Introduction

Webcast archive: Doctors coping with euthanasia

This week, we discuss the difficulties some doctors are having when performing and supporting euthanasia.

Webcast archive: Doctors coping with euthanasia

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • Some doctors have trouble coping with euthanasia

Please note that this text is only a script and that our webcast contains additional commentary.

SOME DOCTORS HAVE TROUBLE COPING WITH EUTHANASIA

  • An article in the National Post this week described some of the problems doctors are having with the euthanasia program.
  • According to Jeff Blackmer, vice-president for medical professionalism at the Canadian Medical Association, some doctors who have euthanized a patient they knew well, have had a hard time killing other people.
  • “They will say, it was just too difficult and too traumatizing … and it is not something I will go through again,” says Blackmer. “They really struggle with it, and for some of those that is the only one they will do.”
  • These comments are supported by a 2006 review of the literature by Dr. Kenneth Stevens entitled “Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia on Participating Physicians“.  According to the review, “doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient’s drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide.”
  • Dr. Stevens’ review cited a study of Dutch doctors. “In 1995-96, 405 Dutch doctors were interviewed regarding their feelings after their most recent case of euthanasia, assisted suicide, life ending without an explicit request, and alleviation of pain and other symptoms with high doses of opioids. The percentage of doctors expressing feelings of discomfort were: 75% following euthanasia, 58% following assisted suicide, 34% following life ending without an explicit request, and 18% for alleviation of pain with high doses of opioids. Fifty percent of the euthanasias and 40% of the assisted suicides were followed by “burdensome” feelings; and 48% of the euthanasia and 49% of the assisted suicide cases were followed by emotional discomfort. The willingness to perform physician-assisted death again was 95% after euthanasia and 82% for life ending without an explicit request. The doctors sought support afterwards following 43% of the euthanasia cases and following 16% of cases involving ending life without an explicit request.”
  • Some of the factors that seem to influence doctors’ experience of euthanasia include: the duration of the relationship between the doctor and the person making the request, the number of euthanasia/assisted suicides the doctor has performed, the public view of the procedure, the amount of support available from peers, and whether the doctor felt euthanasia was “justified” under the circumstances.
  • Just as there are doctors who refuse to perform euthanasia, or who do it once and won’t do so again, there are many who are willing to do it repeatedly.
  • Dr. Stevens describes the number of doctors who wrote prescriptions under the Oregon Death with Dignity law during 2003-2004.  “Of the forty physicians who wrote prescriptions during 2004, twenty-eight wrote one prescription, nine wrote two prescriptions, one wrote three prescriptions, one wrote four prescriptions, and one wrote seven prescriptions. This was the first year that this type of information was provided in the state’s annual report. However, a year earlier, a reporter from The Oregonian newspaper publicly reported the following information for the 2003 year, which he had personally obtained from the Oregon Department of Human Services: ‘Of the 42 doctors who wrote prescriptions for assisted suicide in 2003, 27 wrote one prescription, eight wrote two, six wrote three, and one doctor wrote six prescriptions.’”
  • There are always doctors who actively seek out referrals and publicity for assisted suicide and euthanasia, such as Jack Kevorkian, Dr. Philip Nitschke, and Dr. Wim Distelmans.  Two current “champions” of euthanasia in Canada are Dr. Alain Naud of Québec and Dr. Ellen Wiebe of Vancouver.  Both of these doctors have been active in the campaign to legalize assisted suicide and euthanasia, and have also performed many euthanasias themselves.