Introduction

Webcast archive: CCD Statement of Principles – Part II

This week, we discuss the core principles CCD has put forth for new legislation.

Webcast archive: CCD Statement of Principles – Part II

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • CCD Statement of Principles – Part II: Principles
  • The unassisted suicide of Donna DeLorme

Please note that this text is only a script and that our webcast contains additional commentary.

CCD’S STATEMENT OF PRINCIPLES FOR LEGISLATION FOLLOWING THE CARTER DECISION – PART II

  • Last week we began a three-part series focusing on this statement.
  • The declaration is our response to the Supreme Court decision in the Carter v. Canada On February 6, 2015 the court declared that the criminal law prohibiting assisted suicide was unconstitutional.
  • The court said that a “competent adult with a grievous and irremediable medical condition” that caused enduring suffering could consent to termination of life the help of a doctor.
  • Parliament has until February 6, 2016 to adopt a bill that would create a “carefully regulated scheme” to protect vulnerable people from “incitement to commit suicide.”
  • Following a collaborative process the Council of Canadians with Disabilities presented its recommendations to the Provincial Expert Panel. The recommendations will be presented to the Federal panel as well.
  • Because of the early election call on August 2, the public phase of the Federal Expert Panel’s work was suspended, and Parliament will have less time to examine the question before the deadline.
  • Last week, in the first part of our discussion of the CCD position statement, we focused on the reasons people with disabilities oppose assisted suicide, and some of the myths about assisted suicide that circulate in the media and the general public.
  • Next week we’ll concentrate on specific recommendations for the law and regulations. What the actual procedures, safeguards and sanctions look like.  Space limitations prevented us from providing important detail.  The presentation will therefore be a little longer than usual.
  • This week we’ll talk about the principles that must guide members of parliament in drafting a law on medical killing.

Principles

  1. Only assisted suicide (not euthanasia) will be permitted.
  2. Canada must re-commit to a policy of suicide prevention by:
    1. Providing adequate funding to mental health care and training to help mental health providers increase their skill in intervening with people with disabilities;
    2. preventing the discrimination that would result from defining a class of suicidal persons (ill and disabled) for differential treatment;
    3. Preventing “vulnerable persons from being induced to commit suicide in times of weakness,” and “protecting disabled and terminally ill people from prejudice, negative and inaccurate stereotypes, and ‘societal indifference’”
      1. Vulnerability is a universal human experience. As adults we build up resilience to our innate vulnerability by developing buffers, such as material security, personal supports, recognition and respect, and positive interpersonal relationships.
      2. When these buffers are removed or compromised, people are made vulnerable.
  • Factors such as poverty, isolation, discrimination, gender, age, race, devaluation and lack of needed supports compromise resilience and are therefore central in determining whether a person may be vulnerable to inducement to seek assisted suicide;
  1. In order to prevent situations that lead to requests for assisted suicide, Canada must meet its obligations under the United Nations Convention on the Rights of Persons with disabilities. Each person must have a full range of life
    1. Care must be provided in the least restrictive environment possible with options for consumer-driven services rather than institution-based care.
    2. All Canadians must have timely access to effective palliative care to relieve physical pain and symptoms, as well as emotional and existential distress. No person shall be approved for assisted suicide who has not received such services at least on a trial basis;
  2. A “carefully regulated scheme” cannot prevent all non-consenting and coerced deaths. Therefore, a detailed and explicit law which obviates the reasons for assisted suicide requests, has strict eligibility criteria, focuses on pro-active safeguards, and includes vigilant oversight and severe sanctions is essential to protect old, ill and disabled persons from an increase in such homicides.
    1. Disabled people and their representative organizations must participate directly in the design, delivery, monitoring and evaluation of a program to regulate assisted suicide.
    2. Definitions and standards must be clear, consistent, appropriate, durable and enforceable in order to inform parties of their obligations, avoid an incremental shift toward enlarging the criteria for eligibility, and prevent tolerance for violations of the stated eligibility criteria.
    3. Transparency and accountability must characterize the process of eligibility determination, approval, oversight, data collection and liability in regulating the practice of assisted suicide.
    4. A bias for preserving life should guide policies and actions.
  3. Discriminatory beliefs about disability and the quality of life of persons with disabilities have no place in this process.
    1. Disability (including psychiatric disability) alone is not an “irremediable medical condition” and does not render a person eligible for assisted suicide.
    2. An assisted suicide program must not perpetuate the historical discrimination experienced by women in the health care system, social pressure on women not to become “a burden” on their families, and the over-representation of women among those seeking and being granted assisted suicide.
    3. An assisted suicide program must not perpetuate the discrimination, genocide, cultural annihilation and exploitation experienced by aboriginal peoples and other religious and ethno-cultural groups.
  4. The program shall be managed so as to be accessible to and usable by all persons, including ensuring effective and independent communication. This includes access to qualified and neutral interpreters, adaptive technology and print materials in alternate formats.
  5. Each person shall have timely access to medical equipment, tests and services that accommodate his/her needs.
  6. Any request for assisted suicide must trigger the full range of mental health care for suicide prevention.
  7. The word “person” shall be used, rather than “patient”.
  8. Assisted suicide and euthanasia are not medical care. The practice violates the physician’s fundamental roles as healer and advocate, which must be protected.  Therefore assisted suicide must not be publicly-funded.  The individual making the request should pay for his/her assisted suicide.
  9. Canada recognizes that the continued presence of persons with disabilities and elders in our society is essential to maintaining social health.
  10. Canada recognizes that complete autonomy does not exist in an interdependent society where we all rely on public services, utilities, manufacturing, shipping, and infrastructure to meet our daily needs.

COMMENTARY – THE UNASSISTED SUICIDE OF DONNA DELORME

  • This week Donna DeLorme, an long-time activist for assisted suicide committed suicide.
  • While we are saddened that anyone would feel compelled to end her life, we are nevertheless puzzled at this turn of events.

If it’s necessary to legalize assisted suicide because people are unable to commit suicide, and if regulations are due within the next few months that would allow persons who are suffering to have help to end their lives, how is it that Ms. DeLorme was able to end her life at this moment?