Mercy killing to stay illegal: minister
Debate over doctor-assisted suicide won’t be reopened, Ambrose says
CALGARY The federal government has no intention of reopening the debate on mercy killing and doctor-assisted death, Canada’s health minister said Monday as the nation’s doctors began debating whether physician-assisted suicide is homicide or an ethically justifiable medical act to relieve incurable suffering.
“This is an issue that is very emotional for a lot of people — not just regular Canadians but also physicians,” Rona Ambrose told reporters Monday at the Canadian Medical Association’s annual general council meeting in Calgary.
Canada’s Criminal Code outlaws euthanasia and assisted suicide, decreeing it a criminal offence punishable by up to 14 years in prison. Quebec is moving to challenge the federal law with proposed legislation that would protect from prosecution doctors who administer life-ending drugs to terminally ill patients experiencing unbearable physical or psychological suffering.
“All of us think about the issue because we have elderly grandparents and elderly parents, and it’s on the minds of many because Quebec has introduced their legislation,” Ambrose said. “Parliament voted in 2010 to not change its position on this issue,” she said. “At this time we don’t have any intention of changing our position.”
End-of-life issues dominated Monday’s meeting, where some 300 delegates heard from an expert panel on palliative care, advance care planning and euthanasia.
A key ethical question in the “unending” controversy surrounding euthanasia and doctor-hastened death is whether the “administration of death” contradicts the medical mandate, to “first, do no harm,” delegates heard.
If doctor-assisted dying were made legal anywhere in Canada, “what sort of impact could we possibly imagine this would have on the care of very old, very fragile and deeply — or not so deeply — demented people,” said bioethicist Dr. David Roy.
Euthanasia involves “knowingly and intentionally” performing an act — usually administering a lethal injection of barbiturates — with the sole intention of ending life.
With physician-assisted suicide, the doctor provides a patient with the knowledge or means, or both, required to kill themselves.
The CMA’s policy, last updated in 2007, is unequivocal, stating that Canadian doctors “should not participate in euthanasia or assisted suicide.” A 2011 CMA survey found that 20 per cent of MDs would be willing to participate in euthanasia if it were legalized in Canada, while twice as many — 42 per cent — would refuse to do so. Nearly 40 per cent believed euthanasia should remain outlawed in Canada.
The issue provoked strong reactions from doctors; 20 motions on end-of-life issues are to be debated over the next two days.
“Physician-assisted suicide is not a suicide as far as I’m concerned. This is a killing. I’m certainly not interested as a physician,” said one doctor, who took care of his wife when she was dying 30 years ago.
“If physician-assisted suicide becomes legal in Canada we should have nothing to do with it,” another doctor said.
Calgary anesthesiologist Dr. Robin Cox said that terminally ill patients at the end of life are still being subjected to futile but painful and invasive procedures “that are really of no benefit to the patient.
“This is why advance care plans are so important,” he said.
Advance care plans are legal documents that spell out what life-sustaining interventions people would want or not want at the end of life should they ever lose the capacity to speak for themselves.
Cox said any discussions around end-of-life care needs to include looking at what procedures are being done to patients “that really just add to their distress in their last few days.”
Dr. Laurent Marcoux, president of the Quebec Medical Association, said that no doctor would be forced under the legislation to participate in “medical aid in dying” against his or her will.