Registrar’s message

By now, many of you will have read the College’s interim guidance to the profession on physician-assisted dying (PAD) approved by the Board at its January meeting.

The College thanks those who took the time to share their thoughts and provide feedback on the draft guidance released in December. The responses were extremely helpful in developing the interim guidance in its current form, and will also be considered over the next four months.

Since releasing the interim guidance last month, the College has made an amendment to the document, removing the provision that a nurse may be physically present with the patient as a witness during a teleconference with either the attending or consulting physician. The College made this amendment following a recent meeting with the College of Registered Nurses of BC where concerns were raised that the SCC’s decision does not specifically exempt nurses from the Criminal Code. The College of Registered Nurses of BC has advised that until it is clarified whether nurses are exempt from the Criminal Code, they should not take part in physician-assisted dying in any capacity without first obtaining independent legal advice.

The College anticipates updated guidance will be released prior to June 6, 2016.

Until then, the College will continue to be actively engaged with other stakeholders to address several critical matters regarding PAD, and specifically, the recommendations contained in the final report by the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying. One of the priorities is to liaise with the Ministry of Health and the health authorities to ensure a provincial infrastructure is in place, such as the establishment of provincially funded self-referral agencies, and an oversight body to monitor and review PAD cases and ensure compliance with legal and regulatory requirements. The College will also be highlighting the importance of clarity in legislation to avoid ambiguity, and to protect vulnerable patients from potential abuse or error. 

Feedback from the profession has made it clear that educational supports would benefit physicians who choose to perform PAD. While the College generally does not develop clinical practice or pharmacotherapy guidelines directly, it strongly supports the need for physician education in this area. During this interim period, the College will, through the Federation of Medical Regulatory Authorities, consult with the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada to determine which body is most appropriate to lead this initiative. The College also plans to meet with UBC CPD and the faculty of medicine to discuss curriculum development related to PAD for students and residents. 

The College supports the recommendations made by the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying on end-of-life and palliative care: “Canadians need better access to quality palliative and end-of-life care, and should be made more aware of the options currently available to them,” which now includes PAD. 

Many of you had further questions following the publication of the interim guidance, which we have attempted to address in a questions and answers document. This document will continue to be updated as necessary.

If have any further inquiries or comments regarding the interim guidance, please direct them to

H.M. Oetter, MD

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