Conscientious objection to "physician-assisted dying" is shaping up as a major issue among doctors in Canada after last week's Supreme Court ruling which legalised it.
As an article in the CMAJ , the journal of the Canadian Medical Association, points out, professional associations will play a major rule in writing the rules in the federal and provincial legislatures. The Court's decision has been suspended for a year to allow this, so, technically speaking, assisted suicide is still illegal.
The Supreme Court and the CMA president, Dr Chris Simpson, insisted that doctors must be allowed the right to conscientious objection. What this means in practice is fuzzy.
"The core of that reconciliation will be that we respect individual doctors' rights to conscientiously object," says Dr Simpson. "That's in patients' best interests. Ultimately, no patient is going to want their physician pulled in against their will to help them with such a profound issue."
However, Dr James Downar, who wrote a CMAJ Commentary on physician assisted death last year, interpreted these reassurances in a way which is sure to alarm some doctors. He believes that regulations must force doctors with conscientious objection to refer requests for PAD to a more willing colleague. Otherwise some people will not be able to avail themselves of their newly recognised Charter right to assisted death.
Another issue which interests Americans is whether Canada will allow "suicide tourism", as Switzerland does. Washington Post writer Rachel Feltman points out that there is an obvious case to support it: if " no one can stop an able-bodied person from ending their life, so preventing a terminally-ill patient from receiving the help they needed to do so should be considered a discriminatory act".
On the other hand, "Given the strong emphasis on illness and the patient-doctor relationship in Canada's ruling, it's highly unlikely that the country would adopt such a liberal suicide policy." But since the regulations are still to be written, no one can be sure.