Toronto Symposium Tackles Difficult Issue
Carroll Rees

On Saturday, September 24, 2005, the Euthanasia Prevention Coalition sponsored a one-day symposium in Toronto entitled Bill C-407: Threatens the lives of people with disabilities?  Three speakers were featured: Peter Aarssen, an Elder Planning Consultant, Stephen Drake, the research analyst for a national disability rights organization in the US,  NOT DEAD YET and Mark Pickup, a Canadian disability activist and founder of Human Life Matters.

The symposium sought to address concerns raised by the introduction of a private Member’s Bill by Bloc Quebecois MP, Francine Lalonde, last June 15, 2005.  Bill C-407 seeks to amend Sections 222 and 241 of the Criminal Code which deal with the prohibition against euthanasia and assisted suicide respectively.  (For more information see the July/August issue of the LifeCanada News).  The Bill will receive second reading in this session of Parliament and, if passed, will proceed to the committee stage where arguments for and against the legalization of assisted suicide and euthanasia will be heard.  If this bill passes second reading the result will be another public debate about expanding the role of health practitioners, for the first time in our history, from healer to  empowering them to assist or directly cause the death of others.  Another public debate, with the accompanying media frenzy, will serve to whittle away opposition to legalized euthanasia and lead to a climate of acceptance by many Canadians.  Members of the disabled community fear such an occurrence since it could lead to pressure to end the lives of those who are seen as not able to contribute to society and may be considered a financial drain on our economy since they have additional health care needs.

Peter Aarssen
           
Speaker, Peter Aarssen, presented demographic information about our aging society in order to help us gain a better understanding of society’s challenge in preparing for the future and meeting the needs of its aging population.
           
Peter pointed out that incredible medical advances in recent years have allowed us to live longer and healthier lives.  It seems that 600 Canadians turn 65 every day and the average life span in our country is 79.96 years.  The number of Canadians over 80 years of age is expected to double in the next 20 years and triple in 40 years.  There are now over 100,000 Canadians over 90 and 3800 Canadians over 100 years of age.  This means that we will be retired for longer periods and some of us may actually outlive our pensions.  The fear of dying too soon is being replaced by the fear of living too long.
           
Compounding the problems of an aging population is the decline of the family.  Canadians now have only one or two children which means there are fewer children to care for their aging parents.  Fewer children and an aging population have important implications for our public policies.  By the year 2041, elders will make up 25% of the Canadian population while the number of children being born is decreasing.  This means that there will be fewer workers to support our aging population. In the year 2030, it is estimated that there will be only 1.5 workers for every retiree. Today, schools are closing while more and more retirement homes are being built.
           
This shift in population growth will have an impact on our society.  It could mean:

• that elders may have to delay retirement,
  
• our health care budgets will be stretched since seniors have more health problems and require more frequent hospitalization
  
• 68% of our health care expenses occur after age 65,
  
• seniors without dependents will require more social assistance
• more employee time lost as adult children care for senior parents
  
• the sandwich generation is over-stretched caring for four generations; elderly parents, spouses, children and grandchildren,
  
• fewer children means a potential for worker shortage and a possible economic decline.
  

Mr. Aarssen also shared some positive facts about our aging population.  Many (80%)of our elders in the 55 to 65 age category are healthy and more fit, 80% are considered wealthy, less than 10% of those aged 65 and older suffer from dementia, 93% of seniors live independently, 58% continue to live in their home with their spouse, 7% live with extended family and 29% live alone.

Stephen Drake
     
The second speaker, Stephen Drake, told us that euthanasia has been part of our medical culture for a long time.  Stephen offered us the following quote by Psychiatrist Foster Kennedy from the 1942 edition of The American Journal of Psychiatry to show that this thinking is not new:

"I believe when the defective child shall have reached the age of five years—and on the application of his guardians—that the case should be considered under law by a competent medical board; then it should be reviewed twice more at four-month intervals; then, if the board, acting, I repeat, on the applications of the guardians of the child, and after three examinations of a defective who has reached the age of five or more, should decide that that defective has no future or hope of one; then I believe it is a merciful and kindly thing to relieve that defective—often tortured and convulsed, grotesque and absurd, useless and foolish, and entirely undesirable—of the agony of living."

Doctors regularly make decisions about who should be treated, which treatments should be offered and which withheld because they are considered “futile”.  This is of particular concern in the case of disabled infants who will never be fully able bodied.  Some doctors may feel that these babies are better off dead than having to go through life with their disability so may offer them fewer treatment options than if they were completely healthy infants.
     
Stephen also reminded us that society’s response to the so-called “killing” of a child is much less vociferous if that child is disabled.  One just has to think back to the death of Tracy Latimer whose father ended her life.  Many, many people have sympathized with her father, Robert Latimer, and believe that he should not have been sent to prison for his crime.  This greatly concerns the disabled community who see this as a sign that their lives have less value than able bodied people because if the father of a child who was not disabled had subjected him or her to the same death there would have been a huge public outcry and no question of reducing his prison term.

Mark Pickup
     
Mark Pickup, who has multiple sclerosis, has worked to oppose the cultural changes that lead to the acceptance of euthanasia and assisted suicide.  He is concerned for the lives of the disabled in our country if Bill C-407 were to become law.
     
Mark reminded us that the Canadian Charter of Rights and Freedoms guarantees all of us the right to life, liberty and security of person but the greatest right is the right to exist.  The right to die is not even mentioned in any human right declarations because it is not a human right but an eventuality, an event that is inevitable for all human beings.  Even though a person can be robbed of their right to life they were endowed with it from the beginning.
     
Bill C-407 is very dangerous since it is touted as giving individuals the right to “die with dignity”.  However, it really would establish the right to kill with impunity.  Bill C-407 states that:

• those who are ill or disabled can be euthanized even if they are not dying
  
• anyone over 18 years of age can be eligible for assisted death which means depressed teens could qualify if they are suffering from severe mental pain
  
• the person need not try all treatments available to alleviate their pain and suffering
  
• the person must appear lucid but not necessarily be lucid
  
• two requests for aid in dying must be made at least 10 days apart but need not be in writing
  
• a person can provide aid in dying even if they are not a physician but must be assisted by a team of persons who are licensed to provide health services if the person is not lucid they must be euthanized by a physician           

It is obvious that this legislation could affect a vast array of persons.  The reality today is that 80% of unborn babies with Downs Syndrome are aborted and 50% of those diagnosed with spina bifida are destroyed.  Mark Pickup asks why we would conclude that society would be kinder to him, a disabled person?  Because he is here?  He reminds us that this did not protect Tracy Latimer from an untimely death.
           
It is a dangerous time to be disabled with rising health care costs.  Hospitals now reserve the right to refuse treatment over family requests.  A physician does not have to provide treatment he or she considers futile.  Those with disabilities can be seen as a medical expense with no prospect of a cure. The case of Terri Schiavo illustrates this point well.  Terri was not dying and did not meet Florida’s criteria for persistent vegetative state (PVS) which defines it as “Persistent vegetative state means a permanent and irreversible condition of unconsciousness in which there is: (a) the absence of voluntary action or cognitive behavior of any kind and  (b) an inability to communicate or interact purposefully with the environment.”  Terri could laugh, cry and interact with her environment.  She required a feeding tube just like thousand of others who rely on them.  Feeding tubes are not life support and are not extraordinary treatment.  They are no different than using a straw.  Terri’s mother has said that her daughter did not die a peaceful death but in “unspeakable agony”.
           
Mark reminds us that it is important to retain the prohibitions against state sanctioned killing.  We do not have the right to ask others to kill us because that would compromise their humanity.  Assisted death would affect not only the family members and friends of the patient but also the physician because it would turn him or her from a healer to a killer.  It would also affect our society.  Are we a community or every man for himself?  Are we all little islands or a continent?  If even one person is excluded we can no longer call ourselves a community.  When someone dies it affects every one of us because we are part of mankind.  We should seek life with dignity for all, not dying with dignity for some.  Dying with dignity is not an event but a process.  People die with as much dignity as they lived.  You can not inject dignity into a person when they are dying.  “Dignity is not injected into somebody’s bloodstream when they are at their lowest point”, says Mark Pickup.
           
In order to protect all vulnerable Canadians, it is best to maintain the prohibition against assisted suicide and euthanasia.  MP Francine Lalonde has said that her bill is necessary because good palliative care is not always available.  We believe that society’s efforts would be better spent working towards providing better end-of-life care for all  Canadians.

Carroll Rees is the Executive Director of LifeCanada.