Wednesday, October 16, 2013

Euthanasia Safeguards: "Wishful Thinking"

This letter was written by Catherine Ferrier and published on October 15 in La Presse (in french and google translated into english, with slight edits). 

Catherine Ferrier is responding to her colleague, David Lussier, whose letter "I will support the syringe if..." was published in La Presse on October 11.

Wishful Thinking

Dr Catherine Ferrier
Dear David, I did not have time on Friday to talk to you about your text in La Presse. We were too busy taking care of our patients in the geriatric clinic and our conversation would have risked being long because I am part of the doctors who "unnecessarily scare people" about the legalization of euthanasia.

You explain very precisely under what circumstances you will accept pressing the syringe: end of life, not a temporary motivation, all therapeutic approaches attempted without success, free and informed consent. It seems so simple, how could intelligent and caring doctors oppose it?

I have bad news for you. If these conditions can sometimes exist they represent a very small number of patients, it is impossible to ascertain their existence.

First, there is no scientifically validated criteria for determining whether a patient is able to choose his own death.

Then, if this bill is passed, it will be impossible for you, facing a patient, to ensure that all therapeutic approaches have been tried without success. It will not let you take the time to try because what he wants is to die immediately. If you do not kill him, he will look for someone else to do it, or the system will require you to find someone else .

And how will you know what his motives are? Do you think you can identify deep and hidden behind any request for death motivations? You are geriatrician: you have seen preposterous psycho-social and family situations where you never know who has the patient's best interest at heart while striving to satisfy the psychological needs or - dare we say - money.

How will you know what is said by the family when you're not there? Even a well-intentioned family can unwittingly give the message that the disease of the elderly parent is long and heavy, as they want to return to work, to family, to real life. Who are the least well-meaning relatives? Do you think the patient who wants to die to avoid being a burden to his family will tell you?

I have more bad news for you. You're right that things are very bad in Belgium. Two weeks ago, a Belgian person was euthanized after a sex change operation that failed ("unbearable psychological suffering"). But Quebec promoters of "physician assisted dying" believe it's going very well in Belgium and they modeled their Bill 52 after the Belgian law. Believing that there will be no drift in Quebec reflects not only a baseless optimism, but the so-called psychiatric wishful thinking.

Now that you have announced in the journal your willingness to support the syringe, you may get a line outside your door the day after the adoption of the bill. Despite our differences of opinion, we get along well and I think very highly of you. I do not want you to experience the pain that Belgian and Dutch euthanasia doctors experience.

Yes, it is the physician's duty to relieve suffering with all medical means at their disposal. But killing will never be a medical procedure, even if one day the Quebec National Assembly and the College of Physicians of Quebec report that is.

Dr Ferrier is a leader of the Physicians Alliance for the Total Refusal of Euthanasia in Quebec.

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