In a paper published in Current Oncology,
University of Ottawa palliative care physician Jose Pereira states that the “laws and safeguards [in countries in which euthanasia or assisted suicide have been legalized] are regularly ignored and transgressed in all the jurisdictions and that transgressions are not prosecuted” 1
. He purports to demonstrate that the safeguards and controls put in place in the permissive jurisdictions are an “illusion” 1
What is startling about the Pereira paper is not the anti-assisted dying position taken nor the conclusions asserted. The academic literature is replete with papers arguing for, and other papers arguing against, legalization. Rather, what is startling about the paper is that it was written by an individual identified as an academic and published in a peer-reviewed journal, and yet the evidence provided for the statements and conclusions is profoundly compromised.
The deficiencies matter because Canada is, at this very moment, engaged with the issue of the legal status of euthanasia and assisted suicide on several fronts. In Quebec, a committee of the National Assembly recently released a major report on the issue (recommending, among other things, changing the law so as to permit “medical aid in dying” in some circumstances) 2,3
. In British Columbia, a constitutional challenge to the Criminal Code
prohibitions of assisted suicide and voluntary euthanasia is currently before the courts 4
. Pereira’s paper was submitted in its entirety and heavily relied upon in an expert witness report prepared by Pereira and submitted by the Crown in that case 5
. The paper was also cited approvingly by another witness for the Crown (Dr. Harvey Chochinov who, in his expert witness report, described Pereira’s paper as “an excellent article”) 6
. It has also been profiled in the mainstream media (ctv
News, for example 7
) and widely cited on the Internet (albeit mostly on pro-life Web sites 8–11
). Nationally, the Royal Society of Canada appointed an expert panel to report on end-of-life issues in Canada, and the panel’s report was released November 15, 2011 12
. The public, the courts, and the legislatures are, and will continue to be, engaged in reflection on the question of what the law should be with respect to assisted dying. It is therefore particularly important that the academic literature be rigorous so that the public policy debate can be informed by facts and not misshapen by smoke and mirrors.
In the present paper, we expose problems with the evidence base provided and relied upon by Pereira. It should be noted that we provide only examples of each of the categories of mistakes made by Pereira. The original work contains more, but the examples given should suffice to demonstrate that Pereira’s conclusions are not supported by the evidence provided by him. We conclude that his paper should not be given any credence in the public policy debate about the legal status of assisted suicide and euthanasia in Canada and around the world.