The year of 2016 became critical in means of assisted dying issue for Canadian society, legislators and, of course, health-care professionals. The law, known as Bill C-14 (Chochinov & Frazee, 2016), grants permission for assisted suicide to patients who wish for death. However, certain strict terms condition this permission. The limitation of the patients’ access to the discussed medical service is a widely debated question. Many see it as deficient, sub-optimal, since the law does not assure equal rights to all citizens and far from everybody has access to assisted dying.
In general, assisted dying has become legal in Canada, so all people, according to the Charter of Rights and Freedoms (Upshur, 2016) can expect equal treatment, even in means of assisted suicide. However, the law sets limits for patients eligible for assisted dying. Eligibility implies a) access to government-funded medical service in Canada, b) age of at least 18, c) “grievous and irremediable medical condition” (Chochinov & Frazee, 2016), d) voluntary request for medically assisted death, and e) informed consent. The definition of “grievous and irremediable illness” evokes questions and debates, for the terms used in legislation seem vague and quite equivocal to many. They are “incurable illness, irreversible decline in capability, illness causing intolerable psychological and physical sufferings, [and] natural death reasonably foreseeable” (Chochinov & Frazee, 2016).
This vague definition of incurable illness in the law restricts people’s access to the legally promised service of assisted death. Who should decide if the condition causes intolerable physical and psychological sufferings? Perhaps, only a suffering patient can do that. Another question concerns foreseeable death, it is a very inexact definition, as a lot of time may pass before a patient dies, and denial of needed assistance on the ground of the fact that one will anyway die, only later, may cause unnecessary suffering.
Psychologists (Karesa & McBride, 2016) have to assist in solving this question too, and become the part of the service. Their support and professional opinion may be helpful in situations when it is questionable whether a patient is eligible for assisted dying, whether one is sane and is capable of making a decision to die with medical assistance.
Furthermore, there is a restriction for mature minors who may suffer from their intolerable conditions, but cannot decide upon ending their suffering, even if they have a terminal disease, and their death is clearly foreseeable. The law also excludes people with mental disorders who cannot consciously make their informed consent, but whose conditions are “grievous and irremediable” (Chochinov & Frazee, 2016). Finally, there is also a number of people, mostly elderly, whose conditions are not terminal, but who are incapable of live unassisted. They suffer from serious illnesses (heart diseases, for instance), which evidently diminish the quality of their life and increase their suffering on a daily basis. Of course, as for the latter example, there are already precedents when physicians take their patients’ side (Hutchinson, 2016). In such cases physicians entitled to offer assisted death services, after careful examination grant their patients the needed permission and perform the legally certified procedure.
Considering the categories of patients, excluded from the eligibility list for assisted suicide, the law does not go far enough. Therefore, regulators should reconsider and amend the law to take into consideration the needs of as many types of patients as possible. All patients have their right for equal treatment, even if it is assisted suicide.
References:
Chochinov, H. M., & Frazee, C. (2016). Finding a balance: Canada's law on medical assistance in dying. The Lancet, 388(10044), 543-545.
Hutchinson, B. (2016, Oct 29). ‘Dad got the death he wanted’; assisted death criteria challenged. The Vancouver Sun, 2.
Karesa, S., & McBride, D. (2016). A sign of the changing times? Perceptions of Canadian psychologists on assisted death. Canadian Psychology, 57(3), 188-192.
Upshur, R. (2016). Unresolved issues in Canada's law on physician-assisted dying. The Lancet, 388(10044), 545-547.
