Canadian doctors who refuse to kill their handicapped or debilitated patients could
face discrimination charges if euthanasia death peddlers get their way.
In a brief submitted to the Senate Committee on Euthanasia and Assisted Suicide, Dr.
Eike-Henner Kluge, former Director of Ethics and Legal Affairs for the Canadian
Medical Association, attacked Canada's current law on assisted suicide on the grounds
that it violates three "ethical" principles: "the principle of autonomy and respect for
persons; the principle of equality and justice; and the principle of beneficence."[1] The
Right to Die Society of Canada and the Humanist Association of Canada have both
endorsed Kluge's opinions.
Kluge based much of his brief on the case of Ms. Sue Rodriguez, a woman with
amytrophic lateral sclerosis (ALS) whose 1994 legal challenge to prevailing law
forbidding assisted suicide went all the way to the Canadian Supreme Court. Kluge
argued that Canadian law intruded upon Rodriguez's rights to "autonomy" because it
forced her to endure a death which violated her "conception of the dignity of the
person."
Kluge maintained that this concept, rooted in individual values, should be made the
final measure of what is worthwhile in a life-or-death decision. Under Kluge's
standard, doctors should be allowed to kill even patients who are
not undergoing serious physical pain:
"Ms. Rodriguez accepted palliation [treatment to relieve pain] to some degree.
However it must be recognized that the offer of palliation as a way of dealing with her
request [for assisted suicide] and as an attempt to honor her perspective was
fundamentally inappropriate. It failed to come to grips with the core of the issue. The
issue was not one of pain-of suffering in a physical sense. It was the violation of her
sense of the dignity of the person."[2]
Suffering, Kluge argued, should not be measured in terms of physical pain alone: "The
fact is that suffering should not be understood in merely physical terms. The <Shorter
Oxford English Dictionary> defines suffering, <inter alia>, as 'the bearing or
undergoing of pain, distress or tribulation' and in the definition of suffering includes
grief."[3]
Kluge also alleged Canadian law discriminates against diseased or disabled persons
because it prevents them from committing suicide when they want, and as they want-
an ability that "non-handicapped" people possess.
"This inability-this handicap-could have been overcome if the law had allowed
someone else to assist her [Rodriguez], or if the law had permitted someone to carry
out her wishes for her if and when the time came," Kluge wrote. "However, the law
imposed a bar against anyone assisting her in this fashion. Consequently the law
insisted on confirming her in her inability to take advantage of opportunities otherwise
available to members of society without providing for compensatory and equitable
relief. The law, therefore, had the effect of discriminating against her on the basis of her
handicap."[4]
Kluge's attack, and the legislative recommendations based on it, form part of the effort
patient-killing promoters say they will mount when Canada's Parliament reconvenes
this month. Although political observers in Canada are doubtful that the effort will
progress through standard legislative channels, supporters might seek to mount the
effort as a so-called "private member" bill where the fight could bypass some legislative
hurdles and proceed. Just such a private member's bill provided the vehicle necessary
to bring assisted suicide to Australia's Northern Territories in May 1995.
A symbol of the pro-killing movement
Austin Bastable, a 52-year-old man who suffers from multiple sclerosis, shares an
additional part of the Canadian pro-killing effort. Bastable has taken a public stand in
favor of the legislation and has worked to make himself a publicly recognized symbol
of the pro-killing movement in Canada. He has had his face and cause plastered onto t-
shirts, opened up a fund-raising telephone number and occupied several pages on the
World Wide Web, courtesy of The Right to Die Society's DeathNET.
And the other side has not been silent. The position that the Canadian Conference of
Catholic Bishops (CCCB) took before the Canadian Senate emphasized not the radical
autonomy which Kluge asserted as a human right but instead underscored the ways
and degrees to which human beings in a society relate to one another. Questions of life
and death cannot be examined as solely personal decisions of control, they said.
"Ironically, the use of rights language to allow for euthanasia or assisted suicide would
undermine the rights of our citizens by introducing questions of power and control
over human life itself," the bishops wrote. "Especially given the ways in which
decisions would frequently lie in the hands of medical professionals or political
decision makers, such a context of power and control could easily change questions of
life into matters of social economic utility."[5]
The CCCB pointed out that there is a difference between mere "pity" and "compassion":
"The language of rights and self-determination frequently alters the meaning of
compassion-entering into and sharing the suffering of another, to that of pity- evincing
sadness over the suffering of another who is left to bear the pain alone.... How different
this is from compassion, which involves entering into the pain of another, sharing his
or her life. Here there is not isolation but only a deepening and admittedly difficult tie."
And the evidence makes it clear that the Canadian bishops' concerns are justified.
Although Holland still, technically, makes both euthanasia and assisted suicide illegal,
the Dutch courts allowed both under guidelines which, when first defined in 1981,
looked every bit as "tough" as Kluge's. The first of the Rotterdam guidelines, for
example, dictated that the person asking for the assisted suicide must be "experiencing
unbearable pain."[6]
Kluge's position, as noted previously, doesn't even make much of pain but asserts a
more personally autonomous idea of "suffering." Actually, Kluge criticized the Dutch
regulations because of their alleged strictness, arguing that the guidelines are flawed
because they do not allow doctors to kill patients who might have asked to be killed in
the recent past but have not made the request lately. This "discriminates," in Kluge's
view, against those who might be unconscious or unable to communicate their desire to
die.
Holding death as a good
A major problem with the Dutch guidelines and, by extension, the Canadian proposal
is that courts, medical associations and bureaucracies have a tendency to interpret
whatever rules adopted in ever-broadening terms, which is only natural if attitudes are
promoted which hold death as a good. Thus in 1986 the Hague Court of Appeals ruled
that "unbearable pain" could be taken to mean "psychic suffering" or "the potential
disfigurement of personality," a position remarkably close to Kluge's guideline for
autonomous "suffering."
Likewise, in 1993, a Dutch court allowed doctors to kill their patients for psychiatric
reasons if the patient is suffering depression.[7] The situation in Holland eerily
prefigured the CCCB's observations about the differences between pity and compassion
when, in 1991, the Dutch government reported that the third most frequently cited
reason for terminating the lives of patients without their consent was "the family
couldn't take it anymore."[8]
Concerns about this slippery slope are part of the battle currently raging over assisted
suicide in Australia. The Northern Territories Legislative Assembly May 1995 bill has
yet to be enacted. In the weeks after its passage, other Australian states were widely
reported as eager to follow suit.
However, there has been a marked reluctance on the part of many States to take that
step, and there are reportedly efforts underway in the Northern Territories to have the
bill overturned before it can be enacted. Apparently a number of Australians share the
apprehensions one the Northern Territories legislators expressed during debate:
"The harm to others will surely come about once the door is opened to legalized
euthanasia
because, once open, that door can never be closed again. It can only be shoved open
wider and wider.... There will be pressure to amend whatever bill was passed to
include those who believe themselves excluded from the first instance.... As the
provisions are broadened, invariably it will pick up others-for example, those who feel
guilt at being a burden, of hanging around and still being alive at great cost to their
family. Perhaps they are taking up a hospital bed at time when the health budget dollar
is being squeezed tighter."
'Always a severe process'
Meanwhile, the debate in both Canada and Australia is taking place against a backdrop
of Dutch policy change. In late August 1995, the Royal Dutch Medical Association
recommended a policy revision which would require those seeking death from their
doctors to take their own lives rather than have the doctor kill them. Association
spokesman Reolof Mulder said that the new emphasis on patient responsibility was
meant to alleviate emotional stress doctors experience in euthanasia. "Euthanasia is not
something a doctor does with joy," Mulder said. "It's always a severe process."
David Morrison is a writer/researcher for HLI.
ENDNOTES
1 <Ethics and Deliberate Death>, Dr. Eike-Henner Kluge, submitted to the Senate
Committee on Euthanasia and Assisted Suicide.
2 Ibid.
3 Ibid.
4 Ibid.
5 <To Live and Die in a Compassionate Community>, Canadian Conference of Catholic
Bishops, presented to the Senate Committee on Euthanasia and Assisted Suicide.
6 <Fact Sheet: Euthanasia Practice in Holland>, The Anti-Euthanasia Task Force.
7 5 April 1993, <New York Times>, A3; 22 April, 1993, A2, cited in <Fact Sheet>.
8 <Fact Sheet>.
Taken from the February 1996 issue of "HLI Reports."
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