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Protection of Conscience Project

Service, not Servitude

Policy Positions

College of Physicians and Surgeons of Newfoundland and Labrador(Canada)

Freedom of conscience and religion

Annotated Extracts and Links

Policy on Physician Assisted Dying (29 March, 2016)
[Full Text]

5. Responsibilities of Physicians who Decline to Participate

5.1  No physician can be compelled to prescribe or administer medication for the purpose of ending a patient’s life.

5.2  Physicians unwilling to participate in physician-assisted death for personal, moral, religious, or ethical reasons are expected to freely offer accurate information to patients. No physician may provide false, misleading, intentionally confusing, coercive, or materially incomplete information to patients.

5.3  The College recommends that a physician who declines to participate in physician assisted death offer the patient who seeks such advice or medical care timely access to another physician (or appropriate information resource, clinic or facility, care provider, health authority, or organization) who is:

(a) available to assist the patient;

(b) accessible to the patient; and

(c) willing to provide physician-assisted death to a patient who meets the eligibility criteria.

5.4  A physician who declines to provide physician-assisted death to a patient may not terminate the doctor-patient relationship on that basis alone. At all times, the physician must abide by other relevant College guidelines and policies.

5.5  The objecting physician should:

(a) Provide access to all relevant medical records to any other physician who is providing services related to physician-assisted death; and

(b) Continue to provide medical services unrelated to physician-assisted death, unless the patient requests otherwise, or until another suitable physician has assumed responsibility for the person’s ongoing care.

6. Responsibilities of All Physicians

6.1 Any physician who is approached by a patient for information on physician-assisted death has an obligation to discuss the subject with the patient, the first time it is raised by the patient, regardless of whether the physician objects to providing this service.

6.2 During the first visit where the patient requests or mentions physician-assisted death, all physicians have an obligation to:

(a) engage in a fulsome discussion as to the reasons behind the patient’s request, and answer any questions the patient may pose to the best of the physician’s knowledge and ability;

(b) ensure that the patient has information about (and, if appropriate, a referral to) any other service or clinician that may be of benefit to the patient, including but not limited to palliative care, pain specialist, psychiatry, or non-physician services such as physiotherapy, occupational therapy, counseling, and so on; and

(c) advise the patient whether the physician is willing to personally participate in physician-assisted death;

(d) provide the patient with access to further information, including a copy of this Policy (or information on how it can be readily accessed via

Project Annotations

Physicians are expected to provide information necessary to satisfy the requirements of informed medical decision making.

With respect to 5.3(c), the policy appears to employ an unacceptably narrow definition of "participation."  It fails to acknowledge that objecting physicians may consider it unacceptable to direct a patient to a physician willing to provide euthanasia or assisted suicide, on the grounds that doing so would constitute unacceptable participation in the act.  However, the policy recommends but does not require such referrals.




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