The Canadian Medical Association has turned decisively on its policy, which once held that the doctor's national lobby group did not support euthanasia or assisted suicide. Now, following a meeting of its governing body, the general council, the CMA overwhelming voted to support "the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether to provide medical aid in dying."
The decision is a sign of the dramatically shifting ground in Canada on the issue of a person's right to choose to end their life with the help of a doctor. Assisted suicide and euthanasia, in which another person actively ends life rather than giving an individual information or the means to kill themselves, remains a criminal act but successive court decisions have now forced the issue to the Supreme Court of Canada, where it is expected to be heard this fall.
Last Tuesday, British Columbian Gillian Bennett joined the growing list of Canadians who have taken measures into their own hands and, in the course of doing so, made cogent, passionate pleas for the law to change. Ms. Bennett, 85, was suffering from dementia and feared most the point in life where her body was so incapacitated as to depend upon the care of others, where meaning was stripped from her existence. She got hold of a fast-acting barbituate, brought out a blanket to a favoured spot near her home on Bowen Island and died in the manner she had thought long and deeply about.
Ms. Bennett, in a blog called deadatnoon, laid out a political manifesto of sorts -- she did not want to become a burden upon her family or upon the Canadian welfare state in her advanced state of dying. Many Canadians will agree with her powerful argument, but it is not a road map to a reasoned, careful law, which would have to protect the vulnerable while providing competent individuals suffering unmitigated pain compassionate access to an assisted death.
The Quebec statute passed this spring comes closer to the mark. Set to come into effect late next year, the law provides for doctors to assist the suicide of patients under strict circumstances: The person must have a terminal illness and advanced state of irreversible decline, be of competent mind and in mental or physical pain a physician cannot relieve.
This Quebec law, new legal opinion and the evolving mind of Canadians on the matter pushed the country's physicians to address their position on physician assisted death. Prior to the resolution passing, the CMA said any movement away from its opposing assisted suicide would require a "fundamental reconsideration of traditional medical ethics." Today, it describes the new policy as a "modification" of its opposition, but that is a polite fiction, an attempt to bring a little peace on a complex moral issue the national lobby group acknowledges evades unanimity.
Doctors in Quebec, then, can follow their consciences within the law there; physicians elsewhere, however, as with all other Canadians confronted with dying in protracted suffering, will have to await the deliberation of jurists on the country's highest court.
This is unfortunate. At most, the court might strike down the Criminal Code sections on assisted suicide and euthanasia. It cannot write a workable compromise on a law fraught with peril. A handful of countries or states have legalized assisted-suicide, and their experience provides evidence to support both sides of this argument: That it is the humane thing to do, respecting the rights and autonomy of competent persons in pain; and, that it is a slippery slope endangering the lives of those most vulnerable -- the disabled, the very old and the very young.
A new law on assisted suicide must be intimately informed by the wide perspectives of Canadians. The Harper government cannot escape this fact, regardless of how the Supreme Court rules eventually. It should get started on the long, hard work of consulting citizens to find a made-in-Canada position on an issue that repeatedly has entangled the most learned of jurists and philosophers.