Quebec is trying to legalize euthanasia by calling it something else. It's still wrong.

The following article was written by Margaret Somerville and published in the Globe and Mail on June 19, 2013.

Margaret Somerville

Margaret Somerville - Globe and Mail, June 19, 2013

So, you call your pet duck, which lives with you, a dog, because the law prohibits keeping a duck in your apartment, but allows dogs. A court will convict you for breaking the law.

Now you are the Quebec provincial government and you table a bill in which you call euthanasia, which is prohibited as murder under the Canadian Criminal Code, “medical aid in dying” (MAD) and claim it is medical treatment. You define “end-of-life care” as including MAD and you pass a law which states that physicians must administer MAD to “end-of-life patients,” who fulfill the necessary conditions, unless the physicians have conscientious objections. You also require that “institutions,” such as hospitals and certain “residential and long-term care centres,” must be able to give patients, who qualify, access to MAD.

On the face of the record, a court would convict physicians who did so of criminal offences and the participating institutions as parties to the physicians’ offences and, possibly, guilty of the separate crime of conspiracy to commit an offence.

Bill 52 does not expressly define MAD; rather, it leaves it to the council of physicians, dentists and pharmacists of each institution “in accordance with the clinical standards established by the professional orders concerned, to adopt clinical protocols applicable to terminal palliative sedation and medical aid in dying”. But it’s clear that MAD is a euphemism for euthanasia or, at the least, is intended to include euthanasia.

Likewise, the definition of “the practice of medicine” in the Quebec Medical Act is extended to include a physician “administering the drug or substance allowing an end-of-life patient to obtain medical aid in dying under the Act respecting end-of-life.”

These approaches allow the Quebec government, first, to avoid expressly contravening the Criminal Code in Bill 52 by directly authorizing euthanasia and, second, are almost certainly meant to boost the government’s argument that MAD (euthanasia) is a medical treatment. That characterization is necessary to support the Quebec government’s claim that the legal governance of MAD is within provincial and not federal jurisdiction.

But physicians have never regarded killing as medical treatment. Indeed, the Hippocratic Oath, which has been foundational in medical ethics for over two millennia, originated in order to separate the two roles – healer and executioner – of traditional “medicine men,” the predecessors of physicians. Today’s physicians pledge to care always, cure where possible, and never intentionally to inflict death. Quebec’s proposed legislation directly negates this last obligation.

Bill 52 would give “end-of-life patients” a choice of “fast” or “slow” euthanasia. Fast euthanasia (MAD) would be a lethal injection; slow euthanasia would be what the Bill calls “terminal palliative sedation.” This term is confusing, because some sedation at the end of life is not euthanasia and some can be. It’s an example of the strategy of promoting euthanasia by confusing it with interventions which are not euthanasia and are ethically acceptable and arguing that there are no relevant differences among them and all are ethical and acceptable.

“Palliative sedation,” which is relatively rarely indicated as an appropriate treatment for dying people, is used when it is the only reasonable way to control pain and suffering and is given with that intention. It is not euthanasia. “Terminal sedation,” in which the patient is sedated with the primary intention of precipitating their death, is euthanasia.

Euthanasia advocates argue that we can’t distinguish the intention with which these interventions are undertaken and, therefore, this distinction is unworkable. But the circumstances in which such an intervention is used and its precise nature allow us to do so. For instance, if a patient’s symptoms can be controlled without sedation, and especially if the patient is not dying and food and fluids are withheld, sedating the patient is clearly euthanasia.

In the Netherlands, terminal sedation is not defined as euthanasia and there has been a substantial increase in its use. Some commentators have pondered whether it’s being used instead of lethal injections, because it allows physicians to avoid the reporting and other requirements euthanasia entails. The same would be likely under the Quebec provisions. The requirements for using “terminal palliative sedation” seem to be at the discretion of the physician, provided that the patient or, if they are incompetent, their surrogate decision-maker gives informed consent. The requirements for access to and reporting on MAD are far more onerous and more limiting, and a surrogate decision-maker could not authorize it.

That said, the Quebec Bill would allow MAD to be carried out pursuant to a patient’s advance directive consenting to it. Most jurisdictions which have legalized euthanasia or physician-assisted suicide have limited it to adults who are competent and consenting at the time it is administered,

It is an open question whether MAD includes physician-assisted suicide, as the media have constantly reported it does. The uncertainty arises because Bill 52 provides that “If a physician determines …that medical aid in dying may be administered to a patient requesting it, the physician must administer such aid personally and take care of the patient until their death.” And the Quebec Legislative Assembly committee report which informed Bill 52 rejected physician-assisted suicide.

The reasons to exclude PAS might include that it’s more difficult to frame suicide as a “medical act;” that the Quebec government doesn’t want to promote the idea that suicide, in general, is an appropriate response to suffering; that they want to maintain the current medical norm that the appropriate medical act in dealing with attempted suicide is to try to save life; or that they are doing an end run around the precedent in the Rodriguez case, in which the Supreme Court of Canada upheld the constitutional validity of the crime of assisted suicide.

Finally, who is an “end-of-life” patient who may have access to MAD? Among other requirements, they must “suffer from an incurable serious illness; suffer from an advanced state of irreversible decline in capability; and suffer from constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable.” In other words, they need not be terminally ill and might be mentally, but not physically, ill. Many disabled, old, frail and vulnerable people would fulfil these criteria. And recall that MAD may be administered in “residential and long-term care centres” or a person’s home.

These comments on Bill 52 are far from comprehensive and are intended simply to identify some of the arguments, reasoning and strategies that it manifests and issues it raises. I hope they serve as early warning signals of just some of the dangers Bill 52 presents.

Margaret Somerville is the founding director of the Centre for Medicine, Ethics and Law at McGill University.

Ontario premier, Kathleen Wynne, appears to be considering Quebec euthanasia proposal

Kathleen Wynne, the Liberal premier of Ontario, appears to be considering similar proposals as Quebec did last week when it introduced Bill 52, to legalize euthanasia in Quebec.

Last week, CBC news reported Wynne making overtures of support to Bill 52, to legalize euthanasia in Quebec, and now the Toronto Sun has published an interview with Wynne, who uses careful but supportive language.

Kathleen Wynne

The article published in the Toronto Sun quotes Wynne as stating:

we need to have a chat about “end-of-life” decisions — such as the euthanasia debate Quebec Premier Pauline Marois ignited in her province recently.

Wynne was then quoted to have said:

In a frank, wide-ranging interview Tuesday, Wynne told the Toronto Sun she considers the debate about euthanasia and end-of-life decisions, “the great health-care issue of our time.” 

The Silver Tsunami — the huge number of baby boomers poised to retire and who’ll require greater medical care as they age and die — will prompt debate about when to end life, as governments across the country struggle to cope with this ticking time bomb and as seniors seek to take control of their own lives and destinies. 

“It’s a huge ethical debate, so I think it’s something that every person in this country is going to have to confront and discuss and obviously the people of Ontario are not going to be exempt from that. It’s going to be thrust upon us.” Wynne added individuals and groups are pushing governments to allow terminally ill patients to take control of the way they die through assisted suicide. 

“I don’t think it’s something we’re going to be able to choose to talk about or not,” she said. It’s part of a larger discussion around palliative care and hospices, she said.

The article then quoted from the Ontario government report issued by Don Drummond on government cost savings that stated:

In his report last year on how to rein in provincial spending, economist Don Drummond said that doctors need to engage middle-aged people on end-of-life decisions. 

“Primary care physicians need to open the dialogue about a living will that lays out how individuals wish to be cared for when they are unable to do so, including the need to discuss the living will with family beforehand to mitigate any possible conflicts later,” Drummond said in his report. 

It’s not a cheerful thought, but in bald economic terms, the older you get, the more you cost the health-care system. Don’t forget, Drummond’s report was about saving money — not lives.

Euthanasia is not the same as "living wills" or Power of Attorney for Personal Care documents. 

Alex Schadenberg

I have always stated that when the economic gurus get involved with the euthanasia lobby, then watch out. I fear the economic mismanagement that has occurred in Ontario, Quebec and other provinces, will lead to the promotion of euthanasia.

Euthanasia is sold to the public under the false premise that it will be based on personal autonomy and to eliminate suffering.

When analyzing the outcome of legal euthanasia it becomes apparent that it is often done with request and it is rarely done to eliminate physical suffering.

Belgium and the Netherlands escalate their child euthanasia programmes.

The following article was written by Dr Peter Saunders, the campaign director for the Care Not Killing Alliance in the UK, on June 17, 2013 on his blog. It was originally titled: Belgium and the Netherlands escalate their child euthanasia programmes.

Dr Peter Saunders

By Dr. Peter Saunders - June 17, 2013

In this last week both Belgium and the Netherlands have taken major steps towards euthanasia for children.

A consensus among members of the Belgian Federal Parliament has reportedly formed in support of legislation to allow children to choose to undergo euthanasia in certain dire cases, according to a report in the Belgian daily newspaper Der Morgen, as translated by the Paris-based news agency Presseurop.

If child euthanasia is legalized in Belgium, the country would become the first in the developed world to have a law on the books formally allowing the practice.

Belgium became the second country in the world after the Netherlands to legalize euthanasia in 2002, but the statute currently extends only to people 18 or older.

The bill, introduced by the Socialist party last December, lays out guidelines for doctors to decide on a case-by-case basis whether or not a child is mature enough to make the decision to end his or her own life, as well as whether a child's health is grave and hopeless enough to warrant euthanasia.

Canadian Hospice Palliative Care Association and the Canadian Society for Palliative Care Physicians respond to the Quebec euthanasia bill (Bill 52)

Canadian Hospice Palliative Care Association and Canadian Society for Palliative Care Physicians urge Canadians to Talk About Hospice Palliative Care First

The French version follows after the english verison.

(June 13, 2013) Ottawa, ON – Yesterday in the Quebec National Assembly, the Dying with Dignity Bill 52 was tabled by the Minister for Social Services and Youth Protection Véronique Hivon. Although the Canadian Hospice Palliative Care Association (CHPCA) and the Canadian Society of Palliative Care Physicians (CSPCP) applaud the commitment to improve and implement hospice palliative care standards across Quebec, they believe that Canadians need to ensure that there is universal access to quality hospice palliative care before any introduction of medical aid in dying, more commonly referred to as euthanasia. 

“Currently, only 16-30 per cent of Canadians, have access to comprehensive quality end-of-life care.  We should focus on improving end of life care across the country before we introduce bills allowing physician assisted dying.” stated Sharon Baxter, Executive Director of the CHPCA. 

“The goal of hospice palliative care is to improve the quality of life for patients and their families facing problems associated with life-threatening illness, and intends to neither hasten nor postpone death.”

The CHPCA and the CSPCP believe that hospice palliative care is about ensuring a good death for all Canadians through an interdisciplinary approach that includes pain and symptom management, psychological support, spiritual care, bereavement care, and much more to address the suffering of patients and their families.

 “A recent survey of the Canadian Society of Palliative Care Physicians (CSPCP) showed that an overwhelming majority of CSPCP physicians were opposed to the legalization of euthanasia (88 per cent). Ninety per cent of responding members would not be willing to participate in the act of euthanasia,” added Dr. Doris Barwich, President of the CSPCP.  

“The dedicated and committed physicians who work in hospice palliative care should not be expected to participate in this practice.”

Furthermore, the CHPCA and the CSPCP would like to distinguish the difference between palliative sedation therapy and the proposed “terminal palliative sedation,” where the intent is to cause death. Published standards define “palliative sedation therapy” as the practice of relieving intolerable suffering through the intentional lowering of a patient’s level of consciousness in the last days of life by the proportional and monitored use of non-opioid sedative medications[i]. “Palliative sedation therapy” does not prolong dying or hasten death but addresses refractory suffering. To learn more about this terminology please consult: www.chpca.net/hpcfirst.
 
The CHPCA and the CSPCP want to ensure that all Canadians have the highest quality of life as they live with a life limiting or terminal illness. All Canadians have a right to high quality hospice palliative care.
 
As Canada enters the debate around these contentious issues, we want to reassure Canadians that effective therapies exist to manage symptoms and address fears related to the dying process. Physicians and hospice palliative care providers are available to provide support and referral as necessary. Contact the CHPCA for a list of hospice palliative care resources in your area. You can also learn more about the definitions of key terms and the debate through the “Let’s Talk About Hospice Palliative Care First” campaign at: www.chpca.net/hpcfirst.
 

-30-

 
For further information, please contact:
 
Vanessa Sherry
Communications Officer
Canadian Hospice Palliative Care Association
E-mail: vsherry@bruyere.org
Phone: 613-241-3663 ext: 229
 
The Canadian Hospice Palliative Care Association  is the national voice for hospice palliative care in Canada. We are dedicated to the pursuit of excellence in care for persons approaching death so that the burdens of suffering, loneliness and grief are lessened. The CHPCA operates in close partnership with other national organizations and continues to work to ensure that all Canadians, regardless of where they may live, have equal access to quality hospice palliative care services for themselves and their family. 
 
The Canadian Society of Palliative Care Physicians (CSPCP) was formed with the vision of promoting the highest quality of palliative and end-of-life care by physicians in Canada.  The Society strives to advance quality of life of Canadians and their families who are living with a life-threatening illness, by advancing the field of Palliative Medicine and representing our discipline at local, provincial, and national levels.  Members include medical practitioners with an interest or specialized practice in Palliative Medicine.

---

[i] Fraser Health. Refractory Symptoms and Palliative Sedation Therapy Guideline. 2011; p. 2.

Continue with the French version.

Policy: This blog does not publish anonymous or attacking comments!

In the past few weeks I have received many comments from readers of this blog who did not include their name with their comment. They left an anonymous comment. 

It is frustrating for me to read these anonymous comments because many of these comments make good points, while others include a legitimate challenge to an article.

A few years ago, I decided that I would not publish comments from people who did not  include their name with their comment and I would not publish comments that attack others.

I regularly receive comments from people who are attacking others, or attacking me. I have not published those comments. Many of those comments were also made by people who remained anonymous

I have also received many good and instructive comments from people who did not include their name with their comment. I did not publish those comments either.

Whether the comment is instructive or attacking, I simply will not publish an anonymous or an attacking comment.

Therefore if you want your comment published on this blog, you must post your name with the comment and you must not attack others.

You will notice that this is the tenth time that I have posted a similar comment.

Alex Schadenberg

Quebec Euthanasia: Journalism Malpractice (Globe and Mail).

The following article was published by Wesley Smith on his blog on June 13, 2013 under the title: Quebec Euthanasia: Journalism Malpractice 3.

Wesley Smith

By Wesley Smith - June 13, 2013

Canada’s national newspaper, the Globe and Mail, has also committed journalistic malpractice describing Quebec’s euthanasia bill. It accurately reports that the law would allow doctors to commit euthanasia–e.g., directly kill the patient–but it continues the pretense that the lethality would be limited to the “dying:”  From the story:

Quebec has entered unchartered waters in becoming the first province to propose legislation that allows a dying patient with an incurable disease “at an advanced state of irreversible decline” and suffering “unbearable physical and psychological pain” to decide their moment of death. Strict protocol and criteria are outlined in the bill that calls for continuous medical supervision of patients who must meet specific conditions in order to be eligible for end-of-life treatment. For instance, a paraplegic, despite suffering intolerable pain, would not be admissible.

False! The conditions are not specifically identified. The guidelines aren’t “strict,” and they are certainly not limited to the “dying.” Nor must the suffering be a result “unbearable physical AND psychological pain.” Rather, as you will see below, it is “unbearable physical OR psychological pain,” a hugely different thing!

Once again, here are the guidelines as written in Bill 52:

26. Only a patient who meets the following criteria may obtain medical aid in dying:
(1) be of full age, be capable of giving consent to care and be an insured person within the meaning of the Health Insurance Act (chapter A-29);
(2) suffer from an incurable serious illness;
(3) suffer from an advanced state of irreversible decline in capability; and
(4) suffer from constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable.

Paraplegics could most certainly qualify: It could be deemed an “incurable illness” that has led to “irreversible decline in capability” and which causes “unbearable physical or psychological pain” that cannot be relieved “in a manner the person deems tolerable.”
If the authors wanted the law to be limited to dying patients, it would say so in the bill. It doesn’t. Stating otherwise is journalistic malpractice. 

Quebec Euthanasia (Bill 52): a very dangerous bill.

By Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

The Quebec government recently introduced a bill to legalize euthanasia.

The bill is rife with false claims, euphemisms and ambiguous language.

Bill 52: “An Act respecting end-of-life care” defines “end-of-life care” to mean: palliative care provided to persons at the end of their lives, including terminal palliative sedation, and medical aid in dying.

The bill states that doctors would “administer” medical aid in dying. Euthanasia is the direct and intentional causing of death of another person, usually by administering a lethal injection. 

"Medical aid in dying" is therefore a euphemism for euthanasia.

Since the definition of palliative care includes: terminal palliative sedation and medical aid in dying, therefore the definition of palliative care includes euthanasia.

The bill creates a “right to receive palliative care.” A right to receive palliative care would be good, except that the definition of palliative includes medical aid in dying (euthanasia). Therefore the bill is also creating a right to receive euthanasia.

The definition of Terminal Sedation is not clear and the “rules” concerning Terminal Sedation are vague. Sedation for the purposes of palliation is good, but due to the vague definition, one should be concerned that euthanasia without consent will be done “under the radar” reporting it as Terminal Sedation.

The bill states that end-of-life care (euthanasia), may be done at a palliative care hospice.

Euthanasia is not limited to people who are terminally ill. The Bill defines the criteria for euthanasia as: an incurable serious illness. Many people live with chronic conditions that are incurable and serious.

People with disabilities qualify for euthanasia. The Bill defines the criteria for euthanasia as having: an advanced state of irreversible decline in capability. Many people with disabilities live with an advanced state of irreversible decline.

People with depression and mental illness are not protected from euthanasia. The bill defines the criteria for euthanasia as having: physical or psychological pain which cannot be relieved in a manner the person deems tolerable. People who live with chronic depression or mental illness qualify for euthanasia, even if they reject effective treatment that they deem intolerable.

The criteria that a doctor must follow to approve euthanasia are similar provisions to the Belgian law. The criteria does not include:

• 1. A Waiting period;
• 2. A medical exam by the doctor who receives the request;
• 3. A psychological evaluation; and
• 4. Preventative measures, such as pain control. 

Doctors are not required to refer a person for euthanasia, but they are required to notify authorities to find a doctor to do it.

The bill states that euthanasia deaths must be reported after the death has occurred.

Since the person is dead before the report is submitted, will a person be protected from abuse? The report is also submitted by the doctor who did the euthanasia death. Will a doctor acting outside of accepted practice self-report abuse?

The bill establishes a commission to oversea the law. The commission is charged with producing annual and five year reports. The bill does not specify what data must be in those reports.

The commission will assess compliance with the law but there is no indication of how a physician who is non-compliant would be sanctioned, and the commission has not been given the power to investigate problems.

The Belgian Model of euthanasia.

Quebec is imposing on its people, a medical model for decriminalizing euthanasia by using similar definitions as the Belgian law.

Recent studies concerning the Belgian euthanasia law found that: 32% of the assisted deaths are done without request and 47% of the assisted deaths go unreported in the Flanders region of Belgium. Another recent study found that even though nurses are prohibited from doing euthanasia, that in fact nurses are euthanizing their patients in Belgium. 

Even though independent studies prove that abuse of the Belgian euthanasia law occurs, there has never been an attempted prosecution in Belgium.

Recent Belgian government statistics indicate that the number of reported assisted deaths increased by 25% from 1133 in 2011 to 1432 in 2012, representing 2% of all deaths in Belgium. The number of reported assisted deaths in 2010 was 954. It is important to note that these statistics do not include the unreported assisted deaths.

The response by Belgian legislators to the abuses of the euthanasia law is to change the law to include children with disabilities and people with dementia. By widening the definitions in the law, it becomes less likely that doctors will contravene the law. It is also feared that the proposed changes to the euthanasia law may effect the freedom of conscience for health care workers in Belgium.

The proposed changes to the Belgian euthanasia law, combined with the lack of attempted prosecutions for abuse (in other jurisdictions these abuses would be known as murder), in conjunction with the massive increases in the number of euthanasia deaths, indicates that incremental extensions to the law have occurred in Belgium.

If you think that is bad enough, consider the fact that a woman with anorexia nervosa  recently died by euthanasia, a man wrote that his depressed mother died by euthanasia, belgian twins who were born deaf were euthanized out of fear of blindness, and Belgium is experimenting with euthanasia/organ donation.

Conclusion:

In order to avoid the constitutional battle with the federal Criminal Code, the bill defines euthanasia as health care and the bill calls it “medical aid in dying” (euthanasia), which it defines as part of a continuum of care.

Bill 52 is decriminalizing euthanasia and not assisted suicide.

Hon Rob Nicholson

In response to the Quebec euthanasia bill, federal Justice Minister, (at the time) the Hon Rob Nicholson, stated:

“The Government of Canada will review the implications of Quebec’s proposed legislation on physician-assisted suicide and euthanasia. 

“The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities. 

 “In April 2010, a large majority of Parliamentarians voted not to change these laws, which is an expression of democratic will on this topic. 

Hon Peter MacKay

Bill 52 is full of false claims, euphemisms and ambiguous language. It is a very dangerous bill.

Quebec needs to put Bill 52 aside and re-commit itself to improving true palliative care for all of its citizens.

Please write to the current Justice Minister, the Hon Peter MacKay asking him to: continue to protect all Canadians from euthanasia and assisted suicide.

Hon Peter MacKay mcu@justice.gc.ca or 
MO-CD@justice.gc.ca
284 Wellington St., Ottawa ON K1A 0H8.

Quebec euthanasia bill (Bill 52) a short overview.

By Alex Schadenberg
International Chair, Euthanasia Prevention Coalition

On June 12, the Quebec national assembly introduced Bill 52: "An Act respecting end-of-life care" to legalize euthanasia in Quebec.

Euthanasia is an action or omission that is directly and intentionally done to cause the death of another person, to eliminate suffering. Euthanasia is a form of homicide.

Yes, Bill 52 legalizes euthanasia, even though media reports and other groups continue to refer to it as assisted suicide.

In order to avoid the issue of jurisdiction with the federal Criminal Code the Quebec government defined euthanasia as health care and they claim that euthanasia, that they refer to as “medical aid in dying,” is part of the continuum of palliative care.

The federal Justice Minister, Hon Rob Nicholson responded to the Quebec euthanasia bill by stating: 

“The Government of Canada will review the implications of Quebec’s proposed legislation on physician-assisted suicide and euthanasia. 

“The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities. 

 “In April 2010, a large majority of Parliamentarians voted not to change these laws, which is an expression of democratic will on this topic. 

The Quebec euthanasia Bill 52 is a masterful example of false claims.

The Quebec government claims that there are no laws prohibiting euthanasia in Canada. Section 222 (1) of the Criminal Code of Canada states:

“A person commits homicide when directly or indirectly, by any means, he causes the death of a human being.”

Euthanasia is the direct killing of a human being, usually by lethal injection.

Contrary to what the Quebec government states, Bill 52 does not limit euthanasia to terminally ill people. 

The bill states in Section 26 (2) that a person meets the criteria for medical aid in dying (euthanasia) when: (the person) suffers from an incurable serious illness.

Bill 52 does not define the prognosis of the person. In the State of Oregon, where assisted suicide is legal, a person is defined to be within 6 months of death. In Quebec a person qualifies for euthanasia when they have an incurable serious illness (undefined).

There are many incurable serious illnesses that are in fact chronic conditions where the person is not imminently dying, but may eventually die from the condition. Type 2 Diabetes for example.

Bill 52 allows euthanasia for people experiencing psychological pain. The bill defines suffering in Section 26 (3) to be physical or psychological pain which cannot be relieved in a manner the person deems tolerable. People who are living with chronic depression would qualify for euthanasia even if they reject effective treatments.

Bill 52 legalizes a form of homicide (euthanasia) under the guise of “medical aid in dying.”

Bill 52 is a very dangerous piece of legislation. 

The Quebec government must abandon its intention to legalize euthanasia and recommit itself to providing the best palliative and long-term care for its citizens.

We don't need euthanasia, we need better end-of-life care

The following letter was published in the Montreal Gazette. Dr Catherine Ferrier is one of the leaders of the Quebec doctors group, the Physicians for the Total Refusal of Euthanasia.

The Quebec government has introduced a bill that would make it legal for a doctor to kill his or her patient. The bill is presented as a proposal to improve end of life care, so as to make it more palatable, but the poison is unmistakable. If the bill passes, the law will continue to protect the lives of young and healthy people, but for the elderly and terminally ill the only difference between a legal homicide and an illegal homicide will be a signature on a piece of paper

This bill is being driven by small lobby groups who want legal euthanasia at all cost, and the public has been taken in. Some have experienced the death of a family member whose symptoms were not adequately controlled; still others have no experience of death and are frightened by the reports that it’s always preceded by unbearable pain and suffering. This only happens when palliative care is not available (which is the case for 80 per cent of dying patients in Quebec). Still others think euthanasia is the same as withdrawing burdensome and unwanted treatment, which is perfectly legal and requires no new legislation.
We don’t need euthanasia: we need more and better end-of-life care. Do we really want to deny the tradition of all civilized societies that makes it a crime to take the life of any other human being? To give less protection to the old and sick than we do to convicted murderers? Let’s set a goal of universally available high quality medical and nursing care for every patient at the end of life. Now THAT’S a progressive cause. 

I urge Quebecers to support the 500+ Quebec doctors who don’t want to become executioners: sign at caringalways.com. 

Catherine Ferrier MD

Killing is not Caring, Letters to the National Post.

The National Post printed several excellent letters to the editor explaining why Quebec is wrong to decriminalize euthanasia. It is also very wrong that the Quebec government is defining euthanasia as a part of palliative care and as a medical act. Killing is not Caring.

The following letters were published in the June 14 edition of the national post and each offers a different angle on the issue of euthanasia.

I wish express my great concern regarding the bill tabled in the Quebec National Assembly concerning the legalization of euthanasia in that province. Being of Dutch heritage — my parents emigrated from Holland in 1949 — I have followed the euthanasia trend in that country since it was legalized. There is clear evidence that what begins as an issue for only those few people who request that they be killed, soon develops into an abusive system where people with disabilities, people living with depression, the elderly and even children are put to death, some without their consent. The path that Quebec is taking in legalizing euthanasia is very dangerous for society’s most vulnerable.
Joanna Simpson, West Lorne, Ontario

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Now that Quebec has tabled a bill to legalize euthanasia, it must be said that under such law, society will fail to defend the most vulnerable and the doctor becomes a death dealer instead of a healer. A 2009 UN report found that, in Holland, a physician could euthanize a patient without any independent review to guarantee that the decision was not the subject of undue influence, and, though a second doctor had to give an opinion, even that could be obtained from a telephone hotline.

I am deeply disturbed by those who overlook the failure of this experiment in other countries. Why do they coldly dismiss all those hundreds of people who have been euthanized without their consent? Are they just collateral damage? Canada rightly forbade capital punishment, due to the fact that no system can guarantee that no one will be killed by mistake. We have the freedom to make choices, but those choices should not endanger the lives of others, especially the defenceless.
Dr Rene Leiva, Ottawa Ontario.

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Those who enter the medical professions are, for the most part, caring individuals. To have them involved in killing their patients goes against the basic reason for medicine — to heal the sick.

How soon will the “right to die” become the “duty to die”? Elder abuse is bad enough today, without fortifying it under the guise of those euphemistic words, such as “caring” and “dignity.” Whatever safeguards are devised by the legislators will be circumvented. Surely, the situation in the Netherlands, where anyone over the age of 65 is afraid to go to hospital for anything minor, is proof that these warnings are valid.

But it is not only the elderly who are at risk under this proposed legislation. The disabled, those living with depression and anyone dependent on medical care will be left vulnerable. Perhaps someone in one of these categories does not wish to die. Will he receive the standard of care to which he is entitled? Or would some of the staff resent having to care for him when he could be killed, thus freeing a bed for someone higher on our scale of desirable people?

Resources would be better used to develop pain management tools and improve palliative care. It may be easier to get rid of the problem by killing the patient. But the easiest solution is seldom the right one.
Joyce Pringle, Oxford Station, Ontario

------------

I understand it is very likely that the Quebec government will soon introduce a bill to legalize euthanasia. I strongly oppose this because it would lead to the abuse of the depressed, elderly or disadvantaged, stripping them of the dignity they deserve.

The decision to terminate a life is generally proposed by people who may be depressed or desperate. I’ve heard of people who contemplated suicide because of terminal illness and later realized that their lives where worth living.

Prohibiting euthanasia is an effective way to prevent elder abuse and the abuse of people with disabilities. Euthanasia is a form of homicide. It is not health care, as killing is not caring.
Ana Clarridge, Burlington, Ontario

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I was privileged to help care for my father during his long physical decline. Human dignity is wounded by helplessness, hurt, neglect and loneliness. But every time a sick or dying person is helped, comforted, cleaned, fed, every time he or she converses, is consoled, prays with family or deals with pain through real medical care and the emotional support of loved ones, dignity is protected.

Killing the patient, as Quebec now proposes to do, is the final act in a long story of neglect. It is the ultimate admission of defeat. We should have the courage to question our whole social project and remake it, rather than take this final step into darkness.
John Kane, Gatineau, Que.

Letter: Mental-health crisis intervention worker would never help to kill

The following letter was published in the Montreal Gazette on June 13.

Letter: As a mental-health crisis intervention worker, I would never ‘help someone die’

Re: “Proposal sets out detailed conditions” 
(Gazette, June 13)

It is my understanding that in our province of Quebec and in the North American context, the medical treatment and the level of care to assist the dying in their suffering has never been better. Drugs, multidisciplinary teams and facilities all assist those of us who are in the process of suffering and letting go of our lives. It is hard, suffering is tough ­ no one debates this.

However, it is curious for me to see that today and in this context of high end palliative care, the bill on “medical aid in dying” was proposed in the National Assembly is considered as being a valid option offered by our medical institutions to our most vulnerable people.

As a mental-health crisis intervention worker, I would never “help someone die” even though their suffering is chronic and unbearable. It is not what I do, and it is not what humans do to “care” for one another. My role, our role; is to accompany each other in our suffering ­ not extinguish life. The problem is the suffering and the pain, not the life. Pretty it up all you want: “medical aid in dying” is euthanasia.

Egon De Roth, MSW, PSWPointe-Claire

Alex Schadenberg interviewed by CTV news on Quebec euthanasia bill.

This morning Alex Schadenberg was interviewed by CTV Canada AM news. The some of the interview was then featured in a CTV news article that was written by Angela Mulholland and published on June 13, 2013. The whole interview is not published in the article.

Alex Schadenberg

The following is the published text of the interview:

Quebec is expected to hold public hearings this fall on its controversial right-to-die legislation, tabled Wednesday in the national assembly. But in many circles, the debate has already begun.

Quebec’s landmark bill would open the door to allowing terminally ill patients to have a doctor administer medication to cause death. If it passes, it would be the first legislation of its kind in Canada.

Assisted suicide and euthanasia are both illegal under Canada's Criminal Code, but the Quebec government says it has jurisdiction on the matter, because delivery of health-care services is a provincial responsibility.

Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition, opposes the bill, saying what’s really needed in Canada is improvements to the country’s palliative-care system.

“People don’t want to be suffering or in significant pain and that’s what we should be looking at. That’s what palliative care is supposed to be and we need better palliative care,” he told CTV’s Canada AM, speaking from London, Ontario.

Quebec Social Services Minister Veronique Hivon said Wednesday she is confident Bill 52 will not trigger Criminal Code sanctions because the bill deals with Quebec’s responsibility in the area of health.

“There is nothing in the Criminal Code that deals specifically with an act to put an end to suffering in a medical context,” she said.

Schadenberg doesn’t agree this is a health issue. “Euthanasia is taking the life of a person; it’s not about withdrawing treatment or pulling a plug, it’s about actually injecting someone with a lethal dose. How could that be health care?” he said.

Federal Attorney General Rob Nicholson said Ottawa would review the implications of the proposed legislation, but noted that “a large majority” of parliamentarians voted not to change Canada’s assisted suicide laws in 2010.

Hon. Rob Nicholson

“The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities,” he said in a statement.

“This is a sensitive issue for many Canadians, with deeply held beliefs on both sides of the debate.”

Link to the interview on Canada AM.