Gary Lepine DTh Clinical Ethicist Alberta Health Services Rockyview General Hospital South Health Campus The Changing Canadian Landscape Carter v Canada 2015 Struck down the prohibition against assisted dying for ID: 616390
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Ethical Considerations Around Medical Assistance in Dying
Gary Lepine, DThClinical EthicistAlberta Health ServicesRockyview General Hospital South Health Campus
Slide2
The Changing
Canadian LandscapeSlide3
Carter v. Canada (2015)
Struck down the prohibition against assisted dying for:A competent adult person who clearly consents and who has a
grievous and irremediable medical condition (including an illness, disease or disability) that causes them enduring and
intolerable suffering.
Protects care providers’ rights to conscientious objection.
Requires health systems to protect members of vulnerable populations.Slide4
Basically follows the Carter decision.
It notably adds the requirement that eligible patients must be at a point where their death is reasonably foreseeable.Articulates several procedural safeguards.Explicitly provides legal protection to non-physician health care providers and others operating within their normal scope of practice.
Bill C-14 (June 17, 2016)Slide5
Definitions
Assisted Suicide
Patient self-administers a lethal dose prescribed by a physician
Voluntary Euthanasia
Physician prescribes and administers lethal dose to consenting and capable person
Patient expresses sustained, well-informed,
un-coerced decision to end their life. Slide6
A growing significance of individual evaluations of
quality of life.A growing social acceptance of limited instances of intending death as a means of relieving suffering and respecting autonomy.
Two Key ElementsSlide7
Respect for Patient Autonomy.
Benefiting PatientsFairnessPreciousness of LifeLimits of Human AuthorityProtection of Vulnerable Persons.
The Ethics of Medical
Assistance in DyingSlide8
Our Narrative
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Portraying moral perspectives in terms of arguments “for” and “against” can create the false impression there are only two perspectives to be had on this issue.
We may also make false assumptions about others’ underlying values and beliefs based on what we know about their perspective on medical assistance in dying. In reality, people hold much more diverse and nuanced views.In Thinking About the Ethics, We Need to Take Care Slide11
Federal government has stated that it will review and research:
Potential eligibility of mature minors.Potential eligibility of those whose deaths are not reasonably foreseeable (including, for example, persons with mental health conditions).Potential role for advance directives.Issues down the road...Slide12
Respect – treating others kindly and well, whatever their views are. Compassion – recognizing the struggle in others.
Humility – acknowledging that we likely do not know the nuances of each others values and beliefs. Our Behaviour and Responses to Each Other Should be Guided by:Slide13
Questions