Bill C7, currently before Parliament, is a mess.
The purpose of this act is to revise the criteria which must be met before someone qualifies for medical assistance in dying (MAID). This came about after a Quebec superior court ruled that the original 颅legislation was too restricting, and ordered a redraft.
Specifically, the court took issue with the requirement that to be eligible for MAID, a person must have a serious illness or disability, must be in an irreversible, advanced state of decline and at a point where natural death is foreseeable.
It was this last criterion, in particular, that troubled the court. What about people with disabling, chronic and painful conditions that have ruined their quality of life, yet do not face imminent death? Aren鈥檛 they entitled to decide when enough is enough?
Here though, is the problem. By removing the requirement that death be imminent, Bill C7 leaves physicians who must administer the procedure with next to no guidance.
What counts as an unbearable condition? When is quality of life so depleted that death is a reasonable option?
The legislation says mental illness cannot be the sole criterion for eligibility, but it can be one of the qualifying factors. But doesn鈥檛 that raise questions about such a person鈥檚 ability to make a rational choice?
And what about people with physical handicaps? Are they now eligible?
Two preliminaries. First, I鈥檓 fully in favour of medically assisted dying. I would choose that route every time in preference to an ugly end.
I thought it was a moral disgrace when Victoria鈥檚 Sue Rodriguez, dying of ALS (Lou Gehrig鈥檚 disease), was denied such an option as the law then stood.
Instead, an unnamed physician, taking his career in his hands, administered a lethal injection while her family fled the house to avoid being charged with aiding or abetting. Rodriguez died alone.
Second, I don鈥檛 buy the slippery slope argument often used by opponents of MAID. They claim once you open this door, there will be no end of abuse.
You can make the same argument against any policy. If we let governments tax personal income, couldn鈥檛 they bankrupt us all? Yes, but this being a democracy of reasonable people, they don鈥檛.
Why then is Bill C7 a mess? You have to look at it from the physician鈥檚 perspective.
The original legislation, restrictive as it was, gave fairly clear direction to doctors. They knew where they stood.
Now they face an almost impossible task. The act offers no guidance in determining where the line is crossed into medical 颅malpractice.
Nor does it provide a firm legal basis for physicians who might be sued by the 颅relatives of patients whose lives they鈥檝e helped end.
In other words, far from broadening access to MAID, the bill may very well constrain it, as physicians, unsure of the ground they鈥檙e standing on, shy away.
We had already experienced a little of that under the original legislation, as some doctors struggled to understand what was meant, exactly, by 鈥渇oreseeable death.鈥� Death within a week, two weeks, six months?
Nevertheless a consensus emerged that most physicians were comfortable with.
Now, it鈥檚 impossible to glean from this legislation what will and will not be ethical or lawful.
This is no way to define the conditions for a life-ending procedure.
Lawrie McFalane spent 15 years as a deputy minister in Saskatchewan and British Columbia, running ministries that included education, health, and budget 颅management.
