Medically assisted suicide will be legal in Canada next year, following a Supreme Court decision that overturned a longstanding ban. But legality is just the first step in instituting the right to die in Canada. It will have to be accessible, too.
A new report from the Canadian Medical Association (CMA) found that many of its physicians would not assist patients in a self-determined suicide, nor would they be willing to refer a patient to another doctor who might.
According to recent anonymous polls of 595 CMA members, "a significant minority of respondents to these polls said they will participate in offering this service to their patients." Many comments from physicians also explicitly opposed the Supreme Court's decision and even the CMA's "attempt to provide a balanced perspective" to a touchy issue.
"We've identified three critical areas that legislation needs to address, and effective referral is absolutely critical," said Wanda Morris, CEO of Dying with Dignity Canada, who read the report, and whose group advocates for policy relating to the right to die. "It's essentially an individual having access to the medical system."
A CMA spokesperson was not available to comment.
One solution proposed by two quoted physicians is an independent agency that coordinates deaths for all patients, instead of individual doctors.
One physician's comment, printed in the report, noted that the disparity between a patient's wishes and a doctor's beliefs could lead to a situation similar to that of access to abortion services in Canada.
"Repeating this approach with regards to euthanasia and assisted suicide seems rather ill-conceived and quite frankly, would be a disaster for the notion of 'equitable care," the anonymous physician wrote.
In Canada, access to abortion care remains inadequate. On Prince Edward Island, for example, surgical abortions are flat out not available to women, who must instead search out chemical alternatives.
Some doctors took issue with the idea of a self-referral system, where patients must seek out help themselves, with one physician pointing out that "women attempting to access abortion services are frequently impeded by physicians who refuse to make referrals."
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A key issue for many of the physicians quoted in the CMA report is the possibility of legislation that would make patient referrals mandatory for doctors who refuse to provide assisted death services. One solution proposed by two quoted physicians is an independent agency that coordinates deaths for all patients, instead of individual doctors.
The Supreme Court decision to overturn the ban on assisted suicide—which more than 90 percent of CMA members supported, despite many not being open to the idea of performing the procedures themselves—won't come into effect until next year, giving doctors and patient advocacy groups plenty of time to work out their positions.
But, if the CMA report is any indication, the real question isn't if you'll be able to one day ask for a doctor's help to end your life—it's who will help you do it?