Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
News

Many doctors won’t provide assisted dying

Lauren Vogel
CMAJ September 22, 2015 187 (13) E409-E410; DOI: https://doi.org/10.1503/cmaj.109-5136
Lauren Vogel
CMAJ
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

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.

“The debate of whether it’s good or not is over,” said Jean-Pierre Ménard, a speaker at the meeting and chair of the expert legal panel that recommended in 2013 that Quebec allow medical aid in dying. “Now we have to see how this new right for citizens will be managed and addressed.”

According to results of a CMA member survey presented at the meeting, many doctors remain opposed to assisting in a patient’s suicide. Only 29% of those surveyed said they would consider providing medical aid in dying if requested by a patient, 63% would refuse outright and 8% were undecided. Of those who would consider providing assistance, fewer would do so in cases of nonterminal illness (43%) or psychological suffering (19%).

The online survey, which received 1407 responses, also revealed a diversity of opinion about what physicians should be required to do if they reject a patient’s request for medical aid in dying. More than one in four members (29%) said they shouldn’t have to do anything; others supported referring patients to a colleague (19%), an independent third party (17%) or a medical administrator (8%).

Debate at CMA’s General Council broke down along similar lines, with some delegates and observers arguing for their right to refuse even indirect assistance to patients seeking to end their lives. For example, this might include refusing to share a patient’s chart with a physician providing medical aid in dying.

Figure

Dr. Jeff Blackmer presented results of a survey that found that 63% of members would not consider providing assisted suicide to patients.

Image courtesy of CMA/Mark Holleron

“No physician should be forced to participate against their conscience,” said Dr. Jeff Blackmer, vice president of medical professionalism at CMA. “But there’s disagreement about what this means.”

Some delegates said CMA should advocate for a separate central information service that patients could access without a referral. This would balance physician autonomy with patients’ right to access, they said.

Others argued that conscientious objectors should put their patients’ rights first. “A physician who refuses to provide service is serving his own needs, not his patients’,” said Dr. Bill Cavers, a British Columbia physician. To not inform is “abandoning the patient, pure and simple,” he said.

CMA will consider these comments as it develops guidelines on assisted dying based on ten principles: respect for autonomy, equity, respect for physician values, consent and capacity, clarity, dignity of life, protection of patients, accountability, solidarity and mutual respect.

The guidelines will include recommendations on who should qualify for medical aid in dying, a map for decision-making, the role and responsibilities of physicians, and a framework for moral objection.

Tomorrow, members will vote on a number of motions that will frame the guidelines. Among them, Dr. Ken Burns of BC and Dr. Shawn Whatley of Ontario have moved that CMA policy not include an obligation to refer for medical aid in dying. Whatley also moved that the CMA support a “patient or proxy self-referral method” for physician-assisted dying. During floor debate Aug. 25, he expressed fears that governments will end up offering assisted suicide as an alternative to better coverage and access to medically necessary care.

“I have a cousin with a rare kidney disease and right now he has a federal grant to cover [medication] but his financial burden of care could be considered to be so massive that maybe it would be better to choose assisted suicide,” he explained.

The importance of quality palliative care will also figure prominently. A motion from Dr. Susan MacDonald, president of the Canadian Society of Palliative Care Physicians, and Dr. Chris Simpson, outgoing president of CMA, will ask the CMA to advocate for access to high-quality palliative care for all Canadians, including those with life-limiting illnesses who are considering assisted death.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 187 (13)
CMAJ
Vol. 187, Issue 13
22 Sep 2015
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Many doctors won’t provide assisted dying
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Many doctors won’t provide assisted dying
Lauren Vogel
CMAJ Sep 2015, 187 (13) E409-E410; DOI: 10.1503/cmaj.109-5136

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Many doctors won’t provide assisted dying
Lauren Vogel
CMAJ Sep 2015, 187 (13) E409-E410; DOI: 10.1503/cmaj.109-5136
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Canadian neurosurgeons views on medical assistance in dying (MAID): a cross-sectional survey of Canadian Neurosurgical Society (CNSS) members
  • Right to die in Canada: respecting the wishes of physician conscientious objectors
  • Google Scholar

More in this TOC Section

  • Saying goodbye to CMAJ News
  • National survey highlights worsening primary care access
  • How Canadian hospitals are decreasing carbon emissions
Show more News

Similar Articles

Collections

  • Topics
    • Canadian government
    • End-of-life care & decisions
    • Professional conduct & regulation

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

CMA Civility, Accessibility, Privacy

 

Powered by HighWire