Friday’s decision by the British Columbia Supreme Court was a victory for a dying 64-year-old ALS patient. Gloria Taylor won her right to physician-assisted suicide at a time of her choosing. But, just as important, the decision is a victory for civil liberties in Canada and for the rights of the disabled.
For more than 20 years, Canadians have been telling pollsters that we favour a change to the Criminal Code that would make it legal for patients with incurable physical illness to opt for assisted suicide. Just before Ms. Taylor began her legal challenge, a Forum Research poll showed that more than two-thirds of Canadians favour the right to physician-assisted suicide.
The reason why most Canadians will cheer this decision is that individual autonomy is a core value of our society. The right of competent adults to make important decisions for themselves – including life and death decisions – is part of what defines us as citizens of this country. Autonomy is a cornerstone of our culture, as it is of other liberal democratic societies. It is also enshrined by the Charter of Rights and Freedoms.
You and I have both a moral and a legal right to make important choices based on our beliefs about the good life. But this does not mean that our right to autonomy is absolute. When the Supreme Court decided in 1993, by a 5-4 vote, to deny Sue Rodriguez’s challenge to the criminal prohibition of assisted suicide, they acknowledged that the law violates her right to autonomy. But the majority argued the violation was justified because, without a complete prohibition, there was a danger of error and abuse. They feared that vulnerable members of society – minorities, the disabled, the sick, the elderly, the poor – might be victimized by a more permissive law.
In 1993, doctor-assisted suicide had not been legalized anywhere, so it was plausible to invoke a slippery slope on which the vulnerable could become victims. Today, however, we can trade speculation for evidence gathered from jurisdictions where it has been decriminalized.
After reviewing the evidence presented by both sides, including evidence based on experiences in Oregon and the Netherlands, the B.C. court concluded that none of it supports fears that mistake and abuse are more likely in a permissive but regulated regime. Mistake and abuse can and do occur in Canada as well as in Oregon. But in Canada, there are virtually no safeguards around end-of-life decision-making: deciding, for example, when to “pull the plug” or when to put a patient into “terminal sedation.” In Oregon, decisions are regulated and monitored; there is public accountability.
None of the critics’ dire predictions have come about: Palliative care did not suffer because it would be cheaper to hasten people’s deaths rather than to relieve their suffering. In fact, palliative care in Oregon and the Netherlands is excellent – and it improved because of decriminalization. Nor did the doctor-patient relationship suffer. On the contrary, there is evidence that patients in Oregon feel alienated from physicians who oppose assisted suicide.
Nor is there evidence that respect for the value of life has diminished in jurisdictions that have opted for safeguards rather than a ban. Respect for the religious doctrine of “the sanctity of life” may be waning, as more people favour individual liberty; but respect for quality of life (and for the right of each individual to decide when life has become more burdensome than beneficial) has increased.
As the court noted, Ms. Taylor’s right to life is protected, not imperilled, by decriminalization. She can now wait until she’s ready to die instead of killing herself prematurely, in order to do so without assistance.
Prof. Arthur Schafer is Director of the Centre for Professional and Applied Ethics at the University of Manitoba