Issues associated with euthanasia, assisted suicide and end-of-life care are often difficult to assess due to the individual circumstances connected to the treatment and care of dying persons. Similar difficulties arise concerning the assessment of new guidelines that have been suggested for use in relation to intensive care unit patients.

Several media outlets featured headlines warning that the new guidelines would lead to euthanasia, while the Euthanasia Prevention Coalition believes that these guidelines do not blur the differences between euthanasia and the proper application of palliative care. They are not a step closer toward the acceptance of euthanasia. Were these media outlets wrong or is the Euthanasia Prevention Coalition wrong?

The EPC supports the guidelines because:

  • The guidelines encourage the proper use of palliative care and discourage their abuse. The guidelines encourage medical professionals to aggressively treat pain and manage symptoms for dying patients while not encouraging euthanasia.
  • The guidelines correctly define the difference between euthanasia, “double effect” and the ethical use of palliative care.
  • The guidelines emphasize the need for physicians to properly chart the administering of narcotics and sedatives. This is an important recommendation because it protects ethical physicians when unintended effects occur and it provides protection for patients and recourse for families in relation to acts of unethical physicians.
  • On the issue of terminal sedation, the guidelines correctly define it as: sedation with continuous IV narcotics and/or sedatives until the patient becomes unconscious and death ensues from the underlying illness. This is palliative care and not euthanasia. There have been cases where terminal sedation has been abused; therefore, we welcome these guidelines. We recognize the need to start using a new term for terminal sedation.
  • The guidelines promote the proper use of palliative care outside the typical hospice-palliative care setting.

The EPC has encouraged palliative care techniques to be used by all medical professionals for all pain and symptom management. These guidelines will move medical caregivers in that direction. We believe media that expressed that the guidelines would lead to euthanasia were presenting two separate philosophies. The first philosophy is represented by the National Post. The Post has an editorial policy that opposes the legalization of euthanasia and assisted suicide. It recognizes the inherent problems with allowing medical killing. Its position is not malicious. It does not properly understand the principle of double effect and it is concerned that these guidelines grant too much leeway to physicians by allowing them to intentionally overdose patients with narcotics without being prosecuted. Since these guidelines emphasize that the physician must properly chart his actions and intentions and since the guidelines recommend the development of a process to review the performance of the guidelines, we believe that these guidelines will encourage maximum pain relief while offering protection to patients and families. The second philosophy is represented by most of the media who support the legalization of euthanasia and-or assisted suicide. These media outlets are maliciously confusing the general public, concerning differences between the proper use of palliative care, the double effect principle, euthanasia and assisted suicide. Their goal is to convince Canadians that euthanasia is a common practice in Canada already and that it should be legalized so that it can be regulated. We are saddened that so many of the media fall into this position. A few legitimate suggestions for improvements to the guidelines are:

  • Suffering has been defined to include physical, psychological, emotional, spiritual, and other suffering. The word suffering should be defined before it is used widely or other words should be used in its place.
  • The review process concerning the implementation of the guidelines should specifically include investigating possible abuses of the guidelines, with the intention of punishing medical professionals who have intentionally abused the guidelines and-or euthanized patients. The EPC supports the best possible care for all Canadians, especially those who are suffering and nearing death, and we encourage the use of palliative care techniques for those experiencing chronic pain and symptoms. EPC assures Canadians that we will remain vigilant and will continue to demand that our laws protect vulnerable Canadians from euthanasia and assisted suicide.