DiManno: Court stays off euthanasia.

The following article was written by Toronto Star columnist, Rosie DiManno, and published on October 21, 2013 in the Toronto Star.

Rosie DiManno

By Rosie DiManno, Toronto Star - October 22, 2013

It was a bad week for the “Death With Dignity” shills.

Unlike what they so ardently advocate for others, do not expect this faction to pull the plug on itself. They will continue to pound on the courtroom door in an unending quest to legalize doctor-assisted suicide in Canada and all the other euphemistic versions of rationalized killing.

On Oct. 10, the British Columbia Court of Appeal overturned a B.C. Court ruling which had found the criminal ban against doctor-assisted suicide to be unconstitutional. In other words, it upheld the existing ban. The majority view in the split decision concluded that, while Charter of Rights and Freedoms law has evolved since 1993 — when last the issue of assisted suicide was visited — still not sufficiently so that the landmark decision should be set aside.

Then, on Friday, in a case that might seem to have little in common with the B.C. matter, the Supreme Court of Canada ruled 5-2 against two Sunnybrook Hospital doctors who had stubbornly sought to remove a severely brain-damaged patient from life support, over the objections of his family. The decision applies only to cases in Ontario and does not address the broader ethical questions.

This legal wrangle was particularly deplorable because it turned on the God-complex of a couple of doctors who’ve been fighting to bypass a dispute resolution system that has been in place for nearly two decades: Ontario’s Consent and Capacity Board, which deals on a case-to-case basis where there is disagreement between physicians and families making decisions on behalf of loved ones who can’t express their own wishes.

Rasouli family

The fate of 61-year-old Hassan Rasouli — on a ventilator and feeding tube since catastrophic complications following brain surgery three years ago — may yet come before the Consent and Capacity Board; that remains unclear. But for the moment, his wife and children are immensely pleased and relieved. While the two doctors continue to maintain that treatment for Rasouli is futile, the family has seen evidence that he is in fact responsive to stimuli — he smiles, he follows them with his eyes, he squeezes his fingers, he has even, as the family stated Friday, made thumbs-up and peace-sign gestures.

Even a layperson with no medical degree — unlike Rasouli’s wife, who was a physician in her native Iran — could see the man is not in a vegetative state. Indeed, neurologists have upgraded his condition to “minimally conscious.” There is brain activity and he might indeed still make a marked recovery. He is, at some level, a sentient being.

So, two cases coming at the conundrum of colossal enfeeblement from different angles but still in pursuit of the same outcome: death by choice, whether of the suffering individual or by treatment providers.

On both counts, it must have come as a rude wake-up for the death acolytes to discover they do not have the sympathetic ear of top courts in this country. “Bloody but unbowed,” vowed one of the lawyers in the B.C. case.

Perhaps they’ve been reading too many of their own editorial clippings, or misunderstanding public opinion polls that provide a blurry snapshot of prevailing attitudes because they exist in a vacuum bereft of nuance. It’s one thing for a person enjoying good health to peer into the future and decide that a life of severely limited faculties, of acute pain, of incurable illness, must surely be unendurable. It’s quite another thing when actually confronted by that reality, whether for oneself or on behalf of family members, as society chips away at the most fundamental of societal concepts: Thou shall not kill.

That’s not a faith-based proscription, lest anyone jump to the mistaken assumption that I’m thumping you over the head with a cross, as some were quick to assert the last time I wrote on this subject. At best, I am a lapsed Catholic who disagrees with the church on just about every social issue, from celibacy for priests to the denial of sacraments to divorced couples to abortion to homosexual unions — though I will say the church got it right on liberation theology, which has been a disaster.

No mainstream faith, however, has come out in favour of assisted suicide.

And, while death huggers pretend that it’s only a matter of time before governments catch up with the learning curve, as if Canada is somehow on the reactionary end of the spectrum, I would remind that out of 196 countries on the planet in 2013, only three allow assisted suicide: Belgium, Switzerland and the Netherlands. In America, three states have passed laws permitting limited euthanasia: Oregon, Washington and Vermont.

This is not a vanguard movement and Canada is hardly out of step with global attitudes, though proponents of euthanasia — which is the correct term, rather than the deceptive tautology of “Death with Dignity” — would have us believe otherwise.

Quebec seems intent, as usual, on marching to its own drummer, having recently tabled a bill to legalize mercy killing — another repugnant, pacifying term. Legally, it’s unclear whether Quebec has the authority to unilaterally implement such a law but it’s charging ahead anyway. Under the Criminal Code, assisted suicide in all its permutations is clearly illegal and unambiguous. While the law is federal, however, the decision to prosecute physicians assisting in suicide is provincial.

Clearly, this is an issue headed for the Supreme Court of Canada. While assisted suicide, euthanasia, mercy-killing, however you frame it, is steeped in deep-rooted precepts of morality and ethics, I will put my faith in that highest court in the land to render a decision that cleaves to matters of law rather than emotionalism.

But once you open that door, there’s no slamming it shut again, regardless of reassurances to the contrary.

In the Netherlands, deaths by euthanasia jumped 64 per cent between 2005 to 2010, and “terminal sedation” — defined in Canadian guidelines as “sedation with continuous IV narcotics and/or sedatives until the patient becomes unconscious and death ensues from the underlying illness,” thus not technically euthanasia — spiked from 11,000 to 17,000 in the same period. Not euthanasia, so no documenting paperwork required.

The Dutch even have mobile euthanasia units so doctors can kill patients in their own homes, including people with Alzheimer’s who obviously can’t form cogent intent.

Once that taboo is breached, the parameters keep expanding. That’s why advocates for the most vulnerable among us are so appalled, as children born with spina bifida are put to death (in the Netherlands, with parental consent) and the criteria for “exceptional circumstances” inevitably widen. In Quebec, Bill 52 is unacceptably vague in defining criteria, permitting doctors to assist in suicide when a patient “suffers from an incurable illness” or “from an advanced state of irreversible decline in capability.” That could just as easily define old age.

It’s not just about you, the “my right to die” chorus, as if any of us can opt out.

Beware the lulling croon of the death whisperers.