58 thoughts on “Doctors Forced to Refer for MAiD/Euthanasia”

1. Upon reading that Ontario’s Superior Court ruled doctors must refer, the first thing that went through my mind was that they wasted millions of taxpayers dollars.

   They could simply have made a MAID website and hotline, and have a clerk refer them to the appropriate services in their region, rather than needlessly force a religious issue upon unwilling physicians.

   It’s like arguing which type of crane is necessary to get a bag of feathers off the roof. Just push the bloody thing.

   1. Great comment, Adam

      I agree. There were simpler ways to deal with this issue.

      My only quibble is calling it a “religious issue”. That feeds into the popular narrative of this being a fringe issue for religious fanatics. Freedom of conscience forms the basis of all professions and the foundation of our free society. We undermine all other rights when we allow conscience to be attacked.

      Thanks so much for reading and posting a comment!

2. This is just the latest stop on the (probably irreversible) road trip to hell our culture has been on for some time. Secularists, having no ethics of their own, have made unelected judges the gods of their utopian fantasy. Politicians seem incapable of asserting legislative supremacy. Eventually this monster will devour us all.

   1. Depressing comment, Craig, but I cannot argue with it. Our system fails unless politicians legislate, not courts.

      Thanks for posting !

3. I agree with Adam a 1-800 number for religiously sensitive referrals ie abortions and MAID should be all that s doctor needs to do but I really think that the doctor needs to give this number to the patients needing such a service The college should invest some of our dues to provide such a service ie a 1-800 number that is staffed by a real person who can council patients through their traumatic event and set up a referral to a place where these religious sensitive problems can be dealt with cindy

   1. Great comment, Cindy. Totally agree.

      We have central access for abortions now and it seems to work well.

      But again, my main issue is in having the CPSO and the courts impose themselves into the practice of medicine. When professionals lose the freedom to form and hold professional opinions in the face of complex information, we lose the basis of our democracy. This is not just me being histrionic. This is what the Supreme Court Justices say (more quotes coming in the next blog).

      Thanks so much for reading and posting a comment!

      Cheers

4. How much of it’s member dues did the CPSO spend in order to enforce it’s right to go above and beyond the just laws of a democratic society to remove rights and freedoms from it’s very own members? That the Court of Appeal for Ontario agrees with the CPSO does not make it right.

   The CPSO, in it’s zeal to insert it’s tentacles into all aspects of physician practice in the name of “protecting the public”, has lost the ability to go beyond it’s tunnel vision and cannot see how much it harms patients by dehumanizing the medical profession with it’s edicts and ‘policies’. This is about control. It is about the CPSO saying, with impunity, ‘we get to tell you Ontario doctors what to do because we get to tell you what to do’.

   When conscience rights are removed from a minority group under the guise of ‘doing the greater good’ for a majority group, we are well down the slippery slope of sending physicians into indentured servitude.

   The Ontario government could have gotten this right from the get go by providing central registry access for this service with a list of physicians/HCP (health care professionals) who provide the service. The CPSO, in forcing Ontario physicians to provide a referral against conscience rights, has let the government off the hook and said that they don’t have to get it right…we will MAKE physicians do it…

   1. Well said, Paul. Well said indeed!

      I started to copy and paste my favourite part but ended up highlighting your whole comment!

      “It is about the CPSO saying, with impunity, ‘we get to tell you Ontario doctors what to do because we get to tell you what to do’.”

      We can only hope that the current government has the insight and fortitude to legislate to protect conscience. Bad things happen to countries that support the erosion of this fundamental freedom. Most people do not seem to remember that history.

      Thanks again for reading and posting!

      Cheers

   2. We all know the “indentured servitude” has been here for a long time, Paul! And now here is just one more good (and for many, final) reason to get out of medicine. Between dealing with rampant frivolous cpso complaints, dealing with pneumonia complicating congestive heart failure for $33 minus 50% overhead, and now the heavy boot of the cpso and government crushing the last ounce of humanity out of us, what’s left to stay for?

      1. Well said, Jodie. People will look back on this time and marvel at the arrogance of regulators and judges.

5. Freidrich Hayeck’s “ Road to serfdom” should be standard reading in our educational system, but isn’t.

   The road to hell is certainly paved with good intentions as it is in this case.

   Atheists , non believers have their moral codes just as the religious have theirs….hopefully the first group’s moral codes are based on reason in contrast to second group’s being based on faith.

   The role of government should be to protect the rights of its citizenry which means to protect them , as a policeman/ woman , from physical violence , from criminals, resorting to force only against those who initiate the use of force.

   Personally , I’m allergic to force, in particular to force initiated by the powers that be…the rights of one person cannot be carried out at the expense of the rights of another….a 52 year old FP in the UK was forced to retire from medicine after 23 years following a complaint to the College on the grounds that he had “discriminated “ having asked a mother holding her sick child, to remove her veil because he could not hear her speak.

   Totalitarian socialists states such as those of National Socialist Germany and of the Soviet Union forced their doctors to put aside their professional oaths and moral codes to serve the needs of the state….the Soviets perfected the use of psychiatry to crush its dissidents ( “since the USSR was a socialist utopia any one criticizing it or wishing to leave “ heaven” has to be insane) by giving them psychotropic drugs and confinement in psychiatric hospitals….the German National Socialists forced doctors ( having purged 6-7000 Jewish doctors) to experiment on prisoners, adults and children…in an attempt to purify the German Aryan superior race millions were killed with the forced sterilization of inferiors such as the blind, the deaf, the bipolar, the schizophrenics, those with genetic disorders such as Huntington’s, alcoholics , epileptics and the physically deformed so that their “imperfect” genes could not be passed on.

   First Canadian doctors are being forced to do , against their conscience, x, then y then …. who knows where it will end…likely in hell.

   1. Great comment, Andris. Very well said.

      Most people seem entirely ignorant of the history you write about. When I mention historical facts, most people think I am making up stories. They roll their eyes. How pathetic. How histrionic. That could never happen here!

      Tyranny grows best in the most advanced societies that become drunk on their sanctimony, intelligence, and enlightenment.

      My only quibble with your comment lies in your dichotomy between faith and reason. While I agree that unthoughtful religious people hold unexamined beliefs devoid of reason. But thoughtful believers of all stripes — atheists, agnostics, skeptics, and theists — have always based their beliefs on the evidence at hand. The most important things in life rarely offer conclusive evidence for any opinion we might hold about them. This does not mean we can dispense with evidence and reason. It just means that rational people will form diverse opinions/beliefs based on the available evidence. (I like a Bayes’ theorem approach to belief.)

      Thanks again for reading and posting a thoughtful comment!

      Cheers

6. Shawn, this is not about telling doctors what to do. It is about autonomy for patients. A patient, like anyone, deserves the right to control their own body. No one should be allowed to be a passive or active obstruction to a patient’s exercise of autonomy over their own body.
   What I despise most in religions (all of them) is the notion that the religious authority takes it as its right to tell their followers how to live their lives. Rather than being a guide, it becomes a matter of cannon law, stripping individuals of their autonomy.

   1. Ernest, this fight has nothing to do whatsoever with impeding patient autonomy. No one is saying that anyone can not kill themselves or go to an abortion clinic— what conscientious objectors are saying is, don’t involve me in something I feel is morally objectionable! Is the “doctor-patient relationship” not between two PEOPLE? Or is it between a person and a vending machine? Apparently, the latter!

      1. Another great comment, Jodie!

         Excellent point: “Is the “doctor-patient relationship” not between two PEOPLE?”

         Thanks again!

   2. What might be forgotten, Ernest, is that there are a very large number of patients who have the expectation that the healthcare system can continue to furnish them with a doctor who would never kill them and who has nothing to do with euthanasia. This is a form of autonomy that needs as much respect as the kind you are describing. Justice for this large group, perhaps the vast majority of patients, would involve respectful treatment of physicians who wish to continue a practice of medical diligence and creativity in the face of serious problems. Other patients might prefer doctors who readily bypass that diligence, but their autonomy does not magically trump everyone else’s.
      In short, the wholesale elimination of one kind of professional judgement to privilege another kind diametrically opposed to it seems to be more about injustice than autonomy.

      1. Well said, Will!

         “…the wholesale elimination of one kind of professional judgement to privilege another kind diametrically opposed to it seems to be more about injustice than autonomy.”

         Brilliant.

         Thanks for posting!

      2. Excellent blog post. Thank you! I was in the process of replying to a columnist who stated, “doctors on the religious right cannot play God,” when I came across this blog. I shall be sending the columnist the link. You have stated many good points well and succinctly with the gravitas that comes with being an experienced physician.
         Also an excellent reply from Will. Can we imagine a CCPSO? (Christian College of Physician and Surgeons of Ontario)? Or, J-CCPSO? (Judeo-Christian College …) Or simply, ECPSO? (Ethical College … ) A separate college set up to house and support those physicians fully honouring the Hippocratic Oath.
         I concur with some comboxers that a hotline be set up. I and others suggested this several years ago in the MAiD consultation process. How difficult could it be to set up an in-house line for each hospital? Patients would be apprised by hospital website, and interior hospital notifications that all requests for MAiD information and implementation be directed to the hotline, wherein one of a panel of MAiD-agreeable docs would connect with the patient and family, and consult – and collect the handsome parting fee if MAiD is determined …
         There are easy solutions to this ethical dilemma. It strikes me that some on CPSO board had an agenda they wished to ram down the throats of those physicians who did not share their brand of ethics.

         1. Thanks Donna! You raise some excellent points. Sorry for the delay in approving your comment to go live. After I’ve approved you once, you are good to go. I’ve had family in town. Thanks again!

   3. Thanks for this comment, Ernest.

      I agree with your comments about religion. I think that those who find religion offensive do so, mostly, for the same reason. No one wants to be told what to do by someone else, let alone someone else’s faith. While a discussion of religion strays off topic, it might be fun to explore which worldviews — atheist, agnostic, deist, theist, polytheist, animist, pantheist, etc — lead to the greatest liberty and individualism. Purely rationalistic paradigms often lead to immeasurable tyranny and human suffering.

      I do not understand your comment about autonomy. I share your leanings towards libertarianism. We both think that people should live as they see fit; government intrusion into our lives just causes problems. So I agree that patients should be allowed to decide what they want to do.

      Having said that, your freedom to do what you want should not decrease my freedom. Your freedom to live like a bohemian should not place an obligation on me to clean up after you (Welcome to my house full of teenagers!).

      Doctors’ commitment to provide care to the best of our ability does not mean that patients get to demand whatever they want, whenever they want, and doctors must meet their demands. Never mind that the government system cannot provide everything that patients want. Turning doctors into dispensing machines does not help patients, doctors, or society in general.

      I will write more about this in future blogs. Bad things happen when doctors are not expected to develop and maintain strong consciences based on medical ethics, experience, culture, and a million other things that go into shaping how doctors think. Turn doctors into rationalistic, Spock-like rule followers and very nasty things happen: think Tuskegee, Willowbrook, physician attendance during torture, forced sterilization, not to mention the Holocaust (doctors played a large role in concentration camps).

      But freedom of conscience is about much more than doctors. It is the fundamental basis of a free and prosperous society; the foundation of our parliamentary system. Everyone, not just doctors, must have the freedom to choose whether or not they act based on the direction of their inner compass.

      Stated another way, you might say that your conscience leads you to believe that you should do whatever patients demand of you, whenever they demand it. If patients demand zero waiting times in your clinic, you should deliver it. If they demand implantation of a gene for deafness or dwarfism in an embryo, you must do it. Great. That’s what you believe. I do not share your belief. Protecting freedom of conscience means that you and I agree to live in peace and harmony without decreasing each other’s freedom to follow our conscience wherever it leads.

      Thanks again for taking time to read and post a comment!

      Cheers

7. That’s a very good point about considering the needs of patients whose desire it is to have a doctor who doesn’t refer for MAID or abortion as they only feel comfortable with a doctor who shares their most fundamental convictions about healthcare. Interestingly, out of thousands of patients I have had, the only ones who screen me before accepting me are those who hold those views and will not see a doctor who does those things! Here is another group of people whose rights have been trampled on for the sake of the Iron Boot of the CPSO. What will happen to these patients when there are no doctors left who share their values?

   1. Another great point, Jodie.

      The Ontario human rights commission advises that doctors check their values and morals at the door before entering the clinic. How many patients would like to be cared for by doctors who checked their values and morals at the door?

      Many patients wish to be seen by doctors who would never end the lives (kill) one of their patients. Given the push to purge physicians who question whether it is wise to consider euthanasia as a treatment for suffering, one wonders how much longer patients (a majority) will be able to find physicians who share their beliefs.

      Thanks again

   2. When I am in despair at the end of my life, I would like a physician who would support me in the values I lived my life by and not allow me to succumb to that despair. A physician who will protect me from my worst self.

      1. Wow. Powerful and well said, Kathleen. Thank you.

8. Speaking as a parent of young teenage girls, how can I be sure that our family doctor will support the moral values of my family? I always told my children…if you get pregnant…please tell me…..I promise not to “lose it”. Our family doctor is very pro-abortion and I always worried that they would speak with her first and I would be left to clean up the mess afterwards. Fortunately, when I was tested, my daughter trusted me and we have a lovely granddaughter that she placed in an open adoption arrangement three years ago. Is it a perfect solution? No. But way better than a lifetime of regret. Religion aside, a child does not have the ability to make wise decisions as a teenager. We all know that from experience. On the abortion issue, parents are cut out of the loop. On the MAid issue, families are.

   1. Wow. Great story Kathleen. Thanks so much for sharing it.

      In our hyper individualistic society, we never consider the impacts on families aside from how the family impact affects patients themselves. In other words, if the patient does not care how his family feels, so be it.

      Sure appreciate you adding this angle!

      1. Interesting discussion and comments. I’m married to a retired physician and we volunteer for Dying With Dignity as independent witnesses for MAiD requests.

         I have not seen families cut out of the loop — in almost every case that I’ve been a witness for, the family is intensely involved and the patients and their families express such a sense of relief that the process has started.

         I have witnessed requests in family homes, hospitals, long term care facilities, and even palliative care hospices. The patients and their families are always grateful that we are helping them by providing the independent witness requirement. It is not easy to qualify for an assisted death and the people we have met are grateful that we help in this way, and that this option of a gentler death is available to them.

         I agree that it would have been better if the Ontario Ministry of Health had set up a MAiD request service hotline for patients and their families. As a liberaterian, I disagree with forcing anyone to act against their principles.

         1. Thanks so much for posting such a thoughtful comment, especially given your work with Dying with Dignity.

            I wish that everyone could take a libertarian approach to this, as you do. Our society cannot survive if we force other people to take actions that they would never take if we did not force them. Force is the antithesis of freedom.

            Thanks again for sharing your thoughts! I suspect we would find much to agree on even though we disagree on whether ending life is a good thing.

            Highest regards,

            Shawn

9. How does one proves ones competence to the medical authorities in the termination of patients?

   Dr Harold Shipman , a British FP managed to murder 218-250 patients ( 1975-1998) mainly elderly women…but some as young as 4 .

   He acted as a judge, jury and executioner deciding who would live and die…as to whose time had come.

   Up to the discovery of his crimes he ran an excellent ( from the bureacratic aspect) medical practice and his meticulous record keeping , innoculations,diabetic and hypertensive management was held as an example to others…he was even a celebrity appearing on TV advising as to how the mentally ill should be treated in the community.

   In today’s world he would have been a star holding seminars and CME’s on the termination of clients.

   Rather than putting the onus of finding terminators on the backs of unenthusiastic and inexpert FP’s with a threat of 2 years imprisonment if uncooperative …the government should create an App so that those wishing to be terminated by a government agency could do so without involving the unwilling.

   1. Excellent comment, Andris. You nailed the issue: It is a huge copout to dump all this onto family docs. If society wants this and expects government to provide it, then government needs to find a workable solution. Forcing doctors to do or be involved with what was a felony up until a few years ago is utter nonsense.

10. Q – any reason my comment was deleted?

    1. It’s live. Sorry for the delay. Thanks again

11. Excellent article in the National Post ‘ Freedom of conscience systematically eroding’ ( Barry Bussey).

    “ Freedom of conscience is the very bedrock of all of our freedoms.It is the first freedom listed in the Canadian Charter….but is now the first target of systematic erosion by our elites”.

    1. Brilliant.

       Here’s the link: https://nationalpost.com/opinion/with-ontario-courts-ruling-on-doctors-the-revolution-continues

12. Interesting thread, I don’t support an activist judicial system and I think the college behaves as a fascist organization far too often. My concern is that many patients place a lot of weight on a physician’s opinion/input on medical decisions regardless of what the issue is. Too many patients acquiesce any responsibility they have to their health care because they think that medicine is above their understanding and place blind faith in medical system that falls far short of placing blind faith into. Many people think that medicine is a hard science is beyond debate which is not true or else a “second opinion” would never have to be a consideration (at any rate good luck trying to get a second opinion in Canada). The number of Canadians that go out side of Canada for medical reasons is in the hundreds of thousands every year and this is not only because they can’t gain access to services but also to access medical treatments/services that is not offered in Canada. Some of these services do provide solutions to patients as in the case of some members of my family. I can’t imagine being in a position where I would be considering ending my life and I hope I never will have to face that. I certainly cannot say whether if some one wants to end their life that they shouldn’t but as I said I am concerned that the deciding factor for many patients will be a doctors opinion and doctors whether religious or not do not have any greater insight on the value if a life is worth living or not. I certainly wouldn’t want the responsibility of a patient’s decision to end their life unduly based on my opinion. To be clear I am not trying to unfairly beat up on doctors but trying to advocate for patients to be full and equal partners in their health care and in medical decisions for themselves.

    1. Great point, Brian. I agree on both accounts: patients need to own/lead more AND doctors’ opinions have a huge impact (both for and against euthanasia). This highlights, even more, why we must be vigilant against force/coercion. Patients and physicians must not feel forced into doing what they do not support.

13. When I make a referral to another physician, it is typically to clarify a diagnosis of which I am unsure, or to provide a treatment which I think is indicated but am less qualified to perform. I am endorsing the next physician, always with the patient’s agreement, to move forward with the direction we have agreed upon. It is not uncommon for a patient to think certain treatments or investigations are indicated when I, based on medical judgment, guidelines, experience, or whatever, do not agree. In that case the patient is free to eiher go with my medical judgment or seek another provider. Even if I am expected to set aside conscience, religious convictions, or the oath I took at graduation to not use my medical power to harm others, this daily aspect of medical judgment for the best interest of the patient does not seem to have been adequately addressed in this discussion. If someone wants cosmetic surgery, I am not obligated to refer them for it, which includes finding a consultant and making an argument to the consultant on why they should have it. If a parent wants their child to have surgery to change their identity in some way, I am not (at least this week) obligated to endorse it even if it is legal. I agree with the earlier comments that there are other less intrusive ways for the province to provide MAiD, but suspect the motivation in this case is less that of providing the service and more of a whip to get the party in line. Another unintended, or perhaps intended, consequence of even making such an issue of this will be deterring those considering a career in medicne or nursing if they do not agree with the handful of progressive agendas that are likely to distract them from the “healng arts”. It was significant to me that at a recent medical conference session promoting MAiD, the biggest obstacle faced by the program in that city was that, regardless of religion, the overwhelming majority of health care providers were of the medical opinion that we could be doing a better job to alleviate suffering at end of life with less controversial interventions already available to us.

    1. Fantastic comment, Phil.

       There is far more being left out of this debate than the headlines allow. An ‘effective referral’ turns the concept of a referral on its head. In a traditional referral, I send patients to a physician I agree with to receive a treatment I believe is helpful to improving the health of my patient. An ‘effective referral’ occurs when I send a patient to a physician I disagree with to receive a treatment I believe will decrease the health of my patient.

       This issue requires input from legislators. I cannot believe that anywhere near a majority of Canadians would want physicians forced to refer against conscience.

       Thanks for posting a comment!

       1. “An ‘effective referral’ turns the concept of a referral on its head. In a traditional referral, I send patients to a physician I agree with to receive a treatment I believe is helpful to improving the health of my patient. An ‘effective referral’ occurs when I send a patient to a physician I disagree with to receive a treatment I believe will decrease the health of my patient.”

          Best distillation of this issue that I have ever seen.

          1. Thanks Kathleen!

14. Shenanigans at the hospital where Pat worked at was not all that uncommon. Doctors and nurses over reached beyond their skills and authority on several occasions. What makes this one unusual is that this particular nurse got caught.
    https://nationalpost.com/news/canada/more-cases-of-women-who-received-labour-inducing-drug-emerging-lawyer?utm_term=Autofeed&utm_medium=Social&utm_source=Facebook&fbclid=IwAR2kfPBPoERkJ_tXj4QIDAurURP2GLH75SifE4b1uiDPrAdipcWZeu9c9wc#Echobox=1554670694

15. Shaun had the same article published in the Medical Post generating interesting comments ( none from myself having been exiled) with more negative contributions with excellent counter arguments.

    Material for a new book?

    It seems that negative Kantian metaphysical, epistemological and ethical views dominate today’s western medical schools.

    1. Well said, Andris

       I see this as the wedge that leads to the end of liberal democracy. Secular authoritarianism always leads to suffering for everyone.

       Thanks again!

16. Three thoughts about “conscience” …. out of many …. by some great writers and thinkers.
    ……………………….
    “Atticus, you must be wrong….”

    “How’s that?”

    “Well, most folks seem to think they’re right and you’re wrong….”

    “They’re certainly entitled to think that, and they’re entitled to full respect for their opinions,” said Atticus, “but before I can live with other folks I’ve got to live with myself. The one thing that doesn’t abide by majority rule is a person’s conscience.”
    Harper Lee To Kill a Mockingbird

    ………………
    “The only tyrant I accept in this world is the ‘still small voice’ within me. And even though I have to face the prospect of being a minority of one, I humbly believe I have the courage to be in such a hopeless minority.”
    Mahatma Gandhi

    …………………
    “A clear conscience is the sure sign of a bad memory”
    reputed …. Mark Twain

    1. Love it…that “ still small voice” seems louder in some than in others and also that “ poor memory” remark by Mark Twain….Solzhenitsyn stated that he never acted against his conscience….of course he suffered terribly for it.

    2. Brilliant, Mike! Simply excellent. Thanks so much for posting these!

17. Another excellent article in the National Post on the subject….”Euthanasia’s slippery slope…” by Lucia Corbella….she points out that Alberta holds the gold standard at present on the subject, but that the CPSO “ doesn’t want to learn any lessons from the West…Ontario’s Justice Strathy seems to believe that the solution is for Ontario’s doctors to give up their vocations….that they “ as members of a regulated and publicly funded ( imposed by law against their will decades ago) profession that they have to focus on the public interest (as defined by whoever is in power at the time) ..”…and have no constitutional right to practice medicine…

    1. Agree. I thought it was excellent also.

18. I Find it both saddening and maddening that the majority of doctors on Facebook have the attitude “well, good, now you’ll be forced to do your job.” Not a word of empathy for the emotional angst that we conscientious objectors are going through; no encouragement to stay because we are needed; no words of solidarity or brotherhood. But o wonder— are they fully prepared to take on our patients when we leave, despite there already being so many people without a family doctor? And is medicine really going to be a better profession once those who follow a moral compass outside the dictates of the state, are forced out?

    1. I would say that it is a Kantian moral compass…deemphasizing individual conscience and emphasizing the “ conscience” of groups / of the collective.

       Having a conscience extracts a price from those that posses it.

    2. Jodie ….. I think we should blame the College and not our colleagues …. they’re all entitled to their opinions.
       But I disagree with Paul. This is not tunnel vision. I think it’s inescapably plausible that the College set its policy up this way …. knowing that the policy would be divisive and that colleagues of faith (for want of a better description) would be first out of the gate in opposition.
       Shawn is right about enforcement rather than access. I suspect the College strategized this from the enforcement perspective as another favour to government: Further proof, if proof be needed just how out of touch with members it sometimes is.
       Shawn and the OMA are right in that the core legal freedom is “conscience” rather than “religion”. One is entitled to practice one’s religion …. or not ….. but proselytizing probably needs to be kept out of the examination room.
       Conscience, on the other hand can clearly be secular as well as faith based.
       And I hope the Supremes are asked to hear this.
       Just my opinion, Atticus ….

       1. You are probably right…

          I gave the CPSO too much credit thinking that they were just bumbling along cluelessly. That this was likely a premeditated calculated trap does seem more plausible…and that makes them that much more dangerous to everyone…not just physicians. I will reiterate, though, that in it’s zeal to control physicians it has strayed far beyond it’s mandate of protecting the public and is harming them.

          1. Brilliant, Paul: “it’s zeal to control physicians it has strayed far beyond it’s mandate of protecting the public and is harming them.”

       2. Well said, Mike.

    3. Great comments, Jodie.

       It IS disheartening. However, I am happy to see people’s deep assumptions come to the surface. If a vocal group supports authoritarianism, we have got to do a better job explaining the basis of a liberal democracy. Most docs (myself included) did not have a solid education in philosophy, politics, history or the arts in general. We fall prey to authoritarianism more easily than others might.

       Do not lose hope!

19. Dear Dr. Whatley, (sorry for the double post, just trying to make the paragraphs look better)

    This is the most amazing blog. I just discovered it through a friend, because euthanasia is my hobby horse and when you wrote this blog on the CPSO and conscience, it was forwarded to me.

    If I might make a few quick points :

    Euthanasia in Canada (and Belgium and Netherlands) is different in both quantity and kind from that practice in the USA, or Switzerland. Actually, Canadian euthanasia is way out on a limb all by itself, for although Belgium and the Netherlands provided our inspiration, it is our practice which implements euthanasia as Benelux (Belgium, Netherlands and Luxembourg) enthusiasts would have liked but have still not succeeded in attaining.

    Specifically, Québec Bill 52 (2014) alone in all the world, defines euthanasia as end of life care, co-equal with Palliative Care. Look no farther, the Rubicon has been crossed. From this point, all of the dominos begin to fall. First, because it is a standard, non-controversial medical benefit, all Canadians must have access to it. Thus, it must be practiced everywhere. And, second, as concerns the subject of your article : There is no other reason to refuse to perform or refer for euthanasia than the extreme religious (conscientious objector) exemption, because it has been defined as good medicine. To insist on this key point, there is NO possibility of arguing the medical superiority of any other method of treatment. Case closed. The doctor who refuses to perform euthanasia is now in the position of the Jehovah’s Witness who doesn’t do blood transfusion.

    Is it necessary to point out what a momentous change this is in the status of medical science as a self-regulating profession ?

    To return to the comparison with Switzerland (and USA where applicable), in these places, assisted suicide is merely legal. No determination of the ethical status of the practice has been made. In fact, the Swiss doctors’ association still maintains that it is contrary to the goals of medicine. So, patients are free to seek a compliant doctor. And these doctors are able to form for-profit clinics to provide the service. Therefore, the market is supplied and everybody is happy. Hospitals, on the other hand, remain largely temples of Hippocratic devotion. (Dutch seniors are actually relocating in Switzerland because they no longer trust Dutch doctors !)

    The majority of patients does not want euthanasia, even in Benelux (only 13% of cancer patients in these countries consent to die in this way after nearly 20 years of aggressive marketing). In USA and Switzerland (even longer history with assisted suicide but only HALF the incidence of Benelux), the numbers are even lower. However, in Canada, in spite of this quantitative disconnect, the whole industry has been retooled to respond to the minority suicidal market. Why on earth, you may well ask …

    Well to recap : USA and Switzerland, free commercial competition for client satisfaction. The thing is permitted, but not required. In Canada, euthanasia has been normalized and eventually all hospital teams (including Pall. C. ) will be euthanasia friendly. And the totally perverse effect will be that (even now) a non-suicidal patient in Canada will likely be exposed to doctors who may well believe he should be dead and who will have no compunctions about steering him in that direction.

    No, this is not an accident. It is an inevitable result of the economic fact that in Canada, the docs are not working to satisfy the patient. And that is because the patient is not paying the doctor. The actual client of the Canadian doctor is the single payer state. Euthanasia is not in the interests (or in any way desired) by a majority of patients. However, the normalisation of euthanasia responds perfectly to the requirements of the state-payer. And the beauty of this, is that the “planners” do not even have to admit this to themselves. It is an economic truism like the Newtonian Laws of movement. It is like water flowing down hill.

    Once again, Kudo’s on your blog, I will sign up at once.

    Best Regards,

    Gordon Friesen, Montreal
    http://www.euthanasiediscussion.net/

    1. Wow. Tremendous information here, Gordon.

       Thanks so much for posting. I deleted your first comment because it looked to be identical to this one. I hope I didn’t miss anything. Feel free to post again, if I did.

       Sorry for taking a few days to approve your first post. I have been tied up with other things lately. If you enjoyed this post, be sure to check out the one I just posted. It is of an article I wrote for The Epoch Times.

       Thanks so much for taking time to read and post!

       Cheers

       PS You’ve given me some ideas for another couple blogs! 🙂

    2. Euthanasia is a cost containment strategy Nothing else.

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