Senator Nancy Ruth.
Evidence of meeting #11 for Physician-Assisted Dying in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
Evidence of meeting #11 for Physician-Assisted Dying in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was illness.
A video is available from Parliament.
5:30 p.m.
Nancy Ruth Senator, Ontario (Cluny), C
Ms. Ng, you have said that access should be evenly available and that doctors must transfer patients if they have a conscientious objection. What is the opinion of the Unitarian Council if the hospital is a faith-based hospital that objects to doing physician-assisted death, not just the doctor? Or does the Unitarian—
5:35 p.m.
Executive Director, Canadian Unitarian Council
We understand that there are many faith-based institutions that provide hospice and palliative care. It's even more important in those situations that a good, effective process of transfer of care does happen, as we've been talking about, especially in the more remote communities. It is the constitutional right of every Canadian to receive this care, and it is a fine balance between protecting the rights of conscience of the physician and making sure that the rights of the individual patient have not been violated. A good mechanism needs to exist. Whether it's a direct doctor referral care or a third party referral system, it needs to flow smoothly. I would think that if someone checks into an institution or a hospice facility that is faith-based, they would know ahead of time that certain moral values apply.
To go back to the previous question about institutions if they're publicly funded, we believe that publicly funded institutions should provide this kind of assisted dying.
We also believe in the sanctity of life, but we don't think that life should be extended and preserved at all costs. We believe that quality of life is really important as well. There is no dignity, there is no compassion when someone is terminally ill. They're at the end of their life. They can't take care of themselves. Their bodies have let them down. They are in pain and they can't look after themselves. There is no dignity in that.
My partner died a little over two years ago. He was diagnosed with a condition early in 2000 and lived beyond his original prognosis. He was fortunate enough to receive very good care in a hospice. It was excellent palliative care. But would he have wanted access to physician-assisted dying? Yes, he would have. He was in pain. He was uncomfortable. He was not the person that he knew himself to be. If we force someone to prolong their life because a physician isn't willing to provide that kind of care, then we're violating their constitutional rights.
5:35 p.m.
Senator, Ontario (Cluny), C
Thank you.
You did say that there should be a review after death. Could you explain that a bit more?
5:35 p.m.
Executive Director, Canadian Unitarian Council
I think a review process serves to make sure that effective mechanisms are in play. As this practice and this legislation rolls out, we're not going to know what it looks like. So in terms of helping both the institution and the physician make better choices down the road, I think a thorough review of what request was made, how the request was handled, how the institution handled it, and how the physician handled it will help both the institution and the physician.
5:35 p.m.
Executive Director, Canadian Unitarian Council
I think it should be an objective party, whether it's a committee put together by various stakeholders.... It should not be the institution that provided the care and it shouldn't be the physician who provided the care, but someone objective. And I think the review is even more—
5:35 p.m.
Senator, Ontario (Cluny), C
Can you see this coming under the coroner's office in the provinces?
5:35 p.m.
Senator, Ontario (Cluny), C
Can you see the coroner's offices being expanded to include this kind of thing? What I'm getting at is, is there a need to create a new institution or can we use what already exists in every province and territory across Canada?
5:35 p.m.
Executive Director, Canadian Unitarian Council
I think the options are there, as long as no biases are built in, as long as there's a process to make sure that the reviews are objective and that there are no preconceived agendas.
5:35 p.m.
James S. Cowan Senator, Nova Scotia, Lib.
Welcome to the witnesses, and thank you for your evidence.
Your Eminence, I appreciate your faith-based opposition to physician-assisted dying, but that's not the issue before us. The court has made a decision and we're bound by that decision, and physician-assisted dying is a constitutional right for those eligible to access it. I appreciate the concerns that you've expressed about conscientious objectors and nobody being forced to participate. But it seems to me, and I'd ask for your comments, that what we're really looking at here is, we ought to be looking at it through the eyes of the affected patient. The rights and beliefs we might have have to be accommodated to meet those rights that the patient has.
Perhaps you would wish that there is not going to be physician-assisted death in this country, but there is, so what particular, specific precautions should we be recommending be put in place to protect from abuse and protect the vulnerable? I think all of us would want to afford every protection to the vulnerable, but what specifically should we be recommending that would allow physician-assisted death to proceed, but at the same time provide appropriate protections for the vulnerable?
5:40 p.m.
Cardinal Thomas Collins
I'm certainly sure there are people—many around this table and around the country—who are very much committed to ensuring that physician-assisted suicide takes place. Obviously, after the Carter decision, this is the project of this committee.
As I have made clear, I don't believe this is the direction the country should be going in. Far be it from me to suggest making it about should we have three doctors, two doctors, should we have one, should we do...? I don't believe it should happen, so I can't convince—
5:40 p.m.
Senator, Nova Scotia, Lib.
I understand that, Your Eminence, but that's not where we are.
5:40 p.m.
Cardinal Thomas Collins
I'm sure other people will be doing that, but I don't believe in the thing itself. What I do believe is that the rights of conscience, of people who are constantly involved with compassionately caring for those most in need, need to be protected. I also believe that alternatives should be presented, funded very directly, and that would be palliative care.
5:40 p.m.
Senator, Nova Scotia, Lib.
Again, you're preaching to the choir here, because all of us would believe there ought to be more readily accessible, better palliative care available to more Canadians, but again that's not our issue. Our issue is, and maybe Mr. Worthen can address this issue of precisely what are these...? You spoke about protection of the vulnerable as being a concern. What can we do to protect the vulnerable within a regime which permits the constitutional right of eligible persons to access physician-assisted dying?
5:40 p.m.
Executive Director, Christian Medical and Dental Society of Canada, Coalition for HealthCARE and Conscience
I'm with the cardinal on this. I spent some time a year and a half ago with Dr. Theo Boer, who is the medical ethicist in the Netherlands. He was on a euthanasia commission there, and their job was to review cases. He indicated that they went through every one of the so-called safeguards that were available in the Dutch statute, and he explained to me about cases that he had where doctors had circumvented them. One study has shown that in about 20% of cases doctors were performing euthanasia when they thought they were doing palliative sedation.
In my discussion with Dr. Boer, I said that it appears to me that the so-called safeguards are just there to sell the concept of assisted suicide.
5:40 p.m.
Senator, Nova Scotia, Lib.
Surely if there are safeguards in place, and physicians or other health professionals disregard or circumvent those precautions, then that's a disciplinary matter for the College of Physicians and Surgeons or the nurses' association.
5:40 p.m.
Executive Director, Christian Medical and Dental Society of Canada, Coalition for HealthCARE and Conscience
Unfortunately, if you look at what's happening in these countries, doctors just get a slap on the wrist.
5:40 p.m.
Executive Director, Christian Medical and Dental Society of Canada, Coalition for HealthCARE and Conscience
They get a letter telling them.
What I'm trying to say is that once you accept the idea that state-sanctioned killing of patients is morally acceptable and you open it a crack, it becomes almost impossible to find a place to stop that process.