Category: Codes of Ethics

Saskatchewan doctors could face discipline over assisted suicide

Global News

Doug Lett

SASKATOON – Doctors in the province who refuse to cooperate with physician-assisted suicide could face discipline according to the College of Physicians and Surgeons of Saskatchewan.

“If a physician feels the directives are wrong, they will still, we would expect, they will still follow those directives,” said Bryan Salte, associate registrar of the college, “in spite of the fact they may not agree with them.”

While the college has not come up with policies around assisted suicide, it is circulating a draft policy on conscientious refusal. It says while doctors can refuse to provide a legally provided service if it violates their freedom of conscience, they do have to make a referral to another health care provider who will do it.

That means a doctor who believes suicide is wrong would still have to refer a patient to a doctor who would help them kill themselves. . . [Full Text]

 

Why a ‘conscience clause’ is essential in assisted suicide legislation

Pharmacists must be allowed to opt out of dispensing lethal prescriptions if assisted suicide is legalised, and this right should be protected in law, says Aileen Bryson, policy and practice lead at Royal Pharmaceutical Society Scotland.

The Pharmaceutical Joural

Aileen Bryson

Assisted suicide is a sensitive and emotional subject, and if it were legalised many pharmacists would play important roles in the process  –  including requests to dispense prescriptions that would end lives.

So when legislation to allow assisted suicide was proposed in both Scottish and Westminster Parliaments in 2012, the national pharmacy boards of the Royal Pharmaceutical Society (RPS) developed a policy to address the challenges and issues the profession might encounter.

RPS policy neither supports nor opposes the Bills. But we wanted to ensure politicians understood that the pharmacist’s role reaches far beyond supply, and that pharmacists would need to work in partnership with medical colleagues. Moreover, as healthcare professionals, the concept of dispensing a prescription that would end someone’s life is quite outside the realm of routine pharmacy practice and raises many ethical and practical questions. . . [Full Text]

 

Helping suffering patients die may be doctor’s most humane option, Canadian Medical Association says

National Post

Sharon Kirkley

For the first time, the Canadian Medical Association has said helping a suffering patient die may be a doctor’s most humane option.

In a new position statement approved by its board, the CMA – once firmly opposed to any form of doctor-hastened killing – now states “there are rare occasions where patients have such a degree of suffering, even with access to palliative and end of life care, that they request medical aid in dying. In such a case, and within legal constraints, medical aid in dying may be appropriate.”

The policy change comes as the powerful doctors’ lobby prepares for a possible lifting of the federal ban on assisted suicide when the Supreme Court of Canada releases its historic ruling Friday morning in Ottawa.

If the top court strikes down laws making it a criminal offence to “counsel, aid or abet” another person to commit suicide,  “we’re going to need to hit the ground running if we want to lead and do this well,” said CMA president Dr. Chris Simpson. . . . [Full Text]

Saskatchewan physicians to be forced to do what they believe to be wrong

Policy wording supplied by abortion and euthanasia activists

Policy would apply to euthanasia, if legalized.

Protection of Conscience Project News Release

The College of Physicians and Surgeons of Saskatchewan is proposing a draft policy demanding that physicians who object to “legally permissible and publicly-funded health services” must direct patients to colleagues who will provide them.  If another physician is unavailable, the College demands that they provide “legally permissible and publicly-funded” services,  even if doing so “conflicts with physicians’ deeply held and considered moral or religious beliefs.”

Physicians usually refuse to participate in abortion because they believe it is wrong to kill what the criminal law refers to as a child that has not become a human being.1 The proposed policy will require them to find a physician willing to do the killing they won’t do.  Should the Supreme Court of Canada legalize euthanasia, the policy will require objecting physicians who refuse to kill patients to find someone who will.

The seamless fit between referral for abortion and referral for euthanasia is not surprising.  The draft College policy was largely written by abortion and euthanasia activists, notably Professor Jocelyn Downie of Dalhousie University.

In a 2006 guest editorial in the Canadian Medical Association Journal, Professor Downie and another law professor claimed that objecting physicians are obliged to refer patients for abortion.2  Their views were vehemently rejected by physicians and repudiated by the Canadian Medical Association.3  Partly as a result of the negative response, Professor Downie and her colleagues in the “Conscience Research Group” decided to convince Colleges of Physicians and Surgeons to impose it.4

Saskatchewan’s draft policy is taken almost verbatim from their “Model Conscientious Objection Policy.”

The Conscience Research Group is  a tax-funded initiative that includes Professors Downie and Daniel Weinstock.5   Both  were members of an “expert panel” that recommended that health care professionals who object to killing patients should be compelled to refer patients to someone who would,6 because (they claimed) it is agreed that they can be compelled to refer for “reproductive health services.”7

Current efforts by the College of Physicians and Surgeons of Ontario to suppress freedom of conscience in the medical profession may have been influenced by the Conscience Research Group.  However, the College in Saskatchewan is the first to copy and paste its preferred model into a draft policy.

The Project insists that it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous.

The College Council has approved the policy in principle, but will accept feedback on it until 6 March, 2015.

Notes:

1.  Criminal Code, Section 238(1). (Accessed 2014-12-02)

2. Rodgers S. Downie J. “Abortion: Ensuring Access.” CMAJ July 4, 2006 vol. 175 no. 1 doi: 10.1503/cmaj.060548 (Accessed 2014-12-02).

3.  Blackmer J. Clarification of the CMA’s position on induced abortion. CMAJ April 24, 2007 vol. 176 no. 9 doi: 10.1503/cmaj.1070035 (Accessed 2014-02-22)

4.   McLeod C, Downie J. “Let Conscience Be Their Guide? Conscientious Refusals in Health Care.” Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12075 Volume 28 Number 1 2014 pp ii–iv

5.   Let their conscience be their guide? Conscientious refusals in reproductive health care: Meet the team.(Accessed 2014-11-21)

6.  Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 101 (Accessed 2014-02-23)

7.   Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62 (Accessed 2014-02-23)

Ontario physicians to be forced to do what they believe to be wrong

Draft policy demands that objectors provide or refer.

Policy would apply to euthanasia, if legalized.

Protection of Conscience Project News Release

A draft policy of the College of Physicians and Surgeons of Ontario demands that physicians must provide services to prevent imminent “harm, suffering and/or deterioration,” even if doing so is contrary to their moral beliefs.

Should the Supreme Court of Canada legalize euthanasia, the policy will require objecting physicians to lethally inject patients themselves if a delay would result in “harm” or “suffering.” In less urgent circumstances, the policy will require physicians unwilling to kill patients to promptly refer them to “a non-objecting, available physician or other health-care provider.”

However, many physicians who object to killing patients for reasons of conscience would also object to referral. Dr. Charles Bernard, President of Quebec’s Collège des médecins, has explained that mandatory referral effectively nullifies freedom of conscience: “It is as if you did it anyway.”1

Dr. Bernard was talking about Quebec’s euthanasia law, but the same principle holds with respect to abortion – another procedure that involves killing.

Prominent academics and activists want to force objecting physicians to provide or refer for abortion and contraception. They and others have led increasingly strident campaigns to suppress freedom of conscience among physicians to achieve that goal. The College’s draft policy clearly reflects their influence.

However, crusades against physicians who refuse to provide or refer for abortion are dress rehearsals for eventual campaigns against physicians who refuse to kill patients. It is not a coincidence that activists who would force objecting physicians to facilitate abortion and contraception also intend to force objectors to refer for euthanasia – and for the same reasons.2

The Project insists that it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous.

The College Council has tentatively approved the policy, but will accept further public input until 20 February, 2015 before imposing it on Ontario physicians.

Notes:

1.  Consultations, Tuesday 17 September 2013 – Vol. 43 no. 34: Collège des médecins du Québec, (Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand) T#154

2. For example: Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62, 69, 101 (Accessed 2014-02-23)