In the 20 years since the Supreme Court decided 5-4 against legal assisted suicide in the Sue Rodriguez case, pressure to legalize physician-assisted suicide (PAS) has increased at both the legislative and judicial levels, said Dr. Rory Fisher in a presentation to the CCBI.

Dr. Bill Sullivan pointed out that the Canadian College of Family Physicians now takes a neutral stance on the issue of physician-assisted suicide — despite the clear prohibition in the law and the existing codes of ethics.

With legal PAS in North American jurisdictions including Oregon and Washington, legal euthanasia in Switzerland, legal PAS in the Netherlands and great reluctance to prosecute or punish PAS in the United Kingdom, there’s nothing unthinkable about having doctors prescribe lethal drugs with the sole intention of killing their patients, said Fisher.

While Catholics know the religious arguments against PAS and euthanasia, they also need to access the natural law tradition to make rational, science-based arguments, said CCBI executive director Moira McQueen.

“We’re very good at saying when things are wrong, and that’s all well and good,” said McQueen. “But it’s going to take something more.”

People need to learn to think positively about how they would like to die well in advance of a medical crisis, said McQueen. By making decisions in advance people can limit the scale of technical interventions in the final months of life and choose to die at home surrounded by friends and family, she said.

The myth of untreatable, intractable pain needs to be challenged, said Fisher. There are almost no cases where pain cannot be controlled in a palliative care setting, he said.

In jurisdictions where physician-assisted suicide is legal, depression is increasingly a factor in decisions to request assisted suicide, he said.

“Depression is a treatable condition,” he said.

In Holland physicians are citing “suffering from life, a completed life and done with life” as valid reasons for assisting at suicides, said Fisher.

“There is a slippery slope,” said McQueen.

On the policy level, euthanasia and PAS opponents should support community care access centres and more palliative care, said McQueen. The fact that only about a fifth of Canadians, most of them in large urban areas with teaching hospitals, have access to palliative care is a serious social justice concern, she said.