Dying with dignity
February 6, 2015 8:48 AM Subscribe
In a 9-0 decision, the Supreme Court of Canada ruled today that Canada's century-old legislation banning doctor-assisted suicide is unconstitutional. The decision is stayed for 12 months to allow for legal frameworks to be devised.
And for the Harper government to find some way to sink it.
posted by Naberius at 8:59 AM on February 6, 2015 [1 favorite]
posted by Naberius at 8:59 AM on February 6, 2015 [1 favorite]
I'm relatively confident that Harper won't find a way to sink it that the SCC won't look at very, very dimly. It's a unanimous decision so he can't even rely on dissent, and three quarters of Canadians are in favour. (Approximately; the number changes depending on the specific question asked, the floor is 67%).
posted by feckless fecal fear mongering at 9:05 AM on February 6, 2015 [4 favorites]
posted by feckless fecal fear mongering at 9:05 AM on February 6, 2015 [4 favorites]
Reading through the decision and Chief Justice Bev is on point.
Section 44
Section 44
The doctrine that lower courts must follow the decisions of higher courts is fundamental to our legal system. It provides certainty while permitting the orderly development of the law in incremental steps. However, stare decisis is not a straitjacket that condemns the law to stasis. Trial courts may reconsider settled rulings of higher courts in two situations: (1) where a new legal issue is raised; and (2) where there is a change in the circumstances or evidence that “fundamentally shifts the parameters of the debate” (Canada (Attorney General) v. Bedford, 2013 SCC 72, [2013] 3 S.C.R. 1101, at para. 42).posted by whittaker at 9:05 AM on February 6, 2015
As the second link indicates, I think Harper wants to stay as far away from the issue as possible. Like abortion access, this is one of those issues where his base is on the opposite side from popular opinion. As such, it's a huge loser for him. He needs to win the moderate vote in the next election to have any chance at winning. This is quite bad timing for him, imo. Yet another social issue that's dynamite in the fractures of his coalition.
He'd much rather not talk about it. I would be surprised to see any legeslation on it in the next year. Again, much like the abortion access situation.
posted by bonehead at 9:05 AM on February 6, 2015 [4 favorites]
He'd much rather not talk about it. I would be surprised to see any legeslation on it in the next year. Again, much like the abortion access situation.
posted by bonehead at 9:05 AM on February 6, 2015 [4 favorites]
well the government is going to have to do something - the SCC has suspended their declaration of invalidity of the relevant section of the Criminal Code for one year, which is basically an invitation to the feds to fix that section
posted by iona at 9:08 AM on February 6, 2015
posted by iona at 9:08 AM on February 6, 2015
Americans take note, 7 of the justices were appointed by Harper himself.
posted by any portmanteau in a storm at 9:09 AM on February 6, 2015 [4 favorites]
posted by any portmanteau in a storm at 9:09 AM on February 6, 2015 [4 favorites]
Section 7 of the Charter of Rights and Freedoms (right to life) is affirmed in this decision to be like any other right*—able to be surrendered voluntarily with informed consent.
*cf. Section 2 (freedom of expression) and entering a Non-disclosure agreement.
posted by whittaker at 9:10 AM on February 6, 2015
*cf. Section 2 (freedom of expression) and entering a Non-disclosure agreement.
posted by whittaker at 9:10 AM on February 6, 2015
This will become a platform plank for the Liberals, NDP, BQ, and Greens, I suspect. I'm very happy that the SCC wrote into the decision that doctors cannot be compelled, which very neatly deflates a stupid potential talking point. And that 'pain' is the primary criteria, not 'terminal illness.'
Lemurrhea, so glad you're around today, I was specifically hoping for your analysis of the decision.
posted by feckless fecal fear mongering at 9:12 AM on February 6, 2015 [2 favorites]
Lemurrhea, so glad you're around today, I was specifically hoping for your analysis of the decision.
posted by feckless fecal fear mongering at 9:12 AM on February 6, 2015 [2 favorites]
WOOOOOO! More in a few.
Looking forward to some of that sweet, sweet lawyerin'.
posted by mandolin conspiracy at 9:27 AM on February 6, 2015 [1 favorite]
Looking forward to some of that sweet, sweet lawyerin'.
posted by mandolin conspiracy at 9:27 AM on February 6, 2015 [1 favorite]
As the second link indicates, I think Harper wants to stay as far away from the issue as possible. Like abortion access, this is one of those issues where his base is on the opposite side from popular opinion. As such, it's a huge loser for him.
As someone who's heartily in favor of Physician-Assisted suicide here in the states, I applaud this - and this situation reminds me of the Terry Schaivo case in 2004: I distinctly remember alot of conservatives pulling hard on the 'pull the plug' side of the equation, and GW Bush, fresh from re-election, intervening personally, and not on the side of his base. When pressed about it, he said 'Well, I earned some political capital and I aim to spend it (sic)'.
At least Harper's not that daft.
posted by eclectist at 9:33 AM on February 6, 2015
As someone who's heartily in favor of Physician-Assisted suicide here in the states, I applaud this - and this situation reminds me of the Terry Schaivo case in 2004: I distinctly remember alot of conservatives pulling hard on the 'pull the plug' side of the equation, and GW Bush, fresh from re-election, intervening personally, and not on the side of his base. When pressed about it, he said 'Well, I earned some political capital and I aim to spend it (sic)'.
At least Harper's not that daft.
posted by eclectist at 9:33 AM on February 6, 2015
Americans take note, 7 of the justices were appointed by Harper himself.
Are you suggesting we wait and let President Walker make high court appointments?
posted by Thorzdad at 9:38 AM on February 6, 2015
Are you suggesting we wait and let President Walker make high court appointments?
posted by Thorzdad at 9:38 AM on February 6, 2015
I'm very happy that the SCC wrote into the decision that doctors cannot be compelled, which very neatly deflates a stupid potential talking point.
This reminds me of part of the SCC's decision in Re Same-Sex Marriage (10 years old last December!); one of the three things the SCC said was that religious officials could not be compelled to perform SSM if their faith opposed it, in keeping with the freedom of religion component of the Charter, again deflating a stupid talking point.
posted by Homeboy Trouble at 9:41 AM on February 6, 2015 [2 favorites]
This reminds me of part of the SCC's decision in Re Same-Sex Marriage (10 years old last December!); one of the three things the SCC said was that religious officials could not be compelled to perform SSM if their faith opposed it, in keeping with the freedom of religion component of the Charter, again deflating a stupid talking point.
posted by Homeboy Trouble at 9:41 AM on February 6, 2015 [2 favorites]
So, interesting things:
1. At last count 2 dozen of my lawyer have posted about this on facebook. They are all in support, and much more vocally than I expected. I expected support, but not the level of glee I am seeing.
2. Reading through the decision and Chief Justice Bev is on point.
Technically we don't know if McLachlin CJ wrote it - the decision is by The Court (per curiam). I'd be interested to hear from people who know the Court better than I about which Justice it reads like. Either way, she did some wrangling I'm sure, and it's great. nbd.
3. well the government is going to have to do something - the SCC has suspended their declaration of invalidity of the relevant section of the Criminal Code for one year, which is basically an invitation to the feds to fix that section
I guess theoretically they could leave it alone and then it'd just because a provincially-regulated thing, as with your usual health care? I'm not willing to count on that. But it'll be interesting either way.
4. Section 7 of the Charter of Rights and Freedoms (right to life) is affirmed in this decision to be like any other right*—able to be surrendered voluntarily with informed consent.
Well - only for "competent adults" who "clearly consent" with a "grievous and irremediable medical condition." [paragraph 127 for the exact language]. Your average person, as knowledgeable as possible, could not consent.
5. Honestly from a, like, legal procedure viewpoint, this case didn't feel all that interesting to me. There's a pretty short analysis of the right to life, liberty, and security of the person (and the latter two are lumped together) - the court said essentially that the absolute ban is not arbitrary, which I think is correct (you can see the path from "preventing death" to "ban assisted suicide", it makes sense). They said that it's overbroad - it covers more than it needs to (specifically, people with terminal illnesses yadda yadda). They then ignore questions of gross disproportionality because they've already said it was overbroad. And they ignore the equality argument (which I'm not positive but think is: some people have the resources to travel for assisted suicide in other jurisdictions, some don't, equality engages) because they're already used the life/liberty analysis.
The s.1 analysis (can it be justified in our civil society / does it achieve its goals in a minimally-impairing manner?) is fine but pretty bog-standard. A former prof of mine has been tweeting some great stuff about how the court is, yet again, pretending there's a big distinction between the s.7 analysis and the s.1 analysis here (and she's much, much smarter than I am).
6. One thing I really don't like: in the right to life analysis, the Court says: "the right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. " (paragraph 62). This is bad news for, for example, anti-poverty activists who want to argue that the Charter requires the government to fund affordable housing. It's state action, not inaction that engages the life interest. They are probably correct but I don't like it.
7. This is a fucking great line: "the trial judge also found — and we agree — that the absolute prohibition could not be described as a “complex regulatory response”. The degree of deference owed to Parliament, while high, is accordingly reduced." (paragraph 98). Oh snap.
8. As the second link indicates, I think Harper wants to stay as far away from the issue as possible.
Agreed. I haven't been following what's been happening in Parliament today, I know it's being discussed somewhat (along with the RCMP taking over Parliamentary security), but real life popped up.
9. I LOVE that Bedford (the case striking down sex work laws) is getting cited all over the fucking place. And PHS, with the needle exchanges. I was right that they were important! Suck it, straw people who disagreed with me!
Apologies if #5 is a little jargon-y. I can probably explain it, but I'd suggest reading up on the Oakes test and the PFJs instead.
posted by Lemurrhea at 9:42 AM on February 6, 2015 [12 favorites]
1. At last count 2 dozen of my lawyer have posted about this on facebook. They are all in support, and much more vocally than I expected. I expected support, but not the level of glee I am seeing.
2. Reading through the decision and Chief Justice Bev is on point.
Technically we don't know if McLachlin CJ wrote it - the decision is by The Court (per curiam). I'd be interested to hear from people who know the Court better than I about which Justice it reads like. Either way, she did some wrangling I'm sure, and it's great. nbd.
3. well the government is going to have to do something - the SCC has suspended their declaration of invalidity of the relevant section of the Criminal Code for one year, which is basically an invitation to the feds to fix that section
I guess theoretically they could leave it alone and then it'd just because a provincially-regulated thing, as with your usual health care? I'm not willing to count on that. But it'll be interesting either way.
4. Section 7 of the Charter of Rights and Freedoms (right to life) is affirmed in this decision to be like any other right*—able to be surrendered voluntarily with informed consent.
Well - only for "competent adults" who "clearly consent" with a "grievous and irremediable medical condition." [paragraph 127 for the exact language]. Your average person, as knowledgeable as possible, could not consent.
5. Honestly from a, like, legal procedure viewpoint, this case didn't feel all that interesting to me. There's a pretty short analysis of the right to life, liberty, and security of the person (and the latter two are lumped together) - the court said essentially that the absolute ban is not arbitrary, which I think is correct (you can see the path from "preventing death" to "ban assisted suicide", it makes sense). They said that it's overbroad - it covers more than it needs to (specifically, people with terminal illnesses yadda yadda). They then ignore questions of gross disproportionality because they've already said it was overbroad. And they ignore the equality argument (which I'm not positive but think is: some people have the resources to travel for assisted suicide in other jurisdictions, some don't, equality engages) because they're already used the life/liberty analysis.
The s.1 analysis (can it be justified in our civil society / does it achieve its goals in a minimally-impairing manner?) is fine but pretty bog-standard. A former prof of mine has been tweeting some great stuff about how the court is, yet again, pretending there's a big distinction between the s.7 analysis and the s.1 analysis here (and she's much, much smarter than I am).
6. One thing I really don't like: in the right to life analysis, the Court says: "the right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. " (paragraph 62). This is bad news for, for example, anti-poverty activists who want to argue that the Charter requires the government to fund affordable housing. It's state action, not inaction that engages the life interest. They are probably correct but I don't like it.
7. This is a fucking great line: "the trial judge also found — and we agree — that the absolute prohibition could not be described as a “complex regulatory response”. The degree of deference owed to Parliament, while high, is accordingly reduced." (paragraph 98). Oh snap.
8. As the second link indicates, I think Harper wants to stay as far away from the issue as possible.
Agreed. I haven't been following what's been happening in Parliament today, I know it's being discussed somewhat (along with the RCMP taking over Parliamentary security), but real life popped up.
9. I LOVE that Bedford (the case striking down sex work laws) is getting cited all over the fucking place. And PHS, with the needle exchanges. I was right that they were important! Suck it, straw people who disagreed with me!
Apologies if #5 is a little jargon-y. I can probably explain it, but I'd suggest reading up on the Oakes test and the PFJs instead.
posted by Lemurrhea at 9:42 AM on February 6, 2015 [12 favorites]
Lemurrhea: my gag is that in the SCC decisions drinking game, the Oakes test is like the first swig.
posted by whittaker at 9:48 AM on February 6, 2015 [1 favorite]
posted by whittaker at 9:48 AM on February 6, 2015 [1 favorite]
I guess theoretically they could leave it alone and then it'd just because a provincially-regulated thing, as with your usual health care? I'm not willing to count on that. But it'll be interesting either way
Right, but these are the CC sections that were struck:
14. No person is entitled to consent to have death inflicted on him, and such consent does not affect the criminal responsibility of any person by whom death may be inflicted on the person by whom consent is given.
241. Every one who
(a) counsels a person to commit suicide, or
(b) aids or abets a person to commit suicide,
whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.
If the feds just let them go, that would cause a bunch of other problems
posted by iona at 9:50 AM on February 6, 2015 [1 favorite]
Right, but these are the CC sections that were struck:
14. No person is entitled to consent to have death inflicted on him, and such consent does not affect the criminal responsibility of any person by whom death may be inflicted on the person by whom consent is given.
241. Every one who
(a) counsels a person to commit suicide, or
(b) aids or abets a person to commit suicide,
whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.
If the feds just let them go, that would cause a bunch of other problems
posted by iona at 9:50 AM on February 6, 2015 [1 favorite]
Americans take note, 7 of the justices were appointed by Harper himself.
Are you suggesting we wait and let President Walker make high court appointments?
No, I'm suggesting that you guys need to find a better way of selecting supreme court judges (not that I'd be holding my breath for it).
posted by any portmanteau in a storm at 9:51 AM on February 6, 2015 [1 favorite]
Are you suggesting we wait and let President Walker make high court appointments?
No, I'm suggesting that you guys need to find a better way of selecting supreme court judges (not that I'd be holding my breath for it).
posted by any portmanteau in a storm at 9:51 AM on February 6, 2015 [1 favorite]
Follow-up because I forgot something, then I'm walking away for a bit, don't mean to monopolize the convo:
I'm very happy that the SCC wrote into the decision that doctors cannot be compelled, which very neatly deflates a stupid potential talking point. And that 'pain' is the primary criteria, not 'terminal illness.'
They didn't guarantee this. Looking at paragraphs 131-132 - they were asked by some of the intervenors to require parliament to provide this guarantee on any new legislative scheme. The Court said "eff that, it's for Parliament to make the new law"*, but pointed out that as it stands with them striking down the law, physicians aren't compelled in general, much like with abortion. This doesn't add compulsory assistance but it doesn't preclude it.
Also there's some really interesting stuff about stare decisis (when and how lower courts have to follow higher courts' precedent**) and giving costs to public interest groups who sue the government, but I know so very little about those issues that ¯\(°_o)/¯/?
iona, I think they are only narrowing the law, right? They're not striking down the law in its entirety. "Void insofar as they prohibit blah blah. I'm not sure, and I don't think it matters, you're definitely correct that as a practical matter Parliament has to respond.
*I....may be paraphrasing.
**This has come up in the US SSM context, where morons argue that lower courts are bound by a 197? one-line decision of the Supreme Court not allowing a gay marriage appeal.
posted by Lemurrhea at 9:53 AM on February 6, 2015
I'm very happy that the SCC wrote into the decision that doctors cannot be compelled, which very neatly deflates a stupid potential talking point. And that 'pain' is the primary criteria, not 'terminal illness.'
They didn't guarantee this. Looking at paragraphs 131-132 - they were asked by some of the intervenors to require parliament to provide this guarantee on any new legislative scheme. The Court said "eff that, it's for Parliament to make the new law"*, but pointed out that as it stands with them striking down the law, physicians aren't compelled in general, much like with abortion. This doesn't add compulsory assistance but it doesn't preclude it.
Also there's some really interesting stuff about stare decisis (when and how lower courts have to follow higher courts' precedent**) and giving costs to public interest groups who sue the government, but I know so very little about those issues that ¯\(°_o)/¯/?
iona, I think they are only narrowing the law, right? They're not striking down the law in its entirety. "Void insofar as they prohibit blah blah. I'm not sure, and I don't think it matters, you're definitely correct that as a practical matter Parliament has to respond.
*I....may be paraphrasing.
**This has come up in the US SSM context, where morons argue that lower courts are bound by a 197? one-line decision of the Supreme Court not allowing a gay marriage appeal.
posted by Lemurrhea at 9:53 AM on February 6, 2015
This is a pretty interesting decision from a european & international perspective, the constitutional arrangements of the South African, South American and ECHR courts probably mean that it won't have much immediate effect, but you can bet is will a big topic of study in the future. Proportionality based legal discourse is so influentIal this will be heavily analysed,
posted by Another Fine Product From The Nonsense Factory at 9:54 AM on February 6, 2015 [1 favorite]
posted by Another Fine Product From The Nonsense Factory at 9:54 AM on February 6, 2015 [1 favorite]
The appellant's factum provides a much meatier argument concerning some of the issues that the Court declined to rule on. Particularly interesting (though I'm don't know how I feel about it) is the s 15 equality argument, which is actually about disability rather than means to travel:
"The effect of the impugned laws is that choosing to die is criminalized only for the materially physically disabled. The laws are thus more burdensome for the disabled than the able-bodied. This burden is felt acutely by persons who are grievously and irremediably ill, materially physically disabled or soon to become so, decisionally capable, and who wish to have control over their circumstances at end of life."
The issue of special costs to the pro bono counsel who have been pursuing this is also super cool. Particularly since Harper de-funded the Court Challenges Program that used to support Charter cases.
posted by lookoutbelow at 9:59 AM on February 6, 2015 [3 favorites]
"The effect of the impugned laws is that choosing to die is criminalized only for the materially physically disabled. The laws are thus more burdensome for the disabled than the able-bodied. This burden is felt acutely by persons who are grievously and irremediably ill, materially physically disabled or soon to become so, decisionally capable, and who wish to have control over their circumstances at end of life."
The issue of special costs to the pro bono counsel who have been pursuing this is also super cool. Particularly since Harper de-funded the Court Challenges Program that used to support Charter cases.
posted by lookoutbelow at 9:59 AM on February 6, 2015 [3 favorites]
Somewhat related is this 2004 Doug Saunders piece on the Charter, and how we are in the curious position to ask the folks who drafted it what their "intent" was...because they're still alive.
It's a useful retort to people who go all "hurf durf judicial activism."
posted by mandolin conspiracy at 10:01 AM on February 6, 2015 [2 favorites]
It's a useful retort to people who go all "hurf durf judicial activism."
posted by mandolin conspiracy at 10:01 AM on February 6, 2015 [2 favorites]
1. At last count 2 dozen of my lawyer have posted about this on facebook. They are all in support, and much more vocally than I expected. I expected support, but not the level of glee I am seeing.
I'm in law school right now (literally, I'm ignoring my Property professor while I write this) and my Facebook has exploded and conversations before class this morning were all Carter all the time. We actually really wish we had Constitutional Law today, because we're dying to hear our ConLaw prof's SCC fan-girl take on this decision.
Future lawyers, at least, seem to love to watch the Supremes make good choices.
posted by jacquilynne at 10:02 AM on February 6, 2015 [2 favorites]
I'm in law school right now (literally, I'm ignoring my Property professor while I write this) and my Facebook has exploded and conversations before class this morning were all Carter all the time. We actually really wish we had Constitutional Law today, because we're dying to hear our ConLaw prof's SCC fan-girl take on this decision.
Future lawyers, at least, seem to love to watch the Supremes make good choices.
posted by jacquilynne at 10:02 AM on February 6, 2015 [2 favorites]
yeah, you're right re. struck/narrowing - I don't see how these sections survive without amendment though, unless "prosecutorial discretion" is an acceptable response. And ultimately it will probably be the provinces that create the regime
posted by iona at 10:02 AM on February 6, 2015 [1 favorite]
posted by iona at 10:02 AM on February 6, 2015 [1 favorite]
He'd much rather not talk about it. I would be surprised to see any legeslation on it in the next year. Again, much like the abortion access situation.
Since the court decision is stayed for 12 months I'd guess Harper is unlikely table any new legislation until after the next federal election (which will be October 2015 at the latest). Whether he can avoid discussing the subject during the campaign depends on how much focus the opposition parties place on the issue.
posted by Kabanos at 10:07 AM on February 6, 2015
Since the court decision is stayed for 12 months I'd guess Harper is unlikely table any new legislation until after the next federal election (which will be October 2015 at the latest). Whether he can avoid discussing the subject during the campaign depends on how much focus the opposition parties place on the issue.
posted by Kabanos at 10:07 AM on February 6, 2015
...one of the three things the SCC said was that religious officials could not be compelled to perform SSM if their faith opposed it, in keeping with the freedom of religion component of the Charter, again deflating a stupid talking point.
That's a good point.
But it's not like the Conservatives haven't tried to stack the judicial deck with a few jokers in an attempt to play this hand anyway because the base likes to hear it.
posted by mandolin conspiracy at 10:08 AM on February 6, 2015
That's a good point.
But it's not like the Conservatives haven't tried to stack the judicial deck with a few jokers in an attempt to play this hand anyway because the base likes to hear it.
posted by mandolin conspiracy at 10:08 AM on February 6, 2015
Stupid constitution, according freedom and liberty to those who don't share our political beliefs!
posted by blue_beetle at 10:13 AM on February 6, 2015
posted by blue_beetle at 10:13 AM on February 6, 2015
iona, very good point. And yeah wasn't there a relatively big case recently saying that reliance on prosecutorial discretion is not a cromulent substitute for a non-discriminatory system? That...might have been a dream.
It sounds like a dream.
posted by Lemurrhea at 10:18 AM on February 6, 2015
It sounds like a dream.
posted by Lemurrhea at 10:18 AM on February 6, 2015
I guess theoretically they could leave it alone and then it'd just because a provincially-regulated thing, as with your usual health care?
...just like abortion access. Sorry to keep brining this up, but it's hard not so see this as an almost direct parallel. Are there some legal wrinkles here?
And yeah, if the NDP (in particular) don't use Harper like a pinata on this issue, they're a lot less savvy politicians than I have given them credit for in the past.
posted by bonehead at 10:26 AM on February 6, 2015
...just like abortion access. Sorry to keep brining this up, but it's hard not so see this as an almost direct parallel. Are there some legal wrinkles here?
And yeah, if the NDP (in particular) don't use Harper like a pinata on this issue, they're a lot less savvy politicians than I have given them credit for in the past.
posted by bonehead at 10:26 AM on February 6, 2015
And yeah wasn't there a relatively big case recently saying that reliance on prosecutorial discretion is not a cromulent substitute for a non-discriminatory system?
ah, Anderson maybe? Recent SCC decision re. prosecutorial discretion, but kind of goes the opposite way from what you're suggesting (ie lots of deference to the discretion)
posted by iona at 10:31 AM on February 6, 2015 [1 favorite]
ah, Anderson maybe? Recent SCC decision re. prosecutorial discretion, but kind of goes the opposite way from what you're suggesting (ie lots of deference to the discretion)
posted by iona at 10:31 AM on February 6, 2015 [1 favorite]
The reason I say NDP only is that this issue is problematic for the Liberals too. So much so that at the Lib policy convention in February, Trudeau stepped out of the room rather than have to vote on rights to die. There are many Liberal Catholics as well, particularly in Quebec and Ontario.
It's not just the Cons who are divided on the issue.
posted by bonehead at 10:38 AM on February 6, 2015 [1 favorite]
It's not just the Cons who are divided on the issue.
posted by bonehead at 10:38 AM on February 6, 2015 [1 favorite]
Nah bonehead you're not wrong about the abortion access issue. I think it's too early to tell, right? The history of the post-Morgentaler cases is, what - first they tried a bill that allowed for early abortions and banned late ones, which was defeated (because pro-lifers didn't like the early abortions and pro-choicers didn't like the ban), and then the strict bill which lost due to a tie vote in the Senate.* A former prof of mine has recently written about the history of abortion decrim and social stigma, focusing on the issue of sex work but it could be interesting for this (stigma around suicide certainly being a thing).
iona, yeah I'm not sure what I'm thinking about. Might be police discretion? Seriously it's probably just a dream, ignore me.
*See? The Senate is useful.
posted by Lemurrhea at 10:41 AM on February 6, 2015 [1 favorite]
iona, yeah I'm not sure what I'm thinking about. Might be police discretion? Seriously it's probably just a dream, ignore me.
*See? The Senate is useful.
posted by Lemurrhea at 10:41 AM on February 6, 2015 [1 favorite]
...just like abortion access. Sorry to keep brining this up, but it's hard not so see this as an almost direct parallel. Are there some legal wrinkles here?
One the key talking points of anti-choice people in Canada is that "we have no law on abortion." Yes. That's right. Because it's legal. What they mean is "no law against it." Yes, that's right. Because Morgentaler.
At the end of the day, they want both back in the Criminal Code, so from that standpoint, parallel indeed, at least from the standpoint of political rhetoric.
posted by mandolin conspiracy at 10:41 AM on February 6, 2015
One the key talking points of anti-choice people in Canada is that "we have no law on abortion." Yes. That's right. Because it's legal. What they mean is "no law against it." Yes, that's right. Because Morgentaler.
At the end of the day, they want both back in the Criminal Code, so from that standpoint, parallel indeed, at least from the standpoint of political rhetoric.
posted by mandolin conspiracy at 10:41 AM on February 6, 2015
"the right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. "
Could state inaction not be argued as being an indirect imposition? Choosing not to do something is an action, after all.
Particularly since Harper de-funded the Court Challenges Program that used to support Charter cases.
Every time I think my opinion of him couldn't get lower...
It's not just the Cons who are divided on the issue.
They're only divided if they're not listening to their constituents. At a minimum, two-thirds of Canadians are in favour.
posted by feckless fecal fear mongering at 10:56 AM on February 6, 2015
Could state inaction not be argued as being an indirect imposition? Choosing not to do something is an action, after all.
Particularly since Harper de-funded the Court Challenges Program that used to support Charter cases.
Every time I think my opinion of him couldn't get lower...
It's not just the Cons who are divided on the issue.
They're only divided if they're not listening to their constituents. At a minimum, two-thirds of Canadians are in favour.
posted by feckless fecal fear mongering at 10:56 AM on February 6, 2015
It is really surprising to me how so many mefites are in favor of assisted suicide. I guess I shouldn't be surprised, because a recent survey where I live showed something like 90% of the population to be in favor.
However, the situation right now in the Netherlands, Belgium and Switzerland clearly show that the "slippery slope" arguments against assisted suicide were no straw-men. (Right now I am not able to provide links but will later if asked for).
In my view, the legal issues are much less interesting that the ethics, and I am so liberal even my dog gets a Steiner education.
From here I can describe my own experiences with seriously ill relatives.
- the first person I was really close to who died was my paternal grandmother. She died of cancer - and when the end was near, she asked to be transported home. I was traveling abroad at the time, and she expressly asked that I was lied to about the severity of her illness, so I wouldn't come home. So this is second hand information.
She was cared for by my nurse step-mother, and when I came home our parents were whispering about wether there had been a morphine overdose involved in her death. At the time, there were no hospices and no palliative care research institutions in this country. From the point of view of modern palliative care, my step mother did nothing wrong at all, and it was neither assisted suicide nor worse, man-slaughter. My Gran was dying, in great pain, and although the morphine maybe hastened the proces by a few days, it was totally within the realm of care and best practice. This was in 1987. A very long time ago. We are not there now.
- the second person was my beloved grandfather. An important detail about him was that as long as I had ever known him, he was a spokesperson for assisted suicide and had asked that we overdose him if he was not able to do it himself. In real life, when he became mortally ill, his reaction was denial, fight and flight. He would have nothing to do with death. One consequence of that was that he wouldn't acknowledge that he was suffering from cancer, and for that reason refused treatment of any kind. At the time, palliative treatment was new and rare, but my aunt knew about it from friends, and we could have brought in care. The deathbed of my grandfather was terrifying and probably exactly the situation which has created our human fear of natural death. He screamed from pain, and only had short rests till he was finally let go.
He died in a hospital, but in the cardio section, and when my aunt first, and then myself asked the doctors for pain-management specialists, the doctors accused us of wanting to kill my grandfather. At that time, palliative care was so rare and unusual, it was perfectly normal and OK for cardiologists to never have heard of it. In 2002.
- the third person was my stepmother who died far too young. Her wish was to die at home, surrounded by family. She planned it with us and with the doctors and nurses caring for her. The local hospice has a "home-hospice" service, where they move all the facilities of the hospice into peoples' homes - from the bed over the specialist doctors and nurses to the pastor. My stepmother died peacefully, and almost without pain, at home, with my sisters and my father by her side. (I couldn't make it, but had been there during the day) Almost to the last, she was able to enjoy her favorite pastimes, her family and friends, and her garden. She wanted to enjoy life to the last drop, and the specialists from the hospice helped her do exactly that. Compared to when she cared for our gran, she was probably alert and painfree longer, and her life was shortened by hours, rather than days by the pain-treatment.
- then my dad died. In a hospice as he preferred. He chose to end his own life, not by any medical or physical intervention, but by refusing treatment and not eating. He missed my stepmother, and could feel the onset of dementia. The staff at the hospice made sure that his last days were as painfree and even comfortable as possible. They gave him moments of happiness. But they didn't kill him, even as they knew that was what he wanted. And he died peacefully in his own time.
- the most recent family member to die was my maternal grandmother. Like my grandfather she had been totally pro assisted suicide, and like him she was not at all having death when it arrived. She fought it almost to the last moment.
But since 2002, the attitude of the medical staff has changed. At the hospital, they called me in for a conference, with my grandmother still conscious and alert, and told her that she was dying and that they could not save her with any means (she was 91). It was really, really tough, but knowing the truth was also helpful. The staff told us they would do anything in their might, and at any expense, to make sure she was safe, painfree, where she wanted to be and with whomever she wanted. The palliative team of the hopsital attended along with the staff she had gotten to know during her stay at the hospital. (This was the death-panel of Obama-care as it was played out in Scandinavia a couple of years ago).
My grandmother chose to go home, and the hospital helped me get everything ready within 8 hours. She died exactly as she wanted to - in her favorite rose sheets, in her favorite room, with a full-time palliative nurse at attention to manage the pain, and with her family around her.
Now if I was back in 2002, and knew I was about to die in great pain and distress, I might have been in favor of assisted suicide. But today, I know there is care and also highly qualified medical assistance for the dying, and like my stepmother and grandmother I prefer to live every possible moment of my life, if I am given the chance.
I am very hesitant to judge anyone, and I am not a medical professional, but it seems to me a lot of the support for assisted suicide is not based on knowledge. Turning off the respirator of Terry Schiavo is not assisted suicide in any sense. Carefully dosed painkillers for the dying, so they can die in peace is not assisted suicide. My father choosing to not eat, and being treated as a dignified and worthy human being is not assisted suicide.
Moving my grandmother home probably shortened her life with a week or two. But it was not assisted suicide.
Already now, real "assisted suicide" has slipped off into to killing children, a criminal, depressed people. Obviously, people who are made to feel guilty for being dependent are easy victims, and there is no statistic on how many of the people who request suicide are in this group.
If I were a doctor, I would object strongly to this whole concept. I understand the sentiment of the cardiologists when my grandfather died, even if they were uninformed.
As I wrote above - two of my grandparents strongly believed they were in favor of assisted suicide until they were actually terminally ill, and they might well have signed documents in that intention if it had been legal. Unfortunately, I have a number of relatives who would definitely have pushed for action, in spite of the grandparents feelings in the actual situation (which is why I was the one at the conference when my grandmother was dying).
posted by mumimor at 10:57 AM on February 6, 2015 [2 favorites]
However, the situation right now in the Netherlands, Belgium and Switzerland clearly show that the "slippery slope" arguments against assisted suicide were no straw-men. (Right now I am not able to provide links but will later if asked for).
In my view, the legal issues are much less interesting that the ethics, and I am so liberal even my dog gets a Steiner education.
From here I can describe my own experiences with seriously ill relatives.
- the first person I was really close to who died was my paternal grandmother. She died of cancer - and when the end was near, she asked to be transported home. I was traveling abroad at the time, and she expressly asked that I was lied to about the severity of her illness, so I wouldn't come home. So this is second hand information.
She was cared for by my nurse step-mother, and when I came home our parents were whispering about wether there had been a morphine overdose involved in her death. At the time, there were no hospices and no palliative care research institutions in this country. From the point of view of modern palliative care, my step mother did nothing wrong at all, and it was neither assisted suicide nor worse, man-slaughter. My Gran was dying, in great pain, and although the morphine maybe hastened the proces by a few days, it was totally within the realm of care and best practice. This was in 1987. A very long time ago. We are not there now.
- the second person was my beloved grandfather. An important detail about him was that as long as I had ever known him, he was a spokesperson for assisted suicide and had asked that we overdose him if he was not able to do it himself. In real life, when he became mortally ill, his reaction was denial, fight and flight. He would have nothing to do with death. One consequence of that was that he wouldn't acknowledge that he was suffering from cancer, and for that reason refused treatment of any kind. At the time, palliative treatment was new and rare, but my aunt knew about it from friends, and we could have brought in care. The deathbed of my grandfather was terrifying and probably exactly the situation which has created our human fear of natural death. He screamed from pain, and only had short rests till he was finally let go.
He died in a hospital, but in the cardio section, and when my aunt first, and then myself asked the doctors for pain-management specialists, the doctors accused us of wanting to kill my grandfather. At that time, palliative care was so rare and unusual, it was perfectly normal and OK for cardiologists to never have heard of it. In 2002.
- the third person was my stepmother who died far too young. Her wish was to die at home, surrounded by family. She planned it with us and with the doctors and nurses caring for her. The local hospice has a "home-hospice" service, where they move all the facilities of the hospice into peoples' homes - from the bed over the specialist doctors and nurses to the pastor. My stepmother died peacefully, and almost without pain, at home, with my sisters and my father by her side. (I couldn't make it, but had been there during the day) Almost to the last, she was able to enjoy her favorite pastimes, her family and friends, and her garden. She wanted to enjoy life to the last drop, and the specialists from the hospice helped her do exactly that. Compared to when she cared for our gran, she was probably alert and painfree longer, and her life was shortened by hours, rather than days by the pain-treatment.
- then my dad died. In a hospice as he preferred. He chose to end his own life, not by any medical or physical intervention, but by refusing treatment and not eating. He missed my stepmother, and could feel the onset of dementia. The staff at the hospice made sure that his last days were as painfree and even comfortable as possible. They gave him moments of happiness. But they didn't kill him, even as they knew that was what he wanted. And he died peacefully in his own time.
- the most recent family member to die was my maternal grandmother. Like my grandfather she had been totally pro assisted suicide, and like him she was not at all having death when it arrived. She fought it almost to the last moment.
But since 2002, the attitude of the medical staff has changed. At the hospital, they called me in for a conference, with my grandmother still conscious and alert, and told her that she was dying and that they could not save her with any means (she was 91). It was really, really tough, but knowing the truth was also helpful. The staff told us they would do anything in their might, and at any expense, to make sure she was safe, painfree, where she wanted to be and with whomever she wanted. The palliative team of the hopsital attended along with the staff she had gotten to know during her stay at the hospital. (This was the death-panel of Obama-care as it was played out in Scandinavia a couple of years ago).
My grandmother chose to go home, and the hospital helped me get everything ready within 8 hours. She died exactly as she wanted to - in her favorite rose sheets, in her favorite room, with a full-time palliative nurse at attention to manage the pain, and with her family around her.
Now if I was back in 2002, and knew I was about to die in great pain and distress, I might have been in favor of assisted suicide. But today, I know there is care and also highly qualified medical assistance for the dying, and like my stepmother and grandmother I prefer to live every possible moment of my life, if I am given the chance.
I am very hesitant to judge anyone, and I am not a medical professional, but it seems to me a lot of the support for assisted suicide is not based on knowledge. Turning off the respirator of Terry Schiavo is not assisted suicide in any sense. Carefully dosed painkillers for the dying, so they can die in peace is not assisted suicide. My father choosing to not eat, and being treated as a dignified and worthy human being is not assisted suicide.
Moving my grandmother home probably shortened her life with a week or two. But it was not assisted suicide.
Already now, real "assisted suicide" has slipped off into to killing children, a criminal, depressed people. Obviously, people who are made to feel guilty for being dependent are easy victims, and there is no statistic on how many of the people who request suicide are in this group.
If I were a doctor, I would object strongly to this whole concept. I understand the sentiment of the cardiologists when my grandfather died, even if they were uninformed.
As I wrote above - two of my grandparents strongly believed they were in favor of assisted suicide until they were actually terminally ill, and they might well have signed documents in that intention if it had been legal. Unfortunately, I have a number of relatives who would definitely have pushed for action, in spite of the grandparents feelings in the actual situation (which is why I was the one at the conference when my grandmother was dying).
posted by mumimor at 10:57 AM on February 6, 2015 [2 favorites]
Already now, real "assisted suicide" has slipped off into to killing children, a criminal, depressed people.
I'm going to have to ask you for a citation on that.
posted by feckless fecal fear mongering at 11:05 AM on February 6, 2015 [6 favorites]
I'm going to have to ask you for a citation on that.
posted by feckless fecal fear mongering at 11:05 AM on February 6, 2015 [6 favorites]
Could state inaction not be argued as being an indirect imposition? Choosing not to do something is an action, after all.
s. 7 of the Charter has not generally been held to impose positive obligations on the state - there's been some attempts to push back on that, but not with much success (cf. the recent right to housing case that Lemurrhea mentions that failed at the Court of Appeal)
posted by iona at 11:07 AM on February 6, 2015 [1 favorite]
s. 7 of the Charter has not generally been held to impose positive obligations on the state - there's been some attempts to push back on that, but not with much success (cf. the recent right to housing case that Lemurrhea mentions that failed at the Court of Appeal)
posted by iona at 11:07 AM on February 6, 2015 [1 favorite]
Now if I was back in 2002, and knew I was about to die in great pain and distress, I might have been in favor of assisted suicide.
People can and do still die in great pain and distress in 2015. Palliative care has dramatically improved but it still can't solve everything. People also still die in mental distress after years of being reduced to utter helplessness by degenerative disorders, even if they aren't necessarily in physical pain.
If people want to stick it out to the bitter end, they're still allowed to do that. There's just another option now (or in a year, anyway) for the people who don't want to live their last few months in pain or distress. Nobody's suggesting doctors should go around euthanizing unwilling patients just because they have a terminal illness.
posted by randomnity at 11:36 AM on February 6, 2015 [2 favorites]
People can and do still die in great pain and distress in 2015. Palliative care has dramatically improved but it still can't solve everything. People also still die in mental distress after years of being reduced to utter helplessness by degenerative disorders, even if they aren't necessarily in physical pain.
If people want to stick it out to the bitter end, they're still allowed to do that. There's just another option now (or in a year, anyway) for the people who don't want to live their last few months in pain or distress. Nobody's suggesting doctors should go around euthanizing unwilling patients just because they have a terminal illness.
posted by randomnity at 11:36 AM on February 6, 2015 [2 favorites]
Belgium extends euthenasia law to include children (Sorry, I had the impression they had already gone through with assisted suicide for a child. However, I strongly oppose this law. And I also strongly oppose keeping mortally ill children - or any humans - alive on tubes for months)
Belgian prison inmate asks for and receives assisted suicide This one actually has several dimensions of wrong for me. First of all, neither medical staff nor other prison staff should not under any circumstance be involved in killing people, and neither should medical industry. But there is also a more philosophical discussion about punishment. In my view, this guy need to face and live with the consequences of his crimes. There is no bail out of jail. There may be repentance and forgiveness, but suicide is cowardly.
Dutch debate on assisted suicide for depressed patients I know this is also a thing in Switzerland, but to be honest, one example is an example too much in my view.
posted by mumimor at 11:40 AM on February 6, 2015 [1 favorite]
Belgian prison inmate asks for and receives assisted suicide This one actually has several dimensions of wrong for me. First of all, neither medical staff nor other prison staff should not under any circumstance be involved in killing people, and neither should medical industry. But there is also a more philosophical discussion about punishment. In my view, this guy need to face and live with the consequences of his crimes. There is no bail out of jail. There may be repentance and forgiveness, but suicide is cowardly.
Dutch debate on assisted suicide for depressed patients I know this is also a thing in Switzerland, but to be honest, one example is an example too much in my view.
posted by mumimor at 11:40 AM on February 6, 2015 [1 favorite]
"the right to life is engaged where the law or state action imposes death or an increased risk of death on a person, either directly or indirectly. "
Could state inaction not be argued as being an indirect imposition? Choosing not to do something is an action, after all.
I may be mistaken, but I think the comparison is to personal action, i.e., the state's action (or inaction) is what is protected against by this right. It doesn't protect the person from their own volition.
posted by Mental Wimp at 11:44 AM on February 6, 2015
Could state inaction not be argued as being an indirect imposition? Choosing not to do something is an action, after all.
I may be mistaken, but I think the comparison is to personal action, i.e., the state's action (or inaction) is what is protected against by this right. It doesn't protect the person from their own volition.
posted by Mental Wimp at 11:44 AM on February 6, 2015
two of my grandparents strongly believed they were in favor of assisted suicide until they were actually terminally ill, and they might well have signed documents in that intention if it had been legal
Isn't this why there needs to be a legal framework rather than simply a ban? I am sorry for your losses, but your story would suggest that your grandparents were able to make their wishes known at the end, thankfully, so there needs to be safeguards so that just signing documents at some point isn't the final word on the matter. There must be a way for people to give informed consent which is what the debate is about. As long as it's simply illegal people will find their own way or else suffer immeasurably. I'm in favour of anything which gives autonomy to people and allows for dignity in their final days, and good palliative care is certainly one option but not the only one.
posted by billiebee at 11:45 AM on February 6, 2015 [6 favorites]
Isn't this why there needs to be a legal framework rather than simply a ban? I am sorry for your losses, but your story would suggest that your grandparents were able to make their wishes known at the end, thankfully, so there needs to be safeguards so that just signing documents at some point isn't the final word on the matter. There must be a way for people to give informed consent which is what the debate is about. As long as it's simply illegal people will find their own way or else suffer immeasurably. I'm in favour of anything which gives autonomy to people and allows for dignity in their final days, and good palliative care is certainly one option but not the only one.
posted by billiebee at 11:45 AM on February 6, 2015 [6 favorites]
It is really surprising to me how so many mefites are in favor of assisted suicide.
I'm kind of surprised that so many mefites live in the US, have to deal with American health insurance companies, and still want to hand them such a cheap way to get out of expensive care.
posted by ROU_Xenophobe at 11:52 AM on February 6, 2015 [3 favorites]
I'm kind of surprised that so many mefites live in the US, have to deal with American health insurance companies, and still want to hand them such a cheap way to get out of expensive care.
posted by ROU_Xenophobe at 11:52 AM on February 6, 2015 [3 favorites]
mumimor: Paragraphs 110 through 113 of the linked SCC decision directly address Belgium and the sort of incidents you bring up.
The conclusion:
The conclusion:
[112] We are not convinced that Professor Montero’s evidence undermines the trial judge’s findings of fact. First, the trial judge (rightly, in our view) noted that the permissive regime in Belgium is the product of a very different medico-legal culture. Practices of assisted death were “already prevalent and embedded in the medical culture” prior to legalization (para. 660). The regime simply regulates a common pre‑existing practice. In the absence of a comparable history in Canada, the trial judge concluded that it was problematic to draw inferences about the level of physician compliance with legislated safeguards based on the Belgian evidence (para. 680). This distinction is relevant both in assessing the degree of physician compliance and in considering evidence with regards to the potential for a slippery slope.posted by whittaker at 11:52 AM on February 6, 2015 [2 favorites]
[113]Second, the cases described by Professor Montero were the result of an oversight body exercising discretion in the interpretation of the safeguards and restrictions in the Belgian legislative regime — a discretion the Belgian Parliament has not moved to restrict. These cases offer little insight into how a Canadian regime might operate.
One of the anti soundbites came from The Institute for Canadian Values, who share few - if any - values with Canadians I know.
On balance, this seems to be a compassionate decision. It's a complex situation, and there needs to be a whole lot of kindness in any response.
posted by scruss at 12:03 PM on February 6, 2015 [1 favorite]
On balance, this seems to be a compassionate decision. It's a complex situation, and there needs to be a whole lot of kindness in any response.
posted by scruss at 12:03 PM on February 6, 2015 [1 favorite]
whittaker: to me, that is a weak argument. What I would call an "Asterix"-argument: "They are crazy them Gauls, and thus their practice is irrelevant to us".
But it highlights differences within the medical community, as I tried to describe them with my personal experiences. For some doctors, palliative care = assisted suicide. If that is your opinion, all of my family except my grandfather were killed by trained health-care personel. I do not agree with this point of view. But I am well aware that in some (surprisingly all countries with strong Calvinist influence) places they do equal palliative care and killing people and they extend that argument forever.
When you are caring for people with terminal illnesses, there are a lot of ethical dilemmas, including this one. Luckily, there are few places in the world where this is mixed up with economy. But I have often considered wether my dad's decision to starve himself to death was motivated as much by his concerns for us, his children, as by his grief and loneliness. If it were, it was misconceived, we would have cared for him for many more years, if he had let us, not least because even in his beginning dementia, our kids loved him and we loved him. BTW, some of my siblings were very angry with him when he decided to stop eating. I respected his choice, and tried to have conversations with him about all the good things we had together.
I have yet to see a good example of a legal framework which protects vulnerable, perhaps depressed terminally ill people from their predatory relatives.
posted by mumimor at 12:14 PM on February 6, 2015
But it highlights differences within the medical community, as I tried to describe them with my personal experiences. For some doctors, palliative care = assisted suicide. If that is your opinion, all of my family except my grandfather were killed by trained health-care personel. I do not agree with this point of view. But I am well aware that in some (surprisingly all countries with strong Calvinist influence) places they do equal palliative care and killing people and they extend that argument forever.
When you are caring for people with terminal illnesses, there are a lot of ethical dilemmas, including this one. Luckily, there are few places in the world where this is mixed up with economy. But I have often considered wether my dad's decision to starve himself to death was motivated as much by his concerns for us, his children, as by his grief and loneliness. If it were, it was misconceived, we would have cared for him for many more years, if he had let us, not least because even in his beginning dementia, our kids loved him and we loved him. BTW, some of my siblings were very angry with him when he decided to stop eating. I respected his choice, and tried to have conversations with him about all the good things we had together.
I have yet to see a good example of a legal framework which protects vulnerable, perhaps depressed terminally ill people from their predatory relatives.
posted by mumimor at 12:14 PM on February 6, 2015
mumimor: not irrelevant but weak in the face of the high volume of other evidence presented to demonstrate the reliability of controls. The original trial really did its homework.
Although I love me some Asterix, I do think it's absolutely relevant to point out a completely different disposition towards medical practice that existed when legislation was still congruent between the two countries.
posted by whittaker at 12:19 PM on February 6, 2015 [2 favorites]
Although I love me some Asterix, I do think it's absolutely relevant to point out a completely different disposition towards medical practice that existed when legislation was still congruent between the two countries.
posted by whittaker at 12:19 PM on February 6, 2015 [2 favorites]
Worth noting in this discussion is this summary of stats through 2013 of Oregon's Death With Dignity Act. PDF Link. Patient diagnosis is also listed.
posted by schnee at 12:20 PM on February 6, 2015 [1 favorite]
posted by schnee at 12:20 PM on February 6, 2015 [1 favorite]
And for the Harper government to find some way to sink it.
Quite the opposite. As mild-mannered folks become increasingly despondent at their inability to keep up with the new Toughness, our Windswept Prairie Overlords will wait patiently to push play on some nice Beethoven.
posted by CynicalKnight at 12:34 PM on February 6, 2015
Quite the opposite. As mild-mannered folks become increasingly despondent at their inability to keep up with the new Toughness, our Windswept Prairie Overlords will wait patiently to push play on some nice Beethoven.
posted by CynicalKnight at 12:34 PM on February 6, 2015
But today, I know there is care and also highly qualified medical assistance for the dying, and like my stepmother and grandmother I prefer to live every possible moment of my life, if I am given the chance.
mumimor, I get where you are coming from. Currently, I have a family member with a terminal illness, and there have been a lot of very deep conversations in the family about this question, and it always seems to come down to a question of quantity of life versus quality of life. That is, at what point does someone say that their quality of life has become poor enough that they are no longer motivated by the remaining quantity. It's a very individual decision, and each of us has different places on that continuum. It's about giving each of us that choice of when it is enough, and respecting that decision.
What I am interested to see is how the framework that gets created will deal with the issue of consent, and ensuring that it is clear, because that's where this is going to be sticky.
posted by nubs at 12:45 PM on February 6, 2015 [1 favorite]
mumimor, I get where you are coming from. Currently, I have a family member with a terminal illness, and there have been a lot of very deep conversations in the family about this question, and it always seems to come down to a question of quantity of life versus quality of life. That is, at what point does someone say that their quality of life has become poor enough that they are no longer motivated by the remaining quantity. It's a very individual decision, and each of us has different places on that continuum. It's about giving each of us that choice of when it is enough, and respecting that decision.
What I am interested to see is how the framework that gets created will deal with the issue of consent, and ensuring that it is clear, because that's where this is going to be sticky.
posted by nubs at 12:45 PM on February 6, 2015 [1 favorite]
mumimor, for me it's pretty simple: I don't have the right--society doesn't have the right--to force people to live. You can bet your bippy that if I get diagnosed with dementia, for example, I will be checking out as soon as it starts taking hold. I refuse to live like that. Whether or not I have physician assistance, I will be taking my life. So would many people, if it were an option. Seems to me it's better to have a doctor involved so it's quick and guaranteed than to spin the wheel on any number of methods that are traumatic, unreliable, or both. Not to mention trauma to others--a gunshot to the head, of the right caliber, is probably the fastest and most reliable method. But someone needs to clean it up. So if you don't have access to guns and/or don't want to subject someone to that, what's left?
Well, you could overdose. That's very unreliable (ask me how I know!), and obtaining the necessary drugs isn't easy. Slit your wrists? See above re: gunshots. Etc etc.
I know now, that sometime after a year from now if my life is rendered unlivable by disease or circumstance, I will be able to die on my terms.
Which is really where the discussion ends, for me; we have the right to live our lives on our own terms, subject only to not harming others or society. To me that means we also have the right to die on our own terms.
posted by feckless fecal fear mongering at 12:51 PM on February 6, 2015 [9 favorites]
Well, you could overdose. That's very unreliable (ask me how I know!), and obtaining the necessary drugs isn't easy. Slit your wrists? See above re: gunshots. Etc etc.
I know now, that sometime after a year from now if my life is rendered unlivable by disease or circumstance, I will be able to die on my terms.
Which is really where the discussion ends, for me; we have the right to live our lives on our own terms, subject only to not harming others or society. To me that means we also have the right to die on our own terms.
posted by feckless fecal fear mongering at 12:51 PM on February 6, 2015 [9 favorites]
SNL:
Al Gore: Jim, I'd like to interrupt here and answer that question as if it were my turn to speak. Jim, let me tell about a friend of mine. [ holds up a picture of an elderly woman ] Her name is Etta Munsen. She's 94, she's a widow living on Social Security in Sparta, Tennessee. Etta was born with only one kidney. She also suffers from poilo, spinal menengitis, lung, liver, and pancreatic cancer, an enlarged heart, diabetes, and a rare form of styctic acne. Now, several recent strokes, along with an unfortunate shark attack, have left her paralyzed and missing her right leg under the knee. Just last week she woke from a coma to find that, due to a hospital mix-up, her left arm had been amputated, infected with syphillis, and then reattached.posted by Melismata at 1:01 PM on February 6, 2015 [1 favorite]
Jim Lehrer: Mr. Vice-President, we are short of time..
Al Gore: As you can imagine, Jim.. Etta's prescription drug bills are staggering. They run to nearly $113 million a day! And she tells me that some weeks she has to choose between eating and treating her Lyme Disease. Now, under my plan, Etta's prescription drugs would be covered. Under my opponent's plan, her house would be burned to the ground. And that is wrong. That is just wrong!
Relevant recent Spiegel article (english version):
The Last Days of Annie Bus: A Chronicle of Dutch Euthanasia
posted by Hairy Lobster at 2:06 PM on February 6, 2015
The Last Days of Annie Bus: A Chronicle of Dutch Euthanasia
posted by Hairy Lobster at 2:06 PM on February 6, 2015
feckless fecal fear mongering,: I have no right to judge your judgement, and for that reason it is impossible for me to enter a discussion about your personal choices. I tried to show how the people I knew who were most adamant about the right to assisted suicide changed their minds when it was relevant.
I also told about my dad, who chose to end his life, and was supported and comforted during that process in spite of the grief his decisions caused his family. I also wrote how I supported my father's decision against my own feelings and my family's. I don't believe any person at the outset of dementia or other terminal illness should be force-fed or in other ways be kept alive artificially, and I can assure you that you will die if you want to, with no need of drugs or weapons. You will also have access to care, pain management and comfort, if you engage with the infamous "death panels".
What I am against is health-care workers reversing their roles and actively killing people in their care. I find this situation incontrollable and in my view the data from the countries who have introduced this possibility confirms my assumption. I honestly cannot see any way one could legalize "assisted suicide" without creating a gray zone between this and homicide, and I cannot see how any medical personel would want to involve themselves unless for economic gain. And we all know where that will take you.
posted by mumimor at 2:07 PM on February 6, 2015
I also told about my dad, who chose to end his life, and was supported and comforted during that process in spite of the grief his decisions caused his family. I also wrote how I supported my father's decision against my own feelings and my family's. I don't believe any person at the outset of dementia or other terminal illness should be force-fed or in other ways be kept alive artificially, and I can assure you that you will die if you want to, with no need of drugs or weapons. You will also have access to care, pain management and comfort, if you engage with the infamous "death panels".
What I am against is health-care workers reversing their roles and actively killing people in their care. I find this situation incontrollable and in my view the data from the countries who have introduced this possibility confirms my assumption. I honestly cannot see any way one could legalize "assisted suicide" without creating a gray zone between this and homicide, and I cannot see how any medical personel would want to involve themselves unless for economic gain. And we all know where that will take you.
posted by mumimor at 2:07 PM on February 6, 2015
Belgium extends euthenasia law to include children
A law which has multiple safeguards built into it, including the need for the request to be ratified by "teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents."
'Child' is also perhaps an over-loaded term to use, as one of the experts quoted in the article indicated it would mainly be adolescents requesting this. In any case, the person in question must make the request themselves, and I strongly suspect that the team evaluation would include a hefty dose of ensuring that the request came from the child and not from anyone else.
Belgian prison inmate asks for and receives assisted suicide ... There may be repentance and forgiveness, but suicide is cowardly.
The man was in torment because of his urges, torment that would cease only at death. That strongly suggests to me that he was aware of how wrong his urges and subsequent actions were, and raises the point that torture is unacceptable. (As a side note I'd be intensely curious to know how prisons deal with claustrophobia).
The only ethical concern for me here is that of a prisoner being pressured or coerced into making such a request.
Dutch debate on assisted suicide for depressed patients
If we accept--as I do--that mental illnesses are diseases just as bodily illnesses are, then they should be treated the same. Much depression can be resolved--but not for everyone. My depression waxes and wanes but it's always there. If it were always there the way it is when I'm at my bleakest, and all forms of treatment had failed to alleviate anything despite giving them a good shot, then what difference is there between assisted suicide for me and for someone with, oh let's say inoperable brain cancer?
posted by feckless fecal fear mongering at 2:12 PM on February 6, 2015 [4 favorites]
A law which has multiple safeguards built into it, including the need for the request to be ratified by "teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents."
'Child' is also perhaps an over-loaded term to use, as one of the experts quoted in the article indicated it would mainly be adolescents requesting this. In any case, the person in question must make the request themselves, and I strongly suspect that the team evaluation would include a hefty dose of ensuring that the request came from the child and not from anyone else.
Belgian prison inmate asks for and receives assisted suicide ... There may be repentance and forgiveness, but suicide is cowardly.
The man was in torment because of his urges, torment that would cease only at death. That strongly suggests to me that he was aware of how wrong his urges and subsequent actions were, and raises the point that torture is unacceptable. (As a side note I'd be intensely curious to know how prisons deal with claustrophobia).
The only ethical concern for me here is that of a prisoner being pressured or coerced into making such a request.
Dutch debate on assisted suicide for depressed patients
If we accept--as I do--that mental illnesses are diseases just as bodily illnesses are, then they should be treated the same. Much depression can be resolved--but not for everyone. My depression waxes and wanes but it's always there. If it were always there the way it is when I'm at my bleakest, and all forms of treatment had failed to alleviate anything despite giving them a good shot, then what difference is there between assisted suicide for me and for someone with, oh let's say inoperable brain cancer?
posted by feckless fecal fear mongering at 2:12 PM on February 6, 2015 [4 favorites]
To be honest, I find it difficult to continue this conversation because I am not a professional and not able to continue with professional arguments. I would hate to engage in a discussion of your personal judgement, fffm.
The reason I posted here was an attempt to rise the awareness of the ethic problems concerning assisted suicide, both regarding the patient and the healthcare professionals. And I tried to describe the experiences of my family as a way of showing how we may be less than rational in our life choices over time, and that as a consequence, what we need from health-care is an unwavering dedication to the hippocratic oath. Doctors and nurses are here to heal and care, not to kill. If you want to kill people, you must create a new profession and equivalent education.
If you think about what qualifications such an education would entail, you would quickly come to realize the huge ethical problems involved.
In the case Hairy Lobster posted, maybe anti-depressants or cognitive therapy might be a good deal more relevant than lethal drugs. Millions of people live with physical handicaps, and have no death wish. Those millions might even find it extremely offensive that paralysis could be a reasonable cause for euthanasia.
You might argue that Annie Bus has the right to refuse anti-depressants and therapy and prefer suicide. But the thing is that when you admit Annie "the right" to kill herself, it becomes increasingly difficult to prevent family or authorities to encourage Jane Doe with the same life—situation to "do the right thing".
posted by mumimor at 2:44 PM on February 6, 2015
The reason I posted here was an attempt to rise the awareness of the ethic problems concerning assisted suicide, both regarding the patient and the healthcare professionals. And I tried to describe the experiences of my family as a way of showing how we may be less than rational in our life choices over time, and that as a consequence, what we need from health-care is an unwavering dedication to the hippocratic oath. Doctors and nurses are here to heal and care, not to kill. If you want to kill people, you must create a new profession and equivalent education.
If you think about what qualifications such an education would entail, you would quickly come to realize the huge ethical problems involved.
In the case Hairy Lobster posted, maybe anti-depressants or cognitive therapy might be a good deal more relevant than lethal drugs. Millions of people live with physical handicaps, and have no death wish. Those millions might even find it extremely offensive that paralysis could be a reasonable cause for euthanasia.
You might argue that Annie Bus has the right to refuse anti-depressants and therapy and prefer suicide. But the thing is that when you admit Annie "the right" to kill herself, it becomes increasingly difficult to prevent family or authorities to encourage Jane Doe with the same life—situation to "do the right thing".
posted by mumimor at 2:44 PM on February 6, 2015
Next step in assisted suicide: Ensuring it can be done humanely
From that article, it sounds like there are already a couple of private member's bills (written by a Conservative!) that could be effective jumping off points for figuring out the legislation on this; given that this is an election year, I'm going to be interested to see what happens. My best guess is that the Tories won't want to touch it before the election, but it is going to be a campaign issue.
I don't think they can decide to just not pass legislation; guidance is going to be needed on how to interpret phrases like "enduring, intolerable suffering" as well as ensuring clear consent. If the feds don't act, we're going to wind up with a hodge-podge of provincial legislation with differing regulations and I would hate to see people jumping from province to province to get the rules they need/want.
posted by nubs at 2:49 PM on February 6, 2015
From that article, it sounds like there are already a couple of private member's bills (written by a Conservative!) that could be effective jumping off points for figuring out the legislation on this; given that this is an election year, I'm going to be interested to see what happens. My best guess is that the Tories won't want to touch it before the election, but it is going to be a campaign issue.
I don't think they can decide to just not pass legislation; guidance is going to be needed on how to interpret phrases like "enduring, intolerable suffering" as well as ensuring clear consent. If the feds don't act, we're going to wind up with a hodge-podge of provincial legislation with differing regulations and I would hate to see people jumping from province to province to get the rules they need/want.
posted by nubs at 2:49 PM on February 6, 2015
Quebec's already passed a bill that hasn't come into force, from what I understand.
The Libs have come out as cautiously in support of this decision - I expect NDP to do the same.
Also, the Beaverton: "The Court has long endured the torment of chronically overturning legislation and judicial appointments." I definitely cackled at that one.
posted by Lemurrhea at 2:59 PM on February 6, 2015
The Libs have come out as cautiously in support of this decision - I expect NDP to do the same.
Also, the Beaverton: "The Court has long endured the torment of chronically overturning legislation and judicial appointments." I definitely cackled at that one.
posted by Lemurrhea at 2:59 PM on February 6, 2015
This has been enraging me all day. I feel like I shouldn't make a comment, because my family are all dead now. But there are so many other sick people in hospitals throughout the country who are at even greater risk than before because of this decision. I think it's a terrible ruling, and morally wrong.
When you're sick it's hard to think clearly. Sometimes you're terrified, not wanting to die but also not wanting to be a "burden" to others by hanging on. Many doctors take advantage of this by pressuring patients into signing DNRs. They thunder and bluster, intimidating and haranguing the terminally ill by telling them over and over that they're going to die and treatment would only make things worse. If the patient continues to hold out like my father did, then they'll switch to haranguing and intimidating the family, and if that doesn't work they'll move the patient to crowded rooms, stop paying attention to them, and on and on. Now the Supreme Court has given those same doctors the legal ability to "assist" patients to death, there will abuses.
Some people are lucid and decide on their own, without pressure, that they want to die. There was a patient like that in the same ward that my father died in. I heard him talking with the social workers. He even wrote a letter to the newspaper pleading for a halt to his dialysis treatments. (I often wonder if he was conscious of the agony that he was putting his wife and son through, as I often saw them walking stone faced and stiff through the halls. But we were all out of our minds then, and I didn't want to hurt them so I stayed away.) But those rational, committed people are in the minority, compared to the thousands of terminally ill patients who are just terrified and suffering and easy to manipulate.
posted by Kevin Street at 3:02 PM on February 6, 2015 [1 favorite]
When you're sick it's hard to think clearly. Sometimes you're terrified, not wanting to die but also not wanting to be a "burden" to others by hanging on. Many doctors take advantage of this by pressuring patients into signing DNRs. They thunder and bluster, intimidating and haranguing the terminally ill by telling them over and over that they're going to die and treatment would only make things worse. If the patient continues to hold out like my father did, then they'll switch to haranguing and intimidating the family, and if that doesn't work they'll move the patient to crowded rooms, stop paying attention to them, and on and on. Now the Supreme Court has given those same doctors the legal ability to "assist" patients to death, there will abuses.
Some people are lucid and decide on their own, without pressure, that they want to die. There was a patient like that in the same ward that my father died in. I heard him talking with the social workers. He even wrote a letter to the newspaper pleading for a halt to his dialysis treatments. (I often wonder if he was conscious of the agony that he was putting his wife and son through, as I often saw them walking stone faced and stiff through the halls. But we were all out of our minds then, and I didn't want to hurt them so I stayed away.) But those rational, committed people are in the minority, compared to the thousands of terminally ill patients who are just terrified and suffering and easy to manipulate.
posted by Kevin Street at 3:02 PM on February 6, 2015 [1 favorite]
Mumimor, with respect, if you aren't willing to engage beyond personal experience and emotion into "professional ethics" then I don't see what conversation there can be. No one can (respectfully) engage with e.g. the topic of your father's starving himself to end his own life and how that would contrast with a compassionate end-of-life regime. That's simply not a conversation the internet is suited to, imo.
Similarly, I don't really know how to begin to engage with the argument that "Millions of people live with physical handicaps, and have no death wish." To paraphrase: your personal experience and wishes are irrelevant, because other people vaguely like you disagree. Please either state that you believe there can be no rational thinking that leads to a desire to end one's life or provide significantly more nuance.
posted by pahalial at 3:07 PM on February 6, 2015
Similarly, I don't really know how to begin to engage with the argument that "Millions of people live with physical handicaps, and have no death wish." To paraphrase: your personal experience and wishes are irrelevant, because other people vaguely like you disagree. Please either state that you believe there can be no rational thinking that leads to a desire to end one's life or provide significantly more nuance.
posted by pahalial at 3:07 PM on February 6, 2015
Millions of people live with physical handicaps, and have no death wish. Those millions might even find it extremely offensive that paralysis could be a reasonable cause for euthanasia.
It's only a reasonable cause for euthanasia if the patient requests it. And the Hippocratic Oath has changed a lot over the years, so I don't really see an appeal to it as compelling.
What I am against is health-care workers reversing their roles and actively killing people in their care
Their role is to minimize human suffering. Sometimes that means dying faster. I see this as an absolutely logical extension of that role.
I just don't see the huge ethical problems you see. Why should anyone be forced into a choice between a life of pain and being out of your mind on drugs? Why should anyone be forced to suffer through dementia, or terminal cancer, or end-stage AIDS?
Why should the choice be between that, and methods of suicide that are unreliable and traumatic? What if you want to die but are physically unable to perform the actions required?
The only real ethical concern here is that of coercion. I agree that is something that needs to be examined very carefully.
posted by feckless fecal fear mongering at 3:08 PM on February 6, 2015 [1 favorite]
It's only a reasonable cause for euthanasia if the patient requests it. And the Hippocratic Oath has changed a lot over the years, so I don't really see an appeal to it as compelling.
What I am against is health-care workers reversing their roles and actively killing people in their care
Their role is to minimize human suffering. Sometimes that means dying faster. I see this as an absolutely logical extension of that role.
I just don't see the huge ethical problems you see. Why should anyone be forced into a choice between a life of pain and being out of your mind on drugs? Why should anyone be forced to suffer through dementia, or terminal cancer, or end-stage AIDS?
Why should the choice be between that, and methods of suicide that are unreliable and traumatic? What if you want to die but are physically unable to perform the actions required?
The only real ethical concern here is that of coercion. I agree that is something that needs to be examined very carefully.
posted by feckless fecal fear mongering at 3:08 PM on February 6, 2015 [1 favorite]
Kevin Street: I don't quite understand how the dialysis patient in your comment was the one putting his family through agony, or why you imply that it was his wish to have the right to end his own terminally-ill life on his own time that caused it. It is an unfortunate truth that a terminally ill spouse/parent is difficult on everyone in the best of cases. Can you elaborate?
To your point, I wholeheartedly agree that the sick and vulnerable need to be protected. I think that is actually something our system can do a good job of, if the right guidelines are put forth. More critically, I believe that people who have a very low quality of life and wish to exit on their own terms should not have that choice abrogated by the spectre of the poorly-working system you raise. I think that would be a far more egregious failing of the system, to think so little of it - nay, to not even try to do it well - as to pre-emptively take away one of the most deeply personal choices any human being can make.
posted by pahalial at 3:13 PM on February 6, 2015 [1 favorite]
To your point, I wholeheartedly agree that the sick and vulnerable need to be protected. I think that is actually something our system can do a good job of, if the right guidelines are put forth. More critically, I believe that people who have a very low quality of life and wish to exit on their own terms should not have that choice abrogated by the spectre of the poorly-working system you raise. I think that would be a far more egregious failing of the system, to think so little of it - nay, to not even try to do it well - as to pre-emptively take away one of the most deeply personal choices any human being can make.
posted by pahalial at 3:13 PM on February 6, 2015 [1 favorite]
Reading through the decision and Chief Justice Bev is on point.
I really, really like her. There was a thread here not long ago where someone was going on about how commencement speeches are silly etc and I was sitting there all "nuh-uh cuz mine was Beverley McLachlin and she killed it"
posted by Hoopo at 3:17 PM on February 6, 2015 [1 favorite]
I really, really like her. There was a thread here not long ago where someone was going on about how commencement speeches are silly etc and I was sitting there all "nuh-uh cuz mine was Beverley McLachlin and she killed it"
posted by Hoopo at 3:17 PM on February 6, 2015 [1 favorite]
With respect, I would say that anecdotal evidence is not really workable in the discussion of whether abuse is a concern. There is a lot of empirical evidence addressed in the original decision - somewhere on the order of 300 paragraphs starting around here, which of course reference hundreds of pages of academic studies and patient interviews (which I certainly can't claim to have read). The evidence is such that the risk of abuse is not worth condemning people to torture by refusing them end-of-life treatment.
posted by Lemurrhea at 3:19 PM on February 6, 2015
posted by Lemurrhea at 3:19 PM on February 6, 2015
The main point of my posts here has been to point out that a lot of what people imagine is assisted suicide is actually normal palliative care. I see this as the core misunderstanding of the Canadian ruling. I hope no medical staff in Canada have been conducting assisted suicide, since I believe that would be actively manslaughter.
But: doctors and nurses working with the terminally ill very often administer painkilling and anti-depressant or anti-anxiety drugs in ways that will lead to end of life hours or maybe even days before "natural death". Which they should, because otherwise their practice would be cruel and even inhumane. This is not in any way assisted suicide and if some lawyers imagine it is, they are just wrong.
Concerning patients in respirators, the decision to end treatment may even be months or years before life could be sustained artificially, but obviously long after "natural death". Each of these cases have to be reviewed independently because while most people do not recover once they have been in a vegetable state for months, some do. We cannot base a general principle on either cases.
Artificially sustained life is an independent problem which we are not at all dealing with responsibly. And it causes huge ethical problems at both end of life. If we can artificially support a 20-week "baby", how can we live with late term abortions? If we spend millions on keeping a 20-year old man alive in a vegetative state (one of my friends) why can't we save the life of a 45 year old homeless guy? In my posts here, I am not thinking of these special conditions, because I think they need a different consideration. In theory, my 91-year old gran could have been kept alive in a respirator - but that would obviously have been absurd, even to her.
posted by mumimor at 3:33 PM on February 6, 2015 [1 favorite]
But: doctors and nurses working with the terminally ill very often administer painkilling and anti-depressant or anti-anxiety drugs in ways that will lead to end of life hours or maybe even days before "natural death". Which they should, because otherwise their practice would be cruel and even inhumane. This is not in any way assisted suicide and if some lawyers imagine it is, they are just wrong.
Concerning patients in respirators, the decision to end treatment may even be months or years before life could be sustained artificially, but obviously long after "natural death". Each of these cases have to be reviewed independently because while most people do not recover once they have been in a vegetable state for months, some do. We cannot base a general principle on either cases.
Artificially sustained life is an independent problem which we are not at all dealing with responsibly. And it causes huge ethical problems at both end of life. If we can artificially support a 20-week "baby", how can we live with late term abortions? If we spend millions on keeping a 20-year old man alive in a vegetative state (one of my friends) why can't we save the life of a 45 year old homeless guy? In my posts here, I am not thinking of these special conditions, because I think they need a different consideration. In theory, my 91-year old gran could have been kept alive in a respirator - but that would obviously have been absurd, even to her.
posted by mumimor at 3:33 PM on February 6, 2015 [1 favorite]
Just to clarify since I added nothing else to my post of the Spiegel link:
My personal stance is that individuals (should) have the right to choose the manner and timing of their death if that's a choice they want to make. Their reasons for doing so are not for me or anybody else to judge. It doesn't matter where the choice lands on anybody's yardstick of values. Someone's choice appears cowardly to you? Why does it matter? If they're deemed capable of making decisions then their decisions are their decisions regardless of the opinions of others. It seems like the processes described in the article leave enough room and time for people to change their minds. Some do, some don't. We make countless irreversible decisions, big and small, during the course of our lives. This is no different.
posted by Hairy Lobster at 4:38 PM on February 6, 2015 [2 favorites]
My personal stance is that individuals (should) have the right to choose the manner and timing of their death if that's a choice they want to make. Their reasons for doing so are not for me or anybody else to judge. It doesn't matter where the choice lands on anybody's yardstick of values. Someone's choice appears cowardly to you? Why does it matter? If they're deemed capable of making decisions then their decisions are their decisions regardless of the opinions of others. It seems like the processes described in the article leave enough room and time for people to change their minds. Some do, some don't. We make countless irreversible decisions, big and small, during the course of our lives. This is no different.
posted by Hairy Lobster at 4:38 PM on February 6, 2015 [2 favorites]
3. well the government is going to have to do something - the SCC has suspended their declaration of invalidity of the relevant section of the Criminal Code for one year, which is basically an invitation to the feds to fix that section
Actually no, they don't. When Canada's abortion laws were struck down, the same proviso was included, and the Mulroney government just let the deadline lapse. (Though there was debate in the cabinet about enacting a new law, ultimate it was just dropped)
posted by dry white toast at 4:40 PM on February 6, 2015
Actually no, they don't. When Canada's abortion laws were struck down, the same proviso was included, and the Mulroney government just let the deadline lapse. (Though there was debate in the cabinet about enacting a new law, ultimate it was just dropped)
posted by dry white toast at 4:40 PM on February 6, 2015
The main point of my posts here has been to point out that a lot of what people imagine is assisted suicide is actually normal palliative care.
I don't think so, at all. We are talking about "Hi Doctor, I am in severe pain that won't end until I die. Please help me die." I'm pretty sure our Justices are cognizant of the difference between assisted suicide and palliative care (which has been a significant thing in Canada since I was a child, at least that long) after the amount of evidence that was presented.
I hope no medical staff in Canada have been conducting assisted suicide, since I believe that would be actively manslaughter.
It happens. It's not talked about a lot, but it happens. I remember some pointed conversations when my grandfather was dying in the hospital--this was back in 1996--about morphine, and how much he could safely be given, and they could go over that amount but it could have Serious Consequences and is that something my grandmother wants? (She didn't. I believe to this day that if he'd been able to communicate, he would have grabbed the needle himself.) I've heard that conversation or similar from friends as well. Always plausibly deniable.
And as of this morning, it would not be manslaughter. Well, 6 Feb 2016 actually, but still.
otherwise their practice would be cruel and even inhumane
This is an honest question: how is it not inhumane to force someone to keep living in a state which is unending and intolerable?
posted by feckless fecal fear mongering at 4:56 PM on February 6, 2015 [3 favorites]
I don't think so, at all. We are talking about "Hi Doctor, I am in severe pain that won't end until I die. Please help me die." I'm pretty sure our Justices are cognizant of the difference between assisted suicide and palliative care (which has been a significant thing in Canada since I was a child, at least that long) after the amount of evidence that was presented.
I hope no medical staff in Canada have been conducting assisted suicide, since I believe that would be actively manslaughter.
It happens. It's not talked about a lot, but it happens. I remember some pointed conversations when my grandfather was dying in the hospital--this was back in 1996--about morphine, and how much he could safely be given, and they could go over that amount but it could have Serious Consequences and is that something my grandmother wants? (She didn't. I believe to this day that if he'd been able to communicate, he would have grabbed the needle himself.) I've heard that conversation or similar from friends as well. Always plausibly deniable.
And as of this morning, it would not be manslaughter. Well, 6 Feb 2016 actually, but still.
otherwise their practice would be cruel and even inhumane
This is an honest question: how is it not inhumane to force someone to keep living in a state which is unending and intolerable?
posted by feckless fecal fear mongering at 4:56 PM on February 6, 2015 [3 favorites]
We are talking about "Hi Doctor, I am in severe pain that won't end until I die. Please help me die." I'm pretty sure our Justices are cognizant of the difference between assisted suicide and palliative care (which has been a significant thing in Canada since I was a child, at least that long) after the amount of evidence that was presented.
From the ruling:
It's an emotionally fraught subject to be sure. I know, based on what I've seen in my family, where my line is and when I would want this. It's going to be different for other people, and that's fine with me. I'm not of the judge of anyone else's decision on this matter.
The big, big concern I have is how the consent process will be managed (for both patient and doctor) and how they are going to address issues like mental health, which the ruling is silent on. Consent and mental health is a big issue on its own.
posted by nubs at 5:12 PM on February 6, 2015
From the ruling:
[23]So the court very clearly looked at the difference between the consent to the passive withdrawal of treatment and consent to an active assisted treatment, both with the end goal of ending life. While they haven't been regulated, there's a very long and clear history of allowing people to consent to the withdrawal (or outright refusal) of life-saving treatments. This ruling is extending that right to consent to the active application of treatment that will end life.
The trial judge began by reviewing the current state of the law and practice in Canada regarding end-of-life care. She found that current unregulated end-of-life practices in Canada — such as the administration of palliative sedation and the withholding or withdrawal of lifesaving or life-sustaining medical treatment
— can have the effect of hastening death and that there is a strong societal consensus that these practices are ethically acceptable (para. 357).
After considering the evidence of physicians and ethicists, she found that the “preponderance of the
evidence from ethicists is that there is no ethical distinction between physician assisted death and other end-of-life practices whose outcome is highly likely to be death” (para. 335).
It's an emotionally fraught subject to be sure. I know, based on what I've seen in my family, where my line is and when I would want this. It's going to be different for other people, and that's fine with me. I'm not of the judge of anyone else's decision on this matter.
The big, big concern I have is how the consent process will be managed (for both patient and doctor) and how they are going to address issues like mental health, which the ruling is silent on. Consent and mental health is a big issue on its own.
posted by nubs at 5:12 PM on February 6, 2015
If there was a written "opt-in" option to log in for this, I would sign right up.
posted by ovvl at 7:16 PM on February 6, 2015
posted by ovvl at 7:16 PM on February 6, 2015
Add me to the list of people who would sign up for something like this at the first hint of onsetting dementia. My grandmother went through over a year of degeneration, varying lucidity interspersed with many surgeries and at least two arterial stints in her frail, bony body. She became so tiny my mother could pick her up. At her worst she was sobbing or yelling and having full conversations with her hallucinated now-dead friends about events that happened when she was younger. In future tense, like she was stuck in the 1930s.
At that point I would no longer be myself, there would no longer be a coherent perception of reality to call my own. I would consider advanced dementia even worse than being comatose because there is the illusion that I might actually be there, my laughter bringing false hope to my loved ones. Forcing them to remember how I used to be, and contrasting that against a fractured, broken mind that can't even recognize them.
I respect if other people would not want to end it when confronted with such things, but the reality of that kind of neural degeneration is literally one of the most horrifying things I can imagine. Kudos to Canada for taking a step towards letting people choose their own path in life, including it's ending.
I don't think anyone has the right to tell somebody else "You have to keep dealing with this pain because I feel your life is too precious for you to end it. I know better than you what burdens you are capable of bearing".
posted by Feyala at 10:30 PM on February 6, 2015 [5 favorites]
At that point I would no longer be myself, there would no longer be a coherent perception of reality to call my own. I would consider advanced dementia even worse than being comatose because there is the illusion that I might actually be there, my laughter bringing false hope to my loved ones. Forcing them to remember how I used to be, and contrasting that against a fractured, broken mind that can't even recognize them.
I respect if other people would not want to end it when confronted with such things, but the reality of that kind of neural degeneration is literally one of the most horrifying things I can imagine. Kudos to Canada for taking a step towards letting people choose their own path in life, including it's ending.
I don't think anyone has the right to tell somebody else "You have to keep dealing with this pain because I feel your life is too precious for you to end it. I know better than you what burdens you are capable of bearing".
posted by Feyala at 10:30 PM on February 6, 2015 [5 favorites]
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That's a really interesting point, that fear of not being allowed an assisted suicide actually forces some people to die earlier than they need to just because they want to make sure they can end their lives while they still have the strength. It's such a horrible position to put someone in and certainly seems contrary to the idea of "do no harm".
posted by billiebee at 8:56 AM on February 6, 2015 [19 favorites]