By Isaac Zivkovic
The British Columbia Civil Liberties Union (BCCLA) is currently challenging the constitutionality of physician assisted deaths in Canada.
Bill C-14 was voted into effect last June and outlines various safeguards for patients who may wish to request physician assisted death — otherwise conventionally known as euthanasia. Should a person be old enough and capable of informed consent, they are well within their rights to choose death. Prior to this the procedure was considered nothing less than murder.
A large step though it may be, the BCCLA contends that there is much the law leaves wanting. This refers to the exclusion of people with permanent disabilities or diseases that are curable but affect overall quality of life. Those who may not seek euthanasia include minors, Alzheimer’s patients, or anyone with a degree of mental decline that would prevent their informed consent. What the BCCLA argues is that individual freedoms have been overlooked in favor of arbitrary guidelines.
What does this have to do with the U.S.?
The situation in the United States, in terms of the ethical debate, is not dissimilar. Although not addressed on the federal level (only in common law), states have steadily leaned towards, or at least considered, a policy commonly known by precedent as “death with dignity” since 1994.
To date, six U.S. States have legalized physician assisted death including Vermont, Montana, Oregon, Washington, California and, most recently, Colorado which voted during the general election and formed the proposition into law last month.
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The debate, whether here in the states or in Canada’s Parliament, comes always back to ethical quandaries; who may define informed consent and whether the physician, patient or state may define what merits quality of life. “Quality” being the operative term, illusive in definition though it may be.
The Pros and Cons
Factions, both for and against, present arguments primarily based on ethics. Although, it is important to note the following descriptions are far from a comprehensive review.
Pr0-euthanasia arguments address center around personal liberties, the ethical stance that life is the choice of the individual and not the state, and that physician assisted death is a eventuality. Indeed, some argue it is already practiced in the form of patient requests that life support be terminated given circumstances where brain function is compromised.
Ultimately, the pro-faction contends that defining quality of life and the right to decision-making are the realm of the individual before any other entity.
Those opposed to euthanasia argue that compromising societal and medical ethics in such a way could lead to greater moral conflicts in the future. Much of the argument against physician assisted death is rooted in the moral clauses of religion, but also in the potential violation of public faith in the moral code of doctors.
Concerns that death may be considered a substitute for — or compromise the research of — future treatments, abound. For this reason illegality or high regulation are considered prudent measures.
The debate on a smaller scale
Typically featured at the top of the list for guidelines in legislation where euthanasia has been approved is the age restriction. Persons under the age of 18 may not authorize a doctor to perform a life-ending procedure — an issue unto itself if a teenager, arguably of sound mind, is diagnosed with a painful and terminal illness. Their right to “death with dignity” stands unprotected no matter the severeness or how long (or briefly) they are expected to live.
This serves to illustrate the kind of arbitration that factions of the civil liberty and free-will variety are staunchly opposed to. Yet those opposed to euthanasia may argue decisions like these are reckless with new possibilities and innovative treatments ever just around the corner.
The battle being waged in Canada is well ahead of what U.S. courts and legislators have tackled to date. Although there will, no doubt, be nuances and a litany of other issues, what comes of the controversy in the north must surely foreshadow things to come for the United States.
Annals of Internal Medicine. Physician-Assisted Suicide.
British Columbia Civil Liberties Association. The death with dignity decision explained.
Psychiatric Services. Should Mental Disorders Be a Basis for Physician-Assisted Death?
Pro-Con.org. State-by-State Guide to Physician-Assisted Suicide.