Attendees at the Canadian Medical Association's (CMA's) 149th annual meeting in Vancouver heard how work begun with a discussion on the floor of General Council two years ago on aid in dying has come full circle with the recent passage into law of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).
Over the last two years, the CMA has led the national conversation on end-of-life care in Canada with both members and the public. This broad consultative process also led to the development of the CMA's Principles-based Recommendations for a Canadian Approach to Assisted Dying guided by a set of ten foundational principles. These recommendations provided the lens through which the CMA assessed Bill C-14.
"The conversations with physicians and Canadians allowed us to bring forward the physician perspective as well as to ensure that the needs of our patients were represented in our work with regulators, governments and others," said Dr. Cindy Forbes, CMA President, of the CMA's advocacy work on the issue. "The CMA pushed for passage of Bill C-14 because it reflects what we heard during our national consultations, particularly on the key issues of protecting vulnerable patients and allowing physicians to follow their conscience."
In providing the update to General Council, Dr. Jeff Blackmer, CMA's Vice-president of Medical Professionalism, said that the direction received from delegates in 2014 and 2015, along with the extensive consultations with members, was critical to the CMA's advocacy efforts.
"At the end of each one of these sessions, a number of the participants said thank you for making sure we had time to talk about end-of-life care more broadly," said Dr. Blackmer. "This is not just all about assisted dying — there are so many other parts to this conversation."
Shift to education
CMA members can now access educational offerings on medical aid in dying. Designed to assist physicians as they build skills and competencies related to medical assistance in dying, the courses are a collaboration between the CMA and its new subsidiary, Joule.
The program is built in two components to help Canadian physicians understand and respond appropriately to the end-of-life care wishes of their patients, and prepare them for evaluating whether medical assistance in dying is right for their medical practice.
The first component is a 90-minute online foundational module focused on what is involved in a medical assistance in dying request. Participants can also interact through a moderated discussion board and consult an expert through the "Ask the Expert" function within the course. The online module is free for CMA members and priced at $299 for non-members.
A pilot advanced face-to-face course will be offered this fall in Vancouver and Toronto, and will feature training from a variety of experts in the fields of ethics, palliative care and psychiatry, including a session with a Dutch physician who will share his experiences with medical assistance in dying (assisted dying has been regulated in the Netherlands since 2002). The online module is a prerequisite for the advanced face-to-face course.
The online course, exclusive to the CMA/Joule, is accredited by the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. For more information, please contact firstname.lastname@example.org or visit the education page on cma.ca.