The Corner

Science & Tech

Euthanasia Hurts Palliative Care in Quebec

Legalizing euthanasia can stunt the palliative-care sector. The Netherlands, for example, has traditionally performed comparatively poorly in this field. Indeed, one doctor once infamously said he didn’t need palliative care when he had euthanasia.

Now, in Quebec, the head of provincial medical association — who supports euthanasia — warns that some patients have been forced to “choose” to be killed because they couldn’t access quality palliative care. From the McLean’s story:

Provincial foot-dragging on plans to substantially expand palliative care services is actually denying patients the very choice that was promised in the shift to MAiD, and making it increasingly problematic to discern which patients truly wanted to have a doctor deliberately end their life, [Collège des Médicins President, Dr. Charles] Bernard says.

“In certain identified cases, patients, for the lack of (palliative) care, might have had no choice but to ask for medical assistance in dying to end their days ‘in dignity,’ which deeply concerns us,” the Collège president tells the minister.

Worse, he adds, the Collège has been hearing increasing concerns from its member doctors about re-direction of already scarce resources from palliative care to medical assistance in dying, which risks a violation of both the letter and the spirit of Quebec’s law governing end-of-life care.

Paint my expression as completely unsurprised. The delivery of proper palliative care requires specialized training and can be very labor intensive. The most difficult cases may demand a great deal of inadequately compensated time from the doctor. Euthanasia doesn’t require anything like that kind of expertise.

Indeed, the least trained or most inept doctors in dealing with serious conditions are quite capable of providing death. Jack Kevorkian was a pathologist with no experience after medical school and residency in treating living patients.

In California, the Life Legal Defense Foundation learned in a lawsuit that a large percentage of lethal prescriptions in California have been written by Lonnie Shavelson — a euthanasia crusader, not board certified in any specialty, much of whose medical career he spent as a part-time ER doctor, and who mostly pursued journalistic endeavors in recent years rather than treating patients.

Defenders of assisted suicide will respond to that charge by saying that prescribing morphine increased after legalization in Oregon — which is true. But it also increased in Rhode Island after that state outlawed assisted suicide and provided greater legal protections for doctors who prescribe strong pain-controlling drugs.

Besides, I believe that legalizing assisted suicide — by definition — denies many of those who die by lethal overdose or lethal jab of essential palliative services.

Defenders of assisted suicide will respond to that charge by saying that many patients who take prescribed poison were in hospice. True. But they were denied suicide prevention intervention, an essential hospice service — as much a part of good palliative care as prescribing morphine.

Bottom line: Hospice/palliative care and euthanasia/assisted suicide are mutually exclusive. One cares. The other kills.

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