Right now, though, palliative care is accessible to less than a third of the population. And in Quebec, if Bill 52, the proposed law to decriminalize euthanasia, comes into force — it passed a “vote in principle” last month in the National Assembly, 84-26, so is well on its way — interest in funding research, beds and training for palliative-care departments is likely to wane. This, to me, is the most troubling aspect of our culture’s fixation on assisted suicide and euthanasia as the only route to “death with dignity.”
In general, even intelligent and educated people have rather fuzzy notions about euthanasia (which is not assisted suicide, though many people conflate the two). The only reason the Quebec government is calling euthanasia “medical aid in dying” is that they believe it creates an end run around the Criminal Code, which proscribes the killing of patients by doctors. But euthanasia is killing by doctors: Surveys show 60% of Quebecers do not realize the bill provides for death by lethal injection, just like the death penalty in the U.S. — and euphemisms do not change that.
There is only one form of medical treatment that can accurately be described as “medical aid in dying,” and that is palliative care. Which is why palliative care doctors, as well as many family physicians, are almost as appalled by the wording of the bill as they are by euthanasia itself.
I had the opportunity to appreciate the extent of their anger two weeks ago when I attended a fundraising dinner in Montreal devoted to Bill 52. The event was organized by Quebec’s Coalition of Physicians for Social Justice, whose co-president, family-practice physician Paul Saba, is acting on members’ behalf to deny legislative authority to Bill 52 on the grounds that no matter how the Quebec government frames it, euthanasia remains a Criminal Code issue. It is widely assumed that Quebec’s doctors generally favour the bill. In fact, only a vocal minority do. And those who believe there is consensus would change their minds if they were present, as I was, in that hotel ballroom, filled with hundreds of doctors whose combined moral outrage exuded almost palpable vibes.
I spoke with Manny Borod, a palliative care physician at the Montreal General Hospital, who articulated the grievances his peers feel. Foremost is the illicit intrusion of the government into medicine’s jurisdiction. Governments should not be in the business of deciding what is or what is not a medical treatment. If the government can decide euthanasia is a medical treatment, Dr. Borod asks, “what’s to stop them from legislating other medical treatments?” Like many of his colleagues, he would like to see less aggressive, technology-heavy treatment applied to dying patients and more attention paid to enriching and enlarging the palliative resources that would give those patients a better death.
Many prominent doctors spoke out against the bill throughout the dinner. Most galvanizing were the words of Balfour Mount, the pioneering “father” of the palliative care movement in Quebec. Now elderly, ill and frail, Dr. Mount’s passionate disdain for the medicalization of euthanasia remains undimmed. Calling euthanasia “medical aid in dying” is a “cowardly distortion of language,” he said. The dying do not want to be killed; they want an “easy death,” and “that is what palliative care gives them.”
Dr. Mount was particularly irritated by the influential video put out by his former colleague, Don Low, in his last weeks of life, calling for legal assisted suicide. In the video, Dr. Low said, “there is no place in Canada where you can have support for dying with dignity.” That, Dr. Mount said, “is a gross disservice to our fellow Canadians.” He was contemptuous of the CBC’s Peter Mansbridge for perpetuating the false notion that Dr. Low was “denied death with dignity.” Dr. Low died at home, pain-free, surrounded by his family, according to Dr. Mount, and if that is not dignity, what is?
Putting a “white smock on euthanasia” has laundered euthanasia’s grim reality — a strategy by activists, amongst others, that bio-ethicist Margaret Somerville identified in her address, decrying this “seismic shift” in our attitude to suffering. Religion used to set the standards for morality, she said. Now scientists and lawyers do. The law says, “don’t kill,” and medicine says, “heal.” Euthanasia advocates want to reverse their roles. Ms. Somerville quipped: “How about letting the lawyers kill people?” The remark drew laughter — and heavy applause.