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“They’ve tried to hedge their bets”

Critics say assisted death bill falls short; Lakeridge Health has been planning for bill's introduction for months

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In response to a 2015 Supreme Court decision, the federal government has unveiled a bill for physician-assisted death. The bill, according to one UOIT professor, leaves many of the hard decisions up to the provinces and individual hospitals. Lakeridge Health, meanwhile, has been planning for such a bill to be introduced for the past two months.

By Graeme McNaughton/The Oshawa Express

The federal government’s recently announced bill on physician assisted death has got everyone talking – including people right here in Oshawa. That talk, however, isn’t necessarily in support.

When the bill – which came after a 2015 Supreme Court decision struck down the ban of physician-assisted deaths on Constitutional grounds and ordered the federal government to craft a law in 12 months’ time – was introduced into Parliament earlier this month. And one of the people who was on Parliament Hill that day, Oshawa MP and health critic Colin Carrie, who says the new bill leaves much to be desired.

“It falls short, in my viewpoint,” Carrie tells The Oshawa Express.

“We studied it and we wanted to make sure it excluded minors, had stringent safeguards for those with mental health challenges and understand that there are risks with advanced directives, so they did start to address those in the bill, but I don’t think they have the safeguards that are sufficient to protect the most vulnerable Canadians.”

Carrie says that the government could have taken the lessons learned from countries where similar laws are in place, such as the Netherlands and Belgium, and put safeguards in place for not only vulnerable people, but also those in the healthcare industry – something he says is not there.

“In the current form, (the bill) will be going to committee, and hopefully they make some ammendments that would address those challenges,” he says.

Someone else who says the bill isn’t where it should be is Thomas McMorrow, an assistant professor in legal studies at the University of Ontario Institute of Technology.

“It seems like they’ve tried to hedge their bets,” McMorrow says of the Liberals’ bill. “The most contentious issues that seem to get the greatest amount of media attention is they basically tried to step around the issues and say they’ll be a part of future studies.”

One thing that McMorrow says that is ambigious in the bill is one of its cruxes – what exactly constitutes a “reasonably foreseeable death?”

“It’s not a medical term. It does not have an established definition,” he says.

“But I think that what the government is trying to do there was maintain a link between medical assistance in dying and active death. While the Supreme Court (decision) doesn’t mention a person having to be in a terminal state…but by including this, it suggests there needs to be some kind of nexus. One question then is, well, does this bill fly in the face of the Supreme Court’s decision?”

McMorrow adds that it will be interesting to see what, if any, options doctors and hospitals will have if they have moral obligations against providing such services.

“Parliament needs to bear in mind the rights of patients and of physicians, and that participating in assisted dying is a mater of conscience and can also be a matter of religious belief,” he says.

“Basically what this bill does is kind of leave that up to the provinces and professional bodies to work out how to accomodate conflicts, particularly with Catholic hospitals who don’t want to offer medical assistance in dying. What’s interesting is with abortion services, that’s kind of the status quo too. There’s Catholic hospitals that don’t offer it. But what you’ll see that will be contentious is whether there’s a duty of referral for individual doctors and for hospitals.”

Talking about death

Ahead of the expected announcement of a physician-assisted death bill, Lakeridge Health has been holding internal discussions as to what it will do when such a law comes into effect across the country.

“We’ve commissioned a task force that’s been meeting now for the last couple of months or so,” Dr. Barry Guppy, Lakeridge’s vice-president of medical and academic affairs, tells The Oshawa Express, adding that the group is looking at three different components of any future legislation.

The task force is looking at three different components of any future legislation. First, according to Guppy, the group is looking at should the law change and the hospital decides to go forward with offereing such a service that it is done in a “safe and effective fashion.” Secondly, the group is looking at what education and training would need to be provided. Finally, it is looking to see who if any medical personell in the hospital would be interested in taking part in such services.

“There’s been a lot said about physician-assisted death. The College of Physicians and Surgeons has an interim guidance, so we’ve been considering that, and we’ve been waiting for the bill. Now, the bill’s been introduced and it’ll go through its usual plate of debate, and we’ll see what the outcome of that is,” Guppy says.

“We’re trying to be as forward looking as we can, but still not knowing exactly where this is going to land.”

While the hospital does not yet offer any such services, Guppy says they have been receiving questions from patients on what is going on. However, no patients have taken the next step and asking that they be allowed to go through with such a procedure, Guppy adds.

Although the federal government only introduced this bill in the last week, there has been at least one physician-assisted death in the province this year. Last month, Superior Court Justice Paul Perell approved a request made by an 81-year-old male with aggressive lymphoma to have an assisted death, the first time such a request had been approved in Ontario.

“My only regret in these last months is that my family and I have had to expend what little energy I have left to fight this court battle,” the man, recorded in court records as A.B., said in a statement in court.

“My wish is that our government will see fit to make permanent changes in the law so that no other family will have to do this ever again.”

Since then, at least one more patient – a woman in her 60s known only as C.D., who had stage 4 metastatic breast cancer that has spread to her lungs, limbs, bones, and lymphatic system – has been granted a request to have an assisted death.