Yesterday (24th February 2011), the Halifax Chronicle Herald – Nova Scotia’s major newspaper — reported an act of euthanasia performed by a man in Liverpool on his wife without her consent. He spoke first with the newspaper, and then went to the police, claiming that he had given his wife, who was suffering from end stage breast cancer, an overdose of painkillers. He was, he said, wracked with feelings of guilt, and could no longer live with what he had done. He wanted (according to the newspaper report) someone in authority to tell him that what he had done was not wrong. He also seemed to have in mind that perhaps what he had done would reanimate the much-needed discussion about euthanasia.
The response of the CBC in Nova Scotia was to lead with the story on news and talk shows, and, since I had been in the news in a vaguely similar situation nearly four years ago I was asked to do a number of interviews. This shows, I think, that in the minds of newsmakers, the issue of euthanasia is an important one, in need of open public discussion. The truth, I think, is that it is almost impossible for news media to provide the context for such a discussion, however needed it is. News goes from one dramatic event to the next, and cannot sustain the kind of discussion that is needed, where people get involved at many levels over a period of time sufficiently long to allow people’s views to be thoroughly aired.
According to reports this morning — only one day later — we hear Mr. Stephan Bolton muttering darkly about the Nova Scotia health system being guilty of murder, so it seems obvious that his own role in the matter is not clear in his own mind. Perhaps, as often happens after someone deeply cared for has died, Mr. Bolton is simply confused. Did he, as he first said, give his wife an overdose which he expected would kill her? He is, after all, not a physician, and not in a position to know how much of a given drug would be necessary actually to bring about death. He may have what is called “survivor’s guilt”, guilt that he is still alive, and someone he loved has died. There was nothing he could do to save his wife’s life. The disease was relentless, and all his hopes were dashed. It is not uncommon to feel guilt at times like this.
However, it was into this situation that we all advanced boldly, with inadequate information. But news stories must be caught on the fly, I take it, and we must work with what we know. Well, we didn’t know enough. Margaret Somerville, billed as one of Canada’s foremost authorities on euthanasia, spoke hyperbolically of first degree murder, since Mr. Bolton had apparently planned and carried out the plan of “killing” his wife. Marika Warren, a bioethicist from Dalhousie University, whose major expertise appears to be in the area of equality for intellectually challenged persons, agreed with Margaret Somerville. Alex Schadenburg, of the Euthanasia Prevention Coalition, put in his plug for the wider social implications of accepting assisted dying, and spoke without qualification of homicide, and suggested that Mrs. Bolton’s death was very troubling. Perhaps the most unfortunate part of the CBC handling of the story is that it did not include (perhaps she was unavailable) one of Canada’s foremost authorities on the ethics and the law of assisted dying, Dr. Jocelyn Downie, who also teaches at Dalhousie. From her the response would have been both more nuanced, and far more accepting of the need for a change in the law.
What was my own take on the story? Well, briefly, that there was not enough information to go on, but that I understood why someone might have felt impelled to help someone he loved escape the suffering that she was enduring. I expressed some concern that Mr. Bolton did not seem to have taken his wife into his confidence about what he intended to do — intentions which are now unclear, given Mr. Bolton’s latest remarks — but I also suggested that, given the law as it stands, where even assisting a suicide invokes the ridiculously draconian punishment of up to fourteen years in a federal prison, we would need to know a lot more about the situation before speaking confidently about it.
As it stands in Canada, the law does not allow for so-called “mercy killing.” Every such act of mercy is also, according to a strict reading of the law, an act of murder. Canadians who are facing death are given no choice. There is no easy way out, except lonely suicide; although it seems that an accompanied suicide is not out of the question, since, so long as the suicide is planned and carried out with materials acquired by the person dying by suicide, there is no reason, in law, why someone else may not be present. But it is not so easy to kill yourself as many people have discovered, and since it is against the law even to provide such information, what may and may not be legally done is shrouded in mystery. This makes it difficult even to talk about such matters.
In my own case, my wife Elizabeth had determined that, when she had had enough, she would take her own life, and she made it clear that she did not want me to be involved in any way in what would be her own decision and act. She was a very decisive person, and she had determined very early that, if her disease became very debilitating, she did not want to live it through to the end. However, she did not want to involve me in any way which would have embroiled me in a possible criminal code violation.
The fact that the matter is so complicated — and as I went through a series of four interviews yesterday morning (one of them actually repeated — first taped, and then done live) this became more and more clear to me — had a tendency to make me more cautious, and to make less definite pronouncements about the case in hand. We simply did not have enough information. Had Mr. Bolton spoken about this with his wife during the course of her illness? Did she worry about what the end would be like? It was said that her pain was controlled, but pain may not be the major cause of suffering when people are dying. Did she suffer from other forms of acute distress?Severe air hunger, itchiness because of opiates, hallucinations, incontinence, anxiety: all of these things can make a person’s dying a misery. Speaking confidently about making people comfortable as they die hardly does justice to the many possible sources of distress. Had Mrs. Bolton and her husband spoken of the possibility of simply ending it all? Or had she, perhaps, warned her husband that she did not want him to take matters into his own hands in ways that would bring the law down upon his head? There was simply too little to go on.
And yet the question itself is very important, despite the religious scruples of people like Alex Schadenburg or Margaret Somerville (as well, it needs to be said, of a large number of Members of Parliament). We need to have a national discussion about these matters. The Quebec National Assembly has begun the process, but the Canadian Parliament shut it down last year by defeating Francine Lalonde’s Bill C-384 on Second Reading. Had Parliament sent the matter to committee, we might now be having a wide-ranging debate on the issue right across the country. This is what we need. Going from one startling case to another — which animates the news networks for a few days — does nothing to help us have a reasoned national discussion of the issue. Without that, the main voices that are heard tend to be those with more extreme opinions, like those of Alex Schadenburg and Margaret Somerville who are, it seems, really outriders amongst bioethicists today, and represent a narrow religious orthodoxy on this question. It is high time to have a more wide-ranging and balanced discussion of the issues.