Death with Dignity - Process Matters

DEATH WITH DIGNITY is a right, that should never have had to have been granted, but a right that is inherent in our humanness as determined by our ability to reason.  The Charter of Rights and Freedoms holds as equity millions of lives and more than 300 years of toil, it is a beautiful document, it should be respected.

The following is discourse on the functionality of Bill 14 legislation that would ensure people can exercise choice AND would ensure that DEATH WITH DIGNITY stays entirely in the hands of people. Our country is institutionalized and people tend to forget that Canada is in no way collective citizenry, but rather, a collection of individuals. Thankfully now, with the Charter of Rights and Freedoms, individuals have choice and the government is compelled to provide it absent any influence other than to administer “interface” between people.

   

The critical element in this legislation is that functionality builds a firewall between the state administering “treatment” and the choice to access DEATH WITH DIGNITY measures. The present DEATH WITH DIGNITY process as posited by Bill C 14 is dangerous in the extreme.

CLICK HERE: PRIOR DISCOURSE ON DWD BILL C 14

“PRIOR DIRECTIVES” are essential in administering DEATH WITH DIGNITY measures, while provisions are required for persons absent PRIOR DIRECTIVES; PRIOR DIRECTIVES need to be a part of the mix.  There are basically three management categories for people wanting DEATH WITH DIGNITY measures; PRIOR DIRECTIVE in place (no competency or competency in place), No PRIOR DIRECTIVE in place with competency and No PRIOR DIRECTIVE absent competency. 

Click here: MY PROFESSIONAL WEBSITE

PRIOR DIRECTIVES need to be managed in a manner that informs medical personnel of DEATH WITH DIGNITY triggers and measures, in and for actuation, in a standardized way and the fact that there is Prior Directive in place (as opposed to the "document" itself) and must be registered centrally.  In this way, if an event that removes mental competency occurs there are means in place to have people’s wishes attended to and all relevant family and or designates informed.

The Registry would contain the fact there is a PRIOR DIRECTIVE in place and contacts provided by the patient at the time they registered.  This facilitates strict privacy requirements AND allows for circumstance where people arrive to care absent mental competency to be cared for as they've directed.  The registry would be managed by the respective jurisdiction or it could be nationwide and managed co-cooperatively if various jurisdictions if agreed.

People with PRIOR DIRECTIVES would have no requirement for court proceeding as the process precludes; an immediate assessment of choice, the application of institutional maleficence or other duress.

Click here: MY PROFESSIONAL WEBSITE

In the event a person wants to access DEATH WITH DIGNITY measures absent a Prior Directive and they have mental competency, then all the processes laid out in the present iteration of the legislation must be actuated PLUS, an expedited court process. The aforementioned registry could also serve as a gazette to notify people of pending court processes and requirements to notify next of kin must be in place. A special process measured in hours would require that a court process be initiated, announced via the gazette, reasonable effort to notify next of kin is made, opportunity for intervenors is provisioned and finally the order is provided. This order process would be similar to the “bench order process”: very quickly executed, no hearing required, unless next of kin offered objection or someone applied for intervenor status.

In the event that an individual enters care absent mental competency and absent a PRIOR DIRECTIVE, then all medically necessary measures to sustain life must be undertaken.

It must be emphasized that under no circumstance can state representatives of any kind in any number authorize the ending of life. The provision for two doctors’ opinions absent judicial oversight is sheer folly and obscenely irresponsible from the perspective of vulnerable populations and the possibility of measures being misdirected in some way.

Click here: MY PROFESSIONAL WEBSITE

People have the right to choose their own course in life and in managing life’s end, the state's only role here is to ensure that people’s wishes are attended to and facilitated, that interface between conflicted parties is managed and that the vulnerable are protected. Bill C 14 is failing on all counts. 

Death with Dignity - BILL C 14 Change Please

It is fundamental that an individual holds domain over mind and body, this is the paramount concern in drafting legislation of this sort and this legislation is failing in this concern. The recent attempt at DEATH WITH DIGNITY legislation is weak to say the least, it institutionalizes a personal choice, it makes arbitrary the decision to actuate “treatment”, it fails to attend to legal review, it reduces the safety to the individual that exists now, it seems to preclude the right to offer written authority prior to events of ill health taking place and perhaps worse, it fails to subordinate itself to the Charter of Rights and Freedoms.

Please Note: I am waiting some verification - this a 1st DRAFT

Link to Bill C 14
http://www.parl.gc.ca/HousePublications/Publication.aspx?Language=E&Mode=1&DocId=8183660

All legislation exists under the umbrella of Section 7 of the charter and all legal concern contemplates its application from the perspective of “reasonable” state intrusion on section 7 rights. The fundamental under pinning here is CHOICE. To be at liberty, is to be able to choose and when one chooses something absent harm to others, the state has no authority to intervene and where possible the state should facilitate a chosen action. There are moral concerns of a specific nature being forwarded in the resistance to this legislation and the manner in which choice to DEATH WITH DIGNITY has been “watered down” here. This represents gross intrusion on many fundamental rights that support an individual’s autonomy.

CLICK HERE: Letter to Peter MacKay, past Justice Minister

DEATH WITH DIGNITY is in no way a medical decision, the decision to die is a profoundly personal one, once the choice to seek medical aid to die is made, the medical decisions are in the actuation of the act – how, where when. The only impediment to the choice to end one’s life should be the presence or absent of mental competency as determined by standardized legal tests for mental competency and under the presumption of competency.  Rational people choose to live, unless affected by a complex of factors to choose to die; the perception of legitimacy of those factors as a rationale for choosing to die is a profoundly personal one and one that the state has no place to influence.  So the state putting parameters on the reasons for seeking DEATH WITH DIGNITY breaches sections 7 rights. Medical personnel should be acting on the request of a rational person as opposed to their perception of reality. The determination of grievous and irremediable (medical) condition should lie with the person whose choice it is to make and if this was the case, the term of the condition would have no relevance.  

Click here: MY PROFESSIONAL WEBSITE

With this legislation the state  imposes itself once again on the rights of parents to manage their children’s lives in accord with their specific culture and values. There has been an increasing propensity for the state to encroach on parental choice, an offensive trend. Who better to manage the fate of a child than the ones that love them most?

Suicide, as it is widely perceived, as an aggrieved person taking their own life at a moment of lost perspective, is by any measure an unreasonable act and should in no way be associated with a person seeking DEATH WITH DIGNITY measures.

Click here: MY PROFESSIONAL WEBSITE

The only reason that vulnerable people are put a risk with DEATH WITH DIGNITY legislation is if you institutionalize the process. My making a choice to seek solution to use DEATH WITH DIGNITY measures, in no way imposes on another human being; save the emotional effect on love ones. When you place decision making in the hands of the state, then you expose vulnerable people to risk. The only barrier now to medically induced death in practice, is the opinion of two doctors, there is an absence of judicial review – this is a very dangerous circumstance. There should be an expedited court functionality to facilitate rapid judicial review and opportunity of intervenors to offer weight to court deliberations in circumstances where mental competence is in question. In this way, if the event is being exercised against the interests of the person of subject, third parties can seek intervenor status – that is to say “trusties” may be authorizing medically induced death in circumstance where information is incomplete. If you choose to regulate this choice with law, you require LEGAL process to manage it, if you’re going to insist this is an institutional decision then you require LEGAL process to manage it – two people saying it’s okay is insufficient and it is arbitrary. It is better to insist that the “system” is required to respond to clearly stated wishes related to DEATH WITH DIGNITY and leave all legal and moral onus on the individual.  

It is essential that people be given right for prior directives or better, that prior directives are made mandatory and can be confirmed by family or designates. In doing so the state is barred from in anyway influencing the use of medically assisted death. The provisions provided make no mention of designates or family, it is conceivable, or functionally possible, that medically induced death could be implemented entirely by state actors or strangers, by the co-operative action of four or five people with no judicial review. There can never be a circumstance where a state actor or collection of state actors can facilitate the death of a citizen FOR ANY REASON, humane or otherwise, and most certainly never absent judicial review.

Authorization to for DEATH WITH DIGNITY measures should come from the person affected and no government institution should be provisioned the capability to make that decision on someone’s behalf – functionally it could happen under this law. This being an essential part of crafting this legislation, it follows that it be mandatory that people provision documented directives in advance with their verification at the time of actuation OR verification by a designate; certainly absent advanced directives, judicial review becomes critically important.

The passion that I feel in regard to this issue is driven in large measure by my experience with my own mother, she expressed clearly to me on numerous occasions what her wishes were, she had a stroke and was incapable providing consent – this legislation would force me through the same scenario as I went through, having to let her dehydrate; a most inhuman circumstance.

I believe in Section 7 of the Charter of Rights and Freedoms, this government has forgotten that it has historical equity in the Charter of Rights and Freedoms and has failed to subordinate itself to the Charter of Rights and Freedoms and all our ability to hold domain over mind and body is diminished because of this.

Click here: DEATH WITH DIGNITY - PROCESS

Click here: MY PROFESSIONAL WEBSITE

GENERAL COMMENT ON LAW AND A DISTURBING TREND

"It is the case that in the practice of law, that the minutia tends to take us away from justice, the big picture. In Canada we have a circumstance in play that has the erosion of fundamental law occurring at an alarming rate. If you have a deep belief in common law and its fundamental tenets that are the foundation of our system, then you will share my concern with respect to this disturbing trend, a trend that has expediency trump due process. There are a number of examples of this trend throughout the system, no more glaring however, than the BC Mental Health Act. An act that has drifted away from fundamental law, and that was drafted and is now administered is a manner that flouts common law traditions and the charter. We need to be very wary of the “tribunalisation” of legal process, as it has been applied here a number of ills have emerged; not the least of which is the stagnation of statute absent exposure to court process and alterations due to its administration in the face of precedent effect. We need to ensure that people have the benefit of the “full due process” that courts provide. We need to protect evidentiary process. We need to ensure that the standard of review is commensurate with state sanction. We need clarity in law. We need the absence of arbitrariness. " Bill C14 as written puts far to much power in the hands of medical professions and negates due process - in much the same way the BC Mental Health Act. does. 

Death with Dignity - Our Right Our Choice

Honourable Peter Gordon MacKay

Minister of Justice and Attorney General 

Email: peter.mackay@parl.gc.ca

RE: Supreme Court Decision – Death with Dignity

I am relieved at the Supreme Court's decision to allow us to manage our own life’s end. It is fundamental that we, as free people, retain the right of dominion over mind and body. One always wishes to live forever, we all come to the end, and when we do, we should be permitted to manage it.

I have advocated for this approach aggressively over the years. I sat through my mother’s death; we removed the intravenous and watched her die for 3 days. It was an utterly stupid circumstance, her death was a foregone conclusion, and we were forced to sit, watch her suffer and wait for the inevitable; this is emblematic of “palliative” practices in play now.  I loved my mother, I cared for her without government help, and then I had the government between her and me in her passing, she suffered for no reason – her fate and the fate of millions who have suffered rests on the heads of people who have distorted the compassion that Christ himself taught us.

The management of one’s own life end is an extremely personal matter, the state has no role to play here, save to ensure that people’s wishes are respected. Much of the challenge with ceding choice to the individual on this matter emanates from an archaic interpretation of Christian Theology. The Christian moral complex has served us well in most regards, where it is failing us or where it bumps up against freedom of choice, the state is obligated to side with the individual – that is what a secular democracy requires.

The constant refrain against death with dignity from the people with disabilities is unwarranted. One understands their concern in the context of government conduct in the past, that is to say, programs like state-sanctioned sterilization terrify us all. The same progress that is facilitating the choice this court decision provides, has quelled any inclination that anyone rational actor might have in treating the disabled in a way that is untoward. The concern expressed by many in the disabled community with regard to the systemization of their demise is grossly insulting to us all, or to suggest that we would stand by while people were encouraged to end their lives is equally insulting. The fears are unfounded, we are becoming increasingly more concerned that the disabled community finds its way into society, the whole trend in Canadian society is to become more inclusive.  This group’s fear should in no way affect my choice to end my life as I see fit.

There seems to be a generalized mindset from opponents to the right to choose to end one’s life that somehow the government will, or other actors, begin to take control of that choice. The fearmongering about the systemized euthanizing of our old people or the disabled. These are irrational comments, we are effecting a state of CHOICE, the only way someone can have their life ended is by choice. These irrational arguments and fearmongering emanate from the desire to impose a single moral complex on the entire population, the state has no place in the imposition of morality; morality is best dealt with in the civil society. The sanctity of life is in no way diminished by extending the choice to people to have a dignified end or an end of their choice, the quality of life itself, however, is bolstered.  

The key element of “regulation” or law in this matter is to ensure that CHOICE resides with the individual in totality. This must be ensured by the government, the only means that a Doctor’s assistance to end life is rendered is by the direction of the affected individual OR by a written directive in the form of a living will.  It is critical that this is never a “medical” decision, or a decision of medical personnel or a government representative, this must always be isolated from the state and to the individual. By way of example, should a ward of the state fall into a circumstance that is terminal and be rendered unable to offer clear direction to the state or is deemed absent of capacity to choose, then all the conventions for the preservation of life or hitherto conventions of palliative care must be applied. Provisioning this, loud and clear, in the legislation sees to the liberty of the competent and addresses the concerns of the frail and disabled.  

The days of government managing the personal lives of the populace are waning, the Canadian population is generally progressively inclined, well-educated and very competent – they are best suited to run their own lives. I adhere in the main to the Christian moral complex, which is what shaped me; education and study have informed any choices I make outside that complex – that is my right and my choice. Others may make choices to live under a different code perhaps, which is their choice and their right. One has to have confidence in their belief system’s validity to accept the presence of another under Canada’s dominion, it is theological insecurity that is fueling opposition.

We are a secular democracy as opposed to a theocracy; we need to work to support that in the context of a morality-neutral public square, that is to say, the public square needs to facilitate the innate right to maintain a given morality when exposed to the public square. By ensuring the choice to end one’s life resides solely with the individual, we ensure the public square is neutral – my making a choice in private has no influence or effect on others. This is the spirit of Section 7 of the Charter of Rights and Freedoms and is supported by the subsequent court process, that our actions absent threat of harm, or harm to others, are permitted.

   

Please encourage your counterparts in government to be courageous in forwarding the right to hold dominion of one’s mind and body, it is the most fundamental element of human existence, and it is the most sacred responsibility of governance.   

Thank you for your work and leadership thus far.

Kind Regards,

Neil E. Thomson