Doctor-assisted death a dangerous step


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Manitoba's College of Physicians and Surgeons is asking the public for feedback on physician-assisted dying because the Supreme Court of Canada has declared it will be legal next year.

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Hey there, time traveller!
This article was published 08/11/2015 (2465 days ago), so information in it may no longer be current.

Manitoba’s College of Physicians and Surgeons is asking the public for feedback on physician-assisted dying because the Supreme Court of Canada has declared it will be legal next year.

Here’s a wee bit of feedback from me: yes, I favour physician-assisted dying. Please don’t abandon me as I die. Please provide clean sheets, food and morphine as death takes its course. Thank you.

Oh, wait. Sorry, I misunderstood. You’re really wondering if I’d like you to kill me?

Maybe the college should be asking for public feedback on physician-assisted suicide. If that’s the case, I have more feedback: the College of Physicians and Surgeons should tell the Supreme Court legalizing physician-assisted suicide is a big mistake. I have five reasons:


1. Typical argumentation for physician-assisted suicide hinges on a false dichotomy: physician-assisted suicide or painful death. Significantly, however, there’s a neglected third option: palliative care. Doris Barwich, president of the Canadian Association of Palliative Care Physicians, says most pain and distress can be controlled “to ensure comfort and quality of life.” For (rare) difficult cases, palliative sedation (a deep sleep) relieves extreme suffering as death takes its course. Moreover, allowing terminally ill patients to die from their illness via termination of life-support by withdrawing or withholding extraordinary, burdensome or medically useless treatment is already a legal and ethical part of palliative care. Physician-assisted suicide, then, isn’t needed.


2. Physician-assisted suicide misinterprets the patient’s plea for death. Such a plea is an expression of lamentation, according to palliative-care specialist John Scott. “For us to interpret such a cry as a request for a lethal overdose is to miss the mark completely. Lamentation is a call for support and relief, a search for meaning and an invitation for relationship. It is a cry of life.”


3. Physician-assisted suicide imposes a terrible burden on the vulnerable. If life is no longer society’s default position, then the most vulnerable members of our society — the elderly, terminally ill and disabled — must justify their continued existence. This is a kick in the teeth and just plain nasty.


4. Physician-assisted suicide threatens to dangerously weaken a society’s life-respecting foundations. Consider this observation from Leo Alexander, medical advisor at the Nuremberg war crimes trials: “Whatever proportions these (Nazi) crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude… that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick.”


5. A logical/legal slippery slope looms large with physician-assisted suicide. Reasons for one action also justify unintended actions. With legalized physician-assisted suicide, the fundamental principle undergirding patient autonomy becomes this: the sufferer has the right to doctor-assisted death to end his/her suffering. Significantly, accepting physician-assisted suicide as a legal right on the basis of this fundamental principle opens up and justifies many other situations in which persons suffer and request death. These situations include the non-terminally ill, the elderly, the disabled, persons with chronic pain and the depressed.

— — —

Let’s trust legislative safeguards for protection? Good luck. Aside from abuse (one-third of Belgium’s euthanasia deaths were illegal and lacked patient consent), safeguards will fail because courts promote consistency. Consistency demands all of the above-mentioned persons, if “enduring suffering that is intolerable to the individual” (per the Supreme Court of Canada), can be reasonably seen to have the right to be killed.

After all, at the core of these other situations is a sufferer who requests doctor-assisted death, rendering situational differences incidental. The sufferer’s consent based on his/her subjective perception of intolerable suffering is trump.

Physician-assisted suicide, then, puts us on a non-fallacious slippery slope that embraces death as a solution for suffering (instead of alleviating that suffering).

Physician-assisted suicide is not needed, it misunderstands patient need, it’s nasty, it’s dangerous, and it’s myopic — it’s a short-sighted, long-range recipe for undermining respect for life and weakening the common good.

Dear College of Physicians and Surgeons of Manitoba: please tell the Supreme Court of Canada it is making a mistake, and that excellent, well-funded palliative care — not killing — is the way forward.


Hendrik van der Breggen, PhD, is associate professor of philosophy at Providence University College in Otterburne.


Updated on Sunday, November 8, 2015 4:24 PM CST: Typo fixed.

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