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Famous medical ethics lecturer's credentials challenged in euthanasia case

Sue Rodriguez is consoled by NDP MP Svend Robinson in 1993 after the Supreme Court of Canada turned down her plea for a doctor-assisted suicide.

Jeff Vinnick/Reuters

Marcia Angell was an editor of the most prestigious medical journal in the world for two decades.

She currently gives monthly lectures on ethics to faculty at Harvard Medical School.

And she served on a panel that gave advice on medical issues to the White House.

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But Dr. Angell's credentials were challenged, Wednesday, in the Supreme Court of British Columbia when a lawyer for the federal Department of Justice tried to prevent her affidavit from being entered in a case concerning physician-assisted suicide.

Madam Justice Lynn Smith, who is hearing a constitutional challenge to Criminal Code sanctions that make doctor-assisted suicide illegal in Canada, said she would reserve her decision on the admissibility of the evidence until after hearing Dr. Angell testify. The case is the first such challenge on the issue since 1993, when Sue Rodriguez, a Victoria woman dying of Lou Gehrig's disease, failed in her arguments before the Supreme Court of Canada.

Judge Smith's decision on Wednesday came after Megan Volk, representing the federal government, told the court that Dr. Angell should not be recognized as an expert witness because she is an advocate for euthanasia and because her experience and training doesn't involve original research.

Ms. Volk said Dr. Angell – whom the plaintiffs called to testify "on the medical ethical dimensions of this case," – can only offer opinion and argument.

She pointed out that Dr. Angell had signed a petition calling on the state of Massachusetts to make physician-assisted suicide legal and that as an editor for the New England Journal of Medicine, she had written several articles supporting the practice.

"It is clear that Dr. Angell is deeply passionate about [advocating for]assisted suicide … In doing so, she has sacrificed her impartiality," said Ms. Volk, who argued expert witnesses need to be objective to help the court.

She also noted that Dr. Angell's "academic interest" in the subject was dated, because for the past decade most of her writing has focused on issues concerning pharmaceuticals.

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But Sheila Tucker, one of a team of lawyers representing a group trying to change Canada's laws, said Dr. Angell is an eminent medical ethicist – and her "expertise [was]recognized by Harvard Medical School when they employed her to teach their own doctors medical ethics."

As an editor at the New England Journal of Medicine, she had kept abreast of a wide range of medical issues, and that meant she could offer the court a broad perspective, said Ms. Tucker.

"One does not become an ethicist in euthanasia or pharmaceuticals … she is an ethicist in general, which is what one would seek … as an expert," she said.

And Ms. Tucker said the fact that Dr. Angell had formed her views on physician-assisted suicide years ago should give the court some comfort that she had not just tailored her testimony to suit the trial at hand.

She added that Dr. Angell would not be presenting argument, but offering views formed after deep reflection.

"People who have thought long and hard about these issues have come to hold an opinion … it would be shocking if they had not," she said.

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In testimony, Dr. Angell told the court that "to decide whether to permit dying is not a scientific question … it's an ethical question … it involves the tensions between competing moral claims … that's what makes it so difficult."

She said while doctors are sworn to preserve life, "the most important obligation is the obligation to respect the autonomy of the patient and … to relieve suffering."

The trial is expected to continue for two weeks.

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About the Author
National correspondent

Mark Hume is a National Correspondent for The Globe and Mail, based in Vancouver, writing news and feature stories on a daily basis about his home province of British Columbia. His weekly column, which often challenges the orthodoxy on environmental issues, appears every Monday. More

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