Category: Procedures & Services

Freedom to refuse euthanasia relevant to protection of practitioners, institutions – and patients

Alberta’s Bill 18 in light of assurances to Supreme Court of Canada

News Release

For immediate release

Protection of Conscience Project

Introduced on 18 March in the provincial legislature, the Alberta Government’s Bill 18, the Safeguards for Last Resort Termination of Life Act, will provide the framework for Alberta’s provision of euthanasia and assisted suicide (EAS: known in Canada as “Medical Assistance in Dying”/MAiD).

The bill makes no reference to conscience. Nonetheless, it appears to offer substantial protection for health care practitioners and health care facilities by formally recognizing their freedom to refuse to collaborate in killing patients or helping patients kill themselves.

“In this respect, Bill 18 seems to deliver on assurances given to the Supreme Court of Canada by the late Joseph Arvay,” said Sean Murphy, Administrator of the Protection of Conscience Project.

Joseph Arvay led the constitutional challenge that ended the absolute prohibition of euthanasia and assisted suicide in Canada.

“The title of Bill 18 reflects what Mr. Arvay told the Supreme Court of Canada,” explained Murphy. “He believed that physicians were ideal euthanasia practitioners because, in his words, ‘[I]t is an irrefutable truth that all doctors believe it is their professional and ethical duty to do no harm.’”

Which means, in almost every case, that they will want to help their patients live, not die. It is for the very reason that we advocate only physician assisted dying and not any kind of assisted dying because we know physicians will be reluctant gatekeepers, and only agree to it as a last resort.1

“Mr. Arvay assured the Supreme Court of Canada that physicians would only agree to euthanasia as a ‘last resort,’” said Murphy. “So far, Alberta’s government seems to be the only one in Canada willing to make that a reality.”

“That is important not only for practitioners who object to euthanasia and assisted suicide in principle, but for EAS practitioners who may be unwilling to collaborate in the procedures in particular cases,” he added. “And, if we accept Mr. Arvay’s reasoning, it is equally important for the protection of patients.”

The Protection of Conscience Project does not take a position on the acceptability of morally/ethically contested services like EAS. It is reviewing the text of Bill 18 with a view to making a submission to the Alberta government.

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
protection@consciencelaws.org

Notes:

  1. Carter v Canada (Attorney General), 2015 SCC 5, [2015] 1 SCR 331 (Oral argument, Appellant), Supreme Court of Canada (SCC), “Webcast of the Hearing on 2014-10-15” (22 January, 2018) at 00:20:03 to 00:20:40. ↩︎

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

Action launched against 3 more Toronto doctors for COVID-19 misconduct

Global News

Ashleigh Stewart

An investigation has been launched into a Toronto doctor and two more have had further restrictions imposed on their licences due to alleged COVID-19-related misconduct in the past 24 hours, the College of Physicians and Surgeons of Ontario (CPSO) has confirmed.

Global News has learned that Dr. Ira Bernstein, a family doctor who co-founded the Canadian Covid Care Alliance (CCCA), which has spawned a telehealth service offering ivermectin to Ontarians, is being investigated by the CPSO. . . Dr Christopher Hassell, who Global News also highlighted in its investigation, had his licence restrictions upgraded to a suspension. . . .The second doctor whose licence received restrictions on Thursday due to COVID-related issues was cancer physician Dr Akbar Khan. . . continue reading