National Column: Wrestling with life-and-death decisions

by Tim Harper

Meet the most important MP you may not have heard of, the co-chair of the most important Parliamentary committee no one seems to be noticing.

Don Valley West Liberal Rob Oliphant, a soft-spoken United Church minister, has 13 days to present to Parliament and Justice Minister Jody Wilson-Raybould a framework for a federal law governing physician-assisted suicide, a process now routinely bathed in the softer, more euphemistic name of physician-assisted dying.

The Commons-Senate committee, the first joint committee in two decades, heard from 62 witnesses, expects to receive up to 120 briefs and has done four months of committee work in three weeks, mostly in the quiet of the Ottawa winter evening.

Oliphant, his co-chair, Conservative Sen. Kelvin Ogilvie, and 13 other MPs and senators have absorbed the findings of a federal panel and provincial-territorial task force as they race toward a Supreme Court-imposed deadline that will mean a law enshrined by June.

As a minister, Oliphant believes dying is part of life. He has officiated at hundreds of funerals, he has counselled families who are grappling with the thought of removing life-supporting care of a loved one after a doctor has told them the time may have come.

“How do we live and how do we die are the same set of questions we need to explore as human beings.”

Yet, he wrestles with those issues late into the night, he says, both the individual cases in which he has been involved, and the overarching issue of physician-assisted dying, which is brand new territory for us
all.

Canadians are ready for this law, he believes, yet he adds they are “holding their breath,” waiting to see what it will look like. The media, so trained in searching for conflict, is having difficulty dealing with the
intricacies of a story that cuts to the core of what it means to be human, he says.

Between now and the tabling of his report Feb. 25, Oliphant and the committee must reconcile the shared jurisdiction of any new law.

Two sections of the federal Criminal Code were struck down by the court in February 2015, but health delivery is a provincial responsibility.

But, Oliphant says, the Canada Health Act is federal responsibility and he believes we will see a federal regime for physician-assisted dying with provincial regimes at least equivalent to the federal law.

There are other important issues to be hammered out next week. There are the competing rights of patients to die with the help of a doctor and the right of doctors to conscientiously refuse to provide the service.

Does that mean, as the Canadian Medical Association says, doctors should also be allowed to refuse to refer a patient to a doctor who will help him or her end their life?

Oliphant knows doctors struggle with this and he understands. We trust our physicians with our life – we now will have to learn to trust them with our death, he says. He also knows physicians have never been trained on this.

Behind closed doors, there are other questions.

At what age can a minor give free and informed consent?

There is the question of those with mental illness requesting death. Who should be involved before such consent is given?

Tarek Rajji, chief of geriatric psychiatry at the Centre for Addiction and Mental Health, told the committee: “Within a clinical recovery-based environment, there is always the potential for mental illness to be remediable.”

A study of doctor-assisted dying for patients with mental illness in the Netherlands released this week, found more than half had declined treatment that could have helped them and many simply cited loneliness as a reason to die.

The committee is also expected to call for national standards on palliative care, backed with funding so all Canadians can have access to a prescribed standard of care as they face death. Oliphant believes assisted death and palliative care go hand-in-hand as part of a “holistic” policy of end-of-life issues.

Oliphant would like to deliver a report forged in consensus, but there could be a dissenting report.

Conservative MP Mark Warawa has often stated improved palliative care was preferable to legalized suicide.

Oliphant, however, has always considered death as a part of life and he comes to his theological decision-making guided by something known as the Wesleyan Quadrilateral, which consists of scripture, reason, experience and tradition.

There are contradictions – scripture, Oliphant acknowledges, says thou shall not kill but there are many passages which teach that death is part of life.

In reaching decisions, the four pillars must be in conversation with each other, he says. Any decision that rests on a single pillar will be a weak position.

He says he probably wouldn’t access physician-assisted death, but he realizes none of us can really say until we are faced with the end of life.

“I’m not fighting for my right to get this,” he says.

But he believes Canadians are ready for this legislation. People don’t like to see people suffering, and they want to help them, he believes.

“That is a good human instinct.”

Tim Harper is a national affairs writer. His column appears Monday, Wednesday and Friday.
tharper@thestar.ca. Twitter: @nutgraf1.

Copyright 2016 – Torstar Syndication Services

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