Concerns raised about physician-assisted death policy

Critics worry that families will feel pressured
Critics worry that families will feel pressured

The Supreme Court has spoken, the legislative wing is deliberating, but some in the Jewish community are uncomfortable with the direction the country is going in adopting a policy on physician-assisted suicide.

Discussion on the topic is now so normalized that an acronym has arisen, PAD, referring to it as physician-assisted dying.

As is the case throughout Canada, the Jewish community is not of one mind when it comes to public policy regarding the issue. The Centre for Israel and Jewish Affairs (CIJA) canvassed a broad spectrum of opinion in the Jewish community and presented a series of suggestions to the minister of justice that would regulate how the policy is implemented.

CIJA found support for the initiative on compassionate grounds, along with concerns that safeguards are needed to avoid the proverbial slippery slope that could lead to assisted deaths beyond the narrow bounds contemplated by its advocates.


But there are voices in the community who are deeply troubled with the idea that physicians – whose mandate is to preserve life and heal the sick – would participate in ending lives. Others worry that once implemented, a policy of assisted dying in a narrow band of circumstances will gradually broaden to include situations not originally contemplated by proponents of the policy, including “informed minors.”

The current situation grew out of a Supreme Court ruling one year ago that struck down, on constitutional grounds, sections of the Criminal Code that made it illegal to help someone commit suicide. The court stated the law would remain in effect for one year before it lapsed. It later extended the deadline to June 2016.

The brief CIJA presented to the minister notes that “many in the Jewish community support the Supreme Court’s decision as a moral imperative, empathizing with the rights of the terminally ill to end their lives on their own terms. Many others oppose it for a variety of reasons including traditional religious principles and fear of a slippery slope toward a more broad-based application of euthanasia in Canadian society.”

Noah Shack, CIJA’s director of policy, said consensus in the community is conditional on the protection of physicians who object on moral or religious grounds; that consent is informed, competent and not coerced; and that PAD is only one option among many, including increased access to palliative care.

Psychiatrist Janice Halpern is deeply troubled by the direction Canadian society and the medical establishment are going regarding PAD. She attended a recent seminar at Mount Sinai Hospital and was shocked at the casual way the subject was discussed. “I felt a horrified feeling. Here we are talking about the logistics of killing people,” she said.
As a physician, she’s unhappy doctors will be asked to be complicit in ending a life. “We’re civilized… You don’t kill people who suffer. You try to help them,” she said.

She suggested that instead of ending a person’s life, Canada should devote more resources to expanding palliative care and providing counselling to support individuals and families in trying times.

Halpern also believes PAD will coarsen Canadian society. “I don’t think people will value life in the same way,” she said.

The door is being opened to a social norm in which people who are suffering will see themselves as a burden to their families, children and society. “People could feel that they should kill themselves,” she added.

Rabbi Michael Dolgin doesn’t believe people will be intimidated into ending their lives. “It’s an interesting emotional argument, but in jurisdictions where it exists, there is no evidence of it,” he said.

Rabbi Dolgin, senior rabbi at the Reform Temple Sinai, believes that in Jewish tradition, “bringing someone’s life to an end prematurely is ethically wrong and problematic.” The question, he said, is what is “prematurely?”

Rabbi Dolgin, who stressed he was speaking for himself, said that “instead of extending life, we’re extending suffering. I’ve sat with too many people, whose family member is dying and is in extraordinary pain, and they say, ‘Rabbi, I don’t understand. We treat our pets better.’”

“Lots of energy in Canada is being devoted to an issue that will affect a small number of people and not enough energy to the lack of palliative care,” he added.


He cautioned, however, that PAD should be implemented with safeguards so that it’s not extended to people with mental health issues or to minors.

Bracha Silver has had up-close exposure to the health care system and is far from confident patients and families won’t be influenced, or even intimidated, into agreeing to end a life. Silver’s 25-year-old son, Avi, spent his last 3-1/2 months in hospital suffering from a brain tumour.

Doctors at the hospital were kind and considerate, but one “eventually came down on us because Avi had lived a little longer than he wanted him to. He said, ‘He’s going to die anyway. Why are you being cruel by prolonging his suffering and his life?’”

Silver also felt the doctor didn’t want the hospital to incur the expense of keeping her son alive. As an Orthodox woman, her response was “as long as he has a breath in him, he’s alive. Who are they to tell me how long to live? It’s God’s business to determine who lives and who dies, to the precise second. There are reasons that go beyond our understanding in the world.” While most of the doctors were kind and respectful, Silver said she’s concerned others might unduly influence patients and their families to take steps they might not otherwise take.