domenica 22 novembre 2009

Since the summer of 2009 the question of euthanasia and medically assisted suicide is the subject of a debate of growing intensity in Canada. The initial spark was the introduction last spring of a private member's bill in the Canadian parliament by a member of the opposition, proposing the legalisation of medically assisted suicide, a matter under the jurisdiction of the Canadian (federal) criminal code.

 

Even though so far there are no signs that the proposed bill will achieve a majority in the House of Commons or the Senate, many interest groups have decided to build up pressure to promote the approval of euthanasia. Among these are a few provincial orders of doctors (health care being delivered by provincial jurisdiction in Canada). Support thus far is rooted mainly in the francophone province of Québec, generally considered to be more "progressive"(i.e. left wing) than the rest of Canada. In that province, the leaders of two medical associations (general practitioners and specialists) have publically given their support to a modification of the criminal code that would allow some form of "controlled" euthanasia, arguing that the latest polls show strong support from their members as well as from the population of the province, for such a position. In fact, the validity of these polls has been challenged (even publically) by many doctors and by professional statisticians.

 

The last episode of the debate came in the first week of November, when the organization mandated by the Quebec government to ensure the quality and safety of medical health care, the College des Médecins du Québec, published a press release claiming (in ambiguous language) that there should be modifications to the criminal code in order to allow euthanasia "in certain circumstances".

 

The following article was published in national francophone newspaper, the daily, La Presse, denouncing the fact that by doing so, the Collège des Médecins was betraying its own mandate and "raison d'être". It was published on Friday, November 6th as an op-ed piece. On the same issue a group of students and residents in medicine wrote a letter to the National Post. 

 

A DUTY TO RESTRAIN

 

I have read the press release on euthanasia published on the website of the Collège des Médecins (College of physicians) of Quebec (November 3rd). Dr Lamontagne among others mentions that practices he deems “adequate” are prohibited by the criminal code. He also mentions that a “new legal frame” is required,

 

In short, Dr. Lamontagne, together with the Collège des Médecins, clearly takes the position for a new law that would permit euthanasia, which he himself defines as “the appropriate health care measures to end life”. It is all presented in a humorously confused and vague fashion. However, the authors of the release emphasize the complexity of the question and leave us to understand that (if I have correctly understood the sense of the article) we are above the law.

 

With the mandate of the Collège being first and foremost to protect the life and health of Quebecers, a power delegated by the government, isn’t it rather strange that it also openly supports acts prohibited by the Criminal Code that have also incidentally lead to the deaths of citizens, often weakened, whose lives are to be protected by the mandate? In light of this subject - I remind that before being a question of suffering, it is a question of one’s life and death -, the Collège, in my opinion, by its own mandate, has a duty to restrain.

 

Canadian and Quebecois societies, to the chagrin of the doctor’s college, are founded on the primacy of law. Certain rights, among them the right to life, are protected by laws. We cannot take the life of another, not even with the noblest intentions, nor even their consent. This point of departure will always be appropriate, beyond trends or “evolution of mentality”; contrary to what the directors of the Collège des Médecins may think. History has always shown a consensual effort to uphold this value (if we exclude the Nazi Germany of 1933-1945) and has in a certain way given birth to a cultural pillar that we have inherited from our ancestors that has its origins in ancient beliefs (the Greeks and the Hebrews – Hippocrates among others) and in the development of western law.

 

I leave to others the task of explaining or justifying the reasons for this pillar. Philosophers, judges and historians have always been able to define this and the problem of this “unacceptable suffering” wasn’t born in the 21st century; it has always existed. Assuming that this traditional standpoint (I am aware that the term is detested by certain modern sentiments, but it defines tradition as a method of transmitting the truth) has reached its expiration date reveals either a certain cultural ignorance or an intellectual ignorance immersed in good intentions.

 

By positioning oneself for a new law permitting what many call “death by compassion”, contrary to their praiseworthy desire to humanize health care, the Collège des Médecins of Quebec and its president, Dr Lamontagne, crookedly open the door to the collapse of the human greatness in our medical practice, that rests on the defense and the affirmation of every individual’s value (even the weakest, most vile or debilitated) to their natural end.

 

Marc Beauchamp - orthopedic surgeon.