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What Kay Carter would say

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My mother, Kay Carter, was forced to leave Canada to escape her suffering, to die in Switzerland. As her son, who was with her when she chose to die, I write this letter based on what she taught me.

Shame on Justin Trudeau and his government for retreating from the recommendations made by the committee they struck to review the topic of assisted dying. Although she was the very woman the Supreme Court ruling used as an example for assisted death, my mother would be turned away under Bill C-14, because while her illness left her in agony, it was not terminal. How in any person's common sense could this be an intelligent move?

This was a great opportunity to step into the framework that the Supreme Court so clearly defined; instead, C-14 is a cage trapping suffering Canadians in continued agony. As was argued before the Supreme Court, not ensuring that Canadians have legal access to assistance in dying to alleviate suffering is a form of torture. The Canadian government's response? To allow a select few access to relief while the rest continue to suffer due to age, mental state or lack of terminal diagnosis?

Justin Trudeau's father famously said that the government has no place in the bedrooms of Canadians. Instead, Bill C-14 gives the government a place at Canadians' deathbeds.

My mother's life was that of a quiet champion for the underdogs of society. The government is trampling on the rights of Canadians to make their own end-of-life choices and consigning the vulnerable to agony. Give suffering Canadians the peace of mind that an end-of-life option allows.

Price Carter, Vancouver

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The current government appears to be taking a reasonable, prudent approach to passing legislation on medically assisted death – legislation that may not adhere strictly to the Supreme Court's pronouncement on this issue, but which is certainly one giant step along the road to a more humane Canada.

I love how some parliamentarians get so huffy about the fact that an unelected body – the Senate – is allowed to have a modest impact on the governance of the country, but are adamant that another unelected body – the Supreme Court – should be the unfettered architects of our county's future.

Both the Senate and the Supreme Court are there to serve as useful curbs to bad governance. But neither should have absolute authority to negate reasonable measures passed by the elected House of Commons. After the kind of dialogue that Jeffrey Simpson advocates, Canadian voters will decide whether the changes that were made were reasonable (How Not To Make A Law – June 2).

Dan Turner, Ottawa

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Make it multiple choice

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Re Changing The Vote Requires A Vote (editorial, June 3): Since the federal Liberal government wants to change our current first-past-the-post electoral system, it has an obligation to let the people decide which system it should be. The only way is through a "multiple choice" referendum, where each voter chooses one of several electoral options, instead of voting Yes or No on only one option. One of the choices must include the current system.

D.L. Ime, Vancouver

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Opioid reform: Next up

In the the article Doctors Adopt New Opioid Prescription Rules (June 2), which covers the decision by B.C.'s College of Physicians and Surgeons to mandate adherence to opioid prescribing guidelines recently issued by the U.S. Centers for Disease Control and Prevention , I am quoted as saying, "This is exactly the sort of thing a college should be doing."

While the quote is accurate, the context is not provided. In fact, I am concerned that overly aggressive adoption of the CDC guidelines (which on balance are very sensible) could lead to harm if patients already receiving opioids at high doses are abruptly transitioned to much lower doses by doctors seeking to comply with a regulatory edict. This is likely to result in opioid withdrawal, a condition that itself can have serious consequences and may lead some patients to procure opioids from illicit sources in desperation. With the profusion of bootleg fentanyl in Western Canada, doing so could be fatal.

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High-dose opioid therapy is a dangerous practice that should be discouraged, but so too is abrupt dose reduction. Provincial and territorial colleges should advocate gradual tapering of opioids in such patients to avoid the secondary harms that might otherwise ensue. The CDC guidelines do not offer explicit guidance on this issue, but the forthcoming update of the Canadian guidelines will.

David Juurlink, head, Division of Clinical Pharmacology and Toxicology, University of Toronto

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Finally, our medical profession is starting to deal with the opioid epidemic we have caused. We still have two more medically caused epidemics to deal with: the inappropriate prescription of antibiotics, mainly for viral colds, and the epidemic of polypharmacy – multiple medications per person, mainly in seniors. These two epidemics also kill. Let's see how long it takes to deal with them.

Juan E. Muñoz, MD, Ancaster, Ont.

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Saying sorry? Consider this

Re Australian Apology To Gays Offers An Example For Canada (June 2): While the government is at it, why not an apology to the women of this country? For a long time, women were not considered persons, could not vote, hold office, inherit land, obtain birth control, open bank accounts, have credit cards or hold a job after marriage.

Sounds like there are some very credible reasons for the government to apologize, doesn't it?

Dorothy Watts, Vancouver

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