Feature
as “irremediable” does not require the patient
to exhaust all treatment options. According
to the SCC, the patient is not required to
undertake treatments that are unacceptable to
them.
photo: masterfile
3 What is meant by intolerable suffering? How do I determine whether
the patient’s suffering is intolerable to
them?
According to the SCC to be eligible for
physician-assisted death, individuals
must experience enduring physical and/
or psychological suffering that is intolerable to them in the circumstances of their
condition. This language signals that the
determination of whether a patient’s suffering is intolerable is a subjective one, and is
assessed from the patient’s perspective. The
intolerable suffering experienced by the patient must be caused by the patient’s grievous and irremediable medical condition
Communicating with the patient about
their desire to pursue physician-assisted
death, and engaging in regular dialogue
about their personal experience managing their condition, will help the physician to understand the nature, extent, and
persistence of suffering experienced by the
patient.
4 Does the patient have to be capable
when they request physician-assisted
death, when they receive physicianassisted death, or both?
The SCC specified that physician-assisted
death is accessible only to “competent” adults.
This means that patients who are eligible for
physician-assisted death must have decisionmaking capacity.
It is clear from the SCC’s ruling in Carter
v. Canada that an individual must be capable
when requesting physician-assisted death.
What remains unclear, however, is whether
the patient must retain capacity until physician-assisted death is provided.
During this time of regulatory uncertainty,
the College has elected to take a conservative approach in this regard. The College’s
Interim Guidance indicates that patients must
be capable both at the time of the request for
physician-assisted death, and when physicianassisted death is provided. This requirement
is in place to protect the patient’s right to
rescind a request for physician-assisted death
at any time. Further, it allows the physician
Issue 1, 2016 Dialogue
13