PHIL 1040G Tutorial #4
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PHIL 1040G: Ethic, Law, and Politics
Tutorial #4
Medical Assistance in Dying (MAiD)
Became legal in 2016. Governed by Bill C-14 which (i) outlines who is eligible to provide MAiD and (ii) establishes exemptions for physicians, nurse practitioners, pharmacists and others who assist in MAID (otherwise would be subjected to criminal offences). Bill C-14 is an amendment to Sec. 14 and 241 of the Criminal Code of Canada (CCC).
Sec. 241
- Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than
14 years who, whether suicide ensues or not, (a) counsels a person to die by suicide or abets a person in
dying by suicide; or (b) aids a person to die by suicide. Sec. 14
- No person is entitled to consent to have death inflicted on them, and such consent does not affect
the criminal responsibility of any person who inflicts death on the person who gave consent.
To request MAiD, patients must (1) be competent, (2) request it voluntarily, (3) be diagnosed with an untreatable medical condition, and (3) provide informed consent. Key Issues and Controversy
The protection of vulnerable peoples (elderly, disabled, mentally ill).
People might change their mind immediately after receiving the medication, but the action is final.
‘Thin edge of the wedge’ and ‘slippery slope’ argument—if we allow MAiD for an untreatable medical condition then we make it more likely that it will be allowed for an untreatable medical condition. How can this be? Ambiguities around eligibility/criteria for MAiD, e.g., How can we be certain the request is voluntarily? What does terminal illness mean (2-5 years versus 2-3 months)? The CCC, MAiD, and the Moral Value of Autonomy What does autonomy mean? It is tied to concepts of freedom, liberty, and quality of life. A lack or loss of autonomy can be experienced as suffering and a diminished quality of life.
Rodriguez v. British Columbia:
Sue was diagnosed with ALS (1991) and given 2-5 years to live. Her case was grounded on Sec. 17 of the Charter and denied. The court argued that a regulated scheme of MAID could not reliably protect the vulnerable. The basis of their decision was Sec. 15 (equality rights), not 7 (life, liberty and security of the person). B.C. argued it was in their interest to protect Sue’s life. They worried that lifting the
prohibition would lead to abusing the right to MAiD, especially in vulnerable groups (e.g., lifelong disabilities or long-term mental illness). Carter v. Canada: In 2015, Carter brought and action against the Attorney General of Canada based on the infringement on her charter of rights, grounded on Sec. 7—regarding life, liberty, and security. She argued that the relevant sections of the CCC posed limits that could not “be demonstrably justified in a free and democratic society.” Her appeal was made with respect to dignity and autonomy. The Supreme Court of Canada held that a competent adult’s response to a life-threatening, grievous, and irremediable medical condition is a matter critical to their dignity and autonomy. The court recognized that people who are “suffering intolerably as a result of grievous and irremediable medical condition” may decide to end their own lives.
Principles of fundamental justice at issue in Carter: (i) Is the existing law arbitrary
? (ii) Is the existing law overbroad
? (iii) Is the existing law grossly disproportionate
?
Sec. 241 and 14 of the CCC were not arbitrary; they were overbroad; and they were grossly disproportionate (violated Sec. 7 provisions regarding life, liberty and security of the person)
Important reading for MAiD essay question: Bowal and Saha, “Critiques of Assisted Suicide” (ERT: 15 minutes). https://www.lawnow.org/critiques-assisted-suicide/
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