Newsletter, January 2018

Dear friends,

“On 16-17 November 2017, medical professionals, legal authorities, experts in palliative care and medical ethics, theological scholars and philosophers from over 30 countries gathered in the Aula Vecchia del Sinodo in the Vatican for the World Medical Association European Region Meeting on End-of-Life Questions.”

The World Medical Association’s stance on euthanasia is unambiguous: “Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical.”

Until recently, this was also the position of the Canadian Medical Association. However, Dr. Jeff Blackmer, political voice of the Office of Ethics, and Vice President of the CMA, is now lobbying vigorously for WMA policy to be changed… Continue reading editorial >>

Sincerely,

Catherine Ferrier
President

Announcing our one-day bilingual conference, which will be held on March 24, 2018 from 9:00 a.m. to 5:00 p.m. in Montreal: Improving care; preventing euthanasia.

Topics include:

• Palliative care for the non-palliativist: analgesia at the end of life, existential distress, palliative sedation
• Diagnosis and management of treatment-resistant depression and suicidality
• Update on euthanasia in Quebec and Canada
• Panel discussion on caring for patients who want to die
• Closing plenary, open free of charge to the general public: Illness in post-modern society and barriers to palliative care

Complete information will be sent out shortly.

The Ontario Divisional Court released its decision on Wednesday, January 31, 2018, in the lawsuit of Canadian Physicians for Life, the Christian Medical and Dental Society and the Canadian Federation of Catholic Physicians, Societies against the College of Physicians and Surgeons of Ontario, regarding the College requirement that doctors who have ethical objections to certain acts (including euthanasia) must refer the patient to another health care provider who will carry out the act.

The Court found 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 with such a coercive requirement. Needless to say, although we are not involved in this case, we are very disappointed with this outcome and hope an appeal will be launched to protect both physicians and patients.

Press release from the plaintiffs >>

You may download the decision here >>

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

On December 16, 2017, Health Canada published Draft Monitoring of Medical Assistance in Dying Regulations.

Health Canada invites Canadians and key stakeholders to review the proposed regulations and provide their feedback by February 13, 2018.
See here >>

Ontario will be holding a provincial election this spring. With that in mind, The Coalition for HealthCARE and Conscience has launched a new Ontario Call for Conscience Campaign. The purpose of this campaign will be to have 100,000 supporters from Ontario sign up for the Coalition for HealthCARE and Conscience email list. They will then mobilize this email list to write to the candidates in their riding ahead of the provincial election.

You can sign up here: www.canadiansforconscience.ca

To write to your MPP >>

See here for more information >>

Ontarians are also encouraged to contact their MPP to urge the government to pass Bill 182, the Compassionate Care Act.

• Bill C-277, An Act providing for the development of a framework on palliative care in Canada, received royal assent on December 12, 2017.
• Hearings have begun for the Gladu/Truchon case, in which we are interveners.
• The UN wants to redefine the right to life: 106 French lawyers react.
• The World Medical Association has modified the Declaration of Geneva.
• Is the unequivocal affirmation of the value of human life being eroded?
• Organ donation after euthanasia is now being promoted in Canada.
• As Wesley Smith says: “… conjoining organ donation with being killed sends the insidious and subversive message that the deaths of these patients have more value than their lives.”
• Pressure on Cape Breton doctors to provide euthanasia.
  What about access to real health care?
• “Medical aid in dying” is considered as suicide in Saskatchewan.
• A Winnipeg man has pleaded guilty to criminal negligence causing death after his injured 89-year-old mother was left to die on the floor of their shared home.
• A B.C. woman attempts suicide after an erroneous diagnosis of terminal illness.
• From weird to weirder: a 3D printable home euthanasia machine.
• Italy legalizes death by starvation and dehydration.
• Conflict and departures at the Belgian federal control commission on euthanasia.
• A medical ethicist has resigned from a Dutch regional assessment committee for euthanasia over a law which allows non-consenting demented patients to be euthanized.

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

Aubert Martin of Vivre dans la Dignité on two years of euthanasia in Quebec.

The Quebec College of Physicians has updated its euthanasia guidelines.

Debate on the euthanasia law in Belgium.

And psychiatrists in the Netherlands express concerns about euthanasia for their patients.

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

Retired nurse Micheline Pepin of Amos QC has developed a card game to demystify the end of life.
For information:   Micheline Pepin, agente de la pastorale de la santé et des aînés
Diocèse d’Amos  –  Tel. : 819-732-6515 local 215  (Wednesday or Thursday from 9 a.m. to 4 p.m.)

Canadian Journal of Neurological Sciences, November 2017. Medical Assistance in Dying (MAID) and the Neurosurgeon: Position Statement of the Canadian Neurosurgical Society (CNSS)

Canadian Journal of Psychiatry, January 2018: Perspective: Medical Assistance in Dying and Mental Health: A Legal, Ethical, and Clinical Analysis. “Medical assistance in dying (MAiD) legislation is now over a year old in Canada, and consideration is turning to whether MAiD should be extended to include serious mental illness as the sole qualifying condition for being eligible for MAiD. This article considers this question from ethical and clinical perspectives. It argues that extending the eligibility for MAiD to include those with a serious mental illness as the sole eligibility criterion is not ethical, necessary, or supported current psychiatric practice or opinion.”

Annals of Internal Medicine, October 17, 2017. Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper .

arXiv, November 17, 2017. Improving Palliative Care with Deep Learning. A team from Stanford pilots an algorithm to predict survival.

NEJM, November 30, 2017. An Unconscious Patient with a DNR Tattoo. In case you thought there were no new ethical dilemmas.
Commentary here >>

Le Spécialiste, December 2017. Decoding conscientious objection in medical aid in dying: first results from a unique study.
Our comments >>

Geriatric Nursing, in press. Nurses’ perspectives on whether medical aid in dying should be accessible to incompetent patients with dementia: findings from a survey conducted in Quebec, Canada
The pressure is on.  Note the authors: we’ve seen these names before.

Journal of Pain and Symptom Management, January 2, 2018: “I’d recommend…” How to incorporate your recommendation into shared decision making for patients with serious illness.”  The article describes an approach to formulating a recommendation using a shared decision making framework: (1) evaluate the prognosis and treatment options; (2) understand the range of priorities that are important to your patient given the prognosis; and (3) base your recommendation on the patient’s priorities most compatible with the likely prognosis and available treatment options.”

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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