By Patrick B. Craine

July 16, 2009 ( – In what one prominent euthanasia opponent has called “a straw man argument,” the Quebec College of Physicians is proposing that euthanasia be legalized “as part of the appropriate care in certain particular circumstances.”  The Globe and Mail broke the story today, and at the same time launched an online poll asking its readership, “Do you support the legalization of assisted suicide?”

After having examined the issue for three years, the College's task force on ethics concluded that Quebec society has grown to the point where it can now tolerate euthanasia.  “The question here is to decide whether a drop in dosage or an increase in dosage constitutes a criminal act,” said College secretary, Dr. Yves Robert to the Globe and Mail.

Dr. Robert is referring to circumstances that occur occasionally, where gravely ill patients may be in such pain that the amount of medication they require to relieve their pain could result in their death.  “We are being very cautious in our approach,” said Dr. Robert. “Avoiding the debate contributes to the general hypocrisy around this issue. To say that it doesn't happen because it is illegal is completely stupid. … We have to stop hiding our head in the sand.”

The College is contending that a patient's death in this case would constitute euthanasia.  “We may go as far as to recommend that in certain cases,” says Dr. Robert, “where the pain is unbearable, the amount of analgesic required could correspond to a form of euthanasia.”

Euthanasia Prevention Coalition Executive Director Alex Schadenberg told, however, that the circumstances to which Dr. Robert refers would not be euthanasia at all, and in fact, if properly conducted, is within the law.  “To use large doses of analgesics to kill pain is not euthanasia, it's actually, in certain circumstances, proper care,” he said.

“So why are they bringing this up?” he asked.  “I think what they're doing is they're trying to give, it appears, unless there's some information that's missing, it appears they're trying to give us euthanasia through the back door.”

In an e-mail sent out today commenting on the Globe and Mail article, Schadenberg wrote, “The interesting thing about this article is that [Dr. Robert] only refers to the use of analgesics that may result in the death of the patient.”

“This is not euthanasia if the physician intends to control the pain and not kill the patient,” he said.  “There are approved guidelines that a physician follows to determine the increases in analgesics. If the physician follows the guidelines (within reason) then the physician has nothing to worry about.”

“It is euthanasia,” he said, “if the physician just gives the patient a lethal dose of analgesic with the intention of causing the patients death. … If the Quebec College of Physicians allows for physicians to lethally inject their patients with overdoses they will be erasing the distinction between caring for people and killing people. People will lose faith in the ethics of their physicians and they will fear entering palliative care because the lines between caring and killing will be blurred.”

In his interview today with LSN, Schadenberg emphasized the need for clarity in speaking about euthanasia.  “The [Globe and Mail] article actually confuses what [euthanasia] is,” he said.  “What euthanasia actually is, is giving the right of one person to directly and intentionally kill another person.  That's what it is.  It's not about unintentional death.  It's not about denying medical treatment, or extraordinary medical treatment.”

Commenting in 2002 on the same circumstances that the Quebec physicians are now pointing to, Schadenberg stated, “A physician may accidentally overdose a patient with analgesics while seeking to control pain, but this is clearly different than intentionally killing someone.” 

“This 'double effect' happens in many medical circumstances,” he said.  “Physicians intend to improve the health of patients and yet sometimes patients die unintentionally. The physician has not committed homicide when a patient dies from the unintended effects of properly applied treatments.”

According to the Globe and Mail, the task force's recommendation will likely be included in a “reflection” document that the College will be releasing next fall.  Out of this document, they hope to spark a public debate on the issue that will put pressure on the federal government to amend the Criminal Code.  The College's final proposal is expected to be tabled in November.

The College claims adamantly that their position does not include support for assisted suicide, but Schadenberg is not convinced.  “We should not be surprised,” he said in his e-mail, “that the timing of the Quebec College of Physicians decision will take place at approximately the same time as Bill C-384 [to legalize assisted suicide] goes to a Second Reading vote.”

In his e-mail, Schadenberg has called on pro-lifers to vote 'No' in the Globe and Mail poll regarding assisted suicide.  At time of writing, 73% had voted 'Yes', with a total of 8359 votes.

See related coverage:

Euthanasia Prevention Coalition Supports End-of-Life Care Guidelines

Euthanasia Prevention Group Sees Hope for Pain Control in New Painkiller