The survey of 1,600 CMA members showed only 25.8 per cent of respondents said they would be “very or somewhat likely” to participate in taking the life of someone who requested euthanasia, while 54.19 per cent were “very likely or somewhat unlikely to do so.” These figures were similar to the findings of an earlier survey of members.
While the figures support the CMA’s policy against both physician-assisted suicide and euthanasia, McGill University Centre for Medicine, Ethics and Law professor Margaret Somerville said she received several e-mails after the study was publicized in early August that “expressed a serious worry that the CMA is opening this up because some members might be looking to change its anti-euthanasia stance.”
The CMA holds a general council meeting at the end of August in Calgary where a special session will be devoted to “end-of-life care.” While no changes may be in the offing, Quebec physicians opposed to euthanasia have good reason to be suspicious of member surveys.
Dr. Catherine Ferrier, a spokeswoman for the Physicians’ Alliance for the Total Refusal of Euthanasia (PATRE), notes flawed surveys done by two Quebec unions, the Fédération des médecins omnipraticiens du Québec and the Fédération des médecins spécialistes du Québec, in 2009 have been used repeatedly to show doctors are in favour of euthanasia.
“If I remember correctly they were not scientific opinion surveys, just an e-mail sent to members,” Ferrier said. “For both, the response rate was very low but the majority was in favour.
“The questions were very biased, and some people boycotted them. However, they’re quoted often to prove the doctors are in favour.”
The CMA is a voluntary body, unlike the provincial colleges which have the power to discipline physicians. But Ferrier points out the CMA as a national body has a certain “moral authority” and could have a large sway on public opinion were it to change its policy.
The policy opposes the practice but Ferrier questions how rooted it is in principle as opposed to legality.
“If it becomes legal are you going to change your mind?” she said. “That’s certainly what the Quebec government is trying to do, to make euthanasia the ultimate step in good end-of-life care. That’s how they’re getting around the Criminal Code by calling it health care.”
Somerville warns of the dangers of putting a “medical cloak” over euthanasia to disguise the fact euthanasia involves actively killing the patient.
“I believe the ‘medical cloak’ is an enormously serious worry,” she said.
Somerville and others who oppose euthanasia have asked whether, if it were to be legalized, lawyers or specially trained “thanatologists” instead of doctors should be given the task of euthanizing patients to remove that medical cloak.
“If we take it off and people will not approve the same act carried out by a properly qualified and accredited person, who is not a doctor, then what we see is that we are saying ‘doctors wouldn’t do something unethical or morally wrong so this must be acceptable,’ but the act itself is not ethical or moral,” she said. “We are really characterizing the person, who does the act not the act, and that confuses our moral intuitions, emotional response and reasoning about whether the act of euthanasia itself is ethically and morally acceptable.”
Legalizing euthanasia would have a negative impact on “medicine and health care professionals and medicine’s ability to carry the value of respect for life and, likewise, law’s capacity in that regard,” Somerville said. Law and medicine are the two institutions in a secular society “that carry this value for society as a whole.”
Ferrier, a physician who works in geriatrics, says most of her patients fit the criteria of the Quebec bill for euthanasia. If euthanasia is legalized, the notion that killing the patient is legal “is always going to be there like a spectre haunting you” to take “the easy way out,” she said.
“Hospitals have to be a safe place where you know the doctors are not going to kill you,” she said.
PATRE formed earlier this year to combat the Quebec government’s pledge to treat euthanasia as part of medical care under the euphemism of “medical aid in dying.” So far 500 doctors have signed its manifesto.
In June, the Parti Quebecois government tabled Bill-52 which would include “medical aid in dying” under “palliative care,” which the bill would establish as a “right.”