Assisted dying report goes beyond scope, ignores evidence

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

On February 25, the Special Committee on Physician-Assisted Dying released its report advising the government on euthanasia legislation in Canada.

The Supreme Court struck down Canada's assisted suicide law (February 6, 2015) and have given parliament until June 6, 2016 to implement a new law.

Similar to the Provincial-Territorial panel report that was loaded with pro-euthanasia activists, the federal committee recommended euthanasia for people with dementia, for minors, for people with psychiatric conditions and without effective oversight.

EPC legal counsel and constitutional expert, Hugh Scher, called the committee proposal "a dangerous social policy experiment."

David Baker

On Saturday, February 27; the Globe Mail published an excellent commentary by constitutional lawyer, David Baker, who represented national disability groups in the assisted suicide case at the Supreme Court and Trudo Lemmens, University of Toronto Professor in health law and policy at the Faculty of Law.

Baker and Lemmens argue that the Assisted Dying report goes beyond the scope of the Supreme Court decision, and that they also ignored evidence. According to the article:

The court foresaw it (the government) enacting a “complex regulatory regime” of “carefully designed and monitored safeguards.” Unfortunately, the federal report released yesterday recommends exactly the opposite, and proposes the world’s most open-ended regime with arguably the lowest safeguards.

Trudo Lemmens

The article continues by defining what the Committee on Assisted Dying recommended:

the parliamentary committee seeks to expand the criteria for physician-assisted death way beyond what was required by Carter or Bill 52. It includes mental-health conditions and all other disabilities, including developmental disabilities, autism, acquired brain injuries, fetal alcohol syndrome, not to mention blindness and deafness. 

Essentially all disabilities can be included in the open-ended criteria for access, extending the law beyond the persons with irreversibly declining capacities at the end-of-life that the Supreme Court ruled upon, and disregarding the court’s determination that “psychiatric disorders” were expressly excluded, as well as children, even if children would only have access three years after the new legislation is introduced. The committee further recommends access by advanced directive for people suffering from dementia, which most agree would create a practical and ethical minefield.

The article documents some of the evidence that the Committee had received but ignored:

The committee disregarded strong evidence (detailed analyses as well as various case reports) from Belgium and the Netherlands, that confirms vulnerable people are put at risk when vague and expanding access criteria are employed. The risk worsens when the regulatory system relies on individual physicians for determining access and for assessing competency of patients. 

Physician-assisted death in those countries is increasingly being performed on people who are lonely and are concerned about becoming dependent on others, people who are tired of life, and people suffering from mental-health conditions, including depression, anxiety, schizophrenia, eating disorders, autism, post-traumatic stress, and even complicated grief. In many analyzed euthanasia cases, treatment options were available but not used. Reports from those countries raise questions about how some physicians assess competency, and about how vulnerable patients have been able to shop around until they find a physician who, having had no prior therapeutic relationship with them, are willing to end their life. 

In many reported euthanasia cases, treatment options were available but not used. The report raises questions about how some physicians assess competency, and about how vulnerable patients have been able to shop around until they find a physician who, having had no prior therapeutic relationship with them, are willing to end their life.

The article concludes by stating that experts and political commentators in the Netherlands and Belgium are now calling for an end to the open-ended, after the death review system that exists in their countries, and yet the Committee suggested we go in that direction. Baker and Lemmens state:

Imagine that Canada would become a country where people, including children, receive a physician-assisted death for lack of access to appropriate palliative or other health care.

It is time for Canadians to rise up and say NO.