Doctors say legislation necessary as assisted dying ban lifted

The law that bans physician-assisted death will be null and void by day's end but as the federal government is missing its deadline to pass legislation on the matter, doctors are left without guidelines on how to proceed.

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Dr. Alykhan Abdulla, a family physician in Manotick, wants "appropriate, clear legislation in place" before helping a terminally ill patient die.

"We need the words. The words determine what happens and how the rules are in place, the eligibility criteria, how safeguards are in place to make sure that the most vulnerable people are looked after," Abdulla said.

"Frankly, I will not be doing anything because I don't really have anything clear on how to move forward."

Adjustment period

Senators voted to adopt physician-assisted dying legislation in principle after it was passed in the House of Commons, but Bill C-14 still needs to be reviewed by the Senate's legal committee.

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Medical regulators in every province have issued guidelines for physicians on providing assistance in dying and judges have granted exemptions to allow terminally ill patients to end their lives as they await a new federal law.

The guidelines impose safeguards similar to those proposed in C-14, and in some cases, even stronger. Abdulla said that once a new law is in place, there will be a period of adjustment.

"It requires time for medical organizations to look through the legislation and then reflect on [the guidelines], and then educate all of our population, all of our medical professionals to make sure that we're mindful of what the rules are and that we can assist in this process in a dignified way," he said.

'Vacuum' of legislated protection

Dr. Todd Watkins, who advises doctors on legal matters as managing director of physician services with the Canadian Medical Protection Association, said questions from doctors increased slightly as the June 6 deadline approached.

"They range from general questions regarding end of life care, more broadly speaking, to specific questions about patients that they have that have requested physician aid in dying," he said.

I suspect that many physicians who are uncertain would probably wait for greater clarity so that they feel comfortable.- Dr. Todd Watkins, CMPA

"They're wondering what safeguards they need to put in place, what kind of consent they need and what kind of support they need in being able to fulfil their patient's wishes."

The lack of clear rules leaves doctors concerned they may be at risk of criminal prosecution, civil suits or professional infractions, he said.

"I suspect that many physicians who are uncertain would probably wait for greater clarity so that they feel comfortable," he said.

And even though it seems doctors may no longer have to seek permission from the court to help a patient die, now that the law banning it has been struck down from the court, many doctors may still choose to do so to "navigate the uncertainty" in the absence of legislation, he said.

"Our recommendation would be, in certain circumstances, to seek the clarity of the courts," he said. "There is a vacuum with respect to legislation around protection both for criminality, and civil and regulatory infractions."