Canada
Yukon Medical Council
Policies & statements relevant to freedom of conscience
Medical Assistance in Dying
Standard of Practice
STEP 1 - Patient makes initial inquiry for medical assistance in dying to a physician or a nurse practitioner.
Patient rights:
Patients have the right to make decisions about their bodily integrity (autonomy) and to have access to unbiased and accurate information about relevant medical conditions and their treatment. Registrants have an obligation to provide their patients with health information and health services in a non- discriminatory fashion and an obligation not to abandon their patients. The Yukon Medical Council expects registrants to provide their patients with enough information and assistance to allow them to make informed choices for themselves. This includes consulting with other experts on relevant medical facts and, when needed, obtaining competency assessments.
Physician rights to conscientious objection and duty to transfer care:
There is nothing in the Criminal Code that compels a physician to prescribe or administer MAID. Physicians who have a conscientious objection to medical assistance in dying are not obligated to proceed further through the process map and evaluate a patient’s inquiry for medical assistance in dying. Objecting physicians must provide the patient with timely access to another non-objecting physician or resource with accurate information about all available medical options. The objecting physician must document, in the medical record, the date on which the referral was made, and the physician, nurse practitioner and/or agency to which the referral was directed.
Project Annotations
Medical Assistance in Dying must be read in a manner consistent with Moral or Religious Beliefs Affecting Medical Care in relation to the obligations of of objecting physicians. Taken together, they require objecting physicians responding to initial patient enquiries about euthanasia or assisted suicide to advise patients of their objections and provide patients with information sufficient to enable informed decision making.
Medical Assistance in Dying differs from Moral or Religious Beliefs Affecting Medical Care because it requires objecting physicians "to provide timely access to another non-objecting physician or resource with accurate information about all medical options." This must be documented in the patient chart. This appears to assume that only practitioners who provide or support euthanasia and assisted suicide can respond to patient requests with "accurate information about all available medical options." The assumption is unjustified and demonstrates bias against those opposed to the procedures and favouritism towards those supporting or providing them.
In any case, though this is described as a "referral," providing "timely access" does not necessarily require an objecting practitioner to make a connection with a non-objecting person or entity. It appears that objecting physicians could comply with the policy by providing accurate information about all available medical options sufficient to enable informed decision making, information about an alternative source of accurate information, and documenting their discussion with the patient and identifying the alternative source in the medical record. The source could be a government or non-government agency that helps patients connect with health care workers or services, including - but not exclusively or primarily - euthanasia and assisted suicide.