Euthanasia and Assisted Suicide in the Post-Rodriguez Era: Lessons from Foreign Jurisdictions
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Osgoode Hall Law Journal Volume 38 Issue 4 Volume 38, Number 4 (Winter 2000) Article 5 10-1-2000 Euthanasia and Assisted Suicide in the Post-Rodriguez Era: Lessons from Foreign Jurisdictions Michael Cormack Follow this and additional works at: https://digitalcommons.osgoode.yorku.ca/ohlj Part of the Medical Jurisprudence Commons Article This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. Citation Information Cormack, Michael. "Euthanasia and Assisted Suicide in the Post-Rodriguez Era: Lessons from Foreign Jurisdictions." Osgoode Hall Law Journal 38.4 (2000) : 591-641. https://digitalcommons.osgoode.yorku.ca/ohlj/vol38/iss4/5 This Article is brought to you for free and open access by the Journals at Osgoode Digital Commons. It has been accepted for inclusion in Osgoode Hall Law Journal by an authorized editor of Osgoode Digital Commons. Euthanasia and Assisted Suicide in the Post-Rodriguez Era: Lessons from Foreign Jurisdictions Abstract Euthanasia and assisted suicide are highly controversial subjects that have drawn much attention in Canada over the last two decades. This paper outlines how the Netherlands, the United States, Australia, and Canada have approached the practices. Jurisprudence, public opinion polls, legislative developments, and the positions of medical organizations and their members are included in the analysis. A number of arguments for and against the continued prohibition of the practices in Canada are evaluated. As well, information regarding the extent to which euthanasia and assisted suicide are performed in these countries is assessed. It will be shown that Canadians currently enjoy significant control over decisions concerning the end of life. The principles of autonomy and beneficence provide the foundation necessary to justify lifting the prohibition of voluntary euthanasia and assisted suicide in Canada. With regard to the development of safeguards, the way in which foreign jurisdictions have dealt with both procedures is highly instructive. A qualified system of pre-authorization, unlike those adopted elsewhere, would prevent abuses from occurring and maintain the prohibition of non-voluntary and involuntary euthanasia. Since legislators are in the best position to deal with the issues, change in the law should be made by the government, not the judiciary. Practical legislation is feasible and a proposal of what this should entail is presented. Keywords Euthanasia--Law and legislation; Assisted suicide--Law and legislation; Netherlands; Canada; United States; Australia Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. This article is available in Osgoode Hall Law Journal: https://digitalcommons.osgoode.yorku.ca/ohlj/vol38/iss4/5 EUTHANASIA AND ASSISTED SUICIDE IN THE POST-RODRIGUEZ ERA: LESSONS FROM FOREIGN JURISDICTIONS© BY MICHAEL CORMACK* Euthanasia and assisted suicide are highly controversial Au Canada, l'euthanasie et 'aide au suicide ont 6t6 subjects that have drawn much attention in Canada l'objet d'attention et de controverses pendant les deux over the last two decades. This paper outlines how the derni~res decennies. Cet article d6crit comment ces Netherlands, the United States, Australia, and Canada pratiques ont t6 abord6es aux Pays-Bas, aux Ettats- have approached the practices. Jurisprudence, public Unis, en Australie et au Canada. La jurisprudence, les opinion polls, legislative developments, and the sondages d'opinion, les d6veloppements 16gislatifs ainsi positions of medical organizations and their members que les positions de divers organisations medicales et am included in the analysis. A number of arguments for leurs membres sont inclus dans cette analyse. De and against the continued prohibition of the practices nombreux arguments en faveur et h l'encontre de in Canada are evaluated. As well, information l'interdiction continue de ces pratiques au Canada sont regarding the extent to which euthanasia and assisted 6valu6s. De plus, linformation quant a 'ampleur des suicide are performed in these countries is assessed. It pratiques de l'euthanasie et de l'aide au suicide dans will be shown that Canadians currently enjoy significant d'autres pays est 6valude. L'auteur d6montre que les control over decisions concerning the end of life. The canadiens exercent pr6sentement beaucoup de contr6le principles of autonomy and beneficence provide the quant aux ddcisions concemant la cessation de la vie. foundation necessary to justify lifting the prohibition of Les principes de l'autonomie et de la bienfaisance voluntary euthanasia and assisted suicide in Canada. fourissent le fondement n&cssaire pour justifier ]a fin With regard to the development of safeguards, the way de l'interdiction de l'euthanasie et de l'aide au suicide in which foreign jurisdictions have dealt with both volontaire au Canada. Quant aux sauvegardes, les procedures is highly instructive. A qualified system of pratiques des autres juridictions sont r6v6latrices. Un pre-authorization, unlike those adopted elsewhere, syst~me de pr6-autorisation, diff6rent de ceux would prevent abuses from occurring and maintain the d6velopp~s ailleurs, pourrait Ala fois pr6venir des abus prohibition of non-voluntary and involuntary et pourrait maintenir linterdiction de l'euthanasie non- euthanasia. Since legislators are in the best position to volontaire et involontaire. Puisque les 16gislateurs sont deal with the issues, change in the law should be made en meilleur position pour s'occuper de la question, les by the government, not the judiciary. Practical changements devraient se faire par le biais de la legislation is feasible and a proposal of what this should 16gislation. Cet article propose ce dont pourrait entail is presented. contenir un projet de loi addressant cette question 6pineuse. © 2000, M. Cormack * B.A., Simon Fraser University (School of Criminology), LL.B. Candidate, University of British Columbia. Special thanks to Professor Neil Boyd at Simon Fraser University: Your insight was invaluable. I also wish to thank the anonymous reviewers for their thoughtful critiques. 592 OSGOODE HALL LAW JOURNAL [VOL. 38 NO. 4 I. INTRODUCTION ........................................................... 592 I. DEFINING EUTHANASIA AND ASSISTED SUICIDE .......................... 593 III. THE LEGAL STATUS OF EUTHANASIA AND ASSISTED SUICIDE IN CANADA 595 IV. THE LEGAL STATUS OF EUTHANASIA AND ASSISTED SUICIDE IN OTHER LEGAL REGIMES ............................................... 601 A. A ustralia ................................................................ 601 B. The United States ......................................................... 604 C. The Netherlands .......................................................... 607 V. NORMATIVE JUSTIFICATION OF VOLUNTARY EUTHANASIA AND ASSISTED SUICIDE IN CANADA ....................................... 610 A. The Rodriguez "Consensus". ............................................... 610 B. Killing Versus Letting Die ................................................... 611 C. The Sanctity of Life ........................................................ 614 D. TheRightto Die? .......................................................... 615' E. The Integrity of the MedicalProfession ........................................ 616 F. Quality PalliativeCare is not the Solution ...................................... 617 G. Autonomy and Beneficence ................................................. 618 H. Slippery Slopes ............................................................ 621 I. Summary and Conclusion .................................................. 623 VI. THE NORMATIVE QUESTION MARK: THE SLIPPERY SLOPE ................ 623 A. The Netherlands .......................................................... 624 B. A ustralia ................................................................ 629 C. The UnitedStates ......................................................... 630 D . Canada ........... ..................................................... 632 E. Summary and Conclusion .................................................. 635 VII. PRACTICAL MEASURES ................................................... 636 A. Proposed Legislation ....................................................... 636 VIII. CONCLUSION .......................................................... 640 I. INTRODUCTION Terry Graham, a resident of Brampton, Ontario, suffers from a rare degenerative muscle disease known as mitochondrial myopathy. 2001 Euthanasiaand Assisted Suicide With little muscle to protect his nerves, he experiences overwhelming pain that cannot be entirely alleviated by morphine. He has been lobbying federal officials for the right to have a physician-assisted death, but his efforts have gone unrewarded.! The Graham case is only the tip of the iceberg. Euthanasia and assisted suicide are highly controversial subjects that have drawn much attention in Canada over the last two decades. The issues surrounding the prohibition of both practices are extremely complicated and demand an equally complex examination. The discussion below will outline how the Netherlands, the United States, Australia, and Canada have approached euthanasia and assisted suicide. Jurisprudence, public opinion polls, legislative developments, and the positions of medical organizations and their members will be included in the analysis. A number of arguments for and against the continued prohibition of the practices