Federal legislation permitting the killing of people who meet the
criteria for Medical assistance in dying (MAiD) has challenged most
healthcare professionals to carefully consider where they morally
stand on causing someone’s death. While many healthcare providers may
feel it is against their values to participate in euthanasia, we have all
been asked or will be asked at some point about euthanasia by a patient
or their family.
With the passing of legislation allowing euthanasia, physicians,
nurses, pharmacists, social workers and other healthcare providers who
provide direct care have generally been protected if they have stated
their opposition to causing death. They have been protected in law and
in the policies of their organizations. It is important to note that
euthanasia is occurring within institutions as well as in community.
In general, frontline conscientious objectors have been respected
and accommodated. But, what about those behind the scenes? For
example, for healthcare in a multicultural and multi-linguistic
setting to work we must rely on quality interpreters to ensure that
effective communication has taken place. As a principle of good practice
when we are working with a person who does not speak English we must
ensure that we use proper interpretation. Consequently when
interpretation services are formally requested to process a euthanasia
request, we must ensure that the interpreter knows why they are being
asked so they can have the opportunity to exercise their conscience
and object to participating. Like frontline staff they too may feel
morally compromised if their services contribute to a death.
Another behind the scenes group who are integral to modern
healthcare are staff involved in clinical informatics. These are
professionals who design, implement and oversee our electronic health
records and our organization’s websites. This is the case with
documentation for MAiD especially as the coroner reviews all cases to
ensure participants receive the exception from criminal law. Within
this group of healthcare professionals, they too have had
conscientious objection to MAiD and did not want to participate.
Fortunately those who opposed euthanasia had their conscientious
objection respected.
While interpreters and clinical informatics team members may be
asked to participate in euthanasia their right to conscientious
objection is not recognized as it is for doctors, nurses, pharmacists
and other frontline staff. As such, they need to be considered and
supported in organizational policies addressing MAiD.
I further want to encourage us to consider who and where are
the other hidden professions of conscientious objection who need our
support.