Ramona Coelho Archives - Protection of Conscience Project Library

Ramona Coelho, Trudo Lemmens, K. Sonu Gaind, John Maher

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MAiD deaths have increased dramatically year after year in the short time since Canada’s legalization in 2016. MAiD cases in Canada involve almost exclusively euthanasia, with death being administered by the health care provider via lethal injection. Within three years of its introduction in 2016, the death rate by MAiD had risen to 2% of all deaths. By 2020, the rate had increased to 2.5% of all deaths, and by 2021, it was 3.3% of all Canadian deaths, with some provinces approaching 5%. These figures largely represent the escalating death rates even before the government expanded MAiD to those living with disabilities in 2021 . . . In coming years, death rates are thus likely to increase even more substantially as euthanasia and assisted suicide for those not dying but living with disabilities will be more widely provided, as well as once further expansion occurs in March 2023, to those living with sole mental health disorders.

Coelho R, Lemmens T, Gaind KS, Maher J. Normalizing Death as “Treatment” in Canada:Whose Suicides do we Prevent, and Whose do we Abet? World Med J 2022 Nov;70(3): 4-7

Sean Murphy, Ramona Coelho, Philippe D. Violette, Ewan C. Goligher, Timothy Lau, Sheila Rutledge Harding, Rene Leiva

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Since 1948 the Declaration of Geneva (the Declaration) has insisted that physicians must practise medicine “with conscience and dignity.” In 2017 this provision was modified by adding, “and in accordance with good medical practice” [1].

Good medical practice in Canada is said to include providing euthanasia and assisted suicide or arranging for someone else to do so. From this perspective, physicians who cannot in conscience kill their patients or collaborate in killing are not acting “in accordance with good medical practice,” and – some might say – the revised Declaration.

However, this merely literal application of the text cannot be correct, since the WMA later reaffirmed its support for physicians who refuse to provide or refer for euthanasia and assisted suicide even where they are considered good medical practice [2]. A reading informed by the history of the document is necessary and consistent with the care taken in its revision [1]. This yields a rational and coherent account of the relationship of conscience and dignity to medical practice.

Murphy S, Coelho R, Violette PD, Goligher EC, Lau T, Harding SR, Leiva R. The Declaration of Geneva: Conscience, Dignity and Good Medical Practice . WMJ [Internet]. 2020 Aug; 66(4): 43-47.