By Jasminee Sahoye
As the dialogue continues on the recent Supreme Court ruling that Canadian adults who are mentally competent and suffering intolerably and permanently have the right to a doctor’s help in dying, a study done in Barbados almost 10 years ago which included this issue showed it was not well received.
The court suspended its ruling for 12 months to give the Canadian government, medical regulatory bodies and the provinces a chance to draft new laws and policies around assisted dying. It said doctors have the ability to address whether an individual is capable of consent and said the intolerable suffering can be physical or psychological.
The Barbados study, Knowledge, Attitudes and Practices of Health Care Professionals Towards Care Ethics: A Perspective from the Caribbean, was doen by Dr. Seetharaman Hariharan. Ramesh Jonnalagadda, M.S. and Jagathi Gora, M.S., School of Clinical Medicine & Research, The University of the West Indies, Queen Elizabeth Hospital, Barbados.
It received full participation from 364 respondents to a number of questions, including, “If a patient wishes to die, he or she should be assisted in doing so?” Just 3.7 % agreed.
Except on the issue of whether “Patient wishes should be always adhered to”, there were statistically significant differences in the opinions between professional medical staff and support staff. This implied that medical and nursing professionals had significantly stronger opinions compared to other staff (paramedical staff, maids, porters, clerical staff, etc.) in most issues regarding ethics.
“For the question regarding the source of the knowledge of ethics, 9% of the respondents answered that they got their ethics knowledge from the church. When asked about the preference of whom to consult if one wanted to discuss an ethical problem, 14% included their priests along with others such as the head of their departments and immediate supervisors, while 1.4% answered that they will choose exclusively their priest to discuss the problem,” the study authors said.
The Canadian ruling comes 22 years after the court narrowly rejected the claim of Sue Rodriguez, 42, who was dying of amyotrophic lateral sclerosis, to the right to a physician’s help in ending her life. The current case involved two women, both now dead: Kay Carter, who died in 2010, and Gloria Taylor, who suffered from the same condition as Rodriguez and died of an infection in late 2012.
The court’s ruling quoted Taylor’s wishes at length.
“What I fear is a death that negates, as opposed to concludes, my life,” she said. “I do not want to die slowly, piece by piece. I do not want to waste away unconscious in a hospital bed. I do not want to die wracked with pain.”
Peter MacKay, minister of justice and attorney general, said “this is a sensitive issue for many Canadians, with deeply held beliefs on both sides. We will study the decision and ensure all perspectives on this difficult issue are heard.”
The Canadian Medical Association (CMA) says it supports physicians being able to follow their conscience in choosing whether to participate in medical aid in dying.
“The CMA policy recognizes that there are rare occasions where patients have such a degree of suffering, even with access to palliative and end-of-life care, that they request medical aid in dying. We believe in those cases, and within legal constraints, that medical aid in dying may be appropriate …”
Critics of the ruling said it puts disabled people at risk. In a joint statement, the Council of Canadians with Disabilities (CCD) and the Canadian Association for Community Living (CACL) said they are “profoundly disappointed” with the ruling.
“As we each near the end of our lives, at the time when we are likely to be most vulnerable to despair and fear, we have now lost the protection of the Criminal Code,” the groups said. “Where shall we now find that protection? CCD and CACL caution that our collective response to this question must go far beyond the technical exercise of so-called ‘safeguards’.”