Sunday, November 15, 2009

Death in Canada

I keep reading about the Catholic Church and its recent public stance against gay marriage in the US. Honestly, I have no idea how they feel in Canada because gay marriage has been legal here for the last four and half years and I don't know that I've ever heard the Church speak about it. Actually, I'm not sure that I've ever heard any Canadian church speak about it. There, it's the end of the world; here, not so much.

Right now, the Church here (at least the one down the street from) is concerned about Bill C-384 on euthanasia, and (unlike with same sex marriage) in this case I actually understand their concerns. I certainly also understand why people think the terminally ill should be allowed to die in dignity if they so desire. My problem is that the euthanasia bills tend to be terribly written, and when it comes to the subject of pulling the plug, you really want any guidelines to be very clear. It's not a matter you can half-ass.

In many countries, suicide is illegal. This has always seemed weird to me, especially since it's pretty hard to prosecute. I did know a girl who slashed her wrists and was actually arrested for it; she said the cops had serious trouble because the handcuffs kept sliding off. But this illustrates the simple mindedness of using cops to keep people from killing themselves. My guess is that the law exists mostly because societies believe it would be demoralizing for the state to give its imprimatur to suicide, and they might be right. Still, a law that is so difficult to enforce is a bad law.

This brings us to doctor-assisted suicide. Where I would agree with most euthanasia supporters is in the case of a desperately ill person who asks their doctor to help them to die peacefully and painlessly. In that case, I don't think the state really has any right to enforce the scriptural injunctions against suicide. Let's make that clear right now: I don't have any problem with a doctor carrying out the patient's wishes if they really want to end their suffering.

Where it becomes a bit trickier is when the person has never stated any desire to live or die, and cannot do so because of an accident or illness. There certainly are people who will never be resuscitated- in the case of Terry Shiavo, the brain damage was so severe that there was no hope that she would have ever regained sentient consciousness. In that case, I think I'm not alone in feeling like keeping her alive was cruelty to the point of being a sort of torture.

The problem arises in cases where there's a serious question about the quality of life. Terrie Lincoln is a woman in Rochester who was made a quadriplegic in a car accident at age 19. The doctors initially wanted to pull the plug because they didn't think her life would be worth living, even if she did survive. Anyway, she's alive today and working on a master's degree and, understandably, has a very different take on the experience! What troubles me about euthanasia laws is when we start tying to define in law whose life is worth living without case by case imput. I've known too many disabilities advocates in my time who would argue that only the individual can judge if their own life is worth living, and what worries me is able-bodied people deciding for another that, if they will live in the condition that Christopher Reeve spent his last years in, it's not worth saving them. We just watched a movie called The Diving Bell and the Butterfly (really:
Le scaphandre et le papillon ) in which the poor guy could do nothing but blink one eye, and he went on to write a memoir using a method of blinks! So, I don't feel able to judge what level of ability makes life worth living.

A specific problem with the Canadian bill is that it also includes mental illness as well as terminal illnesses. There are serious problems with assisting the mentally ill to commit suicide, not the least of which is that doctors could feasibly "treat" clinical depression this way. Or, what about a person whose mental illness is so severe that their family would rather not take care of them and, after discussing it with them, they seem to accept suicide? Can you really decide if you're not in your right mind? The law sets a vague standard of "lucidity", but how can that be determined, except on a case by case basis?

I'm also worried about unscrupulous relatives who don't think they can afford to support an elderly relative and would really like that relative to think about euthanasia. If you don't think something like that is possible, you've probably never met some of my family. Another concern is that, if euthanasia is made legal, it might be cheaper to do away with palliative care services altogether than continue as we do now. Probably the main reason that I think the Church has a point here is that there are doctors raising the same concerns about the bill, along with disabilities rights advocates.

So, I don't know that I don't agree with them on this bill. I don't agree with the Church on same sex marriage, as long as none of the laws force them to perform the ceremony. Otherwise, I see it as a civil matter. But, here I see the ethical questions and so I see the value of the Church taking part in the political discussion.

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