In his latest column for DWD Canada's blog, Dr. David Amies rebukes the College of Physicians and Surgeons for Alberta for its draft policy on how doctors in the province should treat requests for assisted dying. The new rules, he charges, are "more concerned with the feelings and preoccupations of physicians and much less concerned with those of the public and patients."
The College of Physicians and Surgeons of Alberta recently issued an advice to registered medical practitioners in its province concerning physician assisted dying. It invited comments from its members and the general public.
I have had very little to do with the college since 1995, when I gave up practice in Alberta and moved to Australia. Before I left I had formed the impression that it was a forward thinking body that had made one or two progressive innovations towards how medicine should be practised. I was surprised, therefore, when I read its advice on assisted dying, by its ultra-cautious and conservative tone. In its defense, it made no secret of its conservative intentions.
The document comes across as being more concerned with the feelings and preoccupations of physicians and much less concerned with those of the public and patients, who may be contemplating ending their lives because of serious and intolerable disease. The document is written in a very legalistic fashion and stresses the need for an accurate definition of "a grievous and irremediable condition." Furthermore, it claims that only a physician can make such a distinction. It emphasizes the necessity for a 15-day waiting period and two independent witnesses as well as two separate medical opinions before the proceeding can take place.
No one will deny that procedures surrounding a request from a patient for life to be artificially ended must be attended by proper processes. I believe that it is ideal that great efforts go into ensuring that the patient is fully aware of the consequences of such a request. Likewise, every effort must be made to ensure that the patient is not suffering from treatable mental disease that if controlled might put a different complexion on their outlook. As I wrote before, a person such as the Englishwoman Gill Pharaoh, who made her request because she feared growing old, would pose difficulties for me. I guess that many doctors would struggle under similar circumstances. Lastly, I would wish to satisfy myself that the patient had a condition with a hopeless prognosis and that, in spite of the best available palliative care, suffering, either mental of physical or both, had reached such a pitch that life was no longer worth living.
Dr. David Amies.
Although, I practised as a physician for 55 years, my sympathies are with patients and their possible distress and much less with my former colleagues. Granted, no doctor must be obliged to go against his or her conscience or religious inclinations. But all doctors must be placed under an obligation to help patients who wish to end their lives under the circumstances I have outlined above. If they are not prepared to take an active role, then in all decency, they have to make a referral to a colleague or to provide information about how the patient should seek help elsewhere.
Unfortunately, it is my view that the Alberta College does not really see things that way. Anyone who takes the trouble to go over their advice to physicians will come to the same view.
Dr. David Amies is a retired doctor in Lethbridge, Alta., and a member of DWD Canada's Physicians Advisory Council.