Doctors with moral objections to assisted dying should be able to opt out, committee hears

Doctors who morally object to physician-assisted dying should not be obligated to refer patients to a doctor who will provide the service, a joint Commons-Senate committee studying the issue heard Wednesday.

Dr. Cindy Forbes, president of the Canadian Medical Association told the panel that doctors shouldn't have to refer a patient, but they must "advise the patient on all of their options … including physician assisted dying, and make sure the patient has the information they need to access that service"

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The special joint Commons committee on physician-assisted dying was struck in response to a Supreme Court of Canada decision last year which ruled that a ban on physician-assisted dying violated Canadians' charter rights, giving the government a year to pass new legislation.

The high court recently extended the deadline until June to allow the Liberal government time to hold public these consultations and deliver a new law. 

Five senators and 11 MPs — including six Liberals, three Conservatives and two New Democrats — form the committee, which convened Monday. They are holding a series of public consultations to hear from experts and stakeholders with the goal of reporting back with legislative suggestions by Feb. 26. 

Dr. Jeff Blackmer, vice-president of the CMA's office of ethics, noted that while only 30 per cent of doctors in Canada would consent to provide the service, the CMA has concluded that this would not impact a patient's ability to receive an assisted death.

"I think that it is absolutely critical to recognize that 30 per cent represents 24,000 Canadian physicians,"  Blackmer said. "I can sit here ... and guarantee that from simply a number perspective, access will not be an issue.

"It is about connecting the people who qualify with assisted dying with the providers that are will to undertake assisted dying," he said

Better palliative care needed

Dr. Monica Branigan, a board member of the Canadian Society of Palliative Care Physicians, told the committee that currently the quality of palliative care a patient receives depends on their postal code and any new assisted-dying legislation should be coupled with an increase in funding to, and national standardization of, palliative care across the country .

Branigan stressed the importance of palliative care by pointing out that while only three per cent of Canadians will seek a physician assisted-death, all Canadians can benefit from improved funding to palliative care.

Branigan said four issues should be considered in developing any assisted-dying legislation:

• There should be a national standard for palliative care across the country.
• A waiting time for assisted-death should be implemented to allow for patients who change their mind.  The waiting time should take into consideration how much time the patient has left to live.
• There should be a national oversight organization to make sure everyone has access to the service.
• There need to be provisions in the criminal code to protect medical professionals providing the service.

Associations representing doctors, nurses, pharmacists and other medical professionals are sharing their views with the committee tonight.

Pharmacists, psychiatrists weigh in

Carlo Berardi, chair of the Canadian Pharmacists Association, said that pharmacists do not want to be involved in the determination of eligibility of a patient, or of their competency to make that choice, but they do want to be satisfied that the criteria has been met before being asked to provide drugs.

Phil Emberley, director of professional affairs for the Canadian Pharmacists Association, said if the best drugs required to facilitate a doctor-assisted death are not available within Canada, there needs to be a process to ensure that drugs being used in other countries for this purpose can be made available here.

Dr. Sonu Gaind, president of the Canadian Psychiatric Association, said psychiatrists should be called in to consult in a situation where the attending doctors think mental illness may be a factor in the illness of a person seeking an assisted death.

Former Conservative MP Steven Fletcher, a quadriplegic who is paralyzed from the neck down after a car crash in 1996, will give evidence on Thursday.