reports from council
tient’s condition is grievous and irremediable,
she said.
Council also heard from Dr. Charles Blanke, a medical oncologist from Portland, who
provides assistance to patients in the context
of Oregon’s Death with Dignity Act.
Since the Death with Dignity Act was enacted
in 1997, more than 1,300 people have obtained life-ending prescriptions, but only 860
have used them. Many people, he said, took a
great deal of comfort in having the prescription, even if it was not ultimately used. Most
people were dying of cancer and most feared a
loss of autonomy, and dignity, he said.
Dr. David Lussier, Director, Geriatric Pain
Clinic, McGill University Health Centre, was
also on hand to provide an overview of Quebec’s law relating to end-of-life care.
Quebec became the first jurisdiction in Canada to legalize medical
Many people, he aid in dying for mentally competent
said, took a great patients who meet a strict set of criteria. The law, which goes into effect
deal of comfort
in December, will allow physicians
in having the
to assist patients with an incurable
condition and intolerable physical or
prescription,
psychological suffering to die.
even if it was not
Dr. Lussier told Council that the
ultimately used
Quebec law contemplates medical
aid in dying as part of end-of-life
care, a complement to palliative
care, and not as a separate activity outside
the spectrum of care. “It is meant to be seen
from a greater perspective,” he said. “It is
not just about assisted death, but it is about
how we see death, how we approach death
and how we take care of patients at the end
of life.”
Quebec’s regulatory body has developed a
step-by-step guide for doctors to follow in the
administration of three injections. The guide
directs physicians what to do before, during and after administering the drugs to an
eligible patient, including the type of drugs to
18
Dialogue Issue 3, 2015
be used, the dose, the injection site and what
to do in the event of complications.
The kits, which will be prepared by a pharmacist, in accordance with the physician’s prescription will include a sedative to calm the
patient; a drug to induce a deep coma; a drug
to induce cardiorespiratory arrest and needles,
syringes, IV tubing and IV solutions.
The guideline was developed in collaboration with the Order of Pharmacists of Quebec
and the Order of Nurses of Quebec.
Dr. Jennifer Gibson, Director, Joint Centre for Bioethics, University of Toronto also
spoke to Council. Dr. Gibson is the recentlyappointed co-chair of the Provincial-Territorial Expert Advisory Group on PhysicianAssisted Dying.
She said the group will consult with
stakeholders – such as the CPSO - and will
provide advice on the development of policies, practices and safeguards for provinces
and territories to consider when physicianassisted death is legal within their respective
jurisdictions. This work is in addition to the
federal government’s external panel, which
is developing options that will inform the
federal government’s legislative response to
the Supreme Court’s decision.
Dr. Carol Leet, College President, said the
College is monitoring the situation closely
and speaking with stakeholders. “Ideally, government will establish and clarify a legislative
framework with respect to physician-assisted
death,” she said.
The College would then develop a complementary stand-alone policy that would reflect
any new legal requirements found in common
law, legislation and/or regulation, along with
any professional expectations Council wishes
to articulate for physicians, she added.
In the event that there is no legislative
framework in place to guide Ontario physicians by February 2016, the College will
provide interim guidance to the profession.