Doctors staying out of it

Contentious euthanasia debate and ‘no’ vote leave some MDS frustrated

Incoming CMA president says ‘medical aid in dying’ issue not being ducked; others disagree,

This country’s leading doctors’ group has voted against wading into the debate about doctor-assisted death, drawing accusations from some of their members that they are burying their heads in the sand on an issue of profound importance to Canadians.

Delegates to the annual general meeting of the Canadian Medical Association on Wednesday voted against a motion urging all levels of government to hold public hearings into “medical aid in dying.”

Some doctors argued that it would be premature to call for nationwide public hearings when doctors themselves haven’t decided whether they would be willing to participate in helping their patients end their life, while others said it wasn’t clear exactly what “medical aid in dying” means.

Others were visibly exasperated.

“I have a bit of a problem understanding the attitude of my colleagues from other provinces regarding what’s going on with this issue,” said Dr. Ruth Vander-Stelt, from Gatineau. “Canadian physicians outside Quebec do not want to talk about this issue of medical aid in dying. We can’t talk about it. You have to shut your ears, shut your eyes and shut up,” she said.

Vander-Stelt said she has her own “conscientious objection” toward a proposed Quebec law that would permit aid in dying for patients experiencing incurable and irreversible illness and suffering.

“Society is waking up — it’s coming. We have to talk about it,” she said.

The debate was so contentious, delegates couldn’t reach agreement on the wording or language, referring a motion to replace “physician-assisted suicide” with “physicianassisted death” on all future communications from the doctors’ group to the board of directors.

One doctor argued the word “suicide” can provoke the same negative emotions as “abortion” and “rape.”

However, Dr. Robin Saunders, outgoing chair of the CMA’s ethics committee, said it is time for doctors to “call a spade a spade.”

“Medical aid in dying is, in fact, euthanasia,” he said. “That is the term we should be using.”

Canada’s Criminal Code makes it an offence to counsel, aid or abet another person to commit suicide.

Federal Health Minister Rona Ambrose said this week that the government has no intention of reopening the debate.

But recent court cases, the proposed Quebec law and a rapidly aging population confronting its own mortality are pushing the issue into the public conscience.

“The baby boomer generation is starting to reach this inevitable crossroads in their lives,” Saunders said. “This cohort — perhaps more than any other — is used to having control.

“Should physicians remain steadfastly committed to one of the most fundamental tenets of ethical practice — namely, to respect the value of human life, and not actively participate in (physicianassisted death) and euthanasia — or does the physician have the moral responsibility to relieve suffering even if by doing so death is hastened?”

Dr. Pierre Harvey, of Riviere-du-Loup, Que., said the CMA’s mandate is to be leaders in health care.

“Give me one good reason, as leaders, we should not confront this inevitable question that has to be discussed everywhere in Canada? On what basis can we refuse to undertake a consultation on something so basic as this?”

Incoming CMA president Dr. Louis Hugo Francescutti said doctors are not ducking the issue.

“As someone who just lost their mom, this is an issue that’s near and dear to my heart,” the Edmonton emergency physician said.

“I don’t think we ducked. What physicians do when they’re not sure is pause and reflect and ask for consultation.”

In another motion, delegates supported a doctor’s right to exercise “conscientious objection” when faced with a request for doctor-assisted death, should the practice be legalized in Canada.

The federal government is appealing a B.C. court ruling that struck down Canada’s ban on doctor-assisted suicide, ruling it unconstitutional. The case is likely to reach the Supreme Court of Canada.