title: Guidelines for legalized euthanasia in Canada: a proposal.
abstract: Arguments for liberty, mercy, and dignity support the legalization of euthanasia, but there remains a possibility of undesirable social consequences should this occur. Accordingly, proposals must prevent involuntary euthanasia, prevent unconscious coercion of the terminally ill to request euthanasia, protect and enshrine the availability of first-class palliative care, ensure documentation for purposes of enforcement and study, and spell out enforceable consequences for violations. Guidelines set by the Royal Dutch Medical Association have largely failed to meet these requirements. In North America, proposals for legalization, such as Oregon's Measure 16 and the minority opinion in Canada's Rodriguez case, also have flaws in meeting these criteria. Legislation in the Northern Territory of Australia came closest to meeting the requirements outlined, but was overruled after a brief period in effect. In Canada, a comprehensive survey of current euthanasia practices and improved availability of palliative care must precede attempts at legalization. A specific proposal is made for ethics committees operating at a regional health board level to approve legal euthanasia fitting within careful guidelines. Composition, procedures and mandate are described. If a set of guidelines, balancing any right there is "to die with dignity" with a responsibility to protect the weakest in society, is proposed first by the medical community, Parliament may have the courage to enact legislation.
authors.affiliation: Vancouver Hospital and Health Sciences Centre, 855 W. 12th Ave., Vancouver BC V5Z 1M9, Canada. knordquist@sprint.ca
authors.forename: T O
authors.initials: TO
authors.lastname: Nielsen
mesh_terms: D001315:Australia; D002170:Canada; D003068:Coercion; D028741:Ethics Committees, Clinical; D028601:Euthanasia, Active / Q000331:legislation & jurisprudence* / Q000592:standards*; D033101:Euthanasia, Active, Voluntary / Q000331:legislation & jurisprudence*; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D038622:Internationality; D009426:Netherlands; D010166:Palliative Care / Q000592:standards; D011639:Public Opinion; D012297:Right to Die / Q000331:legislation & jurisprudence; D012922:Social Change; D017236:Suicide, Assisted; D014481:United States