Dr. David Amies: Ontario court's interim rules for assisted death are a lawyer's picnic

Desperately ill patients in Ontario will have to jump through myriad legal hoops if they wish to access their right to end-of-life choice in the next four months. The province's Superior Court of Justice has released its interim rules for what steps patients must take in order to have their requests approved. Unless they are amended, these Draconian protocols will be in place from Saturday up until June 6, when the Supreme Court's decision on assisted dying finally comes into force.

In his latest column for the DWDC blog, Dr. David Amies details the policy's most nefarious points, warning that they may set a sinister example for lawmakers in other jurisdictions.

Ontario's Superior Court of Justice has issued a list of safeguards for people who wish to seek a doctor's help in dying during the next few months before the federal government writes new law on the subject.

One guideline asks attending physicians if an applicant for physician-assisted dying is or will be physically incapable of ending his or her life without physician-assisted death. Another, demands a psychiatric assessment. Yet another gives the court an option to notify spouses, partners, children, parents, grandparents, siblings and any other person who will be affected. During this interim period, it will be a judge signing the document that authorizes a physician to perform an assisted death.

Let us unpack all of this. The requirement for attending physicians to notify the court that applicants are, and perhaps will continue to be, able to take their own lives, is in my opinion, positively ghoulish. In effect, a physicians might have to testify that their patients are able to get on with the job themselves and don't need their care. This is horrifying.

We have to remember that persons desirous of medical aid to bring their lives to an end, will be grievously sick, probably suffering from pain, likely to be nauseated for most of the day and unable to take care of their normal everyday bodily needs. Such are the people who will need to find a lawyer to make an application to the pertinent court. By and large, legal processes move slightly more slowly than pitch flowing through a funnel. Involving one's self with the law is hard enough for an active, fit person in the prime of life.

Next, from out of left field, comes the need to find a psychiatrist willing and able to report to the court on one’s state of mind. It may be easy enough to organize an urgent psychiatric consultation for those living in urban centres. For others, living in northern Ontario, British Columbia and Manitoba, it will prove much more difficult.

Dr. David Amies

Lethbridge's Dr. David Amies.

Lastly, these provisions insist that one's desire to escape from a life which has become intolerable should be broadcast far and wide. The court does not specify whether remote members of a family can voice their objections and thus prevent physicians from taking action. I am uncertain how far the need to inform distant family members of a decision about ending a life breaches the right to privacy. This is a moot point.

I realize that Ontario's new provisions are an interim measure. As far as I am aware, such provisions do not apply to other approved medical procedures. I am apprehensive that framers of new federal legislation might be encouraged by Ontario's example and write new legislation that will turn out to be a veritable lawyer's picnic.

You can read the full text of the protocols on the Ontario Superior Court's website.

Dr. David Amies is a retired doctor in Lethbridge, Alta., and a member of DWD Canada's Physicians Advisory Council.

(Header image credit: Honoré Daumier/The Yorck Project)

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