How to be an Odd Doc Without Getting Your Goose Cooked

Dan Reilly

A presentation at a medical students’ forum hosted by Canadian Physicians for Life.

2:38 – 4:12  Ethical disputes: disagreeing about an “ought”

4:12 –  11:22  World views: dominant culture, ethics, law, decision making processes, religion, society, culture, experience, philosophy

11:22 – 13:58  The patient wants what you will not provide: ct scan, antibiotics, opioids, abortion, life support, contraception, pre-natal genetic tests, CPR, plastic surgery, elective C-sections, elective induction of labour

13:58 – 1834  fiduciary duty, patient access, moral distress

18:34 – 19:43  When patient asks for what you would like to provide, but can’t

19:43 –  21:44  When professional consensus is that you should say no

21:44 – 25:22  When physicians differ on what fiduciary duty dictates: full information, no abandonment

25:22 – 27:18  In some jursidictions, when refusing on moral grounds, in emergencies – provide service; otherwise- effective referral

27:18 –  32:55 Odd Docs and patients: why disputes arise, best practices: communication, compassion, care, honesty

32:55 – 36:24  Odd Docs and administrators: communication, compassion, do other work

Mexican Senate approves medical conscientious objection bill

Catholic News Agency

Mexico City, Mexico, Mar 26, 2018 / 06:14 pm (ACI Prensa).- The Mexican Senate has approved a measure protecting the conscientious objections of medical personnel who hold moral or ethical objections to certain treatments.

The decree, approved March 22, states that “professionals, technicians, aides, social service providers that are part of the National Healthcare System shall be able to invoke the right of conscientious objection and excuse themselves from participating and/or cooperating in all those programs, activities, practices, treatments, methods or research that contravenes their freedom of conscience based on their values or ethical principles.” . . . [Full text]

 

B.C. doctor cleared of wrongdoing for providing assisted death to woman who starved herself

Globe and Mail

Kelly Grant

British Columbia’s physician regulator has cleared a doctor of any wrongdoing for providing medical aid in dying to a woman who did not qualify for the procedure until she starved herself to the brink of death.

A committee of the College of Physicians and Surgeons of British Columbia (CPSBC) found that Ellen Wiebe did not break the regulator’s rules when she helped a 56-year-old patient known as Ms. S to die last year.

The case is the first to be made public in which a medical regulator has ruled on the contentious question of whether doctors should grant assisted deaths to patients who only satisfy all the criteria of the federal law after they stop eating and drinking.

“It was determined that Ms. S met the requisite criteria and was indeed eligible for medical assistance in dying, despite the fact that her refusal of medical treatment, food, and water, undoubtedly hastened her death and contributed to its ‘reasonable foreseeability,'” the college’s inquiry committee wrote in a Feb. 13 report. . . . [Full text]

 

Protecting conscience: Why this House of Lords bill is aimed at defending healthcare professionals

Christian Today

Laurence Wilkinson

With the Brexit legislation receiving the lion’s share of attention in Parliament, there has been little to no coverage on the progression of any other bill in recent months. This is usually the time of year where activity on private members’ bills (which have only a small chance of passing into law) winds down. However, with the current Parliamentary Session being extended to two years to deal with the magnitude of the Brexit legislation, we are in extraordinary times.

There is one such private member’s bill before the House of Lords which has seen a surprising ramp-up in activity over the last few months. The bill is sponsored by Baroness O’Loan – a widely respected legal mind from Northern Ireland who was the first Police Ombudsman – and will have its committee stage today, Friday. It is focused on the relatively niche area of protection of conscience for healthcare professionals. . . [Full text]

 

Nurse practitioners not always compensated for providing medical assistance in dying

Ministry of Health and Long Term Care does not provide fee-for-service the way it does for physicians

CBC News

Angela Gemmill

The Nurse Practitioners Association of Ontario says some of its members are helping to provide their patients with medically assisted deaths without compensation.

It wasn’t until April of 2017 that nurse practitioners (NPs) in Ontario could prescribe the controlled substances used for medical assistance in dying (MAID).

Since then about 40 NPs across the province have provided either patient assessments or the procedure itself.

A patient must be assessed by two independent health care providers. This can be either a physician or a nurse practitioner. The procedure is the same regardless of who provides it.

One nurse practitioner in Sudbury, Ont. says it’s important for her to provide support to patients who want to take this step. She admits that medical assistance in dying is rather limited in Sudbury, in that not a lot of physicians or nurse practitioners are willing to provide it for patients. . . [Full text]

 

Thousands step up in support of doctors’ conscience fight

The Catholic Register

Michael Swan

An Ontario campaign to pressure politicians over the protection of health care conscience rights is “democracy in action,” said an organizer.

The Coalition of HealthCARE has so far collected 19,000 names and e-mail addresses in its “Call for Conscience Campaign.” That does not include results from the Archdiocese of Toronto.

The non-partisan campaign was launched to oppose and raise awareness about regulations that force doctors to refer for assisted suicide and euthanasia against their moral convictions.

By the end of March, people who have signed up during the campaign should receive instructions about how to e-mail all the candidates in their ridings in the run-up to Ontario’s June 7 provincial election. . . [Full text]

Medics should not be forced to do procedures they object to on ethical grounds

The Conversation
Reproduced with permission

David S. Oderberg*

For most people, the term “conscientious objection” evokes images of Quakers and pacifists registering to avoid military service. Many countries have a long and honourable tradition of accommodating such conscientious objectors. It might not be about bombs and bullets, but healthcare professionals often find themselves fighting a conscience battle of their own.

In the UK, Canada, Sweden and other countries, conscientious objectors in healthcare have found themselves discriminated against in various ways – whether through dismissal, lack of promotion, or more subtle forms of coercion. Most cases involve doctors, nurses or midwives refusing to perform abortion or euthanasia (or to assist with either). Yet these happen, through historical accident, to be the flashpoint of current controversy. . . [Full text]

Bill to give medical staff right to refuse role in abortions condemned

The Guardian

Tim Wyatt

Pro-choice groups have condemned an attempt to create new laws that would allow doctors and nurses to refuse to take part in abortions on moral grounds.

A private bill going through the House of Lords that would expand rights of conscientious objection for healthcare professionals has been dismissed as unnecessary by abortion providers and campaigners.

Those in favour of the bill, sponsored by the Northern Irish crossbench peer Nuala O’Loan, insisted their aim was not to restrict abortion but to uphold freedom of belief and religion they claim is under threat in hospitals since a contentious supreme court ruling in 2014. . . [Full text]

 

Why conscientious objection in the medical profession must be protected

The House Magazine

Fiona Bruce, MP

Accommodation of conscientious objection is a long-respected matter of liberty and equality in this country. This respect should be as relevant today as ever, writes Fiona Bruce

The Conscientious Objection (Medical Activities) Bill is scheduled for Committee Stage in the House of Lords this Friday, and I have been watching its progress with interest. The Bill’s sponsor is Baroness Nuala O’Loan – a widely respected legal mind in the Lords who served as first Police Ombudsman in Northern Ireland, and is a former Chair of the Equality and Human Rights Commission’s Human Rights Inquiry. Among those who spoke in favour of the Bill at Second Reading were the former Conservative Lord Chancellor, Lord Mackay of Clashfern, and senior Conservative Peers Lord Elton, Baroness Eaton and the renowned surgeon, Lord McColl of Dulwich. . . [Full text]

 

Formal network of docs offering medical assistance in dying is in the works for northeastern Ontario

Informal referral network currently in place with local physicians

CBC News

Angela Gemmill

For those in Sudbury and District seeking a doctor’s help to die, it may soon get a little easier to find one who is trained.

About 40 doctors and nurse practitioners in the region are now trained to offer Medical Assistance in Dying (MAID), after they had specialized training last fall in Sudbury from the Canadian Medical Association.

The Supreme Court of Canada ruled in June, 2016  that medical assistance in dying is a constitutional right, under Bill C-14.

Between then and now, there has only been an informal network for people seeking medically assisted death, said Dr. Paul Preston, Vice President of Clinical for the North East Local Health Integration Network, and an advocate for access for those seeking a doctor’s help with dying. . . [Full text]