Mrs. Barbara Sparrow (Parliamentary Secretary to Minister of National Health and Welfare):
Mr. Speaker, this motion of the member for North Island-Powell River on legislation to allow physician assisted suicide raises the issue of euthanasia on request where the
June 7, 1993
patient is no longer able to act, or should there be a distinction.
I am not aware that the medical profession in Canada has asked the government to decriminalize either physician assisted suicide or euthanasia. The reason may very well be that it does not recognize these practices as constituting the practice of medicine. The proper concern of medicine is with treatment, including palliative treatment to relieve pain.
There is a great deal of confusion on whether there is a need for decriminalization and on whether it commands general support. This is complicated by the fact that the media has not always distinguished between euthanasia on request and plain murder.
Moreover palliative treatment to relieve pain which has the effect of hastening death has often also been included in the euthanasia debate, even though courts have indicated that this is not a crime. That is because in such circumstances the disease, rather than the treatment, is considered to be the legal cause of death.
In the face of all this confusion it is not surprising that opinion polls report a majority in favour of something or another. However when one asks what the respondent understands when opinion polls present the question, it is obvious that not only the respondent but also the pollster has failed to appreciate the wide range of very different situations that could be included in the general type of questions favoured by those conducting the polls on this very hotly contested issue.
Once this is understood we may find there is no need and little demand for decriminalization of physician assisted suicide and euthanasia. Once a person is assured of effective palliative treatment to relieve pain he or she is much less likely to demand that these practices be made available.
As a practical matter, court decisions have made it clear that not only is palliative treatment which hastens death not a crime, but neither is removing a respirator at the request of a patient. Similarly, withdrawing food and drugs from patients in a persistent vegetative state at the request of the patient's family has been recognized as an extension of the patient's own right to refuse treatment.
Doctors are aware that in all these situations treatment has not been successful and since they cannot offer
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any further useful treatment, they are willing to accept the decision of the patient or his family to cease treatment.
The medical profession remains by and large opposed to physician assisted suicide and euthanasia. They are aware of the implications of decriminalization. Just as there are specialties in medicine, so we have seen there are doctors who are prepared to bring their death machines to assist people to commit suicide. No doubt a specialty in assisted suicide and euthanasia would develop if the practices cease to be prohibited by the criminal law.
What is absent from the arguments of those promoting these practices is consideration of how decriminalization would affect the plight of children or other persons who are incapable of requesting assisted suicide or euthanasia. Once these facts are available to those who can consent to them they may well be extended to those who are not in a position to request them.
These acts would go beyond withdrawal of treatment that has proven unsuccessful. They would reverse the ancient medical injunction to do no harm and would involve the doctor in deliberately doing harm. They would foist on the medical profession a philosophical position that says killing is better than allowing suffering. In those processes the alternate to accept the challenge to develop the art of palliative treatment to a point where no one need suffer and no one need be killed to avoid suffering may all be ignored.
What is even worse and equally incompatible with our principles of criminal law and our principles of human rights is the fact that euthanasia could eventually be administered to those who are incapable of either consenting or refusing. The only basis for administering euthanasia to these people would be their chronic or terminal illnesses.
There have been prosecutions of doctors in England for acts which in the Netherlands would be prosecuted as euthanasia. Some have failed for lack of evidence.
A doctor was recently convicted of attempted murder and was subsequently found guilty of unprofessional conduct by the general medical council. They found that the criminal conviction was sufficient punishment and declined to remove his licence to practice. However, the
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regional medical council put very strict conditions on his future work.
Some doctors resented the verdict of the court because euthanasia had been requested by the patient and her family. However it was clear that the doctor did not administer a drug aimed at relieving pain but rather a drug aimed only at killing the patient.
This case emphasizes the fact that the criminal law prohibition against euthanasia as murder plays a very necessary role in helping the medical profession regulate itself. It educates the profession in what the law, which reflects social values, regards as permissible and what goes beyond the boundaries of societal acceptance.
Had the doctor administered a drug aimed at relieving pain and the patient died as a secondary effect, provided he did not act in a negligent manner, he would not have been prosecuted.
It was made clear in a jury direction many years ago and was recently confirmed in this decision in the English Court of Appeal that such a case of the law regards the death to be from the disease and not from the attempt to alleviate the pain.
The consequence of this educational and regulatory effect of the criminal law is that members of the medical profession are encouraged to improve their ability to provide effective palliative care, to secure the knowledge they are not going to be in conflict with the law. In contrast, medical practitioners in the Netherlands are really not encouraged to improve their ability to provide effective palliative care because in appropriate circumstances, they may act directly to kill the patient.
I personally think the way to go is to improve our palliative care methods. There is a great deal more we can do in society within the medical profession to alleviate the pain of those suffering. I cannot and do not support the member's motion.
Subtopic: CRIMINAL CODE