Project Logo

Protection of Conscience Project

www.consciencelaws.org

Service, not Servitude

Policy Positions

College of Physicians and Surgeons of Alberta (Canada)

Freedom of conscience and religion

Annotated Extracts and Links


Conscientious Objection (June, 2016)
Formerly Moral or Religious Beliefs Affecting Medical Care (In force January, 2010 - June, 2016)

(1)  A regulated member must communicate promptly and respectfully about any treatments or procedures the regulated member declines to provide based on his/her Charter freedom of conscience and religion.i

(2)  A regulated member must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with his/her Charter freedom of conscience and religion.

(3)  A regulated member must not promote his/her own moral or religious beliefs when interacting with patients.

(4)   When Charter freedom of conscience and religion prevent a regulated member from providing or offering access to information about a legally available medical or surgical treatment or service, the regulated member must ensure that the patient who seeks such advice or medical care is offered timely access to:
  1. a regulated member who is willing to provide the medical treatment, service or information; or
  2. a resource that will provide accurate information about all available medical options.
Project Annotations

The policy recognizes a key distinction between providing information and providing or facilitating a morally contested service or procedure. 

With respect to providing information, it presumes either that the mere giving of information or advice has no moral significance, or, if it does, that it is inconsequential. This is not necessarily the case.  The difficulty here is to balance the desire of a physician to avoid complicity in a wrongful act with the importance of informed decision-making by the patient, which requires that the patient have all of the information relevant for the purpose of choosing a course of treatment. It is necessary to respect both the freedom of conscience of the physician and the freedom and right of the patient to make a fully informed choice.

Physicians are expected to provide information necessary to satisfy the requirements of informed medical decision making, such as prognosis, the treatments or procedures available, benefits and burdens of treatment, risks, etc.  Only if a physician is unwilling to provide this information is an offer of "timely access" to another physician or resource required.  The purpose of arranging timely access in this situation is to ensure that the patient has information needed for decision-making.  Offering timely access may be achieved in various ways.


Medical Assistance In Dying (June, 2016)
[Full Text]

1.  A regulated member who receives, considers or fulfils a written request for medical assistance in dying must do so in accordance with legislation. . . (Emphasis in the original)

3. A regulated member who receives an inquiry from a patient with respect to medical assistance in dying must ensure that contact information for the Alberta Health Services medical assistance in dying care coordination service is provided to the patient, or to another person identified by the patient, without delay. (Emphasis in the original)

4.  A regulated member who receives an oral or written request from a patient for medical assistance in dying and who declines for reasons of conscience or religion to provide or to aid in providing medical assistance in dying must ensure that reasonable access to the Alberta Health Services medical assistance in dying care coordination service is provided to the patient without delay. . . (Emphasis in the original)

8.  In these standards, "medical assistance in dying" means:

a)  the administering by a regulated member of a substance to a person, at their request, that causes their death; or

b)  the prescribing or providing by a regulated member of a substance to a person, at their request, so that they may self-administer the substance and in doing so cause their own death.

Project Annotations (2016-11-02)

The current legislation directly applicable is Section 241.1 of the Criminal Code and Alberta Order in Council  142/216 (10 June, 2016), Order respecting Medical Assistance in Dying Standards of Practice.  The latter is binding only in Alberta.  Sections 3 and 4 of the Order are reproduced as Sections 3 and 4 of this standard.

Section 3

Section 3 is limited to an inquiry from a patient, though the response may be directed to someone delegated by the patient.  "Inquiry" presumably means a question concerning euthanasia or assisted suicide that does not amount to a request.  This provision does not prevent a physician from responding to the question, but requires, in addition, that the patient (or delegate) be given the contact information for the Alberta Health Services medical assistance in dying care coordination service.

Section 4

Section 4 is limited to a request from a patient, and the response is to be provided to the patient.  It does not prevent an objecting physician from discussing options with the patient, including euthanasia and assisted suicide.  Although the section does not specify that the response may be provided to someone delegated by the patient, that would presumably be allowed as a matter of custom.

This provision does not require that the objecting physician provide specific contact information for the Alberta Health Services medical assistance in dying care coordination service, but "reasonable access" must be provided, which, presumably, includes sufficient information for the patient to be able to contact the service.

The patient - not the objecting physician - is responsible for contacting the service.  This is an important point, since objecting physicians frequently object to doing something that may facilitate what they perceive to be a wrongful act.

The nature of the service itself may be of some importance to some objecting physicians, who may be unwilling to facilitate contact with a service primarily designed to deliver euthanasia and assisted suicide, but would be willing to facilitate contact with a general end-of-life care co-ordinating service even if euthanasia and assisted suicide are among the options.

Alberta MAID Care Coordination Service

As the name suggests, the Alberta MAID Care Coordination Service appears to be primarily designed to deliver euthanasia and assisted suicide.  No comparable web pages appear to exist in the Alberta Health Services website to provide direction to such services.

Alta MAD service - page 1The entry page provides three main options: one for patients/families, one for health professionals and volunteers, and one for general enquiries.  No links lead to palliative care or other end of life options. (Click image to enlarge.)

Alta MAD services page 4The general enquiries link leads to a page with links to information about euthanasia and assisted suicide. No links lead to palliative care or other end of life options. (Click image to enlarge.)

Alta MAD services page 5The professionals/volunteers link leads to a page with links to information about euthanasia and assisted suicide.  No links lead to palliative care or other end of life options.(Click image to enlarge.)


Alta-MAD service page 2The patient/family link leads to a page with four headings:
- Care Coordination Services
- Support (links to grief/bereavement and dying process resources)
- How do I access medical aid in dying? (application for euthanasia/suicide)
- Your questions answered (FAQ's) (All but one of 31 questions concern euthanasia/assisted suicide.  Question 8 concerns options and includes a link to a palliative care resource.)

Alta MAD Services, page 3Patients who go to the Care Coordination Services page are offered information about two teams established in the province "available to generally discuss all end of life options available, including medical assistance in dying." The contact link returns the patient to the entry page. No links lead to palliative care or other end of life options.  (Click image to enlarge.)

 

The MyHealth.Alberta.ca website is also maintained by the provincial government and Alberta Health Services.  It includes resources for palliative and end of life care that do not reference euthanasia or assisted suicide.  There is no requirement in the Order in Council or College policy on euthanasia/assisted suicide to provide patients with contact information for this website or to ensure reasonable access to it, though physicians would be free to do so.

 

 

Print Friendly and PDF