Canadian doctors have been facing a difficult decision surrounding patient care, a challenge Dr. Brian Batten had never faced before. Bill C-14, passed last June, allows people with incurable diseases to request an evaluation from two medical practitioners, among other requirements, for a medically-assisted death.
Batten, an emergency doctor at Ross Memorial Hospital in Lindsay, says there is still some controversy and stigma surrounding the new law amongst medical professionals who must make the ultimate decision.
“You have the option, you don’t have to be involved if you are uncomfortable or against it morally,” Batten said. “Some doctors are saying they didn’t go into medicine to assist in peoples dying, they’re there to assist people in living. But other people see it not as helping someone die but helping to end their suffering.”
Batten’s 95-year-old patient had a case that “spoke for itself” and he estimates just over 400 similar cases have happened in Ontario since the bill was passed. Other scenarios can be much harder for doctors to properly access, and Batten believes this is where most of the controversy lies.
“We had a patient with cancer, and surgery and radiation were no longer options. The doctor’s prognosis was maybe three or four months, and she requested a medically assisted death so she didn’t have to put her and her family through it all,” he said. “It didn’t seem right for someone who was barely out of work to have this procedure, but do we tell this woman that we want her to go home and suffer a bit more and maybe we’ll organize this for you?”
The new law is meant to encompass natural deaths that are ‘reasonably foreseeable’, only allowing people with incurable diseases to register. Two witnesses must sign before the physician evaluation, ensuring the person has a healthy state of mind and is willingly free of coercion, followed by a ten-day waiting period.
“It seems incongruous that you can’t vote but you can apply for medically-assisted suicide. . .”
Medically-assisted deaths in Canada are usually left to family doctors who have a history with patients, and the legislation has the same two-doctor evaluation as other countries, such as the Netherlands, where euthanasia has been legal since 2002.
Currently, the Canadian law does not allow people who are mentally unfit to make this difficult decision, and family members cannot sign for it on the other person’s behalf. With cases such as dementia, it can be difficult for the affected person to understand their situation before they can consider the option of death.
“Somebody who is not with it cannot have a medically assisted death,” Batten said. “You can’t even put in a caveat. You can’t sign something so that if you have dementia, when you are no longer capable, that you want to have a medically-assisted death.”
While Canadian laws are lenient in some areas, such as allowing nurse practitioners to make the decision on behalf of another physician, it is more restrictive in the rights of minors. Countries such as Belgium and the Netherlands allow minors to register with their guardians, and although Batten believes the Canadian law will bend for what is “morally right”, the legal right has not been officially given to young people.
Joanne Paterson, a phycology professor at Durham College, says that although an uncommon circumstance, youths should have the same opportunity to end their suffering.
“Minors are not allowed to make certain decisions in their life,” Paterson says. “It seems incongruous that you can’t vote but you can apply for medically-assisted suicide, although I think in some cases, they should at least have the opportunity.”
Bill C-14 isn’t even a year old, but the controversy has yet to die down. Disagreements among medical professionals and senators have repeatedly brought attention to the new law. Although people may come to disagree with the implementation, others like Paterson believe this is “long overdue.”