Dr. Robert’s regrets: Towards death à la carte?

Sean Murphy*

The state medical regulator in the province of Quebec, the Collège des Médecins du Québec, published an reflection in 2009 that effectively encouraged the legalization of euthanasia. During hearings into Quebec’s Bill 52, which eventually became the province’s euthanasia law (the Act Respecting End of Life Care), Dr. Charles Bernard , Dr. Yves Robert and Dr. Michelle Marchand appeared on behalf of the Collège.  They were effusive in their support for the proposed law, describing it as “a very important milestone,” the product of “outstanding work,” and “responsive to the vision we initially proposed.”

One of the points Dr. Bernard  emphasized was that euthanasia should be “an option of last resort for  exceptionally difficult situations at the end of life. . . in the final stages of a serious and incurable disease that is inflicting refractory suffering.”  Dr. Robert himself added that euthanasia should only be considered in what was truly the “last slice of life in the final phase of the life.”  Only then, he said, might it be considered an option “from a medical point of view.”

Consistent with these views, the original text of the Bill was amended to include a provision that a patient had to be “at the end of life,” even though the legislators could not agree on what this meant.  It is not certain that the term is being interpreted consistently throughout the province, though returns from reporting agencies sometimes report refusal to provide euthanasia because a patient is “not at the end of life.”  About 8% of refusals in the first half of 2017 were attributed to patient ineligibility, which includes this criterion, among others.

In any event, Dr. Robert has published a commentary indicating alarm at increasing pressure to provide euthanasia in circumstances and for reasons apparently not envisaged by Collège des Médecins du Québec when it published its 2009 reflection and expressed its support for the new legislation.  Of particular interest, he suggests that, if current trends to broaden criteria for euthanasia continue and are affirmed, it may be appropriate for the medical profession to be replaced by some kind of non-medical (but presumably technically competent) euthanasia service.

During the legislative hearings into Bill 52, Professor Margaret Somerville suggested that lawyers could be trained for this purpose.  Her suggestion was ignored at the time, but Dr. Robert’s comments suggest that he and other euthanasia supporters may now be more open to Dr. Somerville’s proposal.  Having a corps of voluntary euthanasia service providers would relieve the pressure now being experienced by physicians and health care workers who object to euthanasia for reasons of conscience.

  • Dr. Robert’s regrets [Full English translation of Vers la mort à la carte? provided by the Physicians’ Alliance against Euthanasia]

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