This article was published as a CMAJ blog on Feb 3, 2016 and republished with permission.
By Diane Kelsall, Deputy Editor at CMAJ, and editor of CMAJ Open.
In June 1993 I attended my first international research meeting. WONCA (World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians) was having its annual meeting in The Hague and I had gotten funding from my fellowship program to attend.
It was all very exciting for someone new to the research world to see the hustle and bustle, and feel the energy, that accompanies such a large meeting. Even Queen Beatrix attended.
But that’s not what I remember most about the meeting.
One of the sessions put on by the local organizers focused on euthanasia (that was the term used at the conference). At the time, the Netherlands was the only jurisdiction in the world where this practice was legalized. Many attended out of curiosity—and the collective response was interesting. Numerous attendees filed out of the session in silence, clutching handouts that described euthanasia protocols:
Administer this. If the patient is still breathing, administer that. If the patient’s heart is still beating, do this.
We stood in small groups, hardly able to grasp what we were reading. This was so contrary to everything we had been taught and everything we believed. How could physicians have crossed this line? When did “above all do no harm” turn into an algorithm for death?
When I returned home, I put the protocols away in my desk. Every few years, I would stumble across them—and each time, I felt chilled as I read them.