Saturday 10 December 2011

Assisted Dying Debate


Since not one of us is getting out of here alive, we each have a potential stake in the drama now playing out in the B.C. Supreme Court. Experts predict that not only has it been “fast-tracked,” it is headed for the top court in the country. Gloria Taylor,63, who has ALS (Lou Gehrig's Disease) joined by three others including a physician is challenging the law that prohibits assisting a terminally ill person to end their life. The issue is one which our legislators have cowardly avoided revisiting ever since 1992 when the Supreme Court ruled 5-4 against Sue Rodriguez in a similar scenario. She also was from B.C. and had advanced ALS. She died with the assistance of an anonymous doctor in 1993. Under the current law the penalty for assisting carries with it a a jail term of up to 14 years.

It is to be sincerely hoped that this time around our common humanity and compassionate reasoning will trump the rigid, fear-based arguments of those opposed to change. It's a hopeful sign that one of the dissenting judges in the 1992 decision, Beverley McLachlin, is now chief justice of the highest court and also that public opinion polls show that Canadians now are overwhelmingly (about 75 per cent) in favour of liberalization.

As the debate evolves not only in the courts but also in the media and across the nation, several key themes of the opposition and critics of any change need to be examined in the service of greater clarity.

The first of these is the repeated objection that doctors have sworn to abide by the Hippocratic Oath which has as its core value the injunction to “do no harm.” I have yet to meet a physician who remembers ever being asked to swear by such an ancient code in medical school or elsewhere but it needs to be remembered that compelling a terminally ill patient who is in extreme, inexorable pain to linger on in a prolonged dying process could be the greatest harm of all. Not all pain can be controlled. Nor is palliative care a route everyone would choose. For most of us the thought of a prolonged death by suffocation in one's own body fluids or other forms of incapacitating horror conjure up the worst possible opposite of any hope of “dying well” with some shred of dignity intact.

Already too the well-worn charge that any attempt by a physician to meet the wishes of those who repeatedly and with full awareness of their situation request assistance in dying is “playing God” has been called into the debate. This may sound cogent to some but is really a sham argument. Given the sheer technological wizardry and skills of modern medicine, doctors “play God” by their therapies and decisions every moment of the day. The real question for modern medics is what kind of “god” will they be? Will they use their God-given wisdom and compassion at the end of life or permit suffering because of some past tradition or outdated opprobrium?

In my next column I'll discuss the oldest canard of all – the so-called “slippery slope” argument. Here I simply want to close with a deeply personal question for the reader. Do you really believe that it is morally right or in accordance with the deepest dignity and worth of any one of us to be legally forced to die in a manner that reflects not our own values and declared wishes but those of somebody else? In effect, that's what the present law says.