Choosing when and how to die: Are we ready to perform therapeutic homicide?

A new report from the province of Quebec that recommends medical assistance to die will reignite the debate over euthanasia in Canada, states an editorial published in CMAJ (Canadian Medical Association Journal).

The Dying with Dignity commission of the Quebec National Assembly recently issued its report after two years of public and expert consultation and research.

Advocates of this approach argue that medically assisted death is a patient's right. It should therefore be considered as an end-of-life care option rather than a criminal act.

"Many physicians and patients will find this a shocking prospect to consider," write Drs. Ken Flegel, Senior Associate Editor, CMAJ, and John Fletcher, CMAJ Editor-in-Chief. "Frail, dependent patients often feel a burden to their families or caregivers, and the unspoken possibility of a quick resolution to their predicament may complicate an already stressful situation," they write.

If Quebec decides to adopt the recommendations, legal safeguards must be built in to protect and patients from potential abuses once the changes are made. Public consultation in Quebec as well as national discussion and involvement of federal lawmakers are needed if changes are to be made to the criminal code.

"The ethics of are a familiar debate in Canada; one that may have been theoretical, until recently, because of the tacit assumption that doctors do not kill people. In Quebec, the debate is moving from theory toward practice. Which way will legislation go? Will the rest of Canada follow? Those who care about the answers to these questions must speak up now, and with conviction," conclude the authors.

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