Canada takes another step towards its euthanasia law
by Michael Cook | 26 Feb 2016 |
A committee of the Canadian parliament has recommended that the federal government make doctor-assisted dying immediately available to all adults with "grievous and irremediable" medical conditions -- including mental illnesses -- and eventually allow “mature minors” to end their lives.
The committee released 21 recommendations on Thursday to help the government draft euthanasia legislation in accordance with the Supreme Court of Canada ruling in Carter v. Canada last year. Belgium’s permissive euthanasia regime appears to be the model for Canada’s new right-to-die law.
The committee says that new rules should be implemented in two stages. The first would apply immediately to those over 18 experiencing “intolerable” physical or mental suffering. The second stage -- “no later than three years after the first” would extend it to “competent mature minors.”
Patients must be fully assessed by two doctors, independent of each other, to ensure that they have capacity to provide informed consent.
The report recommends that physicians with conscientious objections should be compelled to find someone willing to do so. It also recommends that all publicly funded facilities – even faith-based institutions – be compelled to provide euthanasia and assisted suicide. This goes beyond recommendations made by others that objecting institutions should allow an external provider to perform the procedures on their premises. It also ignores the advice of the Canadian Medical Association, whichtold the Committee that euthanasia and assisted suicide could be provided without suppressing freedom of conscience by forcing objecting physicians to refer for the procedures.
The Supreme Court ruled last year last year that denying patients euthanasia or assisted suicide was a violation of the Canadian Charter of Rights and Freedoms. However, it did not settle the multiple complications involved. So it is possible to interpret the decision in a restrictive or permissive way. The committee has taken the permissive option, treating Carter as a floor, not a ceiling. This is clearest in its recommendation on euthanasia for mental illness, in which it cited the opinion of bioethicist Jocelyn Downie:
[M]ental illness should not be an exclusion criterion. It was not excluded by the Supreme Court, and not all individuals with mental illness are incompetent. Physicians already routinely determine whether someone is competent, even when they have a mental illness. Furthermore, the suffering that can accompany mental illness can be as excruciating as any suffering that can accompany physical illness. Finally, I would argue that excluding individuals on the basis of mental illness would violate the charter.Similarly, the Court had said nothing about age limits. The committee adopted the most liberal view:
[Given] the obvious fact that minors can suffer as much as any adult, the Committee feels that it is difficult to justify an outright ban on access to MAID [medical assistance in dying] for minors. As with issues of mental health, by instituting appropriate safeguards, health care practitioners can be relied upon to identify appropriate cases for MAID and to refuse MAID to minors that do not satisfy the criteria.
Oliver Wendell Holmes Jr may have been the most influential justice of the past 100 years to serve on the US Supreme Court. He was a Civil War hero, a law professor, the oldest justice ever, and the subject of a best-selling biography and a Hollywood film.
Next year will mark the 90th anniversary of his most famous case, Buck v Bell. The Supreme Court ruled in an 8-1 decision that compulsory eugenic sterilization was constitutional. Holmes wrote the majority opinion in his characteristically crisp prose. As a direct result, many more states passed eugenic laws mandating sterilization of “feeble-minded” men and women. Nazi Germany modelled its even harsher laws on American legislation.
His words summing up the argument for eugenics have become notorious for their cruelty:
It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Three generations of imbeciles are enough.
The question that haunts the memory of Holmes is: how did he get it so wrong? How did America’s most eminent and admired jurist support an evil policy which played a part in the Nazis’ rationalisation of the Holocaust? Holmes may have been the only justice cited in defence of Nazi war criminals at the Nuremberg trials.
Holmes was not alone, of course. As we report in an article below, eugenics was a wildly popular policy in early 20th century America, especially amongst the better sort of people, like the Boston Brahmins into which Holmes was born. As we enter a new era of do-it-yourself eugenics with better technology for genetic editing, it is urgent to understand why our predecessors were so blind, lest we repeat their mistakes.
Michael Cook
Editor
BioEdge
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