Assisted dying law too restrictive, says Nova Scotia palliative doctor

A palliative care physician based in Lunenburg is criticizing Canada's new assisted-dying law, saying it is too restrictive because it only applies to those who will die soon, and not those suffering with no immediate end in sight.

The Senate had passed an amendment to Bill C-14 to include those who aren't necessarily near death, but the House of Commons rejected it last week. The more restrictive bill received royal assent Friday after passing a final vote in the Senate earlier in the day.

Dr. David Abriel, who has spent the past 14 years working in palliative care in Nova Scotia, said many of his patients would not be allowed to ask a doctor for help to die under the new legislation, even though they face grievous and irremediable suffering in the long-term. 

"Who is a government, a lawyer, or even a physician to say that they have a better idea of what's tolerable and intolerable, than the person themselves?" he told CBC's Information Morning:  

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'Vulnerable Canadians'

Prime Minister Justin Trudeau has defended his government's decision to reject the Senate's biggest recommended change to the bill. He said the law balanced rights and freedoms with protecting "vulnerable Canadians."

Justice Minister Jody Wilson-Raybould has said expanding the eligibility requirements could allow for anyone with a serious illness, including soldiers with PTSD or young people with spinal cord injuries, to legally be allowed to seek physician-assisted death.

But Abriel said in jurisdictions where assisted dying is already taking place, there's no evidence there's a slippery slope and that "vulnerable populations are being taken advantage of, any more than they are now."

"My job in palliative care is to help people live, and dying is part of living," he said.

You don't take somebody who's vulnerable and take rights and freedoms away from them.- Dr. David Abriel

Patients have asked him for help in dying before, Abriel said, and often proper management of symptoms — both physical and mental — is all they need to keep going.

But in other cases, there is no way to stop the pain, life becomes unbearable, and he said everybody should have the choice to end their life with a doctor's help. Right now they don't.

Some don't have choices

Abriel said it would be perfectly legal for somebody with diabetes to stop taking their insulin and die, for somebody on dialysis to stop the treatment and die, or for somebody with cancer to refuse chemotherapy and die.

These people have choices, he said.

"There are a number of people, though, who perhaps you'd say are more vulnerable, and don't have access to that," Abriel said. The best they can do is starve themselves, or use some kind of weapon to end their lives, he said, and "to me, that's horrible."

"You don't take somebody who's vulnerable and take rights and freedoms away from them."

Ground rules unclear

It's a bit unclear what the ground rules are for doctors in Nova Scotia right now, Abriel said.

The College of Physicians and Surgeons of Nova Scotia is currently revising its standards to bring them in line with the new legislation, so those guidelines are no longer available to physicians online.

• Assisted-dying bill discriminates: N.S. Senator

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Bill C-14, the Federal's government's bid to legislate assisted dying, finally became law last week. The Senate had proposed amending the bill, to extend eligibility for medically assisted death. In the end the House of Commons rejected the amendment and