Newsletter, February 2018

Dear friends,

On Wednesday, January 31, 2018, the Ontario Divisional Court released its decision in the lawsuit led by a coalition of doctors against the College of Physicians and Surgeons of Ontario (CPSO), regarding the requirement that doctors who have ethical objections to certain acts (including euthanasia) must refer their patients to other health care providers who will carry out those acts.

The Court found that the religious freedom rights of Ontario doctors are significantly violated by the CPSO’s policies, but that those violations can be justified to ensure patient access to healthcare. Ontario thus becomes the only jurisdiction in the world (beyond even Belgium and the Netherlands) with such a coercive requirement. Continue reading editorial >>

Sincerely,

Catherine Ferrier
President

We are pleased to announce our first major medical conference, which will take place in Montreal on March 24, 2018: Improving Care.

The conference is addressed especially to doctors and other health professionals facing the dramatic shift that has taken place in our medical environment since the euthanasia laws passed. Equip yourself to care with confidence for patients at risk of requesting euthanasia, including those in palliative care and in nursing homes, as well as chronically ill ambulatory patients.

Basic palliative care topics will be presented by speakers including Dr. Patrick Vinay, a great scientist and humanist, former dean of medicine at the Université de Montréal and former chief of palliative care at the Centre hospitalier de l’Université de Montréal. McGill psychiatry professor Dr. Gabriella Gobbi will discuss management of treatment-resistant depression. We will also offer an overview of the situation in Quebec and Canada since the laws passed, and a panel discussion on responding to euthanasia requests. The day will close with a session open to the public, during which Dr. Vinay and Dr. Marjorie Tremblay will reflect on Illness in post-modern society, as well as the social and systemic barriers to palliative care.

The conference is fully bilingual, with separate French and English sessions in adjacent rooms. There will be plenty of opportunities to network with colleagues, and interested people outside the health professions are also welcome.

We are very excited to offer this conference in the heart of downtown Montreal, and we hope that you will join us on March 24^th. For complete information on the conference and hotel bookings, and to register, please visit our website. Please share this information with friends and colleagues who could also be interested in attending.

Hope to see you there!

If you have an article, letter or interview relevant to our work published in any media, please let us know at info@collectifmedecins.org.

• At the African Regional Meeting of the World Medical Association on February 3, 2018 in Abuja, Nigeria, physicians agreed to improving palliative care while clearly rejecting euthanasia and assisted suicide.
• The struggle of palliative care centres against being forced to euthanize patients continues.
• In Quebec the number of people killed by euthanasia keeps climbing.
• Le Devoir, February 14, 2018. Possibly encouraging news:
  The Commission sur les soins de fin de vie (CSFV) is asking all Quebec health care establishments whether patients requesting medical aid in dying had access to palliative care.
• Judge Baudoin, who is hearing the Gladu-Truchon case (to remove the end of life criterion for euthanasia), has allowed several interveners (including the Alliance), but limits the extent of the interventions.
• A church reacts against the local palliative care centre’s decision to euthanize patients.

If you have experiences related to our work that you would like to share with your colleagues, please send it to info@collectifmedecins.org.

Reactions to the Ontario court judgment suppressing physician conscience rights:

Dr. Diane Kelsall, editor-in-chief of the CMAJ: Physicians are not solely responsible for ensuring access to medical assistance in dying.

The Protection of Conscience Project: Canadian court rules that state can compel participation in homicide and suicide.

Professor Douglas Farrow of McGill University: In effect, the court construed the case as Religion v. Health Care, and quite predictably settled the toss in favour of the latter, telling religious doctors to stand the heat or get out of the kitchen.  It missed the point. The case is really about Health Care v. Health Care – about conflicting visions of what it means to care for the sick and the vulnerable. It also failed to enquire whether the many citizens who want health care workers who won’t kill should be taken into consideration.

National Post: What happens to fundamental rights when a free and democratic society ceases to be one?

This one, from Australia, reminds us of the 2016 letter in the CMAJ that said: Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.

If you have experiences related to our work that you would like to share with your colleagues, please send it toinfo@collectifmedecins.org.

The International Congress on Palliative Care promoted by the Pontifical Academy for Life, which will be held in Rome, February 28 and March 1, 2018, can be followed via livestream.
Conference web page >>

Since 2012, the Autistic Self-Advocacy Network (ASAN), Not Dead Yet, and other disability rights organizations have commemorated disabled people killed by parents and caregivers through the Disability Day of Mourning. Remembrance events are held every March 1st.

Brigham Young University Journal of Public Law, 2017: Legalization of Assisted Suicide and Euthanasia: Foundational Issues and Implications.

Canadian Family Physician, February 2018: New category of opioid-related death. “The state of decline caused by untreated pain and its consequences might lead to increasing requests for medical assistance in dying (MAID). Could achieving MAID be easier than achieving good pain management?”

Journal of Ethics in Mental Health, January 2018: Moral Disengagement – Mechanisms Propelling the Euthanasia/PAS Movement. “The international movement that promotes the legalisation of euthanasia/physician-assisted suicide (PAS) is propelled by highly potent psychological mechanisms to overcome the resistance to its agenda. It is all about cognitive restructuring to justify inhumane actions.”
Summary and comments by Alex Schadenberg

CMAJ, February 12, 2018. Canada and US going opposite directions on conscientious objection for doctors. Once again those who would suppress freedom of conscience refer to the mythical Jehovah Witness health professional refusing to give blood to a critically ill patient.

American Journal of Geriatric Psychiatry, December 27, 2017: Assessing the decision-making capacity of terminally ill patients with cancer. 55 patients with advanced cancer receiving inpatient palliative care and 50 healthy adults were administered the MacArthur Competence Assessment Tool for Treatment to evaluate decision-making capacity. The use of the MacCAT-T revealed high rates of decisional impairment in terminally ill participants.

British Medical Bulletin, February 12, 2018: Death on demand? An analysis of physician-administered euthanasia in The Netherlands.

Impact Ethics, January 23, 2018. Dementia, advance directives and MAID. Allowing future-oriented medical assistance in dying requests by persons with dementia may be at odds with respecting their personhood.

If you come across articles that could be of interest to colleagues in the Alliance please send the reference to info@collectifmedecins.org.

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