Thank you very much.
This is a very interesting, and a very charged set of circumstances. As far as I am concerned, having been a practising physician for 22 years, the idea of an advance directive is that the patient, as you said, should have informed consent, and then the patient should make a decision. If patients are ever going to come to a time when they are not compos mentis, they decide on the conditions that they wish to happen if and when they get there. That's what an advance directive is about.
The Supreme Court was very clear about section 7 of the charter, and then I wonder, because I hear you and Monsieur Deschamps. Does Monsieur Deschamps agree with the Supreme Court decision in Carter under section 7? Do you, sir, believe that a physician should second-guess a patient?
Patients are concerned that there will come a time when other people will do things to them. They are abused. Do you not agree that this abuse can work both ways? It can occur when a patient is not compos mentis and a family would like to get rid of the patient. If the patient in an advance directive says, “I don't care what happens to me; I would like to continue living”, families could in fact make a decision with a physician that that's not so.
Similarly, families could make a decision with a patient who said, “There comes a time when I will not be able to mentally make a decision, and I want to be able to die with a certain amount of dignity, and here are my conditions, being fully informed.”
I don't understand. This is about the patients, as far as I'm concerned. This is about the best interests of the patients, the autonomy and the self-determination of patients who make that advance directive, because they're very concerned that other people will change it when they become incompetent. I'm now hearing people saying that it's okay for physicians who don't know what it's like to have Alzheimer's, who have never had it themselves, who don't know what it's like to live in that patient's body with that patient's autonomy. They are making decisions for them, and I call that physicians playing God.
The Supreme Court was very clear on section 7 of the charter. I am hearing people telling me that the Supreme Court didn't know what it was talking about, that the doctors know better than patients what a patient requires, especially if they disagree with the patient's advance directive. I don't understand advance directives to be about that at all.
I'd like to hear from Monsieur Deschamps and Mr. Cohen about this. Why is it that other people believe that they have the ability to make the decision for a patient who has obviously made that decision in advance, because they were scared of being non compos mentis?