Wednesday November 4, 2009

‘Is the Quebec College of Physicians Deliberately Confusing Canadians on Euthanasia?’ Asks Anti-Euthanasia Leader

“We are saying death can be an appropriate type of care in certain circumstances,” explained a College spokesman in announcing their new document on euthanasia.

By Patrick B. Craine

MONTREAL, Quebec, November 4, 2009 ( – A prominent Canadian anti-euthanasia activist is demanding an explanation from the Quebec College of Physicians (CMQ) following their release yesterday of a highly controversial document in which they call for the legalization of euthanasia.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, says that the CMQ in the document blurs the line between legitimate end-of-life palliative care and euthanasia, and comes out in support of the former while wrongly giving it the name of the latter.

“Are the Quebec physicians deliberately causing confusion for Canadians in order to serve their own political agenda?” asked Alex Schadenberg. “I think there’s a political motivation going on here, and they should have to prove to me otherwise.”

Dr. Yves Robert, CMQ Secretary, at a news conference announcing his organization’s decision on euthanasia said, “We are saying death can be an appropriate type of care in certain circumstances.”

“This is a major breakthrough.”

The CMQ say they have determined that euthanasia should be legalized and “integrated as a part of appropriate end-of-life care as soon as possible.” They contend that there are “certain exceptional situations” where euthanasia is part of appropriate end-of-life care, and maintain that the current legal situation risks putting doctors in a position of facing criminal charges while they are merely exercising their duty of care.

“Legislation can suddenly encroach on the decision making process [at the end of life],” the CMQ document states. “In effect, there are certain exceptional situations – uncontrollable pain or interminable suffering, for example – in which euthanasia could be considered to be a final step required to assure the provision of quality care.”

The CMQ’s stated ‘exceptional situations’ regard occasions where a patient’s pain is so great that the amount of analgesics required to control it results in his death. While the CMQ claim this is a form of euthanasia, Schadenberg insists that “they know better.”

“They continue to improperly define euthanasia,” Schadenberg told “They define euthanasia as being similar to the use of analgesics in high doses, and that is incorrect, at least the proper use of it. … It actually is the direct and intentional killing of another person. … It has nothing to do with high doses of analgesics, unless you’re actually abusing the use, and actually doing that intentionally to cause their death.”

“The fact is that if they get their way, they’re just going to open the door to abusing the proper use of analgesics in Canada, and that shocks me,” he continued.

Schadenberg says he has two questions for the CMQ: “Are they covering up for physicians who are abusing these analgesics? Or are they deliberately trying to confuse Canadians by giving them the wrong idea about what euthanasia actually is?”

This decision follows a report in July from the CMQ’s task force on ethics which proposed the legalization of euthanasia in certain cases. In announcing that report, Schadenberg charges that CMQ Secretary Robert again conflated euthanasia and palliative sedation.

The CMQ is arguing that the law should align itself with the reality that, in seeking to relieve their patients’ pain, doctors already are administering doses of analgesics so high that it hastens their patients’ deaths. But while the CMQ maintains that through such actions these physicians could face criminal charges, Schadenberg insists this practice of palliative sedation is legitimate, legal, and carries no risk of sanction.

“The proper use of sedation is not against the law,” he said. “The proper use of sedation is absolutely moral. It’s the improper – it’s the abuse of sedation that is [illegal].” “There is no risk to physicians who properly use analgesics,” he continued. “All of the court decisions that have already been made in the past clearly define that the use of large doses of medication is not euthanasia, is not morally wrong, unless they intentionally use them to cause someone’s death.”

Dr. José Luis Pereira, chief of palliative care at Bruyère Continuing Care and Ottawa Hospital, agrees with the substance of Schadenberg’s assessment that the CMQ’s document is spreading confusion.

“It has all gone several steps too far,” he told the Globe and Mail. The doctor, who spent three years working under Switzerland’s regime of legal euthanasia, said that the CMQ is confusing end-of-life care with euthanasia and misleading the public.

“They always start off with the premise of extreme cases, and the definition inevitably expands,” he stated. “There’s an enormous amount of misinformation, it’s extremely irresponsible.”

The CMQ document has been released just as Canada’s Parliament deliberates over Bill C-384, to legalize euthanasia and assisted suicide. The bill, brought by Bloc Quebecois MP Francine Lalonde, is undergoing second reading. The second hour of debate is tentatively scheduled for December 1st, with a vote the next day. According to Schadenberg, “Without a question, it will be defeated.”

Despite the apt timing of their decision, the CMQ is criticizing the present bill for “confining doctors to the role of simply carrying out orders.” The bill is not broad enough, they say, in the sense that it does not allow doctors to euthanize those who lack lucidity, but is too broad in that it could require a doctor to euthanize a person who is “depressed or … who refuses the appropriate care.”

“There is no provision for patients who are not competent or for all those who may not have made a request while they were still able to do so,” they say. “And yet, given the consent of a patient’s loved ones, many doctors would probably feel justified in shortening the agony of certain incompetent patients in a terminal phase and suffering from uncomfortable pain.”

According to Schadenberg, however, “The fact is this bill allows [doctors to kill] people who aren’t competent.” “It says ‘appearing to be lucid’,” he said, “which … doesn’t mean you’re lucid.”

Several recent polls conducted in Quebec have indicated widespread support for the legalization of euthanasia. In August, one revealed that 3 out of 4 Quebeckers support legalization, and last month, another poll indicated support from 75% of Quebec medical specialists. Another of Quebec family physicians yielded similar results.

Ironically, given his own organization’s apparent confusion about the definition of euthanasia, CMQ President Dr. Montagne told the Canadian Press that the poll respondents likely misunderstood the meaning of euthanasia. “When we talk about euthanasia, everyone sees it as big as that,” explained Dr. Lamontagne, opening his arms wide. “I feel that in the survey of both federations, it is a bit like that” that the term had been understood.

A poll commissioned by LifeCanada, released this week, revealed that Canadians are more conflicted about euthanasia than the Quebec polls would indicate. While 61% supported legalization, 70% worried that patients would be euthanized without their consent should it be legalized. As well, 69% thought the government should focus on palliative care, compared to 18% who advocated legalized euthanasia as the priority.

To see the Quebec College of Physicians’ document click here.

See related coverage:

Quebec Physicians Propose Legalized Euthanasia

New Poll Reveals that Canadians are Conflicted About Legal Euthanasia

Anti-Euthanasia Group Questions Survey Suggesting Quebec MDs are Favorable to Euthanasia

Canadian Parliament Debates Euthanasia Bill