Madam Speaker, before I came to this place, I spent five years on the ethics committee of the board of directors of the Mississauga hospital. I learned a great deal about self-determination, competency, the whole idea of informed consent, the realities of coercion by family members, friends and other people who have conflicts of interest, and the risk that the patient may be competent but not understand the risk of incorrect diagnosis or prognosis and the possibility that circumstances can change after he or she has given consent but then lapse into incompetence. These are all very minor, simple ethical questions. There are many more complex ones. These are just a sample.
Euthanasia involves a physician directly injecting a lethal substance into another person with the person's consent. Physician assisted suicide involves a physician who provides the individual with information, guidance and the means, such as a prescription for a lethal drug, with the intent that the person himself or herself will take his or her own life. That is the difference.
Bill C-384 seeks to legalize both euthanasia and assisted suicide. It purports to provide the right to die with dignity when in fact what it does is it gives the medical practitioner the right to terminate or assist in the termination of life before natural death.
It would change section 14 of the Criminal Code such that a medical practitioner does not commit homicide if he or she aids a person to die with dignity who has given his or her free or informed consent, who has a terminal illness, and who continues, after expressly refusing the appropriate treatments available, to experience severe physical or mental pain without any prospect of relief.
There are some flaws in the bill. I looked at it carefully. My immediate reaction is that it does not restrict this availability to Canadian residents. Anyone could walk into Canada and request euthanasia, which is silly.
The bill does not define terminal illness. It does not define lucidity. It does not define a whole bunch of things. In fact, it requires the patient to be free from duress or coercion, but it does not give any indication of how that might be addressed.
This bill is an amendment to the Criminal Code. It is two paragraphs long.
I have before me the bill of one jurisdiction and it is 10 pages long. Let me highlight some of it. It includes 20 definitions that are necessary to be there so it is operable. Also, under “Written Request for Medication”, it has section 2, who may initiate a written request; section 3, the form for written requests; section 4, the attendant physician responsibilities; section 5, consulting physician confirmation; section 6, counselling referral; section 7, informed decision; section 8, family written notification. It goes on. It includes written and oral requests; the right to rescind; waiting periods; medical record; documentation requirements; residential requirements; disposal of unused medication; effect on construction of wills, contracts and statutes; insurance and annuity policies; construction of the act. Under “Immunities and Liabilities” it covers the sanctions of prohibiting a health care provider from participating; liabilities and claims from government authorities; and forms to request. I could go on.
This is a comprehensive bill on a very serious subject. The bill before us for debate is not. Based on my review of the bill and the legislation in other jurisdictions, I have concluded that this bill is seriously flawed, inoperable and irreparable in its current form.
We have to look at the experience of other jurisdictions. It is instructive.
Oregon has had the law for 12 years. In 2009, 93 people obtained prescriptions for the lethal drug, but only 53 actually took their lives. In Washington state in the first 10 months, which is how long it has had the law, 63 people got the lethal drug, but only 36 took their lives. Does it paint a little picture? There are some numbers here.
In all of these jurisdictions people were asked why they were seeking euthanasia or assisted suicide. Ninety-one per cent of them said that it was losing the ability to participate in the activities that make life enjoyable. Eighty-two per cent said they were worried about losing their dignity. Only 23% said they were worried about the pain and suffering. We cannot ask people who are not the patient how they feel about this. We have to ask people who are facing this situation.
It is clear to me the concern about pain and suffering, which is really the only major justification the member has given on this bill, in fact is not the compelling reason that some people request termination of life.
Our health care system is there to meet the needs of all, including the disabled, the terminally ill, the aged and the most vulnerable in our society. We meet those needs through continuing care, palliative care, stroke and geriatric rehabilitation, long-term care, hospices, home care and family medicine. We need to continue to improve that care, not terminate it.
Palliative care workers are very concerned about this bill. Organizations and hospices are doing their very best to give the best possible care in difficult situations. The disabled in our society are obviously very concerned about whether their lives are at risk because someone decides they are not living in dignity.
As well, the legalization of euthanasia and assisted suicide would reduce funding for palliative care, reduce the number of palliative care service centres and reduce the number of palliative care physicians.
There are some slippery slope considerations. I would simply point out that people are not valueless because they are chronically dependent or dying. They continue to be human beings and should be respected and supported in their time of need and, as a result of the loss of a patient's autonomy because the final decision will belong to a physician, not to the individual. I mentioned personal autonomy.
Our experience shows that there is an absolute certainty that errors will occur and that lives of people will be wrongly terminated.
Our social, moral and ethical values, as expressed in our laws, practices and customs, define who we are as a people and as a country. The thought of deliberately taking a human life for any reason is simply incompatible with Canadian reality. The decriminalization of euthanasia and assisted suicide depends entirely on the participation of the medical profession, and it should be noted that the majority of the medical profession is opposed. As I mentioned in my question earlier, it will pit doctor against doctor, depending on whether they support it.
What we really need is a national strategy for comprehensive palliative care to address any gaps in compassionate care services. This also involves an increase in education for doctors and medical students who normally receive little training in the benefits or advancements in palliative care.
For all of those reasons, I am strongly opposed to euthanasia and assisted suicide and I will be voting against Bill C-384. In my view, it is simply wrong to deliberately kill another human being. The miracle of life is inherently dignified and each day is a gift to be cherished.
