Downie will be giving a lecture at McGill University on Jan. 13 and says she will not only review where Canadian laws currently stand on these issues, but also suggest the need for law reform.
“My ideal [situation] would be that it, euthanasia and assisted suicide, be taken out of the Criminal Code and be handled through a commission that oversees what’s going on and sets out very clear standards under which euthanasia or assisted suicide can be practised,” she says.
The lecture is co-sponsored by the McGill Research Group on Health and Law and the McGill Biomedical Ethics Unit.
This lecture comes on the heels of public hearings on euthanasia in Quebec and a new poll commissioned by the CBC and Radio-Canada. The poll revealed that 83 per cent of Quebeckers support euthanasia and assisted suicide. However, a minority would not consider this end-of-life option for themselves or a loved one.
Currently, the Criminal Code prohibits euthanasia and assisted suicide. Section 14 states: “No person is entitled to consent to have death inflicted on him, and such consent does not affect the criminal responsibility of any person by whom death may be inflicted on the person by whom consent is given.”
Section 241 takes a stronger position on assisted suicide, stating: “Every one who counsels a person to commit suicide, or aids or abets a person to commit suicide, whether suicide ensues or not, is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.”
“It’s a bit of a mixed bag, because it’s very clearly illegal, both assisted suicide and euthanasia,” says Downie, who holds the Canadian Research Chair in Health Law and Policy. “But then if you look at all the cases . . . you don’t see 100 per cent of the people, or anywhere close, being charged, prosecuted, and then sent to jail. So there’s a bit of a disconnect between what seems to be a very strictly prohibited regime and a regime in which . . . there are plea bargains being accepted, people aren’t even being charged and so on.”
One of the most prominent euthanasia and assisted suicide cases in Canada is the Sue Rodriguez case. Rodriguez challenged the Criminal Code, claiming its prohibition of assisted suicide violated her Charter rights. In 1993, despite a close decision, Rodriguez lost her case at the Supreme Court of Canada. In 1994, she took her own life with the help of a physician. An investigation into her death ensued, but no arrests or charges were made. Many supporters of the legalization of euthanasia and assisted suicide consider this a landmark case in promoting the importance of this issue.
Downie says Canada can look at other countries or states as models for new laws in this area. She points to Belgium, the Netherlands, Washington, Oregon, and, most recently, Montana.
Oregon has strict guidelines when it comes to allowing physician-assisted suicide. To be considered for physician-assisted suicide, a patient must be at least 18 years old, be a resident of Oregon, be capable of making and communicating health-care decisions, and be diagnosed with a terminal illness which will lead to death within six months. After these criteria are met, a patient must make a series of requests to his or her physician, who must then consult with at least one other physician. The patient may be required to undergo psychological testing. Several other criteria and requirements also exist. In 2008, only 88 prescriptions were written for lethal medications under the state’s Death with Dignity Act, and only 54 patients carried out their plans for physician-assisted suicide.
“A lot of people don’t think that they would feel it to be necessary, and not very many people would actually avail themselves of it were it available,” says Downie. “For one thing, it brings an enormous amount of comfort to people knowing that it is legal because then they know they have a way out . . . [even if] they may not actually need to exercise that.
“You want it to be there, but you certainly hope you’ll never have to use it.”
As with any highly controversial issue, the public has provided passionate commentary on the legalization of euthanasia and assisted suicide. Much of the opposition point to the “slippery slope” argument: once euthanasia and assisted suicide are legalized, the vulnerable — the elderly, the disabled, the mentally challenged — will be taken advantage of. Downie argues that there is no evidence of this.
“I’m not sure how familiar people are with the data and the evidence that’s coming out of countries that have started to allow euthanasia and assisted suicide,” she says. “People still make the ‘slippery slope’ argument . . . but there’s no evidence for this.”
Regardless of the outcome, Downie applauds Quebec for drawing attention to this highly charged, yet important issue.
Downie is currently a professor at Dalhousie University in Halifax in the faculties of both law and medicine. She has published much literature on this topic, including Dying Justice: A Case for Decriminalizing Euthanasia and Assisted Suicide in Canada.
McGill’s annual lecture in health and law, “Just dying: A discussion of euthanasia, assisted suicide, and the law,” takes place Jan. 13 at 4:30 p.m. at Day, Chancellor, Hall, room 312, 3644 Peel St., Montreal.