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'Take my name off the list. I can't do any more' - Canadian doctors turning away from euthanasia

16 March 2017

 
​27 doctors have already asked to be removed from the list of those willing to participate in euthanasia, since it was legalised in Canada last June. Image: Martin Barraud

Doctors in Canada have been asking to be removed from the list of those willing to participate in "medical aid in dying", reports the National Post.

In Ontario, one of the few provinces to track the information, 24 doctors have permanently been removed from a voluntary referral list of physicians willing to participate in euthanasia. Another 30 have put their names on temporary hold. As of 17 Feb, there were 137 doctors on the list, though of those 30 would only be willing to provide a second patient assessment, and not administer a lethal injection or prescribe a life-ending dose of drugs themselves.

While they are not required to give a reason, according to a ministry of health spokesman, a number said that they want "a reflection period to decide whether medical assistance in dying is a service they want to provide.

Just too distressing 

"Dr. Jeff Blackmer, the Canadian Medical Association's vice-president of medical professionalism, said that for some doctors, the act was simply too distressing. "...We're seeing doctors who go through one experience and it’s just overwhelming, it’s too difficult, and those are the ones who say, 'take my name off the list. I can't do any more.'"

The act is performed out of care and compassion, Dr Blackmer said. “But for most (doctors), it doesn't make the psychological impact of that final, very definitive act, any less than it would be for anybody."

Dr Blackmer also said that the reports of doctors backing away were not just anecdotal. "I can't tell you how many, but I can tell you that it's enough that it's been noted at a systemic level."

Legal ambiguities

Others have attributed the decline in doctors willing participate in euthanasia to legal ambiguities and a fear of being prosecuted. The federal law, which came into force last June, permits euthanasia and assisted suicide for those with a "grievous and irremediable" condition and "enduring suffering." However, the procedure is limited to people whose death is "reasonably foreseeable." According to Dr James Downar, a critical care and palliative care doctor with Toronto's University Health Network, all of these terms are ambiguous. "Grievous and irremediable" could apply to most chronic conditions, and someone with a five per cent chance of survival could still be considered "curable". In addition, the criteria that death be "reasonably forseeable" is not to be found in any medical textbook.

Illegal killings

There have been a number of noted failings in applying euthanasia law in Canada. Last year, the commission overseeing Quebec’s euthanasia law, the first of its kind in Canada, reported 262 completed euthanasia deaths in the first nine months of the law. Of those, 21 cases were found to be non-compliant with the regulations.

In most of those cases — 18 — the two doctors who assessed the patient were considered not sufficiently independent. Of the remaining three, the commission ruled that two of the people were not at "end of life" while the third, according to the panel, didn't have a serious and incurable condition.

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