Canada has been urged to improve its provision of palliative care following a Supreme Court decision to legalise assisted suicide.
Following the unanimous decision by the court to overturn a 1993 ban on assisted suicide, the Catholic Bishops of Canada issued a statement decrying the move and calling on government to not only “interpret the judgement in the narrowest terms, resisting any calls to go beyond this to so-called acts of ‘mercy killing’ and euthanasia” but to work now to counter the ‘lure’ of assisted suicide with proper palliative care across the country.
“We call on provincial and territorial governments to ensure good-quality palliative care in all their jurisdictions,” the bishops stated, adding for all Canadians an invitation “to do all they can to bring comfort and support for all those who are dying and for their loved ones, so that no one, because of loneliness, vulnerability, loss of autonomy, or fear of pain and suffering, feels they have no choice but to commit suicide”.
In a separate statement, Vancouver’s Catholic Archbishop J. Michael Miller said: “At the root of the desire for assisted suicide is the fact that adequate palliative care is often unavailable, which can lead to thoughts of suicide. In order to provide hope for those who suffer, we call on all levels of government, the healing professions, and hospitals and care facilities to ensure truly equal and inclusive access to such care. We have the technology to control pain, and we have the ability to overcome loneliness and despair.”
In offering guidance to their decision, the Supreme Court judges stated that, in relation to the actual practice of assisted suicide: Patients must be competent adults who clearly consent to terminating their life; they must be suffering from “a grievous and irremediable medical condition … that causes enduring suffering that is intolerable”; Physicians cannot be compelled to assist those who want to die.
Both the court’s decision and its 12-month stay before final enactment has prompted much debate in Canada, with commentators pointing out that the government has to date been slow to follow up on its support, early in 2014, for Motion 456, a plan tabled by the New Democratic Party towards palliative care across Canada. Meanwhile, it has also been noted that neither the ruling nor current legislation deals with depression or mental illness as potential medical conditions under which a candidate for assisted suicide might claim intolerable suffering.
Just four of Canada’s ten provinces currently have structured palliative care provision.