Court ruling – what does it mean for doctors?

The Supreme Court of Canada has rendered a milestone decision by striking down the law prohibiting doctor-assisted death. The decision reflects a marked change in societal views and will   have a huge impact on the care that physicians may provide to some dying patients.

At the same time, the court has restricted physician-assisted death to mentally competent patients who are capable of providing consent, who have a “grievous and irremediable” condition that causes “enduring suffering that is intolerable to the individual in the circumstances of his or her condition” 

The court has given Parliament one year to develop new laws before the ruling takes effect. It is critical that we as physicians have input into this process because the responsibility will ultimately devolve on members of our profession. We must ensure that our patients’ needs are met, that patient safety is upheld, and that the physician voice is heard.

We will be working with the Canadian Medical Association, our national organization, on this issue. There are many complex questions to be answered, such as:

• What is “grievous and irremediable”?
• What is “enduring suffering that is intolerable”?
• What will be the process to allow access yet prevent coercion?

Doctors have principled views on each side of the issue of physician-assisted death, and I am pleased that court ruling will not compel doctors to help patients end their lives. Doctors should be able to follow their conscience. However, I do believe it is important that, when the new law takes effect, doctors who are opposed to the practice will still need to adhere to the College's professional standards and provide their patients with enough information for them to access care elsewhere.

We have an interesting year ahead. This will take time. It will not be easy. And, for the sake of our patients and our profession, we must get it right.

Doctors of BC will continue to advocate for and support a strong, high-quality palliative care system that is accessible to all in need. I urge all physicians to open the conversation with your patients to develop an Advance Care Plan, so that their values, goals and wishes are known and can be followed. And, I urge each of you to develop your own Advanced Care Plan; not only to set an example, but because each of us will, eventually, require care.

For more on advance care planning, click here.    

- Dr Bill Cavers

2014-2015 President