You don’t ignore a mandate from the Supreme Court. But that seems to be the initial response from the Conservative government to the recent Carter decision on assisted suicide. The Supreme Court has given the government one year to draft legislation and yet after a short one-day debate in the House on the issue the Conservative response has been surprisingly laissez-faire. They have done nothing in response other than to have some back benchers complain that the court is being unreasonable and that the government needs more time.
The problem is the government has had lots of time. They knew this decision was coming. They could have taken steps to show that they understand the importance of dealing with end of life issues. For example, last year, Parliament passed the NDP’s Motion 456 to establish a pan-Canadian palliative and end of life strategy. The Conservatives gave their support to this important initiative but have done nothing to follow through.
To be clear palliative care and assisted suicide are very different issues. However, if the government was seen to take action on the huge shortfall in end of life care it could have gone a long way to alleviating Canadians (and the Court’s) concerns about people suffering from unbearable and incurable pain.
The Supreme Court has moved decisively because there has been a vacuum of leadership on this matter from the Harper Conservatives. If the Conservatives continue to stall, the issue will be punted to the provinces or to further court challenges. In such a vacuum, the courts could be inclined to interpret the right to die in a broader context. Either result — a patchwork of provincial legislation or further court action — is not something Canadians should embrace.
Since the Supreme Court ruling, Parliament has debated the issue for just one day. This came as a result of the Liberal party’s push for a special committee to implement the ruling on the right to assisted suicide. I agree with the Liberal position that if Parliamentarians work co-operatively we can meet the deadline imposed by the court and address the Supreme Court directive.
Where I disagree fundamentally with them however, is that a narrow focus on legalizing euthanasia would create a bizarre situation wherein a very small number of cases in extreme circumstances would be given the right to die, while the vast majority of the terminally ill would continue to die without the right to quality palliative care. (Efforts by the New Democrats to amend the motion to include action on palliative care was turned down by the Liberals.)
As Harvey Max Chochinov, the chair of Virtual Hospice has written, “Canadians will have a right to a medically hastened death but no right to quality end-of-life care.”
So why is action on palliative care so important? As it stands now, 70 per cent of Canadians do not have access to quality palliative care. Where palliative services exist, the experience for patients and families can be extraordinary. But where people do not have access to palliative care, it can be a huge stresser on the patient, family and the medical system itself.
It has been reported that one per cent of the population uses up 30 per cent of the health care budget (most often in end of life situations). Given these extraordinary costs you would think that both provincial and federal politicians would get the importance of making palliative options available.
It is also about dying with dignity. In my meetings with palliative care professionals I have learned that the vast majority of issues regarding pain and incurable suffering can be handled in a palliative setting that ensures that patients really are able to die in comfort.
Parliament needs to respond to the Supreme Court decision. New Democrats believe there is a huge role for federal leadership working with the provinces and territories on improving end of life care and options. The Conservative option of ignoring the Court is a recipe for real problems down the road. The liberal option of simply supporting assisted suicide will not address the major issues confronting end of life care. This solution lies in embracing the palliative approach.
It’s time Canadians became involved in a fulsome discussion on how to ensure that the terminally ill are provided the care and dignity they deserve.