Tag: Manitoba

Conscience, euthanasia and assisted suicide in Manitoba

The Medical Assistance in Dying (Protection for Health Professionals and Others) Act

Sean Murphy*

Manitoba is the only Canadian province with a stand-alone statute that protects health care professionals who refuse to provide services: the Medical Assistance in Dying (Protection for Health Professionals and Others) Act (MAiD Act).1

The MAiD Act is a procedure-specific law applying only to euthanasia and assisted suicide. It protects all regulated professionals who refuse to provide or “aid in the provision” of the procedures from professional disciplinary proceedings and adverse employment consequences because they have refused. They remain liable for other misconduct in relation to the refusal.

The Act protects those who refuse for any reason; refusal need not be based on any specific ground. Hence, it equally protects refusal for reasons of personal discomfort, distaste or fear and refusal based on moral or ethical objections.

“Aid in the provision” is not defined. A narrow reading could limit protection against coercion to acts closely associated with the administration of a lethal substance, like inserting an IV line or dispensing lethal drugs. A broad reading could extend it to include facilitation by referral or other means. However, based on the Janaway2 and Doogan3 cases in the United Kingdom (in which the key term, “participate,” was restricted to “hands on” activity), a narrow reading of “aid in the provision” is possible.

Professional obligations in relation to refusal are untouched by the law. Regulators remain free to specify obligations that do not prevent or conflict with refusal to provide or aid in the provision of euthanasia and assisted suicide. Based on a narrow interpretation of “aid,” this could include facilitation by referral to an EAS practitioner. This would be unacceptable to objecting professionals who consider that to entail complicity in killing patients.

Notes:

1.  Medical Assistance in Dying (Protection for Health Professionals and Others) Act , CCSM c M92.

2.  R v Salford Health Authority, Ex p Janaway [1989] AC 537.

3.  Greater Glasgow Health Board (Appellant) v Doogan and another (Respondents) (Scotland) [2014] UKSC 68 at para 37—38.

Freedom of conscience and nursing in Manitoba

Sean Murphy*

Abstract

For the most part, the codes of ethics and standards of Manitoba’s nurse regulators provide little insight into the regulators’ approach to freedom of conscience for nurses, and frequent failure to distinguish between “care” and “treatment” often impairs discussion of conscientious objection. The College of Licensed Practical Nurses of Manitoba code and standards appear inclined to separate personal and professional integrity, giving priority to the latter at the expense of the former. This encourages the view that nurses must leave their personal integrity in the parking lot when they report for work.

The regulators’ views about freedom of conscience for nurses are most clearly demonstrated in the joint publication Duty to Provide Care (2019). They recognize conscientious objection only to providing a service. They fail to recognize (or are unwilling to admit) that one can legitimately refuse to encourage or facilitate a service for reasons of conscience. Consistent with this, they demand that objecting nurses provide effective referral for all morally contested procedures, including euthanasia and accepted suicide. This would be unacceptable to anyone who believes that it is immoral to facilitate what one believes to be immoral.

Unlike earlier guidelines for euthanasia and assisted suicide, Duty to Provide Care (2019) fails to clearly distinguish between “care” and procedures or interventions, and it does not acknowledge the duty of employers (and regulators) to accommodate nurses in the exercise of freedom of conscience. . . [Full text]

Physician freedom of conscience in Manitoba

Sean Murphy*

The MAiD Act

Manitoba is the only Canadian province with a stand-alone statute that protects health care professionals who refuse to provide services: the Medical Assistance in Dying (Protection for Health Professionals and Others) Act (MAiD Act).1

The MAiD Act is a procedure-specific law applying only to euthanasia and assisted suicide (EAS). It protects all regulated professionals who refuse to provide or “aid in the provision” of the procedures from professional disciplinary proceedings and adverse employment consequences because they have refused. They remain liable for other misconduct in relation to the refusal.

The Act protects those who refuse for any reason; refusal need not be based on any specific ground. Hence, it equally protects refusal for reasons of personal discomfort, distaste or fear and refusal based on moral or ethical objections. . . [Full text].

Doctors, advocacy groups address proposed law protecting those who object to assisted dying

CBC News

Holly Caruk

Dr. Frank Ewert wants protection from having to help a patient die — but Dying with Dignity Canada doesn’t want that to happen at the cost of patients receiving full access to end-of-life options.

“When I started back a number of years ago and vowed to follow the Hippocratic oath, I meant it. It was very profound to me, it resonated with my core beliefs, that I would always respect life, that I would do nothing to harm a patient,” Ewert told a legislative committee on Monday evening. . . [Full text]

 

Critics call bill aimed to protect health workers unwilling to offer assisted death ‘one-sided’

CBC: The Current

Interviewer/host: Piya Chattopadhyay

SOUNDCLIP

VOICE 1: Bill 34 is being introduced by the Manitoba government to protect conscience rights for health care professionals, so that health care providers would not be required to participate in assisted suicide.

VOICE 2: While I cannot participate in assisted suicide for a couple of reasons. The first is I made a vow as a medical student 40 years ago that I wouldn’t kill patients, okay? And I’m not willing to cross that line.

PC: It has been less than 18 months now since medically assisted dying became legal in Canada. And health care workers are still adapting to that paradigm change. We just heard part of a video produced by the Coalition for Health Care and Conscience. It’s a national umbrella organization of religious groups, and as you heard it is lobbying for Bill 34 a proposed piece of legislation in Manitoba that was drafted to help health care workers with conscientious objections to helping end patients’ lives. Here’s Manitoba’s health minister Kelvin Goertzen. . . [Full episode transcript]