Euthanasia in Canada, Supreme Court Ruled this Morning

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Kimmio said:
There needs to be a disability rights commission or else people with disabilities are not being justly represented.
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I disagree.

Again, the declaration made by the Supreme Court of Canada is not a cull of disabled persons. There is no group case. Every case will be decided by its individual merits. Disability is currently one of the elements determining vulnerability to inducement so, if anything persons with disabilities will have a higher standard to meet to prove they are indeed competent to end their life.

It is unlikely that any jurisdiction will establish a disability rights commission to hear every case where an individual might be requesting the right to end their life. That determination will be made between the physician and their patient. Legislation may require second opinion or even a local panel review. That remains to be seen.
 
Kimmio said:
Okay (preparing to be called "out of my gourde") for the purpose of debate. I have been suffering chronic depression on and off for decades.
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For the purpose of debate that information puts you in the vulnerable to inducement catagory and for the purpose of debate I would not agree that you have demonstrated competency to make an end of life decision. Instead I would refer you to another doctor who treats depression.
 
revjohn said:
I disagree.

Again, the declaration made by the Supreme Court of Canada is not a cull of disabled persons. There is no group case. Every case will be decided by its individual merits. Disability is currently one of the elements determining vulnerability to inducement so, if anything persons with disabilities will have a higher standard to meet to prove they are indeed competent to end their life.

It is unlikely that any jurisdiction will establish a disability rights commission to hear every case where an individual might be requesting the right to end their life. That determination will be made between the physician and their patient. Legislation may require second opinion or even a local panel review. That remains to be seen.
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Well respectfully people with disabilities who signed the UN Convention which stipulated that signatories must appoint a commission disagree with you.

Not saying there's cull - but there are dangerous cracks affecting the rights of people with disabilities, hence the convention.
 
revjohn said:
For the purpose of debate that information puts you in the vulnerable to inducement catagory and for the purpose of debate I would not agree that you have demonstrated competency to make an end of life decision. Instead I would refer you to another doctor who treats depression.
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A doctor and only a doctor is competent to determine what can help?
 
The purpose of a disability rights commission is not to just hear cases. It is to gather research and findings and present recommendations to the government about where rights gaps are in policy.
 
@revjohn clinical depression is considered a medical diagnosis and a disability.

Consider under the UN Convention on the rights of people with disabilities point "e" which states that: "Disability is an evolving concept, and disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others"

Which has to be balanced with

"n" which states: "Recognizing the importance for people with disabilities of their individual autonomy and independence, including the freedom to make their own choices"

But then also take into consideration the other points like "t": "Highlighting the fact that the majority of persons with disabilities live in conditions of poverty, and in this regard need to address the critical negative impact of poverty on persons with disabilities." - already missing from the medical model of disability - used by most doctors - which brings to mind "k"...

"Concerned that, despite these various instruments and undertakings, persons with disabilities continue to face barriers in equal participation in society and violation of their human rights in all parts of the world" - the medical model of disability used by doctors and governments being one of them - in particular the DSM - because it doesn't consider the rest of the factors.

Then there are articles 10-17 and article 25, 26- perhaps more, that might apply. Article 29? But obligations under Articles 31-35 have not been fulfilled - which would be the responsibility of the missing Disability Rights Commission - to take the rest of the above into account and provide protection and remedy to people with disabilities.

https://www.un.org/disabilities/convention/conventionfull.shtml
 
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And this decision impacts, is potentially risky, for people with disabilities more than any other group because disability is defined by, in part if not in whole (depending on which experts you consult) disadvantage due to medical impairment present.
 
Kimmio said:
A doctor and only a doctor is competent to determine what can help?
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For the sake of the discussion I was playing the role of a GP. And in that role my understanding is that Chronic depression disqualifies you from being competent enough to request physician assisted suicide.

As a GP my next step would be to refer you to a psychiatrist. Why? Because it is my understanding that Psychiatry is that branch of medicine which has had the most success in treating depression.

Notice how I did not simply say yes you should kill yourself? Notice how I did not say there was no help for you beyond what I could offer.

Now if I, who am not a trained physician can know enough to do that why would those who are trained physicians not know enough to do that?

Show me how my response contravenes what the legislation in place directs. Show me how my response contravenes what has been called for.

If the psychiatrist works with you and determines that you are competent to commit suicide that would be another matter. Not knowing any psychiatrists who actually include suicide in their repetoire for the treatment of chronic depression I would be surprised that you would be able to convince a psychiatrist that it was warranted in your case.
 
What I object to and think is discriminatory is that a neither a GP nor psychiatrist is competent - or expected - to address the other factors that might make a person suicidal, except to provide medical diagnosis and treatment. The plus to your answer is - yes - that might save a person from suicide if they approached it that way - a person would be getting medical attention - but not attention to external factors contributing to and perpetuating depresssion. The negative side is that the medical profession takes too much ownership over the assessment, treatment and maintenance of mental health - factors in individuals' independence and autonomy.

But, again, looking at what Belgium is doing I am not sure your answer is accurate (did you see the PBS video I posted?) because GPs there apparently are determining that depressed persons are competent to choose assisted suicide - and their criteria look an awful lot like this latest ruling.
 
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Kimmio said:
@revjohn clinical depression is considered a medical diagnosis and a disability.
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Hence the automatic disqualification regarding competence to make the decision.

Kimmio said:
Consider under the UN Convention on the rights of people with disabilities point "e" which states that: "Disability is an evolving concept, and disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others"
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Which means what in this context Kimmio? That you want a panel to determine that people with disability should not be rendered "vulnerable" and thus protected under the legislation?

Kimmio said:
"n" which states: "Recognizing the importance for people with disabilities of their individual autonomy and independence, including the freedom to make their own choices"
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Consider me confused.

You are concerned that suddenly people with disability are going to be vulnerable to physican assisted suicide. Current legislation would not give them access to physician assisted suicide you want a panel to protect them and you want to invoke a UN convention that would remove disability as a "vulnerability" that currently exists to protect persons with a disability. And you want a new model of disability used to define disability but even so you want persons with disability to have equal rights under the law but you want to shield them from being vulnerable to inducement.

I think you need to make up your mind about what it is that you actually want I certainly cannot follow the logic at the moment.

If you are concerned about persons with disability becoming vulnerable then you need to insure that the vulnerable status currently assigned to persons with disabilities remains.

If you are concerned about persons with disability not having equal rights under possible new legislation then make the argument which does not assign vulnerable status to persons with disabilities.

Because at present persons with disabilities do not have access to physician assisted suicide. The only door that is being opened by the Supreme Court is a narrow one and requires individuals to be regarded mentally competent to make that decision.
 
And I am saying that under a different model of disability that isn't being followed by our government or largely by the medical profession at the moment - esp the DSM - but is recognized by rights groups and the UN and WHO - nobody with a disability or impairment short of terminal illness, except in very exceptional circumstances would ever qualify for assisted suicide - a protected group of persons with the autonomy to exist as persons with impairments that no other person is qualified to determine equate to too much suffering - therefore they are not qualified to carry out the procedure, or have anything to do with it. Without that, other experts can put their spin/ prognosis on what constitutes too much suffering that might influence guidelines.
 
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Kimmio said:
What I object to and think is discriminatory is that a neither a GP nor psychiatrist competent - or expected - to address the other factors that might make a person suicidal, except to provide medical diagnosis and treatment.
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Not quite true. The concern is for individuals generally looking at terminal illness the expected course of which will be exceedingly painful. It could be argued that such a prognosis would be depressing. I doubt it would lead to a clinical diagnosis. And if it did. Hey presto that just put the patient in the vulnerable category and that puts the discussion of Physician Assisted Suicide off limits.

Kimmio said:
But, again, looking at what Belgium is doing I am not sure your answer is accurate (did you see the PBS video I posted?) because GPs there apparently determining that depressed persons are competent to choose assisted suicide - and their criteria look an awful lot like this latest ruling.
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I did. I don't think that we are obligated to emulate everything that Belgium has done. We are free to draft our own legislation and to debate such legislation before it becomes law.

The Belgian criteria might look like what has been suggested by the Supreme Court. The reality is that no criteria are currently in place so we cannot say one way or the other that Canadian legislation around Physician Assisted Suicide looks like what Belgium offers.

Belgium requires two doctors (second opinion/assessment always a good idea) and if the doctors doubt competency a psychologist needs to sign off on the request. Criteria for allowing Physician Assisted Suicide in Belgium includes terminal illness (I know of no disability which fits that criterion), unbearable suffering (again I know of no disability which fits that criterion), conscious of their decision making (I don't think that most persons with disability would fail this particular criteria but a 33% score in a three category test fails to meet the requirements for consideration.
 
Kimmio said:
And I am saying that under a different model of disability that isn't being followed by our government or largely by the medical profession at the moment - esp the DSM - but is recognized by rights groups and the UN and WHO - nobody with a disability or impairment short of terminal illness, except in very exceptional circumstances would ever qualify for assisted suicide
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Agreed. I actually think that even with the current model of disability which is being followed very few will qualify for assisted suicide who have not been diagnosed with a terminal disease.

And the legislation that was considered unconstitutional did not open a huge door through which I can suddenly get rid of people. It opened a door to individuals diagnosed with a terminal disease (not disability) suffering unbearable pain and conscious of their decision and its consequences. Nobody else.
 
Kimmio said:
In other words, doctors are not qualified to make the decision to allow or carry out the procedure unless a person is terminally ill.
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As I understand it that would not be enough in and of itself to qualify as competent to make the decision. On its own it is still only 1/3rd of a 3 part test.

Still need to prove unbearable suffering (and I expect that "I can't bear knowing" will not pass muster).

And then you need to prove that you are sound enough mentally to make the decision..
 
John is on the money. And nothing in the decision stops the government and medical colleges from putting definite rules around how to determine all of those items, which is what will be happening over the next year (though will likely take a backseat to an election at some point).
 
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