Thank you, Mr. Chair.
Thank you to all of our witnesses for being here today.
Many times we hear the criticism of the medical profession that they are too focused on the medicalization of dying, and I found your presentation to be refreshingly different from that. You're addressing what I believe are many of the ethical and moral issues that underlie this big question we are facing as parliamentarians, which is what does it mean to be human, and what gives human life meaning?
I was especially pleased to see these kinds of thoughts coming from those who are charged with the responsibility of licensing our physicians and surgeons. It is really encouraging for me.
I want to read into the record some of the statements you made in your paper, because I think it is crucial for all Canadians to hear this, and, unfortunately, they won't all be able to read your paper.
The term dignity can have different meanings and is open to interpretation.....
There is a general agreement that dignity is intrinsic in all human beings because all have equal worth and belong to the human community. Dignity in this sense cannot be diminished or lost by such changes as disfigurement, illness, or decline in capacities.
There is another sense of dignity that is related to the flourishing or well-being that patients experience in their lives. Dignity as associated with flourishing and well-being can be subject to variation with illness and disability for some individuals, particularly for those who are concerned with their loss of control or independence. These concerns in many patients can be mitigated and addressed by effective care, so that their dignity in this sense can be preserved or even enhanced. In other patients, their adjustment to and acceptance of the limitations imposed by illness, disability, and death can result in overall well-being and the patient and can provide a sense of meaning and inspire their loved ones and others in the midst of suffering.
A third sense of dignity, attributed dignity, is connected with how patients perceive themselves or how they perceive others' regard for them. Negative self-perception and concerns about being a burden to others can often lead patients to consider physician-assisted suicide and euthanasia.
In another paragraph, you indicate that one of our challenges is in challenging attitudes and behaviours that regard some patients as non-productive and costly members of society—for instance, referring to the demographic of aging Canadians as the “silver tsunami”. These attitudes and behaviours among care providers can reinforce patients' sense of being a burden to others and their perception that they have a duty to die.
One of the foundational concerns I have, as a member of Parliament charged with the responsibility of making recommendations to the government as to how we craft legislation, is how we can be 100% certain that what today could be a right to die could, through some kind of coercion, moral or otherwise, become the duty to die. How can we be 100% sure? What kind of safeguards can we put into our recommendations to the government that we will do all we can to be sure that does not happen?