Prior to legalisation of “medical aid in dying” (active euthanasia), from the comfort of an abstract theoretical detachment, 48 % of doctors in the city of Laval QC said they would be willing to intentionally cause the death of a patient. Another third diplomatically gave “conditional responses”. In other words, even among the people sufficiently politicised to respond at that time, fewer than half would be willing to perform euthanasia under the present criteria.
And that was before the prospect became real.
“What we see is that providing medical aid in dying is more complex than we thought”, says Marie-Ève Bouthillier, director of the centre for ethics of CISSS de Laval and coauthor of a study of 61 Laval doctors who received 113 requests for euthanasia. Obviously. And it is a wonder that the ruling class managed to ignore that fact for so long.
Once the Act respecting end-of-life care came into effect, 77% of the doctors who received real requests from real patients discovered that complexity, and concluded that they could not stomach the thought of killing their patients.
What did we expect?
On the one hand, there is an absolutely instinctive and universal human horror and avoidance of death. And although many doctors have learned to work with dying people, the thought of actually killing someone takes suppression of natural instincts to a whole new level.
And on the other hand, we have a political fantasy that doctors (being told euthanasia has been redefined as a benign “medical treatment”) will suddenly be at ease with killing people. Dr. Bouthillier even expands on this wishful thinking by postulating initiatives to make the whole problem go away: “We need to provide training to make this practice more acceptable, to integrate it into doctors’ clinical work.” So what now? When the study authors realize they cannot just “re-educate” people into this practice, what then? Coercion?
Beyond the absurdity, there is a sinister dimension to this research and the agenda which is motivating it.
The only justification legally offered for a refusal to participate is “right of conscience”. But only 14 % of the doctors interviewed for this study were considered to have real moral objections. Therefore, the study seems to conclude, the others are refusing to kill people for no good reason.
Contrary to what some would have us believe, moral conscience is not the unique purview of established religion or traditional moral codes: it is universal. It is one of the many — and one of the most important – things that make us human.
What is the “moral burden” invoked by 59% of respondents, otherwise at ease with accompanying dying patients, if not an innate repugnance to the act of killing someone? The same repugnance at a societal level explains the “fear of stigmatization” mentioned by 27%. And the “lack of expertise” cited by 36% may well conceal similar reasons: it certainly has nothing to do with knowing how to give an injection.
What is the extreme emergency that would require us to convince – or coerce – all doctors to kill people on request? Do we really want doctors who no longer listen to their conscience, however that is defined? Do we really aspire to having a medical profession that cheerfully and unquestioningly carries out whatever political fashion may demand? Is this the best model the profession can offer to future generations?
It seems logical to us that the fewer doctors desensitized to killing, and the more who exercise their prudential moral judgment before jumping on the bandwagon, the better for all concerned.Share