Elizabeth Church reviews an expert panel’s latest report advising provincial and territorial governments on how to proceed with publicly funded doctor-assisted dying.

Appropriate Subject Area(s):

Social studies, current events, history

Key Question to Explore:

• What is the current status of last year’s Supreme Court ruling on doctor-assisted dying?

New Terminology:

Irremediable, bioethics, equitable, bipartisan

Materials Needed:

Globe article

Introduction to lesson and task:

Under Canadian law, until last year doctors were not allowed to assist patients who specifically ask for assistance to end their own lives. In striking down this law last year, the Supreme Court opened the door to doctor-assisted dying in Canada; however, they gave the government until February, 2016, to develop relevant laws before their decision would come into effect. The new Liberal government asked for a six-month extension to allow time to consult with stakeholders and to prepare new laws; the court granted four months.

Controversial as this subject may be, students need to be aware that the law is about to be changed and will allow grievously and irremediably ill patients to end their own lives with the assistance of a doctor. The following lesson involves a ‘media studies’ exercise in which students will work in pairs to respond to questions about specific excerpts from the article supplied to help them form a more informed opinion on the subject.

Action (lesson plan and task):

NOTE: Please use your best judgment before assigning this lesson, which is recommended only for senior and/or very mature students as the subject matter can be very disturbing to some.

Put this question to your students: If you are gravely ill and in continuous serious pain, with no treatment of any kind available to you nor any hope for recovery, is it legal in Canada for a person to help you end your life? (Not yet, but the Canadian Supreme Court has struck down the law that prevents doctors from assisting a patient to die, first giving the government until February, 2016, to develop the requisite laws—then granting a four-month extension)

Discuss as you feel is necessary and then provide the following assignment:

Assignment:

Working with your partner, read the entire article first and then address the following excerpts taken from the article by answering the questions or completing the tasks that follow each:

Canadians should have equal access to publicly funded, doctor-assisted dying with no age limitations, and physicians and institutions that object should be obliged to provide a timely referral, says an expert panel advising provincial and territorial governments.

• What is meant by “equal access?” Does it relate to which Canadians may use this service or to where they might live, or…?
• How might “equal access” be controversial when it involves the age of a patient?
• What is meant by a “timely referral” here, do you think?

…Supreme Court ruling last year that struck down a law that made it illegal for doctors to help competent, consenting adults with “a grievous and irremediable condition that causes enduring suffering” to end their lives.

• What do you think is meant by competent? Consenting? Adult? (what age?) What does the article say, eventually, about age limits?
• Define each term separately: Grievous, irremediable.

Among the panel’s 43 recommendations are calls for uniform rules across the country and for other health professionals, such as nurse practitioners, to be involved as a way to increase access.

• Why is it important that the rules be uniform across the country?
• How might the involvement of nurse practitioners increase access?
• Can you think of an example of a person who might not have access to this service?

The recommendations include a list of safeguards, such as requirements for assessments from two doctors and a witnessed declaration from the patient that would serve as a formal request.

• Describe how you think this process might work. If a patient wanted to die with a doctor’s assistance, what steps would need to be taken?

“Canada is a big country with no single national health service, which together creates special challenges”…

• If Canada does not have a single national health service, which level of government provides health services? How might this fact create special challenges?

Faith-based institutions could conscientiously object, but the report says they should have to “make arrangements for the safe and timely transfer of the patient to a non-objecting institution” for assessment and potentially help with dying.

• How do you understand this sentence? What kind of faith-based institutions might object? What options do they have if they do object?

Do you sense any bias in the author of this article for or against the coming changes to the law? Provide evidence.

Finally, discuss this issue with your partner. How do each of you feel about the “right to die” with the assistance of a doctor? Give reasons for your position.

Consolidation of Learning:

• Conclude with group oral reports and a class discussion on the exercise to see the degree of consensus that may result, if any.

Success Criteria:

• Students can describe the current status of the right to doctor-assisted dying in Canada.

Confirming Activity:

• Consider having students write a short personal piece on this subject, explaining why they are for or against doctor-assisted dying.