PC MPP introducing private member’s bill May 18 on doctors’ roles in medically assisted dying

By Jennifer Bieman, St. Thomas Times-Journal

PC health critic Jeff Yurek is hoping doctors’ conscience rights will prevail when his new private member’s bill is debated at Queen’s Park May 18.

Yurek’s bill to protect doctors who don’t want to be involved – directly or indirectly – in medically assisted dying comes as the province’ legislation on the controversial topic enters its final stages. Though Ontario doctors can refuse to provide the medical service to patients, they’re mandated to refer them to other physicians – a move Yurek is troubled by.

“As of right now, there’s no protection for their conscious objection,” said Yurek.

“Currently, doctors can be disciplined if they refuse to refer a patient. They don’t have to participate, but the effective referral process is indirectly making them participants.”

The Ontario College of Physicians and Surgeons disagrees.

The organization’s Medical Assistance in Dying policy – drafted and endorsed by the self-governing regulatory agency – outlines doctors’ obligations to patients seeking the end-of-life procedure. Providing referrals is one of them.

“The CPSO does not consider providing the patient with an ‘effective referral’ as ‘assisting’ in providing medical assistance in dying,” said Kathryn Clarke, senior communications coordinator.

“An effective referral ensures access to an assessment and demonstrates the respect for patient autonomy that is a core part of medical ethics and professionalism.”

From April 2016 to March 2017, the college received 15 calls from doctors who object to medically assisted death and believe referring patients makes them participants – a small fraction of the approximately 41,000 doctors the regulator represents.

The college is also in the midst of two court cases from doctors and professional organizations who allege the policy violates their charter rights. Both cases will be heard in June.

As Ontario closes in on its long-awaited assisted dying legislation, Yurek wants Ontario to mirror Alberta and British Columbia’s self-referral model – a program where coordinators connect patients to willing doctors – and eliminate the requirement for objecting physicians to refer patients.

Though Ontario is launching a similar government program, Yurek said there are no plans to do away with the referral mandate.

“In Alberta and B.C. their healthcare professionals’ conscience rights are protected. They don’t have to participate if they don’t want to and access is greater in those areas… Ontario is missing the boat on this,” he said.

Yurek isn’t the only one taking the province to task on its medically assisted death policies. London family doctor Ramona Coelho is an outspoken advocate for conscience rights and wants to see the mandatory referral policy reversed.

“With this kind of aggressive policy, it puts people in a bad position,” she said.

“What we’re asking for is a non-participatory model… We’re not trying to be difficult, we’re trying to have a respectful model.”

Referral questions aside, Yurek believes respecting doctors’ personal boundaries benefits more than just the physicians themselves.

“It’s best for access and for patients if you remove an unwilling doctor from the process,” he said.