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An excellent article, “Loving life!” was published in Le Journal de Montréal over the weekend. The author, Nathalie Elgrably-Levy, says that “the legalization of euthanasia must be looked at in the context of our healthcare system”, and adds that over 70% of Canadians don’t have access to palliative care. She warns of the financial risk – the financial imperative will become more important than the individual.

We have been saying for a while now that we must offer adequate palliative care to all, and Mrs. Elgrably-Levy shares that opinion.

The author also suggests that the opposite of “dying with dignity” is “living in shame”. That there will be social pressure for people to “choose” death. We have also been saying for a long time that social pressures cannot be measured, and that it is impossible to ensure that the patient’s choice, especially if he/she is vulnerable, is truly free.

But it is the financial argument that strikes me. Mrs. Elgrably-Levy asks if hospitals, for reasons of economy, wouldn’t have an interest in “neglecting palliative care to force the patient to ask for terminal sedation”. She adds that we cannot be certain that this “right” won’t become a civic duty: dying to lighten the burden on an already overwhelmed healthcare system.

She wrote:

“Still in the name of public interest, is there not a risk that we would expand euthanasia to those who suffer from a chronic illness? Then to those who live or are born with a disability? With Down syndrome? And finally to all those who are expensive for the system? “

This reminds me of a horrifying incident that happened in Oregon, in the United States, where assisted suicide has been legal since the end of the 90s. Barbara Wagner had lung cancer and her doctors had prescribed chemotherapy. She received a letter from the company that manages Oregon’s Health Plan. That letter said that the State would not pay for chemotherapy because it is too expensive, but they would be willing to pay for assisted suicide.

• Cost of chemotherapy: US$4,000 / month
• Cost of assisted suicide: US$50

Like Mrs. Elgrably-Levy, I cannot help thinking that our government is very interested in the financial aspect of it all.

Which is more important: People, or money?