Irreconcilable Differences

Through his review of my Dying Justice, Preston Manning illustrates a point that I took pains to make in the book—those who do not share the book’s core values and hierarchy of values (grounded in the Charter of Rights and Freedoms and the common law) will not be persuaded by my arguments for the decriminalization of euthanasia and assisted suicide. My book is grounded in a liberal individualist conception of autonomy and dignity and a secular view of the value of life that can, at times, be overridden. I did not set out to persuade people like Manning, who hold different values. They may well continue to believe, for example, that the religious view of the sanctity of life should dictate Canadian policy and that euthanasia and assisted suicide should be prevented even for those who are capable of making a free and informed decision to end a life that, for them, has ceased to be of value. Not only do Manning and I come from entirely different places; we speak to different audiences. My goal was to persuade my audience, not his (or him).

In this brief response, I cannot respond to all of Manning’s comments. However, I will pick two illustrative issues to counter his central claim that my approach is informed only by legal consider- ations and not also by “empathy with the dying, cultural sensitivity, democratic consultations, the medical and psychiatric perspectives, the spiri- tual dimension and a deontological approach to ethics.”

First, he states, “I am sure that Downie does care, but the fact that she offers no evidence that she has actually sat with the dying, cried or laughed with them, shared their fears and hopes, or wrestled personally with their doubts and questions, suggests to the reader that Dying Justice is an abstract, not empathetic analysis.” In fact, I have trained and worked as a palliative care volunteer. He also suggests that “real people in real life-and-death situations—especially dying persons—do not start or end there at all [looking at what the law is and what the law should be], nor should any truly humanitarian analysis of the laws or policies that should govern such situations.” He then describes his 90-year-old father- in-law diagnosed with terminal bone cancer and notes that “not once did he ask me ‘what the law is’ governing such situations, nor would I have had the temerity in that situation even to raise the subject.” My experiences are very different from Manning’s. In my experience, many “real people in real life-and-death situations” are profoundly interested in what the law is and are keen to discuss what the law should be. Many, many people in these situations have initiated conversations with me about assisted death. Ironically, it was deep empathy for those people I have worked and talked with—and, most importantly, listened to—that motivated me to write the book.

Second, he states, “Downie makes no reference to having engaged in or taken into account any such democratic consultations.” In fact, in my role as Special Advisor to the Senate Committee on Euthanasia and Assisted Suicide, I was present in Ottawa, Winnipeg and Vancouver when many members of the public testified before the committee. I also read all of the transcripts. Regardless of what one thinks of the Senate as an institution, the process of this committee constituted a significant consultation with “the people” and informed my work. Finally, it is not true that I am “completely silent” on depression and its impact on decision-making capability; it is not true that I “make no reference to the spiritual dimension of death and dying”; and it is not true that I am a utilitarian—a consequentialist but not a utilitarian. It is important to note that, while we have our disagreements, Manning and I actually share a commitment to care for the dying, to have culturally sensitive social policy, to have laws informed by appropriate public consultations, to value the perspectives of all (including medical and spiritual) and to improve access to palliative care in Canada. We just end up in different places when we seek to do so.

Jocelyn Downie
Halifax, Nova Scotia

Mr. Manning and I could probably agree that the state should restrict the liberty of the individual only when a greater good is achieved. So if he wants to deny by law my liberty to obtain help in ending my life when I think the time has come, he must explain what public good is served. On what grounds would he consign me to a lingering death in a cancer ward or a warehouse for the senile? Would that benefit society? In fact, it would cost society medical resources better used elsewhere.

Mr. Manning alludes to spiritual values to justify his position, but I don’t share his values. I don’t wish to impose my agnosticism on him and I don’t want him to impose his version of Christianity on me.

Anthony Westell
Toronto, Ontario