An increasing number of Canadian doctors are receiving requests to with-hold life-support systems or provide active euthanasia, the Canadian Medical Association reports.

However, most doctors, according to the CMA survey, agree that better palliative care would reduce the requests for euthanasia or assisted suicide.

In a survey released at a meeting of Canadian doctors in Calgary recently, 34 per cent reported receiving requests to withdraw or remove life support systems from their patients.

Five per cent of the doctors reported receiving requests that the doctor assist in the suicide of the patients and seven per cent received requests that the doctors actually kill the patient, through active euthanasia.  Sixty-five per cent of the doctors questioned said better care for the dying would reduce or mostly reduce the numbers of people requesting to die.

Contrary to media reports on the survey there seems to be no consensus about what if any legislative changes should be made to the current laws banning assisted suicide and euthanasia.

The survey was based on the information provided by 923 doctors who answered the questionnaire.

The discussion among doctors is considered significant as policy emerging from the CN+MA can be influential on any future legislation.  The CMA’s string endorsement of abortion was influential in the public debate which eventually led to the abortion-on-demand situation which exists today.

Mary Kolbran-Smith, a spokesperson with the CMA, says the ethics committee will issue a policy document outlining recommendations to the government in the upcoming year.

“It’s an extremely complex issue,” she said.  She added that more responses are coming in from doctors across the country but they “haven’t changed the picture.”  She said the Supreme Court ruling on whether Sue Rodriguez has the right to assisted suicide will influence the CMA statement.

The legal and Ethics Committee has released a discussion paper called Canadian Physicians and Euthanasia which is a discussion of the issue prior to the release of a definitive policy statement.

According to the discussion paper, most Canadians are in favour of the legalization of euthanasia.

“Many physicians are both puzzled and troubled by such findings which seem to conflict with the value of life and of medical efforts to preserve and enhance it,” the report says.

The CMA has never made a definitive statement on the subject of euthanasia.

“The prohibition against killing – as reflected in the maxim “First, do no harm,”- has been considered so basic to medical ethics that these practices were not deemed worthy of consideration,” the report says.

The provincial medical associations have thus far stayed out of the debate on euthanasia.  However, the World Medical Association has come out strongly against the practice.

“Euthanasia, that is, the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical,” the WMA statement says.  “This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow in the terminal phase of sickness.”

Both the American and the British medical associations have similar strong statements against the practice of euthanasia.

The Royal Dutch Medical Association, which is strongly in favour of euthanasia, has stated doctors should not impose their moral beliefs on patients requesting to die.  Its statement says “euthanasia belongs to the physician-patient relation.”

Many opponents of euthanasia point to the Dutch experience of the dangers inherent when a society sanctions killing the elderly or the terminally ill.

The number of cases of euthanasia, both voluntary and involuntary, have soared in that country since it was decriminalized.