Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Saturday, March 05, 2016

When Compassion Becomes Murder

"The torture that they were going through -- seeing their friends die slowly, often a very painful death -- my feeling was that by giving them an option, this was going to give them some peace of mind, knowing that they had the possibility of doing something to take control."
"[Treatments were evolving] but we didn't have the combination drugs that we have now, which have pretty well brought this epidemic under control."
"At the time, physicians were in a very difficult situation. We were ethically obliged not to help our patients at the end stages of their life."
Maurice Genereaux, former Toronto M.D. and surgeon
Dr. Maurice Genereux leaves College Street court in Toronto in 1997 after pleading guilty to assisting the suicide of one HIV patient and the attempted suicide of another.
Postmedia Files   Dr. Maurice Genereux leaves College Street court in Toronto in 1997 after pleading guilty to assisting the suicide of one HIV patient and the attempted suicide of another
"There wasn't much to hang  your hat on in terms of staying alive in the long term. So people prepared to die, psychologically."
"They didn't want to end up the way they saw so many other people die."
John Larsson, social worker, counsellor, AIDS Committee of Toronto

"Just because one had AIDS didn't mean their life was over. He [Dr. Genereux] was described as a Pez dispenser of pills. And I think that kind of lackadaisical attitude of prescribing has to be not allowed."
"The one man who died had his prescription for nine months, and he didn't see Genereux in all that time. It's like, 'Here's your lethal dose of medication and I'll see you, whenever'."
"He wasn't a bad man. He wasn't a bad person. I just think he made some very bad decisions. If you think that there is any possibility of having a regulated scheme of assisted death, it has to be able to exclude cases like this. It has to be able to say, 'This is wrong'."
Dr. Phillip Berger, St.Michael's Hospital, Toronto
Canada is preparing to legalize assisted suicide, under certain conditions for certain people for whom life no longer holds meaning that transcends the pain and suffering they labour under; people at their end-stage of life who have a wish to control the time and place of their final departure. And for Dr. Genereux, who once was charged under Canadian law that made it an offence to aid someone seeking death to achieve it, and spent time in prison, that time hasn't come soon enough.

He is, he declares, pleased "that finally we are permitted to be compassionate at the end stage. It's sort of like an achievement, something that I've felt was needed for a long time and finally it's here. My regret is that I'm not able to practise any longer and enjoy that freedom", he concludes with regret. He would prefer not to linger on his 1998 prosecution and imprisonment at a time before triple-drug medicine changed the landscape of AIDS prognosis.

He asserts that it was his misfortune to be caught, that assisted suicide was not the anomaly he was charged with: "It was common practice among physicians treating AIDS at that time", he said, but when he pleaded guilty to the charges brought against him under Section 241(b) of the Criminal Code, of aiding and abetting suicide, he became persona non grata, abandoned by his colleagues. Their reasoning on the other hand, is that he abandoned his patients' needs at a time when drugs like AZT and protease inhibitors were being used, with the promise of more effective drugs in the near future.

He no longer practices medicine. Before his arrest for assisting suicide by prescribing a lethal dose of Seconal that killed a patient, his license to practise medicine was temporarily suspended for nine months when he was charged with improperly sexually touching six patients. He had already been known to be gay, which gave him insight and a greater compassion for those gay men suffering with AIDS. Five months after he resumed practising, he decided to help two patients to achieve their own deaths, and prescribed barbiturates in a lethal dose.

One of the patients, Mark Jewitt, did attempt to commit suicide but survived and still lives, while the other, Aaron McGinn, died a year later at the age of 31. Both had HIV, but not yet AIDS; neither experienced any real distress or was in danger of imminent death. During his sentencing hearing it was revealed that he had provided Seconal to 16 other patients between the years 1992 and 1996. He was taking up the breech when many doctors would not treat HIV or AIDS patients.

Postmedia files
Postmedia files   Aaron McGinn, who couldn't see himself living with AIDS, committed suicide assisted by Dr. Maurice Genereux
The two men to whom he had prescribed a deadly dose of drugs prevaricated for months, prescription in hand, before finally succumbing to their fear of the future. One returned to obtain a fresh prescription; he had mislaid the original during the interval when it had been given him by Dr. Genereux and when he had finally decided to commit suicide. The man who died, Mr. McGinn, had a medical history of drug abuse and depression. The lethal Seconal dose would solve his agony of fear.

It took another nine months before he used the second prescription to obtain that lethal dose of Seconal. When he died, Dr. Genereux arrived at his home, wrote a death certificate stating the cause of death to have been AIDS-related pneumonia, and retrieved the empty Seconal bottle. "I would [in retrospect] have taken more safeguards to protect my licence. I'm not saying that I would not have assisted. But I would have perhaps screened a little bit better, or been more cautious about how I approached it."

Now 69, he operates a bed and breakfast facility in Victoria for gay and bisexual men.

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