Mr. Speaker, the matter of euthanasia and assisted suicide has enormous ethical and legal ramifications. At the outset it is critical to note that the non-initiation and cessation of medical treatment is distinctly different from a deliberate action taken to bring about the death of a patient. A huge difference exists between allowing to die and killing.
We are engaged in a discussion on whether we as legislators should change the Criminal Code of Canada to permit the killing of persons with permanent or terminal illness. Let us be clear about that.
The right of a competent individual to refuse or cease medical treatment has long been accepted in law and in care giving, but for this country to permit euthanasia and assisted suicide, removing the penalties of criminal law, as has been done in Holland, will in effect redefine the values of the state. Further, it will gravely impinge on the traditional relationship between the patient and the physician and the role of palliative care within our health system.
Let us consider the doctor-patient relationship. The trust inherent here must be preserved. The belief that the patient's self-interest is always the physician's priority is the most vital component of that relationship. By creating a society in which the physician may participate in the active taking of life we cross a threshold and threaten the trust of beneficence that is the root of the physician-patient relationship. Where there is already vulnerability we risk the creation of fear and mistrust.
It is imperative to consider what motives might be behind a person's request for euthanasia or assisted suicide. Frequently the patient has begun to see himself as a burden on loved ones and feels obligated to cease being so. Sometimes the seriously ill patient is fearful of unrelieved pain that might not be managed and looks to assisted suicide as a way out.
While it is diminished, our health care system is capable of correction and of providing the resources and priorities necessary to address these fears. With appropriate support from hospitals, hospice and community care the concerns of the patient can be remedied. When the efforts of the care givers shift from curative to creating a comfortable environment wherein the person receives pain control, psychological and spiritual support, the opportunity exists for great integrity in the final weeks or months of the ill person's life.
As a former hospice worker I have witnessed great intimacy and honesty between the terminally ill person and his or her family that would never have occurred should the road chosen have been euthanasia instead of palliative care. Not only does resorting to euthanasia risk hijacking palliative care in this country and endangering the patient-physician relationship, it also leads our society on a trajectory we do not want.
The example of Holland, the only western country to officially sanction euthanasia and assisted suicide, cannot be omitted from any debate. Although the Dutch guidelines require that the patient be experiencing unbearable pain, that requirement is now read to include psychic suffering or the potential disfigurement of personality. I ask my colleagues how far down the slippery slope this shows the Dutch have gone. A further example is the landmark decision of 1993 in which a Dutch psychiatrist was ruled to be justified in helping his depressed but physically healthy patient to commit suicide.
The trajectory becomes a downward spiral, one on which this country must not embark.
In 1982 the Law Reform Commission of Canada raised the concern that there is a real danger that the procedure developed to allow the death of those who are a burden to themselves may be gradually diverted from its original purpose and eventually used to eliminate those who are a burden to others or to society.
In a world that does not try to give positive meaning to old age and suffering, it could become normal to ask to put an end to life and abnormal to want to live despite subtle pressures from all sides. We will have to justify our own survival. The day that an individual must justify his or her own survival must never be allowed to dawn in this country.
The legal framework must enhance the common good. Removing the Criminal Code restrictions against euthanasia and assisted suicide will in the long run deny that common good and the principles that have so enriched this country's jurisprudence. As legislators it is our obligation to reaffirm, not deny, the common good we have been elected to safeguard.
Our denial of euthanasia and assisted suicide must be accompanied by a greater commitment to far greater resources being assigned to palliative care in this country. Death and dying receive the least amount of support from medical research funding agencies. Palliative care is not fairly accessed nor in sufficient quality for all Canadians in all provinces and territories. Likewise greater priorities and resources must be assigned to palliative care in our medical schools than is currently provided.
The distinction drawn in the United States Supreme Court decision in Quill must be seen as critical: When a patient refuses life-sustaining medical treatment, he dies from the underlying fatal disease or pathology; but if a patient ingests lethal medication prescribed by a physician, he is killed by that medication.
In the first instance, the patient is allowed to die. In the second instance, the patient is killed. The distinction is integral. We would be debating the latter, the killing of patients by deliberate action taken to bring about their death. We have rightly accepted the concept of allowing to die. We must not accept the concept of killing.
This House will decide the timing of such a debate. The essence of that debate is as I have described. We must look to all the issues that are before us. We do not have the option to engage in emotionalism.
For us as legislators, there is a great onus to dissect and care for all the ingredients before us before we change a law like this that will have such enormous implications and ramifications for our society, for the continual downward spiral I have been describing.
We are not able to take an easy course. We are not able to participate further in a society that would allow for instant gratification on so many other fronts to be brought to bear on any issue as critical as this.
There must be no fear among people entering hospitals in this country. There must be no concern among seniors who already in many cases are coping as they are with other issues that do not remedy the worst things that come to them. They must feel that their care and their health is their physician's first concern. It is their legislator's first concern.