Are Canadian Doctors Playing God when they Refuse to Assist with their Patient’s Suicide?

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Lee Friday – June 12, 2019

I have a right to end my own life, because it is my life. It therefore follows that I also have a right to ask another person if they are willing to perform this task for me, just as I have hired other willing agents (barbers, lawyers, contractors etc.) to perform various tasks for me throughout my life. But I do not have a right to force anyone to help me end my life.

In contrast, the provincial government of Ontario wants to force doctors to help people fulfill their wish to die.

The Legislation

In 2016, the Canadian Parliament legalised active euthanasia, otherwise known as medical assistance in dying (MAID). Briefly, the law requires two independent witnesses (i.e. they will not receive financial or other benefits when the patient dies) to confirm a patient’s request for MAID. Additionally, two physicians, or nurse practitioners, must confirm that the patient requesting MAID is capable and willing to receive MAID, and that the patient is suffering from an incurable medical condition from which their natural death is reasonably foreseeable. The last step involves a final opportunity for the patient to revoke their request, failing which the physician, or nurse practitioner, personally administers drugs which produce death quickly and painlessly.

As long as medical personnel are available, and the patient is eligible, the process can happen quickly, as it did two years ago when I sadly observed the entire process when someone very close to me was a recipient of MAID. From start to finish, without exception, all doctors and nurses involved in the process were professional and compassionate. They were also willing participants, an important distinction.

A couple weeks prior to meeting with the first of two authorizing physicians, the patient raised the issue with a different physician, who replied “That’s not possible.” End of discussion.

Some Doctors Object

Some doctors are opposed to MAID on moral or religious grounds. The College of Physicians and Surgeons of Ontario (CPSO), the regulatory agency for Ontario doctors, does not require these doctors to administer the drugs or to be one of the two authorizing physicians. However, when a patient requests MAID from a doctor who is a conscientious objector, CPSO regulations require the doctor to provide an effective referral: “An effective referral means a referral made in good faith, to a non-objecting, available, and accessible physician, nurse practitioner or agency. The referral must be made in a timely manner to allow the patient to access medical assistance in dying.” 

Absurdly, CPSO says “For clarity, the College does not consider providing the patient with an ‘effective referral’ as ‘assisting’ in providing medical assistance in dying.” Nonsense! Providing a referral is clearly a form of assistance in the MAID process, for which patients are likely to be very thankful.

Balancing Priorities

CPSO says its referral policy “aims to balance the moral beliefs of individual physicians while ensuring access to care, particularly for vulnerable patients.” A common refrain from politicians and bureaucrats is that they face the thankless and daunting task of balancing various issues as they formulate policy. Rather than protecting and upholding the rights of all people, this magical balancing act consists of nothing more than issuing arbitrary edicts which serve the interests of one group by trampling the rights of another group.

CPSO believes that refusing to provide referrals will limit patient access to MAID. That may be true, but it does not justify violating the rights of objecting doctors. Moreover, limited access to care has nothing to do with these doctors, and everything to do with the government’s failed health care system. If the government was really concerned about timely access to care, it would repeal its coercive health care monopoly, which is a major contributing factor in the deaths of many Canadians who do not want to die. When the government monopolized health care, it promised “to make sure that people could get care when it was needed without regard to other considerations.” For many Canadians, this is a broken promise. From a 2014 study by the Fraser Institute:

Justices of the Supreme Court of Canada have noted that patients in Canada die as a result of waiting lists for universally accessible health care.

Our analysis estimates that between 25,456 and 63,090 (with a middle value of 44,273) Canadian women may have died as a result of increased wait times between 1993 and 2009.

For fifty years, politicians and highly paid health care bureaucrats have been telling us they are balancing priorities, but their perpetual balancing act has resulted in the needless deaths of tens of thousands of Canadians. Universal access to health care is a myth. Universal access to waiting lists is a reality.

As I have written before, “The government’s health care monopoly suppresses the capitalistic impulses which would produce far superior results.” In an unhampered market, competition would drive healthcare costs considerably lower, doctors would not be forced to act against their conscience, and the number of qualified practicing physicians would rise to meet consumer demand. This would include the demand for assisted suicide without discriminating – as the government does – against healthy people requesting assistance in terminating their lives. Furthermore, ‘wait times’ for treatment of patients who do not want to die would be drastically reduced, thereby saving thousands of lives.

Who’s Playing God?

Michele Mandel, an award-winning columnist for the Toronto Sun, wrote:

Ontario doctors on the religious right tried to argue their almighty belief system should allow them to restrict access to health care they find morally repugnant: not only abortion, birth control and medically-assisted death, but also infertility treatment and prescriptions for erectile dysfunction medication.

But who made them God?

Mandel is twisting the facts. Objecting doctors do not have the power to restrict access to MAID or any other treatment. They are simply declining to offer these treatments, or any information about them, but they are not stopping patients from consulting other doctors. Thus, they are not restricting access. As we have seen, it is the government itself that restricts access, with fatal consequences.

Mandel says objecting doctors don’t have “the right to impose their personal views on their patients …” I’m not sure why she thinks a doctor’s refusal to perform a particular act equates to the imposition of their views on patients. I don’t grant every request that other people make of me, but they don’t accuse me of trying to impose my views on them. Furthermore, in the absence of force, there is nothing wrong with trying to persuade someone to adopt a particular point of view, which is exactly what Mandel is doing with her article, and I am doing with this article.

However, according to her way of thinking, Mandel unabashedly embraces a double standard. She says doctors don’t have the right to impose their personal views on their patients, yet she supports CPSO’s requirement to provide an ‘effective referral,’ which means she thinks it is okay for politicians, bureaucrats, and patients to use the force of government to impose their personal views on doctors.

As for who is playing God, Mandel is criticizing the wrong people. Which people are forcing other people to do what they want? Certainly not the objecting doctors, who are not using force at all. But consider the unmistakable decades long trend in Canada’s socialized health care system where ‘wait times’ for treatment increase every year, resulting in the deaths of thousands of Canadians. Despite this irrefutable evidence of a failed healthcare system, the government forcefully prohibits market competition, thus virtually assuring the deaths of many more Canadians. Thus, it is the politicians and bureaucrats who are playing God.

Image credit: Calleamanecer [CC BY-SA 3.0 (]

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