Must a life be preserved?

Gloria Taylor, who suffers from the degenerative Lou Gehrig's disease, has won the legal right to choose the moment of her death with a doctor's help after a B.C. Supreme Court judge ruled the existing ban on assisted suicide is unconstitutional. The ruling raises a contentious and complex question: must a human life be preserved? It is a question of such profound importance that the federal government must appeal this ruling to the Supreme Court of Canada.

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February 28 2012 edit dinky DALE CUMMINGS / WINNIPEG FREE PRESS / MEDICAL ERRORS (DALE CUMMINGS / WINNIPEG FREE PRESS) Photo Store

On June 15, Madam Justice Lynn Smith found that since 1993, when another British Columbian, Sue Rodriguez, was denied the same right, the law restricting individual liberties in order to protect rights of others has changed. Further, the experience of jurisdictions that permit assisted suicide shows that the vulnerable -- those who can be coerced, or those who can't speak for themselves -- can be protected. Now, she said, the absolute ban on assisted suicide unnecessarily denied Ms. Taylor's charter rights of liberty and security.

In 1993, the Supreme Court in a close 5-4 decision ruled that any denial of Ms. Rodriguez's liberties was not arbitrary or overbroad, but necessary to protect the vulnerable. Since the early 1990s, although a variety of Canadian bodies have reasserted the necessity of a ban, other jurisdictions, including four countries, have adopted permissive laws.

In the Netherlands, doctors can assist suicides of competent individuals who make an informed decision to end their suffering. In the U.S. states of Oregon and Washington, doctors can write prescriptions for lethal doses but the patient must administer the drugs.

Judge Smith found the risks, particularly to those who might be coerced into assisted dying, could be addressed by well-crafted rules that safeguard the vulnerable. In this, she reflected the dissenting opinions of the Supreme Court in 1993 -- including those of the former chief justice, Antonio Lamer, and of the current chief justice, Beverley McLachlin.

Very few jurisdictions have adopted assisted suicide laws. And few professional bodies agree that assisted suicide is appropriate or ethical for physicians, who take an oath to preserve life and to do no harm.

There is a developing body of opinion, however, that denying a suffering patient the right to terminate her life prolongs suffering and that, ethically, a physician is compelled to relieve that pain through assisting death.

This gets at the crux of the argument. Much of the opinion falls in favour of helping to end life for someone who is dying and in pain. Assisted dying, however, goes beyond doctors administering lethal doses of drugs to stop the pain of the terminally ill. Ms. Taylor's position is that the law should permit ending the existential suffering of severe psychological and psychosocial distress -- the loss, for example, of dignity of relying totally on others -- that comes when one is locked inside the body by an irremediable condition. She argued, successfully, that the law allows her to kill herself but discriminates against her when she is rendered disabled to do so.

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(DALE CUMMINGS / WINNIPEG FREE PRESS)

In 2010, an opinion poll with a three per cent margin of error indicated that 63 per cent of Canadians supported euthanasia. But when the term was qualified -- a terminally ill patient, in pain and within months of dying, compared to someone with a life-long but non-threatening condition (quadriplegia) -- support fell dramatically from 78 to 36 per cent.

The evidence from countries that permit assisted dying reveals that no model is fail safe and that the rules are not always followed exactly.

Anecdotal evidence indicates Canadian physicians and family members break the law on assisted suicide, technically or otherwise, to help people die. Ms. Taylor has her relief, but the federal government must appeal so all Canadians can know how the law now applies to them. It also should canvass Canadians in public hearings about how the law can balance compassion against protection for the vulnerable.

Republished from the Winnipeg Free Press print edition June 23, 2012 A16