TORONTO — The Canadian Medical Association has released results of a major consultation with members about the best framework for providing physician-assisted death, an issue that continues to divide the country’s doctors.
The organization representing Canada’s almost 80,000 physicians released its report from the June 8-July 20 online consultation on Monday.
Entitled “A Canadian Approach to Assisted Dying: CMA Member Dialogue,” the report is a summary of 545 comments posted by almost 600 doctors on the fundamental issues surrounding end-of-life care and assisted dying, as well as input from other medical groups.
In February, the Supreme Court of Canada overturned the ban on physicians aiding in the death of a patient in the face of extreme suffering, on the grounds the law was unconstitutional. The high court postponed implementation of its ruling for a year to give the federal government time to draft and pass a new law, if it so chooses.
The framework document will be the basis for a debate among delegates at the CMA’s annual meeting in Halifax next week, said Dr. Jeff Blackmer, vice-president of medical professionalism.
“We are anticipating a very lively discussion ... but a very respectful discussion as well,” said Blackmer, adding that among issues raised by doctors, two main concerns stood out.
“One is how do we determine who will qualify for assisted dying and to what extent are we limited by the Supreme Court decision,” given that the ruling was “pretty broad and there was not a lot of guidance,” he said.
Doctors are concerned about patients who will seek to end their lives because of psychological rather than physical suffering, for instance because of severe depression that has not responded to medications.
“The other big one for sure was the whole issue of conscientious objection and the obligation by a doctor who is against assisted death to refer a patient to a willing colleague.
“I would say that the majority of comments and the majority of concerns were around that particular issue.”
The results of next week’s debate will provide input to both the federal panel struck to consult with Canadians on options to respond to the Supreme Court decision and to a newly formed provincial-territorial panel also examining the issue, he said.
Recent surveys of members show that Canada’s doctors are evenly split on the issue of legalizing assisted dying, and a minority of respondents to these polls said they were willing to offer the service to patients.
Blackmer said the CMA will not allow its members to be coerced in any way into providing the means for a patient’s death or delivering a fatal drug dose themselves.
“The big question is how will we ensure that patients who meet the criteria have access, without forcing any physician to go against their moral conscience.”