were mostly in a coma or had dementia fits the description of “vulnerable” patient groups at risk of life-ending without request.”
Section 13 An assisting physician must, not later than 30 days after the death of a person to whom the physician has provided assistance with dying, submit to the Minister of Health, for the purpose of data collection and analysis, a report in the form prescribed by the regulations that includes the following information:
  • The reporting system requires the doctor who does the act to report the death after the person has died. This does not represent a “safeguard” for vulnerable persons. Since the person has already died when the report is submitted, if an abuse of the law occurred, it is too late to protect the person.
Doctors will not self report abuse. The information gathered by the reporting system will only have statistical value.
  • You cannot assume that every assisted death will be reported. The Lancet (September 8, 2012) reported that 23% of all assisted deaths in the Netherlands (2010) were not reported. The BMJ (October 5, 2010) reported that 47% of the assisted deaths in the Flanders region of Belgium (June - November 2007) were not reported.
This bill gives physicians the power, in law, to directly and intentionally cause the death of their patients. People need support and protection, not lethal injections. People with disabilities seek equality in living not more ways to die.

This bill is written with language that can be interpreted widely. We do not live in a utopian society, a place where elder abuse does not exist, coercion is unheard of, and people with disabilities do not experience discrimination. 

Whether or not you support euthanasia or assisted suicide, this bill is deadly. 
Please vote no and reject Bill S - 225.

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