Health

SCC ruling on assisted suicide carries many implications for physicians, regulatory regime required

Toronto health lawyer Elyse Sunshine says it’s critical that physicians pay close attention to any regulatory changes that may affect them in the months following the landmark Supreme Court of Canada ruling that lifts the ban on doctor-assisted suicide.

“The SCC has said that patients are going to be entitled to have an assisted death where appropriate and so physicians are going to have to examine their own practice and make adjustments to deal with this,” she tells AdvocateDaily.com. “Physicians will really have to keep abreast of what’s going on and what guidance is going to be put out there by their own regulatory body and by others who may dictate how they have to provide care.”

Sunshine, partner at Rosen Sunshine LLP, says the decision carries many implications for physicians and there are many issues that still need to be sorted out as a regulatory process has yet to be developed.

“A lot of issues are unclear – including what is Parliament going to do in response to the ruling,” she says. “They could treat it like abortion (with no law), which is unlikely; they could follow the Quebec model or they could work with various stakeholders to create the rules. There are a lot of unknowns as to what will happen in the next 12 months.”

The high court ruling in Carter v. Canada stipulated that Ottawa has one year before the existing provisions in the Criminal Code are officially removed.

A new regime for physicians could fit into a palliative care model, but it’s unknown if there will be restrictions on whether all doctors will be able to provide this service.

“There are questions around who can provide this service under what circumstances and in what manner,” says Sunshine.

She says the lifting of Canada’s ban on physician-assisted death may also raise issues for those doctors who are morally and ethically opposed to providing the service.

She points to a policy by the College of Physicians and Surgeons of Ontario and the Ontario Human Rights Code that deals in part with how physicians are to handle requests for treatments that conflict with their moral conscience.

“One could anticipate that assisted death would fall under this type of regime,” she says.

Sunshine notes that not every doctor is going to be trained to assist in this area and it is obviously understood that physicians don’t have to provide services that aren’t within their area of expertise.

“Even for those for whom it may be within their area of expertise but they are simply not comfortable with it or it conflicts with their own moral or ethical belief system, there has to be a mechanism to guide those doctors in how they’re supposed to handle those types of requests,” she says.

Sunshine says it remains to be seen as to whether the College of Physicians and Surgeons of Ontario will develop their own policy specific to physician-assisted death.

“The College has two policies that may be relevant – one that deals with planning for and providing for quality end-of-life care and the other (as noted above) dealing with the Ontario Human Rights Code,” she says. “I would be surprised if we don’t see some guidance from the College of Physicians on this.”

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