XPost: can.politics, bc.politics, ab.politics   
   XPost: sk.politics, man.politics, mtl.general   
   From: Panca@nyet.ca   
      
   Postmedia News - December 22, 2014   
      
      
   Assisted suicide: Canadian Medical Association quietly preparing for ‘all   
   eventualities’   
      
      
   The nation’s largest doctors’ group is quietly preparing for possible   
   changes   
   in federal laws governing physician-assisted death, as support among its own   
   members for medical aid in dying grows.   
      
   The Canadian Medical Association has consulted medical associations in   
   jurisdictions around the world where euthanasia or assisted suicide is legal to   
   devise possible protocols for Canada if the federal law is changed.   
      
   The powerful doctors’ lobby says it would be naïve not to prepare for “all   
   eventualities” as the country awaits a Supreme Court of Canada ruling over   
   whether the federal prohibition outlawing assisted suicide is unconstitutional.   
      
   “I think we’re looking at the possibility that the court will refer this   
   back   
   to the lawmakers,” said Dr. Jeff Blackmer, the CMA’s director of ethics.   
      
   The Supreme Court could strike down Canada’s ban on assisted suicide and give   
   Parliament one year to craft new legislation, as it did with prostitution.   
      
   “They could suggest some framework from the bench that we might want to be   
   in a   
   position to comment on fairly quickly.  Or there could be a long period for   
   reflection and committee hearings that we would want to be prepared for,”   
   Blackmer said.   
      
   “We’re preparing for all eventualities, and that (a lifting of the ban) is   
   absolutely one of them.”   
      
   If there is a change in law, Blackmer said doctors opposed to   
   physician-assisted death “will be looking to us for protection of their   
   conscience and their right not to participate.”   
      
   “(Doctors) who do support a change in legislation will be looking to us to   
   help   
   make sure that legislation is crafted in a way that make sense from a medical   
   standpoint,” he said. “Whether or not you agree with this, as a physician,   
   I   
   think you still want to see your medical association at the table when those   
   discussions are happening.”   
      
   The organization’s polling shows that 20 to 30 per cent of doctors would be   
   prepared to help terminally ill patients end their lives, should   
   physician-assisted death become legalized, and that a noticeable shift is   
   occurring, with more doctors moving from “undecided” to “pro,”   
   particularly in   
   the area of assisted suicide, Blackmer said.   
      
   With assisted suicide, the doctor would prescribe a lethal dose of drugs that   
   patients would take themselves.   
      
   Euthanasia means the active termination of a life by the doctor, usually by   
   lethal injection.   
      
   The CMA has spent the past year consulting medical associations in Oregon,   
   Washington, Montana, Vermont and New Mexico, U.S. jurisdictions where   
   physician-assisted death is legal, to find out “what has worked, what   
   hasn’t   
   worked and how Canada can learn from those experiences,” Blackmer said.   
      
   “We’ve also had long conversations with the Netherlands, Belgium and   
   Switzerland,” he said.   
      
   “We’re now in the process of internal consultation and thought processing   
   to   
   look at some of the options and possibilities, to try to come up with a   
   reasonable suggested framework and approach.”   
      
   For decades, the CMA’s position on euthanasia was unequivocal: the   
   organization   
   opposed doctor-hastened death in any form.   
   But this summer, the CMA’s general council voted to allow doctors to follow   
   their conscience when deciding whether to participate in medical aid in dying.   
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   In a recent article in the journal HealthcarePapers, Blackmer and past CMA   
   president Dr. Louis Hugo Francescutti said many doctors remain “terrified”   
   by   
   the prospect of a change in federal law.   
      
   When a doctor enters a patient’s room, “their purpose is clear: to cure   
   when   
   possible, to care always,” they wrote. “The fact that they might actively   
   hasten the patient’s death does not enter into the equation.”   
      
   In an interview, Blackmer said some doctors see aid in dying as an extension of   
   compassionate, end-of-life care.   
      
   “And then there are others who say, very clearly, ‘this is not why I   
   became a   
   physician.  It was to protect life, to maintain life — certainly to alleviate   
   suffering whenever possible, but not to prematurely end life.  That was never   
   part of the deal.’ ”   
      
   But, over the past two years, the CMA has held a series of public, as well as   
   doctor-only town hall meetings and online consultations.  As doctors learn more   
   about the experiences in other jurisdictions, “more and more doctors are   
   saying, ‘Okay. I feel more comfortable, like there might be a scenario one   
   could imagine where this type of intervention wouldn’t be abused,”   
   Blackmer said.   
      
   “Where it would be the really exceptional patient that would need this, and   
   that we could set up some sort of system where we make sure that the   
   vulnerable, and other people are protected, and where physicians have support   
   to participate.’”   
      
   Blackmer said it’s a “fool’s game” to try to predict which way the   
   Supreme   
   Court will rule.  “But we’re trying to at least look at some of the options   
   that they might have at their disposal.”   
      
   He said doctors, and the public, are becoming more comfortable about talking   
   about death and dying “They are not taboo subjects in the same way they   
   were.”   
      
   The Supreme Court heard arguments in October over whether the criminal ban on   
   assisted suicide violates the Charter of Rights and Freedoms.   
      
   Judgments are normally rendered, on average, six months after a hearing.   
      
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