National Post (National Edition)
MDs can assist suicide next week. Will they?
IF BILL ISN’T PASSED IN SEVEN DAYS, DOCTORS FACE LEGAL CONFUSION
As of midnight next Monday, Canada’s doctors will be legally free to administer a new medical “service” — death —to competent adults who choose to die.
Whether they will be willing to do so is another matter.
MPs will begin voting Monday on the Liberal government’s controversial assisted-dying legislation and while Prime Minister Justin Trudeau said this weekend he’s “hopeful” Bill C-14 will pass by June 6 — the day the Criminal Code ban on doctor-assisted death becomes null and void — many observers believe that timing is virtually impossible, given the bill must still pass the Senate.
If no new federal law is on the books, many doctors will be reluctant to fulfil requests for hastened death, medical leaders say.
“This is an extraordinarily emotional time,” said Dr. Gus Grant, presi- dent of the Federation of Medical Regulatory Authorities of Canada, which represents Canada’s 13 provincial and territorial regulatory colleges.
“If there’s a lack of clarity — if there is a question of, ‘is this legal?’ — that makes it even more difficult,” he said.
“Our concern is that if physicians are unclear, the natural default will be to be hesitant to act, hesitant to deliver the service, and suffering patients won’t be able to avail themselves of a service that is legally theirs to pursue.”
While provincial regulators have issued interim guidelines to doctors, those policies aren’t consistent across the country and don’t amount to legislation, the Canadian Medical Protective Association (CMPA), the profession’s powerful malpractice insurer, says.
The Ottawa-based group said it expects to involve its lawyers in many requests for assisted death, in part to help doctors determine a person’s eligibility for “MAID” (medical aid in dying) and make sure the act is carried out “in a way that minimizes the physician’s medical-legal risks,” associate executive director Dr. Doug Bell said in an email to the Post.
That could further bog down the process.
Bill C-14 was briefly derailed as a result of the commotion that followed Prime Minister Justin Trudeau’s outburst in the House two weeks ago, when he crossed the floor to drag Conservative MP Gord Brown to his seat and accidentally elbowed New Democratic Party MP Ruth Ellen Brosseau in the process.
The Supreme Court of Canada ruled the ban on doctor-assisted death unconstitutional one year ago, but gave Ottawa an extension until June to change the law accordingly. People have been allowed to seek approval from a court in the interim. As of June 6, that re- quirement also expires.
If no law is in place by then, the College of Physicians and Surgeons of Ontario, the country’s largest medical regulator, will post updated guidelines on its website, setting out doctors’ legal and professional obligations, as well as the criteria for assisted death as set out by the Supreme Court, said college spokeswoman Kathryn Clarke.
The high court decriminalized assisted death for Canadians with a “grievous and irremediable” medical condition (an illness, disease or disability) that causes enduring suffering that is intolerable to the person.
But it didn’t define “grievous and irremediable,” and, unlike the Liberal bill, did not limit it to a terminal illness.
In addition, the Supreme Court only addressed the role of doctors, and not of other health-care workers who might be involved in assisting in a death.
Whether a pharmacist dispensing suicide pills or a nurse preparing the IV line, the person needs to know “he or she is not committing a criminal act,” Grant said.
“That’s the one area that gives me the most pause if June 7th were to come without any legislation — that ancillary healthcare workers would feel legally unable to help physicians,” he said.
In Quebec, an estimated 60 people have received “medical aid in dying” — voluntary euthanasia — since the province’s groundbreaking law came into force in December.