Bioethics News

Filling out euthanasia death certificates in Quebec

Physician-assisted suicide begins in Quebec on December 10. One of the overlooked consequences of this radical change to the law is how doctors will fill out death certificates. Although the immediate cause of death will be a lethal drug, doctors have been advised to list the cause of death as an underlying medical condition.

The Collège des médecins du Québec and pharmacy and nursing regulators have issued a Practice Guide directing Quebec physicians to falsify death certificates in euthanasia cases.

The physician must write as the immediate cause of death the disease or morbid condition which justified [the medical aid in dying] and caused the death. It is not a question of the manner of death (cardiac arrest), but of the disease, accident or complication that led to the death. The term medical aid in dying should not appear on this document.2

Since untruths are not normally part of medical practice, how does the practice guide justify this? It gives two reasons: first, that some patients may not want their families to know how they died, and second, that it protects families who don’t know that their loved ones have been killed by physicians from some unspecified “harm.”

Writing in the Protection of Conscience blog, Sean Murphy comments that this is bound to upset both Quebec physicians and families.

Many physicians, coroners and other health care workers may share these concerns, even if they don’t have moral reservations about euthanasia. Indeed, euthanasia supporters may worry that mandating deceptive practices is counterproductive and inconsistent with the Practice Guide’s expectation that physicians will apply “moral rigour” in processing euthanasia requests.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.