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Quebec euthanasia inquiry hears gruelling tales of suicide

He was an MS patient in rapid decline, and he spent three years searching for the best way to end it all.

Laurent Rouleau went to doctors, looking for a painless way. He studied the law, quickly realizing there was no legal way. In the end, the 59-year-old paper-mill worker was left alone, with two .22 calibre bullets to the gut.

In its first day, Quebec's commission on the growing demand for legalized euthanasia was wading into wrenching anecdotes. Individual suffering was pitted against more clinical and philosophical arguments about the purpose of the health-care system in Quebec society.

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A trio of prominent doctors went before the Dying with Dignity Special Commission, standing against the growing wave of support for euthanasia. They pushed for better palliative care and insisted medicine's basic mission – to preserve life – is undercut when doctors take life.

The physicians who stepped forward Tuesday to oppose euthanasia are taking on powerful opponents. The Quebec College of Physicians has come out in favour, bolstered recently by one recent poll that showed 70 per cent of Quebeckers support euthanasia.

The dissident doctors, who stress they aren't partisan or religious, included orthopedic surgeon Marc Beauchamp and Patrick Vinay, the head of palliative care at theCentre hospitalier de l'Université de Montréal (CHUM). They say the push for euthanasia largely results from poor pain treatment. They argue the poor, weak and elderly will inevitably be preyed upon by unscrupulous caregivers.

Dr. Vinay warned of other unintended consequences, including the guilt that could consume the person who actually ends a patient's life.

"There is no such thing as clean and simple," Dr. Vinay said. "Euthanasia puts the burden on someone else who will be responsible for ending the life. There are other options before we should pursue far ahead of this."

The doctors also say the massive support for euthanasia in Quebec is underpinned by misunderstanding.

The cessation of medical treatment and terminal sedation, where the dying are given heavy doses of pain killers, are current end-of-life practices often mistaken for euthanasia, according to André Bourque, the head of general practice at CHUM.

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"It's a dangerous avenue to decriminalize euthanasia," Dr. Bourque said. "Euthanasia and assisted suicide are killing, plain and simple. We cannot allow killing to be confused with health care in Quebec."

But to Laurent Rouleau's family, the debate had recent, bloody consequences. They blame the lack of a euthanasia law for Mr. Rouleau's agonizing gunshot.

Mr. Rouleau was diagnosed with multiple sclerosis in 1993. His decline steepened early this year when he could no longer drive, cook, read, walk or paint his watercolours.

Mr. Rouleau's case underlines some of the complications behind the debate. While he suffered physically, it seems his greatest pain was from the loss of independence and dignity.

"He suffered intensely from his own perception that he was becoming a greater and greater burden for his family. He would wake next to me crying, saying he was becoming a complete prisoner to his body," said his wife, Sylvie Coulombe.

Mr. Rouleau spoke openly of his desire to end his life before he was completely incapacitated.

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On June 8, he loaded his .22 calibre rifle and shot himself twice, aiming at the stomach so he would die slowly enough to call 9-1-1 and avoid having his wife find his dead body.

Emergency responders got him to the hospital in Amos, Que., where surgeons prepared to repair the damage. Mr. Rouleau spent hours in hospital arguing with doctors for the right to bleed to death.

"I couldn't even kill myself properly," he told his wife. Doctors told Mr. Rouleau he could not refuse treatment because he was a suicide case.

"He was totally lucid and totally bewildered and indignant at this injustice," Ms. Coulombe said.

A psychiatrist eventually intervened, saying Mr. Rouleau was fit to refuse treatment. He died on June 9, 14 hours after firing the shots.

"If euthanasia had been legal, my father could have left us without sneaking out like a thief in the night," said his 35-year-old daughter, Dacha Rouleau-Dumont.

The commission, headed by Geoffrey Kelley, a member of the National Assembly, will spend several months sounding out the province.

While the hearings could lead to changes in provincial medical standards, euthanasia and assisted suicide are illegal under the Criminal Code of Canada and could only be changed through an act of Parliament.

"This is a citizens' approach where we will listen to many people. Whatever the outcome, the federal government will have to respect it," said Mr. Kelley.

But he said consensus is unlikely to result from the hearings.

"There is a great divergence of opinion, and I can assure you as we go forward that won't get any clearer."

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