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Palliative care, not painful goodbyes

by Matthew Shanahan February 17, 2015
Palliative care, not painful goodbyes

Hasty decision and economic reasons shift focus away from palliative care

On Feb. 6, the Canadian Supreme Court ruled that doctors can assist Canadian adults who are suffering from incurable and severe medical diseases to die. The current law, under section 241 of the Criminal Code, states that “every one who counsels a person to commit suicide, or aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.” The government now has one year to rewrite the law.

 

The Canadian Supreme Court has ruled that medical, assisted suicide should be legal in specific cases, sparking a nationwide debate. Photo by Dan Cox on Flickr.

I have come to a point in my academic development where I can no longer take a black-and-white stand on these sorts of complex issues. Simply conforming to one perspective on the issue does not help educate the population beyond our political biases, which are rooted in ideologies that have been passed on from generation to generation.

 

The thing that struck me most about this decision is how quickly it was made. There’s no doubt that people saw this decision coming sooner rather than later, especially with Quebec being the first province to adopt a right-to-die legislation in 2014, according to The Globe and Mail.

 

But it’s no secret that despite the fact that Canadians have free healthcare, the quality isn’t very good. The Canadian government is in a lot of debt and a lot of money is spent on healthcare. This is not to say that they shouldn’t, because it is priority for us Canadians that every one of us gets their fair access to healthcare. Part of the reasoning behind free healthcare is that one person should not be valued more than the other. Whether you’re rich or poor, young or old, we all share the same dignity and rights because we are all human beings that all come from the same root.

 

Given how quickly this decision was made, I can’t help but think that part of its motivation is financial. It may be a way to cut debt from the large amounts that the Canadian government spends on healthcare.

 

However, I don’t wish to simplify this position to just that. At the core of the right to die position is the belief that each individual should have the choice to end their life when they are comfortable in doing so and feel life is no longer worth living.

 

The biggest issue that I take with this court decision is the absence of the role of palliative care. There’s no doubt in my mind that before a country can even consider euthanasia as a viable option for dealing with those in difficult medical conditions, the advancement of palliative care must play a pivotal role in caring for the sick and giving them the best possible end-of-life care.

 

Fundamentally, that is why I am angered by the most recent decision from our Supreme Court. For those who value life before choice, it’s clear that this bill rejects their values. But even for those who value choice over life in a political setting, it is a tricky issue. How can our Canadian government make an objective law on physician-assisted suicide when the very “pro-choice” ideology they are going forward with does not reflect reality? How can a human being make a decision about the end of their life when the palliative care option is basically being shunned?

 

The end result will be problematic for Canadians in this vulnerable position. Rather than making a choice about the end of their life, many Canadians will, naturally, be put in a position where physician-assisted suicide appears to be the best option because palliative care is unavailable.

My main concern is that this is what will result in the writing of this upcoming bill. In our current Canadian context, I feel that much of what would make up this bill fails to promote the “choice ideology” that initialized this debate. Not improving palliative care diminishes the choice of the vulnerable individual while at the same time diminishes the value of life. It’s a lose-lose situation.

 

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