During the 146th Annual General Meeting of the Canadian Medical Association in Calgary, Alberta, discussion of motions concerning euthanasia and assisted suicide demonstrated how contentious the issues are for physicians. The delegates could not even agree upon what terminology should be used for the procedures, referring the question to the CMA board of directors. [Vancouver Sun; CMAJ] However, delegates “easily” passed a motion put forward by one of the delegates to support physician freedom of conscience:
Category: Euthanasia
Editorial: Rx: No to assisted suicide
Calgary Herald
They’re the forgotten ones in the heated debate over assisted suicide — the doctors.
Up until now, discussion of the issue has focused exclusively on patients. However, a new Canadian Medical Association survey that shows only about one-quarter of doctors would be willing to participate in an assisted suicide should act as a warning to all. Suddenly, the doctors’ perspective comes into plain view — doctors do not want to help kill people.[Full text]
Most Canadian doctors unwilling to partake in physician-assisted suicide if legalized, survey suggests
Calgary Herald
Just 26 per cent of doctors surveyed by the Canadian Medical Association said they would be “very or somewhat likely” to participate in doctor-assisted dying.
Only one quarter of the nation’s doctors would be willing to help terminally ill patients end their lives if the practice of doctor-assisted suicide were legalized in this country, a survey by Canada’s biggest doctors’ group suggests.
Just 26 per cent of doctors surveyed by the Canadian Medical Association said they would be “very or somewhat likely” to participate in doctor-assisted dying, while 54 per cent were “very or somewhat unlikely” to do so, according to a summary of the survey posted on the CMA’s website. [ Full text]
Most Flemish physicians avoid euthanasia
Only 400 of 20,000 Flemish physicians are trained to provide euthanasia. It appears that most physicians do not want to be directly involved with it. In consequence, the 400 are called upon frequently to provide the required second opinion and sometimes the lethal injection. There have been complaints that they are not paid for the second opinion. [Bioedge] Confirming the reluctance of physicians to participate in the procedure, Dr. Sarah Van Laer complains that “there are too few doctors ready to perform euthanasia” and that this is a “badly underestimated problem.” [Bioedge]
Redefining the practice of medicine – Part 3
Winks and nods and euthanasia in Quebec
Re: Bill 52: An Act respecting end-of-life care (June, 2013)
Part 3: Working in the MAD matrix
Abstract
“Medical aid in dying” in Bill 52 (An Act respecting end-of-life care) will be transformed into euthanasia using the structures and powers established by other Quebec statutes governing the delivery of health care. These laws have established a multi-layered and overlapping bureaucracy. If Bill 52 passes, health care providers and others who want no part of euthanasia will find their working environments increasingly controlled by a MAD matrix functioning within this system.
The Minister for Social Services and Youth Protection may issue “policy directions” about euthanasia. Health care in every region in Quebec is delivered under the direction of a regional health and social service agency. In addition, local health and social services networks have been established. These will be expected to provide or facilitate euthanasia.
Almost all local community service centres, hospital centres or residential and long-term care centres will be required to offer euthanasia, as will rehabilitation centres, which serve developmentally disabled patients. Palliative care hospices and hospitals are not required to do so. Physicians associated with private health care facilities must not provide euthanasia unless authorized by a local health authority.
Policies, standards, codes of ethics, protocols, guidelines, directives, etc. can be used to normalize euthanasia, and disciplinary and complaints procedures can be used to force participation in it. Local complaints commissioners, the Health and Social Services Ombudsman and syndics (investigators) for professional orders could create considerable difficulty for objecting physicians.
Under Quebec’s Professional Code, the Physicians’ Alliance for Total Refusal of Euthanasia, the Euthanasia Prevention Coalition and other groups that oppose euthanasia might face substantial fines if they persist in encouraging or advising physicians not to participate in the procedure.
Physicians may refuse to provide euthanasia if the patient is legally ineligible, and for other reasons, including conscientious objection. Section 30 of the bill should be amended to avoid unnecessary conflict with objecting physicians. Section 44, the provision specific to conscientious objection, is inadequate. Further, patients may lodge complaints against physicians who refuse to provide or facilitate euthanasia with institutions and the regulatory authority, regardless of the reasons for refusal.
Despite the promise of immunity, some Quebec physicians may be unwilling to provide euthanasia while the criminal law stands, even if they do not object to the procedure. Similar reluctance might arise in regional health agencies, councils of physicians or other entities responsible for issuing MAD guidelines. Some might deliberately and obstinately interpret “medical aid in dying” to exclude killing patients, on the ground that the Act does not explicitly require or permit euthanasia, and the criminal law precludes such an interpretation.
Finally, objecting physicians might be able to appeal to the Public Protector, who is empowered to intervene “whenever he has reasonable cause to believe that a person or group of persons has suffered or may very likely suffer prejudice as the result of an act or omission of a public body.” [Full commentary]