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Don’t fear the slippery slope

The Ottawa Citizen by Hilary Young 1 May 2010

Opponents of assisted suicide argue that to legalize it under any circumstances would diminish the value that Canadians place on life itself. They consider legalization to be the first step on a slippery slope that ends with physicians exerting pressure on the elderly to be euthanized to free up a hospital bed, or even to doctors killing patients without their consent. Such arguments likely contributed to the death last week of Bill C-384, a bill that proposed to legalize assisted suicide.

As a Bloc Québécois private member’s bill on a controversial subject, Bill C-384 never had much of a chance. It was defeated following second reading and never made it to committee.

This is unfortunate, because it is time that Parliament gave serious thought to enacting assisted suicide legislation.

Despite the dire predictions of opponents, there is no reason to fear a well-crafted law that decriminalizes assisted suicide. The experiences of jurisdictions where assisted suicide is legal reveal that few people actually avail themselves of their right to die with dignity. Those who do tend to be dying of painful, terminal diseases like cancer. The slippery slope seems not to have materialized in the Netherlands and Oregon, where assisted suicide has been legal since 2001 and 1997 respectively. In those jurisdictions, reports suggest that people are not pressured to choose death. It is true that, on rare occasions, doctors will euthanize patients without their consent (usually in the last days of their life and out of a desire to end a person’s suffering), but that happens in Canada, too. And it is illegal in Oregon and the Netherlands, just as it is — and would surely remain — here.

Clearly, any Canadian assisted suicide legislation must include safeguards to protect the vulnerable and ensure that there are no reasonable alternatives. Bill C-384, as it stood, included a number of such safeguards, including confirmation of diagnosis by a second doctor and a waiting period. Still, the proposed legislation was not perfect. For example, a potentially controversial provision allowed people with a terminal illness (which is not defined) to obtain assisted suicide even if they are not suffering.

Despite its flaws, the bill deserved to be studied in committee. Amendments could then have been proposed. Sixty-seven per cent of Canadians support legalizing euthanasia. The plight of those such as Sue Rodriguez, the British Columbian who took her fight for the right to assisted suicide all the way to the Supreme Court, elicits public sympathy.

Most of us think that there are at least some circumstances in which it is morally justifiable to help someone to die: not only to remove life-sustaining treatment but to actually write a prescription for a lethal dose of drugs, or perhaps even to administer those drugs.

The committee should have had the opportunity to address what those circumstances are. Would Canadian society have been better off if Sue Rodriguez had suffocated to death when her lung muscles stopped working? She had ALS, a degenerative disease, and ultimately received assistance in killing herself. Many cancer and AIDS patients spend their last days in excruciating pain. Is there a social interest in promoting life that justifies forcing them to live out their lives “naturally” and painfully? Even if there is a social interest in preventing assisted suicide and promoting the value of life, it isn’t obvious that that interest should always trump individuals’ desire to have help in ending their lives.

When I first started studying assisted suicide, I wasn’t convinced that the slippery slope could be avoided. Our medical system is far from perfect and palliative care isn’t always available to those who could benefit from it. Consider, then, that in Oregon, where there is no universal health care, there is no evidence that people are choosing death for financial reasons. In both Oregon and the Netherlands, people cite reasons for choosing death with dignity such as suffering and a loss of dignity and autonomy. This is not to say that palliative care won’t be an issue if and when assisted suicide is ever legalized in Canada – of course it will. It is simply to say that there is reason to think a carefully structured law, that would allow the incurably suffering to die with dignity, could do more good than harm.

Hilary Young is a professor in the Faculty of Law at the University of Ottawa. She teaches a course on Death and the Law.