Provincial-Territorial Experts recommend coercion to ensure delivery of euthanasia and assisted suicide
Recommendations designed to broaden and maximize impact of Supreme Court ruling
Sean Murphy*
Abstract
The Experts’ recommendations are intended to extend and maximize the impact of the Carter ruling. They will effectively require all institutions, facilities, associations, organizations and individuals providing either health care or residential living for elderly, handicapped or disabled persons to become enablers of euthanasia and assisted suicide. This will entail suppression or significant restriction of fundamental freedoms.
The broader the criteria for the provision of morally contested procedures, and the more people and groups captured in the Experts’ enablers’ net, the greater the likelihood of conflicts of conscience. Relevant here are recommendations to make euthanasia/assisted suicide available to mentally ill and incompetent persons, and to children and adolescents, even without the knowledge of their parents.
The Experts’ distinction between “faith-based” and “non-faith-based” facilities is meaningless. They impose identical obligations on both. All will be forced to allow homicide and suicide on their premises, or compelled to arrange for euthanasia or assisted suicide elsewhere.
Likewise, they recommend that objecting physicians be forced to actively enable homicide or suicide by providing referrals, arranging direct transfers or enlisting or arranging the enlistment of patients in a euthanasia/assisted suicide delivery system.
The Supreme Court did not rule that people ought to be compelled to become parties to homicide and suicide, but that is what the Experts recommend. This is not a reasonable limitation of fundamental freedoms, but a reprehensible attack on them and a serious violation of human dignity.
Other countries make euthanasia and assisted suicide available without attacking fundamental freedoms. In this respect, the Experts’ claim to have produced “a uniquely Canadian approach to this important issue” is regrettably accurate. They fail to provide any evidence that the suppression of freedom of fundamental freedoms they propose can be demonstrably justified in a free and democratic society.
Table of Contents
I. Background
I.1 Formation and work of the Advisory Group
II. Overview of the Final Report
II.1 Moral/ethical unanimity
II.2 “Statement of Principles and Values”
II.3 Recommendations broadening the Carter criteria
II.4 Recommendations impacting freedom of conscience and religion
III. The Experts’ “uniquely Canadian approach”
III.1 Expanded criteria and increasing likelihood of conflict
III.1.1 “Irremediable medical condition”.
III.1.3 Euthanasia approved for future suffering.
III.1.7 No waiting/reflection period.
III.1.10 Adolescents and children.
III.1.13 Euthanasia/assisted suicide by non-physicians.
III.1.15 Doctor shopping.
III.1.18 Physicians need not be present at suicides.
III.1.20 Euthanasia/assisted suicide wherever people live.
III.1.22 Families, caregivers may not be advised.
III.2 Institutions, associations, organizations
III.2.1 The meaning of institution.
III.2.3 All “institutions” must allow/arrange euthanasia/assisted suicide
III.2.6 All “institutions” must disclose policies.
III.2.8 “Institutions” may not manifest or enforce commitments
III.3 Objecting physicians: information, disclosure, non-discrimination
III.3.3 Objecting physicians must provide information.
III.3.8 Objecting physicians must disclose views and their implications.
III.3.11 Objecting physicians must not illicitly discriminate.
III.4 Objecting physicians must become critical enablers
III.4.4 Referral or direct transfer of care.
III.4.5 Referral to “system/third party.”
III.4.8 The Experts’ proposal and the CMA’s proposal.
IV. Project response
IV.1 Expert recommendations broadening Carter criteria
IV.2 Expert recommendations and fundamental freedoms in general
IV.3 Expert recommendations and freedom of conscience
V. Conclusion
Appendix “A” Supreme Court of Canada, Carter v. Canada (Attorney General), 2015 SCC 5
A1. Carter criteria for euthanasia and physician assisted suicide
A2. Carter and the criminal law
A3. Carter and freedom of conscience and religion
Appendix “B” Expert recommendations re: broadening Carter criteria
B1. Expanding the Carter criteria
B1.1 “Grievous and irremediable medical condition” includes mental illness
B1.2 Suffering not a prerequisite
B1.3 Competence not a prerequisite: euthanasia for dementia
B1.4 Euthanasia and assisted suicide for children and adolescents
B1.5 Assessment, euthanasia and assisted suicide by non-physicians
B2. Increasing the impact of Carter
B2.3 Doctor shopping
B2.4 No “waiting/reflection” period
B2.5 Physicians need not be present at suicides
B2.6 Euthanasia & assisted suicide in hospitals, hospices, etc.
B2.7 Families and caregivers may not be advised
Appendix “C” Expert recommendations re: freedom of conscience and religion
C1.1 Meaning of “institution”
C1.2 “Institutions” must allow or arrange for euthanasia or assisted suicide
C1.3 All “institutions” must disclose position on euthanasia and assisted suicide
C1.4 “Institutions” must not require patients/residents to give up “the right to access,” interfere with employees providing eutanasia or assisted suicide elsewhere
C2. Objecting physicians/health care providers
C2.1 Must provide information on “all options”
C2.2 Must disclose views on euthanasia and assisted suicide
C2.3 Must not discriminate
C2.4 Must act as critical enablers
C2.4.1 Three alternatives
C2.4.2 Referral
C2.4.3 Direct transfer of care
C2.4.4 Transfer to “a publicly-funded system” or “third party”
C2.4.5 The Experts’ “system/third party” and the CMA’s “central service”
Appendix “D” Canadian Medical Association on euthanasia and assisted suicide
D1. CMA policy: Euthanasia and Assisted Death (2014)
D2. CMA Annual General Council, 2015
D2.1 Surveys on support for euthanasia/assisted suicide
D2.2 Physician freedom of conscience
D3. CMA rejects “effective referral”
Appendix “E” International comparisons
E1. Netherlands
E2. Luxembourg
E3. Belgium
E4. Oregon
E5. Washington
E6. Vermont
E7. California
Appendix “F” An Act to Safeguard Against Homicide and Suicide