Winnipeg Free Press

Winnipeg Free Press (Newspaper) - August 01, 2015, Winnipeg, Manitoba C M Y K PAGE A6 A 6 WINNIPEG FREE PRESS, SATURDAY, AUGUST 1, 2015 SATURDAY SPECIAL winnipegfreepress. com I N just six months, it will be legal in Canada for a doctor, under certain circumstances, to help a patient commit suicide and even to perform euthanasia, but it's an open question whether the medical profession - and the general public - is ready for this momentous change. Medical authorities and government officials across the country are scrambling to have proper protocols in place to meet a Supreme Court of Canada deadline of Feb. 6. Last winter, in a unanimous ruling in a case originating in British Columbia, the high court ended the long debate over whether doctor- assisted suicide should be permitted in Canada. It gave the federal government a year to draft new legislation. So far, Ottawa has made little progress, except to name a three- person advisory panel just two weeks ago. It is to report back in mid- November. If no new law is enacted on time, the provinces and medical regulatory bodies such as the College of Physicians and Surgeons of Manitoba will be left in a quasi- legal vacuum, with only the court ruling as their guide. " It's a huge endeavour," said Dr. Anna Ziomek, registrar of the college, the body that licenses and enforces professional standards for doctors in this province. The issue of assisted suicide became a hot topic of discussion in Canada more than 20 years ago when ALS ( amyotrophic lateral sclerosis) sufferer Sue Rodriguez fought all the way to the Supreme Court for the right to die. She lost her case. More recently, Winnipegger Susan Griffiths again focused the nation's attention on the issue. She told the story about her attempts to cope with a rare incurable brain disorder and, ultimately, her decision to travel to Switzerland in 2013 for help in ending her life. This February, the Supreme Court ruled it will be legal next year to help a " competent adult person" terminate his or her life if the person clearly consents and has a " grievous and irremediable medical condition" that causes enduring suffering intolerable to the individual. Ziomek said if patients have the right to receive assistance in dying, there needs to be a clear process set out on how that is going to happen. " We can't be struggling with trying to decide what we're going to do with this patient now," she said. There is a multitude of questions that need to be addressed as Feb. 6 draws near. For example, should physician- assisted suicide be restricted to an institution such as a hospital, or should patients have the choice of dying in their own homes? Which medical professionals - and how many - should sign off on a decision to permit physician- assisted suicide or euthanasia? If a patient's doctor conscientiously objects to assisting in a patient's death - as many are expected to do - how will that situation be handled? ( The court ruling also protects physicians who are conscientious objectors.) What is a reasonable time frame for complying with a patient's wishes? The college has struck a panel, consisting of 10 physicians and laypersons, to develop protocols for Manitoba doctors. The ' working group' is being guided by a broad set of principles and recommendations developed in June by the Federation of Medical Regulatory Authorities of Canada. The federation's document is only four pages long. In point form, it sets out recommendations on the qualification of attending physicians, assessing patient consent, documentation of patient wishes and other criteria. Dr. Michael Harlos, medical director of palliative care for the Winnipeg Regional Health Authority, said many physicians will find it difficult to participate in assisted suicide. " Is the system ready to implement this now? The answer is no," he said. Harlos said it would be wrong to assume physicians can easily step into the role of helping someone to die. " I've been working 20- something years, and I've never ended someone's life," he said. " And I've talked to intensive care colleagues about how they think they're going to approach this. And they say the same thing: ' We don't know how to do this.' " Harlos, a founding member of the Canadian Society of Palliative Care Physicians, said a recent membership poll found more than 70 per cent did not believe physician- assisted death fell within the scope of palliative care. Palliative care physicians also believe with better access to their services - particularly in rural areas - there would be reduced demand for assisted dying. " As of February, your right to access assisted dying for suffering will be kind of legislated or constitutional; your right to access palliative care, good pain management ( will be) still inconsistent across the country," Harlos said. Doctors aren't the only health professionals who are potentially affected by the new legality surrounding physician- assisted death. Pharmacists - and possibly nurses, who most often dispense drugs in institutional settings - will also be affected. By Larry Kusch ' Is the system ready to implement this now? The answer is no' - Dr. Michael Harlos, medical director of palliative care for the WRHA DEADLINE for assisted- death law draws near Many questions remain for medical professionals Continued on next page PHIL HOSSACK / WINNIPEG FREE PRESS Dr. Anna Ziomek of the College of Physicians and Surgeons, calls preparing for legal limbo a ' huge endeavour.' RUTH BONNEVILLE / WINNIPEG FREE PRESS FILES Winnipegger Susan Griffiths looks through old pictures at her home before leaving for Europe, where she received help ending her life in 2013. Her story became a focal point for the right- to- die movement. A_ 06_ Aug- 01- 15_ FP_ 01. indd A6 7/ 31/ 15 6: 37: 14 PM ;