The Globe and Mail
To give Alzheimer’s patient Mary Wilson the death she sought, her physicians had to make a tough decision in a short time – and risked going to prison if they got it wrong. Now they’ve been cleared of wrongdoing in a decision that could have wide-reaching implications for tens of thousands of Canadians. . . [Full text]
The Globe and Mail
The question: My father was in the advanced stages of prostate cancer and wanted a medically assisted death. He was told he needed the approval of two health-care providers. One said yes, but the other said no because he “was not in any distress.” But that decision was so wrong. My father was a very stoic man, and was not one to complain. Did the doctor want him to break down in tears and beg to be put to death? My father died two weeks later in a hospice – instead of his home, the place where he wanted to die.
The answer: It has been over a year and a half since Parliament passed a law that makes medical assistance in dying – called MAID for short – legal across Canada. The story you tell reflects one of the many challenges in creating a standardized system to handle these requests and to ensure that patients and their families are properly informed.
One key failing in your father’s case is that he was not apparently told he could have asked for another assessment after the second MAID assessor turned him down. If another assessor had agreed that he was eligible, he could have proceeded with an assisted death.
It’s impossible to say whether his assessors were unaware he had this option or simply failed to mention it.
Whatever the case, “we need to do a better job educating health-care providers about what they must be disclosing to patients,” says Jocelyn Downie, a professor in the faculties of law and medicine at Dalhousie University in Halifax.
In the meantime, it’s certainly worthwhile reviewing how the process is supposed to work. . . [Full Text]
In July, 2017, Canadian euthanasia/assisted suicide (EAS) practitioners and advocates alleged that patient access to euthanasia and assisted suicide was in danger because of “barriers” and “disincentives” to physician participation. Dr. Stefanie Green, president of their professional association, described the situation as “a crisis.”1 There was, in fact, no crisis — only a false perception of crisis fuelled by unrealistic expectations about levels of physician participation in euthanasia and assisted suicide.2
Nonetheless, it is reasonable for policy makers to respond to their concerns that physicians are discouraged from participating in euthanasia and assisted suicide. Indeed, objecting physicians are less likely to experience disadvantage and coercion if policy-makers seriously consider suggestions by EAS practitioners and advocates about how to encourage physician participation in euthanasia.
Removing barriers and disincentives to physician participation
Minimizing procedural and administrative requirements
Returning to the complaints and concerns of Canadian euthanasia practitioners (see Canada’s Summer of Discontent2), reducing or streamlining procedural requirements and minimizing burdensome paperwork might encourage more physicians to participate. However, this raises a question that may prove difficult to answer. Is a procedural requirement a “barrier” — or a necessary safeguard? A “disincentive” — or an essential ethical prerequisite? The difficulty is illustrated by developments in Belgium. . . .[Full text]
Physicians can make more doing paperwork than performing this legal, but emotionally demanding, service. For many, it’s just not worth it.
Back in March, Dr. Tanja Daws took time off from her family practice to travel from B.C.’s Comox Valley to a remote community on Vancouver Island and provide an elderly patient who was dying and suffering with medical assistance in dying (MAID). After the five-and-a-half hour endeavour, which involved some of the most emotionally and technically difficult work Daws has ever done, the physician calculated that, after factoring in her staffing costs and other office expenses, she had lost about $28 for every hour she worked.
“It struck me that I can’t keep doing this,” says Daws. “I can work for nothing, but I can’t work for a loss.” . . . [Full text]
‘We’re being paid 50% of what we would doing routine office work. So it’s difficult to justify continuing’
Medically assisted dying has been legal in Canada for over a year, but one B.C. doctor says he can no longer afford to offer the service, because the costs involved are much greater than the $200 payout from the provincial medical services plan.
In a letter, Dr. Jesse Pewarchuk calls the situation “economically untenable” while outlining a number of steps a physician must follow in the medical assistance in dying (MAID) procedure. . . [Full text]