Michel Cadotte, his sister and his sister-in-law entering court
The ink was hardly dry on Canada’s right-to-die legislation before lawsuits began to expand eligibility for euthanasia to those who are not terminally ill. And now a high-profile case in Quebec could lead to euthanising patients with dementia.
On February 20 Michel Cadotte was arrested by Montreal police after a post appeared on his Facebook page: “I’ve cracked, nobody asked how I’m doing, but now you know, I’ve consented to her request of assistance in dying, I’m waiting for the police.”
Cadotte, 56, was paying a visit to his wife, Jocelyne Lizotte, 60, who had Alzheimer’s disease and was living in a nursing home. He took a pillow and smothered her to death. He had been caring for her since 2006 and was exhausted.
She had reportedly wanted to be euthanised. However, even though Canada allows euthanasia (and Quebec also has its own law), a patient has to be legally competent in order to lodge a request for “medical aid-in-dying”. Jocelyne did not qualify.
Touched by the drama of this case, Quebec legislators are considering a change in legislation to allow people to make binding advance directives for euthanasia before they slip into dementia. This is a feature which was rejected by both the Federal and Quebec governments when they drafted their legislation. Quebec’s came into force in December 2015 and the Federal law in June 2016.
Dr Catherine Ferrier, the president of the Physicians’ Alliance against Euthanasia, told STAT that she was surprised that the Cadotte case was being used to broaden the scope of eligibility for euthanasia. “When I heard this story, I thought, ‘This has nothing to do with my euthanasia work, it has to do with my geriatrics work,’” she said. “It has to do with providing proper care, it has to do with providing proper support for caregivers so they don’t flip out. … How come the whole world isn’t saying, ‘Let’s look after people properly?’”
Sunday, August 13, 2017
In a recent article in the American Journal of Bioethics, bioethicist Art Caplan and three colleagues call for a complete overhaul of the venerable Belmont Report (see below). This is the 1979 US government report which set out three famous principles which have governed human research ever since: respect for persons, beneficence, and justice.
Most government reports are already gathering dust within a few months after their publication. But the Belmont Report’s influence has been enormous, as it shaped the bioethical framework for clinical and research decision-making in the US and many other countries as well.
Caplan & Co make a good case for revising the standards in the light of experience and changing times. But it comes at an awkward moment: the Trump Presidency. What kind of commission would Mr Trump create to study this issue? Perhaps a noisy and truculent one, a bull in the bioethics china shop. Be careful what you wish for?
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