Report on physician-assisted dying gives attention to key issues; critical matters still to be addressed with federal legislation

A Statement from Dr. Cindy Forbes, President of the Canadian Medical Association

News Release

Canadian Medical Association

OTTAWA, Feb. 25, 2016 /CNW/ – The Canadian Medical Association (CMA) is pleased to see physician input reflected in a number of recommendations released today in the report of the Special Joint Committee on Physician-Assisted Dying.

In particular, the CMA welcomes the recommendation to re-establish a secretariat on palliative and end-of-life care and to implement a pan-Canadian palliative care strategy with dedicated funding. We are also pleased to see the recommendation for the development of a pan-Canadian strategy to improve quality of care and services received by individuals living with dementia.

While there is much to praise in this report, it does fall short on the issue of respecting a physician’s right to conscientious objection. As the government moves forward in drafting legislation, we must focus on ensuring effective access while also respecting different views of conscientious objection. Both can be achieved. While not addressed by this report, a central mechanism to coordinate access must be a key part of the solution.

The doctors of Canada hope that the recommendations outlined in today’s report will result in a consistent approach across provinces, including federally-coordinated reporting and oversight. In particular, we are dedicated to finding a solution, in partnership with legislators and regulators, that ensures patients have effective access to the service should they need it, no matter where they live.

–Dr. Cindy Forbes, President of the Canadian Medical Association

For further information: mediainquiries@cma.ca, 613-806-1865

The Canadian Medical Association (CMA) is the national voice of Canadian physicians. Founded in 1867, the CMA is a voluntary professional organization representing more than 83,000 of Canada’s physicians and comprising 12 provincial and territorial medical associations and over 60 national medical organizations. CMA’s mission is helping physicians care for patients. The CMA will be the leader in engaging and serving physicians and be the national voice for the highest standards for health and health care.

 

SOURCE Canadian Medical Association Report on physician-assisted dying gives attention to key issues; critical matters still to be addressed with federal legislation

 

Archbishop alarmed at erosion of respect for life

Report fails to reflect witnesses’ call for palliative care, conscience rights

News Release

Roman Catholic Archdiocese of Vancouver

VANCOUVER (Feb. 25, 2016) – The leader of the Catholic community in the Lower Mainland called the joint Senate-Commons committee report on assisted-suicide “deeply disappointing.”

Archbishop J. Michael Miller said “Canadians, especially those dying or suffering from illness, deserve better. It’s alarming how easily suicide is being offered and respect for life eroded.”

Miller pointed out a serious omission in the report. “Where is the plan for protecting the Charter rights of Canadians who don’t want to participate in causing patients to die?” he asked. “Many health-care workers believe strongly in saving lives and ending suffering—but not in ending lives. Canadians from many ethical traditions just won’t be able to go along with this. Where is there room for them in medical care? No one can ethically be forced to take part in causing their patient to die. New laws need to ensure their Charter rights are protected as well.”

The Archbishop said he was troubled that the committee disregarded the testimony of so many witnesses who had called for conscience protection for health-care workers and institutions.

The report also fails to make palliative care the high priority many witnesses called for. “Unfortunately the report treats palliative care almost as an afterthought. It’s dismaying that a committee would propose assisted suicide as a ‘choice’ to people who are suffering. Without a real, effective, alternative, what kind of free choice is that?”

He said the committee appeared to have made its preference for assisted suicide clear from the start by choosing the euphemism “medical assistance in dying.” “Doctors have always assisted people who are dying,” he said. “What we are talking about here is medically causing the patient to die.”

He urged Justice Minister Jody Wilson-Raybould to reject the report, to acknowledge the numerous sincere objections in the dissenting portion of the report, and to draft legislation taking into account the testimony of the many witnesses who brought forward concerns about implementing assisted suicide in Canada.

-30-

Paul Schratz Communications Director
communications@rcav.org
604-683-0281

Special Joint Committee on Physician Assisted Dying

Parliament of Canada (January-February, 2016)

Overview

Contents

Introduction

In February, 2015, in the case of Carter v. Canada (Attorney General), the Supreme Court of Canada struck down the criminal prohibition of physician assisted suicide and physician administered euthanasia, but suspended the ruling for one year to give federal and provincial governments an opportunity to draft new laws that conform to the decision.  In January, 2016, the Court granted an extension of the suspension to 6 June, 2016.  In the interim, ith it allowed euthanasia to proceed in Quebec under provincial legislation in force there, and allowed individuals seeking physician assisted suicide or euthanasia elsewhere to apply to a superior court to obtain authorization.  A special joint committee of the Canadian House of Commons and Senate began work in January to produce a report for the federal government about proposed federal legislation.

Committee Pages

Proceedings

Transcripts

Committee proceedings have not been transcribed verbatim.  On important points, transcripts should be checked against the video to ensure accuracy.

French language materials

French language videos and transcripts can be found by using the links below to access the parliamentary English language page, and then clicking on the French language icon or link at the upper right corner of the parliamentary page.

Meetings

Groups and individuals were heard during 10 Committee meetings, which are listed and outlined below.  The outline of each meeting includes:

  • Meeting number and date
  • Links to full videos and transcripts of the meeting
  • Witness list
  • Links to videos edited to show exchanges relevant to freedom of conscience
  • Links to briefs submitted by the groups/individuals
  • Links to extracts from group/individual briefs relevant to freedom of conscience (+)

Meeting No. 2
18 January, 2016  |  Video |  Transcript

  • Department of Justice
    • Joanne Klineberg, Senior Counsel, Criminal Law Policy Section
    • Jeanette Ettel, Counsel, Human Rights Law Section

Meeting No. 3
25 January, 2016 | Video | Transcript

  • Department of Health
    • Abby Hoffman, Assistant Deputy Minister, Strategic Policy
    • Sharon Harper, Manager, Chronic and Continuing Care Division
  • As an individual
    • Peter Hogg, Scholar in Residence, Blake, Cassels & Graydon LLP
  • Barreau du Québec
    • Marc Sauvé, Director, Research and Legislation Services
    • Jean-Pierre Ménard, Lawyer

Meeting No. 5
26 January, 2016 | Video | Transcript

  • External Panel on Options for a Legislative Response to Carter v. Canada
    • Benoît Pelletier, Member, External Panel
    • Stephen Mihorean, Executive Director, Secretariat
  • Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying
    • Jennifer Gibson, Co-Chair
    • Maureen Taylor, Co-Chair

Meeting No. 6
27 January, 2016 | Video | Transcript

  • Canadian Medical Association
    • Dr. Cindy Forbes, President
    • Dr. Jeff Blackmer, Vice-President, Medical Professionalism
  • Canadian Nurses Association
    • Anne Sutherland Boal, Chief Executive Officer
    • Josette Roussel, Senior Nurse Advisor
  • Canadian Society of Palliative Care Physicians
  • Canadian Pharmacists Association
  • Canadian Psychiatric Association
    • Dr. K. Sonu Gaind, President
    • Katie Hardy, Director, Professional and Member Affairs

Meeting No. 7
28 January, 2016  | Video | Transcript

  • As an individual
    • Hon. Steven Fletcher
  • Council of Canadians with Disabilities
    • Dean Richert, Co-Chair, Ending of Life Ethics Committee
    • Rhonda Wiebe, Co-Chair, Ending of Life Ethics Committee
  • Dying With Dignity Canada
  • As individuals
    • Jocelyn Downie, Professor, Faculties of Law and Medicine, Dalhousie University
    • David Baker, Lawyer, Bakerlaw
    • Trudo Lemmens, Professor, Faculty of Law & Dalla Lana School of Public Health, University of Toronto

Meeting No. 8
1 February, 2016  | Video | Transcript

  • British Columbia Civil Liberties Association
    • Josh Paterson, Executive Director
    • Grace Pastine, Litigation Director
  • Justice Centre for Constitutional Freedoms
  • Dying With Dignity Canada
    • Wanda Morris, Chief Executive Officer
    • Shanaaz Gokool, Chief Operating Officer and National Campaigns Director
  • College of Family Physicians of Canada
    • Dr. Francine Lemire, Executive Director and Chief Executive Officer
  • Alzheimer Society of Canada
    • Mimi Lowi-Young, Chief Executive Officer
    • Debbie Benczkowski, Chief Operating Officer

Meeting No. 9
1 February, 2016  | Video | Transcript

  • Canadian Cancer Society
    • Gabriel Miller, Director, Public Issues
    • Kelly Masotti, Assistant Director, Public Issues
  • First Nations University of Canada
    • Carrie Bourassa, Professor, Indigenous Health Studies

Meeting No. 10
2 February, 2016 | Video | Transcript

  • As an individual
    • Carolyn Ells, Associate Professor, Medicine, Biomedical Ethics Unit, McGill University
  • Canadian Hospice Palliative Care Association
  • Dying With Dignity Canada
    • Derryck Smith, Chair of Physicians Advisory Council
  • College of Physicians and Surgeons of Nova Scotia
    • Dr. Douglas Grant, Registrar and Chief Executive Officer
    • Marjorie Hickey, Legal Counsel
  • Criminal Lawyers’ Association
    • Leo Russomanno, Member and Criminal Defence Counsel
  • Indigenous Physicians Association of Canada
    • Dr. Alika Lafontaine, President

Meeting No. 11
3 February, 2016 | Video | Transcript

  • Coalition for HealthCARE and Conscience
    • Cardinal Thomas Collins, Archbishop, Archdiocese of Toronto
    • Laurence Worthen, Executive Director, Christian Medical and Dental Society of Canada
  • Canadian Unitarian Council
  • Centre for Addiction and Mental Health
    • Dr. Tarek Rajji, Chief, Geriatric Psychiatry
    • Kristin Taylor, Vice-President, Legal Services
  • Canadian Paediatric Society
    • Dr. Dawn Davies, Chair, Bioethics Committee
    • Mary J Shariff, Associate Professor of Law and Associate Dean Academic, University of Manitoba
  • Canadian Council of Imams

Meeting No 12
4 February, 2016  | Video | Transcript

  • DisAbled Women’s Network of Canada
    • Carmela Hutchison, President
  • Alliance of People with Disabilities Who Are Supportive of Legal Assisted Dying Society
    • Margaret Birrell, President
    • Angus M. Gunn, Counsel
  • As an individual
    • Margaret Somerville, Professor, McGill University
  • The Canadian Medical Protective Association
  • Canadian Association for Community Living
    • Michael Bach, Executive Vice-President
  • As an individual
    • Gerald Chipeur, Lawyer
  • Society of Rural Physicians of Canada

Edited Videos

The edited videos provided here focus on

  • terminology,
  • the continuing effects of the criminal law,
  • the exemptions to criminal prosecution required to allow euthanasia and physician assisted suicide under the terms of the Carter ruling,
  • jursidiction of the federal and provincial governments in relation to criminal law and freedom of conscience and religion,
  • freedom of conscience and religion for individual and institutional health care providers who object to providing or becoming parties to euthanasia or assisted suicide.
List of Edited Videos

Group/individual presentations

Multiple participant discussions

Briefs submitted

Links to the full briefs are provided below.  Click on (+) to see statements from a brief relevant to freedom of conscience and religion for healthcare providers.

By groups/ indivduals appearing as witnesses

By groups/individuals not appearing

Quebec’s new assisted-dying law leaves doctors struggling to adapt

Fear of legal reprisal still widespread among health professionals

CBC News

Two months after Quebec’s assisted-dying law came into effect, about 10 patients have chosen to end their lives with the help of a doctor.

Health Minister Gaétan Barrette says this is a sign that things are going well and there are no systematic obstacles.

“The information that I have from the ground and from the College of Physicians is that teams are in place and that access is there,” Barrette said.

“Problems, if there were any, were resolved quickly.”

Doctors and patient advocates tell a different story.

Jean-Pierre Ménard, a lawyer specializing in health law, says his clients have reported trouble obtaining medical assistance to die. . . [Full text]

 

 

Journalist: shut down Catholic health care facilities that refuse euthanasia, assisted suicide

Sean Murphy*

Doctor Examining an Elderly PatientFollowing a strong statement from the Catholic Bishops of Alberta that Catholic health care facilities will not provide euthanasia or assisted suicide, a columnist at the Edmonton Journal has accused them of defying the Supreme Court of Canada, breaking the law, and denying patients their “legal rights”.

Paula Simons wants to deny public funding to Catholic hospitals, hospices and nursing homes that refuse to allow patients to be killed or helped to commit suicide, which would force them to close, or (more  likely) to be seized by the state through expropriation or other means.

Simons’ column was published the day after statements issued by Covenant Health and Alberta’s Catholic bishops affirmed the traditional opposition of the Catholic Church to euthanasia and assisted suicide, despite the Supreme Court of Canada ruling that ordered legalization of the procedures.

Covenant Health’s Dr. Gordon Self emphasized that the organization was confident that it would “find a way to respond respectfully and compassionately to requests for physician assisted death that does not abandon the person in our care nor compromise the values of care providers or our organization.”

Throughout this process we are committed to upholding the right of both personal and institutional conscience. This will be important for all organizations as they grapple with the same issues of safe and timely co-ordination of care between institutions without abandoning the person in care when their own medical staff conscientiously object. Together we can all learn at this time and benefit from mutual dialogue and thoughtful, ethical reflection.

Alberta’s six Catholic bishops noted that “from a Catholic perspective, the intentional, wilful act of killing oneself or another human being is morally wrong,” so that “no Catholic may advocate for, or participate in any way, whether by act or omission, in the intentional killing of another human being either by assisted suicide or euthanasia.”

The following passage is taken from the bishops’ full statement:

Upholding Conscience Rights

Third, other provincial jurisdictions in Canada have proposed regulations that undermine the conscience rights of physicians and other healthcare workers. This must not be allowed to happen here. Physicians, other medical professionals, and our institutions have to be allowed the freedom that is theirs by right to exercise their conscience, not only to accord with our Charter of Rights and Freedoms, but also as a matter of good medical practice. Morally wrong in itself, the attempt to force a physician to assist in a suicide or to kill another by euthanasia would also fundamentally redefine what it means to be a doctor. Killing is not medicine. Likewise, from an ethical perspective, and certainly from that of Catholic moral teaching, a physician who conscientiously objects to these practices must not be coerced into referring a patient to another professional for assisted suicide or to be euthanized. This would, in fact, be complicity and thus a violation of the person’s right to freedom of conscience. Furthermore, medical professionals who refuse for reasons of conscience direct or indirect participation must also be protected from intimidation and discrimination.

Patient rights and the rights of family members must also be respected – that is, their civil right to access medical care for themselves and their loved ones in which there is no pressure to request or to submit to assisted suicide or euthanasia, and indeed their natural right to be served by doctors and institutions that practice only medicine and are not involved in state-sponsored killing. This is essential to maintaining the relationship of trust between patients and doctors or other care-givers. A great many citizens still intend that their doctors, and the institutions to which they entrust themselves at need, be committed to the Hippocratic oath. They must not be deprived of access to such just because there are other citizens who desire assistance in committing suicide. If they are so deprived, this will have far-reaching consequences, disrupting the relationship of trust with the state as well as with the medical community.

The decision of the Supreme Court of Canada makes legally permissible in some circumstances what is morally wrong in every circumstance: the taking of innocent human life. This is unacceptable in a truly just and ethical society.

Most Reverend Richard W. Smith
Archbishop of Edmonton

Most Reverend Frederick Henry
Bishop of Calgary

Most Reverend Gregory J. Bittman
Auxiliary Bishop of Edmonton

Most Reverend Daniel Motiuk
Bishop of the Ukrainian Eparchy of Edmonton

Most Reverend Girard Pettipas,CSsR
Archbishop of Grouard-McLennon

Most Reverend Paul Terrio,
Bishop of St. Paul