Dr. Robert’s regrets: Towards death à la carte?

Sean Murphy*

The state medical regulator in the province of Quebec, the Collège des Médecins du Québec, published an reflection in 2009 that effectively encouraged the legalization of euthanasia. During hearings into Quebec’s Bill 52, which eventually became the province’s euthanasia law (the Act Respecting End of Life Care), Dr. Charles Bernard , Dr. Yves Robert and Dr. Michelle Marchand appeared on behalf of the Collège.  They were effusive in their support for the proposed law, describing it as “a very important milestone,” the product of “outstanding work,” and “responsive to the vision we initially proposed.”

One of the points Dr. Bernard  emphasized was that euthanasia should be “an option of last resort for  exceptionally difficult situations at the end of life. . . in the final stages of a serious and incurable disease that is inflicting refractory suffering.”  Dr. Robert himself added that euthanasia should only be considered in what was truly the “last slice of life in the final phase of the life.”  Only then, he said, might it be considered an option “from a medical point of view.”

Consistent with these views, the original text of the Bill was amended to include a provision that a patient had to be “at the end of life,” even though the legislators could not agree on what this meant.  It is not certain that the term is being interpreted consistently throughout the province, though returns from reporting agencies sometimes report refusal to provide euthanasia because a patient is “not at the end of life.”  About 8% of refusals in the first half of 2017 were attributed to patient ineligibility, which includes this criterion, among others.

In any event, Dr. Robert has published a commentary indicating alarm at increasing pressure to provide euthanasia in circumstances and for reasons apparently not envisaged by Collège des Médecins du Québec when it published its 2009 reflection and expressed its support for the new legislation.  Of particular interest, he suggests that, if current trends to broaden criteria for euthanasia continue and are affirmed, it may be appropriate for the medical profession to be replaced by some kind of non-medical (but presumably technically competent) euthanasia service.

During the legislative hearings into Bill 52, Professor Margaret Somerville suggested that lawyers could be trained for this purpose.  Her suggestion was ignored at the time, but Dr. Robert’s comments suggest that he and other euthanasia supporters may now be more open to Dr. Somerville’s proposal.  Having a corps of voluntary euthanasia service providers would relieve the pressure now being experienced by physicians and health care workers who object to euthanasia for reasons of conscience.

  • Dr. Robert’s regrets [Full English translation of Vers la mort à la carte? provided by the Physicians’ Alliance against Euthanasia]

Hearings on Quebec Bill 52: College of Physicians

Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand

Tuesday 17 September 2013 – Vol. 43 N° 34

Note: The following translation is the product of a first run through “Google translate.”  In most cases it is sufficient to identify statements of interest, but more careful translation is required to properly understand the text.

Original Text

Caution: machine assisted translation

M. Bernard (Charles) : Merci, M. le Président. Alors, M. le Président, Mme la ministre, Mmes, MM. les parlementaires, alors le Collège des médecins du Québec vous remercie de lui permettre de vous présenter ses réflexions sur le projet de loi n° 52 concernant les soins de fin de vie, et j’ajouterais que nous sommes honorés d’être les premiers à auditionner devant cette commission en cette journée de rentrée parlementaire, alors on vous en remercie.Thank you, Mr. President. So, Mr. President, Madam Minister, Mrs, Mr. parliamentarians, while the College of Physicians of Quebec thank you for allowing him to present his thoughts on Bill No. 52 on the end-of-life, and I would add that we are honored to be the first to audition before the Committee on this day parliamentary session, so we thank you.
Alors, ce projet de loi constitue, à nos yeux, un jalon très important dans la réflexion sur les soins de vie, et, à notre avis, il devrait être adopté. Amorcée en mai 2006 à l’occasion de notre assemblée générale annuelle, cette réflexion s’est transformée en un vaste débat public, à l’issu duquel la Commission spéciale sur la question de mourir dans la dignité a remis sont rapport en mars 2012. D’entrée de jeu, vous nous permettrez de souligner le travail exceptionnel effectué sur ce sujet extrêmement complexe et sensible par tous les parlementaires, et en particulier le vôtre, Mme la ministre, vous avez fait preuve d’un respect, d’une qualité d’écoute, d’une rigueur et d’une compréhension des enjeux d’une rare qualité, et nous vous en remercions sincèrement, cela mérite d’être souligné.So this bill is, in our view, a very important milestone in thinking about life care, and, in our opinion, should be adopted. Began in May 2006 at our annual general meeting, the discussion turned into a broad public debate, the end of which the Special Committee on Dying with Dignity are handed over in March 2012. From the outset, please allow us to recognize the outstanding work done on this topic extremely complex and sensitive by all parliamentarians, particularly yours, Madam Minister, you have demonstrated compliance, quality listening, rigor and an understanding of the challenges of a rare quality, and we sincerely thank you, it deserves to be highlighted.

Full Translation