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Donald Low made impassioned plea for assisted suicide September 25, 2013

Posted by rogerhollander in British Columbia, Canada, Civil Liberties, Health, Quebec.
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“I am not afraid of dying,” Dr. Donald Low said in a video made shortly before his death from cancer, “what worries me is how I’m going to die.”

Eight days before he died of a brain tumour, Donald Low, one of Canada’s eminent microbiologists, summoned his waning strength in a video plea for assisted suicide.

“Why make people suffer for no reason when there is an alternative?” he asked, adding an authoritative medical voice to a surging national debate.

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“He wanted to say something public about the struggle he went through to [try to] have an assisted death, preferably with the types of barbiturates that are available in the countries that allow it,” his widow, Maureen Taylor, said in an interview about the video, which went live Tuesday.

Dr. Low, who died Sept. 18 without assistance, was the infectious disease expert who became the calming voice and medical face during the SARS crisis a decade ago. He was diagnosed with a malignant brain tumour seven months ago.

“I am not afraid of dying,” he said in the video, “what worries me is how I’m going to die.”

He wondered aloud if he would end up paralyzed, unable to swallow or even talk with his family while he endured a protracted and painful death.

Even before his diagnosis, Dr. Low, 68, was in favour of legalizing medical assistance for “people who were terminally ill and of sound mind,” Ms. Taylor said, but it wasn’t until he was facing his own imminent demise that he tried to turn theory into reality. “There is no place in Canada where you can have support for dying with dignity,” he concluded.

The couple talked about going to Switzerland, where non-residents can swallow a toxic potion and fall into a terminal sleep, but “he wasn’t prepared to go away to die without his kids and my kids around him,” said Ms. Taylor. And he wanted to be here for the anticipated birth of a grandson in July and the wedding of his stepdaughter in late August. They also investigated speeding his death with helium, but “if I was caught buying the gas tanks, then I could have gone to jail,” she said.

Time was running out when the videographers from the Canadian Partnership Against Cancer arrived in early September. “Don wasn’t able to speak fluently, but he pulled it out of a hat,” Ms. Taylor recalled. Hearing was also a problem. Ms. Taylor had to relay the producer’s questions because hers was the only voice her husband could still distinguish. But there is no mistaking the challenge that the dying physician issued to doctors who oppose assisted suicide: “I wish they could live in my body for 24 hours. … I am frustrated not being able to control my own life.”

Dr. Low isn’t the only dying patient to rail against Canada’s prohibition against assisted suicide. Twenty years ago, Sue Rodriguez, a British Columbia woman with ALS, took her request for medical help in ending her life to the Supreme Court of Canada. Ms. Rodriguez lost her challenge, but the debate continued.

In June, 2012, the British Columbia Supreme Court ruled that the Criminal Code section on assisted suicide was discriminatory and suspended the decision for a year to give the federal government time to draft a revision. Instead, the government has appealed the BC ruling.

Meanwhile, Quebec tabled right-to-die legislation in the National Assembly last June. Committee hearings into Bill 52, which contains the most radical end-of-life options of any jurisdiction in North America, began last week and are scheduled to continue into October. Among the witnesses expected to appear are representatives from Alzheimer’s and disabilities associations and experts on all sides of the debate, including professors Jocelyn Downie of Dalhousie University and Margaret Somerville of McGill University.

B.C. Supreme Court strikes down ban on doctor-assisted suicide June 16, 2012

Posted by rogerhollander in Canada, Civil Liberties, Human Rights.
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Published On Fri Jun 15 2012

www.thestar.com

 

The stunning decision Friday gives Gloria Taylor, a 64-year-old woman with late-stage ALS, a constitutional exemption to proceed with physician-assisted suicide. </p><br />
<p>” /><em>The stunning decision Friday gives Gloria Taylor, a 64-year-old woman with late-stage ALS, a constitutional exemption to proceed with physician-assisted suicide.</em>JONATHAN HAYWARD/THE CANADIAN PRESS</p>
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By Petti FongWestern Bureau
 
 
 VANCOUVER—A terminally-ill woman has the right to have a doctor-assisted suicide following a landmark ruling Friday by a B.C. Supreme Court judge who found current right-to-die laws are discriminatory and unconstitutional.

Justice Lynn Smith granted Gloria Taylor, who has late-stage ALS, or Lou Gehrig’s disease, a constitutional exemption to proceed with physician-assisted suicide.

The ruling does not immediately open the door for assisted suicide for anyone who wants one. Smith placed a 12-month suspension on her ruling to give Parliament time to write new legislation, or for the anticipated appeals that will be brought forward by the provincial and federal governments that argued against changing the current laws.

For now, Taylor remains the only Canadian with a legal exemption to have the option of a doctor-assisted suicide, a decision that her lawyer said the woman has not yet made.

“It’s obviously a very profound decision she has to make and whether she makes it or when she makes it is entirely her decision,” said Joe Arvay. “This has been a very difficult time for her.”

Arvay said he knew as soon as he read the first paragraph of Smith’s ruling that Taylor would get the right to have a doctor-assisted suicide.

“I describe the evidence and the legal arguments that have led me to conclude that the plaintiffs succeed in their challenge,” Smith wrote at the beginning of her 395-page ruling. “They succeed because the provisions unjustifiably infringe on the equality rights of Gloria Taylor and the rights of life, liberty and security of the person.”

The ruling Friday, following a hearing that began last November in B.C. Supreme Court, has long been sought by right-to-die organizations in Canada and long fought against by anti-euthanasia groups.

Dr. Will Johnston, a family doctor in Vancouver with the Euthanasia Prevention Coalition, said an appeal will most certainly be launched.

“The breadth of this case means anyone with an identifiable illness could have the means of suicide provided or be directly killed by anyone acting under the general supervision of a doctor,” said Johnston. “There is no requirement specified for a doctor to be present at the time of death.”

Johnston said there is no law that can be crafted that addresses the problems that have been raised by the B.C. Supreme Court judgment such as the potential for elder abuse.

The Friday ruling found that the Supreme Court of Canada decision in 1993 that absolutely prohibits doctor-assisted suicide in order to prevent vulnerable people from being induced to commit suicide at times of weakness, is not demonstrably justified under the Charter of Rights.

In Taylor’s case, the judge found that not allowing her to have a doctor-assisted suicide violates her Charter rights in Section 7, which gives her the right to life, liberty and security and in Section 15, which guarantees her equality.

While it is not illegal to commit suicide, the ruling concluded that the assisted-suicide law discriminates against people with disabilities because they need assistance.

Taylor, a divorced mother of two grown sons and a grandmother to an 11-year-old girl, was one of five plaintiffs in the suit seeking to overturn the current legislation.

Of the plaintiffs, Taylor became the lead because her condition is the most dire. Her lawyers, from the B.C. Civil Liberties Association, specifically sought for an exemption from the courts that would allow Taylor to proceed with an assisted suicide.

She will be allowed to have a doctor-assisted suicide if she meets a number of conditions set out by the judge, which include an assessment from a psychiatrist and confirmation from her physician that the woman has been fully informed about her prognosis and the ability of drugs and palliative care to alleviate her suffering.

Taylor, of Westbank, B.C., was diagnosed with ALS, a motor neurologically degenerative disease in 2009. In January 2010, she was told by her doctors she would likely be paralyzed in six months and die within the year. She has fared better than predicted and her condition plateaued over the last year. But over the last few weeks, her condition has again deteriorated; she must often use a wheelchair and requires a feeding tube.

Taylor’s case is similar to the landmark case brought to the courts by Sue Rodriguez, a Victoria woman who also had ALS and wanted to get a doctor-assisted suicide. Rodriguez’ case, which went all the way to the Supreme Court of Canada led to the 1993 narrow 5-4 decision which ruled assisted suicide was a criminal offence.

Canada should legalize assisted death, report concludes November 15, 2011

Posted by rogerhollander in Canada, Civil Liberties, Criminal Justice, Health.
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http://www.thestar.com/news/article/1087017–canada-should-legalize-assisted-death-report-concludes?bn=1

Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.

REUTERS FILE PHOTO

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By Megan OgilvieHealth Reporter

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Canada should legalize assisted suicide and voluntary euthanasia for competent adults who have decided their life is not worth living, according to a sweeping new report on end-of-life decision making in Canada.

The report, released Tuesday in Ottawa, recommends that Canada create a “permissive yet carefully regulated and monitored system with respect to assisted death.”

It also recommends governments increase access to palliative care and cover end-of-life planning discussions under health insurance plans. And it says the country needs legal clarity and clear guidelines about some end-of-life practices, including terminal sedation and the use of some pain treatments that may shorten a person’s life.

The report will likely spark renewed controversy and heated discussions about whether people should be allowed to choose when and how they want to die.

The findings of the Royal Society of Canada Expert Panel are out the same week a case is being heard in B.C. Supreme Court that is challenging the country’s laws against assisted suicide. Currently, it is illegal to counsel, aid or abet a person to commit suicide.

Eighteen years ago, the country’s highest court rejected the case of Sue Rodriguez, a B.C. woman in advanced stages of ALS, or Lou Gehrig’s disease, who argued the criminalization of assisted suicide violated her constitutional rights.

Since then, other countries and jurisdictions have legalized assisted death, including Switzerland, Belgium and the Netherlands, and the U.S. states of Washington, Oregon and Montana.

The expert panel report, commissioned by the Royal Society of Canada, the senior national body of distinguished artists, scientists and scholars, is the first in-depth look at end-of-life issues in this country in 15 years.

The international panel, whose six members have expertise in clinical medicine, philosophy, bioethics and health law and policy, looked at all aspects of end-of-life decisions and care.

Panel chair Udo Schuklenk, professor of philosophy and Ontario Research Chair in Bioethics at Queen’s University, said the lengthy report and its conclusions should serve as a trigger for a new national conversation about end-of-life laws and practices.

He noted that although the topic is emotionally charged, it is important to have such discussions in spite of profound disagreements over whether the country should decriminalize assisted death.

“In Canada, we find people simply do not talk and do not plan enough about the end-of-life,” Schuklenk said at an embargoed online press conference Monday. “As a nation we have failed to develop coherent policies and set sufficient standards of end-of-life care.”

Dr. Ross Upshur, panel member and director of the University of Toronto’s Joint Centre for Bioethics, said thinking and talking about end-of-life issues is important for every single Canadian because “whether we like to think of it or not we are all mortal.”

In a literature review, Upshur found that Canadians are willing to engage in a discussion on end-of-life issues and that most would support a more permissive legislative framework for voluntary euthanasia and assisted suicide.

He also stressed that too few Canadians are having meaningful conversations about their final days with their family or their physicians.

“With the advances of modern technology there is more that physicians can do to extend and maintain life,” Upshur said, noting these advances make it even more important for Canadians to make end-of-life plans.

The panel drafted 24 recommendations for the reform of end-of-life care in Canada.

They include, among others:

  Government and health care institutions should educate Canadians about how to complete advanced-care directives, and should work to ensure these directives can be accessed no matter where a patient receives care.

  Government should cover end-of-life planning discussions under health insurance plans.

  Government should increase access to palliative care and expand its scope beyond that for cancer patients.

  Health care providers, regulators and prosecutors should develop clinical practice and prosecutorial charging guidelines on potentially life-shortening symptom relief and terminal sedation.

  The federal government should modify the criminal code so that in “carefully circumscribed and monitored circumstances” assisted suicide and voluntary euthanasia are legally permissible.

  Health care providers should be allowed — but not obliged — to provide voluntary euthanasia and assisted suicide.

  Granting a request for assisted death should only be done when that person’s request is voluntary and informed and that individual has been deemed competent.

  There should be a national oversight commission to monitor and to provide annual, public reports on voluntary assisted deaths.

  The provinces and territories should consider implementing a restorative justice program for voluntary assisted deaths until the practice is decriminalized.

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Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.

 

What assisted suicide really looks like May 25, 2011

Posted by rogerhollander in Civil Liberties, Health, Oregon.
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Wednesday, May 25, 2011 11:01 ET

Having been through this experience, I know how harrowing it is — and so does HBO’s “How to Die in Oregon”      Video

By Zoe FitzGerald Carter

Courtesy of HBO
Cody Curtis

The new documentary “How to Die in Oregon” opens with footage of Roger Sagner, an elderly man with advanced cancer, demanding that he be given a lethal dose of drugs. His impatience — and absolute lack of ambiguity — is startling. After swallowing a milky concoction of Seconal in one long gulp, Sagner thanks his family and the voters of Oregon “for allowing me the honor of doing myself in,” lies down on a bed under a large picture window, and begins to sing.

“I’s coming, I’s coming. Oh my head is hanging low. I hear the gentle voices calling … Old Black Joe.”

His final words? “It was easy, folks. It was easy.”

Watching this documentary (which airs on HBO this Thursday), however, was not. In fact, it took me three separate viewings to get through my advance copy. Given that my mother ended her life after struggling with Parkinson’s for many years, an experience I wrote about in my memoir, “Imperfect Endings,” I was perhaps especially predisposed to find it difficult viewing. But apparently even hardened HBO staffers couldn’t sit through the entire film, and the film’s publicity team at this year’s Sundance was astonished at the reluctance of the media to attend the screening.

This is unfortunate because, while the film does ask its viewers to be willing to be moved and, yes, saddened, “How to Die in Oregon” is a well-crafted, beautifully understated film about an important topic: whether people should have the legal right to end their lives. Without resorting to Michael Moore-type polemics, director Peter D. Richardson follows a half-dozen terminally ill people as they go about the business of planning the end of their lives under Oregon’s Death With Dignity Act. (Passed in 1994, the law makes it legal for physicians to provide “aid-in-dying” for their terminally ill patients.)

Although Richardson clearly supports individuals’ rights to end their own lives, he keeps the proselytizing — and the politics — to a minimum. Instead, he gives us a series of fly-on-the-wall scenes with patients, as well as interviews with oncologists, activists and volunteers. We see how planning for death can involve everything from the mundane (filling prescriptions, giving away one’s clothes and jewelry, even getting a final haircut), to the wrenching and the profound (tearful conversations between family members, and the final recording of a personal eulogy by an 84-year-old terminally ill broadcaster named Ray Carnay). And thankfully, we see people who, despite being in pain and close to the end, have maintained a sense of self — and even a sense of humor, although largely of the gallows variety.

But the warm, beating heart of “How to Die in Oregon” is Cody Curtis, a lovely, articulate 54-year-old wife and mother who has liver cancer. We see her taking walks with her daughter, meeting with her doctor, and joking with her husband all while stockpiling barbiturates and planning her own death. Although in good shape when the film opens, she has suffered the cruel effects of her disease and is determined not to repeat it. “I’m not going to die with the fluid oozing out of the pores in my legs,” she says in one of numerous interviews. “I’m not going to lose my hair again. I’m not going to weigh 200 pounds again. I’m not going to be humiliated with losing control of my bodily functions again.”

In short, she plans to get out while the getting is good, an attitude shared by my mother whose need for control made the Parkinson’s endgame intolerable. But unlike my family, in which my sisters and I debated about whether my mother was actually serious about ending her life, and tried to talk her out of it, the Curtis family is remarkably unified in their support. Her son, “T,” does express some trepidation about the death itself — something I could relate to — but none of them challenges her decision.

As death circles closer, Cody openly shares her shifting emotions, often moving from tears to laughter in the space of a sentence. By contrast, my mother never cried, never expressed any doubt, and never asked us how we felt about being there when she ended her life: She maintained a stoic, unsentimental attitude right to the end. And while I’ve always chalked this up to emotional reticence on her part, when Cody tells the filmmaker, “I want to model for my children a kind of grace and acceptance because I’m really scared of being a coward at the end,” I wondered if my mother was also protecting us from the burden of her ambivalence.

Of course, Cody is anything but a coward in the end and her last words — “This is so easy … I wish people knew how easy it was” – echoes Sagner’s in the beginning of the film. Although this bookending of sentiments may have been coincidental, it does highlight the film’s one-sidedness. With one notable exception, there are very few dissenting voices in “How to Die in Oregon.” That exception is Randy Stroup, a 53-year-old uninsured Oregonian with prostate cancer who was denied coverage for additional treatment by the state. In a letter to Stroup, they suggested he look into doctor-assisted suicide instead. Although the state reversed its decision after he went public, his understandable bitterness – “They’ll pay to kill me, but not to help me!” — provides a disturbing counterpoint to the rest of the film.

Having never understood the argument that laws like the one in Oregon might imperil the uninsured and disadvantaged, I found Stroup’s story eye-opening and I would have liked to hear more of a rebuttal or discussion. Also, given that assisted suicide is legal in only three states in this country and we have right-wing pundits shouting about “death panels” every time healthcare reform comes up, it would have been useful to get a better sense of the larger debate. As a strong supporter of the Death With Dignity laws, I am reluctant to give those who oppose them more of a platform, but I think the film would have benefited from their inclusion.

And yet, Richardson’s decision to eschew overt politics — both pro and con — in “How to Die in Oregon” allows him to do something more quietly radical: to show real people talking honestly with each other about their own impending deaths. In this death-phobic society where doctors offer sure-to-fail, last-ditch treatments instead of gently telling their patients to go home and prepare for death, Richardson’s film is a much-needed antidote.

Zoe FitzGerald Carter is a journalist and author of the memoir, “Imperfect Endings: A Daughter’s Tale of Love, Loss, and Letting Go” (Simon & Schuster). She can be reached at http://www.imperfectendings.com/

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