Senator Betty Unger: Palliative care should be the priority, not physician-assisted dying

This article was published by Senator Unger on February 22, 2016 on her website.

"Palliative care should be the priority, not physician-assisted dying.

There is something terribly wrong when a government

does more to guarantee that the living can die,

than to ensure that the dying can live."

- Betty Unger, Alberta Senator 

Senator Betty Unger

February 22, 2016

Last year, the Supreme Court of Canada ruled that the Criminal Code sections prohibiting physician-assisted suicide violate our Charter rights. After declaring those sections to be invalid, the Court paved the way for assisted suicide and euthanasia to become legal in Canada on June 6, 2016.

This short article does not allow us to list all the concerns raised by the Court’s decision. But the experience of countries with legalized euthanasia clearly demonstrates that the road is fraught with great danger, including hundreds of cases a year where people are euthanized without their consent. Even the Supreme Court itself admitted that the risk of abuse cannot be eliminated. They stated that such risks should be identified and minimized, “through a carefully-designed system imposing stringent limits that are scrupulously monitored and enforced”.

It is this “carefully-designed system” which the Government of Canada is supposed to be in the process of crafting. A joint committee, including both Members of Parliament and Senators, was created last December. It held 12 public meetings, heard from 62 witnesses, and received a multitude of written submissions. From this evidence, the Committee is to “make recommendations on the framework of a federal response on physician-assisted dying that respects the Constitution, the Charter of Rights and Freedoms, and the priorities of Canadians.”

The Committee’s report is due on February 26th, at which time we will discover what their recommendations are. But from the multitude of statements made and questions asked during public meetings, it appears that the majority of Committee members have little regard for safeguards which might limit access to assisted suicide. Rather than crafting a system that imposes “stringent limits” they seem to be preoccupied with how wide the doors can be flung open. Their primary concern appears not to be safeguards, but guaranteed access.

It might come as a surprise to some, but the Supreme Court’s judgment in Carter v. Canada did not make physician-assisted suicide a Charter right. If you read the Charter of Rights and Freedoms you will see that assisted suicide is never mentioned. What the Charter does guarantee is “the right to life, liberty and security of the person.” The Supreme Court determined that in some very select, narrow and unusual circumstances, forbidding access to assisted suicide is a violation of this right. The duty of the government is to grant access in these cases. It is under no obligation, however, to guarantee access.

At first glance, a distinction between granting access and guaranteeing access may appear subtle. But a failure to understand the critical difference launches us down a very dangerous path. Guaranteed access means government must make the way, not simply get out of the way. Which, in turn, creates a strong bias towards diluting safeguards as much as possible, in order to provide access which is as broad as possible.

For example, the Supreme Court said that only competent adults can request physician-assisted death. But the Committee is clearly wrestling with whether to grant access to minors as well. The Court said that nothing should “compel physicians to provide assistance in dying”. Yet the Committee is contemplating whether to force dissenting doctors to refer patients to a physician who will agree to kill them. Even faith-based hospitals might not be safe from the Committee’s zeal. They too, contrary to their community values, could be obligated by law to participate in administering treatments designed to terminate life.

The determination to guarantee access for assisted suicide, when such access doesn’t even exist for palliative care, exposes a warped understanding of compassion. By separating compassion from a belief in the sanctity of life, you are left with a twisted concept of what is right and what is wrong. While masquerading as kindness, this view actually fosters a creeping devaluation of human life.

Access to palliative care is as much a Charter right as access to physician-assisted dying. And while the Committee seems oblivious to this, most people will acknowledge that there is something terribly wrong when a government does more to guarantee that the living can die, than to ensure that the dying can live.

Betty E. Unger, Alberta Senator

Senator Unger worked as a Registered Nurse for several years, then founded and operated an Alberta nursing services company with offices located in Edmonton, Red Deer and Calgary. Services were provided across the province, to national and Alberta life insurance companies, as well as occupational health services to industry.

Betty sold her company after twenty-five years and then engaged actively in politics, with a strong focus on Senate reform.