Thursday, September 26, 2013

My thoughts on "death with dignity"

The recent passing of Dr. Donald Low, who guided Toronto through the SARS crisis in 2003, unexpectedly sparked a revival of the difficult issue of assisted suicide when his widow, CBC alumna and medical expert Maureen Taylor, released Low's final home video where he asked Canadians to consider what it would be like to live in his body -- rapidly degenerating -- for twenty-four hours.

At the outset, I want to express my condolences to Maureen and her family.    His was certainly no way to die.

That said, this is truly a conflicting issue for me.   As most of you know, I'm pro-life.   Unlike a lot of social conservatives, that to me means from birth to natural death.   I certainly don't support capital punishment, and the concept of assisted suicide goes against my conscience at every possible level.

It has been, however, twenty years since Rodriguez v. Attorney General of British Columbia.   In the very close 5-4 decision the point was made by all sides that the plaintiff, Sue Rodriguez, was in an impossible situation with Lou Gehrig's Disease.    Writing for the majority, though, the late John Sopinka began his opinion by making reference to Jack Kevorkian.   It was an understandable viewpoint.   The assisted suicide law doesn't only ban active and passive euthanasia -- this ban was what Rodriguez was challenging -- it also bans counselling someone to commit suicide; and all lines on which Kevorkian was often very close to crossing and which he finally did cross when he openly put down a patient on 60 Minutes -- the first ever televised snuff film.

No question that no one should be bullied into doing anything against one's self-interest, certainly something like that.   Ever.

But when the most strident opponents claim to offer alternatives, the first thing they point to is palliative care; trying to make the patient as comfortable as possible in an attempt to make death more manageable.    Reasonable but the problem there is, as far as I can see, palliative care hasn't really improved that much over the last two decades since the Rodriguez case.   And as the population gets older, the more the clamor for end of life rights is getting.

Every time the issue is brought up in Parliament, the powers that be impose party discipline (at least within the ruling party) and vote down the measure even though this is as much a matter of conscience as abortion is.   So to say Parliament has "voted" and there is no call to revisit the issue is disingenuous at the least.

On the one hand, there is for me a big difference between actually committing suicide as quite a few terminally ill people do before they aren't able to, and getting the help of someone -- presumably a medical professional -- in assisting the patient in ending his or her life.   It certainly goes against both the ancient and modern renditions of the Hippocratic Oath, the latter which includes the promise by the doctor that he or she will not play God.

And let's not forget Robert Latimer, someone with no discernible medical training, who took the law into his own hands when he killed his daughter Tracy.   I have previously argued that this was a situation that called for the creation of a tier of third degree murder -- something between a crime of passion (murder two) and recklessness causing death (voluntary manslaughter) -- but that Mr. Latimer shouldn't have gone unpunished.

On the other hand, there are some patients, perhaps a small fraction of those who say they want to die, for whom there is reached the point that is no hope that medical assistance can ever turn things around.   I say a small fraction because such a drastic measure should not be made available to anyone, presuming such a law is enacted.    The Belgian law that is so broad that recently one patient  ended his life because he was told he was going blind but was otherwise healthy, proves the point.

The number of doctors who would be willing to step up for such a "service" must be very small, for the reason I noted above.   This isn't exactly something one would want to advertise his or her services for.    We certainly don't know -- still -- who helped Rodriguez in her last moments and, really, the vast majority of all of us don't even want to know.

But I suspect that to the argument that a doctor musn't play God, he or she might counter that God has already made the decision for the patient making the point moot; and postponing the inevitable and making things worse is only a disservice to the patient and his or her family.

Martin Luther King, quoting Saint Augustine, pointed out an unjust law is no law at all.   He was referring to the unfairness of segregation and eventually Congress backed him up albeit years after the courts did.  

Morally, and in this instance I still think the law has a place.

But from the legal standpoint that most people have the right to end their own lives and others do not, I have to say that is a denial of the equal protection of the laws and is therefore unconstitutional.    This is based on the same principle why I now support same sex marriage -- whatever moral qualms I have, it's a matter of legal equality.  Given the current composition of the Supreme Court of Canada, there's a better than even chance that Rodriguez will be overturned when a contemporary case working its way up from the BC courts hits its docket, and then Parliament will have a huge hornet's nest to deal with.

It shouldn't get to that.    There has to be a proactive approach to this.  For once, and before the case reaches 301 Wellington Street, we need to have something we've never really had in Parliament -- a serious and broad debate about the issue down the street from the court at 111.   All 302 MPs who are not party leaders (the Speaker, who is neutral, is not included in that number) should be able to give his or her 20 minute talking point.   The five leaders, of course, get unlimited time but they should also make a cogent and concise argument.   Maybe then there can be compromise legislation that draws a line but leaves the door very slightly open and sets very clear rules when a physician -- and not a family member -- can intervene.

That it would take just one man, a true Canadian hero, to reopen the debate, is extraordinary.   But it is refreshing and if anyone should have done it, is was him.   Rest in peace, Dr. Low.

Tuesday, September 24, 2013

Why I'll be voting on the minimum wage in Ontario

Currently, the minimum wage in Ontario is $10.25 per hour.    Presuming a 40 hour week, no sick days and two weeks vacation, that works out to about $20,500 per year.   Not a bad piece of change; but with the lowest marginal income tax rate of 20% and payroll taxes of 7%, that leaves $14965, well below the "low income cutoff" -- a bastardized way of saying poverty line.   And don't forget, a general sales tax rate of 13%, so it goes down to $13,020.

Moreover, the rate has held steady since 2010, during a time when accumulated inflation has increased 6.9% -- and of course that does not include the very volatile energy prices we've experienced as with the rest of the country.   So those on minimum are worse off over time.

There is an argument, a strong one, that at the very least there should be a law requiring the minimum wage increase with the rate of inflation.

But many social activists have said that to put people above the poverty line, the minimum needs to go up to $14.00 per hour.    Now this doesn't have to be all at once; of course that would be a burden on business.   It can be phased in over four years, say 94 cents each.   Once the phase-in is complete, then do annual increases on inflation.

The problem, of course, is that every time there is proposed an increase in the minimum wage, businesses both large and small scream bloody murder; saying they will have to lay off people, it will force them to raise prices to the consumer, and that it acts as a disincentive to hard work.   All three of these are total nonsense.   I'm not aware in the recent past of mass layoffs caused by a raise in the minimum.   If anything, an increase also helps people earning higher wages, more often than not such a raise is applied across the board for both hourly and salaried workers (i.e. a fifty cent increase at minimum is reciprocated for higher wage people).    That it fuels inflation -- probably, but it's not the only reason prices go up, in fact it's only a small part of it.   And rewarding slackers -- seriously?   People these days are more than happy to work for minimum wage, it gives them something to do.   They'd rather pay taxes than collect welfare.

But as to the argument that a higher minimum wage is bad for business, I say bunk.    Here's why I think so:

Those below the low income cut off use a larger portion of their income for basic necessities; food, clothing heat, vehicle fuel.  They don't have the ability to afford not necessarily the finer things in life, but simply the items that actually bolster economic growth.    These are consumer goods such as home electronics, video games, appliances, furniture.    And of course, an annual vacation out of town instead of a "stay-cation".   The more money there is to go around, the more there is to spend.   The more to spend, higher profits lead from that which usually means the ability to hire more workers.

More workers means more income taxes, and the sooner Ontario can get out of "have-not" status and our current forced acceptance of equalization payments from the feds.   Currently, that's just over $3.1 billion, a huge spike from 2010 when it was "just" $347 million.   Equalization may be just a drop in the $117 billion revenue bucket, but it basically runs the agriculture, justice and environment departments.   Not insignificant items at all.

One of the issues with the inevitable election campaign that may happen here as early as this coming spring, a year and a half before it's supposed to be, will be this basic principle.   That no one gets left behind.    While this will not be the only deciding factor in my vote, it is now a huge one.

It's time to have a living wage, not a subsistence one.   I thank God we don't have third world conditions and pray we never will, but even lower income people have the right to have a reasonable level of participation in our society.