Death should not be doctors’ responsibility

Excerpted from a submission by Margaret A. Somerville, founding director, Centre for Medicine, Ethics and Law, McGill University, to the special joint parliamentary committee on physician-assisted suicide, Feb. 4.

I was invited to appear before the “Special Joint Committee on Physician-assisted Dying” of Parliament and provided with written instructions setting out the matters the committee wished me to address. These did not include the question of whether or not Canada should legalize euthanasia and physician-assisted suicide.

Therefore, I want to put on the record that I believe euthanasia and physician-assisted suicide are inherently wrong and should remain criminally prohibited.

It seems, however, to be a foregone conclusion that Parliament will legalize euthanasia (a word I use to refer to both euthanasia and physician-assisted suicide), so the issue is how to limit the harms and risks of that ...

For nearly 2,500 years, physicians and the profession of medicine have recognized that assisted suicide and euthanasia are not medical treatment and this position should be maintained and these interventions should be kept out of medicine.

Consequently, a new profession should be established to carry out euthanasia. The practitioners should not be health care professionals or, if so, only ones who have permanently retired from practice. Practitioners should be specially trained, licensed and have travel money provided to give people across Canada equal access to euthanasia.

If this approach is not adopted, two publicly available lists of physicians and institutions should be established, those who will provide euthanasia and those who will not. This is a reasonable compromise between Canadians who agree with euthanasia and those who oppose or fear it. The Supreme Court emphasized that the Charter right to “security of the person” includes freedom from fear about what could happen to us when we are dying, which often seems to be forgotten or ignored with respect to this right of those fearful of euthanasia. Canadians who reject or fear euthanasia must be able to avoid physicians who have the legal right to end their lives.

This approach will also solve most freedom of conscience issues. Health care professionals must not be forced to provide or refer for euthanasia when they have ethical or conscience objections to doing so. It must be kept in mind that respect for physicians’ freedom of conscience is not only necessary to respect them, it is also required to protect patients and can be the last such protection against doing them serious harm or other serious wrongdoing.

Our members of Parliament must be intensely aware in deciding who will have access to euthanasia and on what conditions that they are not just legislating for presently living Canadians, but also for future ones, their greatgreat-grandchildren and beyond, with respect to how they will die and the extent to which respect for life will be upheld in future Canadian societies.

Whether or not we agree with physician-assisted death, legalizing physician-assisted suicide and euthanasia is a seismic shift in our most fundamental values as individuals and foundational values as a society.

I believe future generations will look back on the legalization of assisted suicide and euthanasia as the most important social-ethical-legal values decision of the 21st century and the decisions that Parliament will make about the legislation and regulations to govern those interventions are an integral part of that decision.