Don't overlook spirituality when debating euthanasia
Bernard Cloutier is a 76-year-old retired engineer in Montreal who has been watching his province's very public debate about euthanasia with great interest.
Cloutier suffers from emphysema and lung fibrosis and says he already has a "dying kit" in his apartment.
"I have no pain," he told me in an interview with Listen Up TV. "But I am terrified, absolutely terrified by the thought that I could be prisoner of the medical machine over my body.
"If I were in pain, I would take my own life, with no hesitation."
Cloutier's, of course, is just one opinion. But it seems that almost everyone in Quebec has one at the moment now that the provincial government has created this six-month window to debate who should control the end of life.
Listen to CBC Radio's Sunday Edition on Nov. 28 at 9 a.m. ET (9:30 NT) as host Michael Enright presents a two-hour forum of what Quebecers are saying about dying and dignity, recorded this week at McGill University.
Listen Up TV has done its own interviews with prominent Quebecers on the euthanasia debate. A sample can be viewed here. (Runs two minutes.)
Indeed, according to a poll commissioned by the CBC, 83 per cent of Quebecers feel that euthanasia and physician-assisted suicide should be legal under certain conditions.
The Quebec legislature has invited just such a response by offering citizens an online questionnaire on the subject and through public hearings that began in September (and conclude in February 2011).
After that, a select committee of the legislature will make a final report on what should be done with the persistent desire to control when and how we die.
A medical issue?
Technically, Quebec would not appear to have the legislative jurisdiction to change the laws against euthanasia.
It is a crime and criminal law is the purview of the federal Parliament. But when it comes to issues like this, with such moral intensity, criminal laws on their own can often fall by the wayside.
As things stand, three sections of the federal Criminal Code prohibit euthanasia. Assisting suicide, or intentional killing even to reduce suffering are criminal offences. It is also criminal conduct for doctors to withhold or withdraw life-sustaining procedure on their own accord.
Citizens, however, have the right to refuse medical care and to reject life-saving procedures even if doing so will lead to their death.
Saying "Stop, I've had enough" or asking for withdrawal of treatment is not euthanasia.
Being a family member and having to decide "do not resuscitate" for a loved one who cannot make the decision on his or her own is not euthanasia; nor is discontinuing life support or increasing morphine to palliate death.
On the other hand, administering life-ending drugs or any intervention carried out with the intention of causing death is euthanasia.
And the distinctions here can translate into very difficult and emotional choices for ordinary families, which is why some speculate that legislators in Quebec may try to determine that euthanasia is a medical treatment.
Since health and social services are a provincial jurisdiction, the Quebec National Assembly could override Canada's criminal law with its own directives, which would open the door to similar debates in every other province.
Who is the executioner?
Helene Bolduc, 70, had a long career as a nurse and decades of involvement as a mental health advocate and community volunteer before she helped create the Quebec Right to Die with Dignity Association in 2007.
As Quebec's public hearings began, her sister was dying of cancer.
"She had good sedation, good treatment, but the last 18 days were really awful," said Bolduc. "Really, I wouldn't like to die like that. I'd like to have the choice and I'm not the only one."
Cautionary tales from family experiences swing both ways in this debate.
When you hear government officials talking about people who don't have all their faculties and who are in diapers, they are talking about my mom, says Linda Couture, director of the Montreal-based group Living with Dignity.
"There is pressure on the system and that is a recipe for abuse," she says. "We have to be careful what message we are sending to our elderly but also to our young people. We have to solve this problem together."
John Zucchi, a history professor at McGill University is one of 54 academics from McGill to sign a brief opposing the legalization of euthanasia.
He spoke to the commission about his experience caring for a deaf, dumb and blind 33 year old who was paralyzed and could not request his own death.
"Who is the executioner?" Zucchi asked. In decisions of this magnitude, "everyone's involved, the bureaucracy, the doctors, the medical practitioners, and family. There's so much room for abuse.
"No matter where you're coming from, common sense would say that we are going down a very, very dangerous path if we are going to choose euthanasia."
Faith's voice
For the most part, the stories from these public hearings have been deeply personal, resonating with autonomy, interdependence, suffering and choice.
There has been pressure to isolate and keep religious views from the debate. But surely that is not realistic, given that science and faith have such deep compatibility and understanding when it comes to the arena of pain and death.
Science addresses how we respond technically to situations like this; religion speaks to the why and the rationale we need to apply.
Take for example what happened the last time this issue made its way to Parliament for a vote, part of a proposed change that would have decriminalized physician-assisted suicide under certain narrow conditions: Canada's only quadriplegic MP, Steven Fletcher, abstained from voting.
Now, Fletcher is someone who wants the legal provision to end his life should he deem it necessary.
But in 2009 he cautioned that we had yet to prove we are a trustworthy society when it comes to playing a role in ending human life; and that even our deliberations may "worsen the plight of the severely injured and ill by relieving the pressure on Canadians to come to terms with the more important challenge of providing support, compassion, love and mercy" to people in pain.
Many faiths clearly have contributions to make to this point. But for those of us who are Christian, this is a challenge that lands squarely in our area of expertise.
For centuries, Christianity has been prime source material for teaching how to love and care for family and strangers in pain.
Of course we need to be honest with those looking to our distinct truth and what we mean by hope.
For two millennia we Christians have said that this body on Earth is but a shadow of the future self that God has waiting for us after death and we need to regain our practice of how to explain and engage that truth with the reality of dying.
That belief helps us understand that there is no purpose to keeping Grandma, son, daughter or self clinging to life support when a greater beauty comes next.
In debates such as this, how great is our loss if we withdraw the contribution of faith from our collective education and view only individualism as the better way to face the perils of death.
As surely as we wrestle through the physical steps of death, particularly on an issue as fraught with emotion as euthanasia, so will we need to come to terms with the spiritual journey.