I applaud Fletcher’s respectful defence of conscientious objection on the sensitive issue of assisted dying.1 He correctly points out that in the CMA’s revised principles-based framework on assisted dying,2 a referral is not required. For an objecting physician, referral would be a form of participation and endorsement of a process that is seen as unacceptable medical care. To a physician who believes in accompanying patients to a natural death, euthanasia and assisted suicide is a form of abandonment of the patient — giving up the creative process of pursuing all medical and non-medical ways of providing compassionate, patient-centred, dignified end-of-life care.
In the revised principles, point 5.2 states that “physicians are expected to provide the patient with complete information on all options available to them, including assisted dying, and advise the patient on how they can access any separate central information, counselling and referral service.” This is a clearer message: that physicians who do not want to provide the service should provide information, but have no obligation to refer.
While we are on the frontier of physicians providing euthanasia and physician-assisted death in Canada, let us respect diversity and not force conformity when it comes to physicians who do not want to abandon their patients to euthanasia and physician-assisted suicide, and instead want to accompany their patients toward a dignified natural death.
References
- 1.Fletcher J. Right to die in Canada: respecting the wishes of physician conscientious objectors. CMAJ 2015;187:1339. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Principles-based recommendations for a Canadian approach to assisted dying. Ottawa: Canadian Medical Association; 2015. Available: www.cma.ca/Assets/assets-library/document/en/advocacy/cma-framework_assisted-dying_approved-by-board_oct2015.pdf#search=principles%20based%20approach%20assisted (accessed 2015 Dec. 16). [Google Scholar]