Amir Attaran and the elves


A law professor makes much ado

Sean Murphy*

In a column in the on-line magazine iPolitics,1 University of Ottawa law professor Amir Attaran asserts that the “corrosive hostility” of the Canadian Medical Association to “physician-assisted dying” is evident in its “cowardly and stupid” position on the procedure. He claims that the Association “all but threatened” the Supreme Court of Canada that “doctors would rise up” to block it.

In his telling, ever since the Court ignored the threat and struck down the law, the CMA has been acting like a “sore loser,” trying to persuade physicians not to participate. As evidence, he quotes a CMA policy recommendation: “Physicians are not obligated to fulfil requests for assisted dying.” And he complains that the CMA won’t force physicians unwilling to kill patients or help them commit suicide to find someone who will.

Now, the CMA also states that all eligible people should have access to the services without undue delay, and physicians will work with others to ensure access to them,2 but Professor Attaran ignores this. His analysis of CMA policy is simple and scathing. Some physicians, he says, are “bigots,” and the CMA is siding with “those bigots” rather than with patients.

Professor Attaran identifies the bigots: physicians who believe that killing patients or helping them commit suicide is gravely wrong, or at least a bad idea, even in the circumstances defined by the Supreme Court. Those whom Professor Attaran denounces as bigots include physicians who believe they are ethically obliged to compassionately accompany and support dying patients, but not to kill them.

On the contrary, says Professor Attaran, they are “duty-bound” to kill patients or help them commit suicide precisely because the Supreme Court “pointedly” approved “physician-assisted suicide.”*  If physicians won’t help patients commit suicide, he rages, “then who does the CMA think should be obliged to help – elves, maybe?”

To which any number of physicians have already replied, “Not elves, but lawyers.”

[Full text]

[iPolitics version- Doctors aren’t obliged — legally or otherwise — to help people die]


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)


Unacceptable to force doctors to participate in assisted dying against their conscience: CMA head

National Post

Sharon Kirkey

No physician in the country should be forced to play a role in any aspect of assisted dying against their moral or religious beliefs — including referring patients to another doctor willing to help them die, the Canadian Medical Association says.

Legalized physician-assisted death will usher in such a fundamental change in practice “we simply cannot accept a system that compels physicians to go against their conscience as individuals on something so profound as this,” CMA president Chris Simpson said in an exclusive interview.

The unanimous Supreme Court of Canada ruling legalizing assisted dying would not compel doctors to help patients end their lives when the historic decision takes effect next year.

But the justices were more guarded on the issue of mandatory referral, saying the Charter rights of both patients and doctors will need to be reconciled.

Dr. Simpson said that many doctors who conscientiously object to assisted dying feel the very act of referral “is contrary to their personal ethics or moral or religious beliefs.” . . . [Full text]

Canada Court Strikes Down Ban on Aiding Patient Suicide

New York Times

Ian Austen

OTTAWA  –  The Supreme Court of Canada on Friday struck down laws banning physician-assisted suicide for patients with “grievous and irremediable” medical conditions.

The unanimous decision, which reverses the position taken by the court 22 years ago, came more quickly than expected and might become an issue in federal elections to be held this year.

“The prohibition on physician-assisted dying infringes the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice,” the court wrote, adding that an absolute ban was not needed to ensure that vulnerable people are not coerced “to commit suicide at a time of weakness.” . . . [Full Text]


Doctor-assisted suicide a therapeutic service, says Canadian Medical Association

 Many technical questions remain following Supreme Court decision to allow medical aid in dying

CBC News

The Canadian Medical Association supports patients who seek “medical aid in dying” as well as physicians’ choice to participate, the group’s president said Thursday in response to a Supreme Court decision.

As the legal environment changes, the CMA said it will support doctors and patients who find medical aid in dying their best option.

“What we want to do is really make sure patients who are eligible under the new rules have access to this therapeutic service, but at the same time we need to be very careful that physicians have the right to conscientious objection for moral or ethical reasons or religious reasons,” CMA president Dr. Chris Simpson said in an interview from Yellowknife. . . [Full Text]


Helping suffering patients die may be doctor’s most humane option, Canadian Medical Association says

National Post

Sharon Kirkley

For the first time, the Canadian Medical Association has said helping a suffering patient die may be a doctor’s most humane option.

In a new position statement approved by its board, the CMA – once firmly opposed to any form of doctor-hastened killing – now states “there are rare occasions where patients have such a degree of suffering, even with access to palliative and end of life care, that they request medical aid in dying. In such a case, and within legal constraints, medical aid in dying may be appropriate.”

The policy change comes as the powerful doctors’ lobby prepares for a possible lifting of the federal ban on assisted suicide when the Supreme Court of Canada releases its historic ruling Friday morning in Ottawa.

If the top court strikes down laws making it a criminal offence to “counsel, aid or abet” another person to commit suicide,  “we’re going to need to hit the ground running if we want to lead and do this well,” said CMA president Dr. Chris Simpson. . . . [Full Text]

Doctor-assisted death appropriate only after all other choices exhausted, CMA president says

Sharon Kirkey

Doctor-hastened death would only be appropriate after all other reasonable choices have been exhausted, says the head of the country’s largest doctors’ group.

Dr. Chris Simpson, newly installed president of the Canadian Medical Association, made the comments in advance of a landmark Supreme Court of Canada hearing expected to add fuel to the emotional end-of-life debate gaining urgency across Canada.

Simpson said there are enough doctors in Canada willing to perform doctor-hastened death, if the federal ban outlawing euthanasia were lifted.

But doctors first need safeguards to protect the vulnerable and a strategy to urgently shore up palliative care “so that this is not seen as a first, or second or even third choice, but a choice that’s appropriate for people after all other reasonable options are exhausted,” he said. [Full text]