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)

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