Quebec physician Bruno Gagnon is feeling squeezed out of his decades-long palliative care career due to his moral objection to medical assistance in dying (MAiD).
With years of experience and a faith-based passion for offering comfort to those living out their final days, Dr. Gagnon says he still has much to offer in the field but feels hampered under the current circumstances.
He has felt marginalized in the profession for some years because of his views on MAiD, he said, and now it’s official.
Dr. Gagnon recently applied to work in a growing facility but was told his objection to MAiD lost him the job. While the facility is required to offer the procedure, it wouldn’t be able to do so on days he was the only doctor on duty if he were hired, he said. That would create logistical issues.
“It’s not palliative care anymore,” Dr. Gagnon said. “I don’t know what it is.”
He gave examples of patients offered MAiD by his colleagues instead of treatment that could have eased their suffering, which is what he says palliative care should be about.
Due to patient confidentiality, he could not speak about the details of those cases. However, he did say that some involved patients with chronic pain, delirium, and a heart condition. Those conditions could have been treated before the decision to go ahead with MAiD, he said.
In one case, Dr. Gagnon came back from vacation to find that MAiD had been arranged for one of his patients. He spoke with the patient and her caregiver, helping resolve some interpersonal issues between them. He also treated some of the patient’s ailments. The patient then chose not to go through with MAiD.
The worst experience of his career—and it’s a difficult career, he said, working with people at the end of their lives—was seeing the fear one of his team’s patients felt as she prepared to receive MAiD.
‘Space for Doctors Who Object to MAiD’
Georges L'Esperance, a neurosurgeon and president of the Quebec Association for the Right to Die in Dignity, supports the new law. He says palliative care workers who object to MAiD can still work in facilities in Quebec, and it’s just the facility itself that has to offer MAiD.“It’s normal that there is a space for doctors or nurses who object to MAiD, but they don’t have to limit other citizens’ rights,” he told The Epoch Times.
When told of Dr. Gagnon’s experience of being limited in his employment opportunities because he won’t offer MAiD, Dr. L'Esperance said he couldn’t comment. “It would be important to have all the facts,” he said.
Regarding Dr. Gagnon’s accounts of patients being offered MAiD instead of treatments for the ailments causing them suffering, Dr. L'Esperance doesn’t think they represent a common experience in Quebec.
“This is one of the arguments. We always hear about that, and it’s untrue,” he said.
Dr. Gagnon says these statistics don’t take into account the quality of palliative care and they show that the remaining 20 percent never received any palliative care, which is a problem. “The great majority of patients die without having access to proper palliative care,” he said.
Dr. L'Esperance called facilities in Quebec that have opposed MAiD “hypocritical” because they offer palliative sedation, which he says is like a slow version of MAiD. A patient is sometimes sedated to avoid suffering in his or her final days or hours.
Dr. Gagnon, however, says this characterization of palliative sedation is unfair.
“Palliative sedation is an extreme treatment for symptoms control which respects the normal dying process. The objective is not to kill but to alleviate,” he said.
He said he has seen health-care workers who once supported MAiD change their perspective after seeing the volume of patients getting the procedure, up to some 10 per day in one facility he worked at.
Faith
Dr. Gagnon said he believes palliative care workers should have Christian-like values. The best doctors and nurses he has seen in his career have been those who are motivated by their faith, he said, noting that they serve patients with a passion and offer them spiritual hope as they face the afterlife.“Palliative care is about being with a patient and family in respectful acceptance of the mystery of the dying process. MAiD is, at the end, refusing part of our humanity,” he said.
Dr. Gagnon said his opposition to MAiD is not, however, faith-based and he would have the same view were he not a man of faith. In his view, it is about universal values regarding life and caring for others, the principles that have always been at the core of palliative care.
Dr. Gagnon said both believers and non-believers can work together, speaking “reasonably with the objective of finding the truth about the morality of MAiD.”
Dr. L'Esperance said many reasons for choosing to die could be considered valid—including not wanting to be a burden to one’s family—“except if you think that life is something that is sacred over anything else.”
St. Raphael’s is a Catholic palliative care facility in Montreal that is one of the few in Quebec not offering MAiD, until now.
Executive director Olivia Leveque told The Epoch Times she isn’t sure how St. Raphael’s will handle the new law.
“We have to follow the law,” she said. “We’re just currently analyzing the situation in its full scope.”
St. Raphael’s has formed a committee to look at how the hospice will implement the requirements. Ms. Leveque said the timeline for implementation isn’t clear yet. She thinks they will have several months.
“Our main focus is always palliative care, and it will always continue to be to offer excellent palliative care and compassionate services.”
