Canadian Medical Association recommends policy allowing doctors to avoid assisted suicide referrals
HALIFAX, August 27, 2015 (LifeSiteNews) – The Canadian Medical Association has approved a policy allowing Christian doctors to avoid referring patients to colleagues they know would help them die.
“It’s a tremendous thing,” Larry Worthen, the head of the Christian Medical and Dental Society, told LifeSiteNews today. “Our doctors will be able to continue the practice of medicine without having to participate in something they consider immoral.”
The CMA is not a regulatory body but Worthen hopes its recommendation will have a powerful influence on the provincial Colleges of Physicians and Surgeons which control who get medical licences and who get suspended.
The colleges across Canada, Worthen said, currently favour requiring doctors with conscientious objections to refer patients requesting assisted suicide or euthanasia to doctors they know will provide it. The CMA has long opposed assisted suicide and at the AGM it released its latest poll of members showing its members still don’t want to assist suicides by a two-to-one margin.
But in February the CMA’s opposition was made moot by the Supreme Court of Canada’s legalization of assisted suicide. The court delayed the decision’s coming into effect for a year to give governments and provincial colleges a chance to develop a legal or regulatory framework.
Now the CMA is both developing courses to train doctors how to assist suicide and at the same time looking for a compromise between those who want doctors forced to refer and those who don’t. Among those advocating the coercive model was British Columbia doctor Bill Cavers, who told the meeting, “A physician who refuses to provide service is serving his own needs, not his patients’.” To not inform is “abandoning the patient, pure and simple.”
But fighting for conscience rights was a coalition comprising the CMDS, the Federation of Catholic Physicians Societies and the Canadian Physicians for Life. This group worked out a proposal for the AGM they felt would address both their own members’ conscientious objections “and the rights of patients to access all medical services legal in Canada,” according to Worthen. The CMA leadership revised it, and the result won the day.
The winning proposal recognizes doctors have “the duty to provide complete information on all options and advise on how to access a separate, central information, counselling, and referral service.”
Worthen explained that this “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.”
The CMA put this, along with three other options, before the members with one formal motion and three straw votes. The motion which simply freed doctors of any obligation got just 8 votes. The straw-vote proposal just as simply requiring doctors with conscientious objections to refer to a willing colleague also lost, but got 60 votes. The option requiring doctors to refer to a third party also got just just 20 straw votes. But the option directing conscientious objectors to discuss all the options clearly won the favour of the most delegates with a big margin—144 straw votes.
This CMA’s governing council will now use this proposal to develop a formal policy.
While the dispute is being cast as one between doctors’ and patients’ rights, Alex Schadenberg, head of the Euthanasia Prevention Coalition, argues that this misses the point.
“The doctor who refuses to do assisted suicide believes in his conscience that killing patients is not good for them,” he told LifeSiteNews. “Now that the law against assisted suicide has been struck down,” he said, “the only protection for vulnerable people is the conscience of their doctor. But if his conscience isn’t protected [if he is required to refer], then he will have weigh his objections against the risk of losing his medical licence.”
Amy Hasbrouck of the Not Dead Yet Canada disabilities rights group echoed Schadenberg’s concerns. “These doctors promoting assisted suicide are only looking at the surface of a snapshot of people with disabilities.” Hasbrouck said patients may come to a doctor just after learning of their condition—or learning how many months they have left to live. They need protection from their own emotions, not quick compliance with their wishes, she said. They may also need protection from exploitive relatives or institutional caregivers who want them dead.
Hasbrouck added her voice to those at the CMA convention calling for better palliative care. “Doctors are inadequately trained to treat pain and emotionally unprepared to face it in their patients. The health system is poorly equipped to provide palliative care. The problem is not with medical science but with the medical practice. Only a third of Canadians get adequate palliative care and that is why so many people want assisted suicide.”
Dr. Shawn Whatley of Ontario told the CMA meeting that governments might well end up encouraging assisted suicide as a cheaper alternative to palliative care. The three pro-life doctors groups joined the palliative care doctors’ association in calling for more spending on end-of-life care.