Brian Jenkins

A fortnight ago, Quebec's junior health minister Véronique Hivon announced that the provincial government is moving ahead with legislation aimed at permitting “dying with dignity.”

In the ensuing days, reaction was swift, both for and against this physician-assisted suicide and euthanasia bill that the government wishes to have in place before the summer break.

The following is a collection of articles and opinion appearing In Montreal's The Gazette - a daily publication, offering both a summary and links to each, where possible.

January 16: “End-of-life rules to be set out in new law,” Kevin Dougherty, A2.

This article treats the legislative and judiciary angles to Quebec’s proposed legislation for assisted suicide. After citing previous Canadian cases, the article presents the provincial government’s goal, based on a recently released study indicating what course to go. Also discussed is how the federal criminal code will be circumvented to permit.

Jan 16: “Not everyone agrees with panel’s controversial findings,” Katherine Wilton, A2.

The author presents several perspectives on physician-assisted suicide. First she summarizes the context as set by the provincial government for pursuing physician-assisted suicide program. From here she moves to treat the importance expanding palliative care services. A first physician is quoted acknowledging that the patient and no one else ought to decide. Next, a legal point is made about proper wording the legislation as not euthanasia nor assisted suicide but “dying with dignity.” Finally, a second palliative doctor is claimed to be an advocate as siding with euthanasia.

Jan 17: “Physician-assisted death will have tight rules,” Katherine Wilton, A8.

This article considers who the clients will be that benefit from the proposed legislation on physician-assisted suicide. It begins by citing a case in Oregon where the patient, a physician makes the decision for physician-assisted suicide. A second case concerns two Belgian twins who opted for death upon learning that they are going blind. Finally, the article ends by profiling the rules in the Quebec proposed legislation.

Jan 17: “A choice the terminally ill should be able to make,” The Gazette’s View, A18.

The Gazette’s editorial board describes as «sensible» the plans of the Quebec government to permit “people with debilitating terminal maladies the right to choose when and how to die.” The editorial rests its case on the report by a panel of “eminent legal experts” Furthermore, it claims that this course of action is endorsed by Quebecers, both in general and the professional ranks.

Jan 18: “A creeping culture of death,” Sherif Emil MD, Opinion, A15.

In this opinion piece, pediatric surgeon, Dr. Emil argues against the provincial government’s plan to enact legislation permitting physician-assisted suicide. The crux of his argument rests on his several decade experience of practicing in Quebec – from a student to working in the Montreal Children’s Hospital. In this period he has seen a degradation of the provincial health care network and that placing the patient in the position to decide his own fate is unfair particularly as it applies to children. Additional comments are made about the adverse moral stance of physicians and the ill-begotten Belgian model on which the Quebec one is based.

Jan 19: “Your Views” presents five letters with varying opinions on the proposed legislative course of the provincial government.

• William Raillant-Clark (re jan18)

Addressing the Emil article, the writer argues that individual rights trump whatever state the health care network is performing at.

• Dr. J.C .Pecknold… loss of dignity, intrinsic value of human life (re jan17)

The writer, a physician, argues against the proposed legislation as it would place members of his profession in an unethical position. Other comments about the importance of palliative care and the intrinsic value of human life are made.

• Robert Marcogliese (re jan17)

The author focuses on semantics, stating that “assisted-suicide” in not the same as “dying with dignity.”

• Shalom Spira (re jan17)

Mr. Spira questions under what authority can the government proceed with its stated course of action.

• Helene Bolduc, President, Association Quebecoise pour le droit de mourir dans la dignite (re jan15)

Ms. Bolduc takes up the individual rights argument in end-of-life matters. Further, she appears to wish to enlarge the scope of who could avail of the proposed legislaltion.

Jan 22: “No role for palliative care in euthanasia,” Dr. Manuel Borod, A16.

Addressing the article written by Mr. Dougherty (Jan16), Dr. Borod writes so as to clarify points that are confusing, misleading, and false. First, he states that the only new matter in the proposed legislation is the “right to have medical assistance in dying.” Second he notes that the end of palliative sedation is not the death of the patient as the article states but care that not “necessarily hastens death.” Finally, he states as Director of the division of Supportive and Palliative Care that the current objective “that all our patients die with dignity” and that the proposed legislation is a smokescreen for allowing “an act that directly causes death.”

Jan 23: “Euthanasia would be better than how my mother died,” Dianne Laheurte, Opinion, A17.

Dianne Laheurte writes in favour of euthanasia. She describes the death of her mother over a four year period, one characterized by gradual deterioration and adverse emotional impact on her and both of her parents.

Commentary

I find Mr. Spina’s observation interesting - what authority does the provincial government have to proceed with this legislative initiative. For example, the briefs presented at the “Dying with Dignity” provincial tour overwhelming favoured a course toward improved palliative care to the exclusion of both euthanasia or assisted suicide, many of whom were from the medical profession.

On the topic of dignity, it seems that dignity already exists in the care for those who are terminally ill. Drs. Emil and Borod write about this and both are well placed to know.

Also, it seems that if life lacks a certain quality about it, then it is not worth living. Hence individuals do want to be hindered in ending their lives.