A matter of time

Pam
Pam Frampton
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Dying with Dignity is optimistic that medically assisted death will soon be legalized in Canada

“The dead cannot cry out for justice. It is a duty of the living to do so for them.”

— Lois McMaster Bujold, American author

Medically assisted death is still not an option in Canada, but it’s  only a matter of time before it is.

And we’re talking a few more years, not decades.

But Canadians are already finding ways to spare themselves unbearable suffering, because there are organizations out there willing to educate them about the alternatives. And those organizations are watching with interest as several court cases wind their way through the justice system — cases which could turn the tide.

In B.C., a woman who fought for the right to end her life rather than suffer the torturous final throes of an incurable disease, died last week of a severe infection. But not before a judge granted her an exemption from the section of the Criminal Code that prohibits physician-assisted suicide.

Gloria Taylor lost her personal fight, but her crusade for medically assisted death for Canadians who want it will carry on through court cases that argue that that particular section of the Criminal Code violates the Canadian Charter of Rights and Freedoms.

And the fight will continue, as well, through groups like Dying with Dignity Canada, which helps inform people about their rights as patients and lends emotional support to those who want medically assisted death and meet certain strict criteria.

Moving experiences

Wanda Morris is the executive director of the Toronto-headquartered Dying with Dignity.

She got involved in the movement after seeing some people’s lives reduced to a very bleak existence.

A chartered accountant, she recalls auditing a long-term care facility 30 years ago where some residents completely lacked any quality of life.

“Inside, you’d be assaulted with the smell of bleach and the smell of despair,” she recalls.

Later, her father-in-law, after years of caring for his wife with dementia, developed it himself and became violent. He moved into a long-term care facility where he eventually had to be restrained in his wheelchair.

“He never ever wanted to go to a home,” Morris said, “but what choice did we have? … My husband came home from a visit in his (father’s) final days and said, ‘You can’t ever let that happen to me.’”

She and her group are not just there to support people who are terminally ill or who have an incurable progressive illness. A big focus of their work is educating people as to what their legal options are in terms of determining their medical care.

“Most people will benefit far more from knowing their patient rights and making an advance care plan,” she said.

All alternatives explored

But Dying with Dignity does talk to people whose suffering has become intolerable and who have decided that they want medically assisted death. The process is hardly precipitous; Dying with Dignity requires rigorous documentation from the person’s physician before they will agree to get involved, and the group has to be satisfied that the person knows of every possible alternative.

As their website notes:

“In a way, we think of ourselves as a suicide prevention service. Many people contact us to explore ending their lives; once we’ve given them information about all their options, they often realize that hastening their death is not their best option.”

Morris was recently at the bedside of someone with a terminal illness who decided she wanted to choose the time and manner of her death. In such cases, the person has to meet all the criteria. If they choose to obtain medication that will allow them to die peacefully, it must be self-administered.

“We were there with her family and she was really grateful to go,” Morris said of the woman’s passing.

Tragic outcomes

Dying with Dignity believes people should not have to die in agony, or alone.

Morris believes medically assisted death is a far kinder option than some of the alternatives. She knows of cases where terminally ill people have tried to take their own lives and failed, with terrible consequences.

In one case, a person threw themselves in front of a train but survived, and was then far more incapacitated than before and therefore incapable of carrying out their own wish to avoid the ravages of their illness.

Morris said she realizes there are people whose religious faith makes them morally opposed to her group’s work, and that some people feel there is redemption in suffering.

Still, she said, some people want to avoid undue pain when their life is coming to a close.

“I feel so passionately that this is something we need,” she said.

“I guess the bottom line is stopping the torture. Sometimes, people’s bodies torture them at the end, and we need to offer them a choice. We do not all have the prospect of a gentle death, and we all should have that choice.”

Already available

Medically assisted death is legal in Oregon and Washington, as well as in Belgium, the Netherlands, Luxembourg and Switzerland, and it will soon be legal in Montana.

With the exception of Switzerland, you have to be a resident of those places in order to avail of it and the criteria to be met varies from jurisdiction to jurisdiction.

Morris is keenly waiting for the outcome of the British Columbia court action and is hopeful it will result in medically assisted death being available for Canadians who feel it is their only alternative.

Inroads are also being made in Quebec.

“I’m certainly cautiously optimistic that all the indicators are there,” she said.

• • •

In my mind, wishing to avoid unnecessary suffering before death is a personal health-care choice, not a criminal action. Still, I respect people whose religious faith precludes them from making such a choice.

Morris steered me to a thoughtful essay from 2003 by Daniel E. Lee, the director for the Center for the Study of Ethics at Augustana College in Rock Island, Ill.

Lee writes with conviction about how the idea of medically assisted death goes against his personal morals and his faith.

He says he believes, as theologian Karl Barth did, that “it is for God and God alone to make an end of life.”

And yet in examining how the practice is administered in Oregon and elsewhere, with strict safeguards in place, he comes to the realization that his morals and the wishes of those who want medically assisted death can harmoniously co-exist.

“When all things are considered,” he wrote, “the arguments in favour of continued prohibition of physician-assisted suicide are not particularly compelling. This is not to suggest that those of us with deep moral reservations about physician-assisted suicide should swallow our scruples and spearhead legalization campaigns.

“But it does suggest that we should not stand in the way of thoughtful individuals … who favour legalization.”

In the meantime, we have Morris and her group, and others like them, if we’re looking for information and support.

“When you need us, we’ll be there,” she said.

Pam Frampton is a columnist and

The Telegram’s associate managing editor.

She can be reached by email at

pframpton@thetelegram.com.

Twitter: pam_frampton

Organizations: Augustana College, Canadian Charter, Dignity Canada Center for the Study of Ethics

Geographic location: Canada, Toronto, Oregon Switzerland Washington Belgium Netherlands Luxembourg Montana British Columbia Quebec Rock Island

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Recent comments

  • Ron Tizzard
    October 17, 2012 - 10:55

    Perhaps the most personal and publically accepted (by the letter of the law) is one's' legally attested Last Will and Testament. It is my opinion that somebody with such a will in place, deemed sane, in the final days of his or her life, suffering physical pain, with no chance of recovery i.e. terminal... there should be a formula whereby that person may hasten an end his/her life, enjoying his/her community's (relatives and friends) assent and support in one's final hours. Communally applied laws exist, and must exist to govern commonly accepted (legal) modes of behaviours amongst people living together, to mutually support on a manner of life together. When, in the final analysis, one's personal life and physical well-being is threatened, levels of unconsciousnesss, limited and finally deemed to be terminal...towards the end, in the throes of unmanageable pain and sensibility there should be a legal means for life to be mercifully assisted to end by a physician....by withdrawing useless medical treatments, and let nature take its course thereafter, applying perhaps, with medical consultation, any required pain relieving medication. Personally, I had a brother who died in such a position..finally in a hospital bed, nothing else to be done medically, in (moans)and out of consciousness, unaware of surrrounds, labouring to breath, grimising in great pain even with sedation. After a discussion with physicians, and knowing any further medication would certainly hasten his death (mercifully)...with family around, the physician and I locked eyes across my broyther's bed side, I nodded to the physician to apply the pain-releiving medication; my bother passed in peace a short will later. I knew my brother, and in the given situation I know I made the right decision. Personally, I trust medical opinions...and agree that useless, prolonged treatments should be discussed earlier with patients and their families regarding the application of medication in the the final days regarding any associated pain relief which may be required..while it may hasten an unintended death process. Good article...a necessary read from my perspective. Thank you Pam.

  • George P
    October 14, 2012 - 15:00

    In the name and cause of human dignity, social acceptance of euthanasia must be accepted as a right of passage. Surely, adequate safegusrds can be put in place to prevent abuse and to legitimize the process. We euthanize animals that are certified incurable so that they will not suffer. Do humans not deserve that same consideration? Physicians could determine when extreme suffering can and should be bypassed and should legally be able to initiate an assisted demise. Religious beliefs have no part in such determinations. So let's get on with appropriate legislation and accept the thinking of the 21st century.

  • Colin Burke
    October 14, 2012 - 10:22

    There may indeed be nothing wrong with legalizing assisted suicide for people who want it and deem it morally licit. But legalizing it in a country where many are convinced it is murder and therefore penalizing those people if they should interfere with it on the ground that it was murder, might well dampen their zeal to prevent other murders which they deem only equally wrong and which the legalizers of medically assisted dying might some day desperately need them to prevent. That is to say, Ms. Frampton might not really welcome the prospect of an able-bodied man's merely passing by if she were being mugged and muttering to himself, "Oh, that's only Pam, who has already asked for that kind of help anyway" because he believed murder is murder according to "abstract, eternal and objective standards" unaffected by people's feelings. But such a man in such a case would only be simply logical.