958 days without medical assistance in dying policy

Lack of government regulation leaves Nova Scotians without access to legal practice and beset by misinformation.

The Coast

Brooklyn Connolly

It’s been 958 days since Bill C-14 passed federal legislation, yet Nova Scotia still lacks a program for medical assistance in dying—MAiD—as well as MAiD policy and regulation.

Without policy, physicians and nurse practitioners have no way of governing MAiD, creating a series of loopholes and lack of general knowledge surrounding the subject. The Nova Scotia Health Authority, meanwhile, has published false information on its website and staff at St. Martha’s hospital in Antigonish still refuse to perform the assistance at all.

Dalhousie professor Jocelyn Downie has been investigating the legal aspects of this for quite some time, and held an open lecture last week in Halifax to present her information. . . [Full text]

Ban on assisted dying at St. Martha’s hospital should end, says law prof

Religious hospital in Antigonish, N.S., has agreement with province allowing it to forego MAID provision

CBC News

Frances Willick

Nova Scotia’s only Catholic hospital is at risk of being found in violation of the Charter of Rights and Freedoms and human rights legislation by refusing to provide medical assistance in dying, a Halifax law professor says.

St. Martha’s Regional Hospital in Antigonish, N.S., is a publicly funded health-care facility. But due to its religious ties, staff are not permitted to provide MAID. . . [Full text]

Physicians are not solely responsible for ensuring access to medical assistance in dying

Diane Kelsall

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.

 


Kelsall D.  Physicians are not solely responsible for ensuring access to medical assistance in dying. CMAJ February 20, 2018 190 (7) E181; DOI: https://doi.org/10.1503/cmaj.180153

Nova Scotia launches toll-free phone line for women considering an abortion

CTV News Atlantic

The Canadian Press

HALIFAX — Women considering an abortion in Nova Scotia will soon be able to call a toll-free number to access information, arrange testing and set up an appointment.

The phone line will eliminate the need for a doctor’s referral to obtain the time-sensitive procedure.

The Nova Scotia Health Authority says the phone line will be staffed by a clerk or nurse from 8 a.m. to 4 p.m., Monday to Friday. Outside of those hours, callers can leave a voicemail and receive a follow-up phone call. . . [Full text]

Should doctors be paid a premium for assisting deaths?

Physicians can make more doing paperwork than performing this legal, but emotionally demanding, service. For many, it’s just not worth it.

MacLeans

Catherine McIntyre

Back in March, Dr. Tanja Daws took time off from her family practice to travel from B.C.’s Comox Valley to a remote community on Vancouver Island and provide an elderly patient who was dying and suffering with medical assistance in dying (MAID). After the five-and-a-half hour endeavour, which involved some of the most emotionally and technically difficult work Daws has ever done, the physician calculated that, after factoring in her staffing costs and other office expenses, she had lost about $28 for every hour she worked.

“It struck me that I can’t keep doing this,” says Daws. “I can work for nothing, but I can’t work for a loss.” . . . [Full text]

Doctors raise alarm about long delays in getting paid for medically assisted deaths

Payments have been slow and amount of time that doctors can bill isn’t enough, says Dr. Tim Holland

CBC News

Emma Davie

The president-elect of Doctors Nova Scotia is concerned that delays in getting paid for administering medically assisted deaths is deterring more doctors from offering the service.

Dr. Tim Holland said he’s yet to be paid for any of the procedures he’s done since Bill-C14 came into effect in June 2016.

Of the 67 claims made in the province for assessments and procedures related to medically assisted deaths, 35 have been paid and 32 are being assessed for payment, the Department of Health and Wellness said Tuesday. . . [Full text]

 

Fewer than half of assisted-death requests in Nova Scotia have been granted

Provincial stats on medical assistance in dying include applications filed between June 2016 and March 2017

CBC News

Frances Willick

Sixty-seven Nova Scotians have requested medical assistance to die since Canada’s assisted dying legislation was passed last June.

But of those 67 applicants, only 31 actually received medical help to die.

The Nova Scotia Health Authority, which oversees assisted dying in the province, said there are several reasons why the remaining applicants may have not received the help they requested. . . .[Full text]

 

Submission to the College of Physicians and Surgeons of Nova Scotia

Re: Standard of Practice: Physician Assisted Death

Abstract

The Project considers the proposed standard of practice satisfactory with respect to the accommodation of physician freedom of conscience and respect for the moral integrity of physicians. Neither direct nor indirect participation in euthanasia and assisted suicide is required.

The Project offers simple and uncontroversial recommendations to avoid conflicts of conscience associated with failed assisted suicide and euthanasia attempts and urgent situations.

The standard does not adequately address the continuing effects of criminal law. The College has no basis to proceed against physicians who, having the opinion that a patient does not fit one of the criteria specified by Carter, refuse to do anything that would entail complicity in homicide or suicide. College policies and expectations are of no force and effect to the extent that they are inconsistent with criminal prohibitions.

While the standard is satisfactory with respect to freedom of conscience, the fundamental freedoms of physicians in Nova Scotia will remain at risk as long as the College Registrar and others persist in the attitude and intentions demonstrated in his presentation to the Special Joint Committee on Physician Assisted Dying.


Contents

I.    Outline of the submission

II.    Avoiding foreseeable conflicts

II.1    Failed assisted suicide and euthanasia
II.2    Urgent situations
II.3    Project recommendations

III.    SPPAD and criminal law

IV.    Remarks of the Registrar

IV.1    The Registrar before the Special Joint Committee on Physician Assisted Dying
IV.2    The Registrar, the Conscience Research Group, and “effective referral”
IV.3    The Registrar’s intentions
IV.4    The Registrar’s complaint
IV.5    An ethic of servitude, not service

V.    Conclusion

Appendix “A”    Supreme Court of Canada, Carter v. Canada (Attorney General), 2015 SCC 5

A1.    Carter criteria for euthanasia and physician assisted suicide
A2.    Carter and the criminal law
A3.    Carter and freedom of conscience and religion

Appendix “B”    Conscience Research Group

B1.    Attempts to coerce physicians: abortion
B2.    Plans to coerce physicians: assisted suicide and euthanasia
B3.   Plans to coerce physicians: the CRG Model Policy
B4.    CRG convenes meeting with College representatives

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