Has euthanasia changed physician attitudes towards suicide in Québec?

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On December 10, 2015; the province of Québec officially sanctioned euthanasia. The Québec government passed Bill 52 in June 2014 and over the next 17 months prepared their nation for doctors having the right to kill their patients.

Now we learn that some Québec physicians have been withholding life-saving treatments that could save lives with possibly no after-effects from suicide victims. In response, the Québec's College of Physicians have issued an ethics bulletin telling all physicians that there is an ethical and legal guideline to provide care even to patients seeking to end their lives.

Yves Robert, the secretary for the Québec College of Physicians told the National Post that:

an unspecified number of doctors were interpreting suicide attempts as an implicit refusal of treatment. They “refused to provide the antidote that could have saved a life. This was the real ethical issue,” 

“If there is a life-threatening situation, you have to do whatever is possible to save a life, then you treat the underlying cause.”

According to the article by Graeme Hamilton, published in the National Post, the four page ethics bulletin states:

“From a moral point of view, this duty to act to save the patient’s life, or to prevent him from living with the effects of a too-late intervention, rests on principles of doing good and not doing harm, as well as of solidarity,” 

“It would be negligent not to act.”

According to the National Post the ethics bulletin states that treatment can only be withheld when their is irrefutable proof that the patient does not want treatment. It then states:

Once stabilized, a survivor of suicide may require psychiatric treatment, the bulletin says. “Recognition of psychological suffering can allow a person who wants to kill himself to picture his life differently,”

But the Québec euthanasia law permits euthanasia for people with psychological suffering.

Is it possible that the confusion concerning the withholding of beneficial treatment is directly related to the legalization of euthanasia in Québec?

A survey of Québec doctors (April 2015) indicated that there is significant confusion concerning withholding and withdrawing treatment and an earlier survey of Québec medical specialists (October 2009) indicated that there was significant confusion concerning what constituted euthanasia and palliative care.

The fact is that the Québec euthanasia law insists that euthanasia is a medical act, which it is not, and that patients have the right to refuse treatment and autonomy. It should not shock people when Québec physicians respond to these edicts by medically abandoning suicidal patients.

Historically Québec has a very high suicide rate. In the past few years, suicide prevention programs have led to a decreased suicide rate. Let's hope that the legalization of euthanasia will not create a suicide contagion effect, leading to higher suicide rates in Québec.