Ontario backs assisted death bill, but medical regulatory body disagrees | iNFOnews | Thompson-Okanagan's News Source

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Ontario backs assisted death bill, but medical regulatory body disagrees

May 10, 2016 - 2:26 PM

OTTAWA - Canada's largest medical regulatory authority is warning that most or all doctors in some Ontario communities could be disqualified from approving requests for a medically assisted death under the federal government's proposed new law.

The Ontario College of Physicians and Surgeons issued the warning Tuesday even as the Liberal government of Ontario threw its support behind the restrictive approach to assisted death taken in the proposed law.

Provincial Health Minister Eric Hoskins and Attorney General Madeleine Meilleur wrote to their federal counterparts to express their support for the controversial bill.

In the letter, released by the federal government, the duo said the bill reflects "a balanced approach" that makes medical assistance in dying available, subject to appropriate safeguards.

But the province's college of physicians told a Senate committee that some of the safeguards the government wants to impose are so stringent they will prevent many otherwise eligible patients from accessing an assisted death.

For instance, the bill stipulates that two doctors — independent of one another, with no connection or business relationship — must approve each request for medical assistance in dying.

Yet in Ontario, college president Joel Kirsh noted that most doctors typically practice in a group setting; indeed, family medicine is delivered entirely through group practice models.

In some rural and urban centres, many or even all doctors are part of the same practice group. For instance, the college said 98 per cent of all family physicians in Peterborough belong to the same family health team, 92 per cent in Barrie-North Simcoe and, in northern Ontario, 14 municipalities are affiliated with a single family health team.

"The prohibition against being in a business relationship or being connected would disqualify all physicians who practice together in hospital or facility groups or in family medicine practice models from providing MAID (medical assistance in dying)," the college said in its written submission to the committee.

"The consequent impact ... on patient access to MAID would be significant."

In another safeguard, the bill would require two independent witnesses to sign each written request for an assisted death. Those witnesses must not be anyone who might materially benefit from the requester's death, or who is directly involved in providing health care or personal care to the requester.

The college warned that some patients who might otherwise be eligible for an assisted death will not be able to find two people outside their family, caregivers or health care providers to be witnesses.

"Such patients would be forced to call upon virtual strangers to act as witnesses to a request that is intensely personal and private."

Moreover, the college warned that the bill's eligibility requirements are so restrictive and deviate so significantly from the parameters set out by the Supreme Court that it will "cause confusion and lack of clarity amongst physicians and the public."

The Supreme Court last year struck down the ban on medical assistance in dying and gave the government until June 6 to draft a new law that recognizes the right to an assisted death for clearly consenting adults with "grievous and irremediable" medical conditions who are enduring physical or mental suffering that they find intolerable.

The government has taken a considerably more restrictive approach than the top court. Its bill would allow medical assistance in dying only for consenting adults in “an advanced stage of irreversible decline” from a serious and incurable disease, illness or disability and for whom a natural death is “reasonably foreseeable.”

Kirsh, a pediatric cardiologist, told the Senate committee that it's impossible for a doctor to predict when a patient will die.

"This is not language that would help me," he said of the reasonably foreseeable death provision.

Douglas Grant, president of the Federation of Medical Regulatory Authorities of Canada, said every doctor will interpret the provision differently.

"Our concern is this is language doctors will not be comfortable with ... I really don't know how to implement it."

News from © The Canadian Press, 2016
The Canadian Press

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