Registrar's message

Many of you will have completed the survey distributed to all registrants on November 16 regarding conscientious objection to providing care as it relates to physician-assisted dying (PAD). The College continues to review the many thoughtful responses and concerns.

This past February, the Supreme Court of Canada ruled in favour of physician-assisted dying in Carter v. Canada, giving government and governing bodies like the College one year to draft laws and regulations around the practice. While there have been reports in the media that Prime Minister Justin Trudeau may be asking court to postpone the decision, the College is resolved to be ready with guidance by early February 2016 regardless of the federal government’s direction.

While PAD is a polarizing and emotional issue, the College does not take a position on whether physician-assisted dying is right or wrong. The College’s role is to respect jurisprudence, and to ensure that patients receive appropriate care. All colleges are grappling with how to strike the right balance between a patient’s right to access lawful medical services and a physician’s right to object based on conscience.

While conducting its own research and holding discussions with special interest groups, the College has been reviewing guidance on PAD released by other colleges. Broadly speaking, the various documents contain similar themes, many of which were articulated in a physician-assisted dying guidance document drafted earlier this year by an advisory group of the Federation of Medical Regulatory Authorities of Canada. 

In developing guidance for the profession, medical regulators agree with the conditions regarding the patient, which were contained in Carter v. Canada: that the patient must be a competent adult with a grievous and irremediable medical condition causing enduring suffering consenting to termination of life with physician assistance. 

These same patient circumstances will be reflected in the College’s own guidance to BC registrants, which is in the process of being developed. The goal is to have draft guidance on PAD circulated for consultation early in the New Year to the profession, Doctors of BC, special interest groups, the public and the Ministry of Health before a final version is brought before the Board for approval in January. 

The College is seeking legislative assistance from government regarding this matter. While the College has an important role to play in establishing ethical and professional expectations for registrants, we call upon those who make laws to consider establishing critical safeguards such as a public oversight commission to ensure high standards of practice and quality assurance are met.

H.M. Oetter, MD

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