Quebec Life Coalition

You have questions about euthanasia and assisted suicide? Click on the frequently asked questions below to learn more about euthanasia and assisted suicide (originally published by COLF):

1. It's my life, my death, my freedom, my choice, my right!
    
2. I want to die with dignity.
3. Living is not an obligation. I don't want to die hooked up to a bunch of machines or be forced to stay alive when I know it's time to pass on.
4. Having the right to die, even if I never exercise it, gives me the control I need to have a peaceful death.
5. We need to be compassionate. I wouldn't even let my dog suffer through a long death. Why would I force someone I love to suffer uncontrollable pain?
6. Good palliative care should include the option of euthanasia. In certain circumstances it's the appropriate form of care.
7. End of life care is very expensive. If someone wants to die, they are actually serving society by freeing up medical resources. They should be allowed to choose to bring meaning to their death by honourably helping others.
8. I don't want to be a burden on my family or society.
9. Disabled people have no quality of life. Their life is not worth living. They would be better off dead.
10. There are already reports of euthanasia being carried out all over the country. Wouldn't it be safer to have it regulated by the government?
11. Why worry about a slippery slope?The experience of other countries and states shows that safeguards in the law effectively prevent abuses.
12. You are trying to impose your religious values on all of society. 
     

1. It's my life, my death, my freedom, my choice, my right!

Euthanasia and assisted suicide are not private matters. These acts involve third parties such as physicians, pharmacists, family and friends who then have to carry the guilt of having killed a human being.

For many vulnerable citizens, legalizing euthanasia would only provide the illusion of choice – choice as a lie. Given the reality of Canada’s aging population and growing healthcare costs, they might be forced to accept euthanasia in order to avoid financial strain on the healthcare system. Their so-called “right to die” might soon become a “duty to die”.

Changing Canadian law to allow euthanasia would have a profound effect on many vulnerable people. Even if euthanasia respects the autonomy of some, it endangers the lives of many others including persons with disabilities, the elderly, and those struggling with depression or severe illness. Such a law would be a guaranteed recipe for abuse of the vulnerable; it would be incapable of protecting them from coercion by family members and others.

No one is an island. My choices and decisions have an impact on others and on society as a whole. My freedom and my rights have limits; they must respect the freedom and rights of other people. Personal freedom, self-determination and individual rights are not absolutes. They can be overridden to protect other values in society (for example to protect the rights of vulnerable citizens and the common good). (back)

 

2. I want to die with dignity.

There is nothing dignified about swallowing a pill or getting a needle that will ensure a quick death. Euthanasia does not restore dignity; it eliminates the sometimes lonely and guilt ridden person in a way which is not always as painless as people would like to think.

Dignity is not determined by physical or mental health, by autonomy or by usefulness to society. Human dignity is founded on the inherent worth of each human person, which can never be taken away by external factors or circumstances. The simple fact of being human gives us a dignity which no other living beings possess.

Palliative care provides a dignified death by giving patients the pain management and the social, emotion and spiritual support they require to live a good death with courage. Giving this support, of course, takes time and perseverance.

We are relational beings capable of loving and caring for others. Our sense of dignity is inextricably tied to the respect that we have for each other as human beings. If people feel they are losing their dignity, it is our responsibility to make them feel valued again. How do they see themselves in our eyes? We all have the power to respond with friendship, love and solidarity to the illness of others in order to uphold and protect their “right to life” until the moment of natural death. We need each other in death as we need each other in life. (back)

 

3. Living is not an obligation. I don't want to die hooked up to a bunch of machines or be forced to stay alive when I know it's time to pass on.

There is no legal obligation to receive treatment in Canada. A competent patient or the proxy of an incompetent patient has the legal power to accept or refuse any treatment, or ask that it be discontinued.

The withdrawal or withholding of extraordinary or disproportionate treatment, when its burdens outweigh its benefit, is not euthanasia because the intention is not to cause death but to allow the person to die naturally; in euthanasia the intention is to cause death – the patient does not die naturally but rather is killed by another human being before his or her time.

When disproportionate treatment is withdrawn or withheld, the cause of death is the underlying disease or condition; in euthanasia the cause of death is the lethal injection, pill or other means used. There is a great difference between allowing to die and making die.

Artificial nutrition and hydration are considered ordinary care – not treatment – and must, in principle, be given to the patient. Food and water are basic necessities of life which do not treat any specific condition. A person should never die because they have been deprived of nutrition and hydration. However in certain circumstances, such as near the end of life, the body may not be able to assimilate food and water or the procedures used can be too burdensome to continue. In these situations, artificial nutrition and hydration can be discontinued. (back)
 

4. Having a right to die, even if I never exercise it, gives me the control I need to have a peaceful death.

A peaceful death comes from acceptance not control. It is important that those people who are suffering are given compassion and help on their journey towards acceptance, until their natural death.

Requests for euthanasia and assisted suicide are often made out of a profound sense of despair. They are generally a call for help. At the heart of such a request is a profound fear of the pain the person may have to endure and of being alone in that suffering. Such a desire is typically transitory, especially when we respond to it with true compassion.

Our society has always reached out to suicidal citizens who need help in living, not help in dying. It would be quite a contradiction to continue funding distress centers and suicide prevention programs while legalizing assisted suicide. If people chose to die while temporarily depressed or in intense pain, instead of receiving proper medical attention, they will potentially be deprived of many good years of life.

Dying patients who are no longer competent to make their own decisions may find that physicians and members of their families take control and decide to end their life. For example, this could happen if a person has prepared a living will clearly stating his or her desire to be euthanized under certain circumstances, but no longer wishes to be killed once the time comes. The so-called right to choose death could become the right of other people to force your choice on you once you have become incompetent. (back)

 

5. We need to be compassionate. I wouldn't even let my dog suffer through a long death. Why would I force someone I love to suffer uncontrollable pain?

Uncontrollable pain is quite rare. In most cases, severe pain can be relieved; if not, it is often because physicians lack formation in pain management. We need more research and training in this area.

Facing a person with a chronic illness or degenerative disease, a person with a terminal illness, a man or a woman with depression or a severe disability, an elderly person, or someone who is dying – especially if that person feels that he or she is a burden, has a duty to die or demands death as a right – presents each of us with a responsibility and a mission.

We are called to “be with” and to “suffer with” those who face some of the greatest challenges of human life. To “suffer with” – that is the true meaning of “compassion” – as we provide proper care and effective pain control, along with social, emotional and spiritual support.

Euthanasia is absolutely opposed to compassion because in the act of killing we abandon the patient when he or she needs us most. True compassion is all about presence, solidarity and love: to become a partner in suffering, helping the other find meaning until death occurs naturally.

We need to eliminate the pain, not the patient. Pain relief medications used appropriately rarely shorten life; the patient usually dies from his or her underlying disease. There is a huge difference between giving drugs to relieve pain and suffering, and intentionally using pain relief treatment to euthanize a person.

In extreme cases, palliative sedation is an acceptable approach to pain management and does not entail the same dangers to society as euthanasia. Its intention is to control the pain, not to put an end to the patient’s life. (back)

 

6. Good palliative care should include the option of euthanasia. In certain circumstances it's the appropriate form of care.

Euthanasia is incompatible with the philosophy and goals of palliative care. Patients who enter a hospital expecting compassion as they live their last months, weeks or days should not have to worry about being euthanized based on a doctor’s judgment of their quality of life. Care can never be killing.

Incorporating euthanasia into palliative care confuses the general public about the true role of palliative care, which is to give optimum quality of life to the patient with a progressive incurable illness until natural death occurs.

Physicians have a right to conscientious objection. If euthanasia is standardized, physicians who object will appear to be abandoning their patients. This becomes even more problematic if euthanasia is seen as a valid component of palliative care.

In countries where euthanasia and/or assisted suicide are legal, fewer financial resources go towards developing palliative care, which is the truly human answer to end of life challenges.

The Criminal Code defines euthanasia as a criminal act. If we want our country to stay a secure place for all its citizens, including the most vulnerable (persons with disabilities, the elderly, the very sick, the dying), we cannot give some people the right to kill others, regardless of the circumstances. If death can be used to solve one problem, it can be used to solve many others. (back)

 

7. End of life care is very expensive. If someone wants to die, they are actually serving society by freeing up medical resources. They should be allowed to choose to bring meaning to their death by honourably helping others.

Human life is invaluable. It is above all price. Its worth and dignity cannot be measured in currency.

Even if a request for assisted suicide or euthanasia is seen by some people as a selfless individual choice, it would be unjust to let financial gain endanger the lives of other vulnerable Canadian citizens.

When life is in its final stage, there is no reason to battle death with expensive aggressive treatment. We should then choose measures that offer a reasonable hope of benefit and can be obtained and used without excessive pain or expense.

Good palliative care can then help the dying to find meaning in their pain and suffering, and enable them to deal with unfinished business in their lives, whether it is through traditional spiritual care or through newly developed existential therapies. The last weeks and days of a person’s life are often a time of spiritual journey and a time of reconciliation with family, friends and God. Choosing to end life prematurely prevents the person from living these profound human experiences, which bring so much joy and peace to the soul. (back)

 

8. I don't want to be a burden on my family or society.

This line of thinking suggests that those who suffer are not worth the time and care they require. We need to approach people with compassion, not with a utilitarian calculus. We have a responsibility to love and support each other so that no one will ever feel compelled to request euthanasia or assisted suicide because they feel they are a burden.

The fear of being a burden is the key reason why some people ask to have their death hastened. Many Canadians also feel abandoned and are very isolated. They need to be consoled, encouraged and comforted.

Elder abuse is already a problem in Canada because many senior citizens do not have the capacity to fight for the care and respect they deserve. If euthanasia becomes an option for the vulnerable and their caregivers, it could very easily be used as a threat or translated into a duty to die.

Some Dutch elders, who experience this kind of pressure, are migrating to nearby Germany because they no longer trust their doctors and fear their loved ones will take advantage of their vulnerability to shorten their lives.¹

We need to focus on providing compassionate care for the elderly and for those with Alzheimer’s disease, dementia, severe disabilities and debilitating diseases, as well as greater support for their families through home care and other services. (back)

 

9. Disabled people have no quality of life. Their life is not worth living. They would be better off dead.

This argument clearly demonstrates that people with disabilities are among some of the most threatened citizens when a country legalizes euthanasia. Vulnerable members of society need to feel they are valued, not encouraged to commit suicide or to ask for euthanasia.

People with disabilities do not think of themselves as “poor quality” human beings. They expect and are entitled to the respect due to any person. It is important not to judge the quality of life of others based on standards and prejudices that are imposed on us by a culture that rewards efficiency and performance. Quality of life reasoning should not be used to evaluate any group of people because it is based on individual perspective which is subject to change.

For more information on the unique perspective of disabled people, visit the Council of Canadians with Disabilities at: www.ccdonline.ca. (back)

 

10. There are already reports of euthanasia being carried out all over the country. Wouldn't it be safer to have it regulated by the goverment?

As Canadians, we have rejected the death penalty knowing that, among other things, occasional judicial errors can lead to the execution of innocent people. It would be a contradiction and an injustice to allow some people to directly and intentionally kill others, especially at a time when they are most vulnerable. This is a question of public safety and social justice.

If euthanasia is being carried out against the law, this shows that the law is incapable of controlling euthanasia. Legalizing euthanasia will not fix this problem. Providing government sanctions for euthanasia will endorse a practice that will harm the most vulnerable members of society and devastate the institution of medicine.

A change in law would jeopardize the role of the medical profession and fundamentally alter the doctor-patient relationship because the so called “right to die” would give doctors the right to directly and intentionally kill. It would undermine the trust between patients and doctors, leading the sick, persons with disabilities and the elderly to fear going to hospitals and other care-giving institutions.

It is important that euthanasia remain illegal in Canada even if the Hippocratic Oath is no longer the cornerstone of medicine. The law must continue to reinforce the doctor-patient relationship and the role of the physician as a truly compassionate person who sometimes heals, often relieves and always comforts.

If something is wrong, legalizing it will not make it right. Public acceptance of euthanasia and assisted suicide would dull our consciences to the gravity of taking human life. It would diminish our compassion for those who choose to continue living when they could ask for death. (back)

 

11. Why worry about a slippery slope? The experience of other countries and states shows that safeguards in the law effectively prevent abuses.

A careful study of the situation in those countries and states shows that a slippery slope exists. Foolproof safeguards do not exist. Laws regulating euthanasia and assisted suicide are in large part unenforceable and incapable of adequately protecting the vulnerable because they rely on self-report by doctors.

Decriminalizing euthanasia provides doctors and healthcare policy makers with the opportunity and the means to abuse vulnerable patients.

• In Oregon, the instance of assisted suicide has steadily increased; however the number of patients sent for psychiatric referrals after requesting assisted suicide has decreased. Patients who could regain their desire to live are not being given the care they deserve²
• Because it considers physician assisted suicide (PAS) a form of palliative care, the Oregon Health Plan will now pay for PAS instead of expensive chemotherapy to treat advanced cancer.
• In 2005, 550 Dutch citizens were killed without their consent³ 
  

Countries that have legalized euthanasia and/or assisted suicide for competent terminally ill patients have continued to extend their programs to include vulnerable members of society.

• In the Netherlands, the government has adopted the Groningen Protocol which allows parents to request euthanasia for their severely disabled newborns.
• A Dutch study found that 23% of terminal cancer patients suffered from depression and were four times more likely to ask for euthanasia. These results were a surprise to the researchers who assumed that those requesting euthanasia were at peace with their decision⁴
• Another study showed that between 1990 and 2000 the Swiss euthanasia group Exit Deutsche Schweiz assisted in 748 suicides. 21.1% of these people did not suffer from fatal conditions⁵
• In Belgium, the pro-euthanasia lobby is now demanding euthanasia for minors and for citizens with dementia. (back)

 

12. You are trying to impose your religious values on society.

There are many good religious reasons to acknowledge the absolute value of the human person and to oppose euthanasia and assisted suicide. But there is no need to rely on them in order to reject these deadly practices.

Whether you are a religious person or an atheist, the fundamental reasons to say “no” to euthanasia and assisted suicide are first and foremost purely natural, human reasons that promote the well-being of all Canadians regardless of race, gender, age, ability or health.

The Universal Declaration of Human Rights clearly states that “Everyone has the right to life, liberty and security of person” (art. 3). In order to uphold this right for all citizens, at this moment in Canadian history when we are faced with the prospect of legalizing euthanasia and assisted suicide, we need to (1) encourage new research and education on pain relief; (2) provide public funding for more palliative care centers and units in order to ensure that all Canadians have access to end of life care; (3) and develop fiscal measures to allow primary care givers to commit themselves freely to the support of their sick or dying loved ones. (back)

 

1 Jean Leonetti, Rapport d’information Solidaires devant la fin de vie, n. 1287, tome 1, Assemblée nationale française, December 2008, p. 136. (back)

2 One can consult the Oregon Annual State Reports on medically assisted suicides at http://www.oregon.gov/DHS/ph/pas/index.shtml (back)

3 Netherlands Ministry of Health, Welfare and Sport, 2007 Evaluation of the Euthanasia Act. (back)

4 van der Lee, M., et al., “Euthanasia and Depression: A Prospective Cohort Study Among Terminally Ill Cancer Patients,” Journal of Clinical Oncology 23 (2005): 6607-6612. Consulted on September 15 at http://jco.ascopubs.org/cgi/reprint/23/27/6607  (back)

5 Bosshard, G., Ulrich, E. et Bär, W. “748 cases of suicide assisted by a Swiss right-to-die organisation,” Swiss Medical Weekly 133 (2003): 310-317. Consulted on September 16, 2009 at http://www.smw.ch/dfe/set_archiv.as p?target=2003/21/smw-10212  (back)