The Euthanasia Prevention Coalition of Ontario has grave concerns about Senator Sharon Carstairs Bill S-2, the Medical Decisions Facilitation Act.

The Euthanasia Prevention Coalition of Ontario (EPCO) has been formed in order to prepare a well-informed, broadly-based network supporting measures that will create an effective social barrier to euthanasia and assisted suicide. One of our goals is to preserve and enforce legal prohibitions and ethical guidelines prohibiting “mercy killing.”

We are concerned that several measures within Bill S-2 will either permit cases of euthanasia and assisted suicide or weaken the current statutes that protect incompetent, elderly or disabled (vulnerable) patients.

We also question the need for Bill S-2. The main purpose of the bill is to legislate a right to refuse treatment or medication, a right which has already been established and is in no need of further clarification. Does Senator Carstairs have other ideas that Bill S-2 is a stepping stone for?

As it is now, the Bill may weaken the current protection that exists in the law for incompetent, elderly or disabled (vulnerable) persons. The bill states in section 3, subsection 2 that a request to withhold or withdraw treatment can be made in writing, or by words or signs, if a valid written directive does not exist. This request can be communicated by any witness who is not a health care provider. This section provides little to no protection for vulnerable people who are seen as having a poor “quality of life” and is open to abuse by relatives more interested in their possible inheritance than the best interests of the patient.

The bill also states in section 3, subsection 3 that when no valid prior instructions have been given by an incompetent patient the medical decisions are made by a proxy who has been appointed under the laws of the province. If there is no proxy or other legal representative, then the decisions are made by the spouse, or closest companion or relative.

Since a spouse, companion or close family member is more likely to know the intentions or understand the values of the patient, we believe that such a statute would lead to decisions being made that do not represent the values or fulfill the intentions of the patient. Therefore the Euthanasia Prevention Coalition of Ontario urges that family members be given first authority over life-sustaining medical decisions for incompetent patients. Section 3, subsection 3 is an example of the state interest having priority over the interest of the family and diminishing the value and respect due to the family in society.

Also, as it is now, section 4 of the bill may result in the intentional starvation and dehydration of elderly, incompetent or disabled (vulnerable) patients who are not terminally ill. This section of the bill defines artificial nutrition and hydration (assisted feeding) as life-sustaining medical treatment rather than basic medical care.

Assisted feeding should not be defined as medical treatment because it opens up the option of withholding food and fluids from patients who have a chronic disease but are not terminally ill or who continue to live against the wishes of others.

Section 5 of the bill may cause some health care workers not to provide routine but necessary medical treatments for elderly, incompetent or disabled (vulnerable) patients. This section of the bill may establish that not providing medical treatment is an acceptable way to end the lives of vulnerable patients who are not terminally ill. For instance, it would allow parents of children with Down syndrome to deny life-saving procedures that would be considered routine for otherwise healthy children.

Section 6 does call for improvements to palliative care training and services, which we agree are necessary, but as a whole the bill is unnecessary and potentially dangerous, and must be rejected.