Canadian Anestesiologists warn: Assisted Death is not simple.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr Cheryl Mack

An article by Sharon Kirkey and published in today's National Post reports on an article published in the Canadian Journal of Anestesia outlining the problem with and reactions to the drugs that are used for euthanasia and assisted suicide. Kirkey reports:

Canada’s anesthesiologists, doctors who work every day with some of the drugs commonly used in euthanasia and assisted suicide, are warning hastened death may not always result in a peaceful exit. 

They say patients could experience convulsions, or a longer-than-expected “time to death,” or “awakenings” while the fatal cocktail of drugs take effect. 

Some are even questioning whether they — or any other doctor — ought to be involved at all, and recommend the task be left instead to “euthanists” or some other group.

Kirkey continues her article with her information from her interview with Dr Cheryl Mack, one of the authors of the article:

Mack, chair of the clinical ethics committee for University of Alberta hospitals, said she and her co-author don’t object, in principle, to a “rational” suicide. “But that’s assuming, of course, we can distinguish between what is a rational suicide, and what is an irrational one.”

... Patients can respond to drugs differently and in unanticipated ways. Dosing is based on careful titration and monitoring of the patient, she said. “We can foresee potential complications.”

For example, with assisted suicide, where the doctor prescribes a fatal drug overdose the patient takes himself, “depending on what kind of safeguards are in place, and who’s present, you can have reactions to overdose — convulsions, vomiting, aspirations,” Mack said. “We could actually have patients incurring harm that they may not have anticipated.”

Kirkey then examines her article by looking at the reality of euthanasia:

During surgery, “We take a lot of care with our monitoring and our assessment of the patient to judge depths of anesthesia,” Mack said. But if an error is made during euthanasia — and the muscle relaxant injected before the person is in a coma deep enough to prevent feeling the effects — he or she could die by suffocation while paralyzed, but conscious.

Guidelines for doctors in Quebec, where the first deaths from euthanasia have been reported since the act became legal in that province in December, state that while the risk of loss of consciousness being “inadequate” or too brief is low, the drugs may be less effective if the IV catheter isn’t inserted properly, or the drugs injected too slowly.

“The other concern is, how do you establish a standard of care for assisted death? How do you judge competency?” Mack said. She performs hundreds of anesthesia procedures a year to maintain her competency. “What would that look like for assisted death?”

If Canada follows the experience in the Netherlands, where euthanasia and assisted suicide make up about three per cent of total yearly deaths, deaths from “PAD” — physician-assisted death — could number more than 7,000 a year in Canada, Ottawa anesthesiologist Dr. Miriam Mottiar estimates.

“I think a lot of people feel uneasy with the entire concept of this,” said Dr. Susan O’Leary, president of the Canadian Anesthesiologists’ Society. “This is not what we intended when we became anesthesiologists.”

Alex Schadenberg

The Supreme Court of Canada, in my opinion, made their decision based on a philosophical point of view, rather than legal and human realities.

Not only will there be problems with the use of the euthanasia "drug cocktail" but, if the experience with euthanasia in Belgium and the Netherlands is examined, we will also expect there to be significant abuse of the euthanasia law.

Legalizing euthanasia gives physicians the legal right to kill you. Not only are the drugs that are employed in the act a problem, but also, the act itself should never be accepted because it permits killing people at their most vulnerable time of their life.