United Church holds panel discussion on medically-assisted dying

Physician-assisted dying and the federal government’s proposed bill, C-14, is a complex and controversial issue that the Barrhead United Church hopes people understand a little better following a public discussion panel on Saturday, May 14.

The church invited four guest speakers, Katherine Duthie and Kim Stever, Alberta Health Services (AHS) clinical ethicists, Caroline Lyster, a bioethics and legal specialist with a bioethics degree from McGill University and Sharon Foster, the reverend of Barrhead United Church.

Barrhead town councillor Leslie Penny, who has spent the majority of her working life in the healthcare field, and is also is on the board of the Alberta Hospice Palliative Care Association, moderated the panel.

Duthie said the topic of physician-assisted death has been discussed among health practitioners for many decades, but with the proposed federal legislation it has become more prominent. It should be noted that Duthie and fellow panelist, Kim Stever, were speaking for themselves and not representing AHS.

“So what is physician-assisted death, or what we are now calling medical assistance in dying (because under proposed legislation a nurse practitioner will be able to provide the service as well)? Essentially this is where a healthcare professional can provide a substance that ends a patient’s life,” she said, adding medical professionals would only be able to provide the service to patients who fall within strict guidelines.

Duthie said: “It is only after having an exhaustive discussion on other clinical options, including more medical treatments and palliative care options. It is only after the process has uncovered all the possibilities and there isn’t anything we can do differently to meet that patient’s goals.”

She added medically assisted death is similar to something that has always been available to Canadians.

Under current legislation a patient has the right to deny or withdraw any medical treatment, even if the result is death.

“On the other side it is a vast shift, not only from different cultural or faith prospectives, but within the culture of healthcare and medicine this is different,” Duthie said. “From removing some kind of treatment versus administering a substance that will cause the end of life and my heart goes back and forth on both sides of the issue.”

Since 2015, when the Supreme Court of Canada (SOC) struck down the ban on physician-assisted death, Duthie said governments and organizations that provide healthcare have been preparing assisted-dying legislation.

The SOC justices, in their unanimous ruling on Feb. 6, 2015, gave federal and provincial governments 12 months to prepare for the decision to come into effect.

After taking office, the Liberal government asked for a six-month extension, but the high court granted only an extra four months, to June 6.

“We want to respect peoples’ autonomy and rights to make decisions about their own bodies and lives, while at the same time making sure we are not forcing healthcare providers to do something doesn’t fit with their values’ systems,” she said.

Caroline Lyster discussed the history of assisted-dying legislation and discussion in Canada as well as the safeguards, which the government has put into the legislation.

She said a lot of the debate over the rights of a person being able to choose whether or not they want to end their life and being able to have a medical professional assist them in doing it stemmed over two court cases.

The first being Sue Rodriguez, a B.C. woman who was diagnosed with ALS in 1991. As her health deteriorated, she asked the federal government to legalize assisted suicide for people suffering painful terminal illnesses. She went to court in British Columbia and finally to the SOC, arguing that the ban on assisted suicide denied her constitutional right to life, liberty and security of person.

Rodriguez also argued the law violated Section 15 of the Charter of Rights, which gives individuals equality under the law without discrimination.

“She argued people who are not able to end their lives without assistance are discriminated against because they are deprived of the option of choosing suicide because they are not physically capable to do so,” Lyster said, adding while the SOC justices agreed the law was discriminatory the violation was acceptable under the principles of fundamental justice. “Basically that means her rights were violated, but the government had a really good reason for doing that. It was in the state’s interest in protecting the lives of multiple citizens who could be unduly influenced to choose suicide in a moment of weakness and that it wasn’t arbitrary.”

The next challenge to the prohibition on assisted suicide was by Kay Carter. Like Rodriguez, Carter argued the law against assisted suicide was discriminatory and violated her Charter rights.

Lyster explained Carter’s lawyers were able to cite examples of jurisdictions where assisted suicide was legal, in places such as the Netherlands, Belgium, Switzerland and Oregon.

“They proved that abuses of the system could be prevented and vulnerable members of society can be protected,” she said, adding the SOC upheld the B.C. Supreme Court ruling in 2015.

Lyster then went on to explain what is proposed in C-14 and the safeguards the government has put in place.

Assisted death will be restricted to mentally competent adults who have serious and incurable illness, disease or disability. Other restrictions include:

• Protect people from being encouraged to die in “moments of weakness.”

• Include a mandatory 15-day “reflection period” so people don’t make rash decision after a diagnosis.

• Re-affirm goals on suicide prevention and encourage a “consistent approach” across Canada.

• Allow doctors and nurse practitioners to provide assistance without risk of criminal charges.

Patients must also be eligible for publicly funded healthcare services in Canada, which precludes people from the U.S. or other jurisdictions travelling to Canada to end their lives with the help of a doctor in what some have called “suicide tourism.”

Foster ended the panel discussion by talking about assisted dying from a faith perspective.

She said as a Christian the Bible teaches that man is made in God’s image and therefore life is a gift.

“It is larger than any one person’s ownership of it and it should not be ours to discard lightly,” Foster said, adding despite that in most Christian churches, there is a belief that suicide is a sin, it is referenced sparingly in the Bible.

She added that although there are references to suicide, the issue of morality of suicide is never addressed, at least in the context of relieving pain due to illness.

“Where it is discussed it is in accounts of those whose actions are of direct consequence of disobedience against God or action against God’s anointed rulers,” she said, adding other biblical examples include those who end their lives to avoid consequences or shame.

Foster closed the panel discussion saying the issue of medically-assisted suicide is a difficult one and that there are many people, Christians included, on both sides of the issue.

“Regardless of the decision that was made (in an assisted suicide case), I think all pastors and people of faith are called upon to walk with patients and their families before and after death,” she said.