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When it comes to assisted dying, whose choice is it?

Earlier this week California Governor Jerry Brown signed an assisted dying bill into law, making California the fifth and most populous state in the union to offer terminally ill citizens an end of life choice.

At least four right-to-die bills have collapsed in the California legislature since 1995, but the latest one, despite opposition from the Catholic Church and a coalition of hardline pro-life and disability-rights activists, passed in the Senate last month.

Can Canada be far behind?

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Yes, says Conservative MP Steven Fletcher. He believes it will take "a legislative miracle" to produce and pass a law by Feb. 6, the first anniversary of the Supreme Court of Canada's historic ruling that decriminalized physician-assisted death.

The first quadriplegic elected to the House of Commons, Fletcher says lots of people are talking to him about the pros and cons of physician-assisted death as he campaigns for re-election in his Winnipeg riding, but he admits the issue hasn't overtaken the economy, trade, refugees or the spurious niqab controversy. The reason is simple: Choice in dying is personal and easy to put aside until you have watched a loved one suffer or confronted your own mortality.

Fletcher was only 23 in 1996 when the car he was driving collided with a bull moose on a remote road in northern Manitoba – "a quintessentially Canadian accident," he later quipped with his trademark sly humour. He suffered a C-4 fracture, paralyzing him from his neck to his toes, spent a year in hospital, often in excruciating pain, frequently terrified that he was going to drown in his own phlegm, unable to talk until he managed to wean himself off a ventilator.

Before his accident, he never thought about death. "I was immortal. I was thinking about my career, my next canoe trip in the wilderness and having lots of sex – and not necessarily in that order," he told me this week. "That was all taken away in an instant."

His own near death experience made him consider the plight of other people suffering from terminal illness or horrific neuro-degenerative diseases, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis, multiple system atrophy – people for whom disease and disability create a gap between their "health span" and their "life span," people for whom dying is neither swift nor peaceful.

Pondering, under what conditions, if any, they should be allowed to ask for a hastened death, was the impetus behind drafting the two private member's bills that Fletcher tabled in March, 2014, setting out a legislative blueprint for Criminal Code amendments and a national physician-assisted death regulatory commission.

Yet, many disabled people fear that legalizing physician-assisted death will make them even more vulnerable. Catherine Frazee, former chief commissioner of the Ontario Human Rights Commission and a professor emerita at the School of Disability Studies at Ryerson University in Toronto, is a well-known advocate for disability rights. A vocal opponent of physician-assisted death, she testified on behalf of the government at the 2011 Carter challenge in British Columbia, the case that led to the Supreme Court ruling last February.

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She has frequently written about what dignity means to her as a disabled person for whom "immobility, incontinence, impairment and dependence" are routine parts of her life because she "cannot bathe or breathe or feed without the aid of some device."

For Frazee, dignity is bound up with her humanity, not her impairments. "See me as anything but your equal in human worth, and at that moment, in that glance, with that sorrowful sigh, you have robbed me of dignity" she wrote in an opinion piece in the Ottawa Citizen last year on the day of the Supreme Court of Canada hearing. "Speak of willful death as a reasonable choice for persons afflicted with the presumed indignity of physical incapacity, and my dignity is undermined."

This fear of being dismissed, of being shunted aside as less than fully human, is at the heart of her opposition to physician-assisted death, or PAD. Isn't there a fundamental difference, I suggested to Frazee in a recent conversation, between respecting the dignity of individuals in all their infinite variety and recognizing a competent adult's right to make a voluntary choice for a rational, untroubled and hastened end to a life that has become unbearable because of irremediable physical or mental suffering? The problem for the physically disabled is that they, unlike the rest of us, often can't act on their choice.

She disagreed that the distinction was that simple. Nevertheless, as one of three appointees to a federal consultation panel charged with developing recommendations for a government response to the court's decision, Frazee believes she can set aside her "advocacy for social justice," and her "views on the theoretical issue of whether PAD is acceptable" in order to engage "honourably" on physician-assisted death "in a way that brings people together after a divisive time in Canada's social history."

I hope so, but how are we to know, since there are no public hearings planned before the hastily assembled panel, chaired by psychiatrist Harvey Chochinov, another adamant opponent of physician-assisted death, submits its report in mid-November to the Minister of Justice – whoever that might be given the Oct. 19 federal election.

Many of Frazee's deeply felt concerns about physician-assisted death were in play in California as legislators struggled with its assisted-dying bill. Why did the California bill succeed? Public opinion, lobbying and the personal story of Brittany Maynard are the short answers. Maynard was the terminally ill Californian who moved with her family to neighbouring Oregon so she could establish residency and take advantage of that state's dying with dignity legislation. She went public with her story before she died at 29, after ingesting a lethal doctor-prescribed potion last November.

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Her mother and her widower were persuasive advocates on behalf of Maynard's cause and her legacy. Still, the bill sat on Brown's desk for weeks while the Governor, a man who had spent three years in a Jesuit seminary training for the priesthood, agonized.

"I do not know what I would do if I were dying in prolonged and excruciating pain," he finally wrote in a letter that accompanies the signed bill. "I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn't deny that right to others."

What it comes down to is allowing others the choice you would want for yourself – a good point to raise when candidates come knocking on your door, seeking your vote on Oct. 19.

Follow me on Twitter: @semartin71

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About the Author
Feature writer

Sandra Martin is a Globe columnist and the author of the award-winning book, A Good Death: Making the Most of Our Final Choices. A long-time obituary writer for The Globe, she has written the obituaries of hundreds of significant Canadians, including Pierre Berton, Jackie Burroughs, Ed Mirvish, June Callwood, Arthur Erickson, and Ken Thomson. More

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