阿尔伯塔女童"安乐死"判决被提交最高法院... She died. The fight is over.

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Precedent-setting ruling appealed to the Supreme Court

Latest Report -

CBC: Jailed parents visit child before life-support removed
Last Updated: Sep 20, 2012 3:34 PM ET
http://www.cbc.ca/m/touch/politics/story/2012/09/20/edmonton-m-supreme-court.html

The parents of a two-year-old girl, who was ordered by an Alberta court to be removed from life-support, were taken under guard to the hospital Thursday morning to say their final goodbyes.

The Alberta Court of Appeal ruled Wednesday that the 34-year-old mother and father were to be allowed no more than 20 minutes to visit the child, who can only be identified as "M."

The parents are charged with beating and starving the girl and must visit her separately as they are not allowed contact with one another.
The visits to the Stollery Children's Hospital were ordered shortly after the appeal court upheld a lower court ruling that M be taken off life support as soon as reasonably possible.

The Court of Appeal also refused to grant a stay of the order pending an appeal to the Supreme Court, stating there were no grounds to take the case to Canada's top court.

On Thursday morning, April Kellett, the lawyer acting on behalf of the mother, filed a motion with the Supreme Court of Canada to keep the child on life-support.

CBC News learned early Thursday afternoon the province had filed a response and the top court judges would be considering the appeal "soon."

Expert Comments -

CBC: Case could have wide-ranging effects
http://www.cbc.ca/news/canada/edmonton/story/2012/09/19/edmonton-m-life-support-appeal.html

Tim Caulfield, an expert in health-care law with the University of Alberta, says he wasn’t surprised that the ruling was upheld.

“I think the court of appeal came to a logical conclusion to this sad tale,” he said.

Caulfield says the case could have wide-ranging effects on future cases. It shows that the court has jurisdiction to step into similar matters, and sets the precedent that taking someone off life-support can be in their best interest.

He also thinks the case could clarify the law when religious beliefs conflict with medical advice.

The parents had previously argued that taking the girl off life-support was against their religious beliefs.

“I think the judge handled the religious aspect carefully, noting that it can be a factor and something that should be considered,” Caulfield said.

“But not in a case like this when you’re talking about an infant that hasn’t adopted a religion yet and hasn’t adopted a culture.”

Read more about the case and court rulings

Court rules injured 2-year-old Alberta girl should be taken off life support
4:54 pm, September 19th, 2012
http://www.sunnewsnetwork.ca/sunnews/canada/archives/2012/09/20120919-165444.html

Update: The Supreme Court of Canada on Thursday dismissed the appeal to keep the child known as M on life support, against her parents' wishes.

 

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希望最高法院能够受理这个上诉，对案中涉及的几个非常基本的问题给予判断澄清。比如，安乐死在加拿大的合法性，谁有权利决定保留或撤销一个濒死者的 life support, 法庭何时可以剥夺这种权利并且介入决策，宗教的影响因素，等等。

 

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中文相关报道
http://www.rcinet.ca/chinese/daily/2012-reports-Chinese/15-52_2012-09-20-/

阿尔伯塔上诉法院的三名法官星期三作出一致裁决，要求对一名住院接受治疗的两岁女童实施“安乐死” ，维持下级法院的原判。阿尔伯塔上诉法院在判决中还拒绝了暂缓判决，从而使孩子父母可以向加拿大最高法院上诉的请求。法官弗兰斯•斯拉特尔在宣读判决中说，“虽然生命的神圣是加拿大社会的核心价值，但这名儿童的生命必须结束。”

阿尔伯塔女王法院原先的判决认定，这名女童处于异常艰难的处境，状况无法改进，结束治疗最符合孩子的利益。虽然这名孩子的父母是穆斯林，他们要求按照穆斯林的信仰，不放弃治疗，但法院认定，孩子父母的宗教信仰和医疗咨询意见有冲突。在这种情况下，应该以孩子的利益和医疗咨询意见为优先。

过去大约四个月来，这名被称为“M”的女童一直在医院接受治疗，仅靠呼吸器和人工食管维持生命。按照上诉法院的判决，医务人员可以在今后一两天移除对这名儿童的生命支持系统。但医院会给这名孩子的父母留出足够的探视时间。在作出判决24小时内，这名孩子的父母可以各自探望孩子二十分钟。

对于法院的判决，孩子父母的律师布贝尔表示反对。布贝尔说，“对于那些认为让这个孩子死去是开恩的人，我想提醒他们，安乐死在加拿大是无法得到原谅的”。

这位名叫“M”的孩子的父母目前正被关押。今年五月份，他们被控严重侵犯他人身体，过失犯罪，以及没有提供必需品以维持生命。

今年5月25日，这名孩子的父亲给医务人员打电话，说孩子出现了异常情况。医务人员赶到后发现，这个家庭一共有三个孩子，一个男孩和一对孪生姐妹。孪生姐妹中的一人出现了心脏骤停，而另一个孪生姐妹身上有许多伤痕。通过抢救，医生救活了心脏骤停的女童，但发现她的头部有致命伤，并因此决定对她进行监护治疗，用呼吸机和人工进食管维持生命。

医务人员还发现，这对27个月大的孪生姐妹严重营养不足，体重分别只有13磅和16磅。而和她们同年纪的孩子的正常体重应该在26到27磅左右。这个家庭的那名男孩并没有受到身体上的伤害。因为出现严重虐待儿童的现象，有关人员立即决定将孪生姐妹送进医院治疗，而把男孩送到亲戚家寄养。经过一段时间的治疗，孪生姐妹中的一人恢复得很好，体重也增加得很快，但那名头部重伤的女童的情况却没有好转。在经过将近四个月的治疗后，医生认为这名女孩大脑所受伤害异常严重，她将永远无法恢复知觉。因此，有关人员终于决定要求法院作出裁决，对这名女童实施安乐死。

有关专家对法院的裁决并不感到惊讶。阿尔伯塔大学医疗保健法专家蒂姆•克菲尔德认为，上诉法院的裁决是这个令人心碎的故事合乎逻辑的结局。他说，这个判例显示，法院对类似事件有司法管辖权，并将对今后的案件产生深远的影响。

尽管孩子父母认为，让孩子安乐死有违宗教信仰，但法庭最终还是维持原判。克菲尔德认为，这表明，当宗教信仰和医疗咨询意见发生冲突时，法院会做出什么样的选择。

星期四，这名女童的母亲的律师，以动议的方式向最高法院提出请求，要求让孩子继续接受治疗。据估计，最高法院很有可能在几天之内就作出答复。看来这一安乐死的案子还没有最后结束。(H.)

 

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What a tragedy!

CBC: Circumstances of girl being taken off life support 'incredible and tragic'
Updated: Sep 21, 2012 6:53 AM MT
http://www.cbc.ca/news/canada/edmonton/story/2012/09/20/m-legal-analysis.html?cmp=rss

The two-year-old Edmonton child known only as "M" couldn't breathe or eat without machines. Her brain function had degraded.

And on Thursday night, after the doctors caring for her were granted legal permission to unhook her from a ventilator, she died.

The girl's parents, citing religious beliefs, had asked the Supreme Court of Canada Thursday morning for an order to keep her alive, even as they stood accused of putting her life in danger in the first place. Their motion for a stay was dismissed later in the day.

"This is incredible and tragic, all the different facts that have come together in this case," says Tim Caulfield, a professor of health law at the University of Alberta.

"Even assuming that M's parents think that their decision is motivated by religious beliefs and love for M, I am left with a concern that their decision may, in fact, be affected by self-interest"
—Justice June Ross, Alberta Court of Queen's Bench
"You have the conflict between the doctors and the parents, the role of religion in this case, and what about life? Is it in the best interests of someone to live or die? So there's a sort of metaphysical aspect."

M's parents, both 34, face charges of aggravated assault, criminal negligence causing bodily harm and failure to provide the necessities of life.

The charges have not yet been proven in court.

With the child's death, however, it is possible authorities "could elevate the charges to manslaughter or second-degree murder," Caulfield said. He was speaking before the girl had died.

The potential benefit for the parents, had they been able to keep their child alive, wasn't lost on Justice June Ross, who made the initial ruling at the Alberta Court of Queen's Bench to unplug M's life support "as soon as reasonably possible."

In her decision last week, Ross wrote: "Even assuming that M's parents think that their decision is motivated by religious beliefs and love for M, I am left with a concern that their decision may, in fact, be affected by self-interest."

As Caulfield sees it, "what Justice Ross did was that she decided the court does have justification to make this decision, and then she decided to focus on the best interest of the child.

"In doing so, she recognized that you do consider religious factors, values, world views, not just medical issues," he said.

"She sensibly touched on those issues, but came back to the best interests of the child, and came to the determination it's in [the child's] best interests to stop sustaining life."

Precedent in Manitoba
A similar case occurred in 1997 in Manitoba, involving Child and Family Services of Central Manitoba, Caulfield said. That case dealt with a "do not resuscitate" (DNR) order sought by the health-care provider for an 11-month-old baby in a vegetative state.

The infant had suffered from shaken-baby syndrome and was likely to suffer further serious problems, doctors said. The order would mean that staff would not perform cardiopulmonary resuscitation, despite the parents' wishes, and the court agreed it was an appropriate decision.

Still, this case differs in an important aspect, Caulfield said.

"Here, we have more of an active decision that has to be made, which is: 'We're going to stop treating this patient and remove life support.'"

The possibility that M might have survived for a long period of time — even after being taken off life support — shouldn't change the fact that her parents could remain liable, said Peter Sankoff, a criminal law professor at the University of Alberta.

"It doesn't matter," Sankoff said. "If she would linger on and she goes on for five years, the fact that she lingered on doesn't change the nature of why she got there in the first place. And why should it?"

In this case, Sankoff suspected that the moment M dies, authorities would consider charges of either manslaughter or criminal negligence causing death.

The law and life support
As for the original decision regarding the removal of life support, the bottom line is that the best interests of the child should prevail, even when religion is involved, said Cheryl Milne, the executive director of the David Asper Centre for Constitutional Rights.

Milne, who teaches constitutional advocacy at the University of Toronto, gave the example of a 1995 case involving the Children’s Aid Society of Toronto and a Jehovah's Witness parent who objected on religious grounds to a life-saving blood transfusion for her infant.

"In some ways, it was similar because of the age of the child and the inability of the child to be able to articulate a point of view, particularly a religious point of view," she said. "The court was divided on how to analyze the Charter rights, but ultimately the parents are not able to have their religious freedom protected by the Charter, if that means denying medical treatment for the child."

The Supreme Court of Canada is also expected this fall to hear the case of Hassan Rasouli, a 60-year-old Toronto man who has been in a near-vegetative state for over a year.

Doctors recommended that Rasouli be taken off life support after his brain became badly damaged from an infection.

"The family fought it, and it turned out that the man's condition did change. He started to show signs of consciousness, signs of awareness," Milne said. "So at the centre of that is, who gets to make that decision? Is it up to the doctors or subsequent decision-makers? The family argued very strongly that the person should remain on life support."

But the possibly mixed motives of M's parents complicate an already complex case, Milne said.

"The parents are supposed to be making decisions on the child's best interests," she said. "Certainly, this is a horrible tragedy regardless of the decision."

 

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我觉得这个case有点特别。M“严重营养不足”，她父母已经"被控严重侵犯他人身体，过失犯罪，以及没有提供必需品以维持生命"。在这种情况下，他们怎么还有权利参与决定M的安乐死与否么？法庭判决可能有这个考虑？

那如果M没被虐待，而“处于异常艰难的处境，状况无法改进，结束治疗最符合孩子的利益”，那法庭还能坚持维护孩子的利益么？

至于父母的宗教信仰，我一直觉得政教分离是现代文明社会的基本原则。不是针对伊斯兰教。任何以宗教或传统为名，挑战法律，都不支持。