No Other Options

Newly revealed documents depict a Canadian euthanasia regime that efficiently ushers the vulnerable to a “beautiful” death.

New Atlantis

Alexander Raikin

“I find that the act of offering the option of an assisted death is one of the most therapeutic things we do,” Stefanie Green tells me. She sees it in the faces of her patients — they’re “relieved.” Sometimes it actually means they’ll choose to live longer, to keep fighting, because now they know they can end their suffering if it becomes intolerable.

I wanted to know if Green, a physician specializing in euthanasia in British Columbia, is finding her job easier now than she did at first. “Is it more normal for me to be writing scripts and picking up lethal drugs and driving across town and doing this?” she asks back. It’s a rhetorical question. “Yeah, it’s oddly okay for me to be doing that. I don’t find it shocking anymore, but the events are still extraordinary.”

Green has her own term for these extraordinary events, drawing on her prior experience as an obstetrician, when she helped bring people into the world. “At both ‘deliveries,’ as I call them, I am invited into a most intimate moment in people’s lives,” she writes in her book.

The procedure, she assures me on our call, is “100 percent effective.” If her patient asks to die, and if her schedule, her ethics, and the law permits it, she will administer a lethal injection. . . continue reading

Ontario College of Physicians cautioned against disciplining physicians

Irremediability of mental illness, eligibility for euthanasia in dispute

News Release

For immediate release

Protection of Conscience Project

MAID (Medical Assistance in Dying, euthanasia/assisted suicide) becomes available in Canada for patients with mental illness alone in March, 2023. A patient must have an irremediable medical condition to be eligible for MAID, but a number of prominent Canadian psychiatrists insist that mental illness cannot be classified as an irremediable medical condition.

Now the College of Physicians and Surgeons of Ontario (CPSO) has been cautioned that it cannot discipline these physicians if they refuse to facilitate requests for euthanasia or assisted suicide from patients they consider ineligible for the services.

The comments are included in a submission from the Protection of Conscience Project on the CPSO’s draft revision of its MAID policy.

The submission also recommends that the CPSO explicitly reiterate its position that euthanasia/assisted suicide requests are not emergencies. A statement to that effect was deleted from the draft MAID policy, which now cites a resource suggesting that practitioners providing euthanasia/assisted suicide in the community should call 911 if they need help from paramedics emergency room staff to establish IV access.

Repeating a previous recommendation, the Project urged that responsible practitioners should be required to be present and remain with patients self-administering MAID drugs until death ensues. Failed unaccompanied self-administration can bring patients to hospital emergency rooms, causing conflict and distress. Successful unaccompanied self-administration could lead to delayed discovery of corpses in disturbing circumstances, triggering police and coroner investigations.

Practitioners unwilling to falsify death certificates for euthanasia/assisted suicide should not be forced to do so, says the Project, since falsification of death certificates is contrary to accepted international standards and can be considered deceptive, unethical or professionally ill-advised.

Finally, the Project recommends that the CPSO provide ethical direction or guidance about proceeding with euthanasia when an incapacitated patient who has signed a waiver of final consent has expressed ambivalence about proceeding. Ambivalence falls short of the Criminal Code threshold of refusal, so a practitioner can legally proceed if a patient has expressed only ambivalence.

The Protection of Conscience Project is a non-profit, non-denominational initiative that supports health care workers who want to provide the best care for their patients without violating their own personal and professional integrity.  It does not take a position on the acceptability of morally contested procedures.


Contact: Sean Murphy, Administrator (protection@consciencelaws.org)

The Protection of Freedom of Conscience Act Introduced in the House of Commons


News Release

FOR IMMEDIATE RELEASE

Kelly Block, M.P.

OTTAWA, Ontario – Earlier today, Kelly Block, Member of Parliament for Carlton Trail – Eagle Creek, tabled a private members bill to protect the conscience rights of medical professionals.

“Over the past two years, we have seen just how important our health care system is and how critical the medical professionals who work in that system are to Canadians,” said MP Block. “We need to create a work environment for medical professionals that protects them, supports them, and encourages them to continue in the critical work they do.”

The bill would amend the Criminal Code to make it a punishable offense to intimidate or coerce a medical professional to take part in medically assisted suicide as well as make it an offence to fire or refuse to hire a medical professional if the sole reason is their refusal to take part in medically assisted suicide.

Dr. Heidi Janz, adjunct professor at the University of Alberta and the chair of the Ending-of-Life Ethics Committee with the Council of Canadians with Disabilities, says, “Canada needs conscience-rights protections for medical professionals because Canadians with disabilities and chronic illnesses have a right to medical professionals who choose to stand against the systemic ableism that deems people to be better off dead than disabled. We have a right to safe doctors who will help us fight for our lives. In short, the human rights of Canadians with disabilities and chronic illnesses demand the protection of the conscience rights of medical professionals.”

When introducing the Bill in the House of Commons, MP Block said, “Medical professionals are facing increasing pressure to participate in assisted suicide, and this is causing many to question their ability to work in Canada. I encourage all my colleagues in this place to support this bill’s speedy passage and thereby demonstrate a deep commitment both to our amazing medical professionals and to the Canadian Charter of Rights and Freedoms.

This Bill protects the doctor-patient relationship by ensuring doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patient. Every patient deserves a second opinion. Conscience protections ensure that second opinions are always an option.

Media contact:
Email: Josh.Boyes.654@parl.gc.ca
Phone: 613-995-1551

College of Psychiatrists of Ireland warns against introduction of assisted dying legislation in Ireland

College publishes major paper on the issue

The College of Psychiatrists of Ireland (College of Psychiatrists) has warned that physician-assisted suicide and euthanasia (PAS-E) is not compatible with good medical care and that its introduction in Ireland could place vulnerable patients at risk.

PAS-E is also known as “assisted dying” and in the New Year the issue will be the focus of a Special Oireachtas Committee set up to examine the Dying with Dignity Bill (2020).

The College of Psychiatrists is the professional and training body for psychiatrists in Ireland and represents 1,000 professional psychiatrists (both specialists and trainees) across the country.  It has today published a position paper on this issue [see editors’ note below] which sets out some key issues regarding the introduction of assisted dying in Ireland.  These include:

  • Assisted dying is contrary to the efforts of psychiatrists, other mental health staff and the public to prevent deaths by suicide.
  • It is likely to place vulnerable people at risk – many requests for assisted dying stem from issues such as fear of being a burden or fear of death rather than from intractable pain.  Improvements in existing services should be deployed to manage these issues.
  • While often introduced for patients with terminal illness, once introduced assisted dying is likely to be applied more broadly to other groups, such that the numbers undertaking the procedure grow considerably above expectations;
  • The introduction of assisted dying represents a radical change in Irish law and a long-standing tradition of medical practice, as exemplified in the prohibition of deliberate killing in the Irish Medical Council ethics guidelines;

Consultant Liaison Psychiatrist Dr Eric Kelleher is a member of the College of Psychiatrists and contributing author to the position paper on assisted dying.

Speaking today, he said: “We are acutely aware of the sensitivity of this subject, and understand and support the fact that dying with dignity is the goal of all end-of-life care. Strengthening our palliative care and social support networks makes this possible. Not only is assisted dying or euthanasia not necessary for a dignified death, but techniques used to bring about death can themselves result in considerable and protracted suffering”.

“Where assisted dying is available, many requests stem, not from intractable pain, but from such causes as fear, depression, loneliness, and the wish not to burden carers. With adequate resources, including psychiatric care, psychological care, palliative medicine, pain services, and social supports, good end-of-life care is possible,” he said.

Dr Siobhan MacHale, Consultant Liaison Psychiatrist, a member of the College of Psychiatrists and contributing author to the position paper on assisted dying, said: “Once permitted in a jurisdiction, experience has shown that more and more people die from assisted dying. This is usually the result of progressively broadening criteria through legal challenges because, if a right to assisted dying is conceded, there is no logical reason to restrict this to those with a terminal illness.”

She continued: “Both sides of this debate support the goal of dying with dignity, but neither the proposed legislation nor the status quo (as evidenced by both clinical experience and the power of this debate) is sufficient. It is imperative for the Irish people to continue to demonstrate leadership as a liberal and compassionate society in working together to achieve this.”

The College of Psychiatrists of Ireland’s position paper on physician-assisted suicide and euthanasia is available to view in full here.

Issued on behalf of the College of Psychiatrists of Ireland by Gordon MRM

Julian Fleming: Ph: 087 6915147 | julian@gordonmrm.ie

Karen McCourt, CPsychI Communications Officer: kmccourt@irishpsychiatry.ie

Ontario conscience campaign

Coalition for HealthCARE and Conscience

  Dear Friend

July 2021 survey shows 85% of Ontarians are supportive of legislation to make participation in MAID (medical assistance in dying) voluntary for healthcare professionals.

We are concerned that patients, particularly vulnerable ones with disabilities, chronic illness and persons with mental health concerns, will choose or be forced into MAID because of a lack of options, social support networks or available services. In all cases, the opinion and clinical experience of the primary healthcare professional provides an important check and balance against hasty, ill-informed, or improper MAID requests.

 Please write the Ontario government today using the letter on our website to encourage them to create legislation to protect doctors, nurses, pharmacists, and other healthcare professionals so they can continue to properly care for patients. Even if you have written before – including recently – please write Ontario legislators today to let them know you want conscience legislation this fall.

Click on the button below to write your MPP.

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