Two recent surveys have re-ignited the euthanasia debate in Quebec.
Three-quarters of doctors in Quebec said they would “certainly or probably be favourable to euthanasia within a clearly defined legislative limit,” according to an Oct. 13 survey conducted by the Quebec Federation of Medical Specialists.
Euthanasia and physician-assisted suicide are illegal under the Canadian Criminal Code, but there is a strong movement coming out of Quebec to amend the law; 77 per cent of Quebecers support the option of euthanasia, according to an Angus Ried poll conducted this summer.
Dr. Eugene Bereza is the director of the Boimedical Ethics Unit of McGill University’s Faculty of Medicine. In a rare interview, Bereza, who researches end-of-life care, physician-assisted suicide and euthanasia, discussed both sides of the debate and cautions against blind faith in surveys.
Of the over 8,700 members of the Federation, 23 per cent responded to the Oct. 13 survey.
“You’ve got to wonder about the quality of public opinion poll questions,” he said. “People will respond with their own idea of what euthanasia is.”
Many members of the general public and of the medical field don’t have a clear understanding of what those terms mean, Bereza said. “So we use them differently.”
Bereza describes euthanasia as specific and deliberate intervention with a patient, with the intention to end that person’s life.
Withdrawal of life support is not euthanasia, he said. “Intention is the critical distinction.”
The movement out of Quebec to amend the law doesn’t only come from surveys, though. Bloc Quebecois MP Francine Lalonde sponsored a private members bill to allow euthanasia exceptions in specific cases.
One of the strongest areas of contention in the debate is palliative, or end-of-life care, Bereza said.
“Excellent palliative care can manage pain and symptoms very well,” he said. “Many people who ask for euthanasia don’t know that.” He asserts euthanasia is often regarded as an escape from pain and suffering, which palliative care is meant to treat.
As part of palliative care, physicians are allowed to administer pain-relieving drugs, including narcotics, as long as it is done according to standards. Bereza said physicians can provide as much medication as necessary to relieve pain and undue distress.
Philosophically, medicine is regarded as a profession of saving lives, not ending lives. Those against amending euthanasia laws may feel that any allowance of euthanasia will undermine the medical profession, said Bereza.
He cautioned that changing the law could become a slippery slope 8212; that there could be a potential abuse of euthanasia, or the rights of those who have no family and nobody to speak on their behalf.
Bereza said personal autonomy is an important consideration as well. “There are those who suffer from existential pain. And those who say, “How can you force me to live in a way that I don’t find acceptable? I’m terminally ill and dying anyways, so it’s not suicide.’ Or, in one of those rare occasions, “When palliative care didn’t work for me, why should I still suffer?'”
Proponents of euthanasia also reject terminal sedation as an option, questioning whether it is any better than death itself.
But there is also significant frustration amongst medical professionals in palliative care. Improvements have been demanded for decades. “There are many citizens in Quebec who don’t have access, and there are many professionals who are not trained well enough.” According to Bereza, the quality and availability of palliative care is of little solace to those for whom it’s inaccessible.
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