Canada’s doctors have struggled mightily with the highly emotionally-charged issue of medical aid in dying. Even the words themselves – “euthanasia”, “assisted suicide”, and so on – invoke powerful images and serve to contribute to the polarization of the debate.
The CMA spent the past year consulting Canadians with a series of town halls across the country to hear the perspectives of patients, families, and health care professionals on end-of-life care. We discussed the need for more people to establish advance directives – ensuring their families know what kind of treatments they would want (and not want) at the end of life. We discussed the need for more and better palliative care services in Canada. And, yes, we tackled – head on – the issue of medical aid in dying.
We heard powerful, profoundly moving stories from patients and their families on both sides of the debate and everywhere in between. We heard about how important it is to protect the most vulnerable. We heard how terrifying it can be to lose control and to feel out of control of one’s own very being. We heard about the sanctity of life, but also about the absurdity of denying death, and how embracing death as a part of life….when the time comes….can be liberating.
What struck me as this consultation process unfolded was how deeply respectful the discussions were; how moving and how deeply personal they were…and how even the most strongly held views never seemed to belittle others who felt differently. And it occurred to me that what unifies us all on this issue, ultimately, is a deep sense of respect for the way others may feel, for themselves; just as we have come to expect respect for our views shown to us by others.
At the end of the day, whether or not to allow medical aid in dying is a decision for society – not doctors – to make. Indeed, changes to the legal environment are happening before our very eyes.
Quebec’s Bill 52 passed with all-party support, with plans to enact medical aid in dying legislation by the end of 2015. The Carter case in BC will come to the Supreme Court this Fall and will challenge Canada’s ban on medical aid in dying. Many experts believe that the law prohibiting medical aid in dying will be struck down. And in the House of Commons, Winnipeg Conservative MP Steven Fletcher’s private member’s bill on medical aid in dying has reignited the discussion at the federal legislative level as well.
As society changes, it is the job of Canada’s doctors to continue to serve our patients. In the final analysis, the debate on medical aid in dying is not about achieving consensus – I have my views and I am sure you all have yours, too. Consensus is unlikely to be achieved on such a personal issue that is imbued with questions of morality, ethics, and religious/spiritual beliefs.
Rather, the challenge we face is one of determining how to support patients, families and doctors best in this changing legal environment that reflects the will of greater society.
What should our role be?
Our role should be to meticulously protect the vulnerable, but to respect individual patients’ autonomy, within the bounds of the law. We should support our patients and their families not by judging, but by listening, respecting, comforting and advocating for them. Our patients must – and will – remain at the very centre of everything we do.