May Court Hospice provides palliative care

The Supreme Court of Canada has struck down a law that makes it a crime for physicians to assist in the death of individuals who are grievously ill. The court’s unanimous decision pleases many Canadians, alarms others and leaves religious leaders and politicians in a most delicate position. An Angus Reid poll in November 2014 indicted that 80 per cent of respondents in Canada support allowing a doctor, at the request of a competent, fully informed, terminally ill patient, to assist that person to die.

The court has ruled that the existing law leaves people suffering from an irredeemable illness with a cruel choice. “[They] cannot seek a physician’s assistance in dying and may be condemned to a life of severe and intolerable suffering,” the court said. The judges added that the law violates the charter rights and is therefore unconstitutional. As such, the court gave the federal government one year to draft a new law, and if Ottawa does not do so, there will be no law in place to regulate physician-assisted death.

Faith groups have long argued that life is a gift from God and that neither people who are ill nor those around them have the right to decide when life should end. They also warn lawmakers of a “slippery slope,” arguing that vulnerable people will come under pressure to choose death rather than burden their loved ones or society at large.

But the trial judge in the initial challenge to the law examined other jurisdictions where assisted death was available and concluded that the risks to vulnerable people were minimal. The Supreme Court judges agreed: “[The evidence] also supports her finding that a properly administered regulatory regime is capable of protecting the vulnerable from abuse or error.”

Judges in Canada don’t look at laws based on the interpretation of religious texts, but the court in this case obviously considered moral and ethical dimensions. “An individual’s response to a grievous and irremediable medical condition is a matter critical to their dignity and autonomy,” they said. “The prohibition [on physician-assisted death] denies people in this situation the right to make decisions concerning their bodily integrity and medical care and thus trenches on their liberty.”

Various religious groups have responded to the Supreme Court’s judgment. The Evangelical Fellowship of Canada expressed “deep” disappointment with the judgment and said that the court had decided that in some circumstances, “the killing of a person will be legal.” The Catholic bishops also expressed their dismay, saying that “helping someone to commit suicide is neither an act of justice or mercy, nor it is part of palliative care.”

Although the United Church of Canada made no formal statement, Moderator Gary Paterson wrote that “[the law] should change in order to allow physician-assisted dying in circumstances that meet carefully defined criteria.” The Primate of the Anglican Church of Canada, Fred Hilz, announced that his church is appointing a task force to guide its discussions on physician-assisted death.

All of these faith groups stressed the importance of improved palliative care. No doubt the Supreme Court judges would agree, although that was not the focus of the appeal that they heard. Better palliative care will not eliminate the requests for physician-assisted death by some people who are gravely ill, but the consensus is that it makes all the difference in the quality of life during one’s final stages.

This piece appeared in a somewhat more abbreviated form on my blog with the United Church Observer on February 12, 2015.