As a lawyer and politician, I have always found the term “slippery slope” to be regularly overused. The full consequences of a change in our laws and the ultimate impact on society can never be forecast perfectly at the time of a court decision or move of a government, so it is never clear where a narrow change amounts to a massive one down the line. When it comes to the issue of euthanasia that is currently facing Canadian society and our Parliament, however, the gravity of the risks associated with a gradual expansion of the ability for the state to end a life is the most slippery of slopes. This is why our society and Parliament must have a serious debate on what assisted-dying will mean for our society.
In early 2015, the Supreme Court of Canada issued a decision in the Carter v. Canada case and struck down Criminal Code provisions that prevented people from assisting someone in the taking of their own life. Despite the fact that the Supreme Court had upheld this same law in 1993, the court changed its position and said that a prohibition against assisted suicide violated the Charter of Rights and Freedoms of Canadians and their right to enjoy life, liberty and security of the person. It then gave Parliament a year to amend the laws or regulate in a way that respected their decision. This is why we are having this debate in Ottawa and across the country.
See: Parliamentary Report – Euthanasia and Assisted Suicide in Canada
I know that this is a very difficult issue to discuss dispassionately. Nobody likes to see pain and suffering and it is impossible to put yourself in the position of someone struggling through a fatal or degenerative disease. Even with strides in recent years in the treatment of pain and more broadly in palliative care, families struggling with these issues are under intense and profound stress and pain.
Read: Special Joint Committee on Physician-Assisted Dying: Dissenting Report
While I recognize that this is a difficult and personal issue for everyone, my personal view is that the state should not support assisted suicide for a variety of reasons. I have looked at the issue as a Parliamentarian and lawyer first and foremost, but certainly I recognize that my opinion is also molded by my religious faith and by being the son of a strong woman who lost her battle with breast cancer when I was nine. Some of my most vivid memories of my mother are from her final days when even her young son knew she was in pain and likely fearful of the days ahead. Everyone will bring their own perspectives to the issue and we should strive to discuss the matter respectfully and with compassion for all views.
My concern with euthanasia is that on a fundamental level, I do not think it is appropriate for society to make determinations on the quality of a life and the ultimate decision on whether we should engage our public healthcare system to end the life of someone. Will we itemize diseases or debilitating conditions into categories where euthanasia becomes a healthcare option under our publicly administered system? We must also remember that the citizen that may want to seek this final option is someone that is likely in a mental state of despair and fear from the pain and uncertainty that comes with a serious illness or debilitating condition.
Read: “Andrew Coyne: Canada is making suicide a public service. Have we lost our way as a society?
There are a range of other important issues related to legalizing assisted-dying that stem from the unusual move of a state making assisted death a healthcare choice. The professionals working in our healthcare system have long worked in an environment structured upon preserving life and assisting those in pain, or in the final stages of life with palliative care. The Hippocratic Oath that has been used for centuries by physicians is often summarized by the basic principle of “do no harm”. How do we incorporate euthanasia into a framework premised upon this principle? How do we recognize the rights of a physician or other healthcare professional to object to participating in assisted-dying for religious, contentious or personal reasons?
The slippery slope I raised at the outset is also central to the serious concerns I have about euthanasia because we already see the slippery slope in action before Parliament has even brought a new law forward. In the Carter decision, the Court considered euthanasia only the case of a “competent adult person” facing “grievous and irremediable medical condition…that causes enduring suffering that is intolerable”. So while the Court narrowed euthanasia to adults with extremely painful, terminal conditions, a Parliamentary Committee recently recommended that assisted death should also be considered for so-called “mature minors” and for people suffering from mental conditions which are often treatable. These recommendations suggest that the state could eventually consider requests for assisted death from 16 year olds or from people suffering from an illness like depression. The recommendations show that there is already pressure to include more groups and maladies into the framework of euthanasia. If the slippery slope is so pronounced mere months after the court decision, what will we see in a few years when access to assisted death becomes a normalized part of our healthcare system?
I think we have all witnessed a family member or friend battle serious illness, or fight through the pain of serious depression. We often feel helpless to give them aid and comfort, but I do not believe that our desire to help alleviate the pain of others justifies wading into the moral murkiness of the state deciding which lives are worth living and of the state making assisted death part of our public healthcare system. Investments in palliative care and other healthcare supports are better options that do not create the moral hazards and slippery slope that we already see emerging with euthanasia.
