Quebec's College of Physicians has endorsed euthanasia in extreme circumstances, provoking fear among opponents that the rest of Canada is getting dragged into an unwanted drive toward mercy killing.
Quebec doctors issued a cautiously worded policy Tuesday suggesting Criminal Code changes to protect doctors who follow an "appropriate care logic" to end the life of suffering patients facing "imminent and inevitable death."
The change would protect doctors who withhold treatment or boost painkillers to end suffering and hasten the end, according to Yves Lamontagne, president of the college.
"Doctors do their best to give appropriate care, knowing it could sometimes be interpreted as a crime in the Criminal Code," Dr. Lamontagne said. "Appropriate care should not be defined as murder."
A series of polls, position papers and a private member's bill in Parliament, all originating in Quebec, have promoted euthanasia in recent months. Quebec Health Minister Yves Bolduc has also said he is open to the idea.
"It has all gone several steps too far," said José Luis Pereira, chief of palliative care at Bruyère Continuing Care and Ottawa Hospital.
Dr. Pereira, who worked for three years under Switzerland's legal euthanasia system, said the Quebec College of Physicians is mixing end-of-life care with outright euthanasia, confusing the public and opening a door that would inevitably lead to more widespread mercy killing.
"They always start off with the premise of extreme cases, and the definition inevitably expands," Dr. Pereira said. "There's an enormous amount of misinformation, it's extremely irresponsible."
While recent polls showed 75 per cent of Quebeckers support euthanasia, support sinks to about 50 per cent in most other provinces.
I think it's something that might be too big for Canada to take on, but just small enough in Quebec Yvon Bureau ethical euthanasia activist
Delores Doherty, a Newfoundland pediatrician and fierce euthanasia opponent, said a bill introduced in Parliament by Bloc MP Francine Lalonde shows activists are successfully advancing the issue.
Ms. Lalonde's bill has little chance of becoming law, but "the debate has been dragged onto the national stage from Quebec," said Dr. Doherty, president of the pro-life umbrella group, LifeCanada. "I don't know why Quebec doctors are pushing it, it defies logic, other than there are some doctors who really want to go ahead and do it."
A spokeswoman for federal Justice Minister Rob Nicholson said the government has "no intention to come forward with legislation on this."
But some Quebec activists aren't looking to Ottawa for a solution. They have already plotted a course for the province to go alone.
Quebec could create a framework for ethical euthanasia for terminally ill patients, said Yvon Bureau, a social worker and long-time activist for legalization. As with abortion several decades ago, the Quebec government could declare an end to prosecutions for euthanasia, as long as the rules are followed.
"I think it's something that might be too big for Canada to take on, but just small enough in Quebec," Mr. Bureau said.
Theories abound to explain the public-opinion gap between Quebec and the rest of Canada on euthanasia. Quebeckers, who rejected religion en masse starting in the 1960s, tend to be more liberal on a range of issues.
Mr. Bureau, who has promoted euthanasia for 25 years, said Canadians outside Quebec tend to defer to doctors and nurses who provide palliative care in the determination of how terminally ill people end their days. In Quebec, more people believe patients should have the last word, he said.
"Maybe it's because we're Latin and we tend to be less rational, more emotional," said the college's president, Dr. Lamontagne.