The Euthanasia Prevention Coalition of Ontario has grave concerns with the wording of Senator
Sharon Carstairs Bill S-2, the Medical Decisions Facilitations Act. The Euthanasia Prevention
Coalition of Ontario 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.”

President, Barrie deVeber M.D. FRCP(C) is Professor Emeritus in Pediatrics/Oncology at the
University of Western Ontario in London and the President of the deVeber Institute in
Toronto. He practised at the Children’s Hospital in London, for 33 years treating children
with cancer and their families.

Vice President, Jean Echlin is a clinical nurse specialist in hospice/palliative care and is
a past Executive Director of the Hospice of Windsor.

We are concerned that several measures within Bill S-2, the Medical Decisions Facilitations
Act, will permit cases of euthanasia and assisted suicide and weaken the current statutes
that protect elderly, disabled or incompetent (vulnerable) patients. We also question the
need for Bill S-2. The stated 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. Why define rights that are already clearly established?

Section 3 of the Bill will weaken the current protection that exists in law for elderly,
disabled or incompetent (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 in
cases where someone is more interested in their possible inheritance than the best interests
of the person.

The Bill also states in section 3, subsection (3) when no valid instructions have been given
by an incompetent patient that a request to withhold or withdraw treatment would be made by:
“(a) a proxy appointed under the laws of a province to make health care decisions on the
person’s behalf, (b) if no proxy has been appointed, by a legal representative having the
authority to make health care decisions on behalf of the person, or (c) if there is no proxy
and no legal representative, by the spouse, companion or relative who is most intimately
associated with the person.”

Since a spouse, companion or relative who is most intimately associated with the person is
more likely to know the intentions or understand the values of the person, we think that
this statute would lead to decisions being made that do not reflect the values or fulfill
the intentions of the person. Therefore, we believe that the order of priority for who will
make life-sustaining medical decisions for incompetent patients be reversed to represent the
supremacy of the family. Section 3, subsection (3) represents 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 and is potentially dangerous for elderly, disabled or
incompetent (vulnerable) persons.

Section 4 of the Bill would result in the intentional starvation and dehydration of elderly,
disabled or incompetent (vulnerable) patients who are not terminal. This section of the Bill
establishes that artificial nutrition and hydration (assisted feeding), would be defined as
life-sustaining medical treatment rather than normal medical care. Assisted feeding should
not be defined as medical treatment because it gives the option of withholding food and fluids
from patients who have a chronic disease but are not terminal or those who are persistently
living against the wishes of others.

We recognize the fact that when one enters the dying phase that they have a lesser need and
desire for nutrition and hydration and at the final stage of life they may have no need or
desire for food or fluids. But we are also aware that cases of intentional starvation and
dehydration have occurred and would more likely occur (without prosecution) if S-2 becomes
law. When it becomes an acceptable practice to dehydrate and starve people to death, even if
they are terminal, then it will be argued that it is more humane to kill them with a needle.

Section 5 of the Bill may cause some health care providers not to provide necessary ordinary
and routine medical treatments for elderly, disabled or incompetent (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 terminal. For instance, it would
allow parents of a Down’s Syndrome baby to deny life saving procedures that would be
considered routine for normal babies. In effect it would foster discrimination against
disabled and vulnerable persons. Disabled people are already being denied medical treatment
based on other people’s perceptions of quality of life. This bill would certainly exacerbate
their problem.

We believe that there is no need for Bill S-2 and we question what the real agenda is for
Senator Sharon Carstairs. Common Law has already established that Canadians have the right
to refuse or cease medical treatment that will prolong their life. There is no confusion
about the right to refuse treatment and it is not necessary to define this right in
legislation. Based on the Bill we must conclude that S-2 is a first bill and others will
follow that will continue to weaken the protections that exist in the law for elderly,
disabled or incompetent (vulnerable) persons.

We believe that the best interest of the incompetent patient who does not have a valid
advanced directive for medical decisions is more likely to be safeguarded by a spouse,
companion or relative who is most intimately associated with the person rather than a proxy
who is appointed by the provincial government. A proxy that is appointed by the government
should be the last option for establishing the course of action with regards to life-
sustaining medical treatment. This type of government intrusion is inappropriate and
potentially dangerous for the elderly, disabled or incompetent (vulnerable) persons who are
often regarded as too expensive to care for.

The only part of the Bill that we see as useful is the part of Section 6 of the Bill which
mandates: governments and professional organizations to promotion and encourage public
education and professional training regarding pain management and hospice/palliative care.
Given this, the Euthanasia Prevention Coalition of Ontario concludes that Bill S-2 should be
rejected since there is no necessity for the Bill and it is dangerous for the elderly, the
disabled, and the incompetent (vulnerable) because it allows of cases euthanasia and assisted
suicide to be practised and will lead to active euthanasia with or without request.

Euthanasia Prevention Coalition of Ontario – 247 Grey Street London, Ontario N6B 1G4
Tel: 519-439-3348 or 1-877-439-3348; Fax: 519-439-7053; E-Mail: [email protected]