Saturday, June 11, 2016
Why the Liberal Government is Defending Bill C-14 So Strongly
Because I know a lot about death, and I've seen a lot of people die, some of my friends have been coming up to me and asking the same question:
Why is Justin Trudeau's government clinging so stubbornly to its assisted dying bill C14?
My blogging friend Kirby Evans asks the same question here.
And my answer to him and the others is, for a very good reason.
For if the Senate dismembers the bill in this fashion.
It could destroy an intricately balanced piece of legislation, demolish its carefully crafted safeguards, and lead to the slaughter of the vulnerable.
And the main reason the Trudeau government is not throwing the doors to assisted suicide wide open, is because it can't be sure of what kind of brave new world we are now entering.
We are entering uncharted territory, we have no idea what might happen. And in a situation like that one caution is a virtue.
Which also explains why, as Michael Den Tandt points out, that even though the bill is less restrictive than many people imagine.
For starters, the language of the bill as now drafted does not say death must be imminent, that is, days or even weeks away. It stipulates that in order to be eligible for assisted death, an individual must have a “serious and incurable illness,” and be in an “advanced state of irreversible decline in capability.”
Aha! says the “make it less restrictive” camp, informally led by Sen. James Cowan; that’s a deviation from the Supreme Court’s language, which cites only “grievous and irremediable” ailments that cause chronic, intolerable suffering.
But then, C-14 introduces this qualifier: “… natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time they have remaining.”
It still leaves the decision in the hands of doctors and patients, and since all our deaths are reasonably foreseeable, it gives them a lot of latitude to determine when to end a life. And since the bill as written covers more than eighty percent of cases and conditions it's extremely unlikely that many Canadians will be condemned to interminable suffering.
But what makes Bill C14 so unique is that it practically challenges the courts, and the court of public opinion, to open that door further if necessary, once we see what brave new world we are living in.
The guiding logic, therefore, was to open the door as far as absolutely necessary but no further — allowing emerging medical practice, future court cases and study to inform amendments down the road.
The Liberals deliberately made their legislation tight, rather than loose, knowing there would be court challenges, and possibly a Supreme Court challenge, because that very process and the time involved were intended to provide opportunity for sober second thought.
Which it is very important to recognize, is the same cautious way EVERY country that has introduced assisted dying has acted. Tiptoed into it rather than rushed into it head first.
For it is an evolving process, we can only learn from experience.
And even in the Netherlands, fourteen years after assisted dying became lawful, they are still struggling to cope with the implications.
Laws permitting assisted suicide may justify the right of even psychiatric patients to end their lives in theory, but the reality of implementing such programs is messy, a study of the Netherlands finds.
"When you actually try to implement it even in a setting where there is excellent healthcare, there are a lot of red flags that need to be investigated further," said lead study author Dr. Scott Kim, a psychiatrist and bioethicist at the National Institutes of Health in Bethesda, Maryland.
There are reasons to be concerned even in that advanced country, and if the restrictions on assisted dying are dismantled, we too could face a flood of psychiatric patients seeking to end their lives.
Which as the president of the Canadian Psychiatric Association points out, complicates the situation.
Mental illness can affect how a person thinks. Depression fuels negative self-thoughts, self-blame, hopelessness and struggling with one’s place in the world. Negative events are dwelt upon and positive ones discounted, with emotional resilience lowered until mundane stresses seem overwhelming.
This predicament could be moot if suffering continued indefinitely. The value of suicide prevention is not to stay alive with intolerable suffering, but to avoid ending life during a vulnerable period. Unfortunately, cognitive distortions can lead some to decline treatment and seek death, despite the prospect of a healthy future.
Because throwing open the doors to assisted suicide could make that vulnerable group even more vulnerable.
In making the shift from a death-denying society to one that views death as another treatment option for illness, we must appreciate the nuanced differences leading to the common endpoint of death. Complex decisions without standards become value judgments or best guesses, and we should not be gambling with the vulnerable lives.
And the same goes for the fragile elderly or the disabled. Because I can't tell you how many times I have heard otherwise happy members of those two groups tell me they wish they could die because they don't want to be a burden to their families.
And I'm concerned that if assisted dying comes to be seen as an easy out rather than a last resort, many old and disabled people could be pressured into ending their lives before they are ready.
And that could also take the pressure off efforts to make their lives more comfortable and enjoyable, or undermine the work that is being done to provide the support seniors need so they can live in their own homes as long as is humanly possible.
Which has for years been one of my main missions in life.
So those are my concerns, or some of them. And while I'm not ruling out that Bill C14 could be improved, I'd be happy if it was.
And while I'm not writing this to defend the Trudeau government, I'm speaking out for the vulnerable who I care about and fear are being forgotten.
I do understand why the government is proceeding cautiously. And to accuse them of mounting an all out assault on the constitution for no good reason, or just for the hell of it, is unfair.
We are entering a brave new world. There are massive societal implications.
And until we figure out where we are going, we do need to tread carefully...
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