Though requests for assisted suicide require two consultations with medical professionals to proceed, the Health Canada standards say assessment of suicide eligibility may take place virtually if the relevant regulatory authority allows it.
Doctors advised not to notify family of assisted suicide request
The recommendations include provisions that say medical providers should not notify friends or relatives of assisted suicide requests without the explicit consent of their patients.
An accompanying document from Health Canada, “Advice to the Profession: Medical Assistance in Dying,” states that eligibility assessors and assisted suicide providers must not disclose to family and friends whether assisted suicide has been requested or received without the patient’s express consent. The document says providers should explain to the patient “the potential harms of nondisclosure.”
Achtman objected “that a loved one can be euthanized without the family having even the slightest idea about it until it’s too late.”
“Health Canada is directing medical professionals not to involve relatives if the patient wants to be euthanized secretly,” she said.
No allowance for conscientious objectors
Though no physician or nurse practitioner may be compelled to prescribe or administer assisted suicide drugs, the standards say, they must refer patients to others who are willing to do so. However, Schadenberg voiced concern about the compulsion of medical professionals who do not wish to take part in assisted suicide.
“When reading the ‘medical practice standards’ it is clear that these ‘guidelines’ undermine rights that exist in certain provinces,” Schadenberg said. “For instance, these standards require physicians who are unwilling to participate in euthanasia to provide an effective referral or transfer of care. Manitoba recognizes conscience rights for physicians and nurses. These guidelines undermine those conscience rights.”
“The ‘guidelines’ also require physicians and nurses to inform patients, who may qualify for MAiD, that MAiD is a legal option,” he added. “Medical professionals who oppose killing will not be willing to inform their patients that they can be killed.”
Guidelines offer no protections, critics say
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Health Canada said Canada’s government is “committed to ensuring that the practice of MAiD balances laws that give autonomy and freedom of choice for Canadians, a system that provides strong safeguards that protect those who may be vulnerable, and a process that guarantees compassionate and diligent consideration of every request for MAiD.”
The medical practice standards say physicians or nurse practitioners must ensure patients are informed of “the full range of treatment options available to relieve suffering.”
If the medical professional finds “reasonable grounds” to believe a patient is eligible for assisted suicide, he or she must determine if this is consistent with the patient’s values and goals. If this is so, the patient should be advised about the potential for MAiD.
Yet critics say the guidance offers little protection for vulnerable patients.
“All of these ‘guidelines’ are designed to make MAiD/euthanasia appear to be carefully carried out and yet, the medical practitioner only needs to be of the opinion that the person fits the criteria of the law,” Schadenberg told CNA. “In other words, these guidelines are ink on paper.”
Assisted suicide to expand to mental health issues