Winnipeg Free Press - PRINT EDITION

Doctors argue for new euthanasia law

Prestigious journal calls for repeal of ban amid legal challenges

TORONTO -- Canadians need to engage in a broad national dialogue on the issue of whether terminally ill patients should have the legal right to "therapeutic homicide," says an editorial in the Canadian Medical Association Journal.

The editorial follows a report by a Quebec government commission that recommends some dying patients should have the right, under strict conditions, to request medical help to die.

The Dying with Dignity commission -- a multi-partisan group of nine members of Quebec's national assembly -- issued its 180-page report a month ago after two years of research and public and expert consultation.

Among its 24 recommendations is one suggesting a Quebec doctor who has helped a terminally ill patient die not be charged with an offence. Euthanasia and assisted suicide are illegal in Canada under the Criminal Code.

Monday's editorial -- entitled Choosing when and how to die: Are we ready to perform therapeutic homicide? -- argues the right-to-die issue should not be decided by the courts, such as the recent ruling rendered by a B.C. judge, but as part of a democratic process.

"Really, what we wanted to say is that there are consequences of having a policy either way, but it's probably time that we do," said senior associate editor Dr. Ken Flegel, who co-authored the opinion piece with editor-in-chief Dr. John Fletcher.

"It's going to involve some sort of democratic process to arrive at a decision. And whatever the decision is, part of the country is not going to be very happy," Flegel said in an interview from Montreal.

"We'll just have to live with the fact that social choices and values will mature, change, move on, and we have to adapt to them. And it's time to have a very open public discussion and, we're hoping, a very democratic process for deciding how to change the law."

On June 15, a B.C. Supreme Court judge struck down the laws banning doctor-assisted suicide as unconstitutional, but suspended her ruling for one year to give Parliament time to draft new legislation. Judge Lynn Smith also ruled one of the plaintiffs in the case, Gloria Taylor, would be allowed to seek assisted suicide within the year if she so chooses. Taylor, 64, of West Kelowna, B.C., has Lou Gehrig's disease.

Euthanasia and/or assisted suicide are legal in some European countries, among them the Netherlands, Belgium and Switzerland.

In Canada, repeated surveys have suggested more than half of the population favour dying patients having the right to end their suffering and the proportion of doctors supporting medically assisted suicide tends to mirror the public's majority view, said Flegel. "But there's a little extra issue inside this, and that's who is going to do this," he said, "because no one perceives themselves to have been trained to do it."

While the Hippocratic oath charges physicians to "do no harm," Flegel said surgery, inserting needles to get blood samples and myriad other invasive procedures mean health providers do indeed do harm, but with the goal of healing. Under the Assault and Battery Act, doctors given patient consent are not subject to charge.

Under a bioethical principle called "second intention," doctors often relieve patients' suffering with drugs to the extent necessary, even if the secondary adverse effect means it shortens their lives, he said. "That's really not an issue anymore and that's a foundational principle of modern palliative care."

-- The Canadian Press

Republished from the Winnipeg Free Press print edition June 26, 2012 C11

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