Subsequent to an intensive three-year period of reflection, the CMQ is revealing its perspective and conclusions today regarding end-of-life care and euthanasia. The CMQ embraces the point of view of the patient who is confronting imminent and inevitable death. In such a situation, the patient looks to their physician and generally requests that they be able to die without undue suffering and with dignity. Neither surveys, nor attorneys, nor politicians can properly advise the physician and the patient facing this situation. In the majority of cases, the patient and their doctor find the appropriate analgesia that respects the ethical obligation of physicians not to preserve life at any cost, but rather, when the death of a patient appears to be inevitable, to act so that it occurs with dignity and to ensure that the patient obtains the appropriate support and relief.
Parichehr Salasel believed that where there was life, there was hope. Two doctors at Toronto’s Sunnybrook Health Sciences Centre disagreed, saying that it is in the best interests of her husband, Hassan Rasouli, who is in a permanent vegetative state, to be taken off life support and provided with palliative care until his death. The seven-month medical conflict over Mr. Rasouli’s fate ended on Wednesday when Ontario’s top court took Ms. Salasel’s side in a ruling that is expected to reignite for Canadians the emotional issue of how to handle end-of-life decisions and whether extraordinary medical interventions save lives or merely prolong dying.
[...] the Panel was persuaded that the law in Canada [...] should be changed to allow some form of assisted suicide and voluntary euthanasia. Putting the philosophical analysis together with the lessons learned from [a] review of the paths taken in other jurisdictions that have moved to more permissive regimes, the Panel considered the options for the design of a permissive regime and suggests the following legal mechanisms for achieving the reform and the core elements of the proposed reform.
Our angst is not limited to cases of assisted-suicide. It is rather that engaging in it alters the mission of medicine. It strikes at the very core of our beings as healers. It would leave an indelible imprint on dialogues with all patients. Our worry is anchored in the deep recognition of the vulnerability of sick persons and the power differential that exists in the doctor-patient relationship.
It’s not practical and it might be illegal but it may be desirable. It’s safe to say there’s a quintessentially Canadian divergence of views when it comes to elective ventilation but it was ever thus when it comes to matters of organ transplantation policy. Little surprise then that the notion of improving organ donation rates by allowing people with severe brain injuries and hopeless prognoses to be placed on ventilators until they suffer brain death isn’t on the Canadian table. The topic hasn’t been broached and the time hasn’t come to even contemplate such a proposition, argues Dr. Sam Shemie, a physician in the Division of Pediatric Critical Care at Montreal Children’s Hospital in Quebec and Canadian Blood Services medical director for organs and tissues donation. Although Canadian organ donation rates are “mediocre at best,” far more rudimentary approaches to resolving the shortfall must be undertaken before even contemplating such “ethically controversial and difficult issues,” S
For some, it comes down to a matter of consent. For others, it’s standard practice or at the very least, one that needs to be more widely adopted to expand the tiny pool of organs now available for transplantation. And for still others, it’s a matter of weighing what’s in a patient’s best interest. Such are the thorny ethical issues surrounding the notion of elective ventilation, the practice of placing comatose patients who are near death on mechanical ventilation until they’re brain dead and their organs can be recovered. The great risk, albeit small, to the patient, is that he might not progress to brain stem death as expected, potentially leaving him in a persistent vegetative state − wherein he is able to breathe on his own but has no evidence of higher-brain activity − or a similar condition. Much of the debate surrounding the ethics of elective ventilation stems from “confusion over what is considered to be in the best interest of the patient,” says Eike-Henner Kluge, professor
At its policy convention in Calgary this week, the Canadian Medical Association was poised to debate one of the most emotionally charged and ethically perilous issues in medicine: doctor-assisted death. But physicians got bogged down in semantics, in lengthy discussions about the appropriate language to use to describe hastening death at the end of life, and deferred real debate to a later, unspecified date and another unspecified time.
The Supreme Court of Canada said today it will hear an appeal by the BC Civil Liberties Association (BCCLA) that could grant terminally ill Canadians the right to assisted suicide. The case seeks to allow seriously and incurably ill but mentally competent adults the right to receive medical assistance to hasten death under specific safeguards. Lawyer Grace Pastine, who will argue the case for the BCCLA, says the decision to hear the appeal is a victory for those who support the right to to die with dignity. "I'm feeling great now. This is an enormous relief, and I'm just so happy that now there will be an opportunity to argue this very important case in front of the Supreme Court of Canada," Pastine told CBC News on Thursday morning. Several witnesses in the case are very ill and the BCCLA applied to have it expedited. But the high court rejected that, and as is customary, it gave no reasons. That means the hearing to determine the future of assisted suicide in Canada will l
A Toronto man’s decision to end his life, simply because he felt it was time to die, has raised questions and concerns among family, friends and experts, some of whom say it could take the assisted suicide debate down a "slippery slope." John Alan Lee, a former professor of sociology at the University of Toronto, died in December. He had carefully planned his own death for months and discussed his decision with a CBC crew. "I can be satisfied," he told the CBC’s Duncan McCue when describing his life and the choice to end it. "I can say it’s been great. It’s enough."
In a historic vote in the National Assembly, Quebec has become the first province to legalize doctor-assisted death as part of comprehensive end-of-life legislation. Bill 52, An Act respecting end-of-life care, received broad support on Thursday from nearly 80 per cent of MNAs. Quebec Premier Philippe Couillard allowed his caucus to vote according to their conscience. The 22 MNAs who voted against were all Liberals, including 10 cabinet ministers.
The first-hand experiences of physicians from coast to coast vividly illuminated a paucity of available palliative care, a simmering health-care crisis in Canada as the baby boomer generation enters old age. The association's members had come together on Tuesday to debate whether to revise the current CMA policy on euthanasia and assisted death. The session ended with an overwhelming vote — 90 per cent — in favour of an advisory resolution that supports "the right of all physicians, within the bonds of existing legislation, to follow their conscience when deciding whether to provide so-called medical aid in dying." The CMA defines "medical aid in dying" as, essentially, euthanasia or physician-assisted suicide.