Monday, December 13, 2021

Quebec anaesthetist fighting "euthanasia" allegation

The following article was written by Michael Cook and published by Bioedge on December 12, 2021. The article refers to the act as euthanasia, but it doesn't appear to be euthanasia. Stories from Québec often refer to euthanasia in the wrong manner. 

Withdrawing a ventilator can be inappropriate, but it is not euthanasia. The patient does seem to have been medically abandoned. Since the patient was not given a lethal dose or suffocated with a pillow or some other device, therefore it is not euthanasia. Euthanasia is a form of homicide.

Providing or withdrawing treatment is a treatment decision that requires consent. The anaestetist disconnected the ventilator without the consent of the patient or the substitute decision maker. Therefore the act appears to be unethical, but it does not appear to be euthanasia. The article by Michael Cook follows:

Michael Cook
By Michael Cook

Police blotter. Here is a case from Quebec which suggests two things. First, that Canada’s medical aid in dying legislation does not mean that doctors are allowed to kill patients willy-nilly. Second, that some doctors take a very utilitarian view of their patients.

This week a court lifted a ban on revealing the name of a retired anaesthetist who is being investigated by the police over a death at Hôpital de la Cité-de-la-Santé de Laval. Dr Isabelle Desormeau had requested confidentiality because publicity could prejudice her case.

The incident in question occurred on October 31, 2019. An 84-year-old man went to the hospital complaining of a stomach ache, which was actually an intestinal obstruction. Emergency surgery was required. Dr Desormeau and the surgeon spoke with the man about the risks. He asked them to “prolong life through limited care”.

The operation began at about 2 am. The surgeon discovered that large parts of the small intestine were necrosed. The man’s niece was consulted and told that if they proceeded with the operation, the man would have to wear a colostomy bag and would be in hospital for a long time. It was decided to “conclude the operation and offer palliative treatment”.

Back in the operating room, the surgeon “closed the patient’s abdominal wall”. But then the anaesthetist and the nurses quarrelled. Dr Desormeau allegedly questioned “the usefulness of finding a room for the patient when he could be taken directly to the morgue”. She said that the man had no one to accompany him in palliative care. One of the nurses retorted that the patient had a daughter.

In the end the anaesthetist disconnected him from the ventilator at around 4:45 am. The nurse claims that she protested several times that “this is not the way to do things and that the patient should be returned to the floor to die with dignity”.

The man died at about 5.04 am. The anaesthetist walked out without signing a death certificate, leaving that job to the surgeon.

The investigation continues.
Euthanasia is an intentional action or omission to cause death. Withdrawing the ventilator was not the cause of death, the medical condition of the patient is the cause of death. Withdrawing a ventilator without consent is medically unethical, but it is not euthanasia.


TL said...

One doctor's interpretation of "large" (parts of the intestine) may be different than another doctor's. How long the patient may have had to live is unknown and unknowable. Maybe the surgeon and anaesthetist were unaware of certain treatment methods for a patient to maintain living with a significantly shortened small intestine. An anaesthetist is not of a medical specialty that is in a good position to decide the prognosis for intestinal disease. Predicting the future is a very inaccurate endeavor. Life with a colostomy isn't a picnic, but it's fairly common and it's not the worst thing in the world. Colostomy prejudice? The man died of asphyxiation, caused by the action of a person. It sounds like euthanasia to me.

Alex Schadenberg said...

As stated before, euthanasia is a form of homicide. In fact, when Canada legalized (MAiD) euthanasia, the Canadian government created an exception to homicide. Withdrawing treatment, such as a ventilator, was likely very wrong in this circumstance. Further to that it was done without consent, nonetheless it is not euthanasia.

TL said...

I agree that it's not MAiD Euthanasia, but I still think it's euthanasia. I also think that lying by omission is every bit as grievous as out and out lying. Terminating a patient's life by involuntary withdrawal of life support is like euthanasia by omission!

Maria Moores said...

My own opinion is that this would not be euthenasia has the man not been intentionally anesthetized at the time of ventilator withdrawal, but that ventilator withdrawal in the context of anaesthetic medications designed to paralyze the respiratory muscles is indeed euthenasia. That said, I do want to caution us all that if there is to be any hope of repealing euthanasia in this country, we will absolutely need to stick together; to ensure that discussions like this one do not deteriorate into augmentation and discord (with this mercifully has not at this point).

A house divided cannot stand, and we must stand!