Friday, October 2, 2009

Canadian Doctors Oppose Bill C-384, Favor Waiting for Miracles.

Today the Canadian Medical Association sent a letter to Parliament opposing bill C-384 which would "amend the Criminal Code so a doctor can assist a consenting terminally ill patient or a patient in severe physical or mental pain 'without any prospect of relief … to die with dignity.'"

The bill was introduced by MP Francine Lalonde in May and opposition has formed against it among "pro-life" groups and doctors.

Jose Pereira, the Chief of Palliative Care at an Ottawa hospital spoke at a news conference, using the case of assisted suicide in Switzerland and his experience working there as example of how palliative care is diminished when assisted suicide is legalized.

In a press conference, Pereira stated:

We must not abandon these vulnerable people through assisted suicide and euthanasia, but instead embark on a quest to find better ways to maintain their dignity and quality of life," he said.

While I agree with the statement on its face, I wonder at the media's inability to drill into details. The bill as proposed looks to be very much like the Oregon Death with Dignity Law which has proven to advance palliative care in that state. Unfortunately, the CBC reporter fails to cover how the bill in constructed and how that compares to the laws in Oregon or Switzerland. The structure of any assisted suicide law, like any other law, determines its effectiveness.

But the bit of his quote that concerns me deeply is the last sentence:

He added that he hears daily about patients recovering from dire situations, and said people should never lose hope.

This argument against assisted suicide abounds in the Westernized and predominantly Christian countries like Canada, Britain and the US where the courts are currently grappling with end-of-life issues, health care reform, and proposed laws. What underlies the need to "never lose hope" is the chance that a patient can recover from a "dire situation" miraculously, against all odds. It reeks not only of the unrealized magical powers of modern medicine (which I acknowledge but don't give full credence to; among the terminally ill, there is a difference between prolonging life and prolonging death) and the Judeo-Christian concept of God's ability to perform miracles.

Opposition to assisted suicide for the mentally ill, I understand. Depression and mental incompetence can preclude one from making sound decisions.

Opposition to regulated assisted suicide for the terminally ill because it may lead us down the "social slippery slope" to euthanasia or other unwarranted killing is really a lack of faith in government regulation.

And this lack of faith implies the religious argument for miracles and God's jurisdiction over suffering (when government asserts individual rights or is seen as unable to dictate moral standards) or a false hope for the powers of medicine. The former is an (in the US) unconstitutional imposition on the beliefs of others; the latter is a denial of scientific fact.

The issue of assisted suicide is complicated by the media's inability or reluctance to discern between varieties of assisted suicide (also called euthanasia, aid in dying or death with dignity by various parties in the debate) - how the laws are drawn and how they work - and who they should be applied to: the terminally ill; those like Terri Schiavo in persistent vegetative states; or the mentally ill or depressed.

Until the laws, miraculous notions and science are clearly discussed as distinguishable and separate factors in how we approach assisted suicide we will be forced to debate the subject with muddy arguments.

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