Palliative care leaders oppose Québec Liberal government's possible plan to introduce euthanasia bill.

By: Dr Balfour Mount, the father of palliative care in Canada.

and Dr Serge Daneault, the chief of palliative care at University Hospital in Montreal.

Dr Balfour Mount

This letter was in the Montreal Gazette on April 23, 2014.

We congratulate Philippe Couillard on his victory in the April 7 election. Nonetheless we feel compelled to express our deep disappointment, and that of many medical colleagues and other Quebec citizens, at his announcement the day after the election that he intends to reintroduce Bill 52, including medical aid in dying.

Dr Serge Daneault

Knowing that in October 2013 he expressed serious reservations about the “medical aid in dying” component of Bill 52, we are mystified by his about-face on this very grave question. It is impossible to legalize euthanasia without putting vulnerable patients at risk, as the experience in Belgium and other countries shows clearly. Bill 52, with or without the amendments, goes even farther than the Belgian law; it defines medical homicide as health care and requires that it be available to all patients who meet the exceedingly broad criteria set out in the bill. As a physician, he is conscious of the power imbalance between physicians and their patients, and how patients can be manipulated to consent even by well-meaning health professionals.

The majority of the citizens and health professionals who made submissions to the Select Committee on Dying with Dignity in 2010-11 opposed legalization of euthanasia, but the report recommended it. The fact that the vast majority of palliative care physicians oppose euthanasia was systematically ignored by the commission and the preceding government. The public, which seems to be clamouring for so-called death with dignity, is largely unaware that what is being proposed to them is a homicidal act and that skilled palliative care and wise management of end-of-life decisions are sufficient to address the fears leading to their request.

From the legal and political point of view, it is clear that the Quebec government lacks jurisdiction to legalize euthanasia, which is contrary to the Criminal Code of Canada, and that this component of the bill will be challenged in court, cause a confrontation with the federal government and ultimately be found illegal. We urge Couillard to examine the legal opinions of the ministry of Justice on this aspect and to publish them as he has promised to do with those regarding the validity of the Secularism Charter (Bill 60).

Balfour Mount MD
Emeritus Eric M. Flanders Professor of Medicine, McGill University

Serge Daneault MD
Chief, Palliative Care Service, Centre hospitalier de l’Université de Montréal (CHUM)