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CMA updates assisted dying policy

The Canadian Medical Association (CMA) has revised its policy on euthanasia and assisted death. The updated version supports the right of CMA members – within the bounds of legislation – to follow their own conscience to decide whether or not to provide medical aid in dying.

The association is preparing a draft regulatory framework on the topic that would be available to assist policy-makers if the Supreme Court of Canada finds that current criminal sanctions against medical aid in dying are unconstitutional.

“It would be foolish not to anticipate and prepare for the possibility of changes to the current legislative framework surrounding assisted dying in Canada,” said Dr. Jeff Blackmer, the CMA’s director of ethics and professional affairs.

These and other changes to the CMA’s approach to end-of-life care issues come in the wake of an extensive consultation process with members and the public, and codify resolutions adopted by delegates at the association’s annual meeting in August.

The updated policy on Euthanasia and Assisted Death states that “there are rare occasions where patients have such a degree of suffering … that they request medical aid in dying. In such a case, and within legal constraints, medical aid in dying may be appropriate.”

The new policy updates an earlier one (from 2014) which stated “Canadian physicians should not participate in euthanasia or assisted suicide.”

In addition to approving this policy at its December meeting, the CMA Board of Directors directed the CMA Office of Ethics, Professionalism and International Affairs to continue work on a document that will assist in clarifying the CMA’s stance on several practical issues if medical aid in dying becomes legal.

The Supreme Court is currently considering the Carter case, and will rule later this year on whether the existing prohibition in the Criminal Code of Canada on assisted death is unconstitutional under the Canadian Charter of Rights and Freedoms.

“Our members expect us to be proactive in considering how best to adapt to these changes, and through extensive consultations the CMA is well positioned to provide guidance that would serve patients and physicians best,” said Blackmer.

The draft framework considers issues such as patient eligibility and the process to follow if a patient requests physician-assisted death.

The CMA board also approved circulating to stakeholders draft policies on palliative care and on advance care planning, for review and feedback. These draft policies update and amalgamate existing policies.

Blackmer noted: “Updating the advance care planning policy will also provide an opportunity for the CMA to be a leader in advocating for Canadians to engage in this important conversation with family, surrogate decision-makers and health care providers.”

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