It is interesting to see reactions to your own culture reflected back at you from abroad. Canadian legal developments rarely get attention south of the border, but when the topic is socialized healthcare and the Canadian development comes at the same time as the implementation of the US Affordable Care Act – i.e. Obamacare – Americans start paying attention. And we Canadians pay attention when Americans pay attention to us.

Timing in this case is everything. Less than a month after the Affordable Care Act came into force, the Supreme Court of Canada released its decision in Cuthbertson v. Rasouli. This confluence of events seems to have provoked Slate.com to publish an article titled Canada Has Death Panels – And that’s a good thing. At the time of this writing, it had been shared on Twitter almost a thousand times.

As the article’s author notes, the news headlines about the Rasouli case in Canada (which we have blogged and posted our own Mark Handelman’s detailed exposition of its reasons) have focused on the first of the top court’s two conclusions: that doctors cannot unilaterally end treatment for a terminally ill patient. However, the more interesting conclusion of the case from the American perspective is the second conclusion: while doctors may not be able to unilaterally end medical treatment, there is a government-appointed board that can.

That board is the Ontario Consent and Capacity Board. Apparently, no similar body exists anywhere in the United States. Nor is one likely to in the near future. In the US political landscape, ever since opponents of Obamacare branded government-appointed medical insurance adjusters as “death panels”, it is almost unthinkable that life or death decisions for a patient incapable to choose for herself would be made by anyone other than the appointed family member.

However, the author of this article (who, notably, is a Canadian studying law at Yale) pitches a case for a government-appointed board of, “experts and wise community members,” as he puts it, to make these kinds of decisions where family members and doctors cannot agree. He notes that the CCB, “provides an objective process for resolving these difficult, end-of-life dilemmas.” The CCB, he notes, “is instructed by law to focus on the patient’s best interests, not the health care system’s, or the government’s bottom line.”

We agree. Compared with the courts, the CCB is faster, less expensive, and more proficient in making these sensitive determinations than the courts. In cases involving end of life decisions, these things really matter.

We will be watching with keen interest as the United States continues to grapple with their healthcare system reforms and especially how they deal with treatment and decision-making at the end of life.