Here are a few rambling thoughts about what Conservative MP Steven Fletcher wrote today in the National Post regarding euthanasia and doctor-assisted suicide. It is a serious article, one that no doubt will move some people on this issue. But it also begs some serious questions and concerns.

Fletcher, a paraplegic confined to a wheelchair since a 1996 automobile accident, says that he would like to see more done to provide those who face terminal illness and/or lifelong disability, as well as the social isolation and depression tied to their maladies and disabilities. That means proper medical care and social assistance. I totally agree that there needs to be better palliative care and that society should do more for people with disabilities. I am uncomfortable with quality of life arguments that too often rely on uninformed assumptions about what others are going through. (I wouldn’t call Fletcher’s comments uninformed or presumptive, although even he cannot know exactly what another suffering person might be going through.) But I think Fletcher is letting the cat out of the bag when he makes these valid points: that euthanasia and doctor-assisted suicide is not ultimately just about letting the terminally ill die a “dignified death” but about killing anyone who does not want to continue living. By using his own example, he says those with disabilities or facing chronic pain, not only those whose death is imminent, should be allowed access to euthanasia or doctor-assisted suicide. This is a significantly different argument than the one pushed publicly by euthanasia and assisted death advocates who unconvincingly insist that liberalized laws on euthanasia/doctor-assisted suicide would only apply to the terminally ill.

Fletcher talks about his own experience of recovery, with its surgeries, pain, fears and challenges. He said after his accident:

I was forever disconnected from my diaphragm, and my lungs collapsed. Intubated and on a respirator, I could not talk but was fully conscious. I had to learn to breathe normally again. It was four months before I could speak, and it took almost a year to breathe comfortably.

The perpetual sense of drowning in my own phlegm made it impossible to sleep — this itself being a type of torture, adding to my emotional pain and terror. I was told if I survived, I would live in an institution.

Sadly, if euthanasia and doctor-assisted suicide were legal when he had his accident 13 years ago, there is a pretty good chance that rather than being an MP today, he’d be dead. Some patients might have loved ones who will persevere with them, but others would not. Some patients might have doctors who want to try to save lives and work toward as much recovery as possible, but others would not. How many future Steven Fletchers will be lost in the emergency room or shortly thereafter because legal euthanasia would signal to medical professionals and family members that it is okay to give up? I’ve never seen Fletcher address this point, but I’m curious how he would respond to the question of whether he cares whether he might have been killed in 1996 were euthanasia legal. He has often noted that he is thankful for the second chance, but he does not acknowledge the probability that under a different set of laws, he would have been denied it.

It is also noteworthy that what Fletcher was told, presumably by medical professionals, was wrong; he isn’t living in an institution today. Instead, he’s working in one of the country’s most most important institutions, the House of Commons, in a job with tremendous prestige, power and responsibility. If euthanasia were legal, we wouldn’t today have Steven Fletcher as one of our MPs, with his courageous and inspiring example of overcoming his near-lethal accident and subsequent challenges.

Fletcher notes that he drew up a living will:

As soon as I could speak after my accident, I had a lawyer develop a living will. This document explains to my parents and loved ones my wishes. My living will allows the prospect of euthanasia under certain circumstances. Unfortunately, the euthanasia provisions in my living will may not be binding or enforceable, which is why I agree that changes should be considered to our current law. Heaven forbid that the provisions in my living will ever need to be carried out, but if the situation does arise, my wishes may be trumped by the criminal code.

I want to be empowered to make the best decisions for myself; and if I am unable, I want the people who love me to do what they think is in my best interest. I do not want to be forced to live in a hell because the law does not take into account my “unique” circumstances or because someone imposed their values on the meaning of life on me. Given the choice of existence without living or death, I would rather choose the latter and take my chances on the other side.

But by his own admission, if he  had the opportunity in 1996 to be killed, he would have welcomed it. The fact is, he changed his mind when his eyes were opened to the possibilities and once he learned to overcome his physical and emotional challenges. A living will is often written (although not by Fletcher) without most of the pertinent facts. People draw up this legal document making assumptions about what they will feel both physically and emotionally when they are feeling pain or are incapacitated.

Furthermore, Fletcher says, “Given the choice of existence without living or death, I would rather choose the latter and take my chances on the other side.” Rhetorically, that is powerful stuff, but here’s my problem: there is no chance for a person to change their mind. I understand the autonomy arguments and have some sympathy for them, but the law should uphold and protect life. If medical staff or family members or even the patient himself is wrong, there is no going back. The preference for life must be stronger than any concern for personal autonomy. Euthanasia and doctor-assisted suicide threatens this preference too much — as Fletcher’s life itself demonstrates.

There are two things with which I agree with Fletcher.

He says that legalizing euthanasia permits Canadians to avoid coming “to terms with the more important challenge of providing the level of support required to make living the first choice.” That is, Fletcher is implicitly agreeing with the pro-life argument that life should be given a strong preference. Life and death are not two equal choices. Furthermore, many palliative care specialists are worried that euthanasia and doctor-assisted suicide would remove the incentives to provide proper end-of-life treatment because it would be cheaper to terminate the life prematurely. That is one part of the equation and the most commonly acknowledged but it goes further. Just as there is less incentive to fund research about Down’s Syndrome because most unborn children diagnosed with the syndrome are killed by abortion, likewise in the future much research could be scuttled by the same type of equation if too many patients and their families and medical providers are choosing death.

The second thing Fletcher says with which I agree is his conclusion:

As this discussion evolves, I hope that the pain and hopelessness of those who experienced what I did are met in our society by empathy, compassion, love, and mercy.

I don’t conceive of killing as merciful (which Fletcher does in certain circumstances) but otherwise we are in complete agreement. My issue is that euthanasia is the absence of compassion and love and mercy properly understood.