Maurice Genereux is living a quiet life of semi-retirement, running a small gay guesthouse in Victoria, BC.
But when the Supreme Court of Canada issued its explosive decision Feb 6 declaring laws against physician-assisted suicide unconstitutional, Genereux’s past met Canada’s future.
Genereux was the first doctor ever convicted under the law the Supreme Court just overturned. He pleaded guilty in 1997 to prescribing barbiturates that were used in a patient’s suicide.
“I still feel it was the right thing to do at the time,” he tells Daily Xtra now, even though he lost his right to practise medicine and spent nine months in prison. At the time, some activists wrote that the sentence made a mockery of the right to life.
For Genereux, the lack of alternatives in the late 1990s for HIV/AIDS patients made for difficult choices. Despite the emergence of protease inhibitors and new drug cocktails, many patients were effectively resistant to treatment.
“The problem with patients at that time was they had been through years of treatment, and as new drugs came out, they had what I refer to as serial monotherapy. Even though we combined drugs, by the time a new drug came out, they were already resistant to all the old drugs. So essentially, they were on one new drug at a time, and it wasn’t effective in reducing viral loads,” he says. “So people were still dying of HIV.”
The suffering of his patients drove his actions. “AIDS patients really had no choice except to go through what in many cases was a very painful and slow death process,” Genereux says.
His conviction centred on two cases, he explains. Both men had HIV but were not facing imminent death. One case involved a very well-educated young man. “He made the decision that he wanted to go on his own terms. Eventually, at the time that he chose he overdosed on a prescription of barbiturates that he had,” he says. “I had prescribed the medication for him.”
Genereux knew what he was doing. “I knew that it was against the law that existed,” he says, but he adds that what he did was not exceptional. “This was common practice at the time. Most of the doctors who were treating HIV at that time were doing this,” he says.
About the same time that Genereux was serving his time in prison, American doctor Jack Kevorkian was making headlines for providing assistance in the suicides of more than 100 people. He was convicted of murder in 1999.
“A lot of people think that it was Kevorkian who was the first physician in North America to be convicted about this,” Genereux says, “but actually, I was in jail when he was convicted.”
After his release, Genereux eventually became medical director of a pharmaceutical company and then retired to the West Coast.
His thoughts on the recent Supreme Court decision?
“Too little, too late, I guess,” he says. “I am, of course, pleased that the Supreme Court and the Canadian Medical Association are finally in agreement with a philosophy that many of us at the front lines of treating catastrophic illnesses have held and practised out of a sense of responsibility and duty to support an informed patient in his/her choices.”
On a personal level, he says that the decision is reassuring in the event he seeks medical assistance at the end of life. He also can’t help reflecting on his own role in this issue.
“It’s sort of a burden that I’ve been carrying around for a long time because practising medicine was the most important thing — and always had been — that I had. It’s what I had worked for all my life. That was a big blow to my self-esteem, to be treated like that and lose my licence. I do have some hostility, I guess, about what happened. I’ve come to terms with it, basically. I wish they would reverse and reinstate my licence, but that’s not likely to happen.”
He laments that the medical establishment did not support him when the case came up. “The medical community was completely unsupportive of me at the time,” he says. “A lot of that had to do with they didn’t want to draw any attention to themselves because many of them had done the same thing.”
In 2007, a Vernon, BC, doctor received a two-year conditional sentence to be served in the community and lost his licence to practice medicine after he prescribed a 92-year-old patient a deadly dose of medications, in what appears to be the only other case in which the law was applied. In 1997, a Nova Scotia doctor was charged with first-degree murder in the death of a cancer patient, but a judge declined to bring the case to trial.