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Gisela Macphail

I really appreciate the opening statement of the preamble which states "CPSA recognizes that regulated members have the right to limit the health services they provide for reasons of conscience, cultural belief or religion." Unfortunately, some of the points in the body of the proposed standard contradict this statement. Specifically, Section 1f uses the language "effective referral, " a process which makes the referring health care provider complicit in the action and thereby violates their conscience, as well as the principles of non-maleficience and beneficience. It should be replaced with a statement such as "proactively maintain a non-judgmental approach and be aware of the resources to provide for frequently requested services they are unwilling to provide." Section 2c talks of adverse clinical outcomes related to delayed therapy. This section is not needed at all. MAID can be accessed in Alberta through self-referral, as can abortion. In my own practice, a lot of the delays for ordinary, non-controversial therapies are related to patient ambivalence. Other delays which have adverse clinical outcomes are secondary to lack of funding for medications, basic human necessities such as housing, and lack of availability of services such as psychiatric care & palliative care. Indeed, these systemic factors are actually not infrequently the basis for someone considering MAID and need to be addressed urgently. Thank you for this opportunity to have input into the future of our profession and our province.

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