Slippery Slope, or Progressive Leap? Quebec’s Euthanasia Bill

Quebec’s Euthanasia Bill 52

UPDATE:  Bill 52 passed yesterday afternoon, June 5th, 2015, at the National Assembly with a vote of 94-22.

Recently the Quebec government in Canada proposed legislation guaranteeing a patient’s right to access doctor assisted suicide. Bill 52 is not the first time such legislation has been proposed in Canada or the United States. In fact, New Mexico became the latest State to enact such a law (pending appeal), joining Montana, Oregon, Vermont and Washington. This divisive issue makes for a heated debate amongst those who consider themselves “pro-life” or “pro-euthanasia”.

Stepping away from the vitriol, we examined the issue from both sides. These are the arguments for and against Bill 52.

Pro:

Practical:

1. The pain and suffering of patients can be greatly reduced. Many ailments such as cancers, Crohn’s disease and muscular dystrophy are immensely painful and usually get worse with time. If allowing a patient to end their suffering “harms” no one but themselves, the net benefit is positive.
2. Allowing people the right to die could free up badly needed health care funds. This argument is not one that is proposed often as the implications seem dire, however that does not mean there isn’t any truth to it. These are some typical figures associated with end of life care: $39,947 for patient with organ failure near the end of life; $36,652 for a terminal illness; and $31,881 for frailty. Sudden death is the least costly at $10,223.[1] According to one study, hospice and home care costs in the United States are about $3.5 billion and $29 billion, respectively.[2] Some with debilitating illnesses who wish to die may live for years at the expense of taxpayers.
3. Since doctor assisted suicide would be premeditated and thought out, vital organs could be obtained and used to save the lives of others. This may not always be the case depending on individual situations, however there is a greater likelihood of organ preservation than with traumatic death or death from old age.
4. The truth of the matter is that people will commit suicide regardless. People who are unable to do so themselves may turn to someone else which could result in severe legal ramifications. Suicides can be messy, traumatic and painful. Doctor assisted suicide would be in a comfortable and safe environment where the family could be given the chance to say goodbye in a manner of their choosing. This is a utilitarian argument that would also fit in under our philosophical category. What benefits the greatest number of people (or disadvantages the least) is the morally correct choice.
5. An argument against euthanasia is the danger of abuse by governments, doctors and family members. This is especially true for those who do not have consciousness or the ability to properly communicate. However countries such as Belgium as well as 4 States in America have all shown that effective and reasonable laws can be put in place to safeguard those most vulnerable. No “death panels” have ever been put in place, no one has ever been euthanized against their will and cases are always treated on an individual basis.

Philosophical:

1. The right to die should be a fundamental freedom of each person. The right to life itself implies that there is a right to die. Likewise, the right to life implies the right to a life well-lived and if that cannot be guaranteed, one should be able to take whatever step they feel necessary to fix that problem. Furthermore, the right not to be killed will ensure that doctors who do end a person’s life without their explicit consent will be held accountable.
2. Death is a private matter and the state should not get involved. This is to say, if an individual wants to end their life and it causes no harm to anyone else, no one should have the right to interfere. This is a utilitarian argument similar to the one above.
3. Giving everyone the right to a dignified death is morally correct and is a principal that can be applied universally. In other words, euthanasia, if one sees it as a net positive, is a principle that could be applied to everyone and is thus the right thing to do.

Con:

Practical:

1. It would violate the Hippocratic Oath that every doctor must take. Simply put, it says that doctors are under an obligation to do no harm. Thus assisting in a person’s suicide would violate this principle. Doctors should only want to help people and not harm them.
2. Doctors and families might give up on a patient in a premature fashion. This could be especially true for patients who are past the point of rational decision making and will rely on others for end of life care. In the case of a coma or cancer, there is always the chance of a recovery and pressure to end a life may be detrimental to many patients.
3. Insurance companies and governments may step in and place pressure on doctors and caregivers to apply assisted suicide measures in situations that do not necessitate it. Doctors may be told to withhold treatments or they may cease going an ‘extra-step’ to save someone’s life. Insurance companies are always concerned with the bottom line and the cost of keeping someone alive is astronomical. Given the track record of insurance companies, we must be suspect. Giving doctors that amount of power is unethical and could have dangerous consequences. If a doctor, who is biased like anyone else and can make mistakes, convinces a family to end a life of a savable person, this would be problematic and unethical. People need to be able to trust doctors. Likewise, this opens up the possibility of abuse by family members. Laws are put in place to protect people and the sanctity of life.
4. Allowing patients the right to end their life could soon extend to non-critical situations. This is to say, what if the laws relax as time goes by and patients begin to convince doctors to end their lives for reasons of mental illness or subjective poor quality of life?  This is the ‘slippery slope’ argument. If terminating life is accepted for the elderly and sick, what would stop society from eventual extending this to those it considers “undesirable”?

Philosophical:

1. Doctor assisted suicide demeans the value of life. Life is a precious gift not to be wasted and the possibilities raised above would do just that. Western society should not tolerate the systematic killing of people because it is economically viable or convenient.
2. Religious faith can prohibit the murder of individuals. This may not be doctrinally true for every religion but the major world religions all have some sort of prohibition on murder. A classic example is “thou shalt not kill” from the Hebrew Bible/Old Testament. For people who believe in a transcendent realm, euthanasia raises the possibility of damnation for not only the patient’s soul but that of the doctor who performed the end of life procedure. To quote from a conference of Catholic leaders:
   “Our tradition, declaring a moral obligation to care for our own life and health and to seek such care from others, recognizes that we are not morally obligated to use all available medical procedures in every set of circumstances. But that tradition clearly and strongly affirms that as a responsible steward of life one must never directly intend to cause one’s own death, or the death of an innocent victim, by action or omission…”[3]
3. Finally, we should not discount the possibility that miracles or recoveries are possible. There are countless stories of people who have been told they have months, week or days to live only to continue living for years, if not decades. This being a reality means that if doctor assisted suicide is allowed, people may prematurely be ending their lives, which has obvious consequences for themselves but also for their social network and loved ones.

The Bottom Line:

We wish we could say that we have come to a decisive answer. The truth of the matter is that this is a nuanced problem with few concrete solutions. Often religious and philosophical reasoning will butt heads with practical reasoning and this is no more true than with the ‘Right to Die’ debate. Even when practical arguments make sense, there exist arguments that can make them appear unpalatable.

After considering the different arguments outlined, what are your thoughts on this issue? If there is an argument on either side we missed or that you feel passionately about, please share in the comments section below.