Euthanasia Prevention Coalition: Submission to the Quebec Committee on Health and Social Services Committee

Submission to the Quebec Committee on Health and Social Services Committee re: Bill 52: “An Act Respecting End-of-Life Care” 

Proposed changes to the law, Bill 52, which have the effect of legalizing euthanasia in Quebec represent a serious risk to people at the most vulnerable time of their life. The proposed changes reflect a fundamental transformation in the doctor patient relationship which runs contrary to the established ethic and values of the medical profession throughout Quebec, Canada and around the world.

Virtually every medical association in Canada and around the world have upheld the principle, to “Do No Harm” by opposing euthanasia and assisted suicide as being contrary to basic medical ethics.

Euthanasia and assisted suicide is legal in seven small jurisdictions throughout the world. Continued prohibition of euthanasia remains the norm in virtually every country, state, and international convention.

It is a mistake that will have tragic consequences if Quebec legalize euthanasia because they will also be placing members of society at risk of subtle pressure for euthanasia or having it inflicted upon them without request.

Maintaining a prohibition on euthanasia is based on patient safety and the equal protection of every Quebec citizen, especially when they are at the most vulnerable time of their life.

The Euthanasia Prevention Coalition (EPC)

EPC is a not-for-profit organization which represents a broad cross-section of the Canadian population, including people with disabilities, seniors, healthcare practitioners and members of different cultural and religious backgrounds. 

Our mandate is to preserve and enforce social, legal and medical safeguards prohibiting assisted death and to promote compassionate healthcare respectful of the lives, dignity and autonomy of vulnerable people.

EPC was granted intervener standing by the Quebec Superior Court in the case of Leblanc c. Canada (Procureur général). This case involved a constitutional challenge to s.241(1)(b) of the Criminal Code in an attempt to strike down laws against assisted suicide in Canada.

EPC was granted intervener standing by the BC Supreme Court and by the BC Court of Appeal in Carter v. Attorney General. This case involved a constitutional challenge to s.241(1)(b) of the Criminal Code and related provisions in an attempt to strike down the laws against assisted suicide and euthanasia in Canada.

EPC was granted intervener standing before the Supreme Court of Canada and the Ontario Court of Appeal in the case of Rasouli v. Cuthbertson (2011) ONCA 482. This case involves the interpretation of Ontario’s Health Care Consent Act and particularly the definition of treatment as including the requirement of consent to implement a plan of treatment which includes the withdrawal of mechanical ventilation and implementation of palliative care where such a plan is anticipated to result in the death of the patient despite objections raised by the applicant’s substitute decision-maker.

EPC was granted intervener standing in the Appeal court of Ontario case of Scardoni v. Hawryluck (2004), 69 O.R. (3d) 700.  This case involved the interpretation of prior expressed wishes under the Health Care Consent Act in Ontario and the proper application of the best interests test set out under Section 21 (1) of that Act, along with argument as to the appropriate means by which to interpret relevant provisions of the Act in a manner consistent with the terms and values set out in the Charter of Rights and Freedoms and particularly sections 7 and 15.

Euthanasia Prevention Coalition’s Position:

The question of legalizing euthanasia is profound. This question cannot be treated lightly and it must be decided based on the common good of every member of society.

The Euthanasia Prevention Coalition opposes all forms of euthanasia and assisted suicide. We are convinced that it is never acceptable to provide a means, in law, for one person to have the right in law, to cause the death of another person. We recognize that prohibitions on causing the death of another human being are designed to equally protect every citizen in society.

We understand that situations occur, whereby people seek to end their lives, but we are convinced that these situations become very different when the law allows someone else to actually cause the other person’s death.

The stakes are high in the euthanasia debate. The euthanasia debate concerns personal and societal decisions to intentionally cause the death of people. 

Definitions:

Euthanasia is to knowingly and intentionally perform an act that is explicitly intended to end another person’s life 1 whereby the death is caused by the act. The specific conditions for euthanasia will vary based on laws, rules, and social acceptance.

Assisted suicide means to knowingly and intentionally provide a person with the knowledge or means or both required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs.1 

Bill 52: “An Act Respecting End-of-Life Care” avoids using the terms euthanasia or assisted suicide in the debate, but rather uses the term “medical aid in dying” as part of “end-of-life care.”2 The term “medical aid in dying” can have a wider application and lacks the precise definitions of euthanasia and assisted suicide.

It is assumed that the Quebec government intends through Bill 52 to regulate the acts of “medical aid in dying.” In his critique of Bill 52, Alex Schadenberg, our executive director, points out that Bill 52 employs ambiguous language.3

EPC published a critique of Bill 52 on June 18th stating:

Bill 52: “An Act respecting end-of-life care” defines “end-of-life care” to mean: palliative care provided to persons at the end of their lives, including terminal palliative sedation, and medical aid in dying.

The bill states that doctors would administer “medical aid in dying.” Euthanasia is to directly and intentionally cause the death of another person, usually by administering a lethal injection. 

"Medical aid in dying" is therefore a euphemism for euthanasia in Bill 52.

Since the definition of palliative care includes: terminal palliative sedation and medical aid in dying, therefore the definition of palliative care includes euthanasia.

Bill 52 states that it creates a “right to receive palliative care.” A right to receive palliative care would be good, except that the definition of palliative care includes medical aid in dying (euthanasia). Therefore Bill 52 also creating a right to receive euthanasia.

The definition of “terminal palliative sedation” in Bill 52 is unclear. Sedation for the purposes of palliation is good, but due to the vague definition, EPC is concerned that the abuse of terminal palliative sedation will result in euthanasia without request being done “under the radar” and being reported as terminal palliative sedation.3

Due to the vague, ambiguous and unclear definitions that Bill 52 uses, the EPC sends out a warning that if passed, Bill 52 is likely to be significantly abused in a similar manner to the Belgian euthanasia law.

Ruth Goodman died by suicide, not assisted suicide.

The Victoria Times Colonist has reported on the story of Ruth Goodman (91) who decided to die by suicide.  Goodman had her son, Dean, send her "goodbye" letter to the Globe and Mail with the hope of creating greater support for legalizing assisted suicide.


The article in the Victoria Times Colonist titled: Healthy Vancouver Senior takes own life in bid to change assisted suicide law interviews Grace Pastine, the litigation director for the BC Civil Liberties Association, the group that is steering the Carter case, the case in British Columbia that seeks to legalize assisted suicide and a limited form of euthanasia.

Grace Pastine

Pastine told the Times Colonist:

Ruth Goodman was not terminally ill or assisted in any way, the association would not have a legal position or opinion on her case.

Since Goodman was not aided, encouraged or counseled to commit suicide therefore the law has not been broken.

Goodman died on February 2, 2013; the same day that Ginette Leblanc died of natural causes. Leblanc was the litigant in the Quebec case to strike down Canada's assisted suicide act. Leblanc, who was living with ALS, died of natural causes after experiencing a stroke a few days before her death.

Gloria Taylor, the main litigant in the Carter case in British Columbia, the case that Pastine  is directing, also died of natural causes on October 5, 2012. Taylor, who was living with ALS, died from an infection.

The deaths of Ruth Goodman, Ginette Leblanc and Gloria Taylor did not require a change in the law. Each of these ladies died on their own terms, without experiencing traumatic deaths and without requiring someone else to assist their suicide or actually lethally inject them.

There is no need to legalize euthanasia or assisted suicide in Canada.

Quebec Assisted Suicide advocate, Ginette Leblanc, dies of natural causes.

Ginette Leblanc

Ginette Leblanc, the woman who launched the court case in Quebec to strike down Canada's assisted suicide law, died of natural causes in her 50th year.

The Euthanasia Prevention Coalition offers condolences to the family of Ginette Leblanc as they grieve her loss.

Leblanc, who was living with ALS, hired a high profile recently retired human rights lawyer, René Duval, to challenge Canada's assisted suicide law. The case that was filed on October 31, 2011 claimed that Canada's assisted suicide law was unconstitutional. The case was scheduled to be heard in Trois Rivières Quebec from March 25 - 28, 2013.


The Toronto Sun reported Duval to have stated on Saturday that:

"Due to Leblanc's death the case is now closed"

The Leblanc case was nearly identical to the Rodriquez case that the Supreme Court of Canada decided in 1993 by a 5 - 4 margin that Canada's assisted suicide law was not unconstitutional.

However, Duval added a clause to the case that would have quietly legalized euthanasia in Canada.  The Leblanc case in Quebec.

Recently the Quebec government published the Menard report that established the direction that the Quebec government appears to be going in order to decriminalize euthanasia.

Quebec citizens should be very concerned that their government appears to be intent on decriminalizing along the lines of the "Belgian model."

When analysing the Belgian model of euthanasia it is clear that the definitions that are used and the system that is in place has led to significant abuses of euthanasia. 

EPC warns Quebecers to be careful for what you wish for.


The Carter case in British Columbia will be heard in Vancouver by the BC Court of Appeal from March 4 - 8, 2013. Let's hope that the BC Court of Appeal will strike down the disturbing decision by Justice Smith in the Carter case.

Gloria Taylor, the plaintiff in the Carter case in BC, who also lived with ALS, also died of natural causes in early October, even though Justice Smith had granted Taylor a constitutional exemption to die by euthanasia.

The Euthanasia Prevention Coalition launched the Declaration of Hope as a positive response to the human issues that lead to people requesting euthanasia or assisted suicide.

Euthanasia Prevention Coalition 2012 review.

Happy New Year to all the supporters of the Euthanasia Prevention Coalition (EPC).

2012 was a demanding and difficult year for EPC as we work to oppose euthanasia and assisted suicide. We have faced many challenges but we also experienced significant success.

We will be facing another demanding and difficult year in 2013. We recognize that our work transcends the decisions of the courts and legislatures as work to protect people from euthanasia and assisted suicide. 

Paris Protest

We celebrate the many victories in 2012:
• January 25, the Council of Europe passed a statement (34 - 16) that: Euthanasia must always be prohibited. This statement was part of a statement on Living Wills.
• March 24, 700 people demonstrated against the legalization of euthanasia in Paris France.
• April 12, the Vermont State Senate debated and defeated a bill to legalize assisted suicide, again.
• May 1, the Governor of Georgia signed a bill to prohibit assisted suicide. This legislative victory became necessary after the Georgia Supreme Court struck down the previous poorly worded law.
• May 1, the New Zealand Medical Association stated that: “Euthanasia is unethical.”
• In May, EPC printed and began distributing the Protecting People pamphlet in English and French. We have now distributed almost 40,000 copies of the Protecting People pamphlet.
• In May, a bill to strengthen the assisted suicide laws in Louisiana passed in the House and Senate.
• May 31, the Supreme Court of Canada granted EPC Intervener Standing in the Rasouli case, that asks: do doctors have the right to unilaterally withdraw life-sustaining medical treatment without consent?
• In June, the British Medical Association and the German Medical Association approved statements opposing assisted suicide.
• July 13, Hon Rob Nicholson (Justice Minister & Attorney General of Canada) ordered an appeal of the decision in Carter by Justice Smith. The appeal of the Carter decision will be heard - March 4 - 8, 2013.
• August 16, the British High Court decided, in the Nicklinson/Martin case, that only parliament can decide to change the laws pertaining to euthanasia and assisted suicide.
• September 7 - 8, EPC co-sponsored the First-European Symposium on Euthanasia & Assisted Suicide in Edinburgh Scotland. This historical conference brought people together from across Europe. For the first time, there is an opportunity to establish an organized opposition to euthanasia and assisted suicide in Europe.
• November 6, the voters in Massachusetts defeated Question 2, that would have legalized assisted suicide by a vote of 51% to 49%. This was a huge victory.
• November 9, EPC elected a new leadership team at its board meeting: Joanne Matters (President),   Dr Margaret Cottle (VP), Rhonda Wiebe (Secretary/Treasurer), Dr. Barrie deVeber (Past President).
• November 10, EPC honoured Dr. Barrie deVeber at our national conference in London Ontario.

•  November 15, the book Exposing Vulnerable People to Euthanasia & Assisted Suicide was published. Exposing Vulnerable People uncovers the data concerning euthanasia in Belgium and the Netherlands.
• December, the Hawaii Medical Association stated that it opposes Physician-Assisted Suicide.
• December 10, EPC was granted the standing at the BC Court of Appeal in the Carter case.
• In 2012 EPC presented a petition of more than 33,000 names to the Attorney General of Canada.
• Our blog: www.alexschadenberg.blogspot.com continues to receive approximately 20,000 hits per month.
• There are currently almost 3600 people who have "liked" the EPC Facebook page.

We acknowledge the challenges that we have experienced in 2012:
• January 27, EPC requested intervenor standing in the Leblanc case in Quebec. The Leblanc case seeks to strike down Canada’s law preventing assisted suicide and to legalize a limited form of euthanasia. The Leblanc case was scheduled to be heard, December 11 - 14, but has been postponed to March 25 - 28, 2013. 

John Coppard

• March 1, Mobile Euthanasia Teams began operating in the Netherlands. It is predicted that the six Mobile Euthanasia Teams will be responsible for approximately 1000 euthanasia deaths per year.
• March 5, EPC spokesperson, John Coppard died after a courageous battle with brain cancer. John has been missed by all of us who had the privilege to work with him.
• March 16, the Global TV News 16 x 9 program featured a story of a woman who wants her adult children with disabilities to die by euthanasia and it portrayed Robert Latimer in a sympathetic manner.
• March 22, the Quebec National Assembly Dying with Dignity report was released. It reads like a euthanasia manifesto. Vivre dans la Dignité has been building a grass-roots opposition to the report.

Justice Lynn Smith

• June 15, Justice Smith decided, in the Carter case, to strike down Canada’s assisted suicide law, she ordered parliament to legalize a limited form of euthanasia and she gave Gloria Taylor a constitutional exemption to die by euthanasia or assisted suicide. Gloria Taylor died of natural causes on October 5.
• September 27, a New Jersey legislator announced his plan to sponsor a bill legalizing assisted suicide.
• November 1, Justice Smith ordered the federal government to pay the BC Civil Liberties Association (BCCLA) one million dollars for their role in the Carter case. Recently, Hon Rob Nicholson, Canada's Justice Minister, appealed the decision to give the BCCLA one million dollars.
• November - EPC applied to intervene at the BC Court of Appeal in the appeal of the Carter decision by Justice Smith. EPC was pressured throughout the process to limit the scope of our intervention. 

Dr Andre Bourque

• December 10, the Supreme Court of Canada heard the Rasouli case.
• December, a report in France stated that Euthanasia should not be legalized but assisted suicide may be legalized.
• At the end of December, the socialist party in Belgium stated that it plans to allow euthanasia for children and people with Alzheimer's.
• Dr. Andre Bourque sadly passed away on December 29, 2012. Dr. Bourque who was a family physician and the President of Vivre dans la Dignité in Quebec will be truly missed.

EPC recognizes the many victories and challenges that have occurred in 2012, and we know that we will experience many challenges in 2013. EPC is intervening at the BC Court of Appeal in the Carter case (March 4 - 8), we are intervening in the Leblanc case in Trois Riviéres Quebec (March 25 - 28). EPC expects there will be attempts to legalize assisted suicide in several States in the US, and there will be attempts to legalize euthanasia in at least Australia, New Zealand, Scotland and France, and there is a court case in Ireland that is trying to legalize assisted suicide and euthanasia by mirroring the Carter case in Canada.

The most visited EPC article in 2012 was written by Alex Schadenberg: Euthanasia is out-of-control in the Netherlands - New Dutch statistics.

Rasouli case: 'End of life' often really means 'ending life.'

While going through my emails I came across this excellent article that was written by Tom Koch, a bio-ethicist and gerontologist in Toronto. This article was published in the Toronto Star on December 15, 2012 under the title: 'End of life' often really means 'ending life.'

Koch examines the Rasouli case based on its similarities to the issues within the Carter case in BC and the Leblanc case in Quebec. The Carter case and the Leblanc case seek to legalize assisted suicide and euthanasia in Canada.

The Euthanasia Prevention Coalition (EPC) had intervenor standing in the Rasouli case at the Supreme Court of Canada and has intervenor standing in the Carter case at the BC Court of Appeal and the Leblanc case at the lower court in Quebec.

'End of life' often really means 'ending life'

Tom Koch

Tom Koch, Toronto Star - December 15, 2012

Hassan Rasouli lies in a bed, his family by his side, as machines assure his bodily functions and the Canadian Supreme Court decides his future. Should Sunnybrook Hospital physicians be given the right to discontinue his respirator or should his family’s wishes for his continued care take priority?

The Rasouli case is the flip side of one heard last summer in B.C. Supreme Court where Gloria Taylor, a woman with Lou Gehrig’s disease (ALS), successfully sued for the right to physician-assisted termination at a moment of her choosing. Taylor later died of an infection while her case was on appeal. Taylor wanted to control her death while the Rasouli family wants to control their father and husband’s continued life.

What the court decides in Rasouli’s case will give us insight into its thinking when the case of Ginette LeBlanc — another woman with ALS seeking physician-assisted termination — is heard in the Quebec Supreme Court next March.

There are two very different positions in all these cases, each defined by the language used by proponents. In thinking about what these cases mean, and how we should address them, it’s the language that tells the tale. Here is a sample of the oppositions that stand for either continued life or termination at a moment of either a person or a doctor’s choosing.

The 2012 Royal Society Expert Panel Report on End of Life Decision Making, for example, talked about “physician-assisted death” while I talk about “physician-assisted or directed termination.” The first describes a passive, morally neutral role by physicians who accept death’s inevitability and take as their mission helping persons to meet it without fuss.

The second is a bare, active description. In providing drugs that stop the heart, in discontinuing life support we do not “assist” but wilfully terminate a life that is ongoing. Maybe we are right to do this, maybe not.

At the very least, we need to know the difference.

The Royal Society’s experts also talked about “end of life decision-making.” So, too, do most popular writers. But none of these cases are about “end of life” and its final choices. The issue is ending a life that is ongoing.

Hassan Rasouli

With continued support, Hassan Rasouli, 61, could continue for years. So, too, would LeBlanc, whose ALS is not “terminal” in any short-term sense of the word. So we are talking about people at the “end of life” only to the degree they are terminated prematurely.

The physicians who seek the court’s permission to terminate Rasouli’s care over the objection of his family insist his condition is “futile.” By this they mean they cannot do anything to improve his condition. And there they are correct. But the family insists the effort it takes to keep him alive is not “futile” because his life has value and care buys him time to recover on his own. “The treatment is 100-per-cent effective,” a family spokesman reported. “It permits him to breathe.”

In arguing for discontinuing life support, the physicians imply that where respiration is mechanized and brain function is at best minimal, there is no life.

But as Rasouli’s advocates said in court — and as others have insisted in other cases — we are unclear about the science of these things. Studies in the 1990s of patients diagnosed as being in a “persistent vegetative state” found many to be, in fact, at least minimally conscious. A few were “locked in,” unable to communicate but very much aware. And we also have “coma miracles” in which persons long believed dead to the world awoke for reasons nobody understands.

That is why some people use “persistently unconscious” rather than “vegetative” in describing such cases The former suggests the potential for an improvement the latter denies.

Beneath this discussion runs the bottom line, not of care and caring, of life and how we value it, but money. Some reporters — and physicians — have suggested the issue is one of triage, of the best use of health-care dollars and equipment in a period of scarcity. But what is right, what we should do in medicine and as a society, is not about cost efficiencies. If we believe it is important, we find the monies for what we need.

We can afford to maintain the occasional citizen whose family insists — even if only on the basis of faith — a restricted life is still a worthy life. The question isn’t money, in other words, but our willingness to spend on the fragile life.

Finally, there is the irksome issue of “autonomy” and choice. For 40 years or more, medical ethics has focused upon the idea of patient autonomy and the right to patient choice. Where the patient is unable it is the “surrogate,” usually a family member, who gets to make the call on care or its cessation.

In this case, that idea is challenged by physicians who seek to trump the choice of the patient’s surrogates who include, by the way, a physician. So do we advocate patient autonomy and choice only when it is cost efficient and convenient? Or is the patient’s right of choice inviolate, even when the attending doctors disagree?

There is a problem of consistency here. If we are to grant people like Gloria Taylor or Ginette LeBlanc a right to termination, doesn’t that mean we must grant to the Rasoulis the right to choose continuance?

The heart of the issue is this: Is there ever an “unworthy life”? Or, as the Rasouli family insists, is life worth preserving even in a fragile, limited state? Here members of the so-called disability community weigh in on the potential of life in restricted states. “We know,” they say, “what you do not. The life you see as insupportable is to us our life and worthy after all.”

Tom Koch is a bioethicist and gerontologist. His latest book is Thieves of Virtue: When Bioethics Stole Medicine.

EPC granted intervenor standing at the BC Court of Appeal in the Carter case.

The Euthanasia Prevention Coalition (EPC) and EPC-BC, were granted intervenor standing today in the appeal of the decision by Justice Smith in the Carter case at the BC Court of appeal. 

The Honourable Madam Justice Neilson granted EPC and EPC-BC intervener standing based on our legal experience and based on the fact that EPC represents a broad cross-section of the Canadian population.

EPC also intervened in Carter before Justice Lynn Smith at the lower court. EPC has been granted intervener standing in the Leblanc case in Quebec, EPC intervened in the Rasouli case at the Ontario Court of Appeal and EPC also intervened today at the Supreme Court of Canada in the Rasouli case.

It was argued by the respondents that EPC should not be given standing in the appeal of Carter based on the fact that parts of the EPC submission are similar to the Government of Canada submission while other parts of the submission were similar to that of the Council of Canadians with Disabilities/Canadian Association for Community Living submission. 

EPC argued that while we share some of the same concerns as other intervenors, that we also offered a unique perspective.

Madame Justice Neilson decided that the EPC submission will focus on the following points:

1) in other jurisdictions where assisted suicide or euthanasia have been legalized, the safeguards put in place are illusory and have resulted in significant abuse. They are value-laden as they differentiate between levels of disability, and do not protect those most vulnerable from abuse;
2) the lower court misapprehended and misapplied expert evidence relative to the efficacy of safeguards in permissive jurisdictions that have legalized assisted suicide;
3) the trial judge erred in her (s. 15) analysis by failing to consider the circumstances of vulnerable groups in jurisdictions with legalized assisted suicide or euthanasia, whose lives are marginalized and devalued by these practices;
4) the trial judge wrongly relied upon the "myth of autonomy" and inverted the notions of autonomy and choice in a manner that derogates from the equality, dignity and respect of vulnerable groups and devalues, stigmatizes and subjects members of these groups to prejudicial views. Her decision effectively creates a class of persons with disabilities for whom death is perceived as not only acceptable but desirable, and diminishes choice and autonomy for the most vulnerable members of society.

EPC welcomes the opportunity to submit legal arguments before the BC Court of Appeal with the goal of protecting vulnerable people from euthanasia and assisted suicide at the BC Court of Appeal during the hearing (March 4 - 8, 2013). EPC recognizes that this case will likely be decided by the Supreme Court of Canada. 

EPC also intervened today before the Supreme Court of Canada in the Rasouli case. We hope that the Supreme Court of Canada will make a balanced decision in a similar manner to the unanimous decision by the Ontario Court of Appeal.

The Euthanasia Prevention Coalition requires your financial support to enable us to intervene in the appeal of the Carter case. Donations to EPC can be made online here.

Assisted suicide: debate deals with abuse, compassion

Wanda Morris and Margaret Dore (left).

Last night, Margaret Dore, a lawyer from Seattle Washington and leader of the group - Choice is an Illusion, debated Wanda Morris from Dying with Dignity Canada in Kamloops BC. Tonight Margaret Dore and Wanda Morris are continuing their debate in Kelowna BC.

The Kamloop Daily News reporter, Mike Youds, wrote the following article today:

Lawyer cautions against legislating through courts

A right to medically assisted suicide may sound compassionate and just, but beware the details when it comes to the act itself, a U.S. lawyer warned Wednesday in a debate at TRU.

Margaret Dore shared some of her experiences with assisted suicide in Washington State, where the practice became legal through a ballot measure four years ago.

“A lot of people think this is a great idea until they start thinking and reading about how you do it,” she told an audience of about 30 people in the Irving K. Barber Centre.

In effect, laws in Washington and Oregon empower people who may choose to abuse the responsibility, Dore said.

 “Your heir can be there to help you sign up. Once the legal dose leaves the pharmacy, there is no oversight whatsoever.”

Wanda Morris, head of the Canadian charity Dying With Dignity, advocated for the right to choose to end life humanely.

“These are individuals who want to live, but they are individuals facing a horrific death,” she said. “The fundamental difference is choice. Choice is important in Canada. Why is it, at the time of life when we’re facing our toughest decision we could ever make, that choice is taken away?”

The issue has long been debated in Canada, where two years ago Parliament easily defeated a bill that would have permitted assisted suicide and euthanasia. Recently the subject has made headlines again with two court high-profile court cases in B.C. and Quebec.

“Autonomy is such a critical value, it is a cornerstone of modern medicine,” Morris continued. “Nothing can be done without consent. And yet here, at the end of life, I’m not given that choice.”

Dore said she agrees that people should have the right to choose how they die, but the U.S. laws don’t give that. Four days after the Washington State law passed, the adult son of a care facility resident showed up asking how “to get them pills,” she said.

“Who’s choice?,” she asked rhetorically. An adult child can administer the lethal dose with no one else to tell whether it was a matter of consent. “There is no oversight over administration.”

Morris insisted that the law her organization has long pushed for would only apply to individuals with six months or less to live. Dore countered that such a restriction does not apply in the U.S. and pointed to a case where an Oregon woman, who was talked out of suicide by her doctor, remains thankful she has survived another 12 years.

There was a $5.4-million lobby for assisted suicide in Washington, a machine that was up against a volunteer group, she said.

“In Canada and the U.S., there is a very significant funder in this debate and it is the Catholic church,” Morris said.

Opponents of assisted suicide argue from dogmatic positions and cannot be satisfied, she said.

“Excuse me, but I never said anything about Catholic dogma,” Dore replied.

She warned that Canada, having rejected the idea in Parliament, is facing the possibility of legislating it through the courts with the Carter and Leblanc court cases.

“We have a blank slate and we can write in whatever controls we want to protect the weak and the vulnerable,” Morris said.

Canada Update - Court cases seek to legalize euthanasia and assisted suicide

On January 27, 2012, EPC legal counsel, Hugh Scher, was in Trois-Rivières Quebec requesting co-intervener standing for EPC and Vivre dans la Dignité in the Leblanc case. The Leblanc case seeks to have Canada’s assistedsuicide law (Section 241b of the Criminal Code) declared unconstitutional and to decriminalize euthanasia.

Even though Duval may have intended to limit the challenge to the assisted suicide act, Section 11 of the Leblanc Notice of claim states:

“Due to her physical limits, the plaintiff will not without the help of a healthcare professional and / or that of a person acting under the supervision of such business, obtain and / or administer medication and / or the necessary treatment (s) to end her life.”

To administer requires another person to do the act, which is euthanasia.

At the preliminary hearing for the Leblanc case, Rene Duval, the lawyer for Ginette Leblanc, and the lawyers for the Attorney General, did not object to EPC and Vivre dans la Dignité being granted intervener standing, the only question was what rights will be given to their intervention.

In the past year, EPC intervened at the Ontario Court of Appeal in the Rasouli case, intervened in the Carter case at the Supreme Court of British Columbia (BC), and we are now seeking to intervene in the Leblanc case in Quebec.

EPC also intervened in the Carter case which was heard from November 14 - December 16 in Vancouver BC. The co-intervention by EPC and EPC - BC was heard by Justice Smith on December 14.

The Carter case clearly intends to decriminalize euthanasia and assisted suicide in Canada.

In the Carter case Notice of Claim, language was inserted that might become the framework for a law to allow the direct and intentional killing of people by euthanasia or assisted suicide.

The Carter case did not restrict actsof euthanasia or assisted suicide to physicians. The Statement of Claim says: a person acting “under the general supervision of a medical practitioner.” Family or other care-givers can act under the general supervision of a medical practitioner. The Carter case would allow a family member to cause the death.

The Carter case did not restrict euthanasiaor assisted suicide to people who are terminally ill. Carter defines eligibility based on people who are “grievously and irremediably ill.” Carter does not define grievously or irremediably ill but provides examples: “cancer, chronic renal failure and/or cardiac failure, and degenerative neurological diseases such as Huntington’s disease and multiple sclerosis.” The definition includes people who are not terminally ill but living with chronic conditions or disabilities.

John Coppard

John Coppard, a military veteran from Victoria BC, became involved with opposing assisted suicide for these reasons. He wrote in a letter to the editor:

 “As a person who is “grievously and irremediably ill” with Grade IV brain cancer, I would be affected should this case succeed. Two and a half years after being given a 20 percent chance of surviving five years, I am doing very well on medication approved by Health Canada only a year ago, within a week of my cancer coming back. 

Had I been given the legal choice of assisted suicide when I first received my terrible prognosis, or when my cancer returned, when I felt hopeless, I don’t know what I would have done. 

Now I’m doing very well, thanks to medical advancements that are coming faster than at any time in our history. Our anti-assisted suicide laws protected me and gave me a chance for a long and happy life, just as they were intended to do.”

In Oregon, where assisted suicide is legal, the Oregon law limits assisted suicide to people with “six months to live.” Jeanette Hall, from Oregon, was terminally ill and wanted to die by assisted suicide. Eleven years later she wrote in a letter to the editor:

“I wanted to do what our [assisted suicide] law allowed, and I wanted my doctor to help me. Instead, he encouraged me not to give up, and ultimately I decided to fight my disease… If my doctor had believed in assisted suicide, I would be dead.”

The Carter case has been argued and we are waiting for a decision from Justice Smith. Based on her reputation as an activist judge, we are concerned that Smith may legislate from the bench.

If Smith legislates from the bench and in some way legalizes euthanasia and/or assisted suicide, the Hon Rob Nicholson (Attorney General of Canada) must immediately appeal the decision to the BC Court of Appeal. From there, the case would go to the Supreme Court of Canada.

Duval, the lawyer representing Leblanc, hopes to have their case join the Carter case at the Supreme Court of Canada.

The Euthanasia Prevention Coalition (EPC) and EPC – BC co-intervened in the Carter case in BC. EPC and Vivre dans la Dignité are seeking to co-intervene in the Leblanc case in Quebec.

You can make a difference.

The petition campaign to the Attorney General of Canada has been incredibly successful. Since we are waiting for a decision from Justice Smith in the Carter case, and since the Leblanc case has been launched in Quebec, you can collect signatures for the petition by downloading the petition online or sign the online petition.

Hon Rob Nicholson

You can write a hand-written letter to the Hon Rob Nicholson, Attorney General, urging him to immediately appeal any court decision that weakens the laws protecting us from euthanasia and assisted suicide. The letter should use a similar introduction plus one or both of the following talking points, with a similar conclusion.

As a Canadian, I ask that you do whatever possible to uphold our laws that protect me from Euthanasia and Assisted Suicide.

*I am concerned that legalizing euthanasia and/or assisted suicide will lead to pressure being placed on people with disabilities. Some deaths may occur without request or consent, as has happened in other jurisdictions.

*I am concerned that legalizing euthanasia and/or assisted suicide will lead to new paths for elder abuse which is already a serious social problem in Canada.

Dependent elderly people or people with disabilities may die by euthanasia or assisted suicide because of pressure from abusive relationships that they are already experiencing.

I ask you to appeal any court decision that would in some way weakens our laws that protect people from euthanasia and/or assisted suicide.

Send the letter to: 

Hon. Rob Nicholson (Attorney General of Canada); 

House of Commons; Ottawa Ontario  K1A 0A6

The Euthanasia Prevention Coalition needs your financial support to protect you from euthanasia and assisted suicide in Canada. The cost to intervene in the Carter case was $53,000. The Euthanasia Prevention Coalition  needs your financial help to continue.

The Leblanc case in Quebec - Further thoughts.

On October 31, René Duval, the lawyer for Ginette Leblanc submitted the notice of claim in Trois-Rivières Quebec, asking the Quebec Superior Court to overturn Section 241b of the Criminal Code in order for Mme Leblanc to die by assisted suicide. Ginette Leblanc lives with ALS.

The Notice of Claim in the Leblanc case stated that it was challenging the constitutionality of Section 241b of the Criminal Code, which is the assisted suicide act. It did not indicate openly indicate that it was challenging any other section of the Criminal Code. After reading the Notice of Claim, I was convinced that the Leblanc case was limited to Section 241b of the Criminal Code, but after speaking to Margaret Dore and after reading her commentary on the Leblanc case, I am convinced that the Leblanc case quietly seeks to legalize euthanasia.

The Euthanasia Prevention Coalition (EPC) and Vivre dans la Dignité are seeking to co-intervene in the Leblanc case.

The Leblanc case appeared to be taking a less aggressive approach than the Carter case in British Columbia that is clearly trying to legalize euthanasia and assisted suicide in Canada. Carter Talking Points. Carter was heard by Justice Lynn Smith in Vancouver BC from November 14 - December 16, 2011. EPC and EPC - BC co-intervened in the Carter case and made its legal presentation before Justice Smith on December 14.

Margaret Dore, the fabulous lawyer and elder abuse advocate from Seattle Washington, pointed out that Section 11 of the Leblanc Notice of Claim states:

11. Due to the physical limits, the plaintiff will not without the help of a health care professional and / or that of a person acting under the supervision of such business, obtain and / or administer medication and / or the necessary treatment (s) to end her life.

To administer medication, would constitute an act of euthanasia and not an act of assisted suicide.

The other point that Margaret makes, which was not missed by myself, is that Canada's assisted suicide act does not refer to physicians, therefore striking down Section 241b of the Criminal Code would grant anyone the right to assist the suicide of another.

The Leblanc case went further by stating in Section 11 that: "a person acting under the supervision of a health care professional" could assist the suicide. This traditionally includes family members.

In conclusion, it appears that if the Quebec court accepts the pleadings in the Leblanc case, that in fact they would be decriminalizing assisted suicide and they would be, under the cover of imprecise language, decriminalizing euthanasia.

If I am wrong, please make your case.

The Leblanc Case in Quebec: A Recipe for Elder Abue and a Threat to the Individual

"Those who believe that legal assisted suicide/ euthanasia will assure their autonomy and choice are naive."

William Reichel, MD

Montreal Gazette, May 30, 2010[1]

By Margaret Dore

January 26, 2012

A. Introduction

Leblanc vs. Attorney General of Canada brings a constitutional challenge to Canada's law prohibiting aiding or abetting a suicide. Leblanc also seeks to legalize assisted suicide and euthanasia as a medical treatment. In 2010, a bill in the Canadian Parliament seeking a similar result was overwhelmingly defeated.

Legalization of assisted suicide and/or euthanasia under Leblanc will create new paths of elder abuse. This is contrary to Canadian public policy. Legalization will also empower the healthcare system to the detriment of individual patients. There will be other problems.

B. Parliament Rejected Assisted Suicide and Euthanasia

On April 21, 2010, Parliament defeated Bill C-384, which would have legalized assisted suicide and euthanasia in Canada.[2] The vote was 228 to 59.[3]

C. The Notice of Civil Claim

In Leblanc, the Notice of Civil Claim seeks to strike down § 241(b) of the Criminal Code of Canada as contrary to the Canadian Charter of Rights and Freedoms.[4] § 241(b) states:

"Every one who . . . (b) aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years."[5]

If § 241(b) would be struck down, it appears that any person, without restriction, would be allowed to assist another person's suicide.

The Notice of Claim also seeks to allow a healthcare professional, not necessarily a doctor, and/or a person acting under the professional's supervision, to "obtain and/or administer medication and/or the necessary treatment to end [the plaintiff's] life."[6] This request, to allow someone to actively administer a lethal modality to another person, is a request for euthanasia. The Canadian Medical Association states:

"Euthanasia means someone taking active measures to end life."[7]

In the context of traditional medical treatment, a person acting under the "supervision" of a healthcare professional would include a family member.[8] An example would be an adult child who administers medication to a parent under the supervision of a doctor who is not present.[9] This would typically be in a home setting.[10]

The Notice of Claim does not define any particular eligibility for assisted suicide/euthanasia other than a description of the plaintiff.[11] She is a disabled woman with ALS.[12]

D. A Comparison to the United States

In the United States, there are two states where assisted suicide is legal: Oregon and Washington.[13] The laws in these states were enacted via ballot initiatives, which are similar to a referendum in Canada.[14] No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[15]

The Oregon and Washington laws apply to patients predicted to have less than six months to live, who are typically age 65 or older.[16] The statutes have safeguards, for example, two doctors are required to approve a lethal prescription; there are also waiting periods.[17] These laws nonetheless leave patients unprotected against elder abuse, coercion and even murder. Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, states:

"With assisted suicide laws in Washington and Oregon, [elder abuse] perpetrators can . . . take a 'legal' route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over the administration. . . . [E]ven if a patient struggled, 'who would know?'" [18]

E. Elder Abuse

Preventing elder abuse is official Government of Canada policy.[19] Elder abuse includes physical, psychological and financial abuse.[20] Financial abuse is the most commonly reported type.[21] Elder abuse is, however, largely unreported and can be very difficult to detect.[22] This is due in part to the reluctance of victims to report. The Government of Canada website states:

"Older adults may feel ashamed or embarrassed to tell anyone that they are being abused by someone they trust."[23]

Will Johnson, MD, echoes these themes as follows:

"I see elder abuse in my practice, often perpetrated by family members and caregivers. A desire for money or an inheritance is typical. To make it worse, the victims protect the perpetrators. In one case, an older woman knew that her son was robbing her blind and lied to protect him. Why? Family loyalty, shame, and fear that confronting the abuser will cost love and care. . . .

Under current law, abusers take their victims to the bank and to the lawyer for a new will. With legal assisted suicide, the next stop would be the doctor’s office for a lethal prescription. How exactly are we going to detect the victimization when we can’t do it now?"[24]

If assisted suicide and/or euthanasia are legalized via Leblanc, new paths of abuse will be created against the elderly, which is contrary to Government of Canada public policy. For this reason alone, the relief requested in Leblanc should be denied.

F. Empowering the Healthcare System

In Oregon, where assisted suicide has been legal since 1997, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead.[25] The most well known cases involve Barbara Wagner and Randy Stroup.[26] Each wanted treatment.[27] The Plan offered them suicide instead.[28]

Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: “I'm not ready to die.”[29] Stroup said: “This is my life they’re playing with.”[30]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering. If assisted suicide and/or euthanasia are legalized in Canada, the Canadian health care system will be similarly empowered. Indeed, even the plaintiff could find herself pushed to her death before she is ready. She could be a Canadian "Barbara Wagner." Her "choice" would be compromised and/or denied.

F. Suicide Contagion.

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[31] Just three years prior, Oregon legalized assisted suicide.[32] This increased suicide rate is consistent with a suicide contagion.[33] In other words, legalizing one type of suicide encouraged other suicides. In Canada, preventing suicide is a significant public health issue.[34]

G. Conclusion

In Leblanc, the relief requested should be denied.

***

Margaret Dore

Margaret Dore is President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia with a focus on the US and Canada. In November 2010, she appeared as an expert witness before the Select Committee on Dying with Dignity of the National Assembly of Quebec, Canada. She was an amicus curie in Baxter v. Montana, which is similar to Leblanc v. Attorney General of Canada.

Ms. Dore has been licensed to practice law in Washington State since 1986. She is a former Law Clerk to the Supreme Court of the State of Washington. She worked for the United States Department of Justice for one year. She has published multiple articles on elder abuse topics and against assisted suicide and euthanasia.

For more information, see: http://www.choiceillusion.org/ and http://www.margaretdore.com/.

Euthanasia and Assisted Suicide – Canadian Update – The battle is in the courts.

By Alex Schadenberg,
Executive Director - Euthanasia Prevention Coalition

On April 21, 2010, Bill C-384, a bill that would have legalized euthanasia and assisted suicide in Canada, was resoundingly defeated in parliament by a vote of 228 to 59. Many Canadians wrote letters or signed post-cards to Members of Parliament urging them to vote against Bill C-384 and to maintain the protections in law from euthanasia and assisted suicide.

The euthanasia lobby in Canada reacted to their massive defeat in parliament by turning their attention to the courts.

In February 2011, the Farewell Foundation, a group in British Columbia that exists to aid their members suicides, launched a case in the BC Court to challenge the constitutional validity of Canada’s assisted suicide act. The Farewell Foundation case was challenging a ruling by the BC Registrar of Companies who denied the Farewell Foundation corporate status. The law does not permit organizations that exist solely to break the law to given corporate status.

In early April 2011, the Farewell Foundation launched a second case in the BC Court that stated that the laws that protect Canadians from assisted suicide are unconstitutional. The Farewell Foundation stated that five of their members wished to die by assisted suicide and the law unconstitutionally infringed upon their “right to die” by assisted suicide.

BC Supreme Court Justice, Lynn Smith, was assigned to the Farewell Foundation case.

In late April 2011, the BC Civil Liberties Association (BCCLA) launched the Carter case to overturn the laws protecting Canadians from euthanasia and assisted suicide. The BCCLA representing the Carter family, stated that the rights of Kay Carter were infringed upon because she had to go to Switzerland to die by assisted suicide. The BCCLA also stated that the Carter family broke the assisted suicide law, by arranging and bringing their mother, Kay, to die by assisted suicide in Switzerland.

The BCCLA, in Carter, did not limit their challenge to the assisted suicide statutes of the Criminal Code. The definitions used in the case includes a challenge to the laws that protect Canadians from euthanasia.

Justice Smith asked to have the Farewell Foundation case and the Carter case heard together. At a pre-trial hearing Justice Smith indicated that the Carter case would be heard but the case lacked urgency, since Kay Carter had already died in Switzerland and the Carter family had not been prosecuted for their part in their mother’s death.

In response to Justice Smith stating that the Carter case lacked urgency, on June 28, the BCCLA amended their notice of claim by adding Gloria Taylor, a woman who is living with ALS.

On August 3, Justice Smith accepted the amended notice of claim. Due to the health condition of Gloria Taylor, Smith decided to fast-track the Carter case. At the same time Smith questioned the relevancy of the Farewell Foundation case and a few weeks later she rejected the Farewell Foundation case, while encouraging the Farewell Foundation to intervene in the Carter case.

The Euthanasia Prevention Coalition (EPC) and EPC – BC received intervener standing in the Carter case. EPC asked to intervene and to have the right to introduce evidence in the court. The court granted EPC and EPC – BC intervener standing but denied them the right to call evidence.

In early November, the Leblanc case was filed by lawyer René Duval in Trois-Rivières Quebec. Duval seeks to have Canada’s assisted suicide law declared unconstitutional on behalf of his client, Ginette Leblanc, who lives with ALS. The Leblanc case is written in a tighter manner by limiting its challenge to the assisted suicide act and not challenging the law pertaining to euthanasia.

The Carter case was heard from November 14 to December 16 in a Vancouver courtroom. The intervention by EPC and EPC - BC was heard by Justice Smith on December 14.

The Carter case is difficult to define because the BCCLA, on behalf of the Carter family and Gloria Taylor, made it appear that they were seeking to legalize assisted suicide but in fact they were seeking a wider decision that would grant the plaintiffs euthanasia and assisted suicide.

The Carter case also included within the Notice of Claim language that might become the framework for a law that allows the direct and intentional killing of people by euthanasia or assisted suicide.

This framework in the Carter case does not restrict the acts of euthanasia or assisted suicide to physicians. Carter defines who carries out the acts as: a person acting “under the general supervision of a medical practitioner.” Family members or other care-givers may be able to act under the general supervision of a medical practitioner. Therefore a family member could cause the death under the language in the Carter case.

The Carter case does not restrict acts of euthanasia or assisted suicide to people who are terminally ill. Carter states that eligibility for death should be based on people who are “grievously and irremediably ill.” Carter does not define the terms grievously or irremediatebly but provides these examples: “cancer, chronic renal failure and/or cardiac failure, and degenerative neurological diseases such as Huntington’s disease and multiple sclerosis.” The definition does not exclude people with chronic disabilities and it is not limited to terminal conditions.

John Coppard

John Coppard, from Victoria British Columbia, became involved with opposing assisted suicide for similar reasons. He stated in a letter to the editor:

“As a person who is “grievously and irremediably ill” with Grade IV brain cancer, I would be affected should this case succeed. Two and a half years after being given a 20 percent chance of surviving five years, I am doing very well on medication approved by Health Canada only a year ago, within a week of my cancer coming back.

Had I been given the legal choice of assisted suicide when I first received my terrible prognosis, or when my cancer returned, when I felt hopeless, I don’t know what I would have done.

Now I’m doing very well, thanks to medical advancements that are coming faster than at any time in our history. Our anti-assisted suicide laws protected me and gave me a chance for a long and happy life, just as they were intended to do.”

In the state of Oregon, where assisted suicide is legal, assisted suicide is limited to people with a terminal prognosis of having six months to live. Jeanette Hall, who lives in Oregon, had a terminal prognosis and she wanted to die by assisted suicide. Instead, her physician convinced her to accept further treatment for her cancer. Eleven years later she stated in a letter to the editor:

“I wanted to do what our [assisted suicide] law allowed, and I wanted my doctor to help me. Instead, he encouraged me not to give up, and ultimately I decided to fight my disease… If my doctor had believed in assisted suicide, I would be dead.”

Carter has now been argued before Justice Smith and we are waiting for her decision. Based on other decisions that Smith has made and her reputation as an activist judge, we are concerned about the potential of a bad decision by Smith.

If Smith decides, in some way, to legislate from the bench and to legalize euthanasia and/or assisted suicide, then the Attorney General of Canada will need to immediately appeal the decision to the British Columbia Court of Appeal. From their, the case will end-up at the Supreme Court of Canada.

On January 27, 2012; the preliminary hearings are starting in Trois-Rivières Quebec on the Leblanc case. The Leblanc case may be more dangerous than the Carter case because Leblanc limits its challenge to assisted suicide and it does not attempt to impose a wide-open regime of assisted suicide on Canada. If the judge in Quebec decides to overturn our assisted suicide law, then the case will need to also be appealed to the Court of Appeal.

Rene Duval, the lawyer representing Ginette Leblanc, hopes to have their case join the Carter case at the Supreme Court of Canada.

The difficulty with battling issues within the court is:

* It is very hard to predict what a Judge will decide.
* It is very expensive to hire lawyers and argue before the courts.

The Euthanasia Prevention Coalition (EPC) and EPC – BC co-intervened in the Carter case in British Columbia. EPC and Vivre dans la Dignité in Quebec are seeking to co-intervene in the Leblanc case in Quebec.

This is a very difficult undertaking and we will keep you up-to-date on the progress of these cases.

Meanwhile, you can make a difference by writing a hand-written letter to your Member of Parliament and the Hon Rob Nicholson, Attorney General, urging the Attorney General to immediately appeal any court decision that weakens our laws that protect us from euthanasia and assisted suicide.  Link to the information about the letter writing campaign.

The Euthanasia Prevention Coalition needs donations towards the cost of the court interventions. Link to donate. http://www.euthanasiaprevention.on.ca/Donations.htm