A dying wish

In a YouTube video now seen by thousands, Toronto doctor Donald Low talks candidly about the realities of dying from a brain stem tumour that were likely coming his way: paralysis, the inability to swallow, having to rely on others to carry him to the bathroom.

The prominent infectious disease doctor, who became a recognizable face and trusted source when he led Canada through the SARS crisis a decade ago, has posthumously become a different type of spokesperson through his earnest, recorded plea to Canadian officials to legalize assisted suicide.

Filmed by his wife just eight days before he died, the University of Manitoba science and medicine alumnus urged fellow doctors to be more open to the idea of stopping the suffering for patients close to death. “A lot of clinicians have opposition to dying with dignity. I wish they could live in my body for 24 hours and I think they would change that, change that opinion,” Low said.

His right eye shut and his left held open with a bandage, in a weakened voice Low revealed his fear not of death but of the painful days leading up to it. “What the end is going to look like, that’s what’s bothering me the most,” he said. The video went on to say Low “did not have the death he had hoped for, but he died in his wife’s arms and was not in pain.”

Mary Shariff, assistant professor in the Faculty of Law

University of Manitoba law professor Mary Shariff is among those who watched and listened closely. She compares assisted-death legislation across the globe.

“It was a really profound, very real video. He asks the question ‘Why would we allow people to suffer when there is an alternative?’ And the answer is, of course, we shouldn’t allow people to suffer when there is an alternative,” says Shariff. “But in terms of law reform, the question is bigger than that.”

Euthanasia (when a doctor gives a patient a lethal injection) and assisted-death (when a doctor provides a patient with a prescription for a lethal dose to take on their own) remain illegal in Canada. A change for terminally ill patients would require navigating through what Shariff calls “a weird hybrid between criminal law and health.”

In June, Quebec introduced a bill in their provincial legislature (in accordance with their jurisdiction over health) to legalize assisted death for people with terminal illnesses. If the bill passes, which is quite likely Shariff believes, a constitutional challenge should come next given criminal law matters are a federal issue.

Meanwhile the British Columbia Supreme Court found that prohibiting euthanasia and assisted suicide is unconstitutional as it violates protections under the Charter of Rights and Freedoms. The Court of Appeal overturned the decision and it will likely go to the Supreme Court of Canada.

Shariff says it’s difficult to predict if and when Canadians will be able to choose when they want to die and do so in their own country. “There is a huge process that needs to take place,” she says. But first the public needs to better understand what they’re talking about legalizing—assisting with death or assisting with dying. “I don’t think that conversation has become clear,” Shariff says, noting there is a difference between helping the dying and helping someone who wants to end their life but doesn’t suffer from a terminal ailment.

Before Low’s video plea, Winnipegger Susan Griffiths, a 72-year-old grandmother diagnosed with a degenerative brain disorder, also made a public call for assisted suicide legislation. She did so before travelling to Zurich, Switzerland, to end her life earlier this year. (Switzerland is most known for its willingness to assist with suicide since it’s the only country where the service is clearly open to non-residents; the Swiss group Dignitas, who describes themselves as a right-to-die association, accepts Canadian patients at their assisted-suicide centre.)

Shariff, who looks at how assisted suicide became legal elsewhere in Europe (the Netherlands, Belgium and Luxembourg) and parts of the USA, credits stories like Low’s and Griffiths’ for bringing a crucial element to the debate: compassion.

“These are real stories. It’s easy to sit and theorize about what we should or shouldn’t do but we need to listen to people who are suffering,” says Shariff. “It’s really important that these things are in the media. It’s really important that Canadians are talking about it but I don’t think we should think there are any easy answers.”

Another U of M alumnus, Conservative MP Steven Fletcher, who was left a quadriplegic following a 1996 car collision with a moose, broke from the Tory party line and agreed with Low. After the video was released he told Global News: “I’m in a situation where I’m trapped in my body and I can understand his fear about dying without dignity, dying without control, dying in pain.”

But others worry the right to die could easily be abused or cause society to make their own assumptions about people with disabilities, Shariff says. Poll results published in February by the Canadian Medical Association show only 20 per cent of its members would be willing to participate in euthanasia and even fewer—16 per cent—in assisted suicide.

Legislation has come about in different ways elsewhere in the world. In the Netherlands, it was an initiative put forward by doctors; and in Oregon and Washington it was decided by popular vote (but passed by narrow margins).

“Even though it seems like the conversation has been around for a very long time (in Canada), legally we’re just at the beginning of getting all of the pieces of the puzzle on the table,” Shariff says. “And Canadians still aren’t quite there yet, even though Canadians want to be able to respond to the suffering of fellow Canadians.”

She’s watched Low’s video three times already and will again. “Because when it comes down to it, he embodies that discussion. We have to listen carefully.”

Read an op-ed Shariff wrote on this topic for the Winnipeg Free Press here.

Katie Chalmers-Brooks