<\/p>\n
\u00a0Abstract<\/strong><\/p>\n Virtually all of what is proposed in Interim Guidance on Physician-Assisted Death<\/span><\/span><\/a><\/em> (IGPAD) is satisfactory, requiring only clarifications to avoid misunderstanding and appropriate warnings concerning the continuing effects of criminal law.<\/p>\n The College has no basis to proceed against physicians who refuse to do anything that would entail complicity in homicide or suicide, including “effective referral,” because they believe that a patient does not fit the criteria specified by Carter<\/em>. College policies and expectations are of no force and effect to the extent that they are inconsistent with criminal prohibitions.<\/p>\n Proposals about respect for patients, access to services, and providing information are acceptable, subject to some clarifications and limitations with respect to offering the option of suicide. Simple and uncontroversial recommendations are offered to avoid problems associated with failed assisted suicide and euthanasia attempts, and in urgent situations.<\/p>\n However, the requirement for “effective referral “is completely unacceptable. It is ludicrous to assert that the reasoning that underpins the law on criminal complicity and culpability, civil liability and the College policy that prohibits referral for Female Genital Cutting can be dismissed as legally irrelevant to the exercise and protection of fundamental freedoms of conscience and religion.<\/p>\n The College cannot justify a demand for “effective referral” on the grounds that it cannot be understood to involve morally significant complicity in killing patients or helping them to commit suicide, nor can it be justified as a reasonable limitation on fundamental freedom. This is not a reasonable limitation of freedom but a reprehensible attack on them. It is a paradigmatic example of the authoritarian suppression of freedom of conscience and religion and a serious violation of human dignity. Examples of alternative acceptable policies demonstrate that access to assisted suicide and euthanasia can be ensured without suppressing freedom of conscience and religion.<\/p>\n I.\u00a0\u00a0\u00a0 Outline of the submission<\/span><\/span><\/a><\/strong><\/p>\n II.\u00a0\u00a0\u00a0 Avoiding foreseeable conflicts<\/span><\/span><\/a><\/strong><\/p>\n II.1\u00a0\u00a0\u00a0 Failed assisted suicide and euthanasia<\/span><\/span><\/a> II.2\u00a0\u00a0\u00a0 Urgent situations<\/span><\/span><\/a> III.\u00a0\u00a0\u00a0 IGPAD and criminal law<\/span><\/span><\/a><\/strong><\/p>\n IV.\u00a0\u00a0\u00a0 IGPAD on respect, access, notification and providing information<\/span><\/span><\/a><\/strong><\/p>\n IV.1\u00a0\u00a0\u00a0 Treat patients respectfully; do not impede access<\/span><\/span><\/a> V.\u00a0\u00a0\u00a0 Freedom of conscience<\/span><\/span><\/a><\/strong><\/p>\n V.1\u00a0\u00a0\u00a0 IGPAD and “effective referral”<\/span><\/span><\/a> VI.\u00a0\u00a0\u00a0 Project response<\/span><\/span><\/a><\/strong><\/p>\n VI.1\u00a0\u00a0\u00a0 Previous submissions<\/span><\/span><\/a> VIII.\u00a0\u00a0\u00a0 Conclusion<\/span><\/span><\/a><\/strong><\/p>\n Appendix “A”\u00a0\u00a0\u00a0 Supreme Court of Canada, <\/span>Carter<\/span><\/em><\/em> v. Canada (Attorney General)<\/span><\/em>, 2015 SCC 5<\/span><\/span><\/a><\/strong><\/p>\n A1.\u00a0\u00a0\u00a0 Carter<\/em><\/em><\/span> criteria for euthanasia and physician assisted suicide<\/span><\/span><\/a> Appendix “B”\u00a0\u00a0\u00a0 Carter<\/em><\/span> in theTrial Court, Part VII: A Judicial Soliloquy on Ethics<\/span><\/span><\/a><\/strong><\/p>\n B1.\u00a0\u00a0\u00a0 A note of caution<\/span><\/span><\/a> Appendix “C”\u00a0\u00a0\u00a0 Physician Exercise of Freedom of Conscience and Religion<\/span><\/span><\/a><\/strong><\/p>\n C1.\u00a0\u00a0\u00a0 Introduction<\/span><\/span><\/a>
\nThe only apparent basis for the College’s demand for effective referral is that it has decided what the Supreme Court of Canada did not decide: that euthanasia and assisted suicide in circumstances defined by Carter<\/em> are morally\/ethically acceptable. College officials seem to consider the College justified in using force – the force of law – to compel dissenting physicians to conform to their moral\/ethical views.<\/p>\n
\n<\/a>Contents<\/h2>\n
\nII.3\u00a0\u00a0\u00a0 Project recommendations<\/span><\/span><\/a><\/p>\n
\nIV.2\u00a0\u00a0\u00a0 Notification of objections<\/span><\/span><\/a>
\nIV.3\u00a0\u00a0\u00a0 Providing information<\/span><\/span><\/a><\/p>\n
\nV.2\u00a0\u00a0\u00a0 “Effective referral” and criminal law<\/span><\/span><\/a>
\nV.3\u00a0\u00a0\u00a0 Legal vs. ethical\/moral evaluation of euthanasia, assisted suicide<\/span><\/span><\/a>
\nV.4\u00a0\u00a0\u00a0 The College position: “error has no rights”<\/span><\/span><\/a><\/p>\n
\nVI.2\u00a0\u00a0\u00a0 Making freedom easy – or impossible<\/span><\/span><\/a>
\nVII.\u00a0\u00a0\u00a0 Alternative acceptable policies<\/span><\/span><\/a><\/p>\n
\nA2.\u00a0\u00a0\u00a0 Carter<\/em><\/em><\/span> and the criminal law<\/span><\/span><\/a>
\nA3.\u00a0\u00a0\u00a0 <\/span>Carter<\/span><\/em> <\/em>and freedom of conscience and religion<\/span><\/span><\/a><\/p>\n
\nB2.\u00a0\u00a0\u00a0 The questions addressed in Part VII<\/span><\/span><\/a>
\nB3.\u00a0\u00a0\u00a0 Plaintiffs’ claim shapes and limits the analysis<\/span><\/span><\/a>
\nB4.\u00a0\u00a0\u00a0 Ethics: which one?<\/span><\/span><\/a>
\nB5.\u00a0\u00a0\u00a0 Medical ethics<\/span><\/span><\/a>
\nB5.1\u00a0\u00a0\u00a0 Ethics and the willingness of physicians<\/span><\/span><\/a>
\nB5.2\u00a0\u00a0\u00a0 Ethics and the positions of medical associations<\/span><\/span><\/a>
\nB5.3\u00a0\u00a0\u00a0 Ethics and the opinions of ethicists<\/span><\/span><\/a>
\nB5.4\u00a0\u00a0\u00a0 Ethics and current end-of-life practices<\/span><\/span><\/a>
\nB<\/span><\/span>6.\u00a0\u00a0\u00a0 Ethics of society<\/span><\/span><\/a>
\nB6.2\u00a0\u00a0\u00a0 Ethics and public opinion<\/span><\/span><\/a>
\nB6.3\u00a0\u00a0\u00a0 Ethics and public committees<\/span><\/span><\/a>
\nB6.4\u00a0\u00a0\u00a0 Ethics and prosecution policies<\/span><\/span><\/a>
\nB7.\u00a0\u00a0\u00a0 Summary of the ethical debate<\/span><\/span><\/a>
\nB8.\u00a0\u00a0\u00a0 Conclusions about the ethical debate<\/span><\/span><\/a>
\nB8.2\u00a0\u00a0\u00a0 Would Canadian physicians provide the services?<\/span><\/span><\/a>
\nB8.3\u00a0\u00a0\u00a0 Current medical practice with respect to end-of-life care?<\/span><\/span><\/a>
\nB8.4\u00a0\u00a0 Does the law attempt to uphold a conception of morality?<\/span><\/span><\/a>
\nB9.\u00a0\u00a0\u00a0 Carter<\/em><\/em> Part VII: in brief<\/span><\/span><\/a>
\nB9.1\u00a0\u00a0\u00a0 Unanswered questions<\/span><\/span><\/a>
\nB9.2\u00a0\u00a0\u00a0 Meaningless findings<\/span><\/span><\/a>
\nB9.3\u00a0\u00a0\u00a0 Inconclusiveness<\/span><\/span><\/a>
\nB9.4\u00a0\u00a0\u00a0 Neglected evidence<\/span><\/span><\/a>
\nB9.5\u00a0\u00a0\u00a0 Deficient review of end-of-life decision-making<\/span><\/span><\/a>
\nB10.\u00a0\u00a0\u00a0 On appeal to the Supreme Court of Canada<\/span><\/span><\/a><\/p>\n
\nC2.\u00a0\u00a0\u00a0 Providing information to patients<\/span><\/span><\/a>
\nC3.\u00a0\u00a0\u00a0 Exercising freedom of conscience or religion<\/span><\/span><\/a>
\nC4.\u00a0\u00a0\u00a0 Reminder: treatments in emergencies<\/span><\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"