麻豆传媒

The Canadian Medical Association suggests there should be a 14-day period to allow patients who want the help of a physician to end their lives to reconsider whether they are making the right decision.

The CMA has unveiled its guidelines for how it thinks doctor-assisted dying should work in Canada once the procedure becomes legal early next year.

Last February, the Supreme Court struck down the laws banning doctors from assisting a patient die who is enduring intolerable suffering. The court stayed its decision for a year, giving the federal government until Feb. 15, 2016 to draft replacement legislation.

With that deadline less than four months away and with no new legislation imminent, the CMA has drafted its own recommendations for any forthcoming legislation.

It recommends a system in which patients would have to make at least two oral requests for a doctor鈥檚 help with dying, and allow a 鈥渃ooling-off period鈥� of 14 days between requests.

The patient would also need to submit a written request for assistance with dying. The patient鈥檚 doctor would assess the request and ensure the patient is mentally capable of making an informed decision and giving consent to assisted dying. The physician would also have to assess whether the patient鈥檚 decision had been made freely, without coercion from family members, health-care providers or others.

The attending physician would need to ask a second, independent physician to also assess the patient for capacity and voluntariness. Both physicians would need to agree that the patient meets all the criteria in order to proceed.

The patient would also have to be informed that they could rescind their request at any time. The aim is to protect both the patient and the doctor, according to CMA鈥檚 president Dr. Cindy Forbes, in an interview with 麻豆传媒 from Halifax.

鈥淚t鈥檚 a process that is meant to protect the vulnerable and to make sure there is a process in place so things happen consistently and in a patient鈥檚 best interests,鈥� she told 麻豆传媒.

Under the CMA鈥檚 new recommendations, doctors would not be obligated to fulfill requests for assisted dying if they had moral opposition. But they would be expected to provide the patient with complete information on all options available to them, including assisted dying, and advise the patient on how to access any other services, such as counselling.

But not everyone agrees Doctors can 鈥渙pt out鈥� of providing their patient with an assisted death if they ask. University of Ottawa Law professor Amir Attaran has been reviewing Canadian law for a manuscript submitted for publication.

鈥淵ou can鈥檛 say, 鈥業 object to giving a particular patient medical care that he or she needs.鈥� That鈥檚 discrimination; that鈥檚 illegal,鈥� said Attaran.

鈥淚n the vast majority of legal cases that looked at doctors and conscientious objection, the judgement has gone against the doctors. And most of the doctors鈥� thinking on getting conscientious objection is wishful thinking, it is legally ignorant, and the CMA鈥檚 guidelines unfortunately is worse than nothing,鈥� said Attaran.

He cited the case of a doctor in B.C. who said he would not provide fertility services to lesbians because it offended his conscience to do so.

鈥淭he decision was labelled discriminatory by the court, and predicted that if doctors actually follow the CMA guidelines to object, they could well be sued,鈥� said Attaran.

鈥淭he doctor must take care of the patient鈥檚 needs not the doctor鈥檚 needs,鈥� he added.

It illustrates the uncertainty and confusion over assisted dying in Canada still must be clarified.

Dr. Forbes, meanwhile, hopes to see national standards for assisted dying, rather than a collection of provincial and territorial regulations that won鈥檛 serve patients across the country equally.

鈥淲e don鈥檛 want to see a patchwork of different regulations and legislation across Canada. So I think this helps to focus the discussion,鈥� she said.

Earlier this year, the CMA invited its 80,000 members to participate in an online survey about assisted death. Of the 1,407 members who responded, 29 per cent said they would consider providing assisted dying, while 63 per cent said they would not, the CMA reported.

With a report by CTV鈥檚 medical specialist Avis Favaro