The Legalization Of Physician-Assisted Suicide In Canada: A Personal Perspective

Benefits of Legalizing Physician-Assisted Suicide for Canadians

Following direction of the Supreme Court of Canada, the Canadian government passed legislation to support medical assistance in dying within a designated time frame – Bill C-14 – Medical Assistance in Dying (MAiD) which received royal assent and became law on June 17, 2016 (Medical assistance in dying, 2017, para. 1).

“Just as advocacy from outside mainstream medicine  brought palliative care from the margins to the center,  so has it brought MAiD into the mainstream of medicine.”  (Li et al. 2017, p. 2088)

In the above quote from the article, Medical assistance in dying — Implementing a hospital-based program in Canada (2017), Dr. M Li and colleagues outline the current program at the University Health Network (UHN), Toronto, to support patients choosing MAiD (the article is available through University of Guelph’s library and the full reference is below). In this article, Li et al. discuss the moral obligation to uphold the legal rights of the terminally ill, indicating “the primary reason for which patients in our setting sought MAiD was to relieve distress over the loss of autonomy and to experience a sense of personal control over the circumstances of dying” (p. 2088). Li et al. also spoke of the distress that was experienced by family members or loved ones when someone has chosen to end their life through MAiD, “a struggle to accept the inevitable death of their loved one, rather than a response to MAiD itself” (p. 2083). Li et al. also discuss the medical liability for professionals associated with MAiD.

After reading the article, think about the following in your personal and peer response posts:
What are your thoughts about MAiD in general and the program at UHN? Would you be comfortable as a professional participating in the MAiD program at UHN or a similar one? Now take some time to imagine if sadly you are dying, would you choose MAiD? What would you need to know more about prior to making the decision?
In your personal and peer response posts, use the article, the text and/or the Instructor’s Commentary on Chapter 9 that reflects your understanding of MAiD.
The full reference for the article is: 

Li, M., Watt, S., Escaf, M., Gardam, M., Heesters, A., O’Leary, G., & Rodin, G. (2017).  Medical assistance in dying — Implementing a hospital-based program in Canada. New England Journal of Medicine, 376(21), 2082-2088.

Write response to following post.

My position on Bill C-14 is that Canada’s decision to legalize physician-assisted suicide was in the best interest of Canadian citizens. This law undoubtedly helps, and will continue to help, Canadians escape unnecessary suffering and have control over their own death. The program at UHN is necessary to make MAiD centralized and accessible to individuals who need it. I would like to see the right to die reach more countries and, with it, that more programs develop like the one at UHN.

Centralization and Accessibility of MAiD Programs

The department of Supportive Care at Princess Margaret Cancer Centre assumed the operational responsibility of MAiD at UHN. Li et al. (2017) note that other clinical departments were unwilling to assume the responsibility of being formally associated with MAiD due to a number of concerns, including conscious objections of staff. Personally, I would not be strong enough to endure the emotional and psychological stress of assisting other people with their death. Legal vulnerability is also a concern for professionals participating in MAiD (Kastenbaum, 2011). Dr. Pitt also provided an interesting take on this from the position of social work, explaining that social workers must be careful when directing individuals seeking assisted dying to MAiD professionals because it is a crime to counsel a person to die by suicide (Pitt, 2019). Due to legal concerns, I would also not be comfortable as a professional participating in the MAiD program. Even though these services are incredibly valuable to Canadians, I realize the people delivering these services are left vulnerable, both emotionally and legally. Hopefully this changes in the near future.

Despite being young and blessed with good health, the fact that physician-assisted dying is legal in Canada brings me a great sense of comfort. If I were ever suffering from a grievous and incurable medical condition, particularly a degenerative disease, where I know my situation would only worsen with time, I would undoubtedly apply for MAiD. There are two reasons for this. First, I understand that life brings with it a certain amount of suffering, but that suffering is redeemed by purpose. I refuse to walk through Hell when I know, with relative certainty, that there is nothing for me on the other side. Second, I have no desire to be diminished in my family’s memory whatsoever. Most recently, I saw this effect in my uncle: he struggled with Alzheimer’s for six or seven years, becoming – impossibly – smaller and frailer each time I saw him. I couldn’t even communicate with him in his last couple years. It was easy to forget he was the man who introduced the first K-9 police unit in Guyana and who trained me in long jump after school. 

Prior to making the decision to apply for MAiD, I would need to have a thorough understanding of my diagnosis and prognosis. It would also be useful to talk to individuals with more advanced in the same illness. I would want to prolong my dying until my suffering became intolerable so having a good idea of timeline would be useful. 

Benefits of Legalizing Physician-Assisted Suicide for Canadians

Euthanasia is the worldwide concern as it has been a debatable topic for many years (Keown, 2018). MAiD or medical assistance in dying is actually the medical act which is commenced by single individual with aim of putting a person to expiry or death either painlessly or failing to prevent the death form usual causes in the scenario of disease of incurable coma (Li, Watt, Escaf, Gardam, Heesters, O’Leary, & Rodin, 2017). It is legal in some countries and illegal in others. According to me MAiD is beneficial and it is like a mercy for the patient who is suffering from an unalterable pain and diseases, but I also think that the decisions should not be taken until the situation is getting worse. The patients and their families should discuss about the situation. My opinion about this particular topic is not one sided. I think the medical assistance in dying is acceptable in some condition but I think it also prevents every chances of future treatment of that particularly person. As everybody knows that medical science is developing day by day and the scientist are continuously working on discovering new treatment options for different diseases, but medical assistance in dying or euthanasia prevents every chances of cure (Kastenbaum, 2015). The program started by UHN is in favour of patients as it relieves them from pain and their family members who are not free from the distress they experience due the patient’s condition (Goldberg, Nissim, An, & Hales, 2019).

On 6 February 2015 Supreme Court of Canada also removes the ban on the MAiD for the diseased person meeting with particular eligibility needs (Fujioka, Mirza, McDonald, & Klinger, 2018). I would be comfortable in the programs like MAiD at UHN. However, I would also refuse if the patient’s condition is curable. If you ask me to put myself in this situation and delivering this assistance, my answer would be yes. As i can think that there are lots of people who are suffering from pain which cannot be cured, it is hard to have such pain for lifetime. If I would be in such situation as I will say as it can also help my family who would be suffering with me. However I would not ask for such assistance if I know that my condition is treatable but not at the place I am getting treated. I am not in favour of euthanasia or MAiD in case of Coma until it is unalterable. Although this decision is quite difficult for anyone who has to decide whether they wants to live and suffer, or they wants to quit. Nobody can imagine the things going on in patient’s mind (Li, et al., 2017). If I would be in such situation I want to know the method for euthanasia or MAiD they will use, I would ask the professional if they searched for every possibility of cure or not, will my family get the money from my medical insurance. I would also ask the professional about who will be involved in MAiD, and whether they have the authority or not to perform MAiD.
 

Centralization and Accessibility of MAiD Programs

This post was quite convincible and I am agreed with the thoughts and comments of the author. I think he mentioned all the personal and professional reasons to avoid and accept the MAiD very well. I am also in favour of the Supreme Court’s decisions to implement right to die in Canada as it can relive the person from incurable pain and unalterable diseases. However I am not fully convinced with the emotional reason to avoid MAiD, according to me, as health professional you need to be strong and take decision without any emotional impacts if it is in favour of the patient. The health professional should know that their first priority is to provide the best interventions to the patient, in the diseases that cannot be cured or altered, MAiD is the best approach. I am agree with the author’s comments on the legal issues a health professional may face while providing MAiD, but being conscious and aware about the ethical and illegal aspects a health professional can avoid the issues. The health providers should asks for consent form from family and the patient before applying the MAiD. Author also expressed his thought about being in a situation of patient very well, and i am fully convinced and agreed with the comments he made. He also reported that people of MAiD providers are left vulnerable, both legally and emotional. I think the points he made are applicable and right in some cases. They need to change this in favour of the patients and their families and also for themselves.
I am very convinced with the comment that the social workers who are involved in the process of MAiD should be careful while directing the patients seeking assistance in dying, as it is actually a crime to suggest or counsel someone for dying by suicide. I think he clearly suggested that the decisions of MAiD should be taken by the patients completely; the health professional or social workers should only advise them if they ask for it (Kastenbaum, 2015). The example provided by the author is also appropriate to express the necessity of MAiD in the adverse situations. There are number of people who are in favour of the medical assisted death and some are against this Approach (Kastenbaum, 2015). Author also mentioned about what he would do if he have to make the decision to apply for MAiD. I think he expressed his side very clearly and I am agreed with the comments. Having an understanding about the diagnosis and prognosis is essential before receiving MAiD. He also reported that he would get the information about the people with same health issues are in more progressed situation. And I am very convinced with it. Prolong the death until the suffering of the person become intolerable is the good ideas of the timeline as it increases the chances of being cured. This is because the scientists inventing different treatments, and medicines that can be helpful in the patient’s condition. In the end I am agreed with the author.
 

References

Fujioka, J. K., Mirza, R. M., McDonald, P. L., & Klinger, C. A. (2018). Implementation of Medical Assistance in Dying: A Scoping Review of Health Care Providers' Perspectives. Journal of pain and symptom management, 55(6), 1564-1576.

Goldberg, R., Nissim, R., An, E., & Hales, S. (2019). Impact of medical assistance in dying (MAiD) on family caregivers. BMJ supportive & palliative care, bmjspcare-2018.

Kastenbaum, R. (2015). Death, Society and Human Experience (1-download). Routledge.

Keown, J. (2018). Euthanasia, ethics and public policy: an argument against legalisation. Cambridge University Press.

Li, M., Watt, S., Escaf, M., Gardam, M., Heesters, A., O’Leary, G., & Rodin, G. (2017). 

Medical assistance in dying — Implementing a hospital-based program in Canada. New England Journal of Medicine, 376(21), 2082-2088.