Physician assisted death is coming to Ontario –are we ready?

On February 6, 2015, the Supreme Court ruled that physicians could assist people in ending their lives.
The government was given one year to change the law so that it would conform to the ruling. The prior Conservative government avoided the issue, and the new government asked for an extension. The Court has given it until June 6, 2016.

Presumably the new law will clarify who, in addition to doctors, is allowed to assist patients’ wishes for a hastened death. However, Health Care is the responsibility of the Provincial Government, and Queen’s Park has to regulate the delivery of this service to Ontarians.

Even without the distraction of an election campaign, our province has provided limited leadership. It has relied on the College of Physicians and Surgeons of Ontario (CPSO) to draft a policy for its members, which although detailed, does not follow some important expert recommendations and may lead to delays in access for some patients.
The Ontario College of Pharmacists has prepared a preliminary document for its members but it is not sufficient to guide practice. The College of Nurses website simply reminds its members that assisted death is illegal and asks them to watch for changes in legislation.

Similarly, the province has been silent on how institutions will respond to a request for assisted death, leaving each hospital, nursing home and other facilities to expend considerable resources to formulate such policies in parallel. And it does not appear that they have made much progress.

In Downsview, a search of “Assisted Death” on the Humber River Hospital website leads to a page entitled “What You Need to Know About Palliative Care”, which was “ Last Revised: October 2011”. There is no mention of assisted death nor that of the process patients must follow.

This makes sense, because assisted death has very little to do with Palliative Care. The latter is a compassionate approach to providing comfort and support to patients diagnosed with an incurable illness, helping them to maximize quality of life.

To underscore this point, the largest group of doctors that provide home palliative care in Toronto has no physicians who work in Downsview and who are prepared to offer assisted death for their patients. Fortunately, the organization has been preparing for a change in the law since before the Supreme Court even heard the case.

“Assisted death is not a part of what I can do as a physician, and it certainly is not a part of Palliative Care”, said one of these doctors on condition of anonymity. However, he added that “we respect the court decision and we respect the rights of our patients.”

His organization will ensure that all of his patients will have access to a referral in the event that they choose assisted death, using a reporting system.

The right to assisted death is no longer up for debate. The Province could ensure facilitated access for all Ontarians by instituting mandatory reporting, a central referral process, and providing direction to its professionals and institutions.

Does the government have the will to show leadership on this issue?
Let us know what you think!

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