Dr. Donald Boudreau and Margaret Somerville: Euthanasia is incompatible with Medicine

Dr. Donald Boudreau and Margaret Somerville: The Incompatibility of Euthanasia with Medicine. “Euthanasia is incompatible with medicine”, state Dr. Donald Boudreau and ethicist Margaret Somerville in a joint article published in July in the Journal Medicolegal and Bioethics.

The two experts from McGill University offer reflections of a multifaceted ethical nature. Here are some in summary:

  • Euthanasia contradicts the fundamental role of the physician, which is to heal. This role, they argue, cannot be exercised in a strictly technical sense, as it seeks the well-being of the whole person. Psychosocial suffering that accompanies a serious illness should also be treated and it is possible to do so even at the end of life through palliative care.
  • In a sense, if euthanasia were to be legalised (which the authors strongly oppose), it is not to doctors that this act should be entrusted, as it goes against the very principle of their profession. Technically speaking, it may be administered by other professionals.
  • For the authors, intentionally killing a human being is intrinsically evil. But even if this were not the case, the risk and damage of euthanasia on the social scale would be enough to make it unacceptable: the danger to the most vulnerable, the breach of the principle of respect for human life in general and the perversion of the role of the physician amply justify its rejection. They also stress that the growth of euthanasia risks harming research efforts in the area of the preservation and enhancement of the dignity of suffering patients.
  • A patient’s informed consent to euthanasia requires mental competency, the existence of fully adequate palliative care and a proven absence of external pressure. The authors doubt that these conditions can actually be met, at least in many terminally ill patients.
  • The experience of the last decade in different countries shows that the “slippery slope” is an inevitable reality, with two sides: the “practical” slippery slope (acts of euthanasia do not meet the established criteria) and the “logical” slippery slope (the extension of these criteria). They are inevitable because once we have lifted the ban on intentionally killing a human being, it is impossible to find a logical limit. As shown in the changing practices in some countries, the argument of the relief of suffering sooner or later makes incompetent patients and children vulnerable to euthanasia; and that of autonomy will sooner or later require its availability for healthy people.
  • The authors begin by denouncing the confusing vocabulary that is prevalent in the euthanasia debate. Confusion about basic facts exists even in the medical community, where it is just as harmful as would be a debate among cardiologists about the merits of an innovative treatment, based on inexact knowledge of the anatomy of the heart. In the first part of the article the authors provide valuable definitions of euthanasia, assisted suicide, palliative sedation and terminal sedation.

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