Mexico enacts provision protecting freedom of conscience for physicians, nurses

Sean Murphy*

Mexico has added a provision to its General Law on Health recognizing freedom of conscience of all physicians and nurses in relation to all services, except in emergencies and life-threatening situations.  In doing so, those responsible took note of existing provisions in The Bioethics Code for Health Personnel and The Code of Conduct for Health Personnel.  The latter includes a particularly striking passage:

32.  It should be emphasized that doctors are  professionals of science and conscience, and cannot be reduced to mere instruments of the patient’s will, since, like the patient, they  are free and responsible persons with a unique collection of values that regulate their lives.

There is no requirement for referral, which many objecting health care workers would find unacceptable because of concern that referral would make them complicit in what they believe to be wrongful conduct.  The new provision is specific to freedom of conscience and does not address issues of access and availability of non-objecting personnel, which will presumably be managed administrative measures or other legal means.

B.C. doctor cleared of wrongdoing for providing assisted death to woman who starved herself

Globe and Mail

Kelly Grant

British Columbia’s physician regulator has cleared a doctor of any wrongdoing for providing medical aid in dying to a woman who did not qualify for the procedure until she starved herself to the brink of death.

A committee of the College of Physicians and Surgeons of British Columbia (CPSBC) found that Ellen Wiebe did not break the regulator’s rules when she helped a 56-year-old patient known as Ms. S to die last year.

The case is the first to be made public in which a medical regulator has ruled on the contentious question of whether doctors should grant assisted deaths to patients who only satisfy all the criteria of the federal law after they stop eating and drinking.

“It was determined that Ms. S met the requisite criteria and was indeed eligible for medical assistance in dying, despite the fact that her refusal of medical treatment, food, and water, undoubtedly hastened her death and contributed to its ‘reasonable foreseeability,'” the college’s inquiry committee wrote in a Feb. 13 report. . . . [Full text]

 

Has stopping eating and drinking become a path to assisted dying?

Policy Options

Jocelyn Downie

Can patients, by stopping eating and drinking, make themselves meet the criteria for a “grievous and irremediable medical condition,” the requirement to access MAiD?

Ms. S. was a 56-year-old woman with advanced multiple sclerosis. In June 2016, when her suffering became intolerable and her state of decline was advanced as a result of her incurable medical condition, she asked Dr. Ellen Wiebe for medical assistance in dying (MAiD). Ms. S. had earlier declined potentially effective treatment. Dr. Wiebe concluded that Ms. S. met most of the eligibility criteria for MAiD in Canada: incurable condition, advanced state of decline in capability, and enduring and intolerable suffering not remediable by any means acceptable to her. However, as she did not believe that Ms. S. would die “in the foreseeable future,” she deemed her not to meet the final eligibility criterion for MAiD: “natural death has become reasonably foreseeable.” Ms. S. asked again for MAiD in December 2016 and January 2017 and each time she was deemed ineligible on the same grounds. . . [Full Text]

Protecting conscience: Why this House of Lords bill is aimed at defending healthcare professionals

Christian Today

Laurence Wilkinson

With the Brexit legislation receiving the lion’s share of attention in Parliament, there has been little to no coverage on the progression of any other bill in recent months. This is usually the time of year where activity on private members’ bills (which have only a small chance of passing into law) winds down. However, with the current Parliamentary Session being extended to two years to deal with the magnitude of the Brexit legislation, we are in extraordinary times.

There is one such private member’s bill before the House of Lords which has seen a surprising ramp-up in activity over the last few months. The bill is sponsored by Baroness O’Loan – a widely respected legal mind from Northern Ireland who was the first Police Ombudsman – and will have its committee stage today, Friday. It is focused on the relatively niche area of protection of conscience for healthcare professionals. . . [Full text]

 

Nurse practitioners not always compensated for providing medical assistance in dying

Ministry of Health and Long Term Care does not provide fee-for-service the way it does for physicians

CBC News

Angela Gemmill

The Nurse Practitioners Association of Ontario says some of its members are helping to provide their patients with medically assisted deaths without compensation.

It wasn’t until April of 2017 that nurse practitioners (NPs) in Ontario could prescribe the controlled substances used for medical assistance in dying (MAID).

Since then about 40 NPs across the province have provided either patient assessments or the procedure itself.

A patient must be assessed by two independent health care providers. This can be either a physician or a nurse practitioner. The procedure is the same regardless of who provides it.

One nurse practitioner in Sudbury, Ont. says it’s important for her to provide support to patients who want to take this step. She admits that medical assistance in dying is rather limited in Sudbury, in that not a lot of physicians or nurse practitioners are willing to provide it for patients. . . [Full text]