Christina Lamb, Marilyn Evans, Yolanad Babenko-Mould, Carol Wong, Ken Kirkwood
Aims: To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice. Design: Interpretive phenomenology was used to guide this study.
Data sources: Data were collected from 2016 ‐ 2017 through one‐on‐one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings. Review methods: Iterative, phased analysis using line‐by‐line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO.
Impact: This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses’ conscience rights are indicated to address nurses’ conscience issues in practice settings.
Results: Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses’ conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice.
Conclusion: Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience‐based COs.
One nurse practitioner in Sudbury, Ont. says it’s important for her to provide support to patients who want to take this step. She admits that medical assistance in dying is rather limited in Sudbury, in that not a lot of physicians or nurse practitioners are willing to provide it for patients. . . [Full text]
The non-partisan campaign was launched to oppose and raise awareness about regulations that force doctors to refer for assisted suicide and euthanasia against their moral convictions.
By the end of March, people who have signed up during the campaign should receive instructions about how to e-mail all the candidates in their ridings in the run-up to Ontario’s June 7 provincial election. . . [Full text]
A landmark lawsuit has been filed by an Ontario man suffering from an incurable neurological disease. He alleges that health officials will not provide him with an assisted home care team of his choosing, instead offering, among other things, medically assisted death.
“My condition is grievous and irremediable,” 42-year-old Roger Foley said from his bed at the London Health Science Centre’s Victoria Hospital in a video that was recently posted online. “But the solution is assisted life with self-directed funding.”
According to Foley, a government-selected home care provider had previously left him in ill health with injuries and food poisoning. Unwilling to continue living at home with the help of that home care provider, and eager to leave the London hospital where he’s been cloistered for two years, Foley is suing the hospital, several health agencies and the attorneys general of Ontario and Canada in the hopes of being given the opportunity to set up a health care team to help him live at home again — a request he claims he has previously been denied. . . [Full Text]
Informal referral network currently in place with local physicians
For those in Sudbury and District seeking a doctor’s help to die, it may soon get a little easier to find one who is trained.
About 40 doctors and nurse practitioners in the region are now trained to offer Medical Assistance in Dying (MAID), after they had specialized training last fall in Sudbury from the Canadian Medical Association.
The Supreme Court of Canada ruled in June, 2016 that medical assistance in dying is a constitutional right, under Bill C-14.
Between then and now, there has only been an informal network for people seeking medically assisted death, said Dr. Paul Preston, Vice President of Clinical for the North East Local Health Integration Network, and an advocate for access for those seeking a doctor’s help with dying. . . [Full text]
Patients’ rights to access to medical assistance in dying (MAiD) trumps the religious rights of physicians under the Canadian Charter of Rights and Freedoms – or so says the Ontario Superior Court of Justice. But ensuring equitable access to health care is a societal responsibility and does not rest solely on the individual physician. Surely there is a way forward that ensures access for patients requesting MAiD without trampling on physician rights enshrined in law.
Assisted suicide has been legal in Canada since June 2016. Discussions are already taking place to expand the criteria to minors, people with psychiatric illness and those with dementia. This puts people who are lonely and isolated at risk of choosing euthanasia simply because they don’t have anyone who cares and can give them hope.
Today in Ontario:
Physicians and other caregivers are forced to participate in euthanasia against their will, by referring their patients.
Pro-euthanasia groups are threatening to sue faith based hospitals unless they allow euthanasia on the premises.
Only a third of the population has access to adequate palliative care, so they are being denied real choice on end of life issues.
This places physicians, nurses and other health professionals in an impossible situation – assist in the killing of their patients or lose the ability to care for patients at all.
This is happening despite constitutional protections for freedom of conscience and religion in the Charter of Rights and Freedoms (s.2).
The Coalition for HealthCARE and Conscience represents more than 110 healthcare facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across Canada. Our members are unable to participate in taking a patient’s life due to moral or ethical convictions.
The Ontario legislature has the power to protect conscience rights for individuals and facilities and to provide adequate palliative care and mental health services so that people will not see assisted suicide as their only option. Our efforts in Manitoba helped to ensure the province passed conscience protection legislation in November 2017.
In advance of the June 2018 provincial election in Ontario, we have the opportunity to ask candidates from all parties three important questions:
Will you support legislation to protect doctors, nurses and other health care providers who are being forced to participate in assisted suicide/euthanasia through making a referral?
How will you protect facilities from being forced to offer euthanasia/assisted suicide on their premises?
How does your party plan to address the lack of quality palliative care in our province?
To get involved, please participate in your Church’s Sign Up Sunday. We will be collecting contact information to help mobilize a large database of people to contact candidates for the 2018 Ontario provincial election.
Dr. Frank Ewert wants protection from having to help a patient die — but Dying with Dignity Canada doesn’t want that to happen at the cost of patients receiving full access to end-of-life options.
“When I started back a number of years ago and vowed to follow the Hippocratic oath, I meant it. It was very profound to me, it resonated with my core beliefs, that I would always respect life, that I would do nothing to harm a patient,” Ewert told a legislative committee on Monday evening. . . [Full text]
A policy on handling requests for medically assisted dying is being prepared for the John Noble Home.
The home’s committee of management this week got a staff report on the drafting of a formal policy on managing medical assistance in dying, or MAID, requests, which is now required in long-term care homes by federal law.
The draft could be presented to the committee for review as early as next month and will be referred to the city’s legal department for comment.
Jennifer Miller, administrator for the home for the aged on Mount Pleasant Street, said that, so far, there have been no MAID requests from residents. . . [Full text]
As euthanasia rates increase in the Canadian province of Ontario, pressure is mounting on Catholic Healthcare providers to abandon their blanket opposition to Medical Assistance in Dying (MAiD).
Over 630 Ontarians have received MAiD since the procedure was legalised in Canada in 2015, according to data from the provincial coroner, yet none of these cases has taken place in a Catholic healthcare facility.
Lobby groups are now calling for sanctions on Catholic healthcare providers, particularly in light of the public funding these providers receive.
Dying With Dignity Canada CEO Shanaaz Gokool told CBA News that her organisation is considering a legal challenge of Catholic hospitals’ right to conscientiously object to participation in euthanasia.
Gokool says that the Catholic healthcare policy of transferring MAiD patients to secular facilities places an undue burden on patients. “It really depends on how precarious their physical medical condition is,” she said. “And if they are in a precarious state physically, then that can cause them more trauma.”
Ontario health minister Eric Hoskins said that access to MAiD was not currently a problem. “We’re obviously monitoring it very, very closely and currently don’t have those concerns in terms of access,” he told CBA News. “And about half of medical assistance in dying happens at home”.
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