Low was the Mount Sinai Hospital microbiologist who guided Toronto through the SARS crisis in 2003. He died Sept. 18 of a tumour in his brain stem. His plea to opponents of assisted suicide that they spend 24 hours living in his body before passing judgment went viral when it was released following his death.
Students in the St. Michael’s College Christianity and Culture program organized a symposium with Canadian Catholic Bioethics Institute director Moira McQueen and Rouge Valley Health System ethicist Christopher de Bono to review Low’s arguments in favour of physician-assisted suicide.
“It has an impact,” said St. Michael’s student Katharine Exarhakos of Low’s video.
The trouble with religious arguments against euthanasia and assisted suicide is that most people have come to expect manipulative and sometimes self-serving arguments from religion, Exarhakos said.
“It may shut off the conversation,” she said.
It’s hard to argue against free choice, said student Christina Lubinsky.
“He’s arguing for the freest possible choice,” she said.
But free choice is a tricky thing. It’s often hard to know who is doing the choosing and in whose interest, McQueen told the students. If frail and dependent patients are made to feel like a burden, or made to feel disconnected from life, would opting for suicide really be a free choice?
Patients who should be in nursing homes or in palliative care are a major problem for hospitals and for health-care budgets, McQueen pointed out.
“They’re very often referred to as bed blockers,” she said.
It’s impossible to talk about pure or clear motives when anybody chooses physician-assisted suicide, said McQueen.
Nor is it possible to entirely dismiss the slippery slope argument, McQueen said. In every case where physician-assisted suicide has been made legal the acceptable conditions for prescribing lethal drugs have relaxed and changed, and the numbers have gone up.
“There’s no possible way of framing legislation that is robust enough to protect the vulnerable,” she said.
De Bono was surprised that Low made his argument for freedom to choose based on the idea that palliative care could not adequately handle the pain and physical limitations associated with dying of brain cancer. Not only has palliative care advanced light years in its ability to control pain and ensure the comfort of patients, Low should have known about those advances, he said.
“Mount Sinai has one of the best palliative care programs for people who want to die at home,” he said.
The father of the Temmy Latner Centre for Palliative Care — and Low’s colleague at Mount Sinai — Dr. Larry Librach died comfortably at home of pancreatic cancer just a month before Low.
What Low really wanted at the end of his life was the same kind of control he exercised throughout his life.
“Control has a central role in Dr. Low’s narrative,” said De Bono.
From birth to death there are always parts of life that are not ours to control, argued the ethicist.
Arguing against physician-assisted suicide and euthanasia should be about policy, law and reason, said McQueen. While there certainly can be religious arguments they’re not necessary, she said.
Catholics often misunderstand Church teaching about pain and suffering, imagining that the Church glorifies suffering and urges stoic heroism in the face of pain, said McQueen.
In 1952 Pius XII tackled the question of the use of opioids at the end of life, approving their use even to the level of unconsciousness and accepting the fact that such drugs may hasten death.
“Our own Church tells us we don’t have to suffer. If there’s medication available, then take it,” said McQueen.