Newman1 and Bright2 both express concerns about the messages of our article,3 but neither appears to have understood them correctly.
We did not express support for, or opposition to, legalization of physician-assisted death. We posed questions that we feel should be addressed about the practical aspects of performing legal physician-assisted death in Canada. Newman1 suggests we are coy in our use of the term “physician-assisted death,” but we explicitly defined this term in the first sentence of our article as including both euthanasia and assisted suicide. The term “physician-assisted death” is widely used, including by Justice Smith in the Carter case.4
We did not assert that the “Yes or No” debate was “over.” We pointed out that the debate will be practically obsolete if physician-assisted death becomes legal by judicial or legislative means, and that physicians have a professional responsibility to prepare for this possibility regardless of whether they support legalization.
We share Newman1 and Bright’s2 concern about the potential effects on the vulnerable. But we are reassured by data from the Netherlands that suggest that involuntary euthanasia became less common after legalization of physician-assisted death,5 and data from Switzerland6 and the United States7 that show that vulnerable populations are less likely to receive physician-assisted death.
Newman1 asserts that the only way to safeguard against the use of physician-assisted death as a cost-saving measure is to ban it. This argument seems to imply a lack of commitment by physicians and other health care professionals to their ethical, legal and professional duties to patients.
Bright2 is particularly concerned that physician-assisted death would hinder the development of palliative care, citing a study from the Netherlands.8 We respectfully point out that the reference he cites says the opposite: “On the one hand, a legally codified practice of euthanasia has been established. On the other hand, there has been a strong development of palliative care.”
We appreciate the comments and feedback, but please read our article (and your references) more carefully.