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Canada Expands Euthanasia

Only months after Canada legalized euthanasia in June 2016, bioethicists are pushing for organ donations from patients who are euthanized. In December’s Journal of Medical Ethics, University of Montreal bioethicists Julie Allard and Marie-Chantal Fortin say there could be some ethical complications, admitting, “It will be difficult to disentangle patients’ motivations for requesting MAID (medical aid in dying).” They say that the decision to donate organs should be separate from the decision to be euthanized, but acknowledge that will be difficult. For patients who feel they are a burden and can only be useful if they were to give their organs, this could constitute a subtle form of coercion.

David Evans, the CEO of Christian Medical and Dental Associations, explains that this effort is part of a worldwide push for “imminent death organ donation.” Evans explains that people seeking assisted suicide often feel their lives have lost all meaning and asking them if they’d like to donate their organs could offer another reason to take their lives. “This gives a noble reason to do it. Once you say there’s a life not worthy to be lived, people begin to do things like you’re seeing with this.”

Quebec is now debating the involuntary euthanasia of demented patients following the smothering death of an Alzheimer’s patient by her husband. Michael Cadotte posted what he had done on Facebook, claiming he had “cracked” when he killed his wife. Under Quebec’s 2015 law, euthanasia for the demented is specifically excluded. Jean-Pierre Menard, a Montreal medical lawyer, said, “This means the patient must understand their state of health and can express their will. A patient with advanced Alzheimer’s no longer has the capacity to consent, no longer has the cognitive capacity to understand.”

Unexpectedly, doctors who had signed up to participate in assisted suicide have begun to regret that decision. Dozens of participating physicians now want their names permanently removed from the list and even more have put their names on temporary hold. The Christian Medical Association’s Jeff Blackmer explained, “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.’” Physicians are also concerned about verbal ambiguities in the law, pointing out that the law’s standard could apply to most any chronic condition. They wonder if voluntary participation will become a “duty” to participate. Many are fearful that their non-participation puts them at risk of being prosecuted.

The Canadian Medical Association Journal (CMAJ) published a study titled “Cost Analysis of Medical Assistance in Dying” on January 1, 2017, which stated that the Canadian healthcare system will save between 34.7 and 138.8 million dollars per year with the legalization of euthanasia. Though the authors said they aren’t encouraging euthanasia, this type of research creates social pressure on people. Associating euthanasia with medical cost savings creates a belief that euthanasia is a social good, resulting in patients considering it altruistic to “choose” death. Also, associating euthanasia with medical savings creates tension for people who have chosen to live until they die naturally. While the authors claim that financial savings could be re-invested into palliative care, the more people die prematurely by a lethal injection, the less demand will exist for palliative care.l 22 and features a session that will give you some tools to get started. Please turn to page 8 for more information.

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.’”
Jeff Blackmer, Christian Medical association

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