June 6, 2016, our government will have to finalize all legislation related to Medical Assistance in Dying (Bill C-14). The Supreme Court of Canada legal challenge that resulted in our previous ban on Medical Assistance in Dying being lifted (The Carter Decision) resulted in the formation of a Parliamentary Committee to develop guidelines of Practice for Medical Assistance in Dying in Canada. This document was released February 2016.
Palliative Sedation Therapy for Intolerable Suffering versus Medically Assisted Death, (Assisted Suicide), and Euthanasia
Palliative Care is defined by the World Health Organization as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.”(1)
• Provides relief from pain and other distressing symptoms
• Affirms life and regards dying as a normal process
• Intend to neither hasten nor postpone death
Palliative Sedation Therapy (PST): Also “Controlled sedation,” “Total Sedation,” or “Continuous Sedation,” is the intentional lowering of a patient’s level of consciousness in the last days of life. It involves the proportional and monitored use of sedative medications to relieve intolerable suffering by a reduction in patient consciousness. The patient experiences symptom relief until death occurs by the natural course of the underlying disease, usually within hours to days.
Medical assisted death means knowingly and intentionally providing a person with the knowledge, means, or both required to commit suicide, including counselling about lethal doses of drugs, prescribing such lethal doses, or supplying the drugs.
Euthanasia means knowingly and intentionally performing an act that is explicitly intended to end another person’s life and that includes the following elements: the person has an incurable illness; the agent knows about the person’s condition, and commits the act with the primary intention of ending the life of that person. Many will experience a moral dilemma with the intentional ending of a person’s life, as in medically assisted death or euthanasia. However, to use deep sedation to relieve intolerable suffering and bring a patient to a peaceful and comfortable state until natural death, the intention is different. It would be preferable to see funding placed into universal funding for palliative/end of life care for all Canadians, palliative care beds, training programs for palliative care Volunteers, increasing Community Nursing funding so that families have the support they require should they choose to care for a family member at home.
Darla McDonald Robson