SUMMARY NOTES

EXTRA BOARD MEETING

APRIL 28, 2015

Decision Session re: Euthanasia / PAS

The Board held a one-day meeting to discuss the role of the CSPCP regarding Euthanasia and Physician Assisted Suicide (PAS) in Canada. To inform their discussion, the Board reviewed comments provided by in the January 2015 Member survey on Euthanasia and PAS, as well as the CSPCP Vision, Mission and Goals and comments received from Members through email and/or personal communication. Importantly, many members and Board members indicated that their views on Euthanasia and PAS are evolving.

Principles

  1. CSPCP statements and messaging should continue to reflect the diversity of views of our membership and the fact that views are evolving
  2. Euthanasia and PAS are complex, values-based subjects.
  3. The views of our members, and of our Board members, reflect this.
  1. Euthanasia and PAS are not core to the CSPCP’s mandate. We exist to promote access to high quality palliative care for all Canadians through advocacy, partnerships, and physician education, as expressed in our vision, mission and goals.
  1. Euthanasia and PAS are important subjectsfor our membership. We have a responsibility to our members to
  2. Represent them at the national level, to the best of our ability.
  3. Support them impartially with information and tools to use in their decision making a the individual, local, and provincial levels.
  1. Our ability to be involved in the crafting of legislature, policy and guidelines around Euthanasia and PAS is constrained by our skills, time and resources. We will do our absolute best to support members within our capabilities.
  1. The field of palliative care is evolving and the definition may change as Canadian society and palliative care providers continue to evolve.

Conclusions

  1. The existing CSPCP position statement remains valid: Position Statement Following Supreme Court Judgement re: Carter (February 12, 2015)
  1. Additional key messages that expand on the statement:
  2. Euthanasia and PAS are complex, values-based subjects. Our members’ views reflect that complexity. Many have stated that their views are evolving.
  3. We don’t know yet what the legislation will look like.
  4. What we will advocate for is clear criteria and guidelines.
  5. No one should be forced to do it, or marginalized because of their choice.
  6. We respect the individual physicians’ choice.
  7. The majority of our members didn’t want it legalized (member survey, January 2015) – but it is happening.
  8. The majority of our members don’t think it should be part of palliative care services (member survey, January 2015)
  9. Some members hold other views. We respect all physicians in their views
  10. Many members have suggested that it should be a separate service from Palliative Care.
  11. Palliative Care physicians should be able tochoose whether they want to be part of that service or not (just like any other physicians).
  12. Nobody should be forced to do it, or forced to refer, or marginalized because of their choice.
  13. The CSPCP supports CMA PresidentDr. Chris Simpson’s statements regarding self referral (i.e., physicians’ concerns about referring)
  14. We are concerned that inconsistent access to Palliative Care will impact peoples’ choices around end of life
  15. We need to continue advocating for access to quality palliative care for all Canadians
  1. The CSPCP will advocate for:
  2. Physicians rights and choice. Specifically:
  3. Do not require palliative care physicians to be gatekeepers
  4. Do not require palliative care physicians to refer
  5. Respect individual decisions regarding participation and/or referral
  6. Concept of a self-referral process for patients, or independent “Advocates” who can guide patients and families with these decisions
  1. We will not advocate for any particular model (Belgium style, Netherlands, Oregon, Washington etc).
  2. We will educate ourselves about different models and make information available to our members for their own decision making
  3. We will articulate and explore different views including experiences elsewhere, including why the majority of Palliative Care physicians believe it should not be part of Palliative Care.
  4. Explore what the are options for interfacing with Palliative Care services
  1. We endorse the spirit of the WHO definition of palliative care. We do not endorse using the WHO definition as the ultimate authority regarding whether or not Euthanasia and/or PAS should be part of palliative care: we believe it is up to palliative care physicians and programs to decide.
  1. When Board members are asked to comment on this subject, we will:
  2. Be clear whether we’re speaking as a Board or an individual
  3. Refer to the CSPCP statement and to the additional key messages in Conclusion #2 above.
  1. When the CSPCP is asked to formally comment or endorse someone else’s work:
  2. We will respond within the limits of our time and resource constraints
  3. We will focus our comments on
  4. Physicians rights and choice regarding participation and referral
  5. Physician education
  6. The need for access to Palliative Care for all Canadians