Christine Jamieson, Montreal (for ICN)

Dr. Somerville is the Samuel Gale Chair in Law, professor in the Faculty of Medicine, and the Founding Director of the Centre for Medicine, Ethics and Law, at McGill University in Montreal. She serves as a frequent commentator on current ethical issues with the Canadian media.
ICN:  Can you tell us a bit about your background? How did you get into the field of ethics and law?

Dr. Somerville is the Samuel Gale Chair in Law, professor in the Faculty of Medicine, and the Founding Director of the Centre for Medicine, Ethics and Law, at McGill University in Montreal. She serves as a frequent commentator on current ethical issues with the Canadian media.
ICN:  Can you tell us a bit about your background? How did you get into the field of ethics and law?
      Well, my parents came from the Outback of Australia, so I grew up very in touch with nature and the land and the mysteries of that. My father was a very interesting and unusual man. Not highly educated but enormously wise. He was brought up Catholic but he had, at best, very mixed feelings about the Catholic Church. I once told him that he was one of the most religious people I have ever met. (I used the word religious, but I should have used the word spiritual.) He looked at me and said “Why do you think that?” I said, “Well just the way you are, with everything you know and how you interact with nature.” He laughed and said, “That’s not religion, that’s living with the universe.” One of my priest friends said that was one of the best definitions of religion he had ever heard. When we were kids Dad used to take my brother and me and we’d sleep out on the back lawn. He would tell us all about the stars. I grew up, in a way, with a very mystical background.
      Then when I left school my parents wanted me to go to university and I studied pharmacy and then I met and married my now ex-husband. A few years later I decided to go back to university and study law. I just loved it and ended up the top student of the law school. At that time, I was only the third woman to do that (in Sydney, Australia). Then many of the Sydney  law firms  wanted me to come and work for them. But the interesting thing was that most of the top law firms had no women lawyers working for them. I was offered a job at one of Australia’s top law firms and again, it was absolutely wonderful. About two years later my husband wanted to do post-doctoral research in medicine. So we came to Montreal. I thought I might do something useful while I was here. So I enrolled for a Master’s degree in medical law because I wanted to put my two backgrounds in pharmacy and in law together.
      It turned out that one of the very few people in the world who had a doctorate in medical law was at McGill. He thought I knew all about him and was coming to McGill to study with him but I had absolutely no idea about this. He told me I should do a PhD not a Masters. I really wanted to go back to Australia and so was not interested in such a long-term degree, but he convinced me to do a doctorate. Just as I was finishing my doctorate the first Parti Québécois government was elected in Quebec. And, in law, McGill had quite a few professors who were Oxford and Cambridge graduates and so were English. Many of them resigned on the spot. McGill was suddenly left with no one to teach some common law subjects. So the Dean asked me to teach them. Nothing was planned; my life has always been like that, serendipitous.
      Soon after that, the Law Reform Commission of Canada was opening up the Protection of Life project and they asked me if I would help them to do some of this work. I wanted to do this, but I was a Commonwealth scholar, which means you have to go back to your own country, which awarded you the scholarship, or you have to pay back everything. McGill and the Law Reform Commission wanted me to stay. A deal was made to “trade” me for a Canadian Commonwealth scholar who was at the Australian National University in Canberra, Australia. He was an Astrophysicist. The Aussies wanted him and the Canadians wanted me. So they swapped us. The Aussies kept the Astrophysicist and the Canadians kept me. So we didn’t have to pay back the money. Everything that has happened since then has been a similar sort of story. Nothing is planned, it just happens.
ICN:  There are not many ethicists as well known as you for public commentary on difficult ethical issues and on underlying values that shape society. Why is it important to you? What are you hoping to achieve?
      I feel strongly that it has to be the general public that is informed and has to make the decision about where we are going with the values issues we are facing today and will be faced with in the future. I also think it is particularly important that young people are as well informed as possible, because they are going to be the decision makers of the future. I am pretty appalled by what the situation is at the moment. They have been brainwashed into the politically correct stances, which they are fearful to challenge. Still, I am an incurable optimist and I think that the younger people are realizing that the values are being messed up for them. I think we can see it most strongly at the moment in the whole sexual relations scene, the idea that sex is nothing important, that it is a casual recreational activity. It is nothing to take seriously and certainly not to be treated as sacred in any way. And what we are seeing is a disaster among young people in forming lifelong committed relationships although that is what the majority tell you they hope to have. When you are in a university, you can really see it. I think their values have been totally screwed up for them and it is not their fault.
ICN:  You have educated people about ethics in a way that they were not educated before. That is an important role you played for the Canadian public. It is because of you that many people understand some of these ethical issues now.
      I do about 35 to 40 major public lectures a year. I probably write about 30 columns in national newspapers a year and I do quite a large amount of television and radio. Some weeks I will do 20 interviews when a big issue is breaking.
      What people often say to me is “I knew what I believed, but I didn’t know how to say it.” So I see my role as giving them the words to say what they believe. They don’t know why they believe that and so what I do, from a secular base, is to explain in ways they can understand all the basics of the secular arguments for the values or positions they want to uphold. I also show them what the arguments are on the other side so they can respond to them.
      For example, in the euthanasia debate, one of the main techniques being used to promote legalization of euthanasia in Canada is confusion, deliberately creating confusion between allowing a person to die when that is a justified approach (which we all agree on) and killing a person. One way to differentiate these two situations is the different intention. But the pro-euthanasia people say, “Well, you can’t tell what the intention was, did they intend to kill them or did they intend to just let them die?” But courts make such decisions about intention every day.
      If you take your car and you drive down the street and you accidently hit somebody and you are not negligent, you’ve got no intention to kill him or her but you happen to kill him or her. You are not criminally liable. On the other hand, if you take out your car and you said, I hate that person, he's run off with my girlfriend and you drive your car into them, that's murder, it’s first degree murder. The two acts are the same, the intention is not. So we use that distinction all the time.
      The Pro-euthanasia people are using multiple confusions. They label actions that are not euthanasia, such as giving necessary pain relief, as euthanasia and argue we approve of this so we should approve of euthanasia, because it’s no different. The other area of confusion is the difference between turning off a respirator, on the one hand, and giving someone a lethal injection on the other. There is a huge different between these actions.
      And they are using confusing language. They’ve done surveys that show that if you use the words “euthanasia” or “assisted suicide” people will say, “No, we don’t want that”. But if you talk about “physician assisted death” they think that sounds okay and they say “yes”. So that's confusion in language.
      I actually think that the basis for that last confusion is because our primary ways of knowing whether euthanasia is right or wrong include both moral intuition and imagination. When you use language that doesn’t activate your intuition or your imagination then you are not having the appropriate intuitive or emotional reaction to what you are doing which would warn you that it is wrong. You are thinking this is a good and kind thing we are doing for this person, who is usually described as suffering, as “the last merciful act of good palliative care”. All that sounds wonderful, but what you are actually doing is killing somebody. Those are the sorts of things I focus on. I tell people that we need to do in deciding whether to legalize euthanasia, is to ask ourselves the question “What sort of a world will your great great grandchildren live in if we move forward with euthanasia?”.  I think it could well be one in which no reasonable person would want to live.
ICN:  What is your take on the Rasouli case that is currently in the press?
      Two things:  First of all, there is no legal or ethical obligation to offer what is called “medically futile treatment”, that is treatment that can have no medically beneficial effect, such as giving a blood transfusion to a person with no need for it, but in the Rasouli case, this treatment is not medically futile treatment, it is keeping this man alive.
      The second issue is that when there is a disagreement between the family and the doctors, who gets to decide? Up to now our law has been that it is the family or the patient themselves if competent. The other point is, if you say the doctors can decide then you may  have a massive refusal of treatment by doctors across the country, including because of pressure on them from hospitals and governments to reduce healthcare costs. The number of cases when there is disagreement is very few. Most people don't want this very invasive life-support  treatment at the end of life, and so if you can allow people to say voluntarily we don't want it, you can keep all our present values and legal approaches to these often very difficult situations  intact. The patient or patient's representative is the decision maker and that is kept intact.