Dissecting Assisted Suicide

In October, the Supreme Court of Canada began hearing arguments in an appeal by the BC Civil Liberties Association that could overturn the prohibition on doctor-assisted suicide. Michael Curry, clinical assistant professor in UBC’s Faculty of Medicine and a graduate of UBC Law School, says that while the current prohibition on assisted suicide may strike some as outdated, crossing the line from alleviating suffering to hastening death is a step that cannot be taken lightly.
Where is the line between withdrawing treatment and alleviating pain, and assisted suicide?
There’s a very important distinction. Withdrawing or withholding care has long been considered an acceptable practice for medical practitioners. Actively participating in suicide is something that’s prohibited by law. You can be punished for the act of taking a patient’s life by up to 14 years in jail.
Is the line between withdrawing treatment and alleviating pain and assisted suicide blurry?
I think a lot of physicians have difficulty determining where the line lies especially when a patient is asking for help or assistance in regards to ending their life. There is definitely a point where doses of painkillers to control pain may be hastening the end of life but that’s an incidental effect of medicines. With assisted suicide, medicines are purposely being used to end a life.
Does assisted suicide contradict the Hippocratic Oath taken by doctors?
The ancient versions of the Hippocratic Oath states that you are not to take a life or provide a poison that would do so. We have modified the Hippocratic Oath over the centuries and that prohibition has been relaxed in more modern editions. Most physicians hold themselves to the more modern standard of, “First, do no harm.” Using that principle the question becomes: is taking a life a harm? If a person is suffering with a painful, incurable illness, it’s very debatable as to whether helping somebody end their life is actually harming them.
A recent poll found 84 per cent of Canadians support assisted suicide. Do you see any danger to legalizing it?
The classic argument has always been a slippery slope argument. Stories have come out of countries that have legalized euthanasia that I’m not sure Canadians would be terribly comfortable with. A person in Belgium was helped with assisted suicide because of terminal depression. There was another case of assisted suicide involving a gender dysphoria. The person had a sex change and was dissatisfied and was judged to be in a terminal condition by a doctor as a result of that. In the Netherlands they have a board that can decide to euthanize babies with severe medical conditions.

So I think the big question has to be, if physician participation in assisted suicide is allowed, what is the next bright line?
Do you think legalized assisted suicide is inevitable?
I think the world tends to be moving in that direction but you can count on one hand the number of countries that allow legalized assisted suicide.

Medical technology allows us to extend the lives of people with conditions beyond what we could have done in the past. We’re also experiencing an ageing society and one that’s becoming divorced from spiritual and religious taboos. The combination of all three factors makes this a bigger and bigger issue.

Once doctors enter the business of ending life, that’s a big, huge step, and we sure as heck better know what our limit is.

 

The appeal case filed by the BC Civil Liberties challenges the criminality of doctor-assisted suicide. The Supreme Court of Canada began hearing arguments October 14. The appeal stems from a 2012 ruling by the BC Supreme Court, which found that the existing law banning assisted suicide was unconstitutional. The federal government appealed the decision and the BC Court of Appeal overturned the ruling in 2013. This marks the first time in 20 years that the country’s highest court has ruled on the issue. In 1993, it heard the case of Sue Rodriguez, a 42-yearold Victoria woman with ALS. Rodriguez’s appeal was denied by the court in a narrow fivefour decision.

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