Any objections? Doctors still pressured against following conscience

Catholic News Service

Carol Glatz

ROME (CNS) — When St. John Paul II called for conscientious objection against laws legitimizing abortion and euthanasia 20 years ago, one Catholic doctor never imagined the struggle and sacrifice to carry out that duty would last for so long.

Dr. Robert Walley, a British obstetrician and gynecologist who founded and heads MaterCare International, organized the group’s very first world conference in Rome in 2001 on the question of conscience in maternal healthcare. And now, 14 years later, “the problem hasn’t gone away, it’s still here.”

To address the ongoing dilemma, MaterCare held its 10th international conference in Rome Aug. 31-Sept. 4 to look at the problem of discrimination against Catholic obstetricians, gynecologists, midwives, medical students and health care staff when they object to training and procedures that go against their beliefs. Part of the World Federation of Catholic Medical Associations, MaterCare was founded in 1995 to serve mothers and their children.

“In 1973, I had three choices” when he practiced under Britain’s state-run National Health System: do the abortions, change his specialization or leave the country, Walley said. “So we left and went to Canada” to start life over with his wife and seven children to support.

While he was “prepared to accept that cross,” he said he felt he did not receive enough support or encouragement from the church and feels medical professionals who become conscientious objectors are still “basically on our own.” . . . [Full text]

Gaétan Barrette insists dying patients must get help to ease suffering

Quebec’s right-to-die law comes into effect on Dec. 10

The Canadian Press

Terminally ill patients in Quebec who seek medical aid in dying must be provided with the service even if some doctors are against it, Quebec’s health minister said Wednesday.

Gaétan Barrette called out unco-operative doctors and directors of institutions in the province’s health care network Wednesday after a palliative care unit in Montreal announced it wouldn’t offer the service.

Quebec’s right-to-die law comes into effect on Dec. 10 and Barrette says the patient will be the priority.

“The role of (medical) institutions is to offer the service,” he said. “And it will be offered.” . . . [Full Text]

Palliative care centres say no to medically assisted death

West Island Palliative Care Residence won’t obey Quebec’s ‘dying with dignity’ law

CBC News

The director of the West Island Palliative Care Residence says patients seeking assistance with dying will have to go elsewhere.

“We are absolutely one of the 29 [palliative care programs in Quebec] that are opting out of providing this service,” says the residence’s executive director, Theresa Dellar.

“The basic philosophy of palliative care is we do nothing to hasten death, and obviously euthanasia does hasten death. Our philosophy to provide comfort, care and dignity at the end of life and to allow for the natural process of death to take place,” she said. . . . [Full text]

Quebec MDs to get euthanasia guide to prepare for legalized assisted death

Unclear whether other provinces and territories will adopt a similar practice

The Canadian Press

Sheryl Ubelacker

The college that regulates Quebec doctors will soon provide practitioners with detailed guidelines – including what drugs to use – for euthanizing terminally ill patients who seek help to end their lives.

But it’s unclear whether other provinces and territories will adopt a similar practice when doctor-assisted death becomes legal across the country early next year.

With the passage of Bill 52 in June 2014, Quebec became the first jurisdiction in Canada to legalize medical aid in dying for mentally competent patients who meet a strict set of criteria. The law goes into effect in December, allowing physicians to begin helping patients with an incurable condition and intolerable physical or psychological suffering to die. . . [Full Text]

National Post View: On physician-assisted suicide, respect the conscience rights of all

National Post

The Supreme Court has spoken on the issue of physician-assisted suicide. Now the physicians are speaking.

According to a poll of 1,047 doctors by the Canadian Medical Association (CMA), released as part of the organization’s annual general meeting in Halifax, 63 per cent would refuse to provide so-called “medical aid in dying.” Twenty-nine per cent said they would consider killing a patient upon request, with 19 per cent saying that they “would be willing to help end the life of a patient whose suffering was psychological, not physical.”

The results suggest there remains strong opposition to assisted suicide among the membership of the CMA, which until recently was officially opposed to a loosening of anti-euthanasia laws in any form. At the same time, it suggests there are enough doctors willing to aid a patient to commit suicide to serve the demand. Unfortunately, that is not enough to settle the matter of just when and how physicians will be involved. . . (Full text)

Podcast: Canadian Medical Association draft framework on euthanasia and assisted suicide

On August 25, 2015, delegates at the 148th Annual General Council of the Canadian Medical Association will be voting on a draft policy framework for euthanasia and assisted suicide.

The draft document warrants close attention because of its potential impact on freedom of conscience among health care workers who do not want to be involved with these procedures.

This podcast supplements the Project’s commentary on the draft framework, which includes an on-line annotated version.

Podcast Contents

Introduction (00:00-06:35)

  • The problem of referral
  • “Providing” or “participating”?

Principles Based Approach to Assisted Dying in Canada (07:09-11:27)

  • Carter v. Canada
  • Strategic Questions

Schedule A: Foundational Principles (11:27-19:05)

  • Equity
  • Respect for physician values
  • Solidarity

Schedule A: Recommendations (19:38-27:33)

  • Patient qualifications
    • Informed decision
    • Capacity
  • Process map for medical decision making
    • Stage 1 & 2: Requesting; Before undertaking
    • Stage 3: After undertaking

Schedule A: Recommendations (28:07-31:02)

  • Conscientious objection by a physician

Schedule B: Legislative criteria across jurisdictions (31:35-35:00)

  • Q3: Reconcile refusal and equitable access?

Summing up (35:32-39:12)

Many doctors won’t provide assisted dying

Canadian Medical Association Journal

Lauren Vogel

Canadian doctors remain deeply divided over whether and how to provide medical aid in dying, and what is required of those who refuse to assist in ending a patient’s life.

Earlier this year, the Supreme Court of Canada unanimously ruled that patients who face intolerable suffering from a “grievous and irremediable medical condition” have a constitutional right to doctor-assisted suicide. The decision overturned a previous ban; now federal legislators must regulate the practice by Feb. 6, 2016.

Exactly how physicians should respond to this new legal reality dominated discussion at the Canadian Medical Association (CMA) General Council in Halifax on Aug. 25. . . (Full text)


Majority of doctors opposed to participating in assisted death of patients: CMA survey

National Post

Sharon Kirkey

HALIFAX – Most Canadian doctors appear to be reluctant to help end a life, despite the Supreme Court of Canada’s ruling Canadians have a constitutional right to physician-assisted death, according to a new poll released Tuesday.

But results of the survey by the Canadian Medical Association – once long opposed to physician-hastened dying in any form – also suggest thousands of doctors would be willing to prescribe a fatal drug overdose for a patient whose suffering was purely psychological.

Overall, the online survey of 1,407 doctors in June and July found 29 per cent said they would consider providing “medical aid in dying” if requested by a patient; 63 per cent would refuse. . . (Full text)


Debate flies at CMA meeting over physician’s role in assisted dying

 Global News

Julia Wong

HALIFAX – Physicians from across the country spent hours at the Canadian Medical Association’s annual general meeting discussing what their role would entail if asked to assist a patient in dying.

Dozens of physicians took the floor to share their thoughts, concerns and worries over what was morally acceptable and what to do if they had a conscientious objection.

The Supreme Court of Canada struck down the ban on assisted dying in February and gave the federal government one year to create a new law. It will technically be legal for a physician to be involved in assisted dying next year.

Dr. Douglas Maynes, a Halifax psychiatrist who has been practicing for 43 years, said he has concerns about those with mental illness. . . (Full text)


Doctors’ Group urges Canadian Medical Association to defend conscience rights on assisted death

News Release

Christian Medical and Dental Society of Canada

HALIFAX, Aug. 24, 2015 /CNW/ – Larry Worthen, Executive Director of the Christian Medical and Dental Society of Canada (CMDS), urged the Canadian Medical Association (CMA), today, to support their members’ freedom of conscience when they meet on Tuesday, August 25th, to consider the CMA’s position on assisted death and conscience rights.

Said Larry Worthen, “Many physicians have moral convictions that will not allow them to participate in medical aid in dying. There should be no discrimination against a physician for her refusal to participate in medical aid in dying for moral or conscience reasons. That is why the Christian Medical and Dental Society of Canada urges the Canadian Medical Association to adopt the third option being presented to them by CMA staff: that physicians have a ‘duty to provide complete information on all options and advise on how to access a separate, central information, counselling and referral service.'”

The Canadian Medical Association will be discussing a policy framework called “Principled Based Approach to Assisted Dying in Canada” at their general council meeting in Halifax on August 25th. Section 5.2 of this document deals with physician conscience protection and assisted death. CMA staff will present four options for dealing with conscientious objection, and delegates will be polled on which option should be included in official CMA policy.

All options deal with the situation in which a physician is not able, for reasons of conscience, to participate in physician-assisted death. The four options are:

  1. Duty to refer directly to a non-objecting physician;
  2. Duty to refer to an independent third party;
  3. Duty to provide complete information on all options and advise on how to access a separate, central information, counselling, and referral service; or
  4. Patient self-referral to a separate central information, counseling, and referral service.

Options ‘1’ and ‘2’ require the objecting physician to refer. Many physicians will have moral convictions that assisted death is never in the best interests of the patient, while others may object to assisted death because of the particular circumstances of the patient. A referral is essentially a recommendation for the procedure, and facilitates its delivery. A requirement to refer means that physicians will be forced to act against their consciences.

Option ‘4’ allows the patient to directly access assisted death, but does not necessarily provide an opportunity for counseling by a physician who has a longer term relationship with the patient.

“Option ‘3’ allows the discussion of all options to occur with the patient and the physician who knows them. If, after considering all of the options, the patient still wants assisted death, the patient may access that directly. This option ensures that all reasonable alternatives are considered. It respects the autonomy of the patient to access all legal services while at the same time protecting physicians’ conscience rights,” added Mr. Worthen.

Option ‘3’ is a summary of a proposal submitted to the CMA by three organizations: the Christian Medical and Dental Society, the Canadian Federation of Catholic Physician Societies, and Canadian Physicians for Life. Taken together, they represent more than 3000 Canadian physicians.

CMDS (Christian Medical and Dental Society) represents some 1600 physicians and dentists across Canada.

See the complete CMDS-CFCPS-CPFL- proposal to the CMA