Ensuring access to euthanasia by encouraging physician participation: it’s complicated

Sean Murphy*

In July, 2017, Canadian euthanasia/assisted suicide (EAS) practitioners and advocates alleged that patient access to euthanasia and assisted suicide was in danger because of “barriers” and “disincentives” to physician participation. Dr. Stefanie Green, president of their professional association, described the situation as “a crisis.”1 There was, in fact, no crisis — only a false perception of crisis fuelled by unrealistic expectations about levels of physician participation in euthanasia and assisted suicide.2

Nonetheless, it is reasonable for policy makers to respond to their concerns that physicians are discouraged from participating in euthanasia and assisted suicide. Indeed, objecting physicians are less likely to experience disadvantage and coercion if policy-makers seriously consider suggestions by EAS practitioners and advocates about how to encourage physician participation in euthanasia.

Removing barriers and disincentives to physician participation

Minimizing procedural and administrative requirements
Returning to the complaints and concerns of Canadian euthanasia practitioners (see Canada’s Summer of Discontent2), reducing or streamlining procedural requirements and minimizing burdensome paperwork might encourage more physicians to participate. However, this raises a question that may prove difficult to answer. Is a procedural requirement a “barrier” — or a necessary safeguard? A “disincentive” — or an essential ethical prerequisite? The difficulty is illustrated by developments in Belgium. . . .[Full text]

Canada’s summer of discontent: euthanasia practitioners warn of nationwide “crisis”

Shortage of euthanasia practitioners “a real problem”

Sean Murphy*

There were 803 euthanasia/assisted suicide (EAS) deaths in Canada during the first six months after the procedures were legalized. In the second half of the first year (ending in June, 2017) there were 1,179 — a 46.8% increase, and about 0.9% of all deaths. Health Canada correctly states that the latter figure falls within the range found in other jurisdictions where euthanasia/assisted suicide are legal, but the Canadian EAS death rate in the first year was not reached by Belgium for seven to eight years. The dramatic increase of EAS deaths in the last half of the first year would have had a direct impact on EAS practitioners, and this may be why they ended the first year by sounding the alarm about access to the service. . . .[Full text]

Quebec euthanasia rates on track to match Belgian 7-8 year rates after 2 years

Sean Murphy*

Available statistics indicate that Quebec is on track to reach euthanasia rates  after two years that correspond to Belgian rates after seven to eight years (i.e., per 100,000 population and as a percentage of deaths from all causes).

Not all Quebec euthanasia statistics have been made public.  However, the following points appear to be of interest:

  • Almost 20 requests for euthanasia were made weekly in the province in the first half of 2017, slightly higher than the last half of 2016.
  • The percentage of requests that did not result in euthanasia increased slightly from about 37% to 40%
    • Increases in this category, when reported, were attributed mainly to patients becoming incompetent, dying or withdrawing their requests.

The Project’s analysis is available at Euthanasia Statistics: Quebec.

 

Vatican summons Belgian order to Rome over euthanasia policy

Catholic Herald

Simon Caldwell

Vatican officials want to hear in person why Brothers of Charity board members insist on allowing the euthanasia

The Vatican is planning to summon members of a Belgian nursing order to Rome to explain why they are refusing to ditch a policy which allows doctors to kill psychiatric patients in Church-run homes.

Senior Vatican officials want to hear in person why board members of the Organisation of the Brothers of Charity insist on allowing the euthanasia of non-terminally ill patients in the face of a top-level order to reverse the policy. . . [Full text]

 

Health professionals’ pledge rejects any form of participation in or condoning torture

Sean Murphy*

Physicians for Human Rights is sponsoring a Health Professionals’ Pledge Against Torture that includes statements that signatories will never “participate or condone” torture and support colleagues who “resist orders to torture or inflict harm.”  It also commits signatories to insist that their professional associations support those facing pressure “to participate or condone torture and ill-treatment.”

What is noteworthy is that the pledge is not limited to simply refusing to torture someone, but is a pledge against participation (which would include forms of facilitation like referral) and against condoning the practice.

Replace “torture” with commonly morally contested procedures and it becomes obvious that the ethical position taken by Physicians for Human Rights vis-à-vis torture is identical to the position of many health care professionals who object to practices like euthanasia or abortion for reasons of conscience.