Free and informed consent?

NOTE: The original article was published in French in the Huffintgon Post on July 20, 2016 (read original article here >>).

Free and informed consent?

We learned in The Gazette (>>) that there have been ministerial modifications to conform the Act respecting end-of-life care to the federal law. Among other changes, a reflection period of 10 days has been added as well as the validation of a request by two independent witnesses. In short, measures to reduce the risks associated with a decision as serious and without any possible comeback as asking for death.

These changes to the Quebec law remind us that there are indeed risks of abuse, and therefore put us back into the heart of a fundamental issue regarding assisted suicide: free and informed consent.

The question of free and informed consent has been and remains at the centre of advocacy in favor of euthanasia and assisted suicide. In addition to a desire to reassure the population in order to adopt a new problematic social practice, this concern also address the risks of pressure that may be suffered by people in a situation of great vulnerability.

In affirming that a well-written law will help to protect the people against any inducement to suicide in moments of great fragility, the advocates of euthanasia have managed to get this act from an exceptional measure to the rank of a public benefactor. Any restriction (even prudent) is then presented, as we often read in the news, as an injustice.

However, in the same way that it is effectively impossible to measure and quantify the freedom of each individual, it will always be very difficult to trace and quantify all the cases of abuse and pressure surrounding euthanasia and assisted suicide. And with good reason.

On the one hand, in addition to the fact that the people who have died by euthanasia are no longer there to testify, the people who perform this act are the same people who write the reports. It is as if the police were to always adopt the testimony of the accused as being the official version of the facts. In this sense, it seems naive to believe that a guilty doctor will himself indicate his fault in his own report...

Not to mention that on these medical reports, the government indicated precisely not to write "medical aid in dying" (euthanasia) as a cause of death. Where’s Waldo?

On the other hand, the people who are abused – and it is a well-known fact – are very often the last to recognize the abuse. Let's imagine, therefore, the case of a person who would come to ask for death under pressure (fear) of his entourage: how can we imagine that they will suddenly have the courage to report it to their doctor as they were prepared to die out of pressure?

However, even if it will always be difficult to identify most of the clandestine abuses, we are able to anticipate them when considering the public treatment reserved for doctors who refuse euthanasia. On the one hand, we exalt the power of the words "free and informed"; and on the other, we insist on publicly hounding (bullying) the "refractory" doctors. Ironically, we threaten and discredit them to push them (pressure) towards the choice of accepting this solution presented as needing to be "free and informed".

As a result, in spite of the fundamental right to "conscientious objection”, physicians and other "opponents" are already subjected to the same pressure that they claimed was foreseeable for vulnerable people: they are pressured to adopt euthanasia as a "good" solution when they are convinced of the contrary.

It is hard to believe, in these conditions, that the fate of the weak and fragile will be different from the one of those strong and healthy...