Euthanasia: Hard question, no easy answer
One in five Canadian doctors would perform assisted suicide if it were legal, poll shows
Most Canadians say they would want doctors to help end their lives or hasten their deaths if they were terminally ill and suffering unbearably. But a new poll suggests few doctors would be willing to intentionally end the life of a patient.
Only one in five doctors surveyed by the Canadian Medical Association said they would be willing to perform euthanasia if the practice were legalized in this country. Twice as many — 42 per cent — said they would refuse to do so.
Twenty-three per cent of doctors polled said they were not sure how they would respond to a request for euthanasia; 15 per cent didn’t answer.
The CMA defines euthanasia as “knowingly and intentionally performing an act that is explicitly intended to end another person’s life” in cases of incurable illness “and the act is undertaken with empathy and compassion.”
One in six doctors (16 per cent) said they have been asked to perform euthanasia within the past five years, according to an article published online by the CMA.
The survey of more than 2,000 doctors also found that nearly half — 44 per cent — would refuse a request for doctor-assisted suicide.
Canada’s criminal code prohibits euthanasia and assisted suicide, making it an offence to counsel or assist someone to commit suicide, or agree to be put to death.
The CMA opposes euthanasia and medically assisted suicide in a policy that has not been updated since 2007.
But the issue has taken on new urgency in the wake of recent developments in several provinces. Last summer, a British Columbia court struck down Canada’s ban on doctor-assisted suicide, ruling it unconstitutional and granting a terminally ill B.C. woman with Lou Gehrig’s disease the right to a physician-assisted death if she could find a willing doctor.
Gloria Taylor, the woman at the centre of the court challenge, died in October from a severe infection. The federal government is appealing the B.C. court’s ruling.
In January, the Quebec government signalled its plans to present legislation setting out rules for doctor-assisted deaths, after a panel of legal experts recommended the province permit “medical assistance to die” in rare cases where a patient is close to death and unable to endure the physical or psychological pain.
The results of the CMA survey contrast sharply with public opinion.
A poll published in 2011 found that a majority of Canadians — 67 per cent — are in favour of legalizing medically assisted suicide.
Yet the doctors who would be expected to help carry out this most difficult decision are far less comfortable with the idea.
Euthanasia involves administering a lethal injection of barbiturates with the sole intent to end a life. Doctor-assisted suicide involves prescribing or counselling about a lethal dose of drugs that a patient would then use to kill himself.
CMA president Dr. Anna Reid said the organization wanted to know “exactly what members are thinking.
“End-of-life care means many different things to different people,” she said in the CMA article.
“It means palliative care for some, and it means euthanasia or assisted suicide for others. The CMA is simply trying to shed light on a very complex issue.”
Some doctors believe a change in law is inevitable.
“My personal opinion, as a physician providing palliative care, is that the day will come,” Dr. Sandy Buchman, past president of the College of Family Physicians of Canada, said in an earlier interview with Postmedia News.
“I teach my (medical) residents now that this is something that’s not only going to happen in their career, but my career.”
Buchman said that while the de- bate is important, it’s more urgent to improve end-of-life care in a country where only one-third of Canadians get access to palliative care, “which is a sort of national shame, in my opinion.
“I get requests from patients to end their life and to hasten their death,” he said.
“And I kind of feel like, right now, I’m off the hook. I can work very hard at trying to relieve their symptoms, without having to face that ethical dilemma of, ‘Can I end a person’s life?’”
He said the issues behind a patient’s request for a hastened death need to be addressed.
“Maybe their symptoms have been poorly managed up to that point. Maybe they’re suffering too much pain, or they’re feeling isolated. Maybe they’re feeling a burden on their families.
“Maybe there’s huge anxiety or depression, or spiritual or existential distress.”
Patients ask for help dying “usually when one of those things is happening.
“When I get (this request from patients) I get right in there and explore with them, what’s behind this?”
More than half of doctors surveyed by the CMA — 59 per cent — said they have withheld a lifesustaining treatment at a patient’s request, which is entirely legal.
Every competent adult has the right to refuse any treatment.
In all, 2,125 doctors completed the online survey in July 2011. With a sample this size, the results are considered accurate to within plus or minus 2.1 per cent, 19 times out of 20.