Physician-Assisted Dying Part 2: Implications For Frontline Healthcare Professionals

"This issue is not one of life or death. The issue is what kind of death, an agonized or peaceful one. Shall we meet death in personal integrity or in personal disintegration? Should there be a moral or demoralized end to mortal life?"

Fletcher, J. (1954). Morals and Medicine. Princeton, NJ: Princeton University Press at 754

Healthcare professionals are intimately involved with end of life processes, and in many cases will play a significant role in the care and planning around those processes with their patients. With the imminent arrival of legislation on physician-assisted death, this unique and privileged role requires particular consideration by lawmakers and regulators, as the rights of patients must be balanced with the rights of those who will facilitate their death.

Effective February 6, 2016, for the duration of the four month extension of the Supreme Court of Canada's ("SCC") suspension of its decision in Carter v. Canada, 2015 SCC 5, individuals seeking a physician-assisted death in BC may to apply to the Supreme Court of British Columbia for approval (See Carter v. Canada, 2016 SCC 4). In the absence of legislation, it has fallen to the professional regulatory bodies to set out the parameters for physician-assisted death in BC.

Interim guidance for physicians

In a media release on January 22, 2015, the College of Physicians and Surgeons of British Columbia ("CPSBC") announced its approval of an interim guidance document for its registrants on physician-assisted dying. The CPSBC's interim guidance document is aimed at assisting physicians in navigating the practical gray area created by the SCC's exception to the suspension of the Carter decision.

The CPSBC's five page guidance document recognizes the need to strike a balance between patient autonomy and the right of BC's physicians to conscientiously object and abstain from performing physician-assisted death on the basis of their personal values and beliefs. Clearly seeking a middle ground between patient autonomy and physician rights, the interim guidance document states that physicians who object are not required to make a formal referral on behalf of their patients seeking physician-assisted suicide; however, they have an overriding duty of care which requires them to provide an effective transfer of care.

The majority of the CPSBC's interim guidance document focuses on the CPSBC's procedural requirements for physician-assisted death, which are summarized below:

  1. A...

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