The week before a parliamentary debate took place on euthanasia and assisted suicide, one of the country’s experts on palliative care spoke to a group of concerned citizens in Ottawa about the issue.

Dr. Jose Pereira

Dr. Jose Pereira

Dr. Jose Pereira is a full professor and head of the division of palliative care at the University of Ottawa, medical chief of palliative medicine at the Elizabeth Bruyère Hospital in Ottawa and was practising in Switzerland during the introduction of the legalization of assisted suicide at the first Swiss hospital in Lausanne.

On Sept. 28, a public talk was hosted by Campaign Life Coalition, entitled “A Discussion of Palliative Care: Euthanasia and Assisted Suicide” at St. Theresa’s Parish in Ottawa. The following week, the first hour of debate for Bill C-384, the private member’s bill introduced by Bloc Québécois MP Francine Lalonde to legalize euthanasia and assisted suicide in Canada, took place in the House of Commons.

Pereira’s talk stressed the importance of clearly separating palliative care from euthanasia and assisted suicide. He identified the main difference between palliative care, which seeks to improve quality of life through addressing needs –physical, psychological, social and spiritual – and euthanasia and physician-assisted suicide, which seek, directly or indirectly, to end a patient’s life. Mixing the two actions in the palliative care ward, he warned, would compromise care for patients who trust the doctor to do no harm.

In Switzerland, at the first hospital to offer assisted suicide, Pereira described his experience in palliative care. Swiss legislation was to provide safeguards for vulnerable individuals in that assisted suicide was only to be used in cases of terminal illness and with the informed consent of the patient.

Pereira reported that the very first patient for whom assisted suicide was legalized was severely depressed and not terminally ill. The patient’s stay was extended in the hospital indefinitely due to mobility issues and a lack of family and social support. The man was deeply upset about having to live for an extended and undetermined time in hospital and requested to die. Thus began the process for the legalization of assisted suicide.

Pereira warned of a slippery slope in that, after the legalization of euthanasia, there was a decrease in funding for palliative care programs in Swiss hospitals.

In Canada, Pereira called for a need to provide a national strategy for palliative care to address gaps in palliative care services (such as waiting lists for beds) and increased education for doctors and medical students who normally receive little training in the benefits of palliative care. He stated that there have been great advances in palliative care; however, further research funding is required to deal with those patients who, despite the best care, still just want to die.