Response to Dr. Donald Low’s Request for Assisted Suicide

Press Release: deVeber Responds to Doctor’s Request for Assisted Suicide

Response to Dr. Donald Low’s Request for Assisted Suicide

Jean Echlin, Advisor to the deVeber Institute, was interviewed by Metro Morning with Matt Galloway CBC News on September 25th, 2013

For her complete interview please click here:

Dr. Donald Low, one of Canada’s leading microbiologists, passed away on September 18th, 2013 after being diagnosed with terminal brain cancer in February of this year. Dr. Low is recognized for his leading role in helping Toronto respond to the SARS crisis in 2003. Eight days prior to his death, Dr. Low recorded his thoughts about his diagnosis, illness symptoms, and his passionate appeal for physician-assisted death (PAD) to be made available and legalized in Canada.

This video can be viewed here:

The deVeber Institute offers its deepest condolences to the Low family and the community surrounding this brilliant physician and leader in medicine. The life-limiting diagnosis of a brain stem tumour at such an early age as Dr. Low’s (68), is difficult to understand and accept, especially when one such as he remains an active, independent and outstanding contributing member to society. Although, Dr. Low’s diagnosis is a rare one and cases like his are not common, his reflections are both compelling and heart wrenching.

In his interview, Dr. Low expressed his feelings of frustration about the gradual loss of his vision and hearing and his progressing inability to do even normal activities. These sentiments are often seen expressed by patients who are nearing the end-of-life and suffering through their last days. These feelings are also regularly experienced by the aging population, as they begin to lose abilities they had when they were younger. However, it is important to realize that underlying these issues of frustration due to declining ability is the possibility of depression or serious anxiety or an overwhelming sense of hopelessness and loss. Should we legalize physician-assisted death for those who feel they are a burden or those who are depressed? Or, instead, should we help them through their mental health issues, their loneliness, their grief to hope? On CBC Radio, September 25, 2013, Maureen Taylor, Dr. Low’s wife, who asked her husband to make the video, explained that it was anxiety, not pain that caused him distress. Research shows that when depression is not properly addressed, people with “feelings of extreme hopelessness” are 4.1 times more likely to request euthanasia.[i]  These same findings concluded that depression is a primary risk factor for requests for euthanasia. Conversely, we see that “with proper palliative care, symptoms like depression and feelings of hopelessness and loss of ability can often be helped” remarked palliative care physician, Dr. Paul Zeni.

What proponents of legalizing PAD often fail to take into consideration are the experiences of countries with legalized euthanasia including Belgium and Holland. In May of 2010 a study found that 32% of euthanasia deaths in the Flanders region of Belgium were done without patients’ request or consent.[ii] Later that same year, a study found 47% of euthanasia deaths were not reported. This study indicated that under-reporting was often linked to questionable deaths. [iii]

How would legalizing physician-assisted suicide impact the elderly?

Noteworthy here, is the largest group of individuals who are at risk with legalizing PAD: the elderly. Current government statistics confirm that elder abuse is a genuine issue and 70% of elder abusers are people who the abused depend on.[iv]

For one means for all

In the film, Dr. Low feels that Canada “needs to mature to a level where we accept dying with dignity” and he envies countries where physician-assisted death (PAD) is legal. He continues to state that palliative care cannot take away symptoms like loss of ability. Palliative care consultant and nurse educator, Jean Echlin, RN, remarks that “one person’s autonomy can lead to another person’s death sentence.” The desire of a few individuals to legalize PAD has the potential to cost the majority in lost trust of doctors, nurses and the medical establishment on a whole. Patients who reject PAD and euthanasia will be forced to be identified as “DNE” (Do Not Euthanize) patients in order to be clearly identified, remarks Echlin. Physicians who have taken an oath to protect life will be enabled and even mandated to provide a referral for or actually administer euthanasia directly or indirectly through a prescription, to cause death of their patients on their request.

In the report, Not to be Forgotten: Care of Vulnerable Canadians, from the Parliamentary Committee on Palliative and Compassionate Care, a large number of different organizations and agencies across Canada collectively agreed that health care providers need the support of government and the general public in their attempts to reform health care and ensure they offer Canadians good palliative care. Palliative care is defined as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”[v]  Palliative care includes non-medical treatment which helps to relieve pain and provide comfort for the dying and this does not include physician-assisted suicide or euthanasia.

With aging come challenges. These may include loss of ability, loss of independence, and chronic discomfort/pain. Canada’s aging population has already begun to present these intense challenges to our health care system and will continue in the years to come.  At the frontline of these challenges are those who need palliative and compassionate care, those who are depressed, those who cannot speak for themselves and Canadians living with disabilities, in other words, our most vulnerable Canadians. 

Dr. Low was one of these vulnerable Canadians. At the conclusion of the video, is written, “Don passed away on September 18th, 2013, 8 days after taking part in this video. He did not have the death he had hoped for, but he died in his wife’s arms and he was not in pain.” In times like these, after the passing of a great man like Dr. Don Low, whose goal in life was to serve his patients and protect his community, it is a tragedy to hear how, because of his condition, he felt that physician-assisted suicide would give him more comfort than the care of the medical establishment that he belonged to for so many years. This alone is reason for us to pause and revisit the importance of proper end-of-life care: teaching and providing genuine palliative care.

At its root, palliative care provides all of the needs of its patients at end-of-life: managing pain and other symptoms, providing social, psychological, cultural, emotional, spiritual and practical support, supporting caregivers, and providing support for bereavement. Without complete palliative care, patients are left to consider alternatives like physician-assisted suicide and euthanasia. Dr. Don Low deserved more than the alternative. This is a reminder to return to a deeper and renewed focus on palliative care education of every member of the medical profession and developing strong teams of palliative care workers trained to address the needs of their patients. Only then will doctors turn patients away from PAD and euthanasia, and turn them back towards hope, and living, and dying, with dignity.

[i] “Euthanasia and Depression: A Prospective Cohort Study Among Terminally Ill Cancer Patients,” Journal of Clinical Oncology—September 20, 2005.

[ii] “Physician-assisted deaths under the euthanasia law in Belgium: a population based survey,” Canadian Medical Association Journal—May 17, 2010.

[iii] “Reporting of euthanasia in medical practice in Flanders Belgium: cross sectional analysis of reporting and unreported cases,” British Medical Association Journal—October, 2010.

[iv] Government of Canada.

[v] "Not to be Forgotten: Care of Vulnerable Canadians." Parliamentary Committee on Palliative and Compassionate Care. Pg. 134