On June 6, the Supreme Court of Canada’s decision making physician-hastened death legal will come into effect. A parliamentary committee asked to help the government plot how that would roll out in Canada has made some far-reaching recommendations, well beyond what was contemplated by the court in Carter v. Canada.
The moment we are born, our lives take flight; and the longer we are airborne, the greater the chance of encountering turbulence along the way. While every flight is destined to land, some landings are harder to contemplate than others.
Who but those who have experienced it can appreciate the soul crushing anguish of mental illness? Afflictions of the mind can be paralyzing and fundamentally change the way we perceive ourselves (I am worthless), anticipate the future (my prospects are hopeless), and experience the world (life is unfair and unforgiving). The combination of self-loathing, hopelessness and despair can tragically lead to suicide.
We are about to become a country that extends patients the right to a hastened death, but offers no legislative guarantees or assurances that they will be well looked after until they die.
Doctors are not generally well trained to engage in end of life conversations, meaning that goals of care often remain unclear; and patients may not receive the care they want, nor the opportunity to live out their final days in the place they would want to die.
Ignorance and lack of skill in attending to the needs of dying patients are still tragically common in Canada.
Canadians now have a right to medically hastened heath, but no right to quality palliative care.
A few days after the Supreme Court of Canada overturned the prohibition against medical aid in dying, I received a note from a wonderful colleague of mine saying that her closest friend’s 53 year old son had just died of spinal cancer.
The last time I was in Israel, I went on some home visits with a palliative care physician in the town of Sfat near the Sea of Galilee. My colleague, a devout Jewish doctor, took me to several homes to offer advice on managing his most serious, terminally ill patients. One older Chassidic Rabbi was dealing with an advanced lung cancer, and having a difficult time accepting any kind of help from his young adult children.