Wednesday, February 26, 2014

Quebec's Right to Die Bill - Will it Die Before It Can Be Passed?

Ok, it's the end of February and it's been two months since I posted last. Why is it that we tend to leave our own things for "later" and then "later" never comes?

I like writing this blog. It gives me an opportunity to write about topics that catch my attention or are important to me. So I really should give the blog more attention than I am giving it. Today I want to write about a bill that the province of Quebec (Canada) has on the table - it's unofficially called the Right to Die Bill, but it is really "The act respecting end-of-life care bill."

Assisted suicide, the right to die, euthanasia - they are all very contentious topics. Most people I've spoken to about this over the years are very strongly on one side of the issue or the other. And, it's not unusual for their views to change once they find themselves in a situation where a loved one is dying. Is there a right or wrong when it comes to end of life?

I've seen death in many ways. As a nurse who worked in acute care, I've fought to save patients from dying - through providing life-saving treatment that includes CPR. I've been part of a team in an ICU where patients were taken off life support. I've worked in palliative care, where I held the hands of patients as they took their last breath. I've lived through the aftermath of suicide of a relative. I've lost people I love to "natural causes." I've also loved animals and had to make the decision to euthanize a few, because they were suffering too much and I couldn't bear that. So death is not unfamiliar to me. But I still can't tell you where I stand on Quebec's proposed bill.

The bill is as well thought out as I have imagined such a bill would be. It's been four years in the making as politicians and experts discussed the various aspects and ramifications of such a law if it went into effect. According to the rules, the patient must be over 18 years old and of sound mind, capable of understanding the consequences of their decisions. They must have an incurable illness, declining in health and near natural death. The patient must be in constant, unbearable pain.

I have seen many people in that stage. Some begged to let us help them die - others fought to the bitter end.

The law would allow physicians to help the patient die, but only after he or she has ensured that the patient has weighed all the options and a second opinion from another physician concurs with the prognosis - that there is no chance of recovery.

But what is "constant, unbearable pain?" Those who are living with deep depression may say that they can no longer go on. What about those who do have debilitating and constant pain because of a trauma but they are not fatally ill. What if that pain is unbearable and they can't handle the idea of living with it for another 5, 10, or more years? What if the patient is a very smart 16-year-old? What if the patient doesn't really want to die, but is feeling pressured to let go?

Many who are against the bill are afraid that this is opening a door that can't be shut again. More illnesses, conditions, and reasons will be added to the list of who can be helped to die. They fear that decisions will be made for people who aren't able to decide for themselves. They fear that temporary illnesses that might be managed properly, may seem so bleak that lives are cut short before treatment can be effective.

In a perfect world, an assisted-suicide law may be what we need. But we don't live in a perfect world and abuses do happen - that we cannot deny. So those who fear abuses in this case shouldn't be silenced. But... then we go back to, what about those who are suffering - what rights do they have over their body, their time to die?

Unfortunately, because the government is a minority government and it may be calling an election very soon, this bill may not go any further. This bill on dying will, in effect, die on the table. I don't say "unfortunately" because I want the bill to pass or not pass, but because this discussion is very important and so much work as gone in to it that it is frustrating to those involved to see it all for naught. I know that the bill can be reintroduced next session - but the will has to be there. And will it be?

I am leaning towards, yes, I think we need something like this, but I am afraid of that door being jammed open too wide.