Category: News Releases

College of Psychiatrists of Ireland warns against introduction of assisted dying legislation in Ireland

College publishes major paper on the issue

The College of Psychiatrists of Ireland (College of Psychiatrists) has warned that physician-assisted suicide and euthanasia (PAS-E) is not compatible with good medical care and that its introduction in Ireland could place vulnerable patients at risk.

PAS-E is also known as “assisted dying” and in the New Year the issue will be the focus of a Special Oireachtas Committee set up to examine the Dying with Dignity Bill (2020).

The College of Psychiatrists is the professional and training body for psychiatrists in Ireland and represents 1,000 professional psychiatrists (both specialists and trainees) across the country.  It has today published a position paper on this issue [see editors’ note below] which sets out some key issues regarding the introduction of assisted dying in Ireland.  These include:

  • Assisted dying is contrary to the efforts of psychiatrists, other mental health staff and the public to prevent deaths by suicide.
  • It is likely to place vulnerable people at risk – many requests for assisted dying stem from issues such as fear of being a burden or fear of death rather than from intractable pain.  Improvements in existing services should be deployed to manage these issues.
  • While often introduced for patients with terminal illness, once introduced assisted dying is likely to be applied more broadly to other groups, such that the numbers undertaking the procedure grow considerably above expectations;
  • The introduction of assisted dying represents a radical change in Irish law and a long-standing tradition of medical practice, as exemplified in the prohibition of deliberate killing in the Irish Medical Council ethics guidelines;

Consultant Liaison Psychiatrist Dr Eric Kelleher is a member of the College of Psychiatrists and contributing author to the position paper on assisted dying.

Speaking today, he said: “We are acutely aware of the sensitivity of this subject, and understand and support the fact that dying with dignity is the goal of all end-of-life care. Strengthening our palliative care and social support networks makes this possible. Not only is assisted dying or euthanasia not necessary for a dignified death, but techniques used to bring about death can themselves result in considerable and protracted suffering”.

“Where assisted dying is available, many requests stem, not from intractable pain, but from such causes as fear, depression, loneliness, and the wish not to burden carers. With adequate resources, including psychiatric care, psychological care, palliative medicine, pain services, and social supports, good end-of-life care is possible,” he said.

Dr Siobhan MacHale, Consultant Liaison Psychiatrist, a member of the College of Psychiatrists and contributing author to the position paper on assisted dying, said: “Once permitted in a jurisdiction, experience has shown that more and more people die from assisted dying. This is usually the result of progressively broadening criteria through legal challenges because, if a right to assisted dying is conceded, there is no logical reason to restrict this to those with a terminal illness.”

She continued: “Both sides of this debate support the goal of dying with dignity, but neither the proposed legislation nor the status quo (as evidenced by both clinical experience and the power of this debate) is sufficient. It is imperative for the Irish people to continue to demonstrate leadership as a liberal and compassionate society in working together to achieve this.”

The College of Psychiatrists of Ireland’s position paper on physician-assisted suicide and euthanasia is available to view in full here.

Issued on behalf of the College of Psychiatrists of Ireland by Gordon MRM

Julian Fleming: Ph: 087 6915147 | julian@gordonmrm.ie

Karen McCourt, CPsychI Communications Officer: kmccourt@irishpsychiatry.ie

Erin O’Toole and conscience rights

Erin O’Toole asked to confirm that he will not force medical professionals to effectively refer for services

News Release

RightNow

 ***Version française ci-dessous***

OTTAWA, ON (August 21, 2021) – Political pro-life organization RightNow is calling on Erin O’Toole to confirm that he will not force medical professionals to effectively refer for medically unnecessary procedures, such as physician-assisted suicide.

“Erin O’Toole promised to pro-lifers during the 2020 Conservative Party of Canada leadership race that he would protect conscience rights of medical professionals across Canada,” said Scott Hayward, Co-Founder and President of RightNow. “Now it appears with his comments yesterday in Winnipeg that his policy would require that medical professionals would have to refer patients to colleagues for medically unnecessary procedures, such as physician-assisted suicide.”

“Erin O’Toole has flip-flopped on a key promise he made to pro-lifers during the Conservative leadership race last year,” said Alissa Golob, co-founder of RightNow. “The Conservative Party is united on this point, having passed a motion at the policy convention that specifically states that medical professionals would not have to provide effective referrals when it comes to assisted suicide, and other procedures such as abortion.”

“I know that many pro-lifers were excited when this policy was announced on Monday as part of the party’s overall campaign platform. However, the conscience rights policy for medical professionals is essentially null and void if they must effectively refer for medically unnecessary procedures, such as physician-assisted suicide,” said Hayward.

 “Our organization is officially calling on Erin O’Toole to maintain his position during the last leadership race and to publicly clarify that an Erin O’Toole Conservative government will not require medical professionals to effectively refer patients for medical procedures, such as assisted suicide, with which they morally disagree”, said Golob.  

About RightNow:

RightNow is a not-for-profit organization committed to nominating and electing pro-life candidates along with educating and engaging pro-life Canadians on the political process. Regardless of faith, politics, or background, RightNow works with people across the country to stand up for human rights for all human beings.

Media Contacts:ALISSA GOLOB 587-435-0166
SCOTT HAYWARD 204-573-0296

BACKGROUNDER:

  • In February 2020, Erin O’Toole stated the following in his Conservative Party of Canada leadership interview with RightNow, “Rights should not trump one another, we should respect the ability for us to have a society where all those rights are respected, and I would extend that to health care professionals. Not only do I think it is possible to do, but it must be done, because we must respect their religious and conscience rights, however they come to their position.”

    RightNow 2020 interview with Erin: http://www.itstartsrightnow.ca/erin_otoole_interview
  • The Conservative Party of Canada policy declaration states that health care professionals do not have to engage in effective referrals, “The Conservative Party supports conscience rights for doctors, nurses, and others to refuse to participate in, or refer their patients for abortion, assisted suicide, or euthanasia.”

    Conservative Party of Canada policy declaration (policy no. 68): https://cpcassets.conservative.ca/wpcontent/uploads/2021/05/04094452/d1effca7a5c8818.pdf

Erin O’Toole et les droits de conscience 

L’organisation politique RightNow demande à Erin O’Toole de clarifier si la plateforme du Parti conservateur du Canada n’exigera pas que les professionnels de la santé fassent des aiguillages dans sa politique de conscience

OTTAWA, Ontario (Le 21 août 2021) – L’organisation politique RightNow demande à Erin O’Toole de confirmer qu’il n’obligera pas les professionnels de la santé à faire des aiguillages pour des procédures médicales qui ne sont pas nécessaires, comme le suicide assisté par un médecin.

« Pendant la course à la chefferie du Parti conservateur du Canada de 2020, Erin O’Toole a promis aux pro-vie qu’il protégerait les droits de conscience des professionnels de la santé de partout au Canada, » a dit Scott Hayward, co-fondateur et président de RightNow. « En raison de ses commentaires de hier à Winnipeg, il semblerait maintenant que sa politique exige que les professionnels de la santé aiguillent des patients vers leurs collègues pour des procédures qui ne sont pas médicalement nécessaires, comme le suicide assisté par un médecin. »

« Erin O’Toole a fait marche arrière en revenant sur une promesse clef faite aux pro-vie lors de la course à la chefferie de l’an dernier » a dit Alissa Golob, co-fondatrice de RightNow. « Le Parti conservateur du Canada est uni par rapport à ce point, ayant adopté une motion au congrès politique qui déclare précisément que les professionnels de la santé n’auraient pas à participer en faisant des aiguillages quand il s’agit de suicide assisté et d’autres procédures, comme l’avortement. »

« Je sais que de nombreux pro-vie étaient emballés quand cette politique fut annoncée lundi comme faisant partie de l’ensemble de la plateforme de campagne. Toutefois, la politique de droits de conscience pour les professionnels de la santé est essentiellement caduque s’ils doivent aiguiller leurs patients pour des procédures médicales qui ne sont pas nécessaires, comme le suicide assisté par un médecin, » a dit Hayward.

« Notre organisation demande officiellement à Erin O’Toole de maintenir la position qu’il avait lors de la dernière course à la chefferie et de clarifier publiquement qu’un gouvernement conservateur sous Erin O’Toole n’exigera pas que les professionnels de la santé fassent des aiguillages pour leurs patients quand il s’agit de procédures médicales auxquelles ils objectent moralement, comme le suicide assisté, » a dit Golob.

Au sujet de RightNow :

RightNow est un organisme sans but lucratif qui se dévoue à nominer et faire élire des candidats pro-vie, ainsi qu’à éduquer et mobiliser les Canadiens pro-vie au sein du processus politique. Peu importe leurs croyances religieuses, leur affiliation politique ou leurs origines, RightNow travaille avec des gens de tout le pays qui défendent les droits humains pour tous les êtres humains.

Coordonnées pour les médias :

ALISSA GOLOB 587-435-0166
SCOTT HAYWARD 204-573-0296

DOCUMENT D’INFORMATION :

  • En février 2020, lors de son entrevue avec RightNow au sujet de la course à la chefferie conservatrice, Erin O’Toole a fait la déclaration suivante : « Les droits ne devraient pas avoir préséance les uns sur les autres, nous devrions respecter notre capacité d’avoir une société où tous ces droits sont respectés et c’est quelque chose que j’appliquerais à tous les professionnels de la santé. C’est non seulement quelque chose qu’il est possible de faire, mais c’est quelque chose qui doit être fait, parce que nous devons respecter les droits de conscience et les droits religieux peu importe comment ils sont arrivés à la position qu’ils ont. »

    L’entrevue de RightNow avec Erin: http://www.itstartsrightnow.ca/erin_otoole_interview
  • L’énoncé de politique du Parti conservateur du Canada déclare que les professionnels de la santé n’ont pas à faire d’aiguillages : « Le Parti conservateur soutient la liberté de conscience des médecins, des infirmiers et autres personnes et leur droit de refuser de participer à l’avortement, au suicide assisté ou à l’euthanasie et d’aiguiller leurs patients vers de tels services. »

    L’énoncé de politiques du Parti conservateur du Canada (politique numéro 68): https://cpcassets.conservative.ca/wp-content/uploads/2021/05/04094606/0dc0d59fda297a1.pdf

Joint statement in support of COVID-19 vaccine mandates for all workers in health and long-term care

News Release

For immediate release
Contact: APHA Media Relations, 202-777-3913

American Public Health Association

Due to the recent COVID-19 surge and the availability of safe and effective vaccines, our health care organizations and societies advocate that all health care and long-term care employers require their workers to receive the COVID-19 vaccine. This is the logical fulfillment of the ethical commitment of all health care workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being.

Because of highly contagious variants, including the Delta variant, and significant numbers of unvaccinated people, COVID-19 cases, hospitalizations and deaths are once again rising throughout the United States.1 Vaccination is the primary way to put the pandemic behind us and avoid the return of stringent public health measures.

Unfortunately, many health care and long-term care personnel remain unvaccinated. As we move toward full FDA approval of the currently available vaccines, all health care workers should get vaccinated for their own health, and to protect their colleagues, families, residents of long-term care facilities and patients. This is especially necessary to protect those who are vulnerable, including unvaccinated children and the immunocompromised. Indeed, this is why many health care and long-term care organizations already require vaccinations for influenza, hepatitis B, and pertussis.

We call for all health care and long-term care employers to require their employees to be vaccinated against COVID-19.

We stand with the growing number of experts and institutions that support the requirement for universal vaccination of health workers.2,3 While we recognize some workers cannot be vaccinated because of identified medical reasons and should be exempted from a mandate, they constitute a small minority of all workers. Employers should consider any applicable state laws on a case-by-case basis.

Existing COVID-19 vaccine mandates have proven effective.4,5 Mandates are an essential policy to increase vaccination rates in health care and long-term care settings and protect the health care workforce and the patients and residents we serve. Simultaneously, we recognize the historical mistrust of health care institutions, including among many in our own health care workforce. We must continue to address workers’ concerns, engage with marginalized populations, and work with trusted messengers to improve vaccine acceptance.

As the health care community leads the way in requiring vaccines for our employees, we hope all other employers across the country will follow our lead and introduce effective policies to encourage vaccination. The health and safety of U.S. workers, families, communities, and the nation depends on it.

SIGNATORIES (listed alphabetically)

Academy of Managed Care Pharmacy
American Academy of Ambulatory Care Nursing
American Academy of Child and Adolescent Psychiatry
American Academy of Family Physicians
American Academy of Nursing
American Academy of Ophthalmology
American Academy of PAs
American Academy of Pediatrics
American Association of Allergy, Asthma & Immunology
American Association of Clinical Endocrinology
American Association of Colleges of Pharmacy
American Association of Neuroscience Nurses
American College of Clinical Pharmacy
American College of Physicians
American College of Preventive Medicine
American College of Surgeons
American Epilepsy Society
American Medical Association
American Nursing Association
American Pharmacists Association
American Psychiatric Association
American Public Health Association
American Society for Clinical Pathology
American Society for Radiation Oncology
American Society of Health-System Pharmacists
American Society of Hematology
American Society of Nephrology
American Thoracic Society
Association for Clinical Oncology
Association for Professionals in Infection Control and Epidemiology
Association of Academic Health Centers
Association of American Medical Colleges
Association of Rehabilitation Nurses
Council of Medical Specialty Societies
HIV Medicine Association
Infectious Disease Society of America
LeadingAge
National Association of Indian Nurses of America
National Association of Pediatric Nurse Practitioners
National Council of State Boards of Nursing
National Hispanic Medical Association
National League for Nursing
National Medical Association
National Pharmaceutical Association
Nurses Who Vaccinate
Organization for Associate Degree Nursing
Pediatric Infectious Diseases Society
Philippine Nurses Association of America, Inc
Society of Gynecological Oncology
Society for Healthcare Epidemiology of America
Society of Hospital Medicine
Society of Infectious Diseases Pharmacists
Society of Interventional Radiology
Texas Nurses Association
The John A. Hartford Foundation
Transcultural Nursing Society
Virgin Islands State Nurses Association
Wound, Ostomy, and Continence Nurses Society

REFERENCES

1. Centers for Disease Control and Prevention. Covid Data Tracker Weekly Review.
2. Weber, D., Al-Tawfiq, J., Babcock, H., Bryant, K., Drees, M., Elshaboury, R., et al. (2021). Multisociety Statement on COVID-19 Vaccination as a Condition of Employment for Healthcare Personnel. Infection Control & Hospital Epidemiology, 1-46. doi:10.1017/ice.2021.322
3. American Hospital Association. AHA Policy Statement on Mandatory COVID-19 Vaccination of Health Care Personnel
4. Hospitals in DC, across the nation follow Houston Methodist in requiring vaccination for workers (USA Today)
5. More Nursing Homes Are Requiring Staff COVID-19 Vaccinations (AARP)

###

The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a nearly 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at www.apha.org.

Conscience Project critiques Ontario Physicians College euthanasia/assisted suicide policy

Referral, urgent situations, death certificates, criminal law

News Release

For immediate release

Protection of Conscience Project

Conscience Project critiques Ontario Physicians College euthanasia/assisted suicide policy

Powell River, BC. (28 April, 2021) The 2019 decision of the Ontario Court of Appeal supporting the College of Physicians and Surgeons of Ontario was not the last word on the subject of physician freedom of conscience.

That message was delivered to the College by the Protection of Conscience Project in a submission responding to the College’s request for public feedback on its policy, Medical Assistance in Dying (MAiD). The submission focuses primarily on the College demand that physicians unwilling to provide euthanasia or assisted suicide (EAS) for reasons of conscience provide an “effective referral”: that is, connect the patient directly with someone willing to provide a lethal injection or assist with suicide.

The submission on MAiD addresses three points unique to euthanasia and assisted suicide.

Conflicts in urgent situations: If a patient is approved for EAS at some future date, a sudden deterioration of the patient’s condition may cause the patient to ask for immediate relief by EAS. In the absence of an EAS practitioner, other practitioners may be willing to alleviate the patient’s distress by palliative interventions, but not to provide EAS. The Project suggests how this conflict can be avoided.

Falsifying death certificates: Falsification of death certificates is contrary to accepted international standards and can be considered deceptive, unethical or professionally ill-advised. The Project suggests how EAS practitioners unwilling to falsify death certificates can be accommodated by the College and Office of the Chief Coroner even if current government policy does not change.

Criminal law limits on College policy: The Project’s position is that the College cannot proceed against practitioners who, having the opinion that a patient is not eligible for EAS, refuse to do anything that would entail criminal responsibility for homicide/assisted suicide, including “effective referral.” Further, to advise or attempt to coerce them to present EAS as treatment options or to participate by effective referral would seem to be a criminal offence. Finally, since counselling suicide remains a criminal offence, it appears that practitioners cannot be compelled to present assisted suicide or MaiD as treatment options unless a patient has expressed an interest in the services.

The College’s clarification that it does not require objecting practitioners to personally kill their patients is welcome. However, the Project’s position is that this ought to be the norm in a democratic society, not a “concession”or an element in the “accommodation” of freedom of conscience.

While the submission includes specific policy recommendations within the existing MAiD policy framework, it recommends that the College adopt a single protection of conscience policy in line with “the basic theory” of the Canadian Charter of Rights affirmed by the Supreme Court of Canada and consistent with rational moral pluralism. Such a generally applicable policy is included in the simultaneous Project submission to the College on Professional Obligations and Human Rights.

Public consultations on Professional Obligations and Human Rights [Consultation Page] and Medical Assistance in Dying [Consultation Page] are open until 14 May, 2021.

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

Ontario College of Physicians policy challenged

Forcing physicians out of Covid fight not in public interest

News Release

For immediate release

Protection of Conscience Project

Ontario College of Physicians policy challenged

Powell River, B.C. (28 April, 2021) The 2019 decision of the Ontario Court of Appeal supporting the College of Physicians and Surgeons of Ontario was not the last word on the subject of physician freedom of conscience.

That message was delivered to the College by the Protection of Conscience Project in a submission responding to the College’s request for public feedback on its policy, Professional Obligations and Human Rights (POHR).

The submission includes a cautionary note about the potential implications of human rights law for practitioners providing euthanasia and assisted suicide. However, the primary focus is on the College demand that physicians unwilling to provide a service or procedure for reasons of conscience provide an “effective referral”: that is, connect the patient directly with someone willing to do what they consider immoral/unethical.

Practitioners who object to providing a service typically provide information and work cooperatively with patients and others in relation to patient access to services. While willing to respectfully cooperate, they are unwilling to collaborate by doing something that makes them a party to what they consider wrongful and/or harmful. The distinctions between providing information vs. providing a service and between cooperation vs. collaboration enable an approach that accommodates both patients and practitioners, argues the Project.

However, the College is clearly confused about such critical distinctions. Citing College policy and reasoning, the submission states, “the College’s assertion that effective referral for euthanasia/assisted suicide does not ‘signal’ endorsement or support for the procedures [Advice:MAiD] is either disingenuous or the product of badly muddled wishful thinking.”

“The College does not even correctly apply its own definition of effective referral in its companion policy document,” observes Sean Murphy, Administrator of the Project.

According to the College, physicians unwilling to comply with its effective referral policy should restrict their practices to specialties like hair restoration.[1] This would force all objecting physicians out of general practice.

“To put it in a currently relevant perspective,” says Murphy, “the College would have them terminate all Covid 19 pandemic activities and take up podiatry or aviation medicine. This is hardly consistent with ensuring access to health care or protecting the public interest.”

The Project recommends that the College adopt a single protection of conscience policy in line with “the basic theory” of the Canadian Charter of Rights affirmed by the Supreme Court of Canada and consistent with rational moral pluralism. The submission includes a such general policy, drawing on policy documents from the Canadian Medical Association, Canadian Nurses’ Association, Catholic Health Association of Canada and the Canadian Medical Protective Association.

The Protection of Conscience Project has also made a submission about College’s policy on euthanasia and assisted suicide, Medical Assistance in Dying. Public consultations on Professional Obligations and Human Rights [Consultation Page] and Medical Assistance in Dying [Consultation Page] are open until 14 May, 2021.

Notes

  1. Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario, 2019 ONCA 393 (CanLII) at para 184.

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