Questioning assisted death secrecy
Physicians join commissioner’s pleas for transparency
There are more people in on the secret than you’d imagine.
The scene is set in a hospital, somewhere in Ontario. A pharmacy technician carefully measures out the medication. An orderly whisks it down the hall. A translator may be sought, and a physician arrives at the patient’s room.
Legally, any one of them can refuse to participate in the physician-assisted death that’s about to take place, recognized for a year now as a person’s legal right in Canada.
But outside the medical facility, no one has to know what’s happening — and that’s sounding off alarms for Ontario’s most senior privacy watchdog.
In his annual report last week, privacy commissioner Brian Beamish took aim at the Medical Assistance in Dying Statute Law Amendment Act, or Bill 84, which became law in Ontario last month.
The act, in part, is a green light for secrecy.
Any information that could identify hospitals, long-term care homes or hospices that offer medically assisted death is now exempt from freedom of information laws.
“The government views protecting facilities as a logical and justifiable extension of protecting clinicians,” health ministry spokesperson David Jensen wrote in an email to the Toronto Star.
There’s nothing in Bill 84 to explicitly prevent a facility from “proactively releasing their policies,” he added.
“The ministry is not considering any changes at this point.”
To Beamish, that decision veers alarmingly off-path from transparency and accountability. Before the bill became law, he recommended amendments that kept the names of physicians anonymous, but the names of facilities public.
“Information should be public unless there’s a really good reason why it shouldn’t be,” Beamish told the Star.
In this case, he said, there was no evidence presented by legislators to suggest any reason why hospitals and care facilities should be exempt from disclosing their practices.
The same concern was presented by Hamilton Health Sciences ethicist Andrea Frolic at a committee meeting about the bill in March. Frolic praised the protection of physicians, but questioned why publicly-funded facilities could draw a dark curtain over their practices.
“Information-sharing with the public is essential to patients’ informed decision-making,” she told the room, recommending that facilities disclose whether they grant assisted-death requests.
But when the bill passed, so, too, did the institutional protections.
Dr. Gerald Ashe, a family physician in Brockville, is onside with Beamish’s plea.
Over the past year, he’s openly helped terminal patients end their lives by achieving what he calls “a good death.”
“I’ll be honest with you, I don’t agree that publicly-funded institutions should have the right not to offer it. But this is so much beyond that,” he said.
Though he understands that individual physicians may find comfort in anonymity, he says he’s faced zero criticism for his involvement.
“I don’t think there’s any danger to physicians,” he said.
“Individuals who are participating and not putting their name out there are just kind of finding their way.”
To him, an institution doesn’t need the same level of protection.