This past Friday, the Supreme Court of Canada ruled that the federal ban on assisting suicide violates the rights of Canadian citizens. As they put it here, "The prohibition on physician‑assisted dying infringes the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice." They ruled that the prohibition is "of no force or effect to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." The Canadian legislature now has twelve months to re-write the law to accommodate the view of the Supreme Court.
This is not the space for a full treatment of this subject (feel free to come to my upcoming talk on the subject at Shaarei Shomayim in Toronto on February 23rd). I will not go into halachah here, other than to say that Jewish law is very clear in forbidding actively ending a patient's life.
In this space, I'd just like to point out a tried and true legal principle: Hard cases make bad law. It would be inhuman and un-Jewish to deny the wishes of people who are suffering without remedy - but crafting legislation to address exceptionally difficult situations will produce laws that endanger the rest of society.
Here are some of the challenges such laws would need to address:
* Will we impose age limits, or will we go the way of Belgium, which permits the death of minors? In the Netherlands, a 17 year old - who cannot be trusted to vote - can override parental refusal and choose death.
* How will we avoid pressure on patients to choose assisted death? As Margaret Dore, a lawyer in the state of Washington, has testified from her experience with their legalized assisted suicide, the existence of this option leads to subtle and unsubtle pressure upon patients to choose death.
* Who will advise the patient in this matter? Will we ask doctors, who function as the protectors of our healthcare resources, to counsel patients on whether or not to tax those resources? [Indeed, the Royal College of Physicians and Surgeons of Canada notes that doctors must be able to "Appreciate the possibility of conflict inherent in their role as a health advocate for a patient or community with that of manager or gatekeeper".]
* Who will testify as to the patient's wishes, where the patient cannot speak? Paragraph 27 of Quebec's Assisted Suicide bill permits relatives to testify [only minors and members of the healthcare "team" may not do so]. Mind you, our Succession Law will not allow relatives to testify regarding the authenticity of a will, because of conflict of interest... but they could testify that a patient wanted to die?
* Will physicians be compelled to help end lives of patients? As noted by the College of Physicians and Surgeons of Ontario, physicians are not necessarily permitted to refuse to treat on moral or religious grounds.
* Who is going to pay for this - should OHIP (Ontario's provincial health insurance), which doesn't cover routine dental and eye exams, pay for death? [Paragraph 26 of Quebec's Act seems to say that Quebec's provincial health insurance does cover the cost of ending a patient's life.] And if not, then could a suffering person be denied death - a human right, per the Supreme Court - because he couldn't pay for it?
As I said above, we must find a way to help people who are suffering. But in my view, licensing assisted suicide is fraught with so many problems as to make responsible legislation an impossibility.