The Supreme Court of Canada has recently issued a decision that may herald a sea of change in my country's approach to death. It has ruled that Gloria Taylor has the right to die with dignity, at a time of her own choosing and with the help of a doctor.
In Canada, counseling, assisting or abetting the death of another person is illegal. The law has broad implications but, in particular, before the decision it meant that if a person was dying and asked their doctor to end their life quickly the doctor could not do that. Now, in the narrow confines of the recent court decision, a doctor can do it for Gloria Taylor. Gloria Taylor has ALS, also known as Lou Gehrig's disease. There is no cure and, unless a doctor acts to help her, she will die an excruciating and undignified death. She went to court to win permission to die on her own terms. Ten years ago another Canadian in the same predicament also petitioned the Court for an assisted death and was denied. Times have apparently changed. The question becomes where will this issue go from here?
We are all dying. Some people fear death itself but virtually everyone fears the process of dying. No one wants to lie in a hospital bed, perhaps for years on end, being kept alive by machines, having almost no quality of life, suffering pain and the indignity of needing others to help them do the most basic of human functions. My mother changed my diapers when I was a baby. I don't want some nurse changing them when I'm old. Modern medicine can work wonders and people are living longer all the time but the fact remains, we are all dying. Often it isn't pretty.
In most countries and cultures, having a doctor assist a person to kill them is against the law. The issue is very complex and fraught with difficulties. Many religions forbid suicide, labeling it a sin. Hinduism permits a person to kill themselves by starvation under certain circumstances, but this is an exception to the general rule. In three American states it is legal for a doctor to help someone die but the conditions under which this can be done are very strict and with good reason. After all, if doctors could, willy-nilly, go around killing people the result would be chaos. Still, to have doctors prosecuted in court and, as in the case of American Dr. Jack Kevorkian, serve jail time for helping someone to die with peace and dignity instead of in protracted suffering, seems grossly inhumane and a complete denial of their innate desire to help their patients. Their oath commits them to do no harm but death presents a Hobson's choice. Where is the greater harm?
I have seen the effects of a protracted death. A good man I knew was confined to a hospital bed, unable to care for himself and was slowly deteriorating. Both his body and mind progressively failed and while he was not in a lot of physical pain, his family suffered horribly in sympathy with him. This situation would have been bad enough had it lasted for a few weeks or months but it went on for almost nine years. I wonder, if he had known what was coming, whether he would have chosen to end it all and avoided putting himself and his family through that?
The issue is complicated. Under what conditions should someone be allowed to ask a doctor, or anyone else, to help them die? Religious arguments about the sanctity of life aside, the process must guard against people, particularly old people, being bullied into agreeing to die, against people making a decision to die when they are (perhaps temporarily) in extreme pain, are not mentally competent to know what they're doing or are just fed up with the daily grind, and against doctors committing unauthorized murder. These are legal and ethical issues and, of course, we cannot leave religion out of this because some people have strong beliefs on the subject, and will try to impose those beliefs on others whether they like it or not.
Still, the decision by the Supreme Court holds interesting possibilities for the future. Canada, in its quiet way, is a progressive country and I hope we will take a leadership position on this issue. It will take time and careful consideration but hopefully what the court has done is crack open the door to the development of legislation that will allow each of us to die, with appropriate safeguards, at a time of his or her own choosing with both dignity and grace. I know that if I have a choice I would sooner do it that way. It isn't death that is frightening, it's the process.
