Thank you for soliciting our feedback. Alberta has done a great job of respecting the wishes of both patients and physicians thus far. However, the requirement to refer would no longer protect the rights of physicians who conscientiously object. For this reason, I believe it needs to be removed.
Physicians who conscientiously object would not be able to practice with integrity as per the CMA code of ethics.
The wellbeing of the patient in the code of ethics does not include MAID as an option for those physicians who conscientiously object.
As an oncologist who does not agree with MAID, I can provide care and support for the patient who is deliberating about MAID even if I am not willing to refer them for that service. I find that many patients who ask about MAID are afraid that they will have unbearable pain or suffering and that often when these fears are acknowledged, and they learn about the pain and symptom options available they choose to carry on. The relationship with my patient can be supportive, informative regarding options, nonjudgemental and I can still act according to my conscience ie: not making a referral.
I copy excerpts from the CMA code of ethics below
The CMA code of ethics states the following:
". VIRTUES EXEMPLIFIED BY THE ETHICAL PHYSICIAN
Trust is the cornerstone of the patient–physician relationship and of medical professionalism.
INTEGRITY. A physician who acts with integrity demonstrates consistency in their intentions and
actions and acts in a truthful manner in accordance with professional expectations, even in the
face of adversity
Commitment to the well-being of the patient
Consider first the well-being of the patient; always act to benefit the patient and promote the
good of the patient.
Provide appropriate care and management across the care continuum.
Take all reasonable steps to prevent or minimize harm to the patient; disclose to the patient if
there is a risk of harm or if harm has occurred.
Act according to your conscience and respect differences of conscience among your
colleagues; however, meet your duty of non-abandonment to the patient by always
acknowledging and responding to the patient’s medical concerns and requests whatever
your moral commitments may be."
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