Protection of Conscience Project

I am writing on behalf of the Protection of Conscience Project concerning the issue of access to euthanasia and assisted suicide. The Project does not take a position on the morality or legalization of the procedures, but jointly intervened in the Carter case at the Supreme Court of Canada in support of freedom of conscience.

The issue of access to the services is frequently raised in connection with the exercise of freedom of conscience and religion by dissenting health care practitioners. This not infrequently generates heated controversy, and has already led to a constitutional challenge in Ontario in which the Project has again jointly intervened. However, informed public discourse and public policy making requires accurate, publicly available information about the actual extent of participation by medical professionals and institutions.

The Project has compiled statistics from Belgium, the Netherlands, Washington state and Oregon about practitioner participation in euthanasia and assisted suicide.

These jurisdictions provide only limited information. For example, one can estimate the maximum number of physicians involved in Belgium and the Netherlands, but the actual number is probably lower. Washington includes the actual number of participating physicians (about 0.5% of all physicians), but not the number of lethal prescriptions written by each.

What the Project proposes would provide better insight into the issue of practitioner participation than is currently available anywhere else. Canada is well-placed to provide leadership in this area. The number of cases has not yet reached a level that would make retrospective analysis unmanageable. It should not be difficult to fill the current statistical lacunae on practitioner participation and arrange for ongoing data collection. This can be done by analyzing existing billing records and returns, and by revising billing and reporting forms to capture future data.

The Project recommends that the information outlined in Appendix "A" be collected and made public as a matter of course, in a manner that safeguards the privacy of practitioners and patients. This will not, of course, resolve all controversies about access to euthanasia and assisted suicide, but should promote more informed discussion of the subject.

Sincerely,

Sean Murphy, Administrator
Protection of Conscience Project

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APPENDIX "A"

Information re: participation in euthanasia and assisted suicide

1. Medical & nurse practitioners involved in each province/territory in each period under review (Break down by relevant geographic or administrative region)

1.1 Number of medical and nurse practitioners who identified themselves as willing to I) provide euthanasia or assisted suicide and/or ii) act as practitioners providing required second opinions.

1.2 Number of medical and nurse practitioners who withdrew from providing euthanasia or assisted suicide.

1.3 Number of medical and nurse practitioners who personally administered euthanasia or assisted suicide, and the number of such cases for each practitioner.

1.4 Number of medical and nurse practitioners who provided assessments or second opinions for euthanasia or assisted suicide, and the number of such cases for each practitioner.

1.5 Number of active registered medical and nurse practitioners in a province.

2. Pharmacists involved in each province/territory in each period under review (Break down by relevant geographic or administrative region)

2.1 Number of pharmacists and pharmacy technicians who have identified themselves as willing to dispense drugs for euthanasia or assisted suicide.

2.2 Number of pharmacists and pharmacy technicians who withdrew from dispensing drugs for euthanasia or assisted suicide.

2.3 Number of pharmacists and pharmacy technicians who personally dispensed drugs for euthanasia or assisted suicide, and the number of cases for each practitioner.

2.4 Number of active registered pharmacists and pharmacist technicians.

3. Institutions involved in each province/territory in each period under review (Break down by relevant geographic or administrative region)

3.1 Number of acute care hospitals and hospices, the staff of which provided euthanasia or assisted suicide on their premises, and the number of such cases in each institution.

3.2 Number of acute care hospitals and hospices that allowed euthanasia or assisted suicide on their premises by practitioners external to the institution, and the number of such cases in each institution.

3.3 Number of acute care hospitals and hospices that did not allow euthanasia or assisted suicide on their premises, but which initiated a patient transfer in order to facilitate the services, and the number of such cases in each institution.

3.4 Number of acute care hospitals and hospices that did not allow euthanasia or assisted suicide on their premises, but which cooperated in (but did not initiate) a patient transfer because a patient requested euthanasia or assisted suicide.

3.5 Number of acute care hospitals and hospices in a province in the period under review.

4. Trends in practitioner participation

4.1 Of those who personally administered euthanasia or assisted suicide or dispensed drugs for the procedures in under 1.3 or 2.3, how many did so for the first time?

4.2 Of those who provided assessments or second opinions under 1.4, how many did so for the first time?

5. Trends in institutional participation

5.1 Of institutions that allowed euthanasia or assisted suicide by their own staff on their premises, how many did so for the first time?

5.2 Of institutions that allowed euthanasia or assisted suicide by practitioners external to the institution, how many did so for the first time?

5.3 Of institutions that initiated a patient transfer of care under 3.3, how many did so for the first time?

5.4 Of institutions that cooperated in a patient transfer of care under 3.4, how many did so for the first time?