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Saturday, August 23, 2014

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JGH opposed to dying with dignity law, director says

Tags: Canada Bill 52 Jewish General Hospital JGH
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Dr. Lawrence Rosenberg

The Jewish General Hospital (JGH) “will explore all possibilities to opt out” of Bill 52, Quebec’s end-of-life-care law which was adopted by the National Assembly on June 5, said executive director Dr. Lawrence Rosenberg.

He told a JGH-sponsored symposium on the so-called dying with dignity legislation held June 12 that the hospital will take an official position and “I can assure you it will not be apolitical.”

Rosenberg blasted the government for apparently choosing the “expediency” of allowing medical intervention that results in death over addressing deficiencies in the health-care system, such as inadequate palliative care.

The legislation allows incurably ill adults capable of consent to request that a doctor administer a lethal injection.

“We do not give life, and we have no right to take life,” Rosenberg affirmed. “The National Assembly has no bona fides to determine what is high-quality medical care and what is not.”

He said he is not aware of a single doctor at the JGH who will comply with the law.

That position is at odds with the Quebec Medical Association which played a significant role in drawing up the bill and “welcomed” its passage. The law is not expected to be implemented for 18 months.

Rosenberg, a McGill University professor who was previously the JGH chief of surgical services, said the decision as to whether its doctors may assist gravely ill adults in ending their lives should be solely within the jurisdiction of health-care institutions’ boards.

This “draconian” legislation sanctions “active euthanasia,” he said.

“It begs the question: Is this euthanasia law a pretext to provide an alternative solution to a problem [lack of proper end-of-life care] that either [the government] can’t afford, doesn’t know how or want to deal with?”

He noted that health care accounts for over half of Quebec’s budget and the greatest costs are incurred at the end of life.

The vote was 94-22, with all the nays coming from Liberals. The sole Jewish MNA, Liberal David Birnbaum of D’Arcy McGee, voted for it with “a certain level of reticence and anxiety.”

“I understand that there is no perfect answer morally speaking, nor an answer that eliminates completely the risk of unforeseen consequences,” Birnbaum said in the legislature.

The day-long symposium for health-care professionals, lawyers and other interested parties began with the JGH’s director of pastoral services, Rabbi Raphael Afilalo, saying that “thousands of people in Quebec will end up being killed every year,” if the experience of the Netherlands, Belgium and Luxembourg, where doctor-assisted suicide has been legal for more than a decade, is a guide. 

The numbers of people dying this way has doubled over that period in Belgium to almost 4,200, he said.

“Frightening, is it not?” Rabbi Afilalo asked, adding that the law in that country is now being extended to children.

According to Judaism, he said,  “we are not the owners of our body; only God can terminate our life…

“In my opinion, there is no dignity whatsoever in being killed by a doctor,” no matter what the level of physical or psychic pain.

Once “euthanasia” becomes legal, he said, it quickly becomes accepted by society and the numbers escalate.

Dr. Gerald Batist, JGH chief of oncology and a McGill professor, appealed to Quebecers to stand up against the law.

“We have to fight for services [for the dying] and resist this law, even if it is the law of the land, for the sake of our society and its values,” he said.

Batist said the government and the bill’s supporters are playing “an extremely dangerous game of words” by using such terms as “dying with dignity.”

The doctors’ role should be to “enhance the dignity of life—right to the end” and that would be possible if there was better access to pain control and psychosocial support.

The new law does provide for improving palliative care but Rosenberg and Batist are skeptical.

Batist said that in his experience “very few people resign themselves to death” and even those who are close to the end struggle to live, even if only for a little while longer.

He fears that the ill or elderly will feel pressured to consider ending their lives if they are “a burden to their families.”

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