Physicians in Canada must be involved in shaping the legal framework to help protect patients and allow competent adults to make decisions about their lives in the lead up to legal physician-assisted dying, argues a commentary in CMAJ (Canadian Medical Association Journal).
On Feb. 6, 2015, the Supreme Court of Canada unanimously ruled that prohibitions on physician-assisted suicide and voluntary euthanasia violate the Canadian Charter of Rights and Freedoms. Canada will have a year to prepare a legal framework for physician-assisted dying, assuming the federal government does not override the Court's decision by invoking the notwithstanding clause in the Constitution.
"As a result of the Court's decision in Carter v. Canada (Attorney General), the medical profession has much to do in the next 12 months," writes Dr. Jocelyn Downie, a professor with the faculties of Law and Medicine at Dalhousie University in Halifax, Nova Scotia.
Competent adults who give consent and who have a grievous and irremediable illness, disease or disability that causes intolerable, enduring suffering will be eligible to access physician-assisted dying.
Downie raises many important questions to stimulate discussion and ideas, such as How long should it be between a request for assisted dying and provision of assistance? How will physicians who do not want to provide assisted dying deal with requests? How many physicians should be involved in providing assisted dying?
Physicians must bring an evidence-based approach to designing policies and practices, ensure there is oversight to protect patients, and advocate for expanded access to palliative care.
"Physicians have an extraordinary opportunity to have a tremendously positive impact on end-of-life care in Canada," Downie concludes.